[Facing the difficult experience even with support: the underage adolescent experiencing motherhood].

PubMed

Andrade, Paula Rosenberg de; Ohara, Conceição Vieira da Silva; Borba, Regina Issuzu Hirooka de; Ribeiro, Circéa Amalia

2015-01-01

To understand the meaning of childcare for the underage adolescent mother, to reveal the demands of care and to build a theoretical model based on this experience. Qualitative research with symbolic interactionism as the theoretical framework and the grounded theory as the methodological framework; nine adolescents participated in the study. The semi-structured interview was used to collect data from September 2008 to September 2011, during paediatric nursing consultation at the Centro Assistencial Cruz de Malta, a philanthropic institution in the city of São Paulo/Brazil. Data analysis led to the construction of the theoretical model,Facing a difficult experience even with support. The experience shows that the difficulties to care for a child, even with help, are not met, only mitigated, and that underage adolescents do not have the maturity to cope with this experience.

Challenges facing early career academic cardiologists.

PubMed

Tong, Carl W; Ahmad, Tariq; Brittain, Evan L; Bunch, T Jared; Damp, Julie B; Dardas, Todd; Hijar, Amalea; Hill, Joseph A; Hilliard, Anthony A; Houser, Steven R; Jahangir, Eiman; Kates, Andrew M; Kim, Darlene; Lindman, Brian R; Ryan, John J; Rzeszut, Anne K; Sivaram, Chittur A; Valente, Anne Marie; Freeman, Andrew M

2014-06-03

Early career academic cardiologists currently face unprecedented challenges that threaten a highly valued career path. A team consisting of early career professionals and senior leadership members of American College of Cardiology completed this white paper to inform the cardiovascular medicine profession regarding the plight of early career cardiologists and to suggest possible solutions. This paper includes: 1) definition of categories of early career academic cardiologists; 2) general challenges to all categories and specific challenges to each category; 3) obstacles as identified by a survey of current early career members of the American College of Cardiology; 4) major reasons for the failure of physician-scientists to receive funding from National Institute of Health/National Heart Lung and Blood Institute career development grants; 5) potential solutions; and 6) a call to action with specific recommendations. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Thermal-to-visible face recognition using partial least squares.

PubMed

Hu, Shuowen; Choi, Jonghyun; Chan, Alex L; Schwartz, William Robson

2015-03-01

Although visible face recognition has been an active area of research for several decades, cross-modal face recognition has only been explored by the biometrics community relatively recently. Thermal-to-visible face recognition is one of the most difficult cross-modal face recognition challenges, because of the difference in phenomenology between the thermal and visible imaging modalities. We address the cross-modal recognition problem using a partial least squares (PLS) regression-based approach consisting of preprocessing, feature extraction, and PLS model building. The preprocessing and feature extraction stages are designed to reduce the modality gap between the thermal and visible facial signatures, and facilitate the subsequent one-vs-all PLS-based model building. We incorporate multi-modal information into the PLS model building stage to enhance cross-modal recognition. The performance of the proposed recognition algorithm is evaluated on three challenging datasets containing visible and thermal imagery acquired under different experimental scenarios: time-lapse, physical tasks, mental tasks, and subject-to-camera range. These scenarios represent difficult challenges relevant to real-world applications. We demonstrate that the proposed method performs robustly for the examined scenarios.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Challenges Beginning Teachers Face in Hong Kong

ERIC Educational Resources Information Center

Lam, Bick-Har

2014-01-01

By conducting in-depth interviews with new teachers who are about to become full-time teachers and then reinterviewing them two years later, the author of this article presents how beginning teachers think and feel about teaching and describes the challenges they face as beginning teachers in the context of Hong Kong. The stories of the teachers,…

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.

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

PubMed

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

2015-09-01

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

A personal perspective on challenges that face women scientists

NASA Astrophysics Data System (ADS)

Cashman, Katharine

2016-04-01

Gender equality has been a topic of discussion throughout my long (now three decade) career. This alone illustrates the complex nature of the issue, and the lack of a simple solution, particularly as many of the daily challenges that women face are institution or discipline-specific. For this reason, I will summarize some of the issues that appear to me to be more general, and therefore ones that may have general solutions. The first and foremost relates to demands on women's time. One way that academic institutions have sought to overcome gender bias has been to require that every university committee have a female member; in departments, schools and faculties where women represent a minority, this necessarily means that women shoulder an inequitable share of the service duties. I have experienced this myself, seen it in promotion files at all levels, and observed it with regard to my female colleagues. Clearly time spent doing service is time not spent doing science. There is also an easy solution to this problem, which is to re-think the underlying assumption that men are necessarily gender-biased if they don't have a woman sitting in the room! Additional time demands can come from informal mentoring of both students and younger colleagues, particularly in cases where senior male colleagues are viewed as too important, or too intimidating, to be consulted on personal issues. Although I suspect that this problem may also be widespread, it is more difficult to quantify, and is therefore more difficult to factor into time allotments of departmental duties. A final thought relates to hiring practices. I have now worked in both the US and UK educational systems, which have very different interview and hiring protocols. I will review both, highlighting components that I think are most likely to promote equitable hiring practices.

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Leading Schools Facing Challenging Circumstances: Some Insights from Western Australia

ERIC Educational Resources Information Center

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

2016-01-01

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

The Challenges Facing Catholic Education in France Today

ERIC Educational Resources Information Center

Moog, François

2016-01-01

The effects of secularisation on society demand a rethinking of the identity and mission of Catholic schools in France. In 2013, the French bishops published a new directory which offers new approaches, described here, based on the three challenges facing Catholic education in France: linking social responsibility and evangelisation, setting up…

A Variety of Diversity: Facing Higher Education's Educational Challenges

NASA Astrophysics Data System (ADS)

Dey, Eric L.

2008-10-01

First among the many important challenges facing American higher education is the need to improve the effectiveness of our educational programs. Public concern has heightened the sense of urgency for colleges and universities to make progress on improving and measuring educational outcomes, which is made more challenging by the varieties of diversity facing us. Diversity is not just an issue related to student recruitment or experience, but rather it is one that also relates to institutions and their faculties. New educational methods must address such diversity to be effective, and one possible example can be found in ongoing research at the University of Michigan that explores the educational implications of implementing a web-based lecture capture system in large lecture courses. Student use of and reactions to such systems is important, as is the potential to influence course performance for students in general, but also for underrepresented and at-risk student subpopulations. In addition to helping bring our current landscape into focus, this paper will identify effective practices as well as continuing challenges to improving educational practice for undergraduate students.

Performance and accountability : challenges facing the Department of Transportation

DOT National Transportation Integrated Search

2001-02-14

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

Challenges and Opportunities Facing Technology Education in Taiwan

ERIC Educational Resources Information Center

Lee, Lung-Sheng Steven

2009-01-01

The technology education in Taiwan is prescribed in the national curriculum and provided to all students in grades 1-12. However, it faces the following challenges: (1) Lack of worthy image, (2) Inadequate teachers in elementary schools, (3) Deficient teaching vitality in secondary schools, and (4) Diluted technology teacher education programs. In…

Challenges faced in long term ventricular assist device support.

PubMed

Ikegami, Hirohisa; Kurlansky, Paul; Takeda, Koji; Naka, Yoshifumi

2016-08-01

The development of ventricular assist device (VAD) has been one of the revolutionary advancements in end-stage heart failure management. Although the device has developed and improved significantly over the last few decades, we still face multiple challenges. This review will discuss quality of life, survival, and clinically encountered complications in patients with VAD support. The literature was extensively reviewed for studies describing the above topic area. We describe the impact of major challenges faced in VAD support and discuss their future and expectations. Expert commentary: The technological advancement of VADs has contributed to major improvement of overall survival, enhancement of quality of life and decrease of incidence of complications. It is expected that technologies will continue to evolve. At the same time, the indications for and timing of device implantation, and selection of device type are continuously important in clinical practice setting.

Reaction Workup Planning: A Structured Flowchart Approach, Exemplified in Difficult Aqueous Workup of Hydrophilic Products

ERIC Educational Resources Information Center

Hill, George B.; Sweeney, Joseph B.

2015-01-01

Reaction workup can be a complex problem for those facing novel synthesis of difficult compounds for the first time. Workup problem solving by systematic thinking should be inculcated as mid-graduate-level is reached. A structured approach is proposed, building decision tree flowcharts to analyze challenges, and an exemplar flowchart is presented…

Challenges Faced by Undergraduate Military Students at American Public University System

ERIC Educational Resources Information Center

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

2014-01-01

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

[Mothers of visually impaired children: difficult and easy aspects faced in care].

PubMed

Pintanel, Aline Campelo; Gomes, Giovana Calcagno; Xavier, Daiani Modernel

2013-06-01

This study aimed to identify the difficult and easy aspects faced by mothers of visually impaired (VI) children in their care. It is a descriptive qualitative study, developed in the second semester of 2011, with ten mothers of children with visual impairment from an Educational Center for the Visually Impaired located in southern Brazil. Data were collected by means of semistructured interviews and submitted to thematic content analysis. The identified difficulties were the lack of knowledge regarding the disease and how to take care of the child, the lack of access to health services, overload generated by the dependence of the child and lack of support and prejudice within their own family. The easy aspects involved the desire for the child's healthy development the chance of being in touch with qualified professionals for their education, and the contact with other VI children. Therefore, it is important to qualify the family for the care of VI children so as to ensure the development of skills and competencies enabling them to live with quality.

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

ERIC Educational Resources Information Center

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

2016-01-01

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

Recommendations on Arresting Global Health Challenges Facing Adolescents and Young Adults.

PubMed

Lassi, Zohra S; Salam, Rehana A; Bhutta, Zulfiqar A

The health challenges faced by young people are more complex than adults and can compromise their full growth and development. Attention must be paid to the health of this age group, yet adolescents and youth remain largely invisible and often disappear from the major global datasets. The aim of this paper is to discuss the global health challenges faced by adolescents and youth, global legislations and guidelines pertaining to this particular age group, recommendations to arrest these challenges, and research priorities. Major direct and indirect global health risks faced by adolescents include early pregnancy and childbirth, femicide, honor killing, female genital mutilation, nutritional habits and choices, social media, and peer pressure. There are no standard legal age cut-offs for adulthood; rather, the age varies for different activities, such as age of consent or the minimum age that young people can legally work, leave school, drive, buy alcohol, marry, be held accountable for criminal action, and make medical decisions. This reflects the fact that the existing systems and structures are focused on either children or adults, with very few investments and interventions directed specifically to young people. Existing legislation and guidelines need transformation to bring about a specific focus on adolescents in the domains of substance use and sexual behaviors, and the capacity for adolescent learning should be exploited through graduated legal and policy frameworks. Sustainable development goals provide an opportunity to target this neglected and vulnerable age group. A multisectoral approach is needed to bring about healthy change and address the challenges faced by adolescents and youth, from modifications at a broader legislative and policy level to ground-level (community-level) implementations. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Challenges Facing Healthwatch, a New Consumer Champion in England.

PubMed

Carter, Pam; Martin, Graham

2016-01-21

This article engages with debates about the conceptualisation and practical challenges of patient and public involvement (PPI) in health and social care services. Policy in this area in England has shifted numerous times but increasingly a consumerist discourse seems to override more democratic ideas concerning the relationship between citizens and public services. Recent policy change in England has seen the creation of new consumer champion bodies in the form of local Healthwatch. The article describes these new organisational structures for PPI and shows how those who seek to influence planning and delivery of services or comment or complain about aspects of their care face considerable complexity. This is due, in part, to the ambiguous remit set out for newly instigated Healthwatch organisations by government. Drawing on governance theory, we show that it can also be understood as a function of an increasingly polycentric governance arena. Challenges that flow from this include problems of specifying jurisdictional responsibility, accountability, and legitimacy. We review Healthwatch progress to date, then we set out four challenges facing local Healthwatch organisations before discussing the implications of these for patients and the public. The first challenge relates to non-coterminous boundaries and jurisdictional integrity. Secondly, establishing the unique features of Healthwatch is problematic in the crowded PPI arena. The third challenge arises from limited resources as well as the fact that resources flow to Healthwatch from the local authorities that Healthwatch are expected to hold to account. The fourth challenge we identify is how local Healthwatch organisations negotiate the complexity of being a partner to statutory and other organisations, while at the same time being expected to champion local people's views. © 2016 by Kerman University of Medical Sciences.

The Challenges Faced by New Science Teachers in Saudi Arabia

NASA Astrophysics Data System (ADS)

Alsharari, Salman

Growing demand for science teachers in the Kingdom of Saudi Arabia, fed by increasing numbers of public school students, is forcing the Saudi government to attract, recruit and retain well-qualified science teachers. Beginning science teachers enter the educational profession with a massive fullfilment and satisfaction in their roles and positions as teachers to educating children in a science classroom. Nevertheless, teachers, over their early years of practice, encounter numerous challenges to provide the most effective science instruction. Therefore, the current study was aimed to identify academic and behavioral classroom challenges faced by science teachers in their first three years of teaching in the Kingdom of Saudi Arabia. In addition, new science teacher gender, school level and years of teaching experience differences in perceptions of the challenges that they encountered at work were analyzed. The present study also investigated various types of support that new science teachers may need to overcome academic and behavioral classroom challenges. In order to gain insights about ways to adequately support novice science teachers, it was important to examine new science teachers' beliefs, ideas and perceptions about effective science teaching. Three survey questionnaires were developed and distributed to teachers of both sexes who have been teaching science subjects, for less than three years, to elementary, middle and high school students in Al Jouf public schools. A total of 49 novice science teachers responded to the survey and 9 of them agreed to participate voluntarily in a face-to-face interview. Different statistical procedures and multiple qualitative methodologies were used to analyze the collected data. Findings suggested that the top three academic challenges faced by new science teachers were: poor quality of teacher preparation programs, absence of appropriate school equipment and facilities and lack of classroom materials and instructional

Voicing the Challenges Faced by an Innovative Teacher Community

ERIC Educational Resources Information Center

Moate, Josephine

2011-01-01

This research draws on sociocultural theories of learning and activity theory to explore the challenges faced by an innovative community of teachers in Central Finland. The aim of the teacher community was to develop a stream of foreign-language (FL)-mediated teaching and learning in the locality from kindergarten to upper secondary level. To…

Holistic face training enhances face processing in developmental prosopagnosia

PubMed Central

Cohan, Sarah; Nakayama, Ken

2014-01-01

Prosopagnosia has largely been regarded as an untreatable disorder. However, recent case studies using cognitive training have shown that it is possible to enhance face recognition abilities in individuals with developmental prosopagnosia. Our goal was to determine if this approach could be effective in a larger population of developmental prosopagnosics. We trained 24 developmental prosopagnosics using a 3-week online face-training program targeting holistic face processing. Twelve subjects with developmental prosopagnosia were assessed before and after training, and the other 12 were assessed before and after a waiting period, they then performed the training, and were then assessed again. The assessments included measures of front-view face discrimination, face discrimination with view-point changes, measures of holistic face processing, and a 5-day diary to quantify potential real-world improvements. Compared with the waiting period, developmental prosopagnosics showed moderate but significant overall training-related improvements on measures of front-view face discrimination. Those who reached the more difficult levels of training (‘better’ trainees) showed the strongest improvements in front-view face discrimination and showed significantly increased holistic face processing to the point of being similar to that of unimpaired control subjects. Despite challenges in characterizing developmental prosopagnosics’ everyday face recognition and potential biases in self-report, results also showed modest but consistent self-reported diary improvements. In summary, we demonstrate that by using cognitive training that targets holistic processing, it is possible to enhance face perception across a group of developmental prosopagnosics and further suggest that those who improved the most on the training task received the greatest benefits. PMID:24691394

Challenges and Concerns Faced by Doctoral Candidates Seeking Academic Positions.

ERIC Educational Resources Information Center

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

A panel discussion offered suggestions and recommendations for faculty and institutions of rehabilitation counseling education on more effective recruitment methods. Strategies were also considered for potential faculty members. Candidates seeking academic positions in rehabilitation counseling education face many challenges. Location of program;…

How anaesthesiologists understand difficult airway guidelines-an interview study.

PubMed

Knudsen, Kati; Pöder, Ulrika; Nilsson, Ulrica; Högman, Marieann; Larsson, Anders; Larsson, Jan

2017-11-01

In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. A qualitative phenomenographic design was chosen to explore anaesthesiologists' views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts' consensus, a set of scientifically based guidelines for handling the difficult airway. The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently.

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

ERIC Educational Resources Information Center

DuBose, Cheryl O.

2017-01-01

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

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

ERIC Educational Resources Information Center

Xiaohao, Ding

2004-01-01

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

How anaesthesiologists understand difficult airway guidelines—an interview study

PubMed Central

Knudsen, Kati; Nilsson, Ulrica; Larsson, Anders; Larsson, Jan

2017-01-01

Background In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. Methods A qualitative phenomenographic design was chosen to explore anaesthesiologists’ views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted. Results Four different ways of understanding were identified, describing airway algorithms as: (A) a law-like rule for how to act in difficult airway situations; (B) a cognitive aid, an action plan for difficult airway situations; (C) a basis for developing flexible, personal action plans for the difficult airway; and (D) the experts’ consensus, a set of scientifically based guidelines for handling the difficult airway. Conclusions The interviewed anaesthesiologists understood difficult airway management guidelines/algorithms very differently. PMID:29299973

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

ERIC Educational Resources Information Center

Silvernail, David L.; Linet, Sarah R.

2014-01-01

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

Challenges facing translational research organizations in China: a qualitative multiple case study

PubMed Central

2013-01-01

Background Translational medicine is attracting much attention worldwide and many translational research organizations (TROs) have been established. In China, translational medicine has developed rapidly, but faces many challenges. This study was aimed at exploring these challenges faced by emerging TROs in China. Method A qualitative, multiple case study approach was used to assess the challenges faced by TROs in China. Data were collected between May and August 2012. Results Eight cases were identified. Overall, four themes that characterized TROs in China emerged from analyses: 1. objectives, organizer, and funding resources, 2. participating partners and research teams, 3. management, and 4. achievements. All TROs had objectives related to translating basic discovery to clinic treatment and cultivating translational researchers. In terms of organizer and funding resources, 7 out of 8 TROs were launched only by universities and/or hospitals, and funded mostly through research grants. As for participating partners and multidisciplinary research teams, all but one of the TROs only involved biomedical research institutions who were interested in translational research, and characterized as clinical research centers; 7 out of 8 TROs involved only researchers from biomedicine and clinical disciplines and none involved disciplines related to education, ethnicity, and sociology, or engaged the community. Current management of the TROs were generally nested within the traditional research management paradigms, and failed to adapt to the tenets of translational research. Half of the TROs were at developmental stages defined as infrastructure construction and recruitment of translational researchers. Conclusions TROs in China face the challenge of attracting sustainable funding sources, widening multidisciplinary cooperation, cultivating multi-disciplinary translational researchers and adapting current research management to translational research. Greater emphasis should

Challenges Facing Principals in the First Year at Their Schools

ERIC Educational Resources Information Center

Bayar, Adem

2016-01-01

The aim of this study is to identify key challenges of practice that principals face. In line with this purpose, the researcher has employed a qualitative research methodology, interviewing principals working in Amasya district, over and above doing document analysis to collect detailed information concerning leadership and administration…

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

ERIC Educational Resources Information Center

Kozikoglu, Ishak

2017-01-01

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

Facing Challenges in Differential Classical Conditioning Research: Benefits of a Hybrid Design for Simultaneous Electrodermal and Electroencephalographic Recording.

PubMed

Pastor, M Carmen; Rehbein, Maimu Alissa; Junghöfer, Markus; Poy, Rosario; López, Raul; Moltó, Javier

2015-01-01

Several challenges make it difficult to simultaneously investigate central and autonomous nervous system correlates of conditioned stimulus (CS) processing in classical conditioning paradigms. Such challenges include, for example, the discrepant requirements of electroencephalography (EEG) and electrodermal activity (EDA) recordings with regard to multiple repetitions of conditions and sufficient trial duration. Here, we propose a MultiCS conditioning set-up, in which we increased the number of CSs, decreased the number of learning trials, and used trials of short and long durations for meeting requirements of simultaneous EEG-EDA recording in a differential aversive conditioning task. Forty-eight participants underwent MultiCS conditioning, in which four neutral faces (CS+) were paired four times each with aversive electric stimulation (unconditioned stimulus) during acquisition, while four different neutral faces (CS-) remained unpaired. When comparing after relative to before learning measurements, EEG revealed an enhanced centro-posterior positivity to CS+ vs. CS- during 368-600 ms, and subjective ratings indicated CS+ to be less pleasant and more arousing than CS-. Furthermore, changes in CS valence and arousal were strong enough to bias subjective ratings when faces of CS+/CS- identity were displayed with different emotional expression (happy, angry) in a post-experimental behavioral task. In contrast to a persistent neural and evaluative CS+/CS- differentiation that sustained multiple unreinforced CS presentations, electrodermal differentiation was rapidly extinguished. Current results suggest that MultiCS conditioning provides a promising paradigm for investigating pre-post-learning changes under minimal influences of extinction and overlearning of simple stimulus features. Our data also revealed methodological pitfalls, such as the possibility of occurring artifacts when combining different acquisition systems for central and peripheral

Facing Challenges in Differential Classical Conditioning Research: Benefits of a Hybrid Design for Simultaneous Electrodermal and Electroencephalographic Recording

PubMed Central

Pastor, M. Carmen; Rehbein, Maimu Alissa; Junghöfer, Markus; Poy, Rosario; López, Raul; Moltó, Javier

2015-01-01

Several challenges make it difficult to simultaneously investigate central and autonomous nervous system correlates of conditioned stimulus (CS) processing in classical conditioning paradigms. Such challenges include, for example, the discrepant requirements of electroencephalography (EEG) and electrodermal activity (EDA) recordings with regard to multiple repetitions of conditions and sufficient trial duration. Here, we propose a MultiCS conditioning set-up, in which we increased the number of CSs, decreased the number of learning trials, and used trials of short and long durations for meeting requirements of simultaneous EEG–EDA recording in a differential aversive conditioning task. Forty-eight participants underwent MultiCS conditioning, in which four neutral faces (CS+) were paired four times each with aversive electric stimulation (unconditioned stimulus) during acquisition, while four different neutral faces (CS−) remained unpaired. When comparing after relative to before learning measurements, EEG revealed an enhanced centro-posterior positivity to CS+ vs. CS− during 368–600 ms, and subjective ratings indicated CS+ to be less pleasant and more arousing than CS−. Furthermore, changes in CS valence and arousal were strong enough to bias subjective ratings when faces of CS+/CS− identity were displayed with different emotional expression (happy, angry) in a post-experimental behavioral task. In contrast to a persistent neural and evaluative CS+/CS− differentiation that sustained multiple unreinforced CS presentations, electrodermal differentiation was rapidly extinguished. Current results suggest that MultiCS conditioning provides a promising paradigm for investigating pre–post-learning changes under minimal influences of extinction and overlearning of simple stimulus features. Our data also revealed methodological pitfalls, such as the possibility of occurring artifacts when combining different acquisition systems for central and peripheral

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

PubMed

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

2010-05-01

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

Strategies for the Challenges Facing Women in Higher Education Administration.

ERIC Educational Resources Information Center

Rehnke, Mary Ann

Women administrators in higher education must deal not only with the usual challenges facing administrators (decision-making, resolving conflict, and advancing professionally), but also with the effects of sex stereotyping. Women are not seen as decision-makers, nor as conflict-resolvers, and are often viewed as supporting personnel rather than…

New Challenges Facing Universities in the Internet-Driven Global Environment

ERIC Educational Resources Information Center

Rajasingham, Lalita

2011-01-01

This paper explores some new challenges facing universities in a global multimediated Internet-based environment, as they seek alternative paradigms and options to remain true to their core business. At a time of rapid technological change, and contested, complex concepts associated with globalisation, knowledge is becoming a primary factor of…

Examining the Challenging Hindrances facing in the Construction Projects: South India’s Perspective

NASA Astrophysics Data System (ADS)

Subramanyam, K.; Haridharan, M. K.

2017-07-01

Developing countries like India require a huge infrastructure to facilitate needs of the people. Construction industry provides several opportunities to the individuals. Construction manager work is to supervise and organize the construction activities in construction projects. Now a day construction manager facing challenges. This paper aimed to study the challenges facing by the construction manager in the perception of construction professionals. 39 variables were taken from the literature review which found to be severe impact on construction managers’ performance. Construction manager, project manager and site engineers are the respondents for this survey. Using SPSS, regression analysis was done and recognized significant challenges. These challenges were classified into 5 domains. In management challenges, resource availability and allocation, risks and uncertainties existing in the project onsite, top management support and cost constraints are the most significant variables. In skills requirement of a construction manager challenges, technical skills required to learn and adapt new technology in the project, decision making and planning according to the situation in site are the most significant variables. In performance challenges, implementation of tasks according to the plan is the important variable whereas in onsite challenges, manage project risks, develop project policies and procedures are the most important.

Solutions to Challenges Facing a University Digital Library and Press

PubMed Central

D'Alessandro, Michael P.; Galvin, Jeffrey R.; Colbert, Stephana I.; D'Alessandro, Donna M.; Choi, Teresa A.; Aker, Brian D.; Carlson, William S.; Pelzer, Gay D.

2000-01-01

During the creation of a university digital library and press intended to serve as a medical reference and education tool for health care providers and their patients, six distinct and complex digital publishing challenges were encountered. Over nine years, through a multidisciplinary approach, solutions were devised to the challenges of digital content ownership, management, mirroring, translation, interactions with users, and archiving. The result is a unique, author-owned, internationally mirrored, university digital library and press that serves as an authoritative medical reference and education tool for users around the world. The purpose of this paper is to share the valuable digital publishing lessons learned and outline the challenges facing university digital libraries and presses. PMID:10833161

The challenges facing wearable sensor systems.

PubMed

McAdams, Eric; Gehin, Claudine; Massot, Bertrand; McLaughlin, James

2012-01-01

It has been pointed out that, in spite of significant national and international funding programmes, there is a dearth of successfully commercialised wearable monitoring systems. Although problems such as financial reimbursement, device interoperability and the present lack of the required connected healthcare infrastructure are major hurdles to the provision of remote clinical monitoring of home-based patients, the "Mount Everest" of monitoring applications, why are wearable systems not already commercialised and used in less demanding applications? The numerous wearable systems which appear on the Web and even in the literature are, for the most part, basic prototypes unsuited to the demands of real-life applications. SMEs which do seek to commercialise clinically promising systems are unfortunately faced with many challenges and few as yet have survived long enough to successfully commercialise their innovations.

Evaluation of the Progress and Challenges facing the Ponseti Method Program in Vietnam

PubMed Central

Wu, Vincent; Nguyen, Michelle; Nhi, Huynh Manh; Thanh, Do Van; Oprescu, Florin; Cook, Thomas; Morcuende, Jose A.

2012-01-01

Introduction In 2003, an ICRC-SFD Ponseti program was introduced in southern Vietnam. Additional programs were introduced by the Prosthetics Outreach Foundation and independently by physicians trained at our center. The purpose of this study was to evaluate the impact, progress and challenges facing Ponseti practitioners and patients' family members in Vietnam. In addition, web-conferencing (Ponseti Virtual Forum) for continued medical education in the method was also assessed. Methods Multiple questionnaires were developed to conduct face-to-face practitioner interviews, focus group interviews, and parental interviews. Observation was done at multiple site clinics to determine or confirm additional challenges faced by practitioners. Web conferencing was introduced to sites in Ho Chi Minh City and Da Nang City. Results The number of clubfoot patients treated with the Ponseti method has increased over time with approximately 1,252 infants treated between 2003 and 2010. Specific challenges were identified relating to communication, networking, distance and transportation, and finances for both practitioners and parents. The PVF was not only found to facilitate rapid, relevant dissemination of medical knowledge – thus increasing physician and patient satisfaction – but it may also be found to act as an interface in which medical culture, insight, and compassion are shared benefiting all virtual forum participants. Conclusion The identified progress and challenges mirrored that of similar studies done in other countries with several factors affecting progress. Focusing on improving communication channels and networking while working with the ministry of health may improve the facilitation of the Ponseti method in Vietnam. Further implementation and evaluation of the PVF may act as a guide for current and future programs in Vietnam or other countries. PMID:23576933

Exploring strategies to overcome extra-organisational challenges faced by community pharmacies in Sarawak, Malaysia.

PubMed

Kho, Boon Phiaw; Hassali, Mohamed Azmi; Lim, Ching Jou; Saleem, Fahad

2018-03-15

The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations. Items were constructed based on the findings of a prior qualitative research supplemented with relevant literature about these issues. High levels of homogeneity in responses were recorded on various extra-organisational challenges faced, particularly those economy-oriented. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than services provision. Highly rated strategies included increasing discounts for customers (n = 54; 68%) and finding cheaper suppliers (n = 70; 88%). Legislative changes proposed that might increase their share of the pharmaceutical market were strongly supported by respondents, particularly about making it compulsory for general practitioners to provide patients the option to have their medicines dispensed in community pharmacies (n = 72; 90%). Current legislative conditions and Malaysian consumer mindset may have constrained the strategic choices of community pharmacies to deal with the strong extra-organisational challenges. A long-term multipronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change. © 2018 Royal Pharmaceutical Society.

Accommodating Extension Clients Who Face Language, Vision, or Hearing Challenges

ERIC Educational Resources Information Center

Angima, Sam; Etuk, Lena; Maddy, Deborah

2016-01-01

A survey-based study explored approaches used by one land-grant university to meet the needs of Extension clients who face language, vision, or hearing challenges. In attempts to serve such clients, the greatest gaps existed for clients whose main language was Spanish, followed by those who had vision impairments and then those who had hearing…

One size fits all? Challenges faced by physicians during shift handovers in a hospital with high sender/recipient ratio

PubMed Central

Yang, Xi Jessie; Park, Taezoon; Siah, Tien Ho Kewin; Ang, Bee Leng Sophia; Donchin, Yoel

2015-01-01

INTRODUCTION The aim of the present study was to investigate the challenges faced by physicians during shift handovers in a university hospital that has a high handover sender/recipient ratio. METHODS We adopted a multifaceted approach, comprising recording and analysis of handover information, rating of handover quality, and shadowing of handover recipients. Data was collected at the general medical ward of a university hospital in Singapore for a period of three months. Handover information transfer (i.e. senders’ and recipients’ verbal communication, and recipients’ handwritten notes) and handover environmental factors were analysed. The relationship between ‘to-do’ tasks and information transfer, handover quality and handover duration was examined using analysis of variance. RESULTS Verbal handovers for 152 patients were observed. Handwritten notes on 102 (67.1%) patients and handover quality ratings for 98 (64.5%) patients were collected. Although there was good task prioritisation (information transfer: p < 0.005, handover duration: p < 0.01), incomplete information transfer and poor implementation of non-modifiable identifiers were observed. The high sender/recipient ratio of the hospital made face-to-face and/or bedside handover difficult to implement. Although the current handover method (i.e. use of telephone communication) allowed for interactive communication, it resulted in systemic information loss due to the lack of written information. The handover environment was chaotic in the high sender/recipient ratio setting, and the physicians had no designated handover time or location. CONCLUSION Handovers in high sender/recipient ratio settings are challenging. Efforts should be made to improve the handover processes in such situations, so that patient care is not compromised. PMID:25532519

Challenges faced by parents of children with learning disabilities in Opuwo, Namibia.

PubMed

Taderera, Clever; Hall, Herna

2017-01-01

Parenting children with learning disabilities requires a high level of knowledge and access to resources, information and services. In developing countries, however, these resources and services are not always available. Parents in Namibia, a developing country, therefore face challenges addressing children's learning and other developmental disabilities, including challenges related to preventative and supportive interventions. This research focuses on challenges faced by parents as they parent children with learning disabilities in Opuwo, Namibia. In-depth interviews were conducted with eight parents regarding the challenges they face in parenting their children with learning disabilities. Thematic analysis enabled the researchers to identify, analyse and report on themes that emerged from the qualitative interview data. Analysis of the interviews indicated that some participants had only a vague understanding of learning disabilities, as they did not have access to essential knowledge about this phenomenon. They also lacked an awareness of the availability of programmes, services and policies meant to benefit their children with learning disabilities. Participants voiced that they, their children with learning disabilities and community members have stereotypes and prejudices regarding learning disabilities. In this study, most of the children with learning disabilities were raised by single, unemployed parents who seemed to have access to less support from external sources than married couples parenting children with learning disabilities. These single parents are usually not married and because of lack of financial support from the other parent, the majority of them indicated that they struggle to meet the financial and material needs of their children. The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main challenges emanate from financial instability, as

Challenges faced by parents of children with learning disabilities in Opuwo, Namibia

PubMed Central

Taderera, Clever

2017-01-01

Background Parenting children with learning disabilities requires a high level of knowledge and access to resources, information and services. In developing countries, however, these resources and services are not always available. Parents in Namibia, a developing country, therefore face challenges addressing children’s learning and other developmental disabilities, including challenges related to preventative and supportive interventions. Objective This research focuses on challenges faced by parents as they parent children with learning disabilities in Opuwo, Namibia. Method In-depth interviews were conducted with eight parents regarding the challenges they face in parenting their children with learning disabilities. Thematic analysis enabled the researchers to identify, analyse and report on themes that emerged from the qualitative interview data. Results Analysis of the interviews indicated that some participants had only a vague understanding of learning disabilities, as they did not have access to essential knowledge about this phenomenon. They also lacked an awareness of the availability of programmes, services and policies meant to benefit their children with learning disabilities. Participants voiced that they, their children with learning disabilities and community members have stereotypes and prejudices regarding learning disabilities. In this study, most of the children with learning disabilities were raised by single, unemployed parents who seemed to have access to less support from external sources than married couples parenting children with learning disabilities. These single parents are usually not married and because of lack of financial support from the other parent, the majority of them indicated that they struggle to meet the financial and material needs of their children. Conclusion The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main

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

PubMed

Dickey, Lore M; Singh, Anneliese A

2017-08-01

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

[Difficult teenagers: the challenges of interdisciplinarity].

PubMed

Saint-Andrté, Stéphane; Botbola, Michel

2013-01-01

The adolescents in great distress, because of ruptures in the course of their lives and of their chaotic family environment, need educational and social actions. The consensual point of view is that responding to the needs of the so called "difficult adolescents" implies the involvement of educational, therapeutic and judicial services. Nevertheless, the usual tendency to categorize the users with the idea it will permit to guide them to the appropriate skill field and the transgressive characteristic of these adolescents' behaviours lead all these services to reject them and send them to the two other services.

Quality Assurance Challenges and Opportunities Faced by Private Universities in Zimbabwe

ERIC Educational Resources Information Center

Garwe, Evelyn Chiyevo

2014-01-01

The study sought to provide an understanding of the quality assurance challenges and opportunities faced by private universities in Zimbabwe. The study analyzed the factors determining provision of quality higher education in private universities and the resultant effects of failing to achieve the minimum acceptable standards. The author employed…

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology

PubMed Central

Magalhães-Sant'Ana, M.; More, S. J.; Morton, D. B.; Hanlon, A.

2016-01-01

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. PMID:27613779

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology.

PubMed

Magalhães-Sant'Ana, M; More, S J; Morton, D B; Hanlon, A

2016-10-29

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. British Veterinary Association.

Face Search at Scale.

PubMed

Wang, Dayong; Otto, Charles; Jain, Anil K

2017-06-01

Given the prevalence of social media websites, one challenge facing computer vision researchers is to devise methods to search for persons of interest among the billions of shared photos on these websites. Despite significant progress in face recognition, searching a large collection of unconstrained face images remains a difficult problem. To address this challenge, we propose a face search system which combines a fast search procedure, coupled with a state-of-the-art commercial off the shelf (COTS) matcher, in a cascaded framework. Given a probe face, we first filter the large gallery of photos to find the top- k most similar faces using features learned by a convolutional neural network. The k retrieved candidates are re-ranked by combining similarities based on deep features and those output by the COTS matcher. We evaluate the proposed face search system on a gallery containing 80 million web-downloaded face images. Experimental results demonstrate that while the deep features perform worse than the COTS matcher on a mugshot dataset (93.7 percent versus 98.6 percent TAR@FAR of 0.01 percent), fusing the deep features with the COTS matcher improves the overall performance ( 99.5 percent TAR@FAR of 0.01 percent). This shows that the learned deep features provide complementary information over representations used in state-of-the-art face matchers. On the unconstrained face image benchmarks, the performance of the learned deep features is competitive with reported accuracies. LFW database: 98.20 percent accuracy under the standard protocol and 88.03 percent TAR@FAR of 0.1 percent under the BLUFR protocol; IJB-A benchmark: 51.0 percent TAR@FAR of 0.1 percent (verification), rank 1 retrieval of 82.2 percent (closed-set search), 61.5 percent FNIR@FAR of 1 percent (open-set search). The proposed face search system offers an excellent trade-off between accuracy and scalability on galleries with millions of images. Additionally, in a face search experiment involving

Challenges faced by international nurses when migrating: an integrative literature review.

PubMed

Pung, L-X; Goh, Y-S

2017-03-01

Results from this literature review were used to identify the challenges faced by international nurses in their host countries following migration. The increasing strain of nursing shortages in the healthcare system has led to the recruitment of international nurses among many countries. However, following migration, international nurses are faced with challenges that may result in poor integration with their host countries. Using Cooper's five stages for integrative research reviews, a literature search was conducted across seven databases using a PRISMA search strategy. Additional manual searches were also conducted on the end-references of the retrieved articles. The authors then independently reviewed the selected articles using the Joanna Briggs Institute appraisal form to extract and generate the themes for the review. Twenty-four articles were selected for the review. The themes generated included: (i) difficulty orientating; (ii) a longing for what is missing; (iii) professional development and devaluing; (iv) communication barriers; (v) discrimination and marginalization; (vi) personal and professional differences; and (vii) a meaningful support system. By identifying the challenges faced by international nurses, interventions that ensure equal treatment (e.g. multifaceted transition programmes and culturally sensitive 'buddy' systems) can be implemented to help international nurses adapt to their new environments. Adequate communication can be achieved by encouraging international nurses to speak English and learn the colloquial language and non-verbal behaviours used by native nurses. With good integration international nurses may be able to reach their full career potential as professional nurses in their host countries. The adaptation process is a dynamic process that requires effort from both international and native nurses. Thus, any strategies that are developed and implemented must be multifaceted. © 2016 International Council of Nurses.

Challenges facing European agriculture and possible biotechnological solutions.

PubMed

Ricroch, Agnès; Harwood, Wendy; Svobodová, Zdeňka; Sági, László; Hundleby, Penelope; Badea, Elena Marcela; Rosca, Ioan; Cruz, Gabriela; Salema Fevereiro, Manuel Pedro; Marfà Riera, Victoria; Jansson, Stefan; Morandini, Piero; Bojinov, Bojin; Cetiner, Selim; Custers, René; Schrader, Uwe; Jacobsen, Hans-Joerg; Martin-Laffon, Jacqueline; Boisron, Audrey; Kuntz, Marcel

2016-10-01

Agriculture faces many challenges to maximize yields while it is required to operate in an environmentally sustainable manner. In the present study, we analyze the major agricultural challenges identified by European farmers (primarily related to biotic stresses) in 13 countries, namely Belgium, Bulgaria, the Czech Republic, France, Germany, Hungary, Italy, Portugal, Romania, Spain, Sweden, UK and Turkey, for nine major crops (barley, beet, grapevine, maize, oilseed rape, olive, potato, sunflower and wheat). Most biotic stresses (BSs) are related to fungi or insects, but viral diseases, bacterial diseases and even parasitic plants have an important impact on yield and harvest quality. We examine how these challenges have been addressed by public and private research sectors, using either conventional breeding, marker-assisted selection, transgenesis, cisgenesis, RNAi technology or mutagenesis. Both national surveys and scientific literature analysis followed by text mining were employed to evaluate genetic engineering (GE) and non-GE approaches. This is the first report of text mining of the scientific literature on plant breeding and agricultural biotechnology research. For the nine major crops in Europe, 128 BS challenges were identified with 40% of these addressed neither in the scientific literature nor in recent European public research programs. We found evidence that the private sector was addressing only a few of these "neglected" challenges. Consequently, there are considerable gaps between farmer's needs and current breeding and biotechnology research. We also provide evidence that the current political situation in certain European countries is an impediment to GE research in order to address these agricultural challenges in the future. This study should also contribute to the decision-making process on future pertinent international consortia to fill the identified research gaps.

Challenges Faced and Support Received: Older Adults' Perceptions of Hurricane Sandy.

PubMed

Heid, Allison R; Schug, Seran; Cartwright, Francine P; Pruchno, Rachel

2017-02-01

Individuals exposed to natural disasters are at risk for negative physical and psychological outcomes. Older adults may be particularly vulnerable; however, social support can act as a resource to help individuals respond to severe stressors. This study explored the challenges older people faced before, during, and after Hurricane Sandy in October 2012 and the people they turned to for support. Semi-structured interviews were conducted with 20 older adults in New Jersey drawn from the ORANJ BOWL (Ongoing Research on Aging in New Jersey - Bettering Opportunities for Wellness in Life) research panel, who experienced high levels of primary home damage during Hurricane Sandy. Content analysis of interview transcripts classified older adults' perceptions on how they "made it" through-the challenges they faced and the support they received. The findings suggested that older adults experienced emotional, instrumental, social, and financial challenges before, during, and after the storm. However, by relying on family and friends, as well as neighbors and community networks, older people were able to respond to stressors. Our findings carry implications for ensuring that older adults are connected to social networks before, during, and after disasters. The role of neighbors is particularly important when disasters strike. (Disaster Med Public Health Preparedness. 2017;11:39-47).

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

PubMed

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

2017-01-25

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

Unconventional combinations of prospective parents: ethical challenges faced by IVF providers.

PubMed

Klitzman, Robert

2017-02-28

Professional guidelines have addressed ethical dilemmas posed by a few types of nontraditional procreative arrangements (e.g., gamete donations between family members), but many questions arise regarding how providers view and make decisions about these and other such arrangements. Thirty-seven ART providers and 10 patients were interviewed in-depth for approximately 1 h each. Interviews were systematically analyzed. Providers faced a range of challenges and ethical dilemmas concerning both the content and the process of decisions about requests for unconventional interfamilial and other reproductive combinations. Providers vary in how they respond - what they decide, who exactly decides (e.g., an ethics committee or not), and how - often undergoing complex decision-making processes. These combinations can involve creating or raising the child, and can shift over time - from initial ART treatment through to the child's birth. Patients' requests can vary from fully established to mere possibilities. Arrangements may also be unstable, fluid, or unexpected, posing challenges. Difficulties emerge concerning not only familial but social, combinations (e.g., between friends). These arrangements can involve blurry and confusing roles, questions about the welfare of the unborn child, and unanticipated and unfamiliar questions about how to weigh competing moral and scientific concerns - e.g., the autonomy of the individuals involved, and the potential risks and benefits. Clinicians may feel that these requests do not "smell right"; and at first respond with feelings of "yuck," and only later, carefully and explicitly consider the ethical principles involved. Proposed arrangements may, for instance, initially be felt to involve consanguineous individuals, but not in fact do so. Obtaining and verifying full and appropriate informed consent can be difficult, given implicit familial and/or cultural expectations and senses of duty. Social attitudes are changing, yet patients

Morbidly obese parturient: Challenges for the anaesthesiologist, including managing the difficult airway in obstetrics. What is new?

PubMed Central

Rao, Durga Prasada; Rao, Venkateswara A

2010-01-01

The purpose of this article is to review the fundamental aspects of obesity, pregnancy and a combination of both. The scientific aim is to understand the physiological changes, pathological clinical presentations and application of technical skills and pharmacological knowledge on this unique clinical condition. The goal of this presentation is to define the difficult airway, highlight the main reasons for difficult or failed intubation and propose a practical approach to management Throughout the review, an important component is the necessity for team work between the anaesthesiologist and the obstetrician. Certain protocols are recommended to meet the anaesthetic challenges and finally concluding with “what is new?” in obstetric anaesthesia. PMID:21224967

Grand Challenges and Great Potential in Foreign Language Teaching and Learning

ERIC Educational Resources Information Center

Hlas, Anne Cummings

2018-01-01

This article argues for the field of foreign languages to begin to identify and define our Grand Challenges, which are difficult yet solvable problems facing our field. Seeking answers to these challenges can provide new opportunities for collaboration and can spur new directions and innovation within language learning and teaching. Researchable…

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

ERIC Educational Resources Information Center

Evangelinou-Yiannakis, Angela

2016-01-01

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

Compulsive exercise: links, risks and challenges faced

PubMed Central

Lichtenstein, Mia Beck; Hinze, Cecilie Juul; Emborg, Bolette; Thomsen, Freja; Hemmingsen, Simone Daugaard

2017-01-01

Compulsive exercise is a condition described since 1970s. It is characterized by a craving for physical training, resulting in uncontrollable excessive exercise behavior with harmful consequences, such as injuries and impaired social relations. It has not been accepted as a mental disorder in either International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders. The aim of this literature review was to critically examine the research on links (comorbidity), risks (negative consequences), and challenges faced (problems in a treatment context). This review found that compulsive exercise is associated with eating disorder pathology, perfectionism, neuroticism, narcissism, and obsessive compulsive traits. The most prominent negative consequences were injuries, social impairment, and depression, but more research is needed to uncover the potential dysfunction resulting from compulsive exercise. As the condition is not recognized as a psychiatric disorder, studies on treatment interventions are sparse. Problems with compliance have been reported; therefore, motivational interviewing has been proposed as a treatment approach, in combination with cognitive behavioral therapy. This review summarizes and discusses findings on links/comorbidity, risks/negative consequences, and treatment challenges. We suggest that future studies should pay attention to both prevention and counseling in sports settings, where compulsive exercise appears, as the condition may be associated with harmful consequences. PMID:28435339

Compulsive exercise: links, risks and challenges faced.

PubMed

Lichtenstein, Mia Beck; Hinze, Cecilie Juul; Emborg, Bolette; Thomsen, Freja; Hemmingsen, Simone Daugaard

2017-01-01

Compulsive exercise is a condition described since 1970s. It is characterized by a craving for physical training, resulting in uncontrollable excessive exercise behavior with harmful consequences, such as injuries and impaired social relations. It has not been accepted as a mental disorder in either International Classification of Diseases or Diagnostic and Statistical Manual of Mental Disorders . The aim of this literature review was to critically examine the research on links (comorbidity), risks (negative consequences), and challenges faced (problems in a treatment context). This review found that compulsive exercise is associated with eating disorder pathology, perfectionism, neuroticism, narcissism, and obsessive compulsive traits. The most prominent negative consequences were injuries, social impairment, and depression, but more research is needed to uncover the potential dysfunction resulting from compulsive exercise. As the condition is not recognized as a psychiatric disorder, studies on treatment interventions are sparse. Problems with compliance have been reported; therefore, motivational interviewing has been proposed as a treatment approach, in combination with cognitive behavioral therapy. This review summarizes and discusses findings on links/comorbidity, risks/negative consequences, and treatment challenges. We suggest that future studies should pay attention to both prevention and counseling in sports settings, where compulsive exercise appears, as the condition may be associated with harmful consequences.

Four Challenges That Global Health Networks Face

PubMed Central

Shiffman, Jeremy

2017-01-01

Global health networks, webs of individuals and organizations with a shared concern for a particular condition, have proliferated over the past quarter century. They differ in their effectiveness, a factor that may help explain why resource allocations vary across health conditions and do not correspond closely with disease burden. Drawing on findings from recently concluded studies of eight global health networks—addressing alcohol harm, early childhood development (ECD), maternal mortality, neonatal mortality, pneumonia, surgically-treatable conditions, tobacco use, and tuberculosis—I identify four challenges that networks face in generating attention and resources for the conditions that concern them. The first is problem definition: generating consensus on what the problem is and how it should be addressed. The second is positioning: portraying the issue in ways that inspire external audiences to act. The third is coalition-building: forging alliances with these external actors, particularly ones outside the health sector. The fourth is governance: establishing institutions to facilitate collective action. Research indicates that global health networks that effectively tackle these challenges are more likely to garner support to address the conditions that concern them. In addition to the effectiveness of networks, I also consider their legitimacy, identifying reasons both to affirm and to question their right to exert power. PMID:28812801

Taxonomy of Challenges for Digital Forensics.

PubMed

Karie, Nickson M; Venter, Hein S

2015-07-01

Since its inception, over a decade ago, the field of digital forensics has faced numerous challenges. Despite different researchers and digital forensic practitioners having studied and analysed various known digital forensic challenges, as of 2013, there still exists a need for a formal classification of these challenges. This article therefore reviews existing research literature and highlights the various challenges that digital forensics has faced for the last 10 years. In conducting this research study, however, it was difficult for the authors to review all the existing research literature in the digital forensic domain; hence, sampling and randomization techniques were employed to facilitate the review of the gathered literature. Taxonomy of the various challenges is subsequently proposed in this paper based on our review of the literature. The taxonomy classifies the large number of digital forensic challenges into four well-defined and easily understood categories. The proposed taxonomy can be useful, for example, in future developments of automated digital forensic tools by explicitly describing processes and procedures that focus on addressing specific challenges identified in this paper. However, it should also be noted that the purpose of this paper was not to propose any solutions to the individual challenges that digital forensics face, but to serve as a survey of the state of the art of the research area. © 2015 American Academy of Forensic Sciences.

Getting to 2014: The Choices and Challenges Ahead

ERIC Educational Resources Information Center

Balfanz, Robert; Cohen, Michael; Hassel, Bryan C.; Hassel, Emily Ayscue; Hyslop, Anne; Odden, Allan; Tucker, Bill

2012-01-01

Over the next few years, educators and policymakers have committed to implementing an array of challenging, but potentially transformative, reforms--reforms that could go beyond rearranging furniture to fundamentally restructuring and improving teaching and learning. Facing this much simultaneous change would be difficult even without the…

Ethical challenges faced by healthcare professionals who care for suicidal patients: a scoping review.

PubMed

Saigle, Victoria; Racine, Eric

2018-04-17

For each one of the approximately 800,000 people who die from suicide every year, an additional twenty people attempt suicide. Many of these attempts result in hospitalization or in contact with other healthcare services. However, many personal, educational, and institutional barriers make it difficult for healthcare professionals to care for suicidal individuals. We reviewed literature that discusses suicidal patients in healthcare settings in order to highlight common ethical issues and to identify knowledge gaps. A sample was generated via PubMed using keywords "[(ethics OR *ethic*) AND suicid*] AND [English (Language) OR French (Language)]" (final N = 52), ethics content was extracted according to scoping review methodology, and categorized thematically. We identified three main areas posing ethical challenges for health professionals caring for suicidal individuals and their families. These were: (1) making clinical decisions for patients in acute care or when presented with specific circumstances; (2) issues arising from therapeutic relationships in chronic care, and (3) organizational factors. There is considerable uncertainty about how to resolve ethical issues when caring for someone who is suicidal. The stigma associated with suicide and mental illness, problems associated with risk-benefit assessments, and the fear of being held liable for malpractice should a patient die by suicide were overarching themes present across these three categories. Caring for suicidal patients is clinically and ethically challenging. The current literature highlights the complexity and range of decisions that need to be made. More attention should be paid to the difficulties faced by healthcare professionals and the development of solutions.

Challenges Faced by Institutions of Higher Education in Migrating to Distance Learning.

ERIC Educational Resources Information Center

Broskoske, Stephen L.; Harvey, Francis A.

This paper presents the results of a research study conducted in fall 1999 to examine the challenges facing higher educational institutions in migrating to distance learning. The study consisted of five case studies conducted at higher educational institutions in Pennsylvania. At each institution the researchers interviewed the president and other…

Challenges Facing Women Academic Leadership in Secondary Schools of Irbid Educational Area

ERIC Educational Resources Information Center

Al-Jaradat, Mahmoud Khaled Mohammad

2014-01-01

This study aimed at identifying the challenges facing women academic leadership in secondary schools of Irbid Educational Area. A random sample of 187 female leaders were chosen. They responded to a 49-item questionnaire prepared by the researcher. The items were distributed into four domains: organizational, personal, social and physical…

Challenges Facing Families at the End of Life in Three Settings

PubMed Central

Kehl, Karen A.; Kirchhoff, Karin T.; Kramer, Betty J.; Hovland-Scafe, Cyndi

2010-01-01

This study examined the challenges faced by family members at the end of life in different care settings and how those challenges compare across settings. A total of 30 participants, who had a family member die in inpatient hospice, a skilled nursing facility or a community support program were interviewed. Semi-structured interviews were recorded and transcribed. Text was coded using qualitative thematic analysis. Themes were determined by consensus. Twelve challenges were identified across care sites. Two themes emerged in all three settings: bearing witness and the experience of loss. The study findings contribute to our knowledge of family perceptions of care in different settings and raises awareness of the need for further research describing the experiences at the end of life in different settings and the importance of creating and testing interventions for both setting specific needs and universal issues. PMID:20563315

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…

Elephant Trunk-Like Teratoma of the Face with Compromised Airway in an Infant with Complex Congenital Cardiac Defects: An Anesthetic Challenge.

PubMed

Maddali, Madan Mohan; Al Balushi, Faisal Khalfan Ahmed; Waje, Niranjan Dilip

2016-02-01

Large head and neck teratomas are very rare. Depending on their site of origin, they can produce varying degrees of airway compromise and can interfere with the conduct of general anesthesia. Large space-occupying lesions of the face may even interfere with the simple task of mask ventilation rendering inhaled induction of general anesthesia and maintenance of spontaneous ventilation difficult. If these neoplasms coexist with cardiac lesions necessitating corrective or palliative procedures, the task of oxygenation, ventilation, and securing a definitive airway becomes challenging especially in the presence of underlying unstable hemodynamics. We report on the anesthetic management of a female infant with a facial teratoma and single-ventricle physiology undergoing a cardiac palliative procedure where securing a definitive airway with minimal hemodynamic instability was the immediate requirement.

Sponge systematics facing new challenges.

PubMed

Cárdenas, P; Pérez, T; Boury-Esnault, N

2012-01-01

Systematics is nowadays facing new challenges with the introduction of new concepts and new techniques. Compared to most other phyla, phylogenetic relationships among sponges are still largely unresolved. In the past 10 years, the classical taxonomy has been completely overturned and a review of the state of the art appears necessary. The field of taxonomy remains a prominent discipline of sponge research and studies related to sponge systematics were in greater number in the Eighth World Sponge Conference (Girona, Spain, September 2010) than in any previous world sponge conferences. To understand the state of this rapidly growing field, this chapter proposes to review studies, mainly from the past decade, in sponge taxonomy, nomenclature and phylogeny. In a first part, we analyse the reasons of the current success of this field. In a second part, we establish the current sponge systematics theoretical framework, with the use of (1) cladistics, (2) different codes of nomenclature (PhyloCode vs. Linnaean system) and (3) integrative taxonomy. Sponges are infamous for their lack of characters. However, by listing and discussing in a third part all characters available to taxonomists, we show how diverse characters are and that new ones are being used and tested, while old ones should be revisited. We then review the systematics of the four main classes of sponges (Hexactinellida, Calcispongiae, Homoscleromorpha and Demospongiae), each time focusing on current issues and case studies. We present a review of the taxonomic changes since the publication of the Systema Porifera (2002), and point to problems a sponge taxonomist is still faced with nowadays. To conclude, we make a series of proposals for the future of sponge systematics. In the light of recent studies, we establish a series of taxonomic changes that the sponge community may be ready to accept. We also propose a series of sponge new names and definitions following the PhyloCode. The issue of phantom species

Face mask ventilation--the dos and don'ts.

PubMed

Wood, Fiona E; Morley, Colin J

2013-12-01

Face mask ventilation provides respiratory support to newly born or sick infants. It is a challenging technique and difficult to ensure that an appropriate tidal volume is delivered because large and variable leaks occur between the mask and face; airway obstruction may also occur. Technique is more important than the mask shape although the size must appropriately fit the face. The essence of the technique is to roll the mask on to the face from the chin while avoiding the eyes, with a finger and thumb apply a strong even downward pressure to the top of the mask, away from the stem and sloped sides or skirt of the mask, place the other fingers under the jaw and apply a similar upward pressure. Preterm infants require continuous end-expiratory pressure to facilitate lung aeration and maintain lung volume. This is best done with a T-piece device, not a self-inflating or flow-inflating bag. Copyright © 2013 Elsevier Ltd. All rights reserved.

The organisational and human resource challenges facing primary care trusts: protocol of a multiple case study

PubMed Central

2001-01-01

Background The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. Methods The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development. PMID:11737883

Assessment Challenges for Business Education in Changing Times

ERIC Educational Resources Information Center

Hazari, Sunil; Gaytan, Jorge; North, Alexa

2008-01-01

In addition to the difficult task of identifying teaching methods that ensure student learning, the American educational system is facing significant challenges. Schools are struggling to maintain standards for high-quality teaching while trying to address the learning needs of students with Limited English Proficiency (LEP). The same struggle is…

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

ERIC Educational Resources Information Center

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

2017-01-01

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

An opportunity and an imperative: Chapter 11 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

USGS Publications Warehouse

Updike, Randall G.; Page, William R.

2013-01-01

Along the nearly 3,200 kilometers (almost 2,000 miles) of the United States–Mexican border, we are witnessing the expression of the challenges of the 21st century. The Borderlands have become a microcosm for the entire United States and Mexico; the issues faced in that region are felt throughout both nations—water availability and quality, ecosystem health, natural resource needs, safety from natural hazards, and human socioeconomic well-being. If these issues were not challenging enough, we now recognize that the difficulties of addressing them are exacerbated by the onset of climate change, and as we come to better understand the complexities of the components of these challenge themes, we discover that each part is inextricably intertwined with other overarching issues. Further, because we are a creative and progressive society, we all seek to understand and appreciate the natural environments associated with the Borderlands while at the same time benefitting from the region’s many social and economic values. It is little wonder that we as a society find it increasingly difficult to ask the right questions, much less find suitable answers to the questions we do ask. For the many scientists who have worked in the Borderlands and contributed to the preceding chapters, this circular is a way to describe to the two nations of the region the capabilities the U.S. Geological Survey can provide to assist in that quest for knowledge and understanding in preparation for the future.

Unusual tumour ablations: report of difficult and interesting cases.

PubMed

Mauri, Giovanni; Nicosia, Luca; Varano, Gianluca Maria; Shyn, Paul; Sartori, Sergio; Tombesi, Paola; Di Vece, Francesca; Orsi, Franco; Solbiati, Luigi

2017-01-01

Image-guided ablations are nowadays applied in the treatment of a wide group of diseases and in different organs and regions, and every day interventional radiologists have to face more difficult and unusual cases of tumour ablation. In the present case review, we report four difficult and unusual cases, reporting some tips and tricks for a successful image-guided treatment.

Face transplant: is it feasible in developing countries?

PubMed

González-García, Ignacio; Lyra-González, Iván; Medina-Preciado, David; Guerrero-Torres, Alejandro; Ramos-Gallardo, Guillermo; Armendáriz-Borunda, Juan

2013-01-01

This article is based on the case of a 28-year-old woman who was involved in a car accident, with diagnosis of polytrauma, loss of left eye, and second- and third-degree burns over the left midface, rendering an exposed area of 8 cm wide and 19 cm length, ranging from glabella to mandible, with skull exposure and loss of left eye.A latissimus dorsi musculocutaneous free flap was transferred into the defect; left eye and nose prosthetics were necessary to restore normal appearance. Excellent results were obtained; reinsertion to patient's normal life and reinstatement of facial appearance were achieved with minimal costs and no postsurgical complications.Analysis of the current situation in developing countries demonstrates that technique and infrastructure do not represent a real challenge to carry on face transplants. However, socioeconomic reality in these societies makes it difficult to establish face transplant as a feasible therapeutic opportunity for the overwhelming majority of patients who are victims of severe facial damage.Therefore, strategies such as latissimus dorsi free flap remains as an excellent therapy to face off our complex facial reconstructive challenges in developing countries such as Mexico.

Challenges Facing 3-D Audio Display Design for Multimedia

NASA Technical Reports Server (NTRS)

Begault, Durand R.; Null, Cynthia H. (Technical Monitor)

1998-01-01

The challenges facing successful multimedia presentation depend largely on the expectations of the designer and end user for a given application. Perceptual limitations in distance, elevation and azimuth sound source simulation differ significantly between headphone and cross-talk cancellation loudspeaker listening and therefore must be considered. Simulation of an environmental context is desirable but the quality depends on processing resources and lack of interaction with the host acoustical environment. While techniques such as data reduction of head-related transfer functions have been used widely to improve simulation fidelity, another approach involves determining thresholds for environmental acoustic events. Psychoacoustic studies relevant to this approach are reviewed in consideration of multimedia applications

A Novel Face-on-Face Contact Method for Nonlinear Solid Mechanics

NASA Astrophysics Data System (ADS)

Wopschall, Steven Robert

The implicit solution to contact problems in nonlinear solid mechanics poses many difficulties. Traditional node-to-segment methods may suffer from locking and experience contact force chatter in the presence of sliding. More recent developments include mortar based methods, which resolve local contact interactions over face-pairs and feature a kinematic constraint in integral form that smoothes contact behavior, especially in the presence of sliding. These methods have been shown to perform well in the presence of geometric nonlinearities and are demonstratively more robust than node-to-segment methods. These methods are typically biased, however, interpolating contact tractions and gap equations on a designated non-mortar face, which leads to an asymmetry in the formulation. Another challenge is constraint enforcement. The general selection of the active set of constraints is brought with difficulty, often leading to non-physical solutions and easily resulting in missed face-pair interactions. Details on reliable constraint enforcement methods are lacking in the greater contact literature. This work presents an unbiased contact formulation utilizing a median-plane methodology. Up to linear polynomials are used for the discrete pressure representation and integral gap constraints are enforced using a novel subcycling procedure. This procedure reliably determines the active set of contact constraints leading to physical and kinematically admissible solutions void of heuristics and user action. The contact method presented herein successfully solves difficult quasi-static contact problems in the implicit computational setting. These problems feature finite deformations, material nonlinearity, and complex interface geometries, all of which are challenging characteristics for contact implementations and constraint enforcement algorithms. The subcycling procedure is a key feature of this method, handling active constraint selection for complex interfaces and mesh

Faculty Teaching Diversity through Difficult Dialogues: Stories of Challenges and Success

ERIC Educational Resources Information Center

Gayles, Joy Gaston; Kelly, Bridget Turner; Grays, Shaefny; Zhang, Jing Jing; Porter, Kamaria P.

2015-01-01

Teaching diversity courses in graduate preparation programs is likely to trigger difficult dialogues that evoke a range of emotional responses. Difficult dialogues on diversity topics must be managed effectively in order to enhance multicultural competence. This interpretive study examined the experiences of faculty who teach diversity courses in…

Military Veterans Face Challenges in Accessing Educational Benefits at Florida Community Colleges

ERIC Educational Resources Information Center

Spiro, Rivka; Hill, Robert

2010-01-01

Florida's community colleges are seeing an influx of students who face unique challenges. They are the men and women who served in the military after the attacks of September 11, 2001, and who are now attending college on the new Post-9/11 GI Bill, with its greatly enhanced educational benefits, and on the expanded, old Montgomery GI Bill, which…

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

ERIC Educational Resources Information Center

Hakami, Samah Mohammed

2012-01-01

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

Robust kernel representation with statistical local features for face recognition.

PubMed

Yang, Meng; Zhang, Lei; Shiu, Simon Chi-Keung; Zhang, David

2013-06-01

Factors such as misalignment, pose variation, and occlusion make robust face recognition a difficult problem. It is known that statistical features such as local binary pattern are effective for local feature extraction, whereas the recently proposed sparse or collaborative representation-based classification has shown interesting results in robust face recognition. In this paper, we propose a novel robust kernel representation model with statistical local features (SLF) for robust face recognition. Initially, multipartition max pooling is used to enhance the invariance of SLF to image registration error. Then, a kernel-based representation model is proposed to fully exploit the discrimination information embedded in the SLF, and robust regression is adopted to effectively handle the occlusion in face images. Extensive experiments are conducted on benchmark face databases, including extended Yale B, AR (A. Martinez and R. Benavente), multiple pose, illumination, and expression (multi-PIE), facial recognition technology (FERET), face recognition grand challenge (FRGC), and labeled faces in the wild (LFW), which have different variations of lighting, expression, pose, and occlusions, demonstrating the promising performance of the proposed method.

Challenges Facing Canadian Federal Offenders Newly Released to the Community: A Concept Map

ERIC Educational Resources Information Center

Brown, Jason D.

2004-01-01

The purpose of the study was to describe the needs of newly released Canadian federal offenders as perceived by community parole supervisors. Seventy-four Canadian parole supervisors were asked to answer the following question: "What challenges do parolees face in the first 90 days after release?" The data were analyzed using…

Electronic health systems: challenges faced by hospital-based providers.

PubMed

Agno, Christina Farala; Guo, Kristina L

2013-01-01

The purpose of this article is to discuss specific challenges faced by hospitals adopting the use of electronic medical records and implementing electronic health record (EHR) systems. Challenges include user and information technology support; ease of technical use and software interface capabilities; compliance; and financial, legal, workforce training, and development issues. Electronic health records are essential to preventing medical errors, increasing consumer trust and use of the health system, and improving quality and overall efficiency. Government efforts are focused on ways to accelerate the adoption and use of EHRs as a means of facilitating data sharing, protecting health information privacy and security, quickly identifying emerging public health threats, and reducing medical errors and health care costs and increasing quality of care. This article will discuss physician and nonphysician staff training before, during, and after implementation; the effective use of EHR systems' technical features; the selection of a capable and secure EHR system; and the development of collaborative system implementation. Strategies that are necessary to help health care providers achieve successful implementation of EHR systems will be addressed.

Challenges facing developers of CAD/CAM models that seek to predict human working postures

NASA Astrophysics Data System (ADS)

Wiker, Steven F.

2005-11-01

This paper outlines the need for development of human posture prediction models for Computer Aided Design (CAD) and Computer Aided Manufacturing (CAM) design applications in product, facility and work design. Challenges facing developers of posture prediction algorithms are presented and discussed.

Challenges Facing Guitar Education

ERIC Educational Resources Information Center

Harrison, Eli

2010-01-01

The guitar is an extremely versatile instrument. It can produce complex chords and arpeggiated textures as readily as single-note melodies. In the twentieth century alone, it has appeared in a wide range of genres; classical, jazz, blues, rock, and bossa nova compose a partial list. The guitar is also a difficult instrument. Inconsistencies across…

Transition Program: The Challenges Faced by Special Needs Students in Gaining Work Experience

ERIC Educational Resources Information Center

Alias, Aliza

2014-01-01

Transition program for special needs students is known to open opportunities for students with learning disabilities to gain work experience in actual work environment. The program provides training activities and also an opportunity to go for internship to gain work experience. Therefore, this study is to identify the challenges faced by special…

Management challenges faced by managers of New Zealand long-term care facilities.

PubMed

Madas, E; North, N

2000-01-01

This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

Electrophysiological correlates of forming memories for faces, names, and face-name associations.

PubMed

Guo, Chunyan; Voss, Joel L; Paller, Ken A

2005-02-01

The ability to put a name to a face is a vital aspect of human interaction, but many people find this extremely difficult, especially after being introduced to someone for the first time. Creating enduring associations between arbitrary stimuli in this manner is also a prime example of what patients with amnesia find most difficult. To help develop a better understanding of this type of memory, we sought to obtain measures of the neural events responsible for successfully forming a new face-name association. We used event-related potentials (ERPs) extracted from high-density scalp EEG recordings in order to compare (1) memory for faces, (2) memory for names, and (3) memory for face-name associations. Each visual face appeared simultaneously with a unique spoken name. Signals observed 200-800 ms after the onset of face-name pairs predicted subsequent memory for faces, names, or face-name associations. Difference potentials observed as a function of subsequent memory performance were not identical for these three memory tests, nor were potentials predicting associative memory equivalent to the sum of potentials predicting item memory, suggesting that different neural events at the time of encoding are relevant for these distinct aspects of remembering people.

HIV and tuberculosis coinfection: a qualitative study of treatment challenges faced by care providers.

PubMed

Wannheden, C; Westling, K; Savage, C; Sandahl, C; Ellenius, J

2013-08-01

Infectious Diseases Department, Karolinska University Hospital, Stockholm, Sweden. To understand the challenges faced by nurses and physicians in the treatment of patients co-infected with the human immunodeficiency virus (HIV) and tuberculosis (TB), with special focus on opportunities for information and communication technology. Using a qualitative study design, on-site observations and informal discussions were carried out to become acquainted with the clinical context. Seven nurses and six physicians were purposefully selected to participate in one-to-one in-depth interviews inspired by cognitive task analysis. Interviews were audio recorded and transcribed verbatim, and analysed using inductive thematic analysis. Care providers faced challenges related to 1) the complexities inherent to TB-HIV co-treatment, 2) clinical knowledge and task standardisation, 3) care coordination and collaboration, 4) information management, and 5) engaging patients in their treatment. Support is needed on several levels to address the emerging burden of TB-HIV coinfection in Sweden. Educational material and tools need to be further developed to support care providers in making decisions about adequate care, and to support collaborative activities and communication among patients and care providers. Information and communication technology based solutions may provide an opportunity to address some of these challenges.

USGS Science: Addressing Our Nation's Challenges

USGS Publications Warehouse

Larson, Tania M.

2009-01-01

With 6.6 billion people already living on Earth, and that number increasing every day, human influence on our planet is ever more apparent. Changes to the natural world combined with increasing human demands threaten our health and safety, our national security, our economy, and our quality of life. As a planet and a Nation, we face unprecedented challenges: loss of critical and unique ecosystems, the effects of climate change, increasing demand for limited energy and mineral resources, increasing vulnerability to natural hazards, the effects of emerging diseases on wildlife and human health, and growing needs for clean water. The time to respond to these challenges is now, but policymakers and decisionmakers face difficult choices. With competing priorities to balance, and potentially serious - perhaps irreversible - consequences at stake, our leaders need reliable scientific information to guide their decisions. As the Nation's earth and natural science agency, the USGS monitors and conducts scientific research on natural hazards and resources and how these elements and human activities influence our environment. Because the challenges we face are complex, the science needed to better understand and deal with these challenges must reflect the complex interplay among natural and human systems. With world-class expertise in biology, geology, geography, hydrology, geospatial information, and remote sensing, the USGS is uniquely capable of conducting the comprehensive scientific research needed to better understand the interdependent interactions of Earth's systems. Every day, the USGS helps decisionmakers to minimize loss of life and property, manage our natural resources, and protect and enhance our quality of life. This brochure provides examples of the challenges we face and how USGS science helps decisionmakers to address these challenges.

The challenges faced by living stock collections in the USA.

PubMed

McCluskey, Kevin; Boundy-Mills, Kyria; Dye, Greg; Ehmke, Erin; Gunnell, Gregg F; Kiaris, Hippokratis; Polihronakis Richmond, Maxi; Yoder, Anne D; Zeigler, Daniel R; Zehr, Sarah; Grotewold, Erich

2017-03-13

Many discoveries in the life sciences have been made using material from living stock collections. These collections provide a uniform and stable supply of living organisms and related materials that enhance the reproducibility of research and minimize the need for repetitive calibration. While collections differ in many ways, they all require expertise in maintaining living organisms and good logistical systems for keeping track of stocks and fulfilling requests for specimens. Here, we review some of the contributions made by living stock collections to research across all branches of the tree of life, and outline the challenges they face.

An exploration of opportunities and challenges facing cervical cancer managers in Kenya

PubMed Central

2013-01-01

Background Kenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers’ perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes. Findings Four themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya. Conclusion Kenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored. PMID:23566436

Challenges and motivators to physical activity faced by retired men when ageing: a qualitative study.

PubMed

Bredland, Ebba Langum; Söderström, Sylvia; Vik, Kjersti

2018-05-15

Active ageing reflects the message from World Health Organisation about addressing the challenge faced by the rapidly ageing population. Knowledge about barriers and facilitators to an active lifestyle must be given more attention. In addition, men seem to participate less in cultural activities and less in fall-prevention groups than women do. When mostly women work with the elderly in primary care, one might question whether the activities offered to older men meet their activity preferences. The aim of this study is to provide new knowledge about challenges and motivators encountered by retired men in maintaining physical activity when ageing. Nine retired men, aged between 66 and 83, wrote a Time Geographic Diary for 7 days each. Two focus group discussions with the men were held. A Systemic Text Condensation was used to analyse the data. The analyses identified three categories to describe challenges in being physical active: differences between men and women; meaningful physical activity; and environmental - especially socio-cultural - constraints. Motivating conditions were seen as: new activities to get younger friends, and more information about how to cope. To achieve the aim of active ageing, service providers as well as local authorities need to have a better understanding of the challenges retired men encounter when ageing. This study highlights vital aspects of the challenges faced by retired men in maintaining their physical activity level.

A Zone for Deliberation? Methodological Challenges in Fields of Political Unrest

ERIC Educational Resources Information Center

Westrheim, Kariane; Lillejord, Solvi

2007-01-01

This article outlines certain problems and challenges facing the qualitative researcher who enters fields that are either extremely difficult to access or potentially hostile towards outsiders. Problems and dilemmas in such contexts are highlighted by reference to fieldwork research among PKK (Kurdistan Worker's Party) guerrillas in North…

Communicating Difficult and Taboo Information: A How-To Guide for Commanders.

PubMed

Moosey, Matthew

2016-01-01

Military commanders frequently mention that communicating difficult or taboo information is especially challenging. In the context of gender-integrated ground combat service there may be additional communication challenges for military commanders who may be unaccustomed to leading both men and women. Often, military commanders must communicate and deliver difficult information, or information that causes a negative emotional response from the communicator or the intended audience. This article is intended to identify some of these challenges and present practical examples and tips for military commanders to effectively communicate difficult or taboo topics and information. In addition, this article is a call for communication experts to reach out to military leaders and offer appropriate assistance in facilitating and delivering difficult communication. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

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

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

The challenges facing midwifery educators in sustaining a future education workforce.

PubMed

Albarran, John W; Rosser, Elizabeth A

2014-08-01

national and international trends have identified concerns over the ability of health and social care workforces in meeting the needs of service users. Attention has increasingly been drawn to problems of recruiting and retaining professionals within higher education; however data in relation to the midwifery profession is scant. to examine the perceptions and experiences of midwifery educators, in south-west England, about the challenges facing them sustaining the education workforce of the future. a mixed methodology approach was adopted involving heads of midwifery education and midwife educators. midwifery participants were recruited from three higher education institutions in south west England. Data collection comprised of self-administered questionnaires plus individual qualitative interviews with heads of midwifery education (n=3), and tape recorded focus groups with midwife academics (n=19). Numerical data were analysed using descriptive statistics. Textual data were analysed for themes that represented the experiences and perspectives of participants. Ethics approval was granted by one University Ethics committee. demographic data suggests that within south-west England, there is a clear ageing population and few in possession of a doctorate within midwifery. The six identified sub-themes represented in the data describe challenges and tensions that midwifery academics experienced in their efforts to attract new recruits and retain those in post in a highly changing educational environment which demands more from a contracting workforce. there remain some serious challenges facing midwifery educators in sustaining the future education workforce, which if unresolved may jeopardise standards of education and quality of care women receive. Active succession planning and more radical approaches that embrace flexible careers will enable educational workforce to be sustained and by a clinically credible and scholarly orientated midwifery workforce. Copyright �

"Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia"

ERIC Educational Resources Information Center

de Lange, Paul; Watty, Kim

2011-01-01

Of the various reports released in 2010, two purport to examine the state of accounting education in Australia. These are "Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia". Both were released as collaborations of the leading academic organisation, the Accounting and Finance…

Energy conservation using face detection

NASA Astrophysics Data System (ADS)

Deotale, Nilesh T.; Kalbande, Dhananjay R.; Mishra, Akassh A.

2011-10-01

Computerized Face Detection, is concerned with the difficult task of converting a video signal of a person to written text. It has several applications like face recognition, simultaneous multiple face processing, biometrics, security, video surveillance, human computer interface, image database management, digital cameras use face detection for autofocus, selecting regions of interest in photo slideshows that use a pan-and-scale and The Present Paper deals with energy conservation using face detection. Automating the process to a computer requires the use of various image processing techniques. There are various methods that can be used for Face Detection such as Contour tracking methods, Template matching, Controlled background, Model based, Motion based and color based. Basically, the video of the subject are converted into images are further selected manually for processing. However, several factors like poor illumination, movement of face, viewpoint-dependent Physical appearance, Acquisition geometry, Imaging conditions, Compression artifacts makes Face detection difficult. This paper reports an algorithm for conservation of energy using face detection for various devices. The present paper suggests Energy Conservation can be done by Detecting the Face and reducing the brightness of complete image and then adjusting the brightness of the particular area of an image where the face is located using histogram equalization.

What Makes Difficult History Difficult?

ERIC Educational Resources Information Center

Gross, Magdalena H.; Terra, Luke

2018-01-01

All modern nation-states have periods of difficult history that teachers fail to address or address inadequately. The authors present a framework for defining difficult histories and understanding what makes them difficult. These events 1) are central to a nation's history, 2) contradict accepted histories or values, 3) connect with present…

The challenges faced by living stock collections in the USA

PubMed Central

McCluskey, Kevin; Boundy-Mills, Kyria; Dye, Greg; Ehmke, Erin; Gunnell, Gregg F; Kiaris, Hippokratis; Polihronakis Richmond, Maxi; Yoder, Anne D; Zeigler, Daniel R; Zehr, Sarah; Grotewold, Erich

2017-01-01

Many discoveries in the life sciences have been made using material from living stock collections. These collections provide a uniform and stable supply of living organisms and related materials that enhance the reproducibility of research and minimize the need for repetitive calibration. While collections differ in many ways, they all require expertise in maintaining living organisms and good logistical systems for keeping track of stocks and fulfilling requests for specimens. Here, we review some of the contributions made by living stock collections to research across all branches of the tree of life, and outline the challenges they face. DOI: http://dx.doi.org/10.7554/eLife.24611.001 PMID:28266913

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

PubMed

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

2016-02-29

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

Rural Teachers' Views: What Are Gender-Based Challenges Facing Free Primary Education in Lesotho?

ERIC Educational Resources Information Center

Morojele, Pholoho

2013-01-01

This paper gives prominence to rural teachers' accounts of gender-based challenges facing Free Primary Education in Lesotho. It draws on feminist interpretations of social constructionism to discuss factors within the Basotho communities that affect gender equality in the schools. The inductive analysis offered makes use of the data generated from…

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

ERIC Educational Resources Information Center

Coope, Caroline M.; Theobald, Sally

2006-01-01

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

The role of public-private partnerships in addressing the biomedical innovation challenge.

PubMed

Said, Maya; Zerhouni, Elias

2014-11-01

Without a step change in the productivity of pharmaceutical research and development, it will be difficult to tackle the public health challenges facing societies worldwide. Public–private partnerships could play a key role in achieving this step change, but they need to be well designed and led.

Facing Our Energy Challenges in a New Era of Science (2011 EFRC Forum)

ScienceCinema

Dehmer, Patricia M.

2018-04-26

Patricia Dehmer, Deputy Director for Science Programs at DOE, opened the May 26, 2011 EFRC Forum session, 'Global Perspectives on Frontiers in Energy Research,' with the talk, 'Facing Our Energy Challenges in a New Era of Science.' In her presentation, Dr. Dehmer gave a tutorial on the energy challenges facing our Nation and showed how the DOE research portfolio addresses those issues. The 2011 EFRC Summit and Forum brought together the EFRC community and science and policy leaders from universities, national laboratories, industry and government to discuss 'Science for our Nation's Energy Future.' In August 2009, the Office of Science established 46 Energy Frontier Research Centers. The EFRCs are collaborative research efforts intended to accelerate high-risk, high-reward fundamental research, the scientific basis for transformative energy technologies of the future. These Centers involve universities, national laboratories, nonprofit organizations, and for-profit firms, singly or in partnerships, selected by scientific peer review. They are funded at $2 to $5 million per year for a total planned DOE commitment of $777 million over the initial five-year award period, pending Congressional appropriations. These integrated, multi-investigator Centers are conducting fundamental research focusing on one or more of several 'grand challenges' and use-inspired 'basic research needs' recently identified in major strategic planning efforts by the scientific community. The purpose of the EFRCs is to integrate the talents and expertise of leading scientists in a setting designed to accelerate research that transforms the future of energy and the environment.

Challenges facing the distribution of an artificial-intelligence-based system for nursing.

PubMed

Evans, S

1985-04-01

The marketing and successful distribution of artificial-intelligence-based decision-support systems for nursing face special barriers and challenges. Issues that must be confronted arise particularly from the present culture of the nursing profession as well as the typical organizational structures in which nurses predominantly work. Generalizations in the literature based on the limited experience of physician-oriented artificial intelligence applications (predominantly in diagnosis and pharmacologic treatment) must be modified for applicability to other health professions.

Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study.

PubMed

Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

2016-01-01

While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling's thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers' insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for healthcare

Oral Academic Discourse Socialisation: Challenges Faced by International Undergraduate Students in a Malaysian Public University

ERIC Educational Resources Information Center

Mahfoodh, Omer Hassan Ali

2014-01-01

This paper reports a qualitative study which examines the challenges faced by six international undergraduate students in their socialisation of oral academic discourse in a Malaysian public university. Data were collected employing interviews. Students' presentations were also collected. Semi-structured interviews were transcribed verbatim and…

Note-Taking and Secondary Students with Learning Disabilities: Challenges and Solutions

ERIC Educational Resources Information Center

Boyle, Joseph R.

2012-01-01

As more secondary students with learning disabilities (LD) enroll in advanced content-area classes and are expected to pass state exams, they are faced with the challenge of mastering difficult concepts and abstract vocabulary while learning content. Once in these classes, students must learn from lectures that move at a quick pace, record…

Western United States Dams Challenges Faced, Options, and Opportunities

NASA Astrophysics Data System (ADS)

Raff, D.

2017-12-01

Water management in the Western United States relies significantly upon a fleet of small to very large engineered dams to store water during times of runoff and distribute that water during times of need. Much of this infrastructure is Federally owned and/or operated, and was designed and funded during the first half of the twentieth century through a complex set of repayment contracts for Federally authorized purposes addressing water supply, recreation, and hydropower, and other water management objectives. With environmental laws, namely the Endangered Species Act, and other environmental concerns taking a more active role in water resources in the mid to latter half of the twentieth century, this infrastructure is being stressed even greater than anticipated to provide authorized purposes. Additionally, weather and climate norms being experienced are certainly near the edges, if not outside, of anticipated variability in the climate and hydrology scenarios for which the infrastructure was designed. And, finally, these dams, economically designed for a lifespan of 50 - 100 years, are experiencing maintenance challenges from routine to significant. This presentation will focus on identifying some of the history and challenges facing the water infrastructure in the Western United States. Additionally, some perspectives on future paths to meet the needs of western irrigation and hydropower production will be provided.

Challenges and issues facing the future of nursing education: implications for ethnic minority faculty and students.

PubMed

Davis, Sheila P; Davis, Danyetta D

2010-01-01

Current trends in higher education in the United States demand that nursing take stock of how it is prepared or being prepared to face challenges and issues impacting on its future. The intense effort made to attract students to pursue advanced training in science and engineering in the United States pales in comparison to the numbers of science and engineering majors produced yearly in international schools. As a result, more and more jobs are being outsourced to international markets. Could international outsourcing become a method of nursing education? Authors submit that to remain competitive, the nursing profession must attract a younger cohort of technologically savvy students and faculty reflective of the growing diverse population in the United States. Additionally, nursing programs in research universities face even more daunting challenges as it relates to mandates for funded research programs of educational units. This article offers suggestions and recommendations for nursing programs in higher education institutions on ways to attract and retain ethnic minorities and of how to harness the power of research to address burgeoning societal health challenges.

Fixed and Growth Mindset in Education and How Grit Helps Students Persist in the Face of Adversity

ERIC Educational Resources Information Center

Hochanadel, Aaron; Finamore, Dora

2015-01-01

Students face a wealth of challenges in college for example a lack of support, sometimes making it difficult to persevere. However, in an academic environment that teaches grit and fosters growth, students can learn to persist. Those who believe intelligence is fixed and cannot be changed exert less effort to succeed. Students who persevere when…

[Brazilian Army nurses and transportation of the wounded: a challenge faced during World War II].

PubMed

Bernardes, Margarida Maria Rocha; Lopes, Gertrudes Teixeira

2007-01-01

This historic-sociologic study aims to analyse the challenges faced by the Brazilian Expeditionary Force's Air Transportation Nurses of the Army with the Theatre of Operations on the course of World War II. The primary source was comprised of a photograph from this time period and oral testimonies of those who participated in the conflict. Ideas by sociologist Pierre Bourdieu support the discussion. Results suggest that Brazilian nurses were challenged to transport the wounded without medical advice. We conclude that the challenge to fulfill the task imposed, which led to independent decision-making, gave confidence and autonomy to the ones already responsible for the transportation of the wounded.

Information Technology Challenges Facing the Strategic Leaders of Homeland Security in the 21st Century

DTIC Science & Technology

2004-05-03

A special thanks to all of these folks (Glenn Starnes, Lee Gutierrez, Bill Rapp, Joel Hillison, Carlos Gomez, Steve Fraunfelter, Janie Hopkins, Dave ...DiClemente, Joe Nunez, John Bonin , and Steve Nerheim). viii INFORMATION TECHNOLOGY CHALLENGES FACING THE STRATEGIC LEADERS OF HOMELAND SECURITY IN THE 21ST

Challenges Faced by Teachers Implementing Socio-Scientific Issues as Core Elements in Their Classroom Practices

ERIC Educational Resources Information Center

Bossér, Ulrika; Lundin, Mattias; Lindahl, Mats; Linder, Cedric

2015-01-01

Teachers may face considerable challenges when implementing socio-scientific issues (SSI) in their classroom practices, such as incorporating student-centred teaching practices and exploring knowledge and values in the context of socioscientific issues. This year-long study explores teachers' reflections on the process of developing their…

Challenges Pre-Service Teachers Face When Implementing a 5E Inquiry Model of Instruction

ERIC Educational Resources Information Center

Enugu, Ramya; Hokayem, Hayat

2017-01-01

This study examined the challenges that pre-service teachers faced when implementing inquiry and their perspective on how to overcome them. The data sample was 55 pre-service teachers (PSTs) enrolled into two sections of a science methods course in a private university in North Texas. The data sources consisted of inquiry-based lesson plans, PST…

Teaching Difficult Topics with Primary Sources

ERIC Educational Resources Information Center

Potter, Lee Ann

2011-01-01

"Difficult" or "challenging" topics to teach include racism, violence, genocide, bullying, gangs, abuse (physical, emotional, and substance), slavery, suffering, hatred, terrorism, war, disease, loss, addiction, and more. But by confronting them with students, in the safety of a classroom through thoughtfully constructed lessons (ones that take…

Challenges Faced by Preceptors Serving in Dual Roles as Health Care Providers and Clinical Educators

ERIC Educational Resources Information Center

Dodge, Thomas; Mazerolle, Stephanie M.; Bowman, Thomas G.

2014-01-01

Context: Preceptors play an integral role in training athletic training students (ATSs). Balancing roles as health care providers and educators can often be challenging. Role strain is a documented concern for the preceptor, yet limited information is available regarding other issues faced while supervising ATSs. Objective: To explore preceptor…

Doing science in difficult socioeconomic circumstances.

PubMed

Karasmanis, Eva P

2018-06-01

Doing scientific research can be a challenging, but creative and rewarding career. However, the challenge of doing research is orders of magnitude more difficult for scientists lacking access to the necessary resources. Resource-scarce environments are quite common worldwide and are highly contingent on the financial and social climate of one's location. Through the experiences of four scientists, this Perspective explores the challenges associated with doing research in disadvantaged socioeconomic circumstances. By reflecting on the humble beginnings of these scientists, we examine the motivation to stay in or leave one's home country, and how hardships can be leveraged to cultivate passionate and productive researchers.

Game Face

ERIC Educational Resources Information Center

Weiner, Jill

2005-01-01

In this article, the author discusses "Game Face: Life Lessons Across the Curriculum", a teaching kit that challenges assumptions and builds confidence. Game Face, which is derived from a book and art exhibition, "Game Face: What Does a Female Athlete Look Like?", uses layered and powerful images of women and girls participating in sports to teach…

Talking about epilepsy: Challenges parents face when communicating with their child about epilepsy and epilepsy-related issues.

PubMed

O'Toole, Stephanie; Lambert, Veronica; Gallagher, Pamela; Shahwan, Amre; Austin, Joan K

2016-04-01

The aim of this qualitative study was to explore the challenges that parents of children with epilepsy experienced when engaging in dialog with their child about epilepsy and epilepsy-related issues. Using a qualitative exploratory approach, interviews were conducted with 34 parents of children with epilepsy (aged 6-16 years), consisting of 27 mothers and 7 fathers. Data were transcribed verbatim and thematically analyzed. Findings revealed five main themes: normalizing epilepsy, the invisibility of epilepsy, information concealment, fear of misinforming the child, and difficulty in discussing particular epilepsy-related issues. Many of the communicative challenges experienced by parents impacted on their ability to engage openly in parent-child dialog about epilepsy in the home. Parents face specific challenges when choosing to communicate with their child about epilepsy, relating to creating a sense of normality, reducing fear of causing their child worry, and having a lack of epilepsy-related knowledge. Healthcare professionals who work closely with families living with epilepsy should remain mindful of the importance of discussing family communication surrounding epilepsy and the challenges parents of children with epilepsy face when talking about epilepsy within the home. Copyright © 2016 Elsevier Inc. All rights reserved.

Immigrant to Canada, newcomer to childhood cancer: a qualitative study of challenges faced by immigrant parents.

PubMed

Klassen, Anne F; Gulati, Sonia; Watt, Lisa; Banerjee, Ananya T; Sung, Lillian; Klaassen, Robert J; Dix, David; Poureslami, Iraj M; Shaw, Nicola

2012-05-01

Given the increasing numbers of immigrant families in Canada, it is imperative that healthcare providers (HCPs) understand the caregiving experiences of immigrant family caregivers. Our study aimed to explore any special challenges faced by immigrant parents of children with cancer and to identify supportive factors. A constructivist grounded theory approach was used. Participants included 50 first generation Chinese and South Asian parents of children with cancer who were at least six months post-diagnosis. Recruitment took place at six Canadian pediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi. Analysis involved coding and the use of the constant comparison method. Interviewing continued until no new themes emerged. While immigrant parents described many challenges faced by any parent of a child with cancer, the context of being an immigrant made certain experiences particularly challenging. Parents described challenges in the following areas: managing caregiving demand and financial strain, accessing support from others, and interfacing with the healthcare system. Parents described receiving a range of practical, emotional, social and informational support from extended family, their workplace, other cancer families, community organizations and HCPs. Our study addresses an important gap in the research literature by providing practical insight into the experiences of immigrant family caregivers. Our findings may help to inform the development of pediatric oncology policies and programs in ways that respond to the unique needs and challenges of culturally and linguistically diverse families. Copyright © 2011 John Wiley & Sons, Ltd.

Applied Theatre Facilitates Dialogue about Career Challenges for Scientists.

PubMed

Segarra, Verónica A; Zavala, MariaElena; Hammonds-Odie, Latanya

2017-04-01

The design of programs in support of a strong, diverse, and inclusive scientific workforce and academe requires numerous difficult conversations about sensitive topics such as the challenges scientists can face in their professional development. Theatre can be an interactive and effective way to foster discussion around such subjects. This article examines the implementation and benefits of such interactive strategies in different contexts, including the benefits of getting early career academics and professionals talking about some of the situations that women and underrepresented minorities face in the workplace, while allowing more seasoned professionals and colleagues to join in the conversation.

Applied Theatre Facilitates Dialogue about Career Challenges for Scientists†

PubMed Central

Segarra, Verónica A.; Zavala, MariaElena; Hammonds-Odie, Latanya

2017-01-01

The design of programs in support of a strong, diverse, and inclusive scientific workforce and academe requires numerous difficult conversations about sensitive topics such as the challenges scientists can face in their professional development. Theatre can be an interactive and effective way to foster discussion around such subjects. This article examines the implementation and benefits of such interactive strategies in different contexts, including the benefits of getting early career academics and professionals talking about some of the situations that women and underrepresented minorities face in the workplace, while allowing more seasoned professionals and colleagues to join in the conversation. PMID:28656070

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

PubMed

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

2013-06-01

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

Challenges Facing Crop Production And (Some) Potential Solutions

NASA Astrophysics Data System (ADS)

Schnable, P. S.

2017-12-01

To overcome some of the myriad challenges facing sustainable crop production we are seeking to develop statistical models that will predict crop performance in diverse agronomic environments. Crop phenotypes such as yield and drought tolerance are controlled by genotype, environment (considered broadly) and their interaction (GxE). As a consequence of the next generation sequencing revolution genotyping data are now available for a wide diversity of accessions in each of the major crops. The necessary volumes of phenotypic data, however, remain limiting and our understanding of molecular basis of GxE is minimal. To address this limitation, we are collaborating with engineers to construct new sensors and robots to automatically collect large volumes of phenotypic data. Two types of high-throughput, high-resolution, field-based phenotyping systems and new sensors will be described. Some of these technologies will be introduced within the context of the Genomes to Fields Initiative. Progress towards developing predictive models will be briefly summarized. An administrative structure that fosters transdisciplinary collaborations will be briefly described.

First liver transplant in Qatar: an evolving program facing many challenges.

PubMed

Khalaf, Hatem; Derballa, Moataz; Elmasry, Mohammed; Khalil, Ahmed; Yakoob, Rafie; Almohannadi, Muneera; Almaslamani, Muna; Fadhil, Riadh; Al-Kaabi, Saad; Al-Ansari, Abdulla; Almaslamani, Yousuf

2013-10-01

Beginning to do liver transplants in a developing country is challenging. We report on the first few liver transplants performed in Qatar and discuss future exceptions and challenges facing our program. The first liver transplant was performed in Qatar on December 6, 2011. Since starting the program, 4 deceased-donor liver transplants have been performed in Qatar. All recipients underwent a standard deceased-donor liver transplant procedure, which included a duct-to-duct biliary anastomosis without a veno-venous bypass. All liver transplants were performed at the Hamad Medical Corporation by a local team of surgeons without external assistance. The 4 patients were all men, with a median age of 56 years (age range, 46-63 y). Indications for liver transplant included hepatitis C cirrhosis in 2 patients, and 1 patient with hepatitis B cirrhosis with hepatocellular carcinoma, and the other patient with cryptogenic liver cirrhosis. Median amount of blood transfused was 6 units (range, 0-10 U); median time spent in the intensive care unit was 2 days (range, 2-5 d); median amount of time spent in the hospital was 10 days (range, 9-16 d). All 4 recipients have survived after a median follow-up of 438 days (range, 33-602 d) and are enjoying a healthy life, with no significant posttransplant complications. A deceased-donor liver transplant can be performed in Qatar with no external assistance. However, a severe organ shortage remains the biggest obstacle facing us. Efforts should be directed toward improving the number and quality of available deceased donors in Qatar. Meanwhile, live-donor liver transplant may be the only way for us, going forward, to prevent deaths on the waiting list.

Guidelines and algorithms for managing the difficult airway.

PubMed

Gómez-Ríos, M A; Gaitini, L; Matter, I; Somri, M

2018-01-01

The difficult airway constitutes a continuous challenge for anesthesiologists. Guidelines and algorithms are key to preserving patient safety, by recommending specific plans and strategies that address predicted or unexpected difficult airway. However, there are currently no "gold standard" algorithms or universally accepted standards. The aim of this article is to present a synthesis of the recommendations of the main guidelines and difficult airway algorithms. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Challenges Facing Group Work Online

ERIC Educational Resources Information Center

Chang, Bo; Kang, Haijun

2016-01-01

Online group work can be complicated because of its asynchronous characteristics and lack of physical presence, and its requirements for skills in handling technology, human relationships, and content-related tasks. This study focuses on the administrative, logistical and relationship-related challenges in online group work. Challenges in areas…

A Short Twenty Years: Meeting the Challenges Facing Teachers Who Bring Rwanda into the Classroom

ERIC Educational Resources Information Center

Gudgel, Mark

2013-01-01

As the twentieth anniversary of the 1994 genocide in Rwanda approaches, Mark Gudgel argues that we should face the challenges posed by teaching about Rwanda. Drawing on his experience as a history teacher in the US, his experience researching and supporting others' classrooms in the US and UK, his training in Holocaust education and his knowledge…

Tolerance for distorted faces: challenges to a configural processing account of familiar face recognition.

PubMed

Sandford, Adam; Burton, A Mike

2014-09-01

Face recognition is widely held to rely on 'configural processing', an analysis of spatial relations between facial features. We present three experiments in which viewers were shown distorted faces, and asked to resize these to their correct shape. Based on configural theories appealing to metric distances between features, we reason that this should be an easier task for familiar than unfamiliar faces (whose subtle arrangements of features are unknown). In fact, participants were inaccurate at this task, making between 8% and 13% errors across experiments. Importantly, we observed no advantage for familiar faces: in one experiment participants were more accurate with unfamiliars, and in two experiments there was no difference. These findings were not due to general task difficulty - participants were able to resize blocks of colour to target shapes (squares) more accurately. We also found an advantage of familiarity for resizing other stimuli (brand logos). If configural processing does underlie face recognition, these results place constraints on the definition of 'configural'. Alternatively, familiar face recognition might rely on more complex criteria - based on tolerance to within-person variation rather than highly specific measurement. Copyright © 2014 Elsevier B.V. All rights reserved.

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

Treesearch

Christine Esposito

2006-01-01

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

Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study

PubMed Central

Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

2016-01-01

Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and

Challenges faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe: The case of Chitungwiza town

PubMed Central

Maphosa, France

2017-01-01

Background Women with disabilities in Zimbabwe face numerous challenges in accessing sexual and reproductive health. Cultural belief still regards them as not sexually active. The government has also failed to promote policies that facilitate access to sexual and reproductive services by women with disabilities. Objectives The reseach objectives were to explore the challenges faced by women with disabilities in accessing sexual and reproductive health in Zimbabwe. Method The data were gathered using in-depth interviews with 23 purposively selected respondents. Thirteen women had physical disabilities, five were visually impaired, three were deaf and two were stammering. The respondents with physical disabilities were using wheelchairs, walking frames, prosthesis, crutches and caliper shoes. The participants’ ages ranged from 18 to 45 years. All interviews were transcribed and translated verbatim into English, and passages were extracted from the transcripts. Key themes and concepts were identified and coded to offer a rich framework for analysis, comparisons and presentation of the data. Results Negative perceptions of health personnel towards people with disabilities, disability-unfriendly infrastructure at health facilities and absence of trained personnel for people with disabilities (sign language) are some of the challenges involved. Conclusion The government, in partnership with other stakeholders, should address challenges faced by women with disabilities when accessing sexual and reproductive health services. Non-government, private hospitals and profit-making organisations should join hands with government in funding health requirements for women with disabilities. PMID:28730062

Droughts and water scarcity: facing challenges

NASA Astrophysics Data System (ADS)

Pereira, Luis S.

2014-05-01

Water scarcity characterizes large portions of the world, particularly the Mediterranean area. It is due to natural causes - climate aridity, which is permanent, and droughts, that are temporary - and to human causes - long term desertification and short term water shortages. Droughts aggravate water scarcity. Knowledge has well developed relative to all processes but management tools still are insufficient as well as the tools required to support appropriate planning and management. Particularly, new approaches on tools for assessing related impacts in agriculture and other economic and social activities are required. Droughts occur in all climates but their characteristics largely differ among regions both in terms frequency, duration and intensity. Research has already produced a large number of tools that allow appropriate monitoring of droughts occurrence and intensity, including dynamics of drought occurrence and time evolution. Advances in drought prediction already are available but we still are far from knowing when a drought will start, how it will evolve and when it dissipates. New developments using teleconnections and GCM are being considered. Climate change is a fact. Are droughts occurrence and severity changing with global change? Opinions are divided about this subject since driving factors and processes are varied and tools for the corresponding analysis are also various. Particularly, weather data series are often too short for obtaining appropriate answers. In a domain where research is producing improved knowledge and innovative approaches, research faces however a variety of challenges. The main ones, dealt in this keynote, refer to concepts and definitions, use of monitoring indices, prediction of drought initiation and evolution, improved assessment of drought impacts, and possible influence of climate change on drought occurrence and severity.

Public health in Canada: a difficult history.

PubMed

Mowat, David L; Butler-Jones, David

2007-01-01

Although the outbreak of severe acute respiratory syndrome in 2003 was the event that focused attention on Canada's capacity in public health, there have been, and will be, many other public health challenges, not just in the form of outbreaks but of a diverse set of threats to health, both infectious and non-infectious. Like many other countries, Canada must face the challenge of building and sustaining the capacity to respond to this broad range of challenges. Recently, there has been an emphasis on strengthening the public health infrastructure, including inter-jurisdictional agreements, research, knowledge translation, information systems and the workforce.

[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.

United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

USGS Publications Warehouse

Updike, Randall G.; Ellis, Eugene G.; Page, William R.; Parker, Melanie J.; Hestbeck, Jay B.; Horak, William F.

2013-01-01

Along the nearly 3,200 kilometers (almost 2,000 miles) of the United States–Mexican border, in an area known as the Borderlands, we are witnessing the expression of the challenges of the 21st century. This circular identifies several challenge themes and issues associated with life and the environment in the Borderlands, listed below. The challenges are not one-sided; they do not originate in one country only to become problems for the other. The issues and concerns of each challenge theme flow in both directions across the border, and both nations feel their effects throughout the Borderlands and beyond. The clear message is that our two nations, the United States and Mexico, face the issues in these challenge themes together, and the U.S. Geological Survey (USGS) understands it must work with its counterparts, partners, and customers in both countries.Though the mission of the USGS is not to serve as land manager, law enforcer, or code regulator, its innovation and creativity and the scientific and technical depth of its capabilities can be directly applied to monitoring the conditions of the landscape. The ability of USGS scientists to critically analyze the monitored data in search of signals and trends, whether they lead to negative or positive results, allows us to reach significant conclusions—from providing factual conclusions to decisionmakers, to estimating how much of a natural resource exists in a particular locale, to predicting how a natural hazard phenomenon will unfold, to forecasting on a scale from hours to millennia how ecosystems will behave.None of these challenge themes can be addressed strictly by one or two science disciplines; all require well-integrated, cross-discipline thinking, data collection, and analyses. The multidisciplinary science themes that have become the focus of the USGS mission parallel the major challenges in the border region between Mexico and the United States. Because of this multidisciplinary approach, the USGS

Challenges that nurses face in caring for morbidly obese patients in the acute care setting.

PubMed

Drake, Daniel; Dutton, Kathy; Engelke, Martha; McAuliffe, Maura; Rose, Mary Ann

2005-01-01

Despite increasing numbers of morbidly obese patients admitted to acute care facilities for surgery or treatment of nonsurgical conditions, there is little evidence of the problems nurses face in providing care to these patients. Anecdotal evidence suggests that the care of these patients is more demanding than the care of nonobese patients. The objective of this study was to describe nurses' perceptions of the challenges that they face when caring for morbidly obese patients. Focus groups of nurses from a tertiary care facility were convened. A trained facilitator posed questions to the group concerning various aspects of care for morbidly obese patients. Comments of respondents were categorized using NVIVO software. Nurses reported concerns about the increased staffing needs required for care of these patients and the particular challenges of the physical care. Concerns also included the availability, placement, and use of specialized equipment. Room size and the absence of some equipment were also problematic. Finally, nurses perceived safety issues, both for themselves and their patients. Morbidly obese patients in the acute care setting require specialized nursing care in terms of techniques, levels of staffing required, and the use of specialized equipment.

Web-Based vs. Face-to-Face MBA Classes: A Comparative Assessment Study

ERIC Educational Resources Information Center

Brownstein, Barry; Brownstein, Deborah; Gerlowski, Daniel A.

2008-01-01

The challenges of online learning include ensuring that the learning outcomes are at least as robust as in the face-to-face sections of the same course. At the University of Baltimore, both online sections and face-to-face sections of core MBA courses are offered. Once admitted to the MBA, students are free to enroll in any combination of…

Challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia.

PubMed

Walubita, Mulima; Sikateyo, Bornwell; Zulu, Joseph M

2018-05-02

Zambia is experiencing high prevalence of childhood cancer. However, very few children access and complete treatment for cancer. This study aimed to document the challenges for health care providers, parents and patients who face a child hood cancer diagnosis in Zambia, and their coping strategies. This was an exploratory health facility-based qualitative study that was conducted at a Paediatric oncology ward at referral hospital in Zambia. In-depth individual interviews conducted with fifteen (15) caregivers and seven (7) key informants were analysed using thematic analysis. Several challenges related to managing the childhood cancer diagnosis were recorded. Individual and family challenges were inadequate knowledge on childhood cancer, lack of finances to meet treatment and transport costs as well as long period of hospitalisation that affected women's ability to perform multiple responsibilities. Whereas challenges at community level were inadequate support to address emotional and physical distress and social stigmatisation experienced by caregivers. Health systems issues included inadequate specialised health workers, poor communication among health workers, limited space and beds as well as insufficient supplies such as blood. Cultural related factors were the belief that cancer is a product of witchcraft as well as religious beliefs regarding the role of faith healing in childhood cancer treatment. Coping strategies used by parents/ caregivers included praying to God, material support from organisations and church as well as delaying having another child. Addressing the challenges for health care providers, parents and patients who face a childhood cancer diagnosis may require adopting a systems or an ecological approach that allows developing strategies that simultaneously address challenges related to the individual, family, community, health system and cultural aspects.

Information Technology and the Informed Citizen: New Challenges for Government and Libraries. ERIC Digest.

ERIC Educational Resources Information Center

White, Charles S.

Arguing that the foundation of a free civilization is an informed citizenry, this ERIC digest discusses the new challenges faced by the government and libraries in the wake of the Information Age. As electronic technology has accelerated the production and transmission of information, it has become more difficult for the average citizen to access,…

The Challenges Facing the Implementation of Early Childhood Development and Education Policy in Bungoma County, Kenya

ERIC Educational Resources Information Center

Wangila, Violet Muyoka

2017-01-01

This paper scrutinises the challenges facing the implementation of Early Childhood Development and Education policy in Bungoma County, Kenya. The study used a mixed research design and study population comprised of the QASOs, the Head teachers, ECDE teachers and the non-teaching staff in respective ECDCs. The sample size of the study comprised of…

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Challenges Facing Design and Analysis Tools

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Broduer, Steve (Technical Monitor)

2001-01-01

The design and analysis of future aerospace systems will strongly rely on advanced engineering analysis tools used in combination with risk mitigation procedures. The implications of such a trend place increased demands on these tools to assess off-nominal conditions, residual strength, damage propagation, and extreme loading conditions in order to understand and quantify these effects as they affect mission success. Advances in computer hardware such as CPU processing speed, memory, secondary storage, and visualization provide significant resources for the engineer to exploit in engineering design. The challenges facing design and analysis tools fall into three primary areas. The first area involves mechanics needs such as constitutive modeling, contact and penetration simulation, crack growth prediction, damage initiation and progression prediction, transient dynamics and deployment simulations, and solution algorithms. The second area involves computational needs such as fast, robust solvers, adaptivity for model and solution strategies, control processes for concurrent, distributed computing for uncertainty assessments, and immersive technology. Traditional finite element codes still require fast direct solvers which when coupled to current CPU power enables new insight as a result of high-fidelity modeling. The third area involves decision making by the analyst. This area involves the integration and interrogation of vast amounts of information - some global in character while local details are critical and often drive the design. The proposed presentation will describe and illustrate these areas using composite structures, energy-absorbing structures, and inflatable space structures. While certain engineering approximations within the finite element model may be adequate for global response prediction, they generally are inadequate in a design setting or when local response prediction is critical. Pitfalls to be avoided and trends for emerging analysis tools

Nanomaterials for Polymer Electrolyte Membrane Fuel Cells; Materials Challenges Facing Electrical Energy Storate

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

Gopal Rao, MRS Web-Editor; Yury Gogotsi, Drexel University; Karen Swider-Lyons, Naval Research Laboratory

Symposium T: Nanomaterials for Polymer Electrolyte Membrane Fuel Cells Polymer electrolyte membrane (PEM) fuel cells are under intense investigation worldwide for applications ranging from transportation to portable power. The purpose of this seminar is to focus on the nanomaterials and nanostructures inherent to polymer fuel cells. Symposium topics will range from high-activity cathode and anode catalysts, to theory and new analytical methods. Symposium U: Materials Challenges Facing Electrical Energy Storage Electricity, which can be generated in a variety of ways, offers a great potential for meeting future energy demands as a clean and efficient energy source. However, the use ofmore » electricity generated from renewable sources, such as wind or sunlight, requires efficient electrical energy storage. This symposium will cover the latest material developments for batteries, advanced capacitors, and related technologies, with a focus on new or emerging materials science challenges.« less

All India Difficult Airway Association 2016 guidelines for the management of unanticipated difficult tracheal intubation in adults.

PubMed

Myatra, Sheila Nainan; Shah, Amit; Kundra, Pankaj; Patwa, Apeksh; Ramkumar, Venkateswaran; Divatia, Jigeeshu Vasishtha; Raveendra, Ubaradka S; Shetty, Sumalatha Radhakrishna; Ahmed, Syed Moied; Doctor, Jeson Rajan; Pawar, Dilip K; Ramesh, Singaravelu; Das, Sabyasachi; Garg, Rakesh

2016-12-01

The All India Difficult Airway Association (AIDAA) guidelines for management of the unanticipated difficult airway in adults provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in adults. They have been developed based on the available evidence; wherever robust evidence was lacking, or to suit the needs and situation in India, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the AIDAA and the Indian Society of Anaesthesiologists. We recommend optimum pre-oxygenation and nasal insufflation of 15 L/min oxygen during apnoea in all patients, and calling for help if the initial attempt at intubation is unsuccessful. Transnasal humidified rapid insufflations of oxygen at 70 L/min (transnasal humidified rapid insufflation ventilatory exchange) should be used when available. We recommend no more than three attempts at tracheal intubation and two attempts at supraglottic airway device (SAD) insertion if intubation fails, provided oxygen saturation remains ≥ 95%. Intubation should be confirmed by capnography. Blind tracheal intubation through the SAD is not recommended. If SAD insertion fails, one final attempt at mask ventilation should be tried after ensuring neuromuscular blockade using the optimal technique for mask ventilation. Failure to intubate the trachea as well as an inability to ventilate the lungs by face mask and SAD constitutes 'complete ventilation failure', and emergency cricothyroidotomy should be performed. Patient counselling, documentation and standard reporting of the airway difficulty using a 'difficult airway alert form' must be done. In addition, the AIDAA provides suggestions for the contents of a difficult airway cart.

[Clinical and health economic challenges of personalized medicine].

PubMed

Brüggenjürgen, B; Kornbluth, L; Ferrara, J V; Willich, S N

2012-05-01

Healthcare systems across the globe are currently challenged by aging populations, increases in chronic diseases and the difficult task of managing a healthcare budget. In this health economic climate, personalized medicine promises not only an improvement in healthcare delivery but also the possibility of more cost-effective therapies. It is important to remember, however, that personalized medicine has the potential to both increase and decrease costs. Each targeted therapy must be evaluated individually. However, standard clinical trial design is not suitable for personalized therapies. Therefore, both scientists and regulatory authorities will need to accept innovative study designs in order to validate personalized therapies. Hence correct economic evaluations are difficult to carry out due to lack of clear clinical evidence, longitudinal accounting and experience with patient/clinician behavior in the context of personalized medicine. In terms of reimbursement, payers, pharmaceutical companies and companion diagnostic manufacturers will also need to explore creative risk-sharing concepts. Germany is no exception to the challenges that face personalized medicine and for personalized medicine to really become the future of medicine many health economic challenges first need to be overcome. The health economic implications of personalized medicine remain unclear but it is certain that the expansion of targeted therapies in current healthcare systems will create a host of challenges.

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

PubMed

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

2018-05-09

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

Challenges faced by nurses in managing pain in a critical care setting.

PubMed

Subramanian, Pathmawathi; Allcock, Nick; James, Veronica; Lathlean, Judith

2012-05-01

To explore nurses' challenges in managing pain among ill patients in critical care. Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill. Qualitative prospective exploratory design. This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses. Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself. Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience. There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines. © 2011 Blackwell Publishing Ltd.

Challenges faced in rural hospitals: the experiences of nurse managers in Uganda.

PubMed

Kakyo, T A; Xiao, L D

2018-04-19

The aim of this study was to understand nurse ward managers perceived challenges in the rural healthcare setting in Uganda. The health workforce, essential medicines and equipment and political unrest are the main factors affecting the international community in addressing the hefty disease burden in World Health Organization African regions. Nurse ward managers have an important role to play to mitigate these factors in health facilities in these regions through leadership, supervision and support for staff. This study utilized interpretive phenomenology based on Gadamer's hermeneutical principles. Eleven nurse managers from two rural public hospitals in Uganda were interviewed. Those with more than a 2-year experience in their management role were invited to participate in the study. Nurse managers pointed out four major challenges with staffing, while they worked in the rural healthcare settings. These are summarized into themes: 'Numbers do matter'; 'I cannot access them when I need them at work'; 'Challenges in dealing with negative attitudes'; and 'Questioning own ability to manage health services'. Health facilities in rural areas face extremely low staff-to-patient ratio, a high level of workload, lack of essential medicines and equipment, low salaries and delayed payment for staff. Nurse managers demonstrated situation-based performance to minimize the impact of these challenges on the quality and safety of patient care, but they had less influence on policy and resource development. It is imperative to mobilize education for nurse ward managers to enable them to improve leadership, management skills and to have a greater impact on policy and resource development. © 2018 International Council of Nurses.

Feature extraction for face recognition via Active Shape Model (ASM) and Active Appearance Model (AAM)

NASA Astrophysics Data System (ADS)

Iqtait, M.; Mohamad, F. S.; Mamat, M.

2018-03-01

Biometric is a pattern recognition system which is used for automatic recognition of persons based on characteristics and features of an individual. Face recognition with high recognition rate is still a challenging task and usually accomplished in three phases consisting of face detection, feature extraction, and expression classification. Precise and strong location of trait point is a complicated and difficult issue in face recognition. Cootes proposed a Multi Resolution Active Shape Models (ASM) algorithm, which could extract specified shape accurately and efficiently. Furthermore, as the improvement of ASM, Active Appearance Models algorithm (AAM) is proposed to extracts both shape and texture of specified object simultaneously. In this paper we give more details about the two algorithms and give the results of experiments, testing their performance on one dataset of faces. We found that the ASM is faster and gains more accurate trait point location than the AAM, but the AAM gains a better match to the texture.

Facing the challenges and building solutions in clinical psychiatric nursing in Iran: a qualitative study.

PubMed

Zarea, Kourosh; Nikbakht-Nasrabadi, Alireza; Abbaszadeh, Abbas; Mohammadpour, Ali

2012-10-01

Psychiatric nurses play an important role in the process of caring for mentally ill patients and are continually faced with the numerous challenges and complex issues related to this field. This study aimed to understand the perspectives of psychiatric nurses regarding the issues they face while providing care and examine the possible solutions for improvement of inpatient care in clinical settings. The study adopted a qualitative approach that utilized a content analysis of audio taped, semi-structured interviews that had been conducted with 24 nurses. Two main themes emerged from the data. The first, Challenges in Providing Care within Psychiatric Wards, had the following subthemes: Politics and Rules of Organization, Safety and Security Issues, Uncertainty about the Role, Lack of Trained Staff, and Sociocultural Issues. The second theme, Solutions for Improving Psychiatric Care, had the subthemes of Empowerment across four domains: Psychiatric Nurses, Mentally Ill Patients and their Families, The Psychiatric Mental Health System, and the Cultural Context. The results indicated that if nurses are expected to provide optimal nursing care within a psychiatric ward, then there is a need for a stable and responsible organizational structure, skilled psychiatric nurses, and community-based care along with an anti-stigma program.

Challenges & Roadmap for Beyond CMOS Computing Simulation.

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

Rodrigues, Arun F.; Frank, Michael P.

Simulating HPC systems is a difficult task and the emergence of “Beyond CMOS” architectures and execution models will increase that difficulty. This document presents a “tutorial” on some of the simulation challenges faced by conventional and non-conventional architectures (Section 1) and goals and requirements for simulating Beyond CMOS systems (Section 2). These provide background for proposed short- and long-term roadmaps for simulation efforts at Sandia (Sections 3 and 4). Additionally, a brief explanation of a proof-of-concept integration of a Beyond CMOS architectural simulator is presented (Section 2.3).

Stable face representations

PubMed Central

Jenkins, Rob; Burton, A. Mike

2011-01-01

Photographs are often used to establish the identity of an individual or to verify that they are who they claim to be. Yet, recent research shows that it is surprisingly difficult to match a photo to a face. Neither humans nor machines can perform this task reliably. Although human perceivers are good at matching familiar faces, performance with unfamiliar faces is strikingly poor. The situation is no better for automatic face recognition systems. In practical settings, automatic systems have been consistently disappointing. In this review, we suggest that failure to distinguish between familiar and unfamiliar face processing has led to unrealistic expectations about face identification in applied settings. We also argue that a photograph is not necessarily a reliable indicator of facial appearance, and develop our proposal that summary statistics can provide more stable face representations. In particular, we show that image averaging stabilizes facial appearance by diluting aspects of the image that vary between snapshots of the same person. We review evidence that the resulting images can outperform photographs in both behavioural experiments and computer simulations, and outline promising directions for future research. PMID:21536553

Faces in Context: Does Face Perception Depend on the Orientation of the Visual Scene?

PubMed

Taubert, Jessica; van Golde, Celine; Verstraten, Frans A J

2016-10-01

The mechanisms held responsible for familiar face recognition are thought to be orientation dependent; inverted faces are more difficult to recognize than their upright counterparts. Although this effect of inversion has been investigated extensively, researchers have typically sliced faces from photographs and presented them in isolation. As such, it is not known whether the perceived orientation of a face is inherited from the visual scene in which it appears. Here, we address this question by measuring performance in a simultaneous same-different task while manipulating both the orientation of the faces and the scene. We found that the face inversion effect survived scene inversion. Nonetheless, an improvement in performance when the scene was upside down suggests that sensitivity to identity increased when the faces were more easily segmented from the scene. Thus, while these data identify congruency with the visual environment as a contributing factor in recognition performance, they imply different mechanisms operate on upright and inverted faces. © The Author(s) 2016.

Validated questionnaires heighten detection of difficult asthma comorbidities.

PubMed

Radhakrishna, Naghmeh; Tay, Tunn Ren; Hore-Lacy, Fiona; Stirling, Robert; Hoy, Ryan; Dabscheck, Eli; Hew, Mark

2017-04-01

Multiple extra-pulmonary comorbidities contribute to difficult asthma, but their diagnosis can be challenging and time consuming. Previous data on comorbidity detection have focused on clinical assessment, which may miss certain conditions. We aimed to locate relevant validated screening questionnaires to identify extra-pulmonary comorbidities that contribute to difficult asthma, and evaluate their performance during a difficult asthma evaluation. MEDLINE was searched to identify key extra-pulmonary comorbidities that contribute to difficult asthma. Screening questionnaires were chosen based on ease of use, presence of a cut-off score, and adequate validation to help systematically identify comorbidities. In a consecutive series of 86 patients referred for systematic evaluation of difficult asthma, questionnaires were administered prior to clinical consultation. Six difficult asthma comorbidities and corresponding screening questionnaires were found: sinonasal disease (allergic rhinitis and chronic rhinosinusitis), vocal cord dysfunction, dysfunctional breathing, obstructive sleep apnea, anxiety and depression, and gastro-oesophageal reflux disease. When the questionnaires were added to the referring clinician's impression, the detection of all six comorbidities was significantly enhanced. The average time for questionnaire administration was approximately 40 minutes. The use of validated screening questionnaires heightens detection of comorbidities in difficult asthma. The availability of data from a battery of questionnaires prior to consultation can save time and allow clinicians to systematically assess difficult asthma patients and to focus on areas of particular concern. Such an approach would ensure that all contributing comorbidities have been addressed before significant treatment escalation is considered.

Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache.

PubMed

Silva, Ariovaldo Alberto da; Brandão, Karina Viana; Faleiros, Bruno Engler; Tavares, Rafael Mattos; Lara, Rodrigo Pinto; Januzzi, Eduardo; Carvalho, Anísio Bueno de; Carvalho, Eliane Maria Duarte de; Gomes, João Bosco Lima; Leite, Frederico Mota Gonçalves; Alves, Betania Mara Franco; Gómez, Rodrigo Santiago; Teixeira, Antônio Lúcio

2014-02-01

Clinical differentiation between the primary headaches and temporomandibular disorders (TMD) can be challenging. To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (p<0.001). Tension-type headache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (p<0.001). TMD is an important comorbidity of migraine and difficult to distinguish clinically from tension-type headache, and this headache was more frequent in the dental center than at the medical center.

Management of the difficult airway.

PubMed

Schwartz, D E; Wiener-Kronish, J P

1991-09-01

For clinicians involved in airway management, a plan of action for dealing with the difficult airway or a failed intubation should be developed well in advance of encountering a patient in whom intubation is not routine. When difficulty is anticipated, the equipment necessary for performing a difficult intubation should be immediately available. It also is prudent to have a surgeon skilled in performing a tracheotomy and a criothyroidotomy stand by. The intubation should be attempted in the awake state, preferably using the fiberoptic bronchoscope. The more challenging situation is when the difficult airway is confronted unexpectedly. After the first failed attempt at laryngoscopy, head position should be checked and the patient ventilated with oxygen by mask. A smaller styletted tube and possibly a different laryngoscope blade should be selected for a second attempt at intubation. The fiberoptic bronchoscope and other equipment for difficult intubation should be obtained. A second attempt should then be made. If this is unsuccessful, the patient should be reoxygenated, and assistance including a skilled anesthesiologist and surgeon should be summoned. On a third attempt, traction to the tongue can be applied by an assistant, a tube changer could be used to enter the larynx, or one of the other special techniques previously described can be used. If this third attempt fails, it may be helpful to have a physician more experienced in airway management attempt intubation after oxygen has been administered to the patient. If all attempts are unsuccessful, then invasive techniques to secure the airway will have to be performed.

Challenges Facing Higher Education at the Millennium. American Council on Education/Oryx Press Series on Higher Education.

ERIC Educational Resources Information Center

Hirsch, Werner Z., Ed.; Weber, Luc E., Ed.

This collection of 17 essays focuses on the major changes that higher education needs to make so that it can effectively pursue teaching and research and significantly contribute public service in a rapidly changing world. The essays include: (1) "Survey of the Main Challenges Facing Higher Education at the Millennium" (Luc E. Weber);…

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

PubMed

Kenzig, Melissa J

2015-09-01

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

Tolerance to spatial-relational transformations in unfamiliar faces: A further challenge to a configural processing account of identity recognition.

PubMed

Lorenzino, Martina; Caminati, Martina; Caudek, Corrado

2018-05-25

One of the most important questions in face perception research is to understand what information is extracted from a face in order to recognize its identity. Recognition of facial identity has been attributed to a special sensitivity to "configural" information. However, recent studies have challenged the configural account by showing that participants are poor in discriminating variations of metric distances among facial features, especially for familiar as opposed to unfamiliar faces, whereas a configural account predicts the opposite. We aimed to extend these previous results by examining classes of unfamiliar faces with which we have different levels of expertise. We hypothesized an inverse relation between sensitivity to configural information and expertise with a given class of faces, but only for neutral expressions. By first matching perceptual discriminability, we measured tolerance to subtle configural transformations with same-race (SR) versus other-race (OR) faces, and with upright versus upside-down faces. Consistently with our predictions, we found a lower sensitivity to at-threshold configural changes for SR compared to OR faces. We also found that, for our stimuli, the face inversion effect disappeared for neutral but not for emotional faces - a result that can also be attributed to a lower sensitivity to configural transformations for faces presented in a more familiar orientation. The present findings question a purely configural account of face processing and suggest that the role of spatial-relational information in face processing varies according to the functional demands of the task and to the characteristics of the stimuli. Copyright © 2018 Elsevier B.V. All rights reserved.

Development of Critical Thinking Skills through Writing Tasks: Challenges Facing Maritime English Students at Aqaba College, AlBalqa Applied University, Jordan

ERIC Educational Resources Information Center

Alidmat, Ali Odeh Hammoud; Ayassrah, Mohamed Ayed

2017-01-01

Teaching English for Special Purposes (ESP) in a context where English is taught as a Foreign Language (EFL) is no easy task. There is in fact extensive research reporting on challenges facing both teacher and student in the Foreign Language classroom where language skills must be learnt outside their usual context. Even more challenging is…

Animal models of binge drinking, current challenges to improve face validity.

PubMed

Jeanblanc, Jérôme; Rolland, Benjamin; Gierski, Fabien; Martinetti, Margaret P; Naassila, Mickael

2018-05-05

Binge drinking (BD), i.e., consuming a large amount of alcohol in a short period of time, is an increasing public health issue. Though no clear definition has been adopted worldwide the speed of drinking seems to be a keystone of this behavior. Developing relevant animal models of BD is a priority for gaining a better characterization of the neurobiological and psychobiological mechanisms underlying this dangerous and harmful behavior. Until recently, preclinical research on BD has been conducted mostly using forced administration of alcohol, but more recent studies used scheduled access to alcohol, to model more voluntary excessive intakes, and to achieve signs of intoxications that mimic the human behavior. The main challenges for future research are discussed regarding the need of good face validity, construct validity and predictive validity of animal models of BD. Copyright © 2018 Elsevier Ltd. All rights reserved.

[The Quebec Healthy Cities and Towns Network: a powerful movement faced with new challenges].

PubMed

Simard, Paule

2007-01-01

After twenty years serving its members, the Quebec Healthy Cities and Towns Network (QHCTN) faces several challenges. There are currently many changes being made in the local organization and the administration of services. The Network, through its capacity to mobilize the different municipalities, is the best placed to advocate and support a coordinated approach to government initiatives and also to encourage partnerships with other institutions (education, health, socio-economic) and communities. There is, nonetheless, a need to rethink its direct support to members, especially in terms of communication and networking among them.

Challenges of microtome‐based serial block‐face scanning electron microscopy in neuroscience

PubMed Central

WANNER, A. A.; KIRSCHMANN, M. A.

2015-01-01

Summary Serial block‐face scanning electron microscopy (SBEM) is becoming increasingly popular for a wide range of applications in many disciplines from biology to material sciences. This review focuses on applications for circuit reconstruction in neuroscience, which is one of the major driving forces advancing SBEM. Neuronal circuit reconstruction poses exceptional challenges to volume EM in terms of resolution, field of view, acquisition time and sample preparation. Mapping the connections between neurons in the brain is crucial for understanding information flow and information processing in the brain. However, information on the connectivity between hundreds or even thousands of neurons densely packed in neuronal microcircuits is still largely missing. Volume EM techniques such as serial section TEM, automated tape‐collecting ultramicrotome, focused ion‐beam scanning electron microscopy and SBEM (microtome serial block‐face scanning electron microscopy) are the techniques that provide sufficient resolution to resolve ultrastructural details such as synapses and provides sufficient field of view for dense reconstruction of neuronal circuits. While volume EM techniques are advancing, they are generating large data sets on the terabyte scale that require new image processing workflows and analysis tools. In this review, we present the recent advances in SBEM for circuit reconstruction in neuroscience and an overview of existing image processing and analysis pipelines. PMID:25907464

Challenges Facing Managers in Managing Conflict in Schools in the South and South Central Regions of Botswana

ERIC Educational Resources Information Center

Morake, Nnior Machomi; Monobe, Ratau John; Dingwe, Stephonia

2011-01-01

The purpose of this study was to examine the challenges facing managers in managing conflict in schools of South and South Central Regions of Botswana. In this study, the schedule of interview was used to collect empirical data. A random sample of 50 school managers and deputy school managers was selected for interviews. Major findings of the…

ASF: Facing the Challenges for 15 Years and Counting

NASA Astrophysics Data System (ADS)

La Belle-Hamer, N.; Nicoll, J.; Atwood, D.; Arko, S.

2006-12-01

The Alaska Satellite Facility (ASF) of the Geophysical Institute, University of Alaska Fairbanks, has just celebrated its 15th year of experience in satellite remote sensing. ASF is involved in a wide range of activities - - from downlinking satellite data to developing data analysis tools, value-added products, and training for Synthetic Aperture Radar (SAR) users. Satellite remote sensing data are acquired, processed, analyzed, and archived by ASF from several satellites; ASF has built expertise in handling and manipulating the data, SAR in particular. SAR is the only satellite imagery in the world today that can be acquired at any time of the day or night and during adverse weather conditions. It can be used to develop value-added products to aid in global climate change research. Examples include the SAR-derived coastal winds in the Gulf of Alaska and Bering Sea; monitoring of the major ice shelves in the Arctic and Antarctic; and examining the impact on sea level from the Greenland ice sheets and glaciers. The challenges facing the use of remote-sensing data in climate change research can be divided into three major categories: economical, political, and technical. The expense of designing, building, and launching a satellite is substantial. The costs of the ground segment including data management can be substantial and should not be neglected. The US agency funding climate often has the research community pushing for new missions against declining federal budgets in direct competition with ongoing missions. On the political front, data policy, data ownership, and cost recovery are issues often perceived as insurmountable by the user community. The technical issues, while challenging, are often the easiest to solve. The Japan Aerospace Exploration Agency, with the successful launch of the Advanced Land Observing System (ALOS), has embarked on a new way of handling the ground segment with the introduction of international data nodes. ASF will serve with NOAA

Using an Iterative Mixed-Methods Research Design to Investigate Schools Facing Exceptionally Challenging Circumstances within Trinidad and Tobago

ERIC Educational Resources Information Center

De Lisle, Jerome; Seunarinesingh, Krishna; Mohammed, Rhoda; Lee-Piggott, Rinnelle

2017-01-01

In this study, methodology and theory were linked to explicate the nature of education practice within schools facing exceptionally challenging circumstances (SFECC) in Trinidad and Tobago. The research design was an iterative quan>QUAL-quan>qual multi-method research programme, consisting of 3 independent projects linked together by overall…

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

Visual Search Efficiency is Greater for Human Faces Compared to Animal Faces

PubMed Central

Simpson, Elizabeth A.; Mertins, Haley L.; Yee, Krysten; Fullerton, Alison; Jakobsen, Krisztina V.

2015-01-01

The Animate Monitoring Hypothesis proposes that humans and animals were the most important categories of visual stimuli for ancestral humans to monitor, as they presented important challenges and opportunities for survival and reproduction; however, it remains unknown whether animal faces are located as efficiently as human faces. We tested this hypothesis by examining whether human, primate, and mammal faces elicit similarly efficient searches, or whether human faces are privileged. In the first three experiments, participants located a target (human, primate, or mammal face) among distractors (non-face objects). We found fixations on human faces were faster and more accurate than primate faces, even when controlling for search category specificity. A final experiment revealed that, even when task-irrelevant, human faces slowed searches for non-faces, suggesting some bottom-up processing may be responsible for the human face search efficiency advantage. PMID:24962122

Human preferences for sexually dimorphic faces may be evolutionarily novel

PubMed Central

Scott, Isabel M.; Clark, Andrew P.; Josephson, Steven C.; Boyette, Adam H.; Cuthill, Innes C.; Fried, Ruby L.; Gibson, Mhairi A.; Hewlett, Barry S.; Jamieson, Mark; Jankowiak, William; Honey, P. Lynne; Huang, Zejun; Liebert, Melissa A.; Purzycki, Benjamin G.; Shaver, John H.; Snodgrass, J. Josh; Sosis, Richard; Sugiyama, Lawrence S.; Swami, Viren; Yu, Douglas W.; Zhao, Yangke; Penton-Voak, Ian S.

2014-01-01

A large literature proposes that preferences for exaggerated sex typicality in human faces (masculinity/femininity) reflect a long evolutionary history of sexual and social selection. This proposal implies that dimorphism was important to judgments of attractiveness and personality in ancestral environments. It is difficult to evaluate, however, because most available data come from large-scale, industrialized, urban populations. Here, we report the results for 12 populations with very diverse levels of economic development. Surprisingly, preferences for exaggerated sex-specific traits are only found in the novel, highly developed environments. Similarly, perceptions that masculine males look aggressive increase strongly with development and, specifically, urbanization. These data challenge the hypothesis that facial dimorphism was an important ancestral signal of heritable mate value. One possibility is that highly developed environments provide novel opportunities to discern relationships between facial traits and behavior by exposing individuals to large numbers of unfamiliar faces, revealing patterns too subtle to detect with smaller samples. PMID:25246593

Real-time scheduling faces operational challenges.

PubMed

2005-01-01

Online real-time patient scheduling presents a number of challenges. But a few advanced organizations are rolling out systems slowly, meeting those challenges as they go. And while this application is still too new to provide measurable benefits, anecdotal information seems to point to improvements in efficiency, patient satisfaction, and possibly quality of care.

Changing panorama for surveillance of device-associated healthcare infections: Challenges faced in implementation of current guidelines.

PubMed

Gupta, Renu; Sharma, Sangeeta; Saxena, Sonal

2018-01-01

Healthcare-associated infections (HAI) are preventable in up to 30% of patients with evidence-based infection prevention and control (IPC) activities. IPC activities require effective surveillance to generate data for the HAI rates, defining priority areas, identifying processes amenable for improvement and institute interventions to improve patient's safety. However, uniform, accurate and standardised surveillance methodology using objective definitions can only generate meaningful data for effective execution of IPC activities. The highly exhaustive, complex and ever-evolving infection surveillance methodology pose a challenge for effective data capture, analysis and interpretation by ground level personnel. The present review addresses the gaps in knowledge and day-to-day challenges in surveillance faced by infection control team for effective implementation of IPC activities.

The challenge of funding hospital employee retirement benefits.

PubMed

Román, Christina

2012-12-01

Hospitals face a difficult challenge in meeting existing benefits obligations to employees while maintaining financial reserves to invest in electronic health records, quality improvement, and more effective integration of care. Although they may no longer be able to afford offering employees defined-benefit plans, many forward-looking healthcare organizations are finding ways to keep their commitments without sacrificing the balance sheet. One such organization is Scripps Health in San Diego, whose innovative benefits packages have contributed to its being ranked 56th in Fortune's "100 Best Companies to Work For" list in 2012.

Prevalence and correlates of community re-entry challenges faced by HIV-infected male prisoners in Malaysia

PubMed Central

Choi, P; Kavasery, R; Desai, M M; Govindasamy, S; Kamarulzaman, A; Altice, F L

2010-01-01

Summary HIV-infected prisoners face an inordinate number of community re-entry challenges. In 2007, 102 HIV-infected prisoners in Malaysia were surveyed anonymously within six months prior to release to assess the prevalence and correlates of community re-entry challenges. Staying out of prison (60.8%), remaining off drugs (39.2%), finding employment (35.3%) and obtaining HIV care (32.4%) were the re-entry challenges reported most frequently. Global stigma, negative self-image and public attitudes-related stigma were independently associated with challenges to obtaining HIV care. In multivariate analyses, those with previous incarcerations (adjusted odds ratio [AOR], 3.2; 95% confidence interval [CI], 1.4–7.6), higher HIV-related symptoms (AOR, 2.0; 95% CI, 1.0–4.1) and higher public attitudes-related stigma (AOR, 2.5; 95% CI, 1.2–5.1) had a significantly higher likelihood of identifying more re-entry challenges. Targeted interventions, such as effective drug treatment, HIV care and public awareness campaigns, are crucial for stemming the HIV epidemic and improving health outcomes among HIV-infected prisoners in Malaysia. PMID:20606222

Challenges facing drug development for malaria.

PubMed

Craft, J Carl

2008-10-01

Malaria is a significant cause of morbidity and mortality in the developing world. Until recently malaria was winning but with increase in funding particularly from philanthropic groups the ability to control malaria is again possible. There are still many challenges to developing the next generations of anti-malarials. This article will briefly discuss the challenges and the advance that are being made.

Adapting a Face-to-Face Role-Playing Simulation for Online Play

ERIC Educational Resources Information Center

Bos, Nathan; Shami, N. Sadat

2006-01-01

The rapid acceleration of online course offerings presents a design challenge for instructors who want to take materials developed for face-to-face settings and adapt them for asynchronous online usage. Broadcast lectures are relatively easy to transfer, but adapting content is harder when classes use small-group discussions, as in role-playing or…

Face-to-face interference in typical and atypical development

PubMed Central

Riby, Deborah M; Doherty-Sneddon, Gwyneth; Whittle, Lisa

2012-01-01

Visual communication cues facilitate interpersonal communication. It is important that we look at faces to retrieve and subsequently process such cues. It is also important that we sometimes look away from faces as they increase cognitive load that may interfere with online processing. Indeed, when typically developing individuals hold face gaze it interferes with task completion. In this novel study we quantify face interference for the first time in Williams syndrome (WS) and Autism Spectrum Disorder (ASD). These disorders of development impact on cognition and social attention, but how do faces interfere with cognitive processing? Individuals developing typically as well as those with ASD (n = 19) and WS (n = 16) were recorded during a question and answer session that involved mathematics questions. In phase 1 gaze behaviour was not manipulated, but in phase 2 participants were required to maintain eye contact with the experimenter at all times. Looking at faces decreased task accuracy for individuals who were developing typically. Critically, the same pattern was seen in WS and ASD, whereby task performance decreased when participants were required to hold face gaze. The results show that looking at faces interferes with task performance in all groups. This finding requires the caveat that individuals with WS and ASD found it harder than individuals who were developing typically to maintain eye contact throughout the interaction. Individuals with ASD struggled to hold eye contact at all points of the interaction while those with WS found it especially difficult when thinking. PMID:22356183

Encountering unexpected difficult airway: relationship with the intubation difficulty scale

PubMed Central

Koh, Wonuk; Kim, Hajung; Kim, Kyongsun; Ro, Young-Jin

2016-01-01

Background An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. Methods We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. Results For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. Conclusions Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation. PMID:27274369

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

ERIC Educational Resources Information Center

Nelson, Bethany; Froehner, Megan; Gault, Barbara

2013-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2018-02-01

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

Cultural Challenges Faced by American Mission Control Personnel Working with International Partners

NASA Technical Reports Server (NTRS)

Clement, J. L.; Ritsher, J. B.

2006-01-01

Operating the International Space Station (ISS) involves an indefinite, continuous series of long-duration international missions, and this requires an unprecedented degree of cooperation across multiple sites, organizations, and nations. Both junior and senior mission control personnel have had to find ways to address the cultural challenges inherent in such work, but neither have had systematic training in how to do so. The goals of this study were to identify and evaluate the major cultural challenges faced by ISS mission control personnel and to highlight the approaches that they have found most effective to surmount these challenges. We pay particular attention to the approaches successfully employed by the senior personnel and the training needs identified by the junior personnel. We also evaluate the extent to which the identified approaches and needs are consistent across the two samples. METHODS: Participants included a sample of 14 senior ISS flight controllers and a contrasting sample of 12 more junior controllers. All participants were mission operations specialists chosen on the basis of having worked extensively with international partners. Data were collected using a semi-structured qualitative interview and content analyzed using an iterative process with multiple coders and consensus meetings to resolve discrepancies. RESULTS: The senior respondents had substantial consensus on several cultural challenges and on key strategies for dealing with them, and they offered a wide range of specific tactics for implementing these strategies. Data from the junior respondents will be presented for the first time at the meeting. DISCUSSION: Although specific to American ISS personnel, our results are consistent with recent management, cultural, and aerospace research on other populations. We aim to use our results to improve training for current and future mission control personnel working in international or multicultural mission operations teams.

One in three U.S. households faced challenges in paying energy bills in 2015

EIA Publications

2017-01-01

Nearly one-third of U.S. households (31%) reported facing a challenge in paying energy bills or sustaining adequate heating and cooling in their home in 2015. According to the most recent results from EIA’s Residential Energy Consumption Survey (RECS), about one in five households reported reducing or forgoing basic necessities like food and medicine to pay an energy bill and 14% reported receiving a disconnection notice for energy service. Households may have also used less energy than they would prefer to: 11% of households surveyed reported keeping their home at an unhealthy or unsafe temperature.

Improving the Quality of Home Visitation: An Exploratory Study of Difficult Situations

ERIC Educational Resources Information Center

LeCroy, Craig Winston; Whitaker, Kate

2005-01-01

Objective: The primary purpose of this study was to use an ecological assessment model to obtain a better understanding of difficult situations that home visitors confront when implementing home visitation services. Method: A mixed method study was used which included conducting focus groups to identify specific situations faced by home visitors…

Challenges Faced by Development Partners in Supporting the Growth and Development of Commercial Enterprises in Lira District, Northern Uganda

ERIC Educational Resources Information Center

Eton, Marus; Mwirumubi, Richard; Edaku, Charles

2017-01-01

Entrepreneurship is defined as the process where an individual discovers, evaluates and exploit opportunities independently. Most countries have embraced entrepreneurship development as ways of creating employment and economic growth and development. The objective of the study was to examine the challenges faced by commercial enterprises in Lira…

Family medicine in Iran: facing the health system challenges.

PubMed

Esmaeili, Reza; Hadian, Mohammad; Rashidian, Arash; Shariati, Mohammad; Ghaderi, Hossien

2014-11-30

In response to the current fragmented context of health systems, it is essential to support the revitalization of primary health care in order to provide a stronger sense of direction and integrity. Around the world, family medicine recognized as a core discipline for strengthening primary health care setting. This study aimed to understand the perspectives of policy makers and decision makers of Iran's health system about the implementation of family medicine in Iran urban areas. This study is a qualitative study with framework analysis. Purposive semi-structured interviews were conducted with Policy and decision makers in the five main organizations of Iran health care system. The codes were extracted using inductive and deductive methods. According to 27 semi-structured interviews were conducted with Policy and decision makers, three main themes and 8 subthemes extracted, including: The development of referral system, better access to health care and the management of chronic diseases. Family medicine is a viable means for a series of crucial reforms in the face of the current challenges of health system. Implementation of family medicine can strengthen the PHC model in Iran urban areas. Attempting to create a general consensus among various stakeholders is essential for effective implementation of the project.

The Education Challenges Facing Small Nation States in the Increasingly Competitive Global Economy of the Twenty-First Century

ERIC Educational Resources Information Center

Bacchus, Mohammed Kazim

2008-01-01

Publication of this piece is intended as a tribute to the late Professor M. Kazim Bacchus who passed away in March 2007. The paper provides a general discussion concerning the social and educational challenges faced by small nation states in an age characterised by globalisation. The analysis first identifies some of the basic features of small…

Facing the Challenges of Today and the Future: Ensuring Successful Outcomes for Students from Culturally and Linguistically Diverse Backgrounds

ERIC Educational Resources Information Center

Bullock, Lyndal M.; Gable, Robert A.; Carrero, Kelly; Lewis, Calli; Collins, Emerald; Zolkowski, Staci; Lusk, Mandy

2014-01-01

American schools are witnessing the increasing cultural heterogeneity of our nation's population. Educators are faced with the challenge of ensuring positive educational outcomes for all students, despite the lack of empirical understanding of how to effectively educate culturally and linguistically diverse learners. The purpose of this paper is…

Ukrainian prisoners and community reentry challenges: implications for transitional care

PubMed Central

Morozova, Olga; Azbel, Lyuba; Grishaev, Yevgeny; Dvoryak, Sergii; Wickersham, Jeffrey A.; Altice, Frederick L.

2013-01-01

Purpose The study aims to assess reentry challenges faced by Ukrainian prisoners and to determine the factors associated with having a greater number of challenges in order to suggest pre- and post-release interventions with the aim of facilitating community reintegration. Design/methodology/approach A representative national cross-sectional study with a sample size of 402 prisoners was conducted among imprisoned adults within six months of release. The study consisted of interviews and biological testing for infectious diseases. Anticipated reentry challenges were assessed using a structured questionnaire. Findings The most difficult and relatively important challenges identified were finding a job or a stable source of income and staying out of prison following release. Risk-specific challenges pertinent to drug users and HIV-infected individuals were assessed as difficult, but generally less important. Similarly, challenges associated with reducing drug relapse were ranked as less important, with only 0.6 percent identifying opioid substitution therapy as a helpful measure. In the multivariate analysis, having a greater number of challenges is associated with previous incarcerations, drug use immediately before incarceration and lower levels of social support. Practical implications To facilitate community re-integration, it is vital to design interventions aimed at reducing recidivism and improvement of social support through comprehensive case management as well as to improve understanding about and address drug dependence issues among inmates by implementing evidence-based treatment both within prisons and after release. Originality/value This is the first comprehensive assessment of community reentry challenges by prisoners in the former Soviet Union. PMID:25152767

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

Post-Adoption Face-to-Face Contact with Birth Parents: Prospective Adopters' Views

ERIC Educational Resources Information Center

Turkington, Selina; Taylor, Brian J.

2009-01-01

The trend in adoption since the 1960s has been away from secrecy and towards greater openness; contact through an intermediary, and direct contact by letter, is now widely accepted. More controversial is the challenge of face-to-face contact with birth parents, and social workers involved in the decision-making process find themselves having to…

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

PubMed Central

King, Rauni Prittinen

2015-01-01

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

About-face on face recognition ability and holistic processing.

PubMed

Richler, Jennifer J; Floyd, R Jackie; Gauthier, Isabel

2015-01-01

Previous work found a small but significant relationship between holistic processing measured with the composite task and face recognition ability measured by the Cambridge Face Memory Test (CFMT; Duchaine & Nakayama, 2006). Surprisingly, recent work using a different measure of holistic processing (Vanderbilt Holistic Face Processing Test [VHPT-F]; Richler, Floyd, & Gauthier, 2014) and a larger sample found no evidence for such a relationship. In Experiment 1 we replicate this unexpected result, finding no relationship between holistic processing (VHPT-F) and face recognition ability (CFMT). A key difference between the VHPT-F and other holistic processing measures is that unique face parts are used on each trial in the VHPT-F, unlike in other tasks where a small set of face parts repeat across the experiment. In Experiment 2, we test the hypothesis that correlations between the CFMT and holistic processing tasks are driven by stimulus repetition that allows for learning during the composite task. Consistent with our predictions, CFMT performance was correlated with holistic processing in the composite task when a small set of face parts repeated over trials, but not when face parts did not repeat. A meta-analysis confirms that relationships between the CFMT and holistic processing depend on stimulus repetition. These results raise important questions about what is being measured by the CFMT, and challenge current assumptions about why faces are processed holistically.

About-face on face recognition ability and holistic processing

PubMed Central

Richler, Jennifer J.; Floyd, R. Jackie; Gauthier, Isabel

2015-01-01

Previous work found a small but significant relationship between holistic processing measured with the composite task and face recognition ability measured by the Cambridge Face Memory Test (CFMT; Duchaine & Nakayama, 2006). Surprisingly, recent work using a different measure of holistic processing (Vanderbilt Holistic Face Processing Test [VHPT-F]; Richler, Floyd, & Gauthier, 2014) and a larger sample found no evidence for such a relationship. In Experiment 1 we replicate this unexpected result, finding no relationship between holistic processing (VHPT-F) and face recognition ability (CFMT). A key difference between the VHPT-F and other holistic processing measures is that unique face parts are used on each trial in the VHPT-F, unlike in other tasks where a small set of face parts repeat across the experiment. In Experiment 2, we test the hypothesis that correlations between the CFMT and holistic processing tasks are driven by stimulus repetition that allows for learning during the composite task. Consistent with our predictions, CFMT performance was correlated with holistic processing in the composite task when a small set of face parts repeated over trials, but not when face parts did not repeat. A meta-analysis confirms that relationships between the CFMT and holistic processing depend on stimulus repetition. These results raise important questions about what is being measured by the CFMT, and challenge current assumptions about why faces are processed holistically. PMID:26223027

You may look unhappy unless you smile: the distinctiveness of a smiling face against faces without an explicit smile.

PubMed

Park, Hyung-Bum; Han, Ji-Eun; Hyun, Joo-Seok

2015-05-01

An expressionless face is often perceived as rude whereas a smiling face is considered as hospitable. Repetitive exposure to such perceptions may have developed stereotype of categorizing an expressionless face as expressing negative emotion. To test this idea, we displayed a search array where the target was an expressionless face and the distractors were either smiling or frowning faces. We manipulated set size. Search reaction times were delayed with frowning distractors. Delays became more evident as the set size increased. We also devised a short-term comparison task where participants compared two sequential sets of expressionless, smiling, and frowning faces. Detection of an expression change across the sets was highly inaccurate when the change was made between frowning and expressionless face. These results indicate that subjects were confused with expressed emotions on frowning and expressionless faces, suggesting that it is difficult to distinguish expressionless face from frowning faces. Copyright © 2015 Elsevier B.V. All rights reserved.

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

PubMed

Halim, Abdel-Baset

2015-06-01

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

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Construction and Validation of a Survey Instrument to Determine the Gender-Related Challenges Faced by Pre-Service Male Primary Teachers

ERIC Educational Resources Information Center

Cruickshank, Vaughan; Pedersen, Scott; Hill, Allen; Callingham, Rosemary

2015-01-01

The gender-related challenges facing males entering the primary-school teaching profession have been well documented in the academic literature over recent decades. The majority of these data have come about through qualitative reports. Whilst qualitative methods provide important perspectives into these issues, the use of valid and reliable…

Challenges faced by primary care physicians when prescribing for patients with chronic diseases in a teaching hospital in Malaysia: a qualitative study.

PubMed

Sellappans, Renukha; Lai, Pauline Siew Mei; Ng, Chirk Jenn

2015-08-27

The aim of this study was to identify the challenges faced by primary care physicians (PCPs) when prescribing medications for patients with chronic diseases in a teaching hospital in Malaysia. 3 focus group discussions were conducted between July and August 2012 in a teaching primary care clinic in Malaysia. A topic guide was used to facilitate the discussions which were audio-recorded, transcribed verbatim and analysed using a thematic approach. PCPs affiliated to the primary care clinic were purposively sampled to include a range of clinical experience. Sample size was determined by thematic saturation of the data. 14 family medicine trainees and 5 service medical officers participated in this study. PCPs faced difficulties in prescribing for patients with chronic diseases due to a lack of communication among different healthcare providers. Medication changes made by hospital specialists, for example, were often not communicated to the PCPs leading to drug duplications and interactions. The use of paper-based medical records and electronic prescribing created a dual record system for patients' medications and became a problem when the 2 records did not tally. Patients sometimes visited different doctors and pharmacies for their medications and this resulted in the lack of continuity of care. PCPs also faced difficulties in addressing patients' concerns, and dealing with patients' medication requests and adherence issues. Some PCPs lacked time and knowledge to advise patients about their medications and faced difficulties in managing side effects caused by the patients' complex medication regimen. PCPs faced prescribing challenges related to patients, their own practice and the local health system when prescribing for patients with chronic diseases. These challenges must be addressed in order to improve chronic disease management in primary care and, more importantly, patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not

Factors Influencing Men Entering the Nursing Profession, and Understanding the Challenges Faced by Them: Iranian and Developed Countries’ Perspectives

PubMed Central

Zamanzadeh, Vahid; Valizadeh, Leila; Negarandeh, Reza; Monadi, Morteza; Azadi, Arman

2013-01-01

Context: Men entering the nursing profession have been investigated from several different perspectives. Due to male gender characteristics and existing public image, nursing is often not considered as a career choice by men. Whether nursing would benefit from increased number of men is a key question in the literature. The purpose of this integrative review of the literature was to identify factors influencing men to enter the nursing profession. In addition, it sought to understand the challenges they are confronted within this profession. Evidence Acquisition: A systematic search of the existing literature was performed using an Internet search with broad keywords to access related articles in both Persian and English databases. Finally, 34 studies (written between 2000 and early 2013) were selected and surveyed. Results: Most of the studies were conducted in developed counties. The review identified reasons why males choose nursing, and other challenges facing men entering and working in nursing. Themes that emerged from the literature include educational and societal barriers experienced by men in nursing, recruitment, career choice, and role strain. Conclusions: Regarding men’s influences on professional development, and also the importance of gender-based caring, policies for recruitment and retention of men in nursing must be followed hastily. However, there is a need for further research regarding the challenges faced by men entering nursing, in both Iran and other developing countries. PMID:25414879

Efficient live face detection to counter spoof attack in face recognition systems

NASA Astrophysics Data System (ADS)

Biswas, Bikram Kumar; Alam, Mohammad S.

2015-03-01

Face recognition is a critical tool used in almost all major biometrics based security systems. But recognition, authentication and liveness detection of the face of an actual user is a major challenge because an imposter or a non-live face of the actual user can be used to spoof the security system. In this research, a robust technique is proposed which detects liveness of faces in order to counter spoof attacks. The proposed technique uses a three-dimensional (3D) fast Fourier transform to compare spectral energies of a live face and a fake face in a mathematically selective manner. The mathematical model involves evaluation of energies of selective high frequency bands of average power spectra of both live and non-live faces. It also carries out proper recognition and authentication of the face of the actual user using the fringe-adjusted joint transform correlation technique, which has been found to yield the highest correlation output for a match. Experimental tests show that the proposed technique yields excellent results for identifying live faces.

Hyper-realistic face masks: a new challenge in person identification.

PubMed

Sanders, Jet Gabrielle; Ueda, Yoshiyuki; Minemoto, Kazusa; Noyes, Eilidh; Yoshikawa, Sakiko; Jenkins, Rob

2017-01-01

We often identify people using face images. This is true in occupational settings such as passport control as well as in everyday social environments. Mapping between images and identities assumes that facial appearance is stable within certain bounds. For example, a person's apparent age, gender and ethnicity change slowly, if at all. It also assumes that deliberate changes beyond these bounds (i.e., disguises) would be easy to spot. Hyper-realistic face masks overturn these assumptions by allowing the wearer to look like an entirely different person. If unnoticed, these masks break the link between facial appearance and personal identity, with clear implications for applied face recognition. However, to date, no one has assessed the realism of these masks, or specified conditions under which they may be accepted as real faces. Herein, we examined incidental detection of unexpected but attended hyper-realistic masks in both photographic and live presentations. Experiment 1 (UK; n = 60) revealed no evidence for overt detection of hyper-realistic masks among real face photos, and little evidence of covert detection. Experiment 2 (Japan; n = 60) extended these findings to different masks, mask-wearers and participant pools. In Experiment 3 (UK and Japan; n = 407), passers-by failed to notice that a live confederate was wearing a hyper-realistic mask and showed limited evidence of covert detection, even at close viewing distance (5 vs. 20 m). Across all of these studies, viewers accepted hyper-realistic masks as real faces. Specific countermeasures will be required if detection rates are to be improved.

Mars can wait: facing the challenges of our civilization.

PubMed

Goodman, Geoffrey; Gershwin, M Eric; Bercovich, Dani

2014-12-01

We are overwhelmed by warnings about inevitable geophysical and human problems. Earth is beset by escalating, manmade, environmental crises and our exploding population will eventually lack water, food and vital materials. This suggests, together with increasing poverty, deepening social unrest and advanced techniques for mass killing, that civilization will break down long before atmospheric CO2 or resistant microbes become catastrophic. Despite intensive searching, life has not been found in space, even though thousands of planets have been found and life there may be as problematic and unpredictable as on Earth. The human brain is already a 'universe', with 85 billion neurons and a hundred trillion synapses, more than the stars in our galaxy. Understanding consciousness, the brain, its aging and pathologies, and eliminating the propensity for human aggression are urgent challenges. During 1958-2012, NASA spent $800 billion. In contrast, the annual cost of brain disease in the U.S. is $600 billion, more than cardiovascular disease and cancer combined. We suggest that a massive switching of financial and human resources is required to explore the full potential of the human brain. Visiting Mars can wait. We further propose a novel Two-Brain Hypothesis: the animal 'brain' evolved as two fundamentally different though interdependent, complementary organs: one electroionic (tangible, known and accessible), and the other, electromagnetic (intangible and difficult to access)--a relatively independent, stable, structured and functional 3D compendium of variously induced interacting EM fields.

Challenges faced by ice sheet projections: lessons from the SeaRISE effort

NASA Astrophysics Data System (ADS)

Nowicki, S.

2013-12-01

Projecting the future evolution of the Greenland and Antarctic ice sheets is a problem of enormous societal importance, as ice sheet influence our future sea levels. This crucial issue is however a non trivial task, as demonstrated by the Sea level Response to Ice Sheet Evolution (SeaRISE) effort: prescribing simple external forcings to a group of ice sheet models results in a spread in responses. Understanding the source of the diversity in the model results is therefore crucial in order to reduce the uncertainty in the projection. Just as in any future climate simulation, the analysis presented here demonstrates that the model spread in the SeaRISE effort is due to a number of factors. First is the problem of obtaining an initial configuration for the projection. The two commonly used methods, interglacial spin-up or data assimilation, have both advantages and drawbacks, and will affect the determination of fields that cannot be measured (such as basal slipperiness). Second is the uncertainty in actual observations, which includes but is not limited to surface mass balance, basal topography, ice thickness, and surface velocities. An additional issue with these observations is that they can be transient quantities which are not measured at the same time, but ice sheet models require them to be simultaneous. Third is the uncertainty in the models' physics and discretization, which is limited by our understanding (or lack of understanding) of crucial processes that often occur at subgrid scale relative to the resolution used by continental ice sheet models, and thus require parameterization. Grounding line migration and sliding laws are such an example. Fourth is the determination of the future forcing scenarios and their implementation as the external forcing. Unfortunately, as demonstrated in this analysis, all ice sheet models face these limitations to some degree, so that it is extremely difficult to identify a set of models and projections that should be

Courage and Compassion: Virtues in Caring for So-Called "Difficult" Patients.

PubMed

Hawking, Michael; Curlin, Farr A; Yoon, John D

2017-04-01

What, if anything, can medical ethics offer to assist in the care of the "difficult" patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the "difficult" patient as an example of a "moral stress test" that especially challenges the physician's character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of "difficult" patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training. © 2017 American Medical Association. All Rights Reserved.

Racial dialogues: challenges faculty of color face in the classroom.

PubMed

Sue, Derald Wing; Rivera, David P; Watkins, Nicole L; Kim, Rachel H; Kim, Suah; Williams, Chantea D

2011-07-01

Research on the experiences of faculty of color in predominantly White institutions (PWIs) suggests that they often experience the campus climate as invalidating, alienating, and hostile. Few studies, however, have actually focused on the classroom experiences of faculty of color when difficult racial dialogues occur. Using Consensually Qualitative Research, eight faculty of color were interviewed about their experiences in the classroom when racially tinged topics arose. Three major findings emerged. First, difficult racial dialogues were frequently instigated by the presence of racial microaggressions delivered toward students of color or the professor. Dialogues on race were made more difficult when the classrooms were diverse, when heated emotions arose, when there was a strong fear of self-disclosure, and when racial perspectives differed. Second, all faculty experienced an internal struggle between balancing their own values and beliefs with an attempt to remain objective. This conflict was often described as exhausting and energy-depleting. Third, faculty of color described both successful and unsuccessful strategies in facilitating difficult dialogues on race that arose in the course of their teaching. These findings have major implications for how PWIs can develop new programs, policies, and practices that will aid and support colleagues of color.

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

PubMed

Axelrod, Vadim; Yovel, Galit

2013-11-01

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

Toward a Social Psychophysics of Face Communication.

PubMed

Jack, Rachael E; Schyns, Philippe G

2017-01-03

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

Difficult airway in a pediatric case of pycodysostosis

PubMed Central

Alkhalaf, Maizar M.; Ali, Hassan Mohamed; Al Otaibi, Rashed

2015-01-01

Pycodysostosis is a genetic autosomal rare disease with an incidence of 1:1.7 million births; the pathophysiology of the disease is related to mutation of cathepsin K gene. Sleep apnea, respiratory difficulties because of chest and oral abnormalities may cause a challenge to the anesthetist during intubation and/or mechanical ventilation. In this case report we will discuss a case of pycodysostosis with a difficult airway. PMID:25886438

Airway physical examination tests for detection of difficult airway management in apparently normal adult patients.

PubMed

Roth, Dominik; Pace, Nathan L; Lee, Anna; Hovhannisyan, Karen; Warenits, Alexandra-Maria; Arrich, Jasmin; Herkner, Harald

2018-05-15

The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities. We performed this individually for each of the four descriptors of the difficult airway: difficult face mask ventilation, difficult laryngoscopy, difficult tracheal intubation, and failed intubation. We searched major electronic databases including CENTRAL, MEDLINE, Embase, ISI Web of Science, CINAHL, as well as regional, subject specific, and dissertation and theses databases from inception to 16 December 2016, without language restrictions. In addition, we searched the Science Citation Index and checked the references of all the relevant studies. We also handsearched selected journals, conference proceedings, and relevant guidelines. We updated this search in March 2018, but we have not yet incorporated these results. We considered full-text diagnostic test accuracy studies of any individual index test, or a combination of tests, against a reference standard. Participants were adults without obvious airway abnormalities, who were having laryngoscopy performed with a standard laryngoscope and the trachea intubated with a standard tracheal tube. Index tests included the Mallampati test, modified Mallampati test, Wilson risk score, thyromental distance, sternomental distance, mouth opening test, upper lip bite test, or any combination of these. The target condition was difficult airway, with one of the following reference

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

PubMed

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

2017-03-01

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

Many Faces Have I.

ERIC Educational Resources Information Center

Zilliox, Joseph T.; Lowery, Shannon G.

1997-01-01

Describes an extended investigation of polygons and polyhedra which was conducted in response to a challenge posed in Focus, a newsletter from the Mathematical Association of America (MAA). Students were challenged to construct a polyhedron with faces that measure more than 13 inches to a side. Outlines the process, including the questions posed…

Illumination robust face recognition using spatial adaptive shadow compensation based on face intensity prior

NASA Astrophysics Data System (ADS)

Hsieh, Cheng-Ta; Huang, Kae-Horng; Lee, Chang-Hsing; Han, Chin-Chuan; Fan, Kuo-Chin

2017-12-01

Robust face recognition under illumination variations is an important and challenging task in a face recognition system, particularly for face recognition in the wild. In this paper, a face image preprocessing approach, called spatial adaptive shadow compensation (SASC), is proposed to eliminate shadows in the face image due to different lighting directions. First, spatial adaptive histogram equalization (SAHE), which uses face intensity prior model, is proposed to enhance the contrast of each local face region without generating visible noises in smooth face areas. Adaptive shadow compensation (ASC), which performs shadow compensation in each local image block, is then used to produce a wellcompensated face image appropriate for face feature extraction and recognition. Finally, null-space linear discriminant analysis (NLDA) is employed to extract discriminant features from SASC compensated images. Experiments performed on the Yale B, Yale B extended, and CMU PIE face databases have shown that the proposed SASC always yields the best face recognition accuracy. That is, SASC is more robust to face recognition under illumination variations than other shadow compensation approaches.

Pose-Invariant Face Recognition via RGB-D Images.

PubMed

Sang, Gaoli; Li, Jing; Zhao, Qijun

2016-01-01

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

Web-based versus face-to-face interprofessional team encounters with standardized patients.

PubMed

Lempicki, Kelly A; Holland, Christine S

2018-03-01

Challenges exist in developing interprofessional education (IPE) activities including coordinating schedules and obtaining appropriate space for teams to work. Virtual worlds have been explored as a means to overcome some of these challenges. We sought to develop a web-based interprofessional team interaction with a standardized patient (SP), as compared to a face-to-face SP interaction, focusing on the competency area of interprofessional communication. Interprofessional teams of students were randomized to complete a web-based or face-to-face SP encounter. The web-based encounter was conducted via video conference that students accessed using their own electronic device. Interprofessional communication was evaluated by faculty observers and the SPs. Participants of the web-based encounter also completed a perceptions questionnaire. Interprofessional communication was rated as average/above average by the authors and SPs. Perceptions of the web-based encounter were mixed with not all students willing to complete such an encounter again despite finding it enjoyable and a positive learning experience. The need for adequate preparation was identified, including the opportunity to review the patient case before the encounter. The web-based SP encounter afforded students the opportunity to utilize communication technology to provide patient-centered care while collaborating as an interprofessional team. Video conferencing presents an opportunity to bypass some logistical challenges in scheduling IPE experiences and can be implemented as a co-curricular activity, avoiding course revisions. Additional studies are needed to further explore student and patient perspectives and clarify when, and with what level of trainees, the experiences are most valuable. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-10-01

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

Efficacy of a training program designed to help address challenges faced by health promotion volunteers.

PubMed

Taguchi, Atsuko; Murayama, Hiroshi; Arakawa, Mihoko; Terao, Atsushi

2017-01-01

Objective　To evaluate the effectiveness of a training program designed to address the following three challenges facing health promotion volunteers: lack of new volunteers, short tenure of volunteering, and failure to build a collaborative relationship with other civic organizations.Methods　Thirty-eight volunteer leaders representing 36 school districts (one from each district and two additional leaders) from southern parts of Shiga Prefecture participated in the training program. Four training sessions were conducted between July 2012 and January 2013. Each session lasted for 2 hours. The program included a lecture, group work, and role playing, all of which centered on the challenges experienced by the volunteers and possible solutions. Those who participated constituted the "training group," and other volunteers in the same area of Shiga, who did not take part in the program, made up the "non-training group." A third, control group consisted of health promotion volunteers based in City A, located outside the areas where the training occurred. To compare the three groups, we collected data before and after the training. The main evaluation index comprised the following three survey items: having confidence in recruiting new volunteers, having confidence in overcoming the difficulties or discouragement to continue to volunteer, and having confidence in explaining their activities to other local organizations to earn their cooperation. These questions were asked in a self-administered questionnaire using a 6-point Likert scale (1: strongly disagree, 6: strongly agree).Results　The data were compared among the training group (28 out of the 38 participants completed the survey), non-training group (n=293), and control group (n=107). On the question about recruiting new volunteers, the training group's mean score increased from 2.9 (standard deviation (SD)=1.3) to 3.3 (SD=1.0) following the training, and the improvement relative to the other two groups was

RCN faces challenges over rising inequalities within profession.

PubMed

Owen, Michael

2014-08-19

It is difficult to understand why the RCN will not join colleagues in the Royal College of Midwives and other health unions in balloting members on industrial action (Editorial and News July 30). Is the RCN fearful of the outcome should the response be a yes?

Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions.

PubMed

Elwyn, Glyn; Frosch, Dominick; Volandes, Angelo E; Edwards, Adrian; Montori, Victor M

2010-01-01

This article provides an analysis of 'decision aids', interventions to support patients facing tough decisions. Interest has increased since the concept of shared decision making has become widely considered to be a means of achieving desirable clinical outcomes. We consider the aims of these interventions and examine assumptions about their use. We propose three categories, interventions that are used in face-to-face encounters, those designed for use outside clinical encounters and those which are mediated, using telephone or other communication media. We propose the following definition: decision support interventions help people think about choices they face; they describe where and why choice exists; they provide information about options, including, where reasonable, the option of taking no action. These interventions help people to deliberate, independently or in collaboration with others, about options, by considering relevantattributes; they support people to forecast how they might feel about short, intermediate and long-term outcomes which have relevant consequences, in ways which help the process of constructing preferences and eventual decision making, appropriate to their individual situation. Although quality standards have been published for these interventions, we are also cautious about premature closure and consider that the need for short versions for use inside clinical encounters and long versions for external use requires further research. More work is also needed on the use of narrative formats and the translation of theory into practical designs. The interest in decision support interventions for patients heralds a transformation in clinical practice although many important areas remain unresolved.

Current Challenges Facing the Future of Secondary Education and Transition Services for Youth with Disabilities in the United States. Discussion Paper

ERIC Educational Resources Information Center

National Center on Secondary Education and Transition (NCSET), University of Minnesota, 2004

2004-01-01

This paper is intended to promote discussion among professionals, policymakers, employers, parents, and individuals with disabilities concerning current and future challenges facing secondary education and transition services nationally. The issues identified and discussed should not, however, be viewed as inclusive of the full range of possible…

Challenges of Virtual School Leadership

ERIC Educational Resources Information Center

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

2015-01-01

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

Intimate partner violence and challenges facing women living with HIV/AIDS in accessing antiretroviral treatment at Singida Regional Hospital, central Tanzania

PubMed Central

Kosia, Agnes; Kakoko, Deodatus; Semakafu, Ave Maria Emilius; Nyamhanga, Tumaini; Frumence, Gasto

2016-01-01

Background Human immunodeficiency virus (HIV) remains a global public health problem. Sub-Saharan Africa is the region most affected by HIV/AIDS in the world. Globally, and in Tanzania in particular, women are more affected by HIV/AIDS than men. Tanzania has been reported to be among the countries with the highest burden of intimate partner violence (IPV). This study explored the challenges facing women living with HIV/AIDS (LWHA) attending the care and treatment clinic (CTC) in Singida Regional Hospital in Tanzania. Design A qualitative study was performed in which data were collected through in-depth interviews with 35 women LWHA who also experienced IPV. Content analysis was used to analyse the data. Results The study findings showed that women LWHA experienced challenges from their male partners in the form of lack of fare to attend CTC, delayed attendance to CTC, verbal threats and intimidation, mistrust partner resulting in changed antiretroviral (ARV) dosing time. Also, systemic challenges such as malfunction of CD4 count testing apparatus contributed to mistrust from their male partners which led to IPV. Conclusion In this study, women LWHA experienced IPV challenges that resulted in poor adherence to ARV medication and CTC attendance, as well as insufficient time to collect ARV medication. It is recommended that the government address systemic challenges faced by women LWHA, introduce multiple approaches to address the needs of women LWHA experiencing IPV, and develop strong policies to prevent IPV against women in Tanzania, regardless of their HIV status. PMID:27987296

Interpersonal similarity between body movements in face-to-face communication in daily life.

PubMed

Higo, Naoki; Ogawa, Ken-ichiro; Minemura, Juichi; Xu, Bujie; Nozawa, Takayuki; Ogata, Taiki; Ara, Koji; Yano, Kazuo; Miyake, Yoshihiro

2014-01-01

Individuals are embedded in social networks in which they communicate with others in their daily lives. Because smooth face-to-face communication is the key to maintaining these networks, measuring the smoothness of such communication is an important issue. One indicator of smoothness is the similarity of the body movements of the two individuals concerned. A typical example noted in experimental environments is the interpersonal synchronization of body movements such as nods and gestures during smooth face-to-face communication. It should therefore be possible to estimate quantitatively the smoothness of face-to-face communication in social networks through measurement of the synchronization of body movements. However, this is difficult because social networks, which differ from disciplined experimental environments, are open environments for the face-to-face communication between two individuals. In such open environments, their body movements become complicated by various external factors and may follow unstable and nonuniform patterns. Nevertheless, we consider there to be some interaction during face-to-face communication that leads to the interpersonal synchronization of body movements, which can be seen through the interpersonal similarity of body movements. The present study aims to clarify such interaction in terms of body movements during daily face-to-face communication in real organizations of more than 100 people. We analyzed data on the frequency of body movement for each individual during face-to-face communication, as measured by a wearable sensor, and evaluated the degree of interpersonal similarity of body movements between two individuals as their frequency difference. Furthermore, we generated uncorrelated data by resampling the data gathered and compared these two data sets statistically to distinguish the effects of actual face-to-face communication from those of the activities accompanying the communication. Our results confirm an

Interpersonal Similarity between Body Movements in Face-To-Face Communication in Daily Life

PubMed Central

Higo, Naoki; Ogawa, Ken-ichiro; Minemura, Juichi; Xu, Bujie; Nozawa, Takayuki; Ogata, Taiki; Ara, Koji; Yano, Kazuo; Miyake, Yoshihiro

2014-01-01

Individuals are embedded in social networks in which they communicate with others in their daily lives. Because smooth face-to-face communication is the key to maintaining these networks, measuring the smoothness of such communication is an important issue. One indicator of smoothness is the similarity of the body movements of the two individuals concerned. A typical example noted in experimental environments is the interpersonal synchronization of body movements such as nods and gestures during smooth face-to-face communication. It should therefore be possible to estimate quantitatively the smoothness of face-to-face communication in social networks through measurement of the synchronization of body movements. However, this is difficult because social networks, which differ from disciplined experimental environments, are open environments for the face-to-face communication between two individuals. In such open environments, their body movements become complicated by various external factors and may follow unstable and nonuniform patterns. Nevertheless, we consider there to be some interaction during face-to-face communication that leads to the interpersonal synchronization of body movements, which can be seen through the interpersonal similarity of body movements. The present study aims to clarify such interaction in terms of body movements during daily face-to-face communication in real organizations of more than 100 people. We analyzed data on the frequency of body movement for each individual during face-to-face communication, as measured by a wearable sensor, and evaluated the degree of interpersonal similarity of body movements between two individuals as their frequency difference. Furthermore, we generated uncorrelated data by resampling the data gathered and compared these two data sets statistically to distinguish the effects of actual face-to-face communication from those of the activities accompanying the communication. Our results confirm an

From Nonclinical Research to Clinical Trials and Patient-registries: Challenges and Opportunities in Biomedical Research

PubMed Central

de la Torre Hernández, José M.; Edelman, Elazer R.

2018-01-01

The most important challenge faced by human beings is health. The only way to provide better solutions for health care is innovation, true innovation. The only source of true innovation is research, good research indeed. The pathway from a basic science study to a randomized clinical trial is long and not free of bumps and even landmines. These are all the obstacles and barriers that limit the availability of resources, entangle administrative-regulatory processes, and restrain investigators’ initiatives. There is increasing demand for evidence to guide clinical practice but, paradoxically, biomedical research has become increasingly complex, expensive, and difficult to integrate into clinical care with increased barriers to performing the practical aspects of investigation. We face the challenge of increasing the volume of biomedical research and simultaneously improving the efficiency and output of this research. In this article, we review the main stages and methods of biomedical research, from nonclinical studies with animal and computational models to randomized trials and clinical registries, focusing on their limitations and challenges, but also providing alternative solutions to overcome them. Fortunately, challenges are always opportunities in disguise. PMID:28838647

Challenges faced by multidisplinary new investigators on addressing grand challenges in global health

PubMed Central

2014-01-01

Background The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an ‘Integrated Innovation™’ approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the ‘Rising Stars in Global Health’ award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Discussion Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors’ visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Conclusions Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators

Challenges faced by multidisplinary new investigators on addressing grand challenges in global health.

PubMed

Logie, Carmen; Dimaras, Helen; Fortin, Anny; Ramón-García, Santiago

2014-04-15

The grand challenges approach aims to spark innovative and transformative strategies to overcome barriers to significant global health issues. Grand Challenges Canada endorses an 'Integrated Innovation™' approach that focuses on the intersection of scientific/technological, social and business innovation. In this article we explore themes emerging from a dialogue between the authors, who are multidisciplinary recipients of the 'Rising Stars in Global Health' award from Grand Challenges Canada, regarding benefits of engaging in integrated innovation research, and recommendations for how this approach may develop in the future. Our dialogue followed a semi-structured interview format that addressed three topics: 1) reflections on applying an Integrated Innovation™ approach for global health; 2) thoughts on participation in the Grand Challenges 2012 meeting; and 3) authors' visions of Grand Challenges Canada and the Grand Challenge movement towards 2020. The dialogue was transcribed verbatim and we used thematic analysis techniques to identify, analyze and report themes in the data. Benefits of working using the Grand Challenges approach centered on two themes: a) the potential for scientific breakthrough and b) building interdisciplinary collaborations and a community of scholars. Challenges and opportunities for Grand Challenges in moving forward included: a) capacity building, particularly regarding Integrated Innovation™ and scale-up planning; b) interdisciplinary and international mentorship for new investigators; and c) potential for future commercialization. Our discussion highlighted that Integrated Innovation™ offers the opportunity to develop new theories, methods and approaches to global health while simultaneously fostering a collaborative spirit grounded in international, interdisciplinary collaborations. However, the arguable over-emphasis on corporatization poses a major challenge for new investigators. We propose a more balanced way forward

Knowledge Production and Transmission in a Changing Society: Challenges Facing Law Lecturers in a Distance Education Environment in South Africa

ERIC Educational Resources Information Center

Scott, Susan

2006-01-01

In this article I highlight the challenges facing a law lecturer in a multicultural society in transformation where the student is being prepared to serve society in different occupational fields as a professional person. I indicate that the law itself cannot effect change. For this we need properly trained lawyers. For an effective transformation…

Challenges facing the veterinary profession in Ireland: 1. clinical veterinary services.

PubMed

Magalhães-Sant'Ana, Manuel; More, Simon J; Morton, David B; Hanlon, Alison J

2017-01-01

The provision of veterinary clinical services is known to elicit a range of challenges which require an ethical appraisal. In a recent Policy Delphi study, referrals/second opinions and 24 h emergency care were identified as matters of key concern by veterinary professionals in Ireland. In this case study (the first in a series of three resulting from a research workshop exploring challenges facing the veterinary profession in Ireland; the other two case studies investigate the on-farm use of veterinary antimicrobials and emergency/casualty slaughter certification) we aim to provide a value-based reflection on the constraints and possible opportunities for two prominent veterinary clinical services in Ireland: referrals/second opinions and 24 h emergency care. Using a qualitative focus group approach, this study gathered evidence from relevant stakeholders, namely referral and referring veterinarians, clients, animal charities, and the regulatory body. Six overarching, interrelated constraints emerged from the thematic analysis: the need to improve current guidance, managing clients' expectations, concerns with veterinarian well-being, financial issues, timeliness of referral, and conflicts between veterinary practices. Possible solutions to improve veterinary referral and out-of-hours clinical services included clarifying the terms used in current norms and regulations (namely 'referral', 'second opinion', '24 h emergency care' and '24 h cover'), improved communication (making the client aware of the different levels of veterinary care that are being offered, and transparent and full disclosure of clinical records), and the promotion of Continuing Veterinary Education in communication, business management and ethical decision-making. These findings may help inform the Veterinary Council of Ireland about future recommendations and regulatory measures.

Still a difficult business? Negotiating alcohol-related problems in general practice consultations.

PubMed

Rapley, Tim; May, Carl; Frances Kaner, Eileen

2006-11-01

This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews--two with GPs and one with a primary care team--where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.

In Pursuit of Ethical Research: Studying Hybrid Communities Using Online and Face-to-Face Communications

ERIC Educational Resources Information Center

Busher, Hugh; James, Nalita

2015-01-01

Hybrid communities using online and face-to-face communications to construct their practices are increasingly part of everyday life amongst people who have easy access to the internet. Researching these communities raises a number of challenges for researchers in the pursuit of ethical research. The paper begins by exploring what is understood by…

The medical leadership challenge in healthcare is an identity challenge.

PubMed

Andersson, Thomas

2015-01-01

The purpose of this article is to describe and analyse the identity challenges that physicians with medical leadership positions face. Four qualitative case studies were performed to address the fact that identity is processual, relational and situational. Physicians with managerial roles were interviewed, as well as their peers, supervisors and subordinates. Furthermore, observations were made to understand how different identities are displayed in action. This study illustrates that medical leadership implies identity struggles when physicians have manager positions, because of the different characteristics of the social identities of managers and physicians. Major differences are related between physicians as autonomous individuals in a system and managers as subordinates to the organizational system. There are psychological mechanisms that evoke the physician identity more often than the managerial identity among physicians who are managers, which explains why physicians who are managers tend to remain foremost physicians. The implications of the findings, that there are major identity challenges by being both a physician and manager, suggest that managerial physicians might not be the best prerequisite for medical leadership, but instead, cooperative relationships between physicians and non-physician managers might be a less difficult way to support medical leadership. Acknowledging and addressing identity challenges can be important both in creating structures in organizations and designing the training for managers in healthcare (both physicians and non-physicians) to support medical leadership. Medical leadership is most often related to organizational structure and/or leadership skills, but this paper discusses identity requirements and challenges related to medical leadership.

Robust Point Set Matching for Partial Face Recognition.

PubMed

Weng, Renliang; Lu, Jiwen; Tan, Yap-Peng

2016-03-01

Over the past three decades, a number of face recognition methods have been proposed in computer vision, and most of them use holistic face images for person identification. In many real-world scenarios especially some unconstrained environments, human faces might be occluded by other objects, and it is difficult to obtain fully holistic face images for recognition. To address this, we propose a new partial face recognition approach to recognize persons of interest from their partial faces. Given a pair of gallery image and probe face patch, we first detect keypoints and extract their local textural features. Then, we propose a robust point set matching method to discriminatively match these two extracted local feature sets, where both the textural information and geometrical information of local features are explicitly used for matching simultaneously. Finally, the similarity of two faces is converted as the distance between these two aligned feature sets. Experimental results on four public face data sets show the effectiveness of the proposed approach.

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…

Engineering craniofacial structures: facing the challenge.

PubMed

Zaky, S H; Cancedda, R

2009-12-01

The human innate regenerative ability is known to be limited by the intensity of the insult together with the availability of progenitor cells, which may cause certain irreparable damage. It is only recently that the paradigm of tissue engineering found its way to the treatment of irreversibly affected body structures with the challenge of reconstructing the lost part. In the current review, we underline recent trials that target engineering of human craniofacial structures, mainly bone, cartilage, and teeth. We analyze the applied engineering strategies relative to the selection of cell types to lay down a specific targeted tissue, together with their association with an escorting scaffold for a particular engineered site, and discuss their necessity to be sustained by growth factors. Challenges and expectations for facial skeletal engineering are discussed in the context of future treatment.

Classroom Management Strategies for Difficult Students: Promoting Change through Relationships

ERIC Educational Resources Information Center

Beaty-O'Ferrall, Mary Ellen; Green, Alan; Hanna, Fred

2010-01-01

Teachers in middle level schools face overwhelming demands and challenges in their classrooms. They are expected to know content and pedagogy, develop engaging lessons that meet the needs of diverse learners, and use a variety of instructional strategies that will boost student achievement while they simultaneously develop positive relationships…

[Political challenges facing the consolidation of the Sistema Único de Saúde: a historical approach].

PubMed

Rodrigues, Paulo Henrique de Almeida

2014-01-01

This article investigates the circumstances in which Brazil’s sanitation reform was conceived and the Sistema Único de Saúde (SUS) was constructed. A brief analysis is conducted of Brazil’s political transition to democracy, focusing on three political challenges facing the consolidation of SUS: its weak support base amongst workers, competition with the private sector, and the fragmentation of its administration caused by its municipalization. Finally, the changes in the scenario caused by the weakening of neoliberalism since the 2008 crisis, the reemergence of a multipolar political scenario internationally, and the financing conditions of the Brazilian State are described.

Challenges Facing Children with Special Healthcare Needs and Their Families: Telemedicine as a Bridge to Care.

PubMed

Hooshmand, Mary; Yao, Kristiana

2017-01-01

Telemedicine is an increasingly utilized mode of healthcare delivery, which improves access to care for vulnerable populations. Children with Special Healthcare Needs (CSHCN) and their families face significant challenges, such as geographic, financial, and sociocultural barriers, in accessing needed healthcare services. The literature supports telemedicine as an effective accepted bridge between CSHCN and their providers. A growing body of telemedicine projects also suggests cost-effectiveness when considering the direct and indirect costs the families of CSCHN incur in seeking healthcare services. These new systems of care should prioritize caring and family centeredness while reducing the burdens of CSHCN and their families.

UNSCOM faces entirely new verification challenges in Iraq

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

Trevan, T.

1993-04-01

Starting with the very first declarations and inspections, it became evident that Iraq was not acting in good faith, would use every possible pretext to reinterpret UNSCOM's inspection rights, and occasionally would use harassment tactics to make inspections as difficult as possible. Topics considered in detail include; initial assumptions, outstanding issues, and UNSCOM's future attitude.

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.…

Smiles in face matching: Idiosyncratic information revealed through a smile improves unfamiliar face matching performance.

PubMed

Mileva, Mila; Burton, A Mike

2018-06-19

Unfamiliar face matching is a surprisingly difficult task, yet we often rely on people's matching decisions in applied settings (e.g., border control). Most attempts to improve accuracy (including training and image manipulation) have had very limited success. In a series of studies, we demonstrate that using smiling rather than neutral pairs of images brings about significant improvements in face matching accuracy. This is true for both match and mismatch trials, implying that the information provided through a smile helps us detect images of the same identity as well as distinguishing between images of different identities. Study 1 compares matching performance when images in the face pair display either an open-mouth smile or a neutral expression. In Study 2, we add an intermediate level, closed-mouth smile, to identify the effect of teeth being exposed, and Study 3 explores face matching accuracy when only information about the lower part of the face is available. Results demonstrate that an open-mouth smile changes the face in an idiosyncratic way which aids face matching decisions. Such findings have practical implications for matching in the applied context where we typically use neutral images to represent ourselves in official documents. © 2018 The British Psychological Society.

ORNL Experience and Challenges Facing Dynamic Wireless Power Charging of EV's

DOE PAGES

Miller, John M.; Jones, Perry T.; Li, Jan-Mou; ...

2015-05-21

As visionary as dynamic, or in-motion, wireless charging of electric vehicles appears the concept is well over a century old as this paper will show. This is because the concept of magnetic induction dates back to the pioneering work of physicist Michael Faraday in the early 19th century. Today wireless power transfer (WPT) is being standardized for stationary and quasi-stationary charging of electric vehicles (EV). The Society of Automotive Engineers (SAE) has undertaken the standardization of stationary charging and will make this public during 2016. In addition to this the IEEE-SA (Standards Activities) initiated standards development for EV?s in theirmore » EVWPT working group in 2012. This study introduces the many challenges facing EVWPT in not only high power transfer to a moving vehicle and energy management at a utility scale, but communications in a vehicle to infrastructure (V2I) environment and management of high data rates, ultra-low latency, and dealing with communications loss in dense urban areas. Finally, future concepts such as guideway powering of EV?s are presented to illustrate one technical trajectory EVWPT may take.« less

Large Face on Spiral Galaxy NGC 3344

NASA Image and Video Library

2005-05-05

This ultraviolet image from NASA Galaxy Evolution Explorer is of the large face on spiral galaxy NGC 3344. The inner spiral arms are wrapped so tightly that they are difficult to distinguish. http://photojournal.jpl.nasa.gov/catalog/PIA07904

Face-masks for facial atopic eczema: consider a hydrocolloid dressing.

PubMed

Rademaker, Marius

2013-08-01

Facial involvement of atopic eczema in young children can be difficult to manage. Chronic scratching and rubbing, combined with parental reluctance to use topical corticosteroids on the face, often results in recalcitrant facial eczema. While wet wraps are a useful management option for moderate/severe atopic eczema involving the trunk and limbs they are difficult to use on the face. We describe the use of a face-mask using a widely available adhesive hydrocolloid dressing (DuoDerm extra thin) in three children with recalcitrant facial atopic eczema. Symptomatic control of itch or soreness was obtained within hours and the facial atopic eczema was markedly improved by 7 days. The face-masks were easy to apply, each lasting 1-4 days. One patient had a single adjuvant application of a potent topical corticosteroid under the hydrocolloid dressing. All three patients had long remissions (greater than 3 months) of their facial eczema, although all continued to have significant eczema involving their trunk and limbs. Face-masks made from hydrocolloid dressings, with or without topical corticosteroids, are worth considering in children with recalcitrant facial eczema. © 2012 The Author. Australasian Journal of Dermatology © 2012 The Australasian College of Dermatologists.

Challenges of a community based pragmatic, randomised controlled trial of weight loss maintenance.

PubMed

Randell, Elizabeth; McNamara, Rachel; Shaw, Christine; Espinasse, Aude; Simpson, Sharon Anne

2015-12-18

Randomised controlled trials (RCTs) have a reputation for being inherently difficult to deliver as planned and often face unforeseen challenges and delays, particularly in relation to organisational and governance difficulties, participant interest, constraints due to allocation of costs, local investigator interest and lengthy bureaucracy. Recruitment is often difficult and the challenges faced often impact on the cost and delivery of a successful trial within the funded period. This paper reflects upon the challenges faced in delivering a pragmatic RCT of weight loss maintenance in a community setting and suggests some potential solutions. The weight loss maintenance in adults trial aimed to evaluate the impact of a 12 month, individually tailored weight maintenance intervention on BMI 3 years from randomisation. Participants were recruited primarily from participant identification centres (PICs)-GP surgeries, exercise on referral schemes and slimming world. The intervention was delivered in community settings. A recruitment strategy implementation plan was drafted to address and monitor poor recruitment. Delays in opening and recruitment were experienced early on. Some were beyond the control of the study team such as; disagreement over allocation of national health service costs and PIC classification as well as difficulties in securing support from research networks. That the intervention was delivered in community settings was often at the root of these issues. Key items to address at the design stage of future trials include feasibility of eligibility criteria. The most effective element of the recruitment implementation plan was to refocus sources of recruitment and target only those who could fulfil the eligibility criteria immediately. Learnings from this trial should be kept in mind by those designing similar studies in the future. Considering potential governance, cost and research network support implications at the design stage of pragmatic trials of

An Investigation into Challenges Faced by Secondary School Teachers and Pupils in Algebraic Linear Equations: A Case of Mufulira District, Zambia

ERIC Educational Resources Information Center

Samuel, Koji; Mulenga, H. M.; Angel, Mukuka

2016-01-01

This paper investigates the challenges faced by secondary school teachers and pupils in the teaching and learning of algebraic linear equations. The study involved 80 grade 11 pupils and 15 teachers of mathematics, drawn from 4 selected secondary schools in Mufulira district, Zambia in Central Africa. A descriptive survey method was employed to…

Flexray - An Answer to the Challenges Faced by Spacecraft On-Board Communication Protocols

NASA Astrophysics Data System (ADS)

Gunes-Lasnet, S.; Furano, G.

2007-08-01

The current spacecraft on-board network protocols are facing challenges: They need to consume low power, to handle a high data rate, and eventually need to have real-time capabilities as well as fault-tolerance; all of this at a low cost. Meanwhile, the automotive protocols are showing ever increasing enhanced performances: the automotive industry has shown recent break-throughs in communication networks. Among them, FlexRay targets specifically the next generation of automotive applications allowing Steer-by-Wire and Brake-by- Wire. FlexRay supports a very high data rate, is fault- tolerant, has real-time capabilities, and supports both periodic and aperiodic data transfer on a single bus. Space avionics has benefited from the automotive spin- ins in the past, so could FlexRay answer the space systems demands? This paper aims at demonstrating that space avionics could profit from the use of FlexRay.

Challenges facing the farm animal veterinary profession in England: A qualitative study of veterinarians' perceptions and responses.

PubMed

Ruston, Annmarie; Shortall, Orla; Green, Martin; Brennan, Marnie; Wapenaar, Wendela; Kaler, Jasmeet

2016-05-01

The farm animal veterinary profession in the UK has faced a number of challenges in recent decades related to the withdrawal of government funding and a contraction of the agricultural sector. They have come under pressure to respond by developing skills and focusing on disease prevention advisory services. However, this puts veterinarians in competition with other providers of these services, and moves in this direction have only been partial. Failure to respond to these challenges puts the veterinary profession at risk of de-professionalisation-a loss of their monopoly over knowledge, an erosion of client beliefs in their service ethos and a loss of work autonomy. This paper explores how farm animal veterinarians in England perceive these challenges and are responding to them. Semi-structured qualitative interviews were carried out with 28 veterinarians from Royal College of Veterinary Surgeon farm accredited practices. Veterinarians were chosen from high, medium and low density cattle farming regions. Interviews were recorded, transcribed and themes identified through the constant comparison method. The majority of respondents recognised the challenges facing the veterinary profession. Most believed their role had changed, moving towards that of a disease prevention adviser who was part of the farm management team. In terms of maintaining and redefining their professional status, farm animal veterinarians do have a defined body of knowledge and the ability to develop trusting relationships with clients, which enhances their competitiveness. However, while they recognise the changes and challenges, moves towards a disease prevention advisory model have only been partial. There seem to be little effort towards using Farm accreditation status or other strategies to promote their services. They do not appear to be finding effective strategies for putting their knowledge on disease prevention into practice. Disease prevention appears to be delivered on farm on an ad

Difficult to control atopic dermatitis

PubMed Central

2013-01-01

Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection contribute to disease exacerbation and thus justify additional antimicrobial / antiseptic treatment. Systemic antihistamines (H1) may relieve pruritus but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength. “Eczema school” educational programs have been proven to be helpful. PMID:23663504

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.

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

The challenges that parents of children with epilepsy face: A qualitative study.

PubMed

Kampra, Matina; Tzerakis, Nikolaos; Lund Holm Thomsen, Louise; Katsarou, Efstathia; Voudris, Konstantinos; D Mastroyianni, Sotiria; Mouskou, Stella; Drossou, Kyriaki S; Siatouni, Anna; Gatzonis, Stylianos

2017-06-01

This qualitative study explored the challenges that Greek parents/caregivers of children with controlled epilepsy (CwE) face regarding the disorder. Interviews were conducted based on open-ended questions guided by a review of the literature. A total of 91 parents/caregivers were recruited by neurologists at the neurology clinics of two Athens public hospitals. A hermeneutic phenomenological approach was used to explore parent/caregiver experiences. The data were grouped and analyzed through a textual interpretation. Two key challenges were identified for parents of CwE: the disclosure of epilepsy and the absence of adequate information about coping with epilepsy. Parents in Greece were hesitant to reveal their child's epilepsy to school staff and their wider social milieu. Also, although satisfied with the patient-centered approach they experienced with their hospital doctor, parents/caregivers found that they needed more education about the existing sources of psychosocial and emotional support to cope with their child's epilepsy personally and as a family. Finally, the parents/caregivers who let their child know about the epilepsy and discussed the implications with the child found that parent-child communication improved. This study provides valuable insight into the impact of epilepsy on parents of CwE, which might help hospital and school staff support families with greater understanding, sensitivity, and skill. The findings suggest that Greek authorities should staff hospitals and schools with experts and more systematically advertise sources of information about epilepsy and ways to cope with it. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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

ERIC Educational Resources Information Center

Afridi, Sam

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

Economic Development: A Community College Faces the Challenge.

ERIC Educational Resources Information Center

Crowley, Jackie; Boatright, Joyce

1988-01-01

Faced with a changing economy, the Houston Community College System (Texas) set goals and objectives to pull together its resources in response to the crisis in the Houston area. This article describes successful strategies and approaches used to network, market, and develop company partnerships and training activities to meet local needs. (Author)

Two areas for familiar face recognition in the primate brain.

PubMed

Landi, Sofia M; Freiwald, Winrich A

2017-08-11

Familiarity alters face recognition: Familiar faces are recognized more accurately than unfamiliar ones and under difficult viewing conditions when unfamiliar face recognition fails. The neural basis for this fundamental difference remains unknown. Using whole-brain functional magnetic resonance imaging, we found that personally familiar faces engage the macaque face-processing network more than unfamiliar faces. Familiar faces also recruited two hitherto unknown face areas at anatomically conserved locations within the perirhinal cortex and the temporal pole. These two areas, but not the core face-processing network, responded to familiar faces emerging from a blur with a characteristic nonlinear surge, akin to the abruptness of familiar face recognition. In contrast, responses to unfamiliar faces and objects remained linear. Thus, two temporal lobe areas extend the core face-processing network into a familiar face-recognition system. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas.

PubMed

Kivelevitch, Dario; Frieder, Jillian; Watson, Ian; Paek, So Yeon; Menter, M Alan

2018-04-01

Despite great therapeutic advancements in psoriasis, four notable difficult-to-treat areas including the scalp, nails, intertriginous (including genitals), and palmoplantar regions, pose a challenge to both physicians and patients. Localized disease of these specific body regions inflicts a significant burden on patients' quality of life and requires an adequate selection of treatments. Areas covered: This manuscript discusses appropriate therapies and important treatment considerations for these difficult-to-treat areas based on the available clinical data from the literature. Expert opinion: Clinical trials assessing therapies for the difficult-to-treat areas have been inadequate. With the first biological clinical trial for genital psoriasis pending publication, it is with hope that other biological agents will be evaluated for region-specific psoriasis. A greater understanding of the genetic and immunologic aspects of regional psoriasis, as well as identification of unique biomarkers, will further guide management decisions. For example, the recent discovery of the IL-36 receptor gene for generalized pustular psoriasis may prove valuable for other forms of psoriasis. Ultimately, identification of the most beneficial treatments for each psoriasis subtype and difficult-to-treat area will provide patients with maximal quality of life.

Challenges faced in e-infrastructure at the Ministry of Mines and Energy, Namibia

NASA Astrophysics Data System (ADS)

Maletzky, Monica; Mhopjeni, Kombada

2014-05-01

The e-infrastructure at the Ministry of Mines is undergoing considerable restructuring with most of it in the planning phase. One of the main challenges faced is the Local Area Network that is outdated and not capable to handling the volume of data that is transferred in the network. Most of the Network Interface Cards (NIC) on the servers and all related LAN equipment have a capability of 10/100Mb/s and cannot support the volume of data transported over the network. This is not adequate for the need of high end users such as geoscientists who work with large geological, remote sensing and geophysical datasets. Taking the above into consideration the Ministry has embarked on implementing changes to the network. The initiative involves the acquisition of Cisco Layer3 switches that have the capability of transferring large volumes of data, up to 10Gb/s. Subsequent upgrades of the NICs and small form-factor pluggable (SFP) are planned in the near future. Apart from the internal network, the Ministry's present internet connection is insufficient as the Ministry shares the outbound link with all other Ministries in the Namibian government. The internet provided by the Office of the Prime Minister (OPM), which serves as the government's internet service provider (ISP), to our institution is currently 2Mb/s. OPM has embarked on the upgrade of the network infrastructure. The first phase of the involved the upgrade of the national point of presence (POP) to operate at a capacity of 300Mb/s. This would be followed by the expansion of a fibre network to all the government institutions. Upon completion, the internet performance will be improved as it is envisaged that the Ministry of Mines and Energy's bandwidth will be upgraded to 10Mb/s and hopefully alleviate the current strain on the system. This project is expected to be completed by June 2014. However, due to the challenges that our office is faced with, we have acquired a 4Mb/s internet link for the interim period

Face learning and the emergence of view-independent face recognition: an event-related brain potential study.

PubMed

Zimmermann, Friederike G S; Eimer, Martin

2013-06-01

Recognizing unfamiliar faces is more difficult than familiar face recognition, and this has been attributed to qualitative differences in the processing of familiar and unfamiliar faces. Familiar faces are assumed to be represented by view-independent codes, whereas unfamiliar face recognition depends mainly on view-dependent low-level pictorial representations. We employed an electrophysiological marker of visual face recognition processes in order to track the emergence of view-independence during the learning of previously unfamiliar faces. Two face images showing either the same or two different individuals in the same or two different views were presented in rapid succession, and participants had to perform an identity-matching task. On trials where both faces showed the same view, repeating the face of the same individual triggered an N250r component at occipito-temporal electrodes, reflecting the rapid activation of visual face memory. A reliable N250r component was also observed on view-change trials. Crucially, this view-independence emerged as a result of face learning. In the first half of the experiment, N250r components were present only on view-repetition trials but were absent on view-change trials, demonstrating that matching unfamiliar faces was initially based on strictly view-dependent codes. In the second half, the N250r was triggered not only on view-repetition trials but also on view-change trials, indicating that face recognition had now become more view-independent. This transition may be due to the acquisition of abstract structural codes of individual faces during face learning, but could also reflect the formation of associative links between sets of view-specific pictorial representations of individual faces. Copyright © 2013 Elsevier Ltd. All rights reserved.

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…

Holistic face processing can inhibit recognition of forensic facial composites.

PubMed

McIntyre, Alex H; Hancock, Peter J B; Frowd, Charlie D; Langton, Stephen R H

2016-04-01

Facial composite systems help eyewitnesses to show the appearance of criminals. However, likenesses created by unfamiliar witnesses will not be completely accurate, and people familiar with the target can find them difficult to identify. Faces are processed holistically; we explore whether this impairs identification of inaccurate composite images and whether recognition can be improved. In Experiment 1 (n = 64) an imaging technique was used to make composites of celebrity faces more accurate and identification was contrasted with the original composite images. Corrected composites were better recognized, confirming that errors in production of the likenesses impair identification. The influence of holistic face processing was explored by misaligning the top and bottom parts of the composites (cf. Young, Hellawell, & Hay, 1987). Misalignment impaired recognition of corrected composites but identification of the original, inaccurate composites significantly improved. This effect was replicated with facial composites of noncelebrities in Experiment 2 (n = 57). We conclude that, like real faces, facial composites are processed holistically: recognition is impaired because unlike real faces, composites contain inaccuracies and holistic face processing makes it difficult to perceive identifiable features. This effect was consistent across composites of celebrities and composites of people who are personally familiar. Our findings suggest that identification of forensic facial composites can be enhanced by presenting composites in a misaligned format. (c) 2016 APA, all rights reserved).

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

ERIC Educational Resources Information Center

Berch, Daniel B.

2017-01-01

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

[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.

From Toques to Tokes: Two challenges facing nationwide legalization of cannabis in Canada.

PubMed

Bear, Daniel

2017-04-01

In 2015, a new Liberal Government came to power in Canada, elected on a platform that included legalization and regulation of cannabis for recreational purposes. Their legislation, based on recommendations from a Federal Task Force on Marijuana Legalization and Regulation, is due in early April 2017. This commentary utilizes Canadian Federal policy papers, previous literature, and internal and international agreements to examine two key areas critical to the development of a nationwide regulated market for cannabis in Canada; the need to overcome restrictions to legalizing cannabis in United Nations' drug control treaties, and the unique challenges that non-medical cannabis creates for navigating interprovincial trade policies in Canada. Irrespective of UN conventions that appear to prohibit legalization of cannabis the Government is preparing to bring forward legislation as this article goes to print. At the same time significant squabbles impede the selling of even beer and wine inter-provincially in Canada. This paper identifies the challenges facing Canadian legalization efforts, but also shows how the legalization legislation may provide opportunities to engender significant change beyond the simple legalization of a specific drug. This commentary does not argue for any specific course of action for Canada, but rather explores the nuance of legalization absent from the declaration in the Liberal party platform. The paper argues that Canada's efforts may hasten the dismantling of the UN drug control structure, and provide renewed opportunities for intern-provincial trade in Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

The Informatics Challenges Facing Biobanks: A Perspective from a United Kingdom Biobanking Network

PubMed Central

Groves, Martin; Jordan, Lee B.; Stobart, Hilary; Purdie, Colin A.; Thompson, Alastair M

2015-01-01

The challenges facing biobanks are changing from simple collections of materials to quality-assured fit-for-purpose clinically annotated samples. As a result, informatics awareness and capabilities of a biobank are now intrinsically related to quality. A biobank may be considered a data repository, in the form of raw data (the unprocessed samples), data surrounding the samples (processing and storage conditions), supplementary data (such as clinical annotations), and an increasing ethical requirement for biobanks to have a mechanism for researchers to return their data. The informatics capabilities of a biobank are no longer simply knowing sample locations; instead the capabilities will become a distinguishing factor in the ability of a biobank to provide appropriate samples. There is an increasing requirement for biobanking systems (whether in-house or commercially sourced) to ensure the informatics systems stay apace with the changes being experienced by the biobanking community. In turn, there is a requirement for the biobanks to have a clear informatics policy and directive that is embedded into the wider decision making process. As an example, the Breast Cancer Campaign Tissue Bank in the UK was a collaboration between four individual and diverse biobanks in the UK, and an informatics platform has been developed to address the challenges of running a distributed network. From developing such a system there are key observations about what can or cannot be achieved by informatics in isolation. This article will highlight some of the lessons learned during this development process. PMID:26418270

Speaking from the Inside: Challenges Faced by Communication Researchers Investigating Disease-Related Issues in a Hospital Setting.

PubMed

Bourquin, Céline; Stiefel, Friedrich; Singy, Pascal

2015-09-01

This commentary came from within the framework of integrating the humanities in medicine and from accompanying research on disease-related issues by teams involving clinicians and researchers in medical humanities. The purpose is to reflect on the challenges faced by researchers when conducting emotionally laden research and on how they impact observations and subsequent research findings. This commentary is furthermore a call to action since it promotes the institutionalization of a supportive context for medical humanities researchers who have not been trained to cope with sensitive medical topics in research. To that end, concrete recommendations regarding training and supervision were formulated.

Face recognition using facial expression: a novel approach

NASA Astrophysics Data System (ADS)

Singh, Deepak Kumar; Gupta, Priya; Tiwary, U. S.

2008-04-01

Facial expressions are undoubtedly the most effective nonverbal communication. The face has always been the equation of a person's identity. The face draws the demarcation line between identity and extinction. Each line on the face adds an attribute to the identity. These lines become prominent when we experience an emotion and these lines do not change completely with age. In this paper we have proposed a new technique for face recognition which focuses on the facial expressions of the subject to identify his face. This is a grey area on which not much light has been thrown earlier. According to earlier researches it is difficult to alter the natural expression. So our technique will be beneficial for identifying occluded or intentionally disguised faces. The test results of the experiments conducted prove that this technique will give a new direction in the field of face recognition. This technique will provide a strong base to the area of face recognition and will be used as the core method for critical defense security related issues.

Inter-hemispheric interaction facilitates face processing.

PubMed

Compton, Rebecca J

2002-01-01

Many recent studies have revealed that interaction between the left and right cerebral hemispheres can aid in task performance, but these studies have tended to examine perception of simple stimuli such as letters, digits or simple shapes, which may have limited naturalistic validity. The present study extends these prior findings to a more naturalistic face perception task. Matching tasks required subjects to indicate when a target face matched one of two probe faces. Matches could be either across-field, requiring inter-hemispheric interaction, or within-field, not requiring inter-hemispheric interaction. Subjects indicated when faces matched in emotional expression (Experiment 1; n=32) or in character identity (Experiment 2; n=32). In both experiments, across-field performance was significantly better than within-field performance, supporting the primary hypothesis. Further, this advantage was greater for the more difficult character identity task. Results offer qualified support for the hypothesis that inter-hemispheric interaction is especially advantageous as task demands increase.

An equine pain face

PubMed Central

Gleerup, Karina B; Forkman, Björn; Lindegaard, Casper; Andersen, Pia H

2015-01-01

Objective The objective of this study was to investigate the existence of an equine pain face and to describe this in detail. Study design Semi-randomized, controlled, crossover trial. Animals Six adult horses. Methods Pain was induced with two noxious stimuli, a tourniquet on the antebrachium and topical application of capsaicin. All horses participated in two control trials and received both noxious stimuli twice, once with and once without an observer present. During all sessions their pain state was scored. The horses were filmed and the close-up video recordings of the faces were analysed for alterations in behaviour and facial expressions. Still images from the trials were evaluated for the presence of each of the specific pain face features identified from the video analysis. Results Both noxious challenges were effective in producing a pain response resulting in significantly increased pain scores. Alterations in facial expressions were observed in all horses during all noxious stimulations. The number of pain face features present on the still images from the noxious challenges were significantly higher than for the control trial (p = 0.0001). Facial expressions representative for control and pain trials were condensed into explanatory illustrations. During pain sessions with an observer present, the horses increased their contact-seeking behavior. Conclusions and clinical relevance An equine pain face comprising ‘low’ and/or ‘asymmetrical’ ears, an angled appearance of the eyes, a withdrawn and/or tense stare, mediolaterally dilated nostrils and tension of the lips, chin and certain facial muscles can be recognized in horses during induced acute pain. This description of an equine pain face may be useful for improving tools for pain recognition in horses with mild to moderate pain. PMID:25082060

The Nature of Elementary Science Teachers' Experiences with Synchronous Online, Asynchronous Online and Face-to-Face Coaching

NASA Astrophysics Data System (ADS)

Gilbert, Amanda M.

This study investigated the nature of instructional coaching interactions in three formats: online synchronous, online asynchronous, and face-to-face. Knight's (2007) Seven Partnership Principles of Instructional Coaching were used as a framework to analyze and compare the coaching interactions between coach and teacher to determine whether online coaching may be a viable option to provide support for the teachers unprepared to teach the new science standards. Some previous research has suggested that online communication can result in deeper personal interactions (Walther, 1996), while other studies suggest that interactions are more natural and easier in formats that are more similar to face-to-face interactions (Kock, 2005). The findings of this study support the media naturalness theory (Kock, 2005) and suggest that collaboration may be especially difficult in asynchronous online communication. Although differences were noted in the actual interactions, teacher perception remained fairly consistently positive across the three formats. Research beyond this exploratory study is needed to make findings generalizable.

Impression Management in Kindergarten Classrooms: An Analysis of Children's Face-Work in Peer Interactions.

ERIC Educational Resources Information Center

Hatch, J. Amos

A systematic analysis was made of the communications of 5- and 6-year-old children in two kindergarten classrooms to discover whether children's face-to-face interactions with peers included "face work" components (rituals through which individuals manage impressions when it becomes difficult to maintain a social situation) and, if so,…

How to Handle Difficult Parents: Proven Solutions for Teachers. Second Edition

ERIC Educational Resources Information Center

Tingley, Suzanne Capek

2012-01-01

"How to Handle Difficult Parents" is a funny, but practical, guide to working effectively with parents and avoiding unnecessary conflict. Whether you're a teacher (regular or special education) or a coach, this book will give you practical suggestions regarding what to say and how to say it to parents who question your lesson plans, challenge your…

Difficult incidents and tutor interventions in problem-based learning tutorials.

PubMed

Kindler, Pawel; Grant, Christopher; Kulla, Steven; Poole, Gary; Godolphin, William

2009-09-01

Tutors report difficult incidents and distressing conflicts that adversely affect learning in their problem-based learning (PBL) groups. Faculty development (training) and peer support should help them to manage this. Yet our understanding of these problems and how to deal with them often seems inadequate to help tutors. The aim of this study was to categorise difficult incidents and the interventions that skilled tutors used in response, and to determine the effectiveness of those responses. Thirty experienced and highly rated tutors in our Year 1 and 2 medical curriculum took part in semi-structured interviews to: identify and describe difficult incidents; describe how they responded, and assess the success of each response. Recorded and transcribed data were analysed thematically to develop typologies of difficult incidents and interventions and compare reported success or failure. The 94 reported difficult incidents belonged to the broad categories 'individual student' or 'group dynamics'. Tutors described 142 interventions in response to these difficult incidents, categorised as: (i) tutor intervenes during tutorial; (ii) tutor gives feedback outside tutorial, or (iii) student or group intervenes. Incidents in the 'individual student' category were addressed relatively unsuccessfully (effective < 50% of the time) by response (i), but with moderate success by response (ii) and successfully (> 75% of the time) by response (iii). None of the interventions worked well when used in response to problems related to 'group dynamics'. Overall, 59% of the difficult incidents were dealt with successfully. Dysfunctional PBL groups can be highly challenging, even for experienced and skilled tutors. Within-tutorial feedback, the treatment that tutors are most frequently advised to apply, was often not effective. Our study suggests that the collective responsibility of the group, rather than of the tutor, to deal with these difficulties should be emphasised.

Challenges When Introducing Electronic Exam

ERIC Educational Resources Information Center

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

2014-01-01

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

Measurement and visualization of face-to-face interaction among community-dwelling older adults using wearable sensors.

PubMed

Masumoto, Kouhei; Yaguchi, Takaharu; Matsuda, Hiroshi; Tani, Hideaki; Tozuka, Keisuke; Kondo, Narihiko; Okada, Shuichi

2017-10-01

A number of interventions have been undertaken to develop and promote social networks among community-dwelling older adults. However, it has been difficult to examine the effects of these interventions, because of problems in assessing interactions. The present study was designed to quantitatively measure and visualize face-to-face interactions among elderly participants in an exercise program. We also examined relationships among interactional variables, personality and interest in community involvement, including interactions with the local community. Older adults living in the same community were recruited to participate in an exercise program that consisted of four sessions. We collected data on face-to-face interactions of the participants by using a wearable sensor technology device. Network analysis identified the communication networks of participants in the exercise program, as well as changes in these networks. Additionally, there were significant correlations between the number of people involved in face-to-face interactions and changes in both interest in community involvement and interactions with local community residents, as well as personality traits, including agreeableness. Social networks in the community are essential for solving problems caused by the aging society. We showed the possible applications of face-to-face interactional data for identifying core participants having many interactions, and isolated participants having only a few interactions within the community. Such data would be useful for carrying out efficient interventions for increasing participants' involvement with their community. Geriatr Gerontol Int 2017; 17: 1752-1758. © 2017 Japan Geriatrics Society.

Antenatal counselling for parents facing an extremely preterm birth: limitations of the medical evidence.

PubMed

Janvier, Annie; Lorenz, John M; Lantos, John D

2012-08-01

When physicians are asked for a consult for women in premature labour, they face a complex set of challenges. Policy statements recommend that women be given detailed information about the risks of various outcomes, including death, long-term disability and various specific neonatal problems. Both personal narratives and studies suggest that parents also base their decisions on factors other than the probabilistic facts about expected outcomes. Statistics are difficult to understand at any time. Rational decision-making may be difficult when taking life-and-death decisions. Furthermore, the role of emotions is not discussed in peri-viability guidelines. We argue against trying to tell parents every fact that we think might be relevant to their decision. This may be overwhelming for many parents. Instead, doctors should try to discern, on a case-by-case basis, what particular parents want and need. Information and delivery of information should be personalized. Unfortunately, evidence in this area is limited. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Hierarchical Spatio-Temporal Probabilistic Graphical Model with Multiple Feature Fusion for Binary Facial Attribute Classification in Real-World Face Videos.

PubMed

Demirkus, Meltem; Precup, Doina; Clark, James J; Arbel, Tal

2016-06-01

Recent literature shows that facial attributes, i.e., contextual facial information, can be beneficial for improving the performance of real-world applications, such as face verification, face recognition, and image search. Examples of face attributes include gender, skin color, facial hair, etc. How to robustly obtain these facial attributes (traits) is still an open problem, especially in the presence of the challenges of real-world environments: non-uniform illumination conditions, arbitrary occlusions, motion blur and background clutter. What makes this problem even more difficult is the enormous variability presented by the same subject, due to arbitrary face scales, head poses, and facial expressions. In this paper, we focus on the problem of facial trait classification in real-world face videos. We have developed a fully automatic hierarchical and probabilistic framework that models the collective set of frame class distributions and feature spatial information over a video sequence. The experiments are conducted on a large real-world face video database that we have collected, labelled and made publicly available. The proposed method is flexible enough to be applied to any facial classification problem. Experiments on a large, real-world video database McGillFaces [1] of 18,000 video frames reveal that the proposed framework outperforms alternative approaches, by up to 16.96 and 10.13%, for the facial attributes of gender and facial hair, respectively.

Side-branch technique for difficult guidewire placement in coronary bifurcation lesion.

PubMed

He, Xingwei; Gao, Bo; Liu, Yujian; Li, Zhuxi; Zeng, Hesong

2016-01-01

Despite tremendous advances in technology and skills, percutaneous coronary intervention (PCI) of bifurcation lesion (BL) remains a particular challenge for the interventionalist. During bifurcation PCI, safe guidewire placement in the main branch (MB) and the side branch (SB) is the first step for successful procedure. However, in certain cases, the complex pattern of vessel anatomy and the mix of plaque distribution may make target vessel wiring highly challenging. Therefore, specific techniques are required for solving this problem. Hereby, we describe a new use of side-branch technique for difficult guidewire placement in BL. Copyright © 2015 Elsevier Inc. All rights reserved.

Feature instructions improve face-matching accuracy

PubMed Central

Bindemann, Markus

2018-01-01

Identity comparisons of photographs of unfamiliar faces are prone to error but important for applied settings, such as person identification at passport control. Finding techniques to improve face-matching accuracy is therefore an important contemporary research topic. This study investigated whether matching accuracy can be improved by instruction to attend to specific facial features. Experiment 1 showed that instruction to attend to the eyebrows enhanced matching accuracy for optimized same-day same-race face pairs but not for other-race faces. By contrast, accuracy was unaffected by instruction to attend to the eyes, and declined with instruction to attend to ears. Experiment 2 replicated the eyebrow-instruction improvement with a different set of same-race faces, comprising both optimized same-day and more challenging different-day face pairs. These findings suggest that instruction to attend to specific features can enhance face-matching accuracy, but feature selection is crucial and generalization across face sets may be limited. PMID:29543822

The Air Transportation Policy of Small States: Meeting the Challenges of Globalization

NASA Technical Reports Server (NTRS)

Antoniou, Andreas

2001-01-01

The air transport policies of small states are currently at a crossroad. Policy makers in these countries are facing a difficult dilemma: either follow the general trend of liberalization and pay the high cost of the resulting restructuring or maintain the existing regulatory and ownership structures at the risk of isolation thus undermining the viability and sustainability of their air transport sector and their economies in general. This paper proposes to explore the broad issues raised by this difficult dilemma, to outline its special significance in the context of small states and to delineate the options opened to the economic policymakers; in these states. After a brief note on the method of research, we sketch the main elements of the international air transport industry in which the airlines of small states are called upon to act. We then propose to review the main features of the analytical framework of this debate as it pertains to the special circumstances of these states. Then we focus on the challenges facing the airlines of Small States, while the next section proposes a number of the alternative policy options open to the policy makers in these states. The main conclusions are drawn in the final section.

Rewards and unique challenges faced by African-American custodial grandmothers: the importance of future planning.

PubMed

Crowther, Martha R; Huang, Chao-Hui Sylvia; Allen, Rebecca S

2015-01-01

This exploratory study examined the context and consequences of custodial grandparenting, along with attitudes and preferences regarding future planning among 22 African-American custodial grandmothers. A mixed-method research design was employed. Based on our integration of two theories regarding future planning and health behavior change, caregiving, emotional distress, religiosity and spirituality, and future planning were assessed using questionnaires along with semi-structured interviews. African-American custodial grandmothers (mean age M = 53.64, SD = 9.58) perceived their caregiving role as rewarding (72%) yet challenging (86%). More than 40% reported significant emotional distress (CES-D ≥ 16) that warrants clinical attention. Findings showed that while 64% of study participants had future plans regarding who will substitute in their caregiving role if they become incapacitated, only 9% had completed a living will. Three major themes emerged regarding custodial grandmothers' caregiving role which includes: (1) rewards; (2) challenges including feeling overwhelmed and health concerns; and (3) caregiving decisions including conflicts between 'My plan was…/put self on-hold' for grandchildren and difficulty with future planning. These themes highlighted the dynamics of caregiving across time, including current context and the ongoing process of decision-making. Findings suggest that while African-American custodial grandmothers find caregiving rewarding, they face unique challenges in contemplating and developing future plans. Custodial grandmothers think about substitute caregivers for their grandchildren but need assistance communicating a plan focused on their own needs for future care. Culturally sensitive interventions designed to facilitate effective utilization of future plans within this caregiver population are needed.

A survey of real face modeling methods

NASA Astrophysics Data System (ADS)

Liu, Xiaoyue; Dai, Yugang; He, Xiangzhen; Wan, Fucheng

2017-09-01

The face model has always been a research challenge in computer graphics, which involves the coordination of multiple organs in faces. This article explained two kinds of face modeling method which is based on the data driven and based on parameter control, analyzed its content and background, summarized their advantages and disadvantages, and concluded muscle model which is based on the anatomy of the principle has higher veracity and easy to drive.

Designing for Student-Facing Learning Analytics

ERIC Educational Resources Information Center

Kitto, Kirsty; Lupton, Mandy; Davis, Kate; Waters, Zak

2017-01-01

Despite a narrative that sees learning analytics (LA) as a field that aims to enhance student learning, few student-facing solutions have emerged. This can make it difficult for educators to imagine how data can be used in the classroom, and in turn diminishes the promise of LA as an enabler for encouraging important skills such as sense-making,…

Face recognition accuracy of forensic examiners, superrecognizers, and face recognition algorithms.

PubMed

Phillips, P Jonathon; Yates, Amy N; Hu, Ying; Hahn, Carina A; Noyes, Eilidh; Jackson, Kelsey; Cavazos, Jacqueline G; Jeckeln, Géraldine; Ranjan, Rajeev; Sankaranarayanan, Swami; Chen, Jun-Cheng; Castillo, Carlos D; Chellappa, Rama; White, David; O'Toole, Alice J

2018-06-12

Achieving the upper limits of face identification accuracy in forensic applications can minimize errors that have profound social and personal consequences. Although forensic examiners identify faces in these applications, systematic tests of their accuracy are rare. How can we achieve the most accurate face identification: using people and/or machines working alone or in collaboration? In a comprehensive comparison of face identification by humans and computers, we found that forensic facial examiners, facial reviewers, and superrecognizers were more accurate than fingerprint examiners and students on a challenging face identification test. Individual performance on the test varied widely. On the same test, four deep convolutional neural networks (DCNNs), developed between 2015 and 2017, identified faces within the range of human accuracy. Accuracy of the algorithms increased steadily over time, with the most recent DCNN scoring above the median of the forensic facial examiners. Using crowd-sourcing methods, we fused the judgments of multiple forensic facial examiners by averaging their rating-based identity judgments. Accuracy was substantially better for fused judgments than for individuals working alone. Fusion also served to stabilize performance, boosting the scores of lower-performing individuals and decreasing variability. Single forensic facial examiners fused with the best algorithm were more accurate than the combination of two examiners. Therefore, collaboration among humans and between humans and machines offers tangible benefits to face identification accuracy in important applications. These results offer an evidence-based roadmap for achieving the most accurate face identification possible. Copyright © 2018 the Author(s). Published by PNAS.

Challenges facing the development of the Arabic chatbot

NASA Astrophysics Data System (ADS)

AlHagbani, Eman Saad; Khan, Muhammad Badruddin

2016-07-01

The future information systems are expected to be more intelligent and will take human queries in natural language as input and answer them promptly. To develop a chatbot or a computer program that can chat with humans in realistic manner to extent that human get impressions that he/she is talking with other human is a challenging task. To make such chatbots, different technologies will work together ranging from artificial intelligence to development of semantic resources. Sophisticated chatbots are developed to perform conversation in number of languages. Arabic chatbots can be helpful in automating many operations and serve people who only know Arabic language. However, the technology for Arabic language is still in its infancy stage due to some challenges surrounding the Arabic language. This paper offers an overview of the chatbot application and the several obstacles and challenges that need to be resolved to develop an effective Arabic chatbot.

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

PubMed

Forsman, Lea; Eliasson, Ann-Christin

2016-12-01

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

Faces are special but not too special: Spared face recognition in amnesia is based on familiarity

PubMed Central

Aly, Mariam; Knight, Robert T.; Yonelinas, Andrew P.

2014-01-01

Most current theories of human memory are material-general in the sense that they assume that the medial temporal lobe (MTL) is important for retrieving the details of prior events, regardless of the specific type of materials. Recent studies of amnesia have challenged the material-general assumption by suggesting that the MTL may be necessary for remembering words, but is not involved in remembering faces. We examined recognition memory for faces and words in a group of amnesic patients, which included hypoxic patients and patients with extensive left or right MTL lesions. Recognition confidence judgments were used to plot receiver operating characteristics (ROCs) in order to more fully quantify recognition performance and to estimate the contributions of recollection and familiarity. Consistent with the extant literature, an analysis of overall recognition accuracy showed that the patients were impaired at word memory but had spared face memory. However, the ROC analysis indicated that the patients were generally impaired at high confidence recognition responses for faces and words, and they exhibited significant recollection impairments for both types of materials. Familiarity for faces was preserved in all patients, but extensive left MTL damage impaired familiarity for words. These results suggest that face recognition may appear to be spared because performance tends to rely heavily on familiarity, a process that is relatively well preserved in amnesia. The findings challenge material-general theories of memory, and suggest that both material and process are important determinants of memory performance in amnesia, and different types of materials may depend more or less on recollection and familiarity. PMID:20833190

RRR for NNN-a rapid research response for the Neglected Tropical Disease NGDO Network: a novel framework to challenges faced by the global programs targeting neglected tropical diseases.

PubMed

Toledo, Chelsea E; Jacobson, Julie; Wainwright, Emily C; Ottesen, Eric A; Lammie, Patrick J

2016-03-01

While global programs targeting the control or elimination of five of the neglected tropical diseases (NTDs)-lymphatic filariasis, onchocerciasis, soil-transmitted helminthiasis, schistosomiasis and trachoma-are well underway, they still face many operational challenges. Because of the urgency of 2020 program targets, the Bill & Melinda Gates Foundation and the U.S. Agency for International Development devised a novel rapid research response (RRR) framework to engage national programs, researchers, implementers and WHO in a Coalition for Operational Research on NTDs. After 2 years, this effort has succeeded as an important basis for the research response to programmatic challenges facing NTD programs. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

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

PubMed

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

2015-01-01

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

Enhanced facial texture illumination normalization for face recognition.

PubMed

Luo, Yong; Guan, Ye-Peng

2015-08-01

An uncontrolled lighting condition is one of the most critical challenges for practical face recognition applications. An enhanced facial texture illumination normalization method is put forward to resolve this challenge. An adaptive relighting algorithm is developed to improve the brightness uniformity of face images. Facial texture is extracted by using an illumination estimation difference algorithm. An anisotropic histogram-stretching algorithm is proposed to minimize the intraclass distance of facial skin and maximize the dynamic range of facial texture distribution. Compared with the existing methods, the proposed method can more effectively eliminate the redundant information of facial skin and illumination. Extensive experiments show that the proposed method has superior performance in normalizing illumination variation and enhancing facial texture features for illumination-insensitive face recognition.

The Evolution of Holistic Processing of Faces

PubMed Central

Burke, Darren; Sulikowski, Danielle

2013-01-01

In this paper we examine the holistic processing of faces from an evolutionary perspective, clarifying what such an approach entails, and evaluating the extent to which the evidence currently available permits any strong conclusions. While it seems clear that the holistic processing of faces depends on mechanisms evolved to perform that task, our review of the comparative literature reveals that there is currently insufficient evidence (or sometimes insufficiently compelling evidence) to decide when in our evolutionary past such processing may have arisen. It is also difficult to assess what kinds of selection pressures may have led to evolution of such a mechanism, or even what kinds of information holistic processing may have originally evolved to extract, given that many sources of socially relevant face-based information other than identity depend on integrating information across different regions of the face – judgments of expression, behavioral intent, attractiveness, sex, age, etc. We suggest some directions for future research that would help to answer these important questions. PMID:23382721

Testing protects against proactive interference in face-name learning.

PubMed

Weinstein, Yana; McDermott, Kathleen B; Szpunar, Karl K

2011-06-01

Learning face-name pairings at a social function becomes increasingly more difficult the more individuals one meets. This phenomenon is attributable to proactive interference--the negative influence of prior learning on subsequent learning. Recent evidence suggests that taking a memory test can alleviate proactive interference in verbal list learning paradigms. We apply this technique to face-name pair learning. Participants studied four lists of 12 face-name pairings and either attempted to name the 12 faces just studied after every list or did not. Recall attempts after every list improved learning of the fourth list by over 100%. Moreover, no reduction in learning of face-name pairings occurred from list 1 to list 4 for participants who attempted to name studied faces between lists. These results suggest that testing oneself on the names of a group of new acquaintances before moving on to the next group is an effective mnemonic technique for social functions.

Comparing face-to-face and online qualitative research with people with multiple sclerosis.

PubMed

Synnot, Anneliese; Hill, Sophie; Summers, Michael; Taylor, Michael

2014-03-01

We compared face-to-face focus groups and an online forum in qualitative research with people with multiple sclerosis (MS) and family members. Although the merits and challenges of online qualitative research have been considered by others, there is limited literature directly comparing these two data collection methods for people with disability or chronic illness. Twenty-seven people participated in one of four focus groups and 33 people took part in an online forum. Demographic and MS-related characteristics were similar between the two groups, with a slight nonsignificant trend toward nonmetropolitan residence in online forum participants. There was a high level of overlap in the themes generated between groups. Participant responses in the online forum were more succinct and on-topic, yet in the focus groups interaction was greater. Online qualitative research methods can facilitate research participation for people with chronic illness or disability, yielding generally comparable information to that gathered via face-to-face methods.

Conflict Management: Difficult Conversations with Difficult People

PubMed Central

Overton, Amy R.; Lowry, Ann C.

2013-01-01

Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed. PMID:24436688

Conflict management: difficult conversations with difficult people.

PubMed

Overton, Amy R; Lowry, Ann C

2013-12-01

Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed.

Challenge clusters facing LCA in environmental decision-making-what we can learn from biofuels.

PubMed

McManus, Marcelle C; Taylor, Caroline M; Mohr, Alison; Whittaker, Carly; Scown, Corinne D; Borrion, Aiduan Li; Glithero, Neryssa J; Yin, Yao

Bioenergy is increasingly used to help meet greenhouse gas (GHG) and renewable energy targets. However, bioenergy's sustainability has been questioned, resulting in increasing use of life cycle assessment (LCA). Bioenergy systems are global and complex, and market forces can result in significant changes, relevant to LCA and policy. The goal of this paper is to illustrate the complexities associated with LCA, with particular focus on bioenergy and associated policy development, so that its use can more effectively inform policymakers. The review is based on the results from a series of workshops focused on bioenergy life cycle assessment. Expert submissions were compiled and categorized within the first two workshops. Over 100 issues emerged. Accounting for redundancies and close similarities in the list, this reduced to around 60 challenges, many of which are deeply interrelated. Some of these issues were then explored further at a policy-facing workshop in London, UK. The authors applied a rigorous approach to categorize the challenges identified to be at the intersection of biofuels/bioenergy LCA and policy. The credibility of LCA is core to its use in policy. Even LCAs that comply with ISO standards and policy and regulatory instruments leave a great deal of scope for interpretation and flexibility. Within the bioenergy sector, this has led to frustration and at times a lack of obvious direction. This paper identifies the main challenge clusters: overarching issues, application and practice and value and ethical judgments. Many of these are reflective of the transition from application of LCA to assess individual products or systems to the wider approach that is becoming more common. Uncertainty in impact assessment strongly influences planning and compliance due to challenges in assigning accountability, and communicating the inherent complexity and uncertainty within bioenergy is becoming of greater importance. The emergence of LCA in bioenergy governance is

Obstacles facing Africa's young climate scientists

NASA Astrophysics Data System (ADS)

Dike, Victor Nnamdi; Addi, Martin; Andang'o, Hezron Awiti; Attig, Bahar Faten; Barimalala, Rondrotiana; Diasso, Ulrich Jacques; Du Plessis, Marcel; Lamine, Salim; Mongwe, Precious N.; Zaroug, Modathir; Ochanda, Valentine Khasenye

2018-06-01

Current and future climate change poses a substantial threat to the African continent. Young scientists are needed to advance Earth systems science on the continent, but they face significant challenges.

Cognitive demands of face monitoring: evidence for visuospatial overload.

PubMed

Doherty-Sneddon, G; Bonner, L; Bruce, V

2001-10-01

Young children perform difficult communication tasks better face to face than when they cannot see one another (e.g., Doherty-Sneddon & Kent, 1996). However, in recent studies, it was found that children aged 6 and 10 years, describing abstract shapes, showed evidence of face-to-face interference rather than facilitation. For some communication tasks, access to visual signals (such as facial expression and eye gaze) may hinder rather than help children's communication. In new research we have pursued this interference effect. Five studies are described with adults and 10- and 6-year-old participants. It was found that looking at a face interfered with children's abilities to listen to descriptions of abstract shapes. Children also performed visuospatial memory tasks worse when they looked at someone's face prior to responding than when they looked at a visuospatial pattern or at the floor. It was concluded that performance on certain tasks was hindered by monitoring another person's face. It is suggested that processing of visual communication signals shares certain processing resources with the processing of other visuospatial information.

Topical Steroid Damaged/Dependent Face (TSDF): An Entity of Cutaneous Pharmacodependence

PubMed Central

Lahiri, Koushik; Coondoo, Arijit

2016-01-01

Topical Steroid Damaged/Dependent face (TSDF) is a phenomenon which has been described very recently (2008). It is characterized by a plethora of symptoms caused by an usually unsupervised misuse/abuse/overuse of topical corticosteroid of any potency on the face over an unspecified and/or prolonged period of time. This misuse and damage have a serious effect on the quality of life of the patients in general and the skin of the face in particular. Management is difficult and necessitates psychological counseling as well as physical soothing of the sensitive skin. PMID:27293246

The mighty oak faces challenges in the Pacific West

Treesearch

Gail Wells

2010-01-01

In popular imagination, the oak tree stands for strength, endurance, and longevity. But in the coastal lowlands and central valleys of British Columbia, Washington, Oregon, and California, oaks face a battery of natural and human-induced threats. Sudden oak death, caused by a virulent pathogen identified in 2000, has killed millions of tanoaks, California black oaks,...

Activating social strategies: Face-to-face interaction in technology-mediated citizen science.

PubMed

Cappa, Francesco; Laut, Jeffrey; Nov, Oded; Giustiniano, Luca; Porfiri, Maurizio

2016-11-01

The use of crowds in research activities by public and private organizations is growing under different forms. Citizen science is a popular means of engaging the general public in research activities led by professional scientists. By involving a large number of amateur scientists, citizen science enables distributed data collection and analysis on a scale that would be otherwise difficult and costly to achieve. While advancements in information technology in the past few decades have fostered the growth of citizen science through online participation, several projects continue to fail due to limited participation. Such web-based projects may isolate the citizen scientists from the researchers. By adopting the perspective of social strategy, we investigate within a measure-manipulate-measure experiment if motivations to participate in a citizen science project can be positively influenced by a face-to-face interaction with the scientists leading the project. Such an interaction provides the participants with the possibility of asking questions on the spot and obtaining a detailed explanation of the citizen science project, its scientific merit, and environmental relevance. Social and cultural factors that moderate the effect brought about by face-to-face interactions on the motivations are also dissected and analyzed. Our findings provide an exploratory insight into a means for motivating crowds to participate in online environmental monitoring projects, also offering possible selection criteria of target audience. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hyperspectral face recognition with spatiospectral information fusion and PLS regression.

PubMed

Uzair, Muhammad; Mahmood, Arif; Mian, Ajmal

2015-03-01

Hyperspectral imaging offers new opportunities for face recognition via improved discrimination along the spectral dimension. However, it poses new challenges, including low signal-to-noise ratio, interband misalignment, and high data dimensionality. Due to these challenges, the literature on hyperspectral face recognition is not only sparse but is limited to ad hoc dimensionality reduction techniques and lacks comprehensive evaluation. We propose a hyperspectral face recognition algorithm using a spatiospectral covariance for band fusion and partial least square regression for classification. Moreover, we extend 13 existing face recognition techniques, for the first time, to perform hyperspectral face recognition.We formulate hyperspectral face recognition as an image-set classification problem and evaluate the performance of seven state-of-the-art image-set classification techniques. We also test six state-of-the-art grayscale and RGB (color) face recognition algorithms after applying fusion techniques on hyperspectral images. Comparison with the 13 extended and five existing hyperspectral face recognition techniques on three standard data sets show that the proposed algorithm outperforms all by a significant margin. Finally, we perform band selection experiments to find the most discriminative bands in the visible and near infrared response spectrum.

Firefighter Training in Sweden: From Face-to-Face Learning in Training Grounds to Distance Learning--A Challenge for Exercise Instructors?

ERIC Educational Resources Information Center

Holmgren, Robert

2016-01-01

When distance learning supported by digital technologies was introduced in firefighter training in Sweden some years ago, training exercise instructors accustomed to face-to-face teaching in the field had to adapt their professional roles to an electronic landscape with a number of new opportunities and constraints. Based on activity theory and…

Face recognition system using multiple face model of hybrid Fourier feature under uncontrolled illumination variation.

PubMed

Hwang, Wonjun; Wang, Haitao; Kim, Hyunwoo; Kee, Seok-Cheol; Kim, Junmo

2011-04-01

The authors present a robust face recognition system for large-scale data sets taken under uncontrolled illumination variations. The proposed face recognition system consists of a novel illumination-insensitive preprocessing method, a hybrid Fourier-based facial feature extraction, and a score fusion scheme. First, in the preprocessing stage, a face image is transformed into an illumination-insensitive image, called an "integral normalized gradient image," by normalizing and integrating the smoothed gradients of a facial image. Then, for feature extraction of complementary classifiers, multiple face models based upon hybrid Fourier features are applied. The hybrid Fourier features are extracted from different Fourier domains in different frequency bandwidths, and then each feature is individually classified by linear discriminant analysis. In addition, multiple face models are generated by plural normalized face images that have different eye distances. Finally, to combine scores from multiple complementary classifiers, a log likelihood ratio-based score fusion scheme is applied. The proposed system using the face recognition grand challenge (FRGC) experimental protocols is evaluated; FRGC is a large available data set. Experimental results on the FRGC version 2.0 data sets have shown that the proposed method shows an average of 81.49% verification rate on 2-D face images under various environmental variations such as illumination changes, expression changes, and time elapses.

Trismus in Face Transplantation Following Ballistic Trauma.

PubMed

Krezdorn, Nicco; Alhefzi, Muayyad; Perry, Bridget; Aycart, Mario A; Tasigiorgos, Sotirios; Bueno, Ericka M; Green, Jordan R; Pribaz, Julian J; Pomahac, Bohdan; Caterson, Edward J

2018-06-01

Trismus can be a challenging consequence of ballistic trauma to the face, and has rarely been described in the setting of face transplantation. Almost half of all current face transplant recipients in the world received transplantation to restore form and function after a ballistic injury. Here we report our experience and challenges with long standing trismus after face transplantation. We reviewed the medical records of our face transplant recipients whose indication was ballistic injury. We focused our review on trismus and assessed the pre-, peri- and postoperative planning, surgery and functional outcomes. Two patients received partial face transplantation, including the midface for ballistic trauma. Both patients suffered from impaired mouth opening, speech intelligibility, and oral competence. Severe scarring of the temporomandibular joint (TMJ) required intraoperative release in both patients, and additional total condylectomy on the left side 6 months posttransplant for 1 patient. Posttransplant, both patients achieved an improvement in mouth opening; however, there was persistent trismus. One year after transplantation, range of motion of the jaw had improved for both patients. Independent oral food intake was possible 1 year after surgery, although spillage of liquids and mixed consistency solids persisted. Speech intelligibility testing showed impairments in the immediate postoperative period, with improvement to over 85% for both patients at 1 year posttransplant. Ballistic trauma to the face and subsequent reconstructive measures can cause significant scarring and covert injuries to structures such as the TMJ, resulting in long standing trismus. Meticulous individual planning prior to interventions such as face transplantation must take these into account. We encourage intraoperative evaluation of these structures as well as peri- and postoperative treatment when necessary. Due to the nature of the primary injury, functional outcomes after face

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

NASA Astrophysics Data System (ADS)

Karam, Lina J.; Zhu, Tong

2015-03-01

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

Rosetta Structure Prediction as a Tool for Solving Difficult Molecular Replacement Problems.

PubMed

DiMaio, Frank

2017-01-01

Molecular replacement (MR), a method for solving the crystallographic phase problem using phases derived from a model of the target structure, has proven extremely valuable, accounting for the vast majority of structures solved by X-ray crystallography. However, when the resolution of data is low, or the starting model is very dissimilar to the target protein, solving structures via molecular replacement may be very challenging. In recent years, protein structure prediction methodology has emerged as a powerful tool in model building and model refinement for difficult molecular replacement problems. This chapter describes some of the tools available in Rosetta for model building and model refinement specifically geared toward difficult molecular replacement cases.

Prediction of Difficult Laryngoscopy in Obese Patients by Ultrasound Quantification of Anterior Neck Soft Tissue1

PubMed Central

Ezri, T.; Gewürtz, G.; Sessler, D.I.; Medalion, B.; Szmuk, P.; Hagberg, C.; Susmallian, S.

2005-01-01

Prediction of difficult laryngoscopy in obese patients is challenging. In 50 morbidly obese patients, we quantified the neck soft tissue from skin to anterior aspect of trachea at the vocal cords using ultrasound. Thyromental distance <6 cm, mouth opening <4 cm, limited neck mobility, Mallampati score >2, abnormal upper teeth, neck circumference >45 cm, and sleep apnoea were considered predictors of difficult laryngoscopy. Of the nine (18%) difficult laryngoscopy cases, seven had obstructive sleep apnoea history; whereas, only 2 of the 41 easy laryngoscopy patients did (P<0.001). Difficult laryngoscopy patients had larger neck circumference [50 (3.8) vs. 43.5 (2.2) cm; P<0.001] and more pre-tracheal soft tissue [28 (2.7) mm vs. 17.5 (1.8) mm; P<0.001] [mean (SD)]. Soft tissue values completely separated difficult and easy laryngoscopies. None of the other predictors correlated with difficult laryngoscopy. Thus, an abundance of pretracheal soft tissue at the level of vocal cords is a good predictor of difficult laryngoscopy in obese patients. PMID:14616599

Standing by Their Principles: Two Librarians Who Faced Challenges

ERIC Educational Resources Information Center

Adams, Helen; Leu, DaNae; Venuto, Dee Ann

2015-01-01

What do school librarians fear most? Hands down, their biggest fear is a formal challenge to a resource in the school library. There are no accurate statistics about the number of challenges to school library resources. The staff of ALA's Office for Intellectual Freedom estimates that only about 20 percent are reported to ALA annually. For the…

Face Recognition in Humans and Machines

NASA Astrophysics Data System (ADS)

O'Toole, Alice; Tistarelli, Massimo

The study of human face recognition by psychologists and neuroscientists has run parallel to the development of automatic face recognition technologies by computer scientists and engineers. In both cases, there are analogous steps of data acquisition, image processing, and the formation of representations that can support the complex and diverse tasks we accomplish with faces. These processes can be understood and compared in the context of their neural and computational implementations. In this chapter, we present the essential elements of face recognition by humans and machines, taking a perspective that spans psychological, neural, and computational approaches. From the human side, we overview the methods and techniques used in the neurobiology of face recognition, the underlying neural architecture of the system, the role of visual attention, and the nature of the representations that emerges. From the computational side, we discuss face recognition technologies and the strategies they use to overcome challenges to robust operation over viewing parameters. Finally, we conclude the chapter with a look at some recent studies that compare human and machine performances at face recognition.

"It's Intense, to an Extent": A Qualitative Study of the Emotional Challenges Faced by Staff Working on a Treatment Programme for Intellectually Disabled Sex Offenders

ERIC Educational Resources Information Center

Sandhu, Daljit K.; Rose, John; Rostill-Brookes, Helen J.; Thrift, Su

2012-01-01

Background: This study explores the emotional challenges faced by staff working on a sex offender treatment programme for people with an intellectual disability. Methods: Semi-structured interviews were carried out with eight participants working on a treatment programme for sex offenders with an intellectual disability. Interviews were analysed…

When Worlds Collide--Examining the Challenges Faced by Teacher Education Programmes Combining Professional Vocational Competence with Academic Study, Lessons from Further Education to Higher Education

ERIC Educational Resources Information Center

Shaw, Angela

2016-01-01

This paper examines the challenges faced by higher education institutions in designing, teaching and quality assuring programmes of study which, of necessity, must combine the gaining of professional vocational competence with academic study. The paper gives recognition to the policy framework in which these programmes fit--with particular…

Science Education and the Challenges Facing Its Integration into the 21st Century School System in a Globalized World: A Case of Igbo Nation

ERIC Educational Resources Information Center

Ezeudu, F. O.; Nkokelonye, C. U.; Ezeudu, S. A.

2013-01-01

This paper is a study of historical foundations of science education in Igboland, its nature and scope as well as the challenges facing its integration into the 21st century school system in a globalized world. The authors found that there were many scientific activities in Igbo culture, but many problems hinder their integration into the basic…

Panel workload assessment in US primary care: accounting for non-face-to-face panel management activities.

PubMed

Arndt, Brian; Tuan, Wen-Jan; White, Jennifer; Schumacher, Jessica

2014-01-01

An understanding of primary care provider (PCP) workload is an important consideration in establishing optimal PCP panel size. However, no widely acceptable measure of PCP workload exists that incorporates the effort involved with both non-face-to-face patient care activities and face-to-face encounters. Accounting for this gap is critical given the increase in non-face-to-face PCP activities that has accompanied electronic health records (EHRs) (eg, electronic messaging). Our goal was to provide a comprehensive assessment of perceived PCP workload, accounting for aspects of both face-to-face and non-face-to-face encounters. Internal medicine, family medicine, and pediatric PCPs completed a self-administered survey about the perceived workload involved with face-to-face and non-face-to-face panel management activities as well as the perceived challenge associated with caring for patients with particular biomedical, demographic, and psychosocial characteristics (n = 185). Survey results were combined with EHR data at the individual patient and PCP service levels to assess PCP panel workload, accounting for face-to-face and non-face-to-face utilization. Of the multiple face-to-face and non-face-to-face activities associated with routine primary care, PCPs considered hospital admissions, obstetric care, hospital discharges, and new patient preventive health visits to be greater workload than non-face-to-face activities such as telephone calls, electronic communication, generating letters, and medication refills. Total workload within PCP panels at the individual patient level varied by overall health status, and the total workload of non-face-to-face panel management activities associated with routine primary care was greater than the total workload associated with face-to-face encounters regardless of health status. We used PCP survey results coupled with EHR data to assess PCP workload associated with both face-to-face as well as non-face-to-face panel management

Face identification with frequency domain matched filtering in mobile environments

NASA Astrophysics Data System (ADS)

Lee, Dong-Su; Woo, Yong-Hyun; Yeom, Seokwon; Kim, Shin-Hwan

2012-06-01

Face identification at a distance is very challenging since captured images are often degraded by blur and noise. Furthermore, the computational resources and memory are often limited in the mobile environments. Thus, it is very challenging to develop a real-time face identification system on the mobile device. This paper discusses face identification based on frequency domain matched filtering in the mobile environments. Face identification is performed by the linear or phase-only matched filter and sequential verification stages. The candidate window regions are decided by the major peaks of the linear or phase-only matched filtering outputs. The sequential stages comprise a skin-color test and an edge mask filtering test, which verify color and shape information of the candidate regions in order to remove false alarms. All algorithms are built on the mobile device using Android platform. The preliminary results show that face identification of East Asian people can be performed successfully in the mobile environments.

Generating virtual training samples for sparse representation of face images and face recognition

NASA Astrophysics Data System (ADS)

Du, Yong; Wang, Yu

2016-03-01

There are many challenges in face recognition. In real-world scenes, images of the same face vary with changing illuminations, different expressions and poses, multiform ornaments, or even altered mental status. Limited available training samples cannot convey these possible changes in the training phase sufficiently, and this has become one of the restrictions to improve the face recognition accuracy. In this article, we view the multiplication of two images of the face as a virtual face image to expand the training set and devise a representation-based method to perform face recognition. The generated virtual samples really reflect some possible appearance and pose variations of the face. By multiplying a training sample with another sample from the same subject, we can strengthen the facial contour feature and greatly suppress the noise. Thus, more human essential information is retained. Also, uncertainty of the training data is simultaneously reduced with the increase of the training samples, which is beneficial for the training phase. The devised representation-based classifier uses both the original and new generated samples to perform the classification. In the classification phase, we first determine K nearest training samples for the current test sample by calculating the Euclidean distances between the test sample and training samples. Then, a linear combination of these selected training samples is used to represent the test sample, and the representation result is used to classify the test sample. The experimental results show that the proposed method outperforms some state-of-the-art face recognition methods.

The Synaptic Challenge

ERIC Educational Resources Information Center

Montrezor, L. H.

2014-01-01

Medical school students are expected to learn many subjects at the same time. As a result, they often experience stress and find it difficult to cope with the curriculum. In addition, some first-year students find theory and practical classes to be monotonous. One of the difficulties faced by faculty members is, therefore, to maintain student…

Challenges faced by health volunteers in comprehensive health centers in the southwest of Iran: A qualitative content analysis.

PubMed

Vizeshfar, Fatemeh; Momennasab, Marzieh; Yektatalab, Shahrzad; Iman, Mohamad Taghi

2018-01-01

Introduction: Health volunteers are employed to execute governmental health promotion programs in most countries around the world. The present study aimed to assess the challenges of health volunteers program to provide a better understanding of the present situation. Methods: This study was conducted using a qualitative approach. 14 participants were selected purposively selected from two comprehensive health care centers in the southwest of Iran. The data were collected through 14 semi-structured interviews, 2 observations, and 3 diaries and analyzed using content analysis. Results: Data analysis resulted in emergence four themes, namely role confusion, the inefficiency of volunteers training, the inefficiency of attraction and maintenance of volunteers, and being unknown to people. Unfertilized capacity is the main theme extracted from all themes. Conclusion: Health volunteers' perfect accomplishment of roles will have a positive impact on the provision of primary healthcare services and health objectives. Hence, comprehensive planning based on the needs of health volunteers will change them into a strong arm in the health system. Thus, managerial support and precise planning seem to be necessary for facing these challenges.

Challenges faced by health volunteers in comprehensive health centers in the southwest of Iran: A qualitative content analysis

PubMed Central

Vizeshfar, Fatemeh; Momennasab, Marzieh; Yektatalab, Shahrzad; Iman, Mohamad Taghi

2018-01-01

Introduction:Health volunteers are employed to execute governmental health promotion programs in most countries around the world. The present study aimed to assess the challenges of health volunteers program to provide a better understanding of the present situation. Methods:This study was conducted using a qualitative approach. 14 participants were selected purposively selected from two comprehensive health care centers in the southwest of Iran. The data were collected through 14 semi-structured interviews, 2 observations, and 3 diaries and analyzed using content analysis. Results:Data analysis resulted in emergence four themes, namely role confusion, the inefficiency of volunteers training, the inefficiency of attraction and maintenance of volunteers, and being unknown to people. Unfertilized capacity is the main theme extracted from all themes. Conclusion:Health volunteers’ perfect accomplishment of roles will have a positive impact on the provision of primary healthcare services and health objectives. Hence, comprehensive planning based on the needs of health volunteers will change them into a strong arm in the health system. Thus, managerial support and precise planning seem to be necessary for facing these challenges. PMID:29696067

Technology survey on video face tracking

NASA Astrophysics Data System (ADS)

Zhang, Tong; Gomes, Herman Martins

2014-03-01

With the pervasiveness of monitoring cameras installed in public areas, schools, hospitals, work places and homes, video analytics technologies for interpreting these video contents are becoming increasingly relevant to people's lives. Among such technologies, human face detection and tracking (and face identification in many cases) are particularly useful in various application scenarios. While plenty of research has been conducted on face tracking and many promising approaches have been proposed, there are still significant challenges in recognizing and tracking people in videos with uncontrolled capturing conditions, largely due to pose and illumination variations, as well as occlusions and cluttered background. It is especially complex to track and identify multiple people simultaneously in real time due to the large amount of computation involved. In this paper, we present a survey on literature and software that are published or developed during recent years on the face tracking topic. The survey covers the following topics: 1) mainstream and state-of-the-art face tracking methods, including features used to model the targets and metrics used for tracking; 2) face identification and face clustering from face sequences; and 3) software packages or demonstrations that are available for algorithm development or trial. A number of publically available databases for face tracking are also introduced.

Category search speeds up face-selective fMRI responses in a non-hierarchical cortical face network.

PubMed

Jiang, Fang; Badler, Jeremy B; Righi, Giulia; Rossion, Bruno

2015-05-01

The human brain is extremely efficient at detecting faces in complex visual scenes, but the spatio-temporal dynamics of this remarkable ability, and how it is influenced by category-search, remain largely unknown. In the present study, human subjects were shown gradually-emerging images of faces or cars in visual scenes, while neural activity was recorded using functional magnetic resonance imaging (fMRI). Category search was manipulated by the instruction to indicate the presence of either a face or a car, in different blocks, as soon as an exemplar of the target category was detected in the visual scene. The category selectivity of most face-selective areas was enhanced when participants were instructed to report the presence of faces in gradually decreasing noise stimuli. Conversely, the same regions showed much less selectivity when participants were instructed instead to detect cars. When "face" was the target category, the fusiform face area (FFA) showed consistently earlier differentiation of face versus car stimuli than did the "occipital face area" (OFA). When "car" was the target category, only the FFA showed differentiation of face versus car stimuli. These observations provide further challenges for hierarchical models of cortical face processing and show that during gradual revealing of information, selective category-search may decrease the required amount of information, enhancing and speeding up category-selective responses in the human brain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Anti-racist pedagogy: challenges faced by faculty of color in predominantly white schools of nursing.

PubMed

Hassouneh, Dena

2006-07-01

Despite the significant effects of systems of oppression on health, nursing education tends not to include anti-racist pedagogy in its curricula, preferring instead to focus more narrowly on culture. This narrow focus allows nurses to depoliticize discussions of race and other social differences, largely ignoring the influence that systems of oppression, imperialism, and historical trauma have had on health in marginalized populations. In contrast, anti-racist pedagogy educates students in ways that make racialized power relations explicit, deconstruct the social construction of race, and analyze interlocking systems of oppression that serve to marginalize and exclude some groups while privileging others. This article describes anti-racist pedagogy from the perspective of a faculty member of color, drawing on personal experience and a review of the anti-racist pedagogical literature. Specifically, this article highlights some of the personal and professional challenges faced by faculty of color when engaged in anti-racist pedagogy in predominantly white schools of nursing.

Comparison of face masks in the bag-mask ventilation of a manikin.

PubMed

Redfern, D; Rassam, S; Stacey, M R; Mecklenburgh, J S

2006-02-01

We conducted a study investigating the effectiveness of four face mask designs in the bag-mask ventilation of a special manikin adapted to simulate a difficult airway. Forty-eight anaesthetists volunteered to bag-mask ventilate the manikin for 3 min with four different face masks. The primary outcome of the study was to calculate mean percentage leak from the face masks over 3 min. Anaesthetists were also asked to rate the face masks using a visual analogue score. The single-use scented intersurgical face mask had the lowest mean leak (20%). This was significantly lower than the mean leak from the single-use, cushioned 7,000 series Air Safety Ltd. face mask (24%) and the reusable silicone Laerdal face mask (27%) but not significantly lower than the mean leak from the reusable anatomical intersurgical face mask (23%). There was a large variation in both performance and satisfaction between anaesthetists with each design. This highlights the importance of having a variety of face masks available for emergency use.

'What is it like to have ME?': the discursive construction of ME in computer-mediated communication and face-to-face interaction.

PubMed

Guise, Jennifer; Widdicombe, Sue; McKinlay, Andy

2007-01-01

ME (Myalgic Encephalomyelitis) or CFS (chronic fatigue syndrome) is a debilitating illness for which no cause or medical tests have been identified. Debates over its nature have generated interest from qualitative researchers. However, participants are difficult to recruit because of the nature of their condition. Therefore, this study explores the utility of the internet as a means of eliciting accounts. We analyse data from focus groups and the internet in order to ascertain the extent to which previous research findings apply to the internet domain. Interviews were conducted among 49 members of internet groups (38 chatline, 11 personal) and 7 members of two face-to-face support groups. Discourse analysis of descriptions and accounts of ME or CFS revealed similar devices and interactional concerns in both internet and face-to-face communication. Participants constructed their condition as serious, enigmatic and not psychological. These functioned to deflect problematic assumptions about ME or CFS and to manage their accountability for the illness and its effects.

The experiences and challenges faced by rehabilitation community service therapists within the South African Primary Healthcare health system

PubMed Central

2017-01-01

Background Twenty-two years after the promulgation of a plethora of progressive health policies since 1994, the South African public health system reflects a number of stumbling blocks regarding implementation. Rehabilitation professionals are not sufficiently equipped nor allowed the opportunity to comprehensively implement Primary Healthcare (PHC) from a bottom-up approach, thus engaging communities. Training on addressing social health determinants and their impact on ill-health and health outcomes is inadequate. The inadequate understanding of the advocacy role that rehabilitation professionals could play in addressing social health determinants remains a challenge in healthcare. Rehabilitation, a pillar of PHC, remains poorly understood in terms of its role within the health system. Aim We argue for rehabilitation as a vehicle for addressing social determinants of health with community service practitioners playing a critical role in addressing the inequities within the healthcare package. Setting The article reflects the opportunities and challenges faced by rehabilitation community service therapists in the delivery of rehabilitation services in a rural area of the Eastern Cape province of South Africa. Methods A single case study from the perspective of a researcher was used to explore the experience and reflection of the first author during her community service as an occupational therapist. Results The case study highlights some existing gaps within the delivery of rehabilitation services in the rural Eastern Cape. A community service package with a specific approach towards addressing social determinants of health for persons with disability at a community level is suggested. Conclusion Advocating for a rehabilitation service package to shift to community-based levels is critical. It is envisaged that a community-based approach will facilitate an understanding of the barriers faced by persons with disabilities as constituting disability, thus

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study.

PubMed

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-04-01

NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the 'one sheet of paper' mind-map method to identify the line of argument in each thematic report. Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other's practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. © British Journal of General Practice 2018.

Challenge clusters facing LCA in environmental decision-making—what we can learn from biofuels

DOE PAGES

McManus, Marcelle C.; Taylor, Caroline M.; Mohr, Alison; ...

2015-08-07

Purpose: Bioenergy is increasingly used to help meet greenhouse gas (GHG) and renewable energy targets. However, bioenergy’s sustainability has been questioned, resulting in increasing use of life cycle assessment (LCA). Bioenergy systems are global and complex, and market forces can result in significant changes, relevant to LCA and policy. The goal of this paper is to illustrate the complexities associated with LCA, with particular focus on bioenergy and associated policy development, so that its use can more effectively inform policymakers. Methods: The review is based on the results from a series of workshops focused on bioenergy life cycle assessment. Expertmore » submissions were compiled and categorized within the first two workshops. Over 100 issues emerged. Accounting for redundancies and close similarities in the list, this reduced to around 60 challenges, many of which are deeply interrelated. Some of these issues were then explored further at a policy-facing workshop in London, UK. The authors applied a rigorous approach to categorize the challenges identified to be at the intersection of biofuels/bioenergy LCA and policy. Results and discussion: The credibility of LCA is core to its use in policy. Even LCAs that comply with ISO standards and policy and regulatory instruments leave a great deal of scope for interpretation and flexibility. Within the bioenergy sector, this has led to frustration and at times a lack of obvious direction. This paper identifies the main challenge clusters: overarching issues, application and practice and value and ethical judgments. Many of these are reflective of the transition from application of LCA to assess individual products or systems to the wider approach that is becoming more common. Uncertainty in impact assessment strongly influences planning and compliance due to challenges in assigning accountability, and communicating the inherent complexity and uncertainty within bioenergy is becoming of greater

Young persons with visual impairment: challenges of participation.

PubMed

Salminen, Anna-Liisa; Karhula, Maarit E

2014-07-01

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

The role of movement in the recognition of famous faces.

PubMed

Lander, K; Christie, F; Bruce, V

1999-11-01

The effects of movement on the recognition of famous faces shown in difficult conditions were investigated. Images were presented as negatives, upside down (inverted), and thresholded. Results indicate that, under all these conditions, moving faces were recognized significantly better than static ones. One possible explanation of this effect could be that a moving sequence contains more static information about the different views and expressions of the face than does a single static image. However, even when the amount of static information was equated (Experiments 3 and 4), there was still an advantage for moving sequences that contained their original dynamic properties. The results suggest that the dynamics of the motion provide additional information, helping to access an established familiar face representation. Both the theoretical and the practical implications for these findings are discussed.

From medical invention to clinical practice: the reimbursement challenge facing new device procedures and technology--part 2: coverage.

PubMed

Raab, G Gregory; Parr, David H

2006-10-01

This paper, the second of 3 that discuss the reimbursement challenges facing new medical device technology in various issues of this journal, explains the key aspects of coverage that affect the adoption of medical devices. The process Medicare uses to make coverage determinations has become more timely and open over the past several years, but it still lacks the predictability that product innovators prefer. The continued uncertainty surrounding evidence requirements undermines the predictability needed for optimal product planning and innovation. Recent steps taken by the Centers for Medicare and Medicaid Services to provide coverage in return for evidence development should provide patients with access to promising new technologies and procedures while generating important evidence concerning their effectiveness.

Challenge and Change

ERIC Educational Resources Information Center

Mehaffy, George L.

2012-01-01

In the past twenty years, various industries have been forever altered by technology: newspapers, book publishing, the photography business, and many more. Higher education too faces unprecedented challenges primarily driven by rapid changes in technology. To meet these challenges and adapt to these changes, new models are needed. Six challenges…

Challenges and Roadblocks

ERIC Educational Resources Information Center

Hargrove, Kathy

2011-01-01

Gifted education has many challenges, and gifted programs sometimes throw up significant roadblocks. But passionate teachers can still make a difference in developing the gifts of the children. In this article, the author summarizes the challenges teachers face in serving gifted students and the roadblocks preventing a strong, supportive gifted…

Socio-economic and cultural vulnerabilities to cervical cancer and challenges faced by patients attending care at Tikur Anbessa Hospital: a cross sectional and qualitative study.

PubMed

Tadesse, Sara Kebede

2015-09-16

Cervical cancer is a leading cause of death among women in Ethiopia, affecting them at a time of their life when they are critical to social and economic stability. This study was mainly focused on assessing different socioeconomic and cultural related factors that make women vulnerable to cervical cancer and challenges women face in the process of diagnosis and treatment. To achieve the objective of the study both qualitative and quantitative methods were utilized.198 participants were enrolled in a cross- sectional survey and 10 in-depth interviews were conducted with patients in Tikur Anbessa Hospital. A consecutive sampling method was used to select participants in the survey while purposive sampling was employed to select participants in the qualitative design. For the population covered in the study, poverty along with other socio-cultural practices such as early marriage, high parity and to certain extent polygamy were identified as factors that increased the vulnerability of women to cervical cancer. In addition, the study has uncovered several challenges faced by cervical cancer patients in the diagnosis and treatment process. Three types of challenges that include, health care based, psychological and economic were identified. System and practitioner delay were found as the main hurdles within the variable of health care related challenges. What's more, the psychological challenges identified included, fear of recurrence, negative social attitude and distress associated with the side effects from treatments such as fecal & urinary leakage. Furthermore, inability of bearing costs related to treatment and accommodation were cited as the main economic challenges. The study showed various socio-economic and cultural vulnerabilities that expose women to cervical cancer and the challenges encountered by cervical cancer patients after their diagnosis. Addressing this issue largely lies in strengthening primary and secondary preventive mechanisms, providing

Race-specific perceptual discrimination improvement following short individuation training with faces

PubMed Central

McGugin, Rankin Williams; Tanaka, James W.; Lebrecht, Sophie; Tarr, Michael J.; Gauthier, Isabel

2010-01-01

This study explores the effect of individuation training on the acquisition of race-specific expertise. First, we investigated whether practice individuating other-race faces yields improvement in perceptual discrimination for novel faces of that race. Second, we asked whether there was similar improvement for novel faces of a different race for which participants received equal practice, but in an orthogonal task that did not require individuation. Caucasian participants were trained to individuate faces of one race (African American or Hispanic) and to make difficult eye luminance judgments on faces of the other race. By equating these tasks we are able to rule out raw experience, visual attention or performance/success-induced positivity as the critical factors that produce race-specific improvements. These results indicate that individuation practice is one mechanism through which cognitive, perceptual, and/or social processes promote growth of the own-race face recognition advantage. PMID:21429002

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

PubMed

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

2015-09-01

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

Total Face, Eyelids, Ears, Scalp, and Skeletal Subunit Transplant: A Reconstructive Solution for the Full Face and Total Scalp Burn.

PubMed

Sosin, Michael; Ceradini, Daniel J; Levine, Jamie P; Hazen, Alexes; Staffenberg, David A; Saadeh, Pierre B; Flores, Roberto L; Sweeney, Nicole G; Bernstein, G Leslie; Rodriguez, Eduardo D

2016-07-01

Reconstruction of extensive facial and scalp burns can be increasingly challenging, especially in patients that have undergone multiple procedures with less than ideal outcomes resulting in restricting neck and oral contractures, eyelid dysfunction, and suboptimal aesthetic appearance. To establish a reconstructive solution for this challenging deformity, a multidisciplinary team was assembled to develop the foundation to a facial vascularized composite allotransplantation program. The strategy of developing and executing a clinical transplant was derived on the basis of fostering a cohesive and supportive institutional clinical environment, implementing computer software and advanced technology, establishing a cadaveric transplant model, performing a research facial procurement, and selecting an optimal candidate with the aforementioned burn defect who was well informed and had the desire to undergo face transplantation. Approval from the institutional review board and organ procurement organization enabled our face transplant team to successfully perform a total face, eyelids, ears, scalp, and skeletal subunit transplant in a 41-year-old man with a full face and total scalp burn. The culmination of knowledge attained from previous experiences continues to influence the progression of facial vascularized composite allotransplantation. This surgical endeavor methodically and effectively synchronized the fundamental principles of aesthetic, craniofacial, and microvascular surgery to restore appearance and function to a patient suffering from failed conventional surgery for full face and total scalp burns. This procedure represents the most extensive soft-tissue clinical face transplant performed to date. Therapeutic, V.

Effective communication during difficult conversations.

PubMed

Polito, Jacquelyn M

2013-06-01

A strong interest and need exist in the workplace today to master the skills of conducting difficult conversations. Theories and strategies abound, yet none seem to have found the magic formula with universal appeal and success. If it is such an uncomfortable skill to master is it better to avoid or initiate such conversations with employees? Best practices and evidence-based management guide us to the decision that quality improvement dictates effective communication, even when difficult. This brief paper will offer some suggestions for strategies to manage difficult conversations with employees. Mastering the skills of conducting difficult conversations is clearly important to keeping lines of communication open and productive. Successful communication skills may actually help to avert confrontation through employee engagement, commitment and appropriate corresponding behavior

Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults†

PubMed Central

Frerk, C.; Mitchell, V. S.; McNarry, A. F.; Mendonca, C.; Bhagrath, R.; Patel, A.; O'Sullivan, E. P.; Woodall, N. M.; Ahmad, I.

2015-01-01

These guidelines provide a strategy to manage unanticipated difficulty with tracheal intubation. They are founded on published evidence. Where evidence is lacking, they have been directed by feedback from members of the Difficult Airway Society and based on expert opinion. These guidelines have been informed by advances in the understanding of crisis management; they emphasize the recognition and declaration of difficulty during airway management. A simplified, single algorithm now covers unanticipated difficulties in both routine intubation and rapid sequence induction. Planning for failed intubation should form part of the pre-induction briefing, particularly for urgent surgery. Emphasis is placed on assessment, preparation, positioning, preoxygenation, maintenance of oxygenation, and minimizing trauma from airway interventions. It is recommended that the number of airway interventions are limited, and blind techniques using a bougie or through supraglottic airway devices have been superseded by video- or fibre-optically guided intubation. If tracheal intubation fails, supraglottic airway devices are recommended to provide a route for oxygenation while reviewing how to proceed. Second-generation devices have advantages and are recommended. When both tracheal intubation and supraglottic airway device insertion have failed, waking the patient is the default option. If at this stage, face-mask oxygenation is impossible in the presence of muscle relaxation, cricothyroidotomy should follow immediately. Scalpel cricothyroidotomy is recommended as the preferred rescue technique and should be practised by all anaesthetists. The plans outlined are designed to be simple and easy to follow. They should be regularly rehearsed and made familiar to the whole theatre team. PMID:26556848

Challenge theme 2: assuring water availability and quality in the 21st century: Chapter 4 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

USGS Publications Warehouse

Callegary, James; Langeman, Jeff; Leenhouts, Jim; Martin, Peter

2013-01-01

Along the United States–Mexican border, the health of communities, economies, and ecosystems is inextricably intertwined with the availability and quality of water, but effective water management in the Borderlands is complicated. Water users compete for resources, and their needs are increasing. Managers are faced with issues such as finding a balance between agriculture and rapidly growing cities or maintaining public supplies while ensuring sufficient resources for aquatic ecosystems. In addition to human factors, the dry climate of the Borderlands, as compared to more temperate regions, also increases the challenge of balancing water supplies between humans and ecosystems. Warmer, drier, and more variable conditions across the southwestern United States—the projected results of climate change (Seager and others, 2007)—would further stress water supplies.

Missile Defense: European Phased Adaptive Approach Acquisitions Face Synchronization, Transparency, and Accountability Challenges

DTIC Science & Technology

2010-12-21

House of Representatives Subject: Missile Defense: European Phased Adaptive Approach Acquisitions Face Synchronization , Transparency, and...TITLE AND SUBTITLE Missile Defense: European Phased Adaptive Approach Acquisitions Face Synchronization , Transparency, and Accountability...However, we found that DOD has not fully implemented a management process that synchronizes EPAA acquisition activities and ensures transparency and

Clustering Millions of Faces by Identity.

PubMed

Otto, Charles; Wang, Dayong; Jain, Anil K

2018-02-01

Given a large collection of unlabeled face images, we address the problem of clustering faces into an unknown number of identities. This problem is of interest in social media, law enforcement, and other applications, where the number of faces can be of the order of hundreds of million, while the number of identities (clusters) can range from a few thousand to millions. To address the challenges of run-time complexity and cluster quality, we present an approximate Rank-Order clustering algorithm that performs better than popular clustering algorithms (k-Means and Spectral). Our experiments include clustering up to 123 million face images into over 10 million clusters. Clustering results are analyzed in terms of external (known face labels) and internal (unknown face labels) quality measures, and run-time. Our algorithm achieves an F-measure of 0.87 on the LFW benchmark (13 K faces of 5,749 individuals), which drops to 0.27 on the largest dataset considered (13 K faces in LFW + 123M distractor images). Additionally, we show that frames in the YouTube benchmark can be clustered with an F-measure of 0.71. An internal per-cluster quality measure is developed to rank individual clusters for manual exploration of high quality clusters that are compact and isolated.

Mentoring Matters: The Challenge for Teacher Education

ERIC Educational Resources Information Center

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

2009-01-01

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

"Put on a Happy Face"

ERIC Educational Resources Information Center

Morris, Michael

2004-01-01

All evaluators face the challenge of striving to adhere to the highest possible standards of ethical conduct. Translating the AEA's Guiding Principles and the Joint Committee's Program Evaluation Standards into everyday practice, however, can be a complex, uncertain, and frustrating endeavor. Moreover, acting in an ethical fashion can require…

Face-to-face: Perceived personal relevance amplifies face processing

PubMed Central

Pittig, Andre; Schupp, Harald T.; Alpers, Georg W.

2017-01-01

Abstract The human face conveys emotional and social information, but it is not well understood how these two aspects influence face perception. In order to model a group situation, two faces displaying happy, neutral or angry expressions were presented. Importantly, faces were either facing the observer, or they were presented in profile view directed towards, or looking away from each other. In Experiment 1 (n = 64), face pairs were rated regarding perceived relevance, wish-to-interact, and displayed interactivity, as well as valence and arousal. All variables revealed main effects of facial expression (emotional > neutral), face orientation (facing observer > towards > away) and interactions showed that evaluation of emotional faces strongly varies with their orientation. Experiment 2 (n = 33) examined the temporal dynamics of perceptual-attentional processing of these face constellations with event-related potentials. Processing of emotional and neutral faces differed significantly in N170 amplitudes, early posterior negativity (EPN), and sustained positive potentials. Importantly, selective emotional face processing varied as a function of face orientation, indicating early emotion-specific (N170, EPN) and late threat-specific effects (LPP, sustained positivity). Taken together, perceived personal relevance to the observer—conveyed by facial expression and face direction—amplifies emotional face processing within triadic group situations. PMID:28158672

Face-to-face: Perceived personal relevance amplifies face processing.

PubMed

Bublatzky, Florian; Pittig, Andre; Schupp, Harald T; Alpers, Georg W

2017-05-01

The human face conveys emotional and social information, but it is not well understood how these two aspects influence face perception. In order to model a group situation, two faces displaying happy, neutral or angry expressions were presented. Importantly, faces were either facing the observer, or they were presented in profile view directed towards, or looking away from each other. In Experiment 1 (n = 64), face pairs were rated regarding perceived relevance, wish-to-interact, and displayed interactivity, as well as valence and arousal. All variables revealed main effects of facial expression (emotional > neutral), face orientation (facing observer > towards > away) and interactions showed that evaluation of emotional faces strongly varies with their orientation. Experiment 2 (n = 33) examined the temporal dynamics of perceptual-attentional processing of these face constellations with event-related potentials. Processing of emotional and neutral faces differed significantly in N170 amplitudes, early posterior negativity (EPN), and sustained positive potentials. Importantly, selective emotional face processing varied as a function of face orientation, indicating early emotion-specific (N170, EPN) and late threat-specific effects (LPP, sustained positivity). Taken together, perceived personal relevance to the observer-conveyed by facial expression and face direction-amplifies emotional face processing within triadic group situations. © The Author (2017). Published by Oxford University Press.

Making difficult decisions: Immigrants' experiences of employment preparation and participation.

PubMed

Huot, Suzanne; Chen, Xiaojie; King, Christiana; Painter-Zykmund, Ellen; Watt, Kaitlin

2016-06-13

Immigrants engage in complex integration processes that are mediated through daily occupations. A central element of socio-economic integration relates to labor market preparation and participation, including job searching, learning cultural values in the workplace, pursuing credential recognition and engaging in volunteering roles and paid employment. To examine how immigrants experienced occupations relating to preparing for, seeking, and gainingemployment. A secondary analysis using whole text analysis and line-by-line coding of twenty verbatim transcripts from interviews held with ten recently arrived immigrants to London, Ontario, Canada. Sessions consisted of a narrative interview, creation of an occupational map and a semi-structured follow-up interview. The participants' employment related occupations were characterized by the overarching theme of 'making difficult decisions'. This main theme was connected to four related sub-themes: 1) mechanisms of exclusion, 2) learning the host country's culture, 3) the influence of one's outlook on the decisions made, and 4) accessing support. This study identifies factors influencing immigrants' experiences of labor market preparation and participation. 'Making difficult decisions' was faced by all participants throughout the process of becoming part of the Canadian workforce and, ultimately, society at large.

Challenges Faced by Graduate Business Education in Southern Africa: Perceptions of MBA Participants

ERIC Educational Resources Information Center

Temtime, Zelealem T.; Mmereki, Rebana N.

2011-01-01

Purpose: The purpose of this paper is to examine the degree of satisfaction and perceived relevance of the Graduate Business Education (GBE) programme at the University of Botswana. Design/methodology/approach: A self-administered questionnaire and face to face interviews were used to collect data from Master of Business Administration (MBA)…

Lessons from forest FACE experiments provide guidance for Amazon-FACE science plan (Invited)

NASA Astrophysics Data System (ADS)

Norby, R. J.; Lapola, D. M.

2013-12-01

Free-air CO2 enrichment (FACE) experiments have provided novel insights into the ecological mechanisms controlling the cycling and storage of carbon in terrestrial ecosystems, and they provide a strong foundation for next-generation experiments in unexplored biomes. Specific lessons from FACE experiments include: (1) Carbon cycle responses are time-dependent because component processes have different rate constants: for example, net primary productivity is increased by elevated CO2, but the response may diminish with time as N cycling feedbacks become important. (2) Carbon partitioning patterns determine the fate of the extra C taken up by CO2-enriched plants, but partitioning responses remain an important challenge for ecosystem models. (3) The influence of N cycling on plant and ecosystem C cycling continues to be a critical uncertainty, and new experiments, especially in the tropics, must also consider P cycling. (4) Plant community structure can influence the ecosystem response to elevated CO2, but dynamic vegetation effects have not been adequately addressed. These experiences from FACE experiments in temperate forests are now guiding the development of a science plan for a FACE experiment in Amazonia. Models and small-scale experimental results agree that elevated CO2 will affect the metabolism of tropical ecosystems, but the qualitative and quantitative expression of the effects are largely unknown, representing a major source of uncertainty that limits our capacity to assess the vulnerability of the Amazon forest to climate change. Recognizing the high importance of the forests of the Amazon basin on global carbon, water, and energy cycles, biodiversity conservation, and the provision of essential services in Latin America, a consortium of Brazilian researchers and international collaborators have developed a science plan for Amazon-FACE. While the challenges presented both by infrastructure needs (roads, electricity, and provision of CO2) and biology (the

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

PubMed

Mayeux, Lara; Kraft, Caroline

2017-09-01

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

Getting out of the house: the challenges mothers face when their children have long-term care needs.

PubMed

Yantzi, Nicole M; Rosenberg, Mark W; McKeever, Patricia

2007-01-01

In most industrialised countries, the care needs of those who are sick, disabled and frail are increasingly met in peoples' homes. One of the implications of this shift in the site of care is that individuals with long-term care needs and their family care providers experience social and spatial isolation. Many are housebound and most face considerable challenges in getting out of the house. This paper illuminates these challenges as they are experienced by mothers of children with long-term care needs, and the resulting isolation and disconnection that they experience. Eleven semistructured interviews were conducted in two regions of Ontario, Canada. Grounded theory informed the analysis of the mothers' accounts of their experiences of getting out of the house. The present findings are derived from a larger investigation of the meanings and experiences of the home as a place of caring for families with children who have long-term care needs. Secondary analysis of the data found that three main challenges restricted the mothers' abilities to leave their houses. Mothers experienced difficulties getting out of the house when they attempted to leave with the child, and when the child was left with an alternative care provider. Physical challenges were associated with the work and planning required in moving the child's equipment and supplies, meticulous planning of the outing within the daily schedule, and navigating barriers in the built and natural environments. Social challenges reflected the lack of people within the mothers' social network of family and friends who have the knowledge and expertise to care for the child. Service challenges resulted from the gaps between the policies and practices of paid respite, and the conditions that must be satisfied in order for mothers to be able and/or willing to leave the house. The authors also examined the reasons why some of the mothers worked from home, and the strategies that they used to get out of the house for

Alternatives to the face-to-face consultation in general practice: focused ethnographic case study

PubMed Central

Atherton, Helen; Brant, Heather; Ziebland, Sue; Bikker, Annemieke; Campbell, John; Gibson, Andy; McKinstry, Brian; Porqueddu, Tania; Salisbury, Chris

2018-01-01

Background NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. Aim To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice. Design and setting Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016. Method Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report. Results Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal. Conclusion Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team. PMID:29378697

Bedside ultrasound of the soft tissue of the face: a case of early Ludwig's angina.

PubMed

Gaspari, Romolo J

2006-10-01

A case is reported of a 38-year-old man presenting with early Ludwig's angina. It is difficult to differentiate superficial from deep infections of the face and neck by physical examination alone. The diagnosis of this condition with bedside soft tissue ultrasound of the face is described. Ludwig's angina is an uncommon infection of the deep tissues of the face and neck that usually evolves from more superficial infections such as dental abscesses.

Anaesthesia and intensive care management of face transplantation.

PubMed

Sedaghati-nia, A; Gilton, A; Liger, C; Binhas, M; Cook, F; Ait-Mammar, B; Scherrer, E; Hivelin, M; Lantieri, L; Marty, J; Plaud, B

2013-10-01

The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.

Redesigning photo-ID to improve unfamiliar face matching performance.

PubMed

White, David; Burton, A Mike; Jenkins, Rob; Kemp, Richard I

2014-06-01

Viewers find it difficult to match photos of unfamiliar faces for identity. Despite this, the use of photographic ID is widespread. In this study we ask whether it is possible to improve face matching performance by replacing single photographs on ID documents with multiple photos or an average image of the bearer. In 3 experiments we compare photo-to-photo matching with photo-to-average matching (where the average is formed from multiple photos of the same person) and photo-to-array matching (where the array comprises separate photos of the same person). We consistently find an accuracy advantage for average images and photo arrays over single photos, and show that this improvement is driven by performance in match trials. In the final experiment, we find a benefit of 4-image arrays relative to average images for unfamiliar faces, but not for familiar faces. We propose that conventional photo-ID format can be improved, and discuss this finding in the context of face recognition more generally. PsycINFO Database Record (c) 2014 APA, all rights reserved.

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…

The challenges facing mental health programs for post-conflict and refugee communities.

PubMed

Silove, Derrick

2004-01-01

The majority of refugees and communities exposed to warfare and oppression live in low-income countries with few resources or special skills. Yet, epidemiological studies have identified high levels of traumatic stress reactions in such populations. These stress reactions can be intensified by harsh policies aimed at deterring survivors from seeking refuge in technologically advanced societies. The scale of the problem of mass violence and displacement creates formidable challenges for mental health professionals in their efforts to develop practical frameworks for responding to the extensive needs of displaced persons. In this article, a model is proposed for low-income, post-conflict countries, based on a two-tiered formulation. At the eco-social level, mental health professionals can play a supportive, but not a lead, role in facilitating recovery of core adaptive systems that hasten natural recovery from stress for the majority of the population. Where small-scale, community mental health services are established, the emphasis should be on assisting persons and their families who are at greatest survival and adaptive risk. Training and promotion of local workers to assume leadership in such programs are essential. In technologically advanced societies in which refugees are in a minority, torture and trauma services can focus more specifically on traumatic stress reactions, acculturation, and resettlement. In a historical epoch in which displaced persons are facing particularly harsh treatment, there is a pressing need for consensus amongst mental health professionals in advocating for their needs.

Cognitive Behavioural Therapy: From Face to Face Interaction to a Broader Contextual Understanding of Change

ERIC Educational Resources Information Center

Jahoda, A.; Dagnan, D.; Kroese, B. Stenfert; Pert, C.; Trower, P.

2009-01-01

Cognitive behavioural therapy (CBT) is increasingly used to address the emotional and interpersonal problems of people with ID. There is a limited but promising evidence base supporting this activity. However, these individuals face real and continuing challenges in their lives that have implications for their self and interpersonal perceptions.…

Atypical Face Perception in Autism: A Point of View?

PubMed

Morin, Karine; Guy, Jacalyn; Habak, Claudine; Wilson, Hugh R; Pagani, Linda; Mottron, Laurent; Bertone, Armando

2015-10-01

Face perception is the most commonly used visual metric of social perception in autism. However, when found to be atypical, the origin of face perception differences in autism is contentious. One hypothesis proposes that a locally oriented visual analysis, characteristic of individuals with autism, ultimately affects performance on face tasks where a global analysis is optimal. The objective of this study was to evaluate this hypothesis by assessing face identity discrimination with synthetic faces presented with and without changes in viewpoint, with the former condition minimizing access to local face attributes used for identity discrimination. Twenty-eight individuals with autism and 30 neurotypical participants performed a face identity discrimination task. Stimuli were synthetic faces extracted from traditional face photographs in both front and 20° side viewpoints, digitized from 37 points to provide a continuous measure of facial geometry. Face identity discrimination thresholds were obtained using a two-alternative, temporal forced choice match-to-sample paradigm. Analyses revealed an interaction between group and condition, with group differences found only for the viewpoint change condition, where performance in the autism group was decreased compared to that of neurotypical participants. The selective decrease in performance for the viewpoint change condition suggests that face identity discrimination in autism is more difficult when access to local cues is minimized, and/or when dependence on integrative analysis is increased. These results lend support to a perceptual contribution of atypical face perception in autism. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Challenges in the management of community pharmacies in Malaysia

PubMed Central

2017-01-01

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

Incidence, predictors, and outcome of difficult mask ventilation combined with difficult laryngoscopy: a report from the multicenter perioperative outcomes group.

PubMed

Kheterpal, Sachin; Healy, David; Aziz, Michael F; Shanks, Amy M; Freundlich, Robert E; Linton, Fiona; Martin, Lizabeth D; Linton, Jonathan; Epps, Jerry L; Fernandez-Bustamante, Ana; Jameson, Leslie C; Tremper, Tyler; Tremper, Kevin K

2013-12-01

Research regarding difficult mask ventilation (DMV) combined with difficult laryngoscopy (DL) is extremely limited even though each technique serves as a rescue for one another. Four tertiary care centers participating in the Multicenter Perioperative Outcomes Group used a consistent structured patient history and airway examination and airway outcome definition. DMV was defined as grade 3 or 4 mask ventilation, and DL was defined as grade 3 or 4 laryngoscopic view or four or more intubation attempts. The primary outcome was DMV combined with DL. Patients with the primary outcome were compared to those without the primary outcome to identify predictors of DMV combined with DL using a non-parsimonious logistic regression. Of 492,239 cases performed at four institutions among adult patients, 176,679 included a documented face mask ventilation and laryngoscopy attempt. Six hundred ninety-eight patients experienced the primary outcome, an overall incidence of 0.40%. One patient required an emergent cricothyrotomy, 177 were intubated using direct laryngoscopy, 284 using direct laryngoscopy with bougie introducer, 163 using videolaryngoscopy, and 73 using other techniques. Independent predictors of the primary outcome included age 46 yr or more, body mass index 30 or more, male sex, Mallampati III or IV, neck mass or radiation, limited thyromental distance, sleep apnea, presence of teeth, beard, thick neck, limited cervical spine mobility, and limited jaw protrusion (c-statistic 0.84 [95% CI, 0.82-0.87]). DMV combined with DL is an infrequent but not rare phenomenon. Most patients can be managed with the use of direct or videolaryngoscopy. An easy to use unweighted risk scale has robust discriminating capacity.

Challenges and opportunities for the control and elimination of porcine reproductive and respiratory syndrome virus.

PubMed

Rowland, R R R; Morrison, R B

2012-03-01

The control and elimination of porcine reproductive and respiratory syndrome virus (PRRSV) represent two of the most challenging tasks facing the pig industry worldwide. Several factors related to the biology of the virus make disease detection and elimination difficult. Efforts are further hampered by the lack of vaccines that can protect naïve herds from infection. With this in mind, elimination efforts are being initiated which incorporate existing tools and knowledge. A new approach extends herd control strategies to the level of a region. One example of success in PRRSV regional elimination is the Stevens County project in Minnesota. © 2012 Blackwell Verlag GmbH.

Face Recognition Using Local Quantized Patterns and Gabor Filters

NASA Astrophysics Data System (ADS)

Khryashchev, V.; Priorov, A.; Stepanova, O.; Nikitin, A.

2015-05-01

The problem of face recognition in a natural or artificial environment has received a great deal of researchers' attention over the last few years. A lot of methods for accurate face recognition have been proposed. Nevertheless, these methods often fail to accurately recognize the person in difficult scenarios, e.g. low resolution, low contrast, pose variations, etc. We therefore propose an approach for accurate and robust face recognition by using local quantized patterns and Gabor filters. The estimation of the eye centers is used as a preprocessing stage. The evaluation of our algorithm on different samples from a standardized FERET database shows that our method is invariant to the general variations of lighting, expression, occlusion and aging. The proposed approach allows about 20% correct recognition accuracy increase compared with the known face recognition algorithms from the OpenCV library. The additional use of Gabor filters can significantly improve the robustness to changes in lighting conditions.

Challenges of Attending E-Learning Studies in Nigeria

ERIC Educational Resources Information Center

Bugi, Stephan Z.

2012-01-01

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

Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009-2013).

PubMed

de Lesquen, Henri; Beranger, Fabien; Berbis, Julie; Boddaert, Guillaume; Poichotte, Antoine; Pons, Francois; Avaro, Jean-Philippe

2016-09-01

This study reports the challenges faced by French military surgeons in the management of thoracic injury during the latest Afghanistan war. From January 2009 to April 2013, all of the civilian, French and Coalition casualties admitted to French NATO Combat Support Hospital situated on Kabul were prospectively recorded in the French Military Health Service Registry (OPEX(®)). Only penetrating and blunt thoracic trauma patients were retrospectively included. Eighty-nine casualties were included who were mainly civilian (61%) and men (94%) with a mean age of 27.9 years old. Surgeons dealt with polytraumas (78%), severe injuries (mean Injury Severity Score=39.2) and penetrating wounds (96%) due to explosion in 37%, gunshot in 53% and stabbing in 9%. Most of casualties were first observed or drained (n=56). In this non-operative group more than 40% of casualties needed further actions. In the operative group, Damage Control Thoracotomy (n=22) was performed to stop ongoing bleeding and air leakage and Emergency Department Thoracotomy (n=11) for agonal patient. Casualties suffered from hemothorax (60%), pneumothorax (39%), diaphragmatic (37%), lung (35%), heart or great vessels (20%) injuries. The main actions were diaphragmatic sutures (n=25), lung resections (wedge n=6, lobectomy n=4) and haemostasis (intercostal artery ligation n=3, heart injury repairs n=5, great vessels injury repairs n=5). Overall mortality was 11%. The rate of subsequent surgery was 34%. The analysis of the OPEX(®) registry reflects the thoracic surgical challenges of general (visceral) surgeons serving in combat environment during the latest Afghanistan War. Copyright © 2016 Elsevier Ltd. All rights reserved.

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics*

PubMed Central

Mushambi, M C; Kinsella, S M; Popat, M; Swales, H; Ramaswamy, K K; Winton, A L; Quinn, A C

2015-01-01

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview. Algorithm 1 gives a framework on how to optimise a safe general anaesthetic technique in the obstetric patient, and emphasises: planning and multidisciplinary communication; how to prevent the rapid oxygen desaturation seen in pregnant women by advocating nasal oxygenation and mask ventilation immediately after induction; limiting intubation attempts to two; and consideration of early release of cricoid pressure if difficulties are encountered. Algorithm 2 summarises the management after declaring failed tracheal intubation with clear decision points, and encourages early insertion of a (preferably second-generation) supraglottic airway device if appropriate. Algorithm 3 covers the management of the ‘can't intubate, can't oxygenate’ situation and emergency front-of-neck airway access, including the necessity for timely perimortem caesarean section if maternal oxygenation cannot be achieved. Table 1 gives a structure for assessing the individual factors relevant in the decision to awaken or proceed should intubation fail, which include: urgency related to maternal or fetal factors; seniority of the anaesthetist; obesity of the patient; surgical complexity; aspiration risk; potential difficulty with provision of alternative anaesthesia; and post-induction airway device and airway patency. This decision should be considered by the team in advance of performing a general anaesthetic to make a provisional plan should failed intubation occur. The table is also intended to be used as a teaching tool to facilitate discussion and learning regarding the complex nature of decision-making when faced with a failed intubation. Table 2 gives practical considerations of how

District of Columbia: D.C. Public Schools' Modernization Program Faces Major Challenges. Testimony before the Subcommittee on the District of Columbia, Committee on Appropriations, House of Representatives.

ERIC Educational Resources Information Center

Cooper, David E.

This Congressional testimony focuses on the challenges faced by the District of Columbia in modernizing its public schools. Specifically, it addresses: (1) increases in the cost of modernizing the schools; (2) delays in completing the schools; (3) quality inspection problems; and (4) concerns about managing asbestos hazards. The testimony…

Drug Testing Programs Face Snags and Legal Challenges.

ERIC Educational Resources Information Center

Cowart, Virginia S.

1988-01-01

A description of the problems that occurred with attempts to conduct drug tests at the 1987 Pan American games leads to a discussion of the legal challenges to drug testing and the need to establish a clear, effective, and fair policy for drug tests of athletes. (CB)

Issues and Challenges Facing the Minority Woman Dentist.

ERIC Educational Resources Information Center

Sinkford, Jeanne C.

1992-01-01

The status of minority women dentists is reviewed, and initiatives to improve it are noted. Issues and challenges for African-American female dentists are outlined, including negative racial/gender stereotypes, lack of advancement opportunities, difficulties in starting practices and securing professional and social support systems, lack of…

Comparing Costs of Telephone versus Face-to-Face Extended Care Programs for the Management of Obesity in Rural Settings

PubMed Central

Radcliff, Tiffany A.; Bobroff, Linda B.; Lutes, Lesley D.; Durning, Patricia E.; Daniels, Michael J.; Limacher, Marian C.; Janicke, David M.; Martin, A. Daniel; Perri, Michael G.

2012-01-01

Background A major challenge following successful weight loss is continuing the behaviors required for long-term weight maintenance. This challenge may be exacerbated in rural areas with limited local support resources. Objective This study describes and compares program costs and cost-effectiveness for 12-month extended care lifestyle maintenance programs following an initial 6-month weight loss program. Design A 1-year prospective controlled randomized clinical trial. Participants/Setting The study included 215 female participants age 50 or older from rural areas who completed an initial 6-month lifestyle program for weight loss. The study was conducted from June 1, 2003, to May 31, 2007. Intervention The intervention was delivered through local Cooperative Extension Service offices in rural Florida. Participants were randomly-assigned to a 12-month extended care program using either individual telephone counseling (n=67), group face-to-face counseling (n=74), or a mail/control group (n=74). Main Outcome Measures Program delivery costs, weight loss, and self-reported health status were directly assessed through questionnaires and program activity logs. Costs were estimated across a range of enrollment sizes to allow inferences beyond the study sample. Statistical Analyses Performed Non-parametric and parametric tests of differences across groups for program outcomes were combined with direct program cost estimates and expected value calculations to determine which scales of operation favored alternative formats for lifestyle maintenance. Results Median weight regain during the intervention year was 1.7 kg for participants in the face-to-face format, 2.1 kg for the telephone format, and 3.1 kg for the mail/control format. For a typical group size of 13 participants, the face-to-face format had higher fixed costs, which translated into higher overall program costs ($420 per participant) when compared to individual telephone counseling ($268 per participant) and

Can we match ultraviolet face images against their visible counterparts?

NASA Astrophysics Data System (ADS)

Narang, Neeru; Bourlai, Thirimachos; Hornak, Lawrence A.

2015-05-01

In law enforcement and security applications, the acquisition of face images is critical in producing key trace evidence for the successful identification of potential threats. However, face recognition (FR) for face images captured using different camera sensors, and under variable illumination conditions, and expressions is very challenging. In this paper, we investigate the advantages and limitations of the heterogeneous problem of matching ultra violet (from 100 nm to 400 nm in wavelength) or UV, face images against their visible (VIS) counterparts, when all face images are captured under controlled conditions. The contributions of our work are three-fold; (i) We used a camera sensor designed with the capability to acquire UV images at short-ranges, and generated a dual-band (VIS and UV) database that is composed of multiple, full frontal, face images of 50 subjects. Two sessions were collected that span over the period of 2 months. (ii) For each dataset, we determined which set of face image pre-processing algorithms are more suitable for face matching, and, finally, (iii) we determined which FR algorithm better matches cross-band face images, resulting in high rank-1 identification rates. Experimental results show that our cross spectral matching (the heterogeneous problem, where gallery and probe sets consist of face images acquired in different spectral bands) algorithms achieve sufficient identification performance. However, we also conclude that the problem under study, is very challenging, and it requires further investigation to address real-world law enforcement or military applications. To the best of our knowledge, this is first time in the open literature the problem of cross-spectral matching of UV against VIS band face images is being investigated.

Malaria eradication: the economic, financial and institutional challenge.

PubMed

Mills, Anne; Lubell, Yoel; Hanson, Kara

2008-12-11

Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices). More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities), the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between malaria control and economic

Malaria eradication: the economic, financial and institutional challenge

PubMed Central

Mills, Anne; Lubell, Yoel; Hanson, Kara

2008-01-01

Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices). More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities), the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: ∘ issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between malaria control and economic

Difficulties facing physician mothers in Japan.

PubMed

Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

2011-11-01

Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. © 2011 Tohoku University Medical Press

Challenges in Commercializing Biomimetic Membranes.

PubMed

Perry, Mark; Madsen, Steen Ulrik; Jørgensen, Tine; Braekevelt, Sylvie; Lauritzen, Karsten; Hélix-Nielsen, Claus

2015-11-05

The discovery of selective water channel proteins-aquaporins-has prompted growing interest in using these proteins, as the building blocks for designing new types of membranes. However, as with any other new and potentially disruptive technology, barriers for successful market entry exist. One category includes customer-related barriers, which can be influenced to some extent. Another category includes market-technical-related barriers, which can be very difficult to overcome by an organization/company aiming at successfully introducing their innovation on the market-in particular if both the organization and the technology are at early stages. Often, one faces barriers from both these categories at the same time, which makes it necessary to gain insight of the particular market when introducing a new innovative product. In this review we present the basic concepts and discuss some of these barriers and challenges associated with introducing biomimetic aquaporin membranes. These include technical issues in membrane production and product testing. Then we discuss possible business models for introducing new technologies in general, followed by a presentation of beach-head market segments relevant for biomimetic aquaporin membranes.

Breaking difficult news in a newborn setting: Down syndrome as a paradigm.

PubMed

Dent, Karin M; Carey, John C

2006-08-15

Breaking the difficult news of an unexpected diagnosis to parents in the newborn setting is a common occurrence in genetic counseling. Many clinical geneticists and genetic counselors have had the challenge of delivering a postnatal diagnosis of Down syndrome to parents of newborns. Down syndrome is a common chromosome condition occurring in approximately 1 in 800 live births. Presenting the diagnosis to families must be accomplished in a supportive, positive, caring, and honest manner. However, there are few scientific data and little instruction in training programs on how best to convey this news in an appropriate manner. Several articles in the literature over the last three decades have proposed various guidelines for the so-called informing interview. Discussions of parents' preferences and experiences in receiving this news have also been documented. Few reports, however, have focused on breaking difficult news of the diagnosis of a genetic condition to parents in a newborn setting in the genetics literature. In this paper, we will review the medical literature on delivering difficult news, specifically focused on that regarding the diagnosis of Down syndrome in the newborn setting. We propose a theoretical framework from which the informing interview can be planned and future outcome data can be measured. In this way, researchers of this theme can investigate the process, including the healthcare professionals' delivery of difficult news and make recommendations for continued improvement of the process. Our model can be generalized to breaking difficult news for a variety of other congenital conditions.

Fusing face-verification algorithms and humans.

PubMed

O'Toole, Alice J; Abdi, Hervé; Jiang, Fang; Phillips, P Jonathon

2007-10-01

It has been demonstrated recently that state-of-the-art face-recognition algorithms can surpass human accuracy at matching faces over changes in illumination. The ranking of algorithms and humans by accuracy, however, does not provide information about whether algorithms and humans perform the task comparably or whether algorithms and humans can be fused to improve performance. In this paper, we fused humans and algorithms using partial least square regression (PLSR). In the first experiment, we applied PLSR to face-pair similarity scores generated by seven algorithms participating in the Face Recognition Grand Challenge. The PLSR produced an optimal weighting of the similarity scores, which we tested for generality with a jackknife procedure. Fusing the algorithms' similarity scores using the optimal weights produced a twofold reduction of error rate over the most accurate algorithm. Next, human-subject-generated similarity scores were added to the PLSR analysis. Fusing humans and algorithms increased the performance to near-perfect classification accuracy. These results are discussed in terms of maximizing face-verification accuracy with hybrid systems consisting of multiple algorithms and humans.

Recognition profile of emotions in natural and virtual faces.

PubMed

Dyck, Miriam; Winbeck, Maren; Leiberg, Susanne; Chen, Yuhan; Gur, Ruben C; Gur, Rurben C; Mathiak, Klaus

2008-01-01

Computer-generated virtual faces become increasingly realistic including the simulation of emotional expressions. These faces can be used as well-controlled, realistic and dynamic stimuli in emotion research. However, the validity of virtual facial expressions in comparison to natural emotion displays still needs to be shown for the different emotions and different age groups. Thirty-two healthy volunteers between the age of 20 and 60 rated pictures of natural human faces and faces of virtual characters (avatars) with respect to the expressed emotions: happiness, sadness, anger, fear, disgust, and neutral. Results indicate that virtual emotions were recognized comparable to natural ones. Recognition differences in virtual and natural faces depended on specific emotions: whereas disgust was difficult to convey with the current avatar technology, virtual sadness and fear achieved better recognition results than natural faces. Furthermore, emotion recognition rates decreased for virtual but not natural faces in participants over the age of 40. This specific age effect suggests that media exposure has an influence on emotion recognition. Virtual and natural facial displays of emotion may be equally effective. Improved technology (e.g. better modelling of the naso-labial area) may lead to even better results as compared to trained actors. Due to the ease with which virtual human faces can be animated and manipulated, validated artificial emotional expressions will be of major relevance in future research and therapeutic applications.

"Members of the same club": challenges and decisions faced by US IRBs in identifying and managing conflicts of interest.

PubMed

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be "indirect financial" conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves

New Challenges Facing Small Undergraduate Departments And The Role Of Faculty And Administrators.

NASA Astrophysics Data System (ADS)

El-Shazly, A. K.

2003-12-01

Small geoscience departments with 5 faculty members or less in undergraduate institutions are facing serious challenges that will have a profound impact on their future, as well as the future of geoscience education. In addition to past and future budget cuts that affect all departments, small departments are more vulnerable to such problems as (i) decreased enrollments in introductory level classes, (ii) small number of geology majors, (iii) small number of graduates per year (iv) lack or paucity of equipment necessary for faculty and student research, (v) limited opportunities for external funding, (vi) need to offer upper division classes on an alternate year basis, (vii) difficulty in recruiting and retaining students, (viii) high teaching loads for faculty, and (ix) designing rigorous curricula based on 120 credit hours with a significant component of liberal art classes. These problems pose new challenges for faculty, department chairs and administrators. Faculty need to design curricula tailored to the need of the job market, without compromising rigor or the quality of the program. New classes/ concentrations in environmental science, hydrogeology and geographical information systems should be offered, and traditional classes in petrology, geophysics and tectonics should be maintained. Classes in Physics, Chemistry and Math should be core requirements. Student involvement in research should be encouraged at an early stage (sophomore/ junior levels). Department chairs need to assign duties in their department carefully to capitalize on the strengths of their faculty: faculty with strong research backgrounds should be helped in their efforts to pursue external funding opportunities, whereas those with strong teaching abilities should be evaluated primarily on their performance in the classroom. Student credit hour production should not be used as a criterion for evaluating faculty. Administrators should evaluate programs and departments based on the success

Professional development for teachers of students who are deaf or hard of hearing: facing the assessment challenge.

PubMed

Cawthon, Stephanie

2009-01-01

Teachers of students with low-incidence disabilities, such as students who are deaf or hard of hearing, face unique challenges in putting education policy into practice. The present article presents professional development findings from the Third Annual National Survey of Accommodations and Assessment for Students Who Are Deaf or Hard of Hearing (Cawthon, Hersh, Kim, & Online Research Lab, in press). A total of 391 participants described professional development they had experienced related to assessment of students who are deaf or hard of hearing. Teachers reported greater exposure to topics in school/district sessions and discussion with their colleagues than in their preparation programs. Teaching at a school for the deaf or teaching students in high school were significant predictors of an increased prevalence of professional development opportunities on assessment-related topics for students who are deaf or hard of hearing.

Community in Online Higher Education: Challenges and Opportunities

ERIC Educational Resources Information Center

Arasaratnam-Smith, Lily A.; Northcote, Maria

2017-01-01

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

"Pedogeriatrics": a pediatric nephrologist's outlook on common challenges facing pediatric and geriatric nephrologists.

PubMed

Grünberg, Jose

2010-03-01

Dramatic demographic changes longevity and medical progress helped create a new population made up of the survivors of previously fatal diseases. These trends pose new major social and economic challenges that should be accounted for in health policy making. This paper discusses the similarities between the specialties of pediatrics and geriatrics, especially in the realm of patient care. Children and the elderly share a limited autonomy and dependence on the human environment (i.e., willing and able caregiving persons) due to age or disease. The long-term care of dependent patients (DP) requires caregiving persons who share with dependent persons the risk of losing autonomy, facing burnout, family disruption, and interference with work and educational activities. Families with DPs may face potential losses of income because both patients and caregivers are partially or completely unable to work, the former for medical reasons and the latter due to the new demands on their time and energy. Additionally, new expenses have to be met because while direct medical expenses might be covered by insurance or the State, other expenses have to be financed by the family, such as co-payments for medicines, new water or electricity home installations, and transport and eventual hotel costs if they have to stay overnight near a hospital outside of their town. The main objectives of long-term care should be to maximize patients' independence and prevent their physical and psychological deterioration while minimizing the social, economic and personal costs to caregivers. To achieve these goals, one needs a holistic approach, a multidisciplinary professional team (doctors, nurses, social workers, nutritionists and psychologists) and auxiliary staff (secretaries, electricians, administrators, messengers, cleaning staff, doormen, nursing aids and coordinators of medical appointments and medical procedures). Optimal management of DPs on chronic treatments such as chronic dialysis

Facing Global Challenges with Materials Innovation

NASA Astrophysics Data System (ADS)

Rizzo, Fernando

2017-10-01

The path of society evolution has long been associated with a growing demand for natural resources and continuous environmental degradation. During the last decades, this pace has accelerated considerably, despite the general concern with the legacy being left for the next generations. Looking ahead, the predicted growth of the world population, and the improvement of life conditions in most regions, point to an increasing demand for energy generation, resulting in additional pressure on the Earth's sustainability. Materials have had a key role in decreasing the use of natural resources, by either improving efficiency of existing technologies or enabling the development of radical new ones. The greenhouse effect (CO2 emissions) and the energy crisis are global challenges that can benefit from the development of new materials for the successful implementation of promising technologies and for the imperative replacement of fossil fuels by renewable sources.

Broadening Participation in the Sciences within and from Africa: Purpose, Challenges, and Prospects

PubMed Central

Okeke, Iruka N.; Babalola, Chinedum P.; Byarugaba, Denis K.; Djimde, Abdoulaye; Osoniyi, Omolaja R.

2017-01-01

Many of Africa’s challenges have scientific solutions, but there are fewer individuals engaged in scientific activity per capita on this continent than on any other. Only a handful of African scientists use their skills to capacity or are leaders in their disciplines. Underrepresentation of Africans in scientific practice, discourse, and decision making reduces the richness of intellectual contributions toward hard problems worldwide. This essay outlines challenges faced by teacher-scholars from sub-Saharan Africa as we build scientific expertise. Access to tertiary-level science is difficult and uneven across Africa, and the quality of training available varies from top-range to inadequate. Access to science higher education needs to increase, particularly for female students, first-generation literates, and rural populations. We make suggestions for collaborative initiatives involving stakeholders outside Africa and/or outside academia that could extend educational opportunities available to African students and increase the chance that Africa-based expertise is globally available. PMID:28408409

Face processing pattern under top-down perception: a functional MRI study

NASA Astrophysics Data System (ADS)

Li, Jun; Liang, Jimin; Tian, Jie; Liu, Jiangang; Zhao, Jizheng; Zhang, Hui; Shi, Guangming

2009-02-01

Although top-down perceptual process plays an important role in face processing, its neural substrate is still puzzling because the top-down stream is extracted difficultly from the activation pattern associated with contamination caused by bottom-up face perception input. In the present study, a novel paradigm of instructing participants to detect faces from pure noise images is employed, which could efficiently eliminate the interference of bottom-up face perception in topdown face processing. Analyzing the map of functional connectivity with right FFA analyzed by conventional Pearson's correlation, a possible face processing pattern induced by top-down perception can be obtained. Apart from the brain areas of bilateral fusiform gyrus (FG), left inferior occipital gyrus (IOG) and left superior temporal sulcus (STS), which are consistent with a core system in the distributed cortical network for face perception, activation induced by top-down face processing is also found in these regions that include the anterior cingulate gyrus (ACC), right oribitofrontal cortex (OFC), left precuneus, right parahippocampal cortex, left dorsolateral prefrontal cortex (DLPFC), right frontal pole, bilateral premotor cortex, left inferior parietal cortex and bilateral thalamus. The results indicate that making-decision, attention, episodic memory retrieving and contextual associative processing network cooperate with general face processing regions to process face information under top-down perception.

Russian Military Reform: Problems and Challenges

DTIC Science & Technology

2010-03-25

RUSSIAN MILITARY REFORM : PROBLEMS AND CHALLENGES BY LIEUTENANT COLONEL ZURAB AGLADZE Georgian Army...USAWC STRATEGIC REASERCH PROJECT RUSSIAN MILITARY REFORM : PROBLEMS AND CHALLENGES by Lieutenant Colonel...noncommissioned officers still continue to be unsolved. Despite some successes, Russian military reform still faces many challenges that will

Holistic Processing in the Composite Task Depends on Face Size.

PubMed

Ross, David A; Gauthier, Isabel

Holistic processing is a hallmark of face processing. There is evidence that holistic processing is strongest for faces at identification distance, 2 - 10 meters from the observer. However, this evidence is based on tasks that have been little used in the literature and that are indirect measures of holistic processing. We use the composite task- a well validated and frequently used paradigm - to measure the effect of viewing distance on holistic processing. In line with previous work, we find a congruency x alignment effect that is strongest for faces that are close (2m equivalent distance) than for faces that are further away (24m equivalent distance). In contrast, the alignment effect for same trials, used by several authors to measure holistic processing, produced results that are difficult to interpret. We conclude that our results converge with previous findings providing more direct evidence for an effect of size on holistic processing.

Self-Assessment of Governance Teams in an Argentine Private University: Adapting to Difficult Times

ERIC Educational Resources Information Center

Durand, Julio; Pujadas, Carlos

2004-01-01

Argentine Universities like similar institutions all around the world are facing a complex and challenging environment that demands a more sophisticated leadership and the development of complex managerial skills. In this paper we propose that enhancing the quality of collective decision making, and building more complex teams as a way to preserve…

Recognizing Disguised Faces: Human and Machine Evaluation

PubMed Central

Dhamecha, Tejas Indulal; Singh, Richa; Vatsa, Mayank; Kumar, Ajay

2014-01-01

Face verification, though an easy task for humans, is a long-standing open research area. This is largely due to the challenging covariates, such as disguise and aging, which make it very hard to accurately verify the identity of a person. This paper investigates human and machine performance for recognizing/verifying disguised faces. Performance is also evaluated under familiarity and match/mismatch with the ethnicity of observers. The findings of this study are used to develop an automated algorithm to verify the faces presented under disguise variations. We use automatically localized feature descriptors which can identify disguised face patches and account for this information to achieve improved matching accuracy. The performance of the proposed algorithm is evaluated on the IIIT-Delhi Disguise database that contains images pertaining to 75 subjects with different kinds of disguise variations. The experiments suggest that the proposed algorithm can outperform a popular commercial system and evaluates them against humans in matching disguised face images. PMID:25029188

Perceived Challenges in Primary Literature in a Master’s Class: Effects of Experience and Instruction

PubMed Central

Lie, Richard; Abdullah, Christopher; He, Wenliang; Tour, Ella

2016-01-01

Primary literature offers rich opportunities to teach students how to “think like a scientist,” but the challenges students face when they attempt to read research articles are not well understood. Here, we present an analysis of what master’s students perceive as the most challenging aspects of engaging with primary literature. We examined 69 pairs of pre- and postcourse responses from students enrolled in a master’s-level course that offered a structured analysis of primary literature. On the basis of these responses, we identified six categories of challenges. Before instruction, “techniques” and “experimental data” were the most frequently identified categories of challenges. The majority of difficulties students perceived in the primary literature corresponded to Bloom’s lower-order cognitive skills. After instruction, “conclusions” were identified as the most difficult aspect of primary literature, and the frequency of challenges that corresponded to higher-order cognitive skills increased significantly among students who reported less experience with primary literature. These changes are consistent with a more competent perception of the primary literature, in which these students increasingly focus on challenges requiring critical thinking. Students’ difficulties identified here can inform the design of instructional approaches aimed to teach students how to critically read scientific papers. PMID:27909027

Patients whom neurologists find difficult to help

PubMed Central

Carson, A; Stone, J; Warlow, C; Sharpe, M

2004-01-01

Objective: To test the hypothesis that patients whose symptoms were less explained by organic disease would be perceived as more difficult to help. Methods: In a consecutive series of 300 new neurology outpatients, neurologists indicated on four point Likert-type scales how "difficult to help" they found the patient and to what extent the patient's symptoms were explained by organic disease. The patients' demographics, health status, number of somatic symptoms, and mental state were also assessed. Results: The neurologists rated 143 patients (48%) as "not at all difficult" to help, 111 (37%) as "somewhat difficult", 27 (9%) as "very difficult", and 18 (6%) as "extremely difficult". A logistic regression model was constructed and the hypothesis that patients whose symptoms were less explained by organic disease would be perceived as more difficult to help was supported. The only other measured variable that contributed to perceived difficulty was physical disability, but it explained only a small amount of the variance. Conclusions: Neurologists find patients whose symptoms are not explained by organic disease more difficult to help than their other patients. PMID:15548505

Overcoming challenges faced by breastfeeding mothers.

PubMed

Amir, Lisa H; Bearzatto, Anita

2016-08-01

Women who are breastfeeding often consult their general practitioner (GP) with concerns about nipple and breast pain, or the adequacy of their milk supply. Common concerns for their breastfed infant include slow weight gain, 'fussiness' with breastfeeding and 'funny stools'. This article offers suggestions for clinicians to support breastfeeding women and their infants. Good attachment to the breast is important to reduce nipple pain and trauma, and to ensure adequate breast drainage and ongoing milk supply. Other causes of nipple pain include vasospasm, dermatitis and infection. Breast pain may be due to blocked ducts, mastitis or abscess. Very early mastitis may be treated by improved emptying. Slow weight gain in a breastfed infant may indicate a medical problem or low supply of breast milk. Some infants have breastfeeding challenges because they are small or premature, or from anatomical issues affecting feeding. In such cases, further help from a lactation consultant may be beneficial.

Reconstructive Management of Devastating Electrical Injuries to the Face.

PubMed

Janis, Jeffrey E; Khansa, Ibrahim; Lehrman, Craig R; Orgill, Dennis P; Pomahac, Bohdan

2015-10-01

Devastating fourth-degree electrical injuries to the face and head pose significant reconstructive challenges. To date, there have been few peer-reviewed articles in the literature that describe those reconstructive challenges. The authors present the largest case series to date that describes the management of these injuries, including the incorporation of face transplantation. A retrospective case series was conducted of patients with devastating electrical injuries to the face who were managed at two level-1 trauma centers between 2007 and 2011. Data describing patient injuries, initial management, and reconstructive procedures were collected. Five patients with devastating electrical injuries to the face were reviewed. After initial stabilization and treatment of life-threatening injuries, all five underwent burn excision and microsurgical reconstruction using distant flaps. Two of the patients eventually underwent face transplantation. The authors describe differences in management between the two trauma centers, one of which had the availability for composite tissue allotransplantation; the other did not. Also described is how initial attempts at traditional reconstruction affected the eventual face transplantation. The care of patients with complex electrical burns must be conducted in a multidisciplinary fashion. As with all other trauma, the initial priority should be management of the airway, breathing, and circulation. Additional considerations include cardiac arrhythmias and renal impairment attributable to myoglobinuria. Before embarking on aggressive reconstruction attempts, it is advisable to determine early whether the patient is a candidate for face transplantation in order to avoid antigen sensitization, loss of a reconstructive "lifeboat," surgical plane disruption, and sacrifice of potential recipient vessels. Therapeutic, V.

Beyond Faces and Expertise

PubMed Central

Zhao, Mintao; Bülthoff, Heinrich H.; Bülthoff, Isabelle

2016-01-01

Holistic processing—the tendency to perceive objects as indecomposable wholes—has long been viewed as a process specific to faces or objects of expertise. Although current theories differ in what causes holistic processing, they share a fundamental constraint for its generalization: Nonface objects cannot elicit facelike holistic processing in the absence of expertise. Contrary to this prevailing view, here we show that line patterns with salient Gestalt information (i.e., connectedness, closure, and continuity between parts) can be processed as holistically as faces without any training. Moreover, weakening the saliency of Gestalt information in these patterns reduced holistic processing of them, which indicates that Gestalt information plays a crucial role in holistic processing. Therefore, holistic processing can be achieved not only via a top-down route based on expertise, but also via a bottom-up route relying merely on object-based information. The finding that facelike holistic processing can extend beyond the domains of faces and objects of expertise poses a challenge to current dominant theories. PMID:26674129

Taking a holistic approach to managing difficult stress fractures.

PubMed

Miller, Timothy L; Best, Thomas M

2016-09-09

Stress fractures and other bony stress injuries occur along a spectrum of severity which can impact treatment and prognosis. When treating these injuries, it should be borne in mind that no two stress fractures behave exactly alike. Given that they are not a consistent injury, standardized treatment protocols can be challenging to develop. Treatment should be individualized to the patient or athlete, the causative activity, the anatomical site, and the severity of the injury. A holistic approach to the treatment of the most difficult stress fractures should be taken by orthopedists and sports medicine specialists. This approach is necessary to obtain optimal outcomes, minimize loss of fitness and time away from sports participation, and decrease the risk of recurrence.

Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

PubMed

Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

2017-07-01

To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

Video face recognition against a watch list

NASA Astrophysics Data System (ADS)

Abbas, Jehanzeb; Dagli, Charlie K.; Huang, Thomas S.

2007-10-01

Due to a large increase in the video surveillance data recently in an effort to maintain high security at public places, we need more robust systems to analyze this data and make tasks like face recognition a realistic possibility in challenging environments. In this paper we explore a watch-list scenario where we use an appearance based model to classify query faces from low resolution videos into either a watch-list or a non-watch-list face. We then use our simple yet a powerful face recognition system to recognize the faces classified as watch-list faces. Where the watch-list includes those people that we are interested in recognizing. Our system uses simple feature machine algorithms from our previous work to match video faces against still images. To test our approach, we match video faces against a large database of still images obtained from a previous work in the field from Yahoo News over a period of time. We do this matching in an efficient manner to come up with a faster and nearly real-time system. This system can be incorporated into a larger surveillance system equipped with advanced algorithms involving anomalous event detection and activity recognition. This is a step towards more secure and robust surveillance systems and efficient video data analysis.

Teaching Improvisation in Elementary General Music: Facing Fears and Fostering Creativity

ERIC Educational Resources Information Center

Whitcomb, Rachel

2013-01-01

Improvisation is a vital part of an elementary general music education. While some music teachers successfully include improvisation in music instruction, others have fears and face challenges when attempting improvisational activities in the classroom. This article acknowledges obstacles facing music educators when attempting to incorporate…

Adaptive weighted local textural features for illumination, expression, and occlusion invariant face recognition

NASA Astrophysics Data System (ADS)

Cui, Chen; Asari, Vijayan K.

2014-03-01

Biometric features such as fingerprints, iris patterns, and face features help to identify people and restrict access to secure areas by performing advanced pattern analysis and matching. Face recognition is one of the most promising biometric methodologies for human identification in a non-cooperative security environment. However, the recognition results obtained by face recognition systems are a affected by several variations that may happen to the patterns in an unrestricted environment. As a result, several algorithms have been developed for extracting different facial features for face recognition. Due to the various possible challenges of data captured at different lighting conditions, viewing angles, facial expressions, and partial occlusions in natural environmental conditions, automatic facial recognition still remains as a difficult issue that needs to be resolved. In this paper, we propose a novel approach to tackling some of these issues by analyzing the local textural descriptions for facial feature representation. The textural information is extracted by an enhanced local binary pattern (ELBP) description of all the local regions of the face. The relationship of each pixel with respect to its neighborhood is extracted and employed to calculate the new representation. ELBP reconstructs a much better textural feature extraction vector from an original gray level image in different lighting conditions. The dimensionality of the texture image is reduced by principal component analysis performed on each local face region. Each low dimensional vector representing a local region is now weighted based on the significance of the sub-region. The weight of each sub-region is determined by employing the local variance estimate of the respective region, which represents the significance of the region. The final facial textural feature vector is obtained by concatenating the reduced dimensional weight sets of all the modules (sub-regions) of the face image

Tracking and recognition face in videos with incremental local sparse representation model

NASA Astrophysics Data System (ADS)

Wang, Chao; Wang, Yunhong; Zhang, Zhaoxiang

2013-10-01

This paper addresses the problem of tracking and recognizing faces via incremental local sparse representation. First a robust face tracking algorithm is proposed via employing local sparse appearance and covariance pooling method. In the following face recognition stage, with the employment of a novel template update strategy, which combines incremental subspace learning, our recognition algorithm adapts the template to appearance changes and reduces the influence of occlusion and illumination variation. This leads to a robust video-based face tracking and recognition with desirable performance. In the experiments, we test the quality of face recognition in real-world noisy videos on YouTube database, which includes 47 celebrities. Our proposed method produces a high face recognition rate at 95% of all videos. The proposed face tracking and recognition algorithms are also tested on a set of noisy videos under heavy occlusion and illumination variation. The tracking results on challenging benchmark videos demonstrate that the proposed tracking algorithm performs favorably against several state-of-the-art methods. In the case of the challenging dataset in which faces undergo occlusion and illumination variation, and tracking and recognition experiments under significant pose variation on the University of California, San Diego (Honda/UCSD) database, our proposed method also consistently demonstrates a high recognition rate.

Frontal fibrosing alopecia and lichen planus pigmentosus: diagnosis and therapeutic challenge*

PubMed Central

Mulinari-Brenner, Fabiane Andrade; Guilherme, Marina Riedi; Peretti, Murilo Calvo; Werner, Betina

2017-01-01

Frontal fibrosing alopecia is a variant of lichen planopilaris with marginal progressive hair loss on the scalp, eyebrows and axillae. We report a case of frontal fibrosing alopecia and lichen planus pigmentosus in a postmenopausal woman, that started with alopecia on the eyebrows and then on the frontoparietal region, with periocular and cervical hyperpigmentation of difficult management. The condition was controlled with systemic corticosteroid therapy and finasteride. Lichen planus pigmentosus is an uncommon variant of lichen planus frequently associated with frontal fibrosing alopecia in darker phototipes. It should be considered in patients affected by scarring alopecia with a pattern of lichen planopilaris and areas of skin hyperpigmentation revealing perifollicular hyperpigmentation refractory to multiple treatments. This case illustrates diagnostic and therapeutic challenge in face of scarring alopecia and perifollicular hyperpigmentation. PMID:29267454

Frontal fibrosing alopecia and lichen planus pigmentosus: diagnosis and therapeutic challenge.

PubMed

Mulinari-Brenner, Fabiane Andrade; Guilherme, Marina Riedi; Peretti, Murilo Calvo; Werner, Betina

2017-01-01

Frontal fibrosing alopecia is a variant of lichen planopilaris with marginal progressive hair loss on the scalp, eyebrows and axillae. We report a case of frontal fibrosing alopecia and lichen planus pigmentosus in a postmenopausal woman, that started with alopecia on the eyebrows and then on the frontoparietal region, with periocular and cervical hyperpigmentation of difficult management. The condition was controlled with systemic corticosteroid therapy and finasteride. Lichen planus pigmentosus is an uncommon variant of lichen planus frequently associated with frontal fibrosing alopecia in darker phototipes. It should be considered in patients affected by scarring alopecia with a pattern of lichen planopilaris and areas of skin hyperpigmentation revealing perifollicular hyperpigmentation refractory to multiple treatments. This case illustrates diagnostic and therapeutic challenge in face of scarring alopecia and perifollicular hyperpigmentation.

Passport Officers’ Errors in Face Matching

PubMed Central

White, David; Kemp, Richard I.; Jenkins, Rob; Matheson, Michael; Burton, A. Mike

2014-01-01

Photo-ID is widely used in security settings, despite research showing that viewers find it very difficult to match unfamiliar faces. Here we test participants with specialist experience and training in the task: passport-issuing officers. First, we ask officers to compare photos to live ID-card bearers, and observe high error rates, including 14% false acceptance of ‘fraudulent’ photos. Second, we compare passport officers with a set of student participants, and find equally poor levels of accuracy in both groups. Finally, we observe that passport officers show no performance advantage over the general population on a standardised face-matching task. Across all tasks, we observe very large individual differences: while average performance of passport staff was poor, some officers performed very accurately – though this was not related to length of experience or training. We propose that improvements in security could be made by emphasising personnel selection. PMID:25133682

Passport officers' errors in face matching.

PubMed

White, David; Kemp, Richard I; Jenkins, Rob; Matheson, Michael; Burton, A Mike

2014-01-01

Photo-ID is widely used in security settings, despite research showing that viewers find it very difficult to match unfamiliar faces. Here we test participants with specialist experience and training in the task: passport-issuing officers. First, we ask officers to compare photos to live ID-card bearers, and observe high error rates, including 14% false acceptance of 'fraudulent' photos. Second, we compare passport officers with a set of student participants, and find equally poor levels of accuracy in both groups. Finally, we observe that passport officers show no performance advantage over the general population on a standardised face-matching task. Across all tasks, we observe very large individual differences: while average performance of passport staff was poor, some officers performed very accurately--though this was not related to length of experience or training. We propose that improvements in security could be made by emphasising personnel selection.

Fraudulent ID using face morphs: Experiments on human and automatic recognition

PubMed Central

Robertson, David J.; Kramer, Robin S. S.

2017-01-01

Matching unfamiliar faces is known to be difficult, and this can give an opportunity to those engaged in identity fraud. Here we examine a relatively new form of fraud, the use of photo-ID containing a graphical morph between two faces. Such a document may look sufficiently like two people to serve as ID for both. We present two experiments with human viewers, and a third with a smartphone face recognition system. In Experiment 1, viewers were asked to match pairs of faces, without being warned that one of the pair could be a morph. They very commonly accepted a morphed face as a match. However, in Experiment 2, following very short training on morph detection, their acceptance rate fell considerably. Nevertheless, there remained large individual differences in people’s ability to detect a morph. In Experiment 3 we show that a smartphone makes errors at a similar rate to ‘trained’ human viewers—i.e. accepting a small number of morphs as genuine ID. We discuss these results in reference to the use of face photos for security. PMID:28328928

Fraudulent ID using face morphs: Experiments on human and automatic recognition.

PubMed

Robertson, David J; Kramer, Robin S S; Burton, A Mike

2017-01-01

Matching unfamiliar faces is known to be difficult, and this can give an opportunity to those engaged in identity fraud. Here we examine a relatively new form of fraud, the use of photo-ID containing a graphical morph between two faces. Such a document may look sufficiently like two people to serve as ID for both. We present two experiments with human viewers, and a third with a smartphone face recognition system. In Experiment 1, viewers were asked to match pairs of faces, without being warned that one of the pair could be a morph. They very commonly accepted a morphed face as a match. However, in Experiment 2, following very short training on morph detection, their acceptance rate fell considerably. Nevertheless, there remained large individual differences in people's ability to detect a morph. In Experiment 3 we show that a smartphone makes errors at a similar rate to 'trained' human viewers-i.e. accepting a small number of morphs as genuine ID. We discuss these results in reference to the use of face photos for security.

The Challenges of Pharmacy Education in Yemen

PubMed Central

2014-01-01

Pharmacy education in Yemen has faced many challenges since its introduction in the 1980s. Most Yemeni pharmacy schools, especially private ones, are experiencing difficulties in providing the right quality and quantity of clinical educational experiences. Most of these challenges are imbedded in a teaching style and curricula that have failed to respond to the needs of the community and country. The slow shift from traditional drug-dispensing to a patient-centered or focused approach in pharmacy practice requires a fundamental change in the roles and responsibilities of both policymakers and educators. The purpose of this paper is twofold: (1) to discuss the challenges facing the pharmacy education in Yemen; (2) to provided recommendations to overcome challenges. PMID:25386011

[Nursing stance in the face of Jinn possession in Mayotte].

PubMed

Gillard-Berthod, Claire

2013-01-01

Caregivers and nursing students practising in Mayotte can find themselves in a difficult position when faced with patients believing themselves to be possessed by spirits called Jinn. Through a multidisciplinary roundtable, different perspectives and practices can be shared leading to a more enlightened treatment of patients which respects their beliefs, blending traditional and modern medicine.

Percutaneous treatment of Lutembacher syndrome in a case with difficult mitral valve crossing.

PubMed

Bhambhani, Anupam; Somanath, H S

2012-03-01

Most cases of combination congenital cardiac anomalies are treated with open-heart surgeries because the coexisting anomalies change the cardiac anatomy in an adverse way, making catheter manipulations complex. Lutembacher syndrome is a combination of acquired mitral stenosis and congenital ostium secundum atrial septal defect. The large defect in the septum makes an Inoue balloon catheter unstable, which provides excessive space for free floatation of the catheter, making its passage into the left ventricle difficult by Inoue technique. We present a case of elective definitive percutaneous treatment of Lutembacher syndrome, discussing the technical difficulties faced in mitral valve crossing and reviewing the possible strategies to improve chances of success.

Recognition Profile of Emotions in Natural and Virtual Faces

PubMed Central

Dyck, Miriam; Winbeck, Maren; Leiberg, Susanne; Chen, Yuhan; Gur, Rurben C.; Mathiak, Klaus

2008-01-01

Background Computer-generated virtual faces become increasingly realistic including the simulation of emotional expressions. These faces can be used as well-controlled, realistic and dynamic stimuli in emotion research. However, the validity of virtual facial expressions in comparison to natural emotion displays still needs to be shown for the different emotions and different age groups. Methodology/Principal Findings Thirty-two healthy volunteers between the age of 20 and 60 rated pictures of natural human faces and faces of virtual characters (avatars) with respect to the expressed emotions: happiness, sadness, anger, fear, disgust, and neutral. Results indicate that virtual emotions were recognized comparable to natural ones. Recognition differences in virtual and natural faces depended on specific emotions: whereas disgust was difficult to convey with the current avatar technology, virtual sadness and fear achieved better recognition results than natural faces. Furthermore, emotion recognition rates decreased for virtual but not natural faces in participants over the age of 40. This specific age effect suggests that media exposure has an influence on emotion recognition. Conclusions/Significance Virtual and natural facial displays of emotion may be equally effective. Improved technology (e.g. better modelling of the naso-labial area) may lead to even better results as compared to trained actors. Due to the ease with which virtual human faces can be animated and manipulated, validated artificial emotional expressions will be of major relevance in future research and therapeutic applications. PMID:18985152

Oral health challenges facing Dubai children with Autism Spectrum Disorder at home and in accessing oral health care.

PubMed

Mansoor, D; Al Halabi, M; Khamis, A H; Kowash, M

2018-06-01

To investigate the challenges faced by Autism Spectrum Disorder (ASD) children and their families in Dubai from three different perspectives of dental care: oral care at home, oral care at the dentist and access to oral care, and to compare the results to their normally developing peers. A case-control comparative study of 84 ASD and 53 healthy children attending special needs centres and schools in Dubai including siblings of the autistic children. Data collection was by a survey questionnaire completed by parents or guardians. More parents of ASD children compared to parents of healthy children reported difficulties across almost all oral care variables explored. The majority of ASD children's parents (83.3%) reported that their children need assistance in brushing their teeth compared with 15.4% of the healthy controls (p-value < 0.001). The ASD children's uncooperative behaviour increased during dental visits and significantly more parents (37%) rated their child's experience as negative compared with 9.5% among the parents of control children (p-value=0.006). The autistic children had visited a dentist mostly for extractions. This study indicates that autistic children in Dubai experience more challenges and barriers to oral care than their typically developing healthy peers.

Holistic Processing in the Composite Task Depends on Face Size

PubMed Central

Ross, David A.; Gauthier, Isabel

2015-01-01

Holistic processing is a hallmark of face processing. There is evidence that holistic processing is strongest for faces at identification distance, 2 – 10 meters from the observer. However, this evidence is based on tasks that have been little used in the literature and that are indirect measures of holistic processing. We use the composite task– a well validated and frequently used paradigm – to measure the effect of viewing distance on holistic processing. In line with previous work, we find a congruency x alignment effect that is strongest for faces that are close (2m equivalent distance) than for faces that are further away (24m equivalent distance). In contrast, the alignment effect for same trials, used by several authors to measure holistic processing, produced results that are difficult to interpret. We conclude that our results converge with previous findings providing more direct evidence for an effect of size on holistic processing. PMID:26500423

Behavioural and neurophysiological evidence for face identity and face emotion processing in animals

PubMed Central

Tate, Andrew J; Fischer, Hanno; Leigh, Andrea E; Kendrick, Keith M

2006-01-01

Visual cues from faces provide important social information relating to individual identity, sexual attraction and emotional state. Behavioural and neurophysiological studies on both monkeys and sheep have shown that specialized skills and neural systems for processing these complex cues to guide behaviour have evolved in a number of mammals and are not present exclusively in humans. Indeed, there are remarkable similarities in the ways that faces are processed by the brain in humans and other mammalian species. While human studies with brain imaging and gross neurophysiological recording approaches have revealed global aspects of the face-processing network, they cannot investigate how information is encoded by specific neural networks. Single neuron electrophysiological recording approaches in both monkeys and sheep have, however, provided some insights into the neural encoding principles involved and, particularly, the presence of a remarkable degree of high-level encoding even at the level of a specific face. Recent developments that allow simultaneous recordings to be made from many hundreds of individual neurons are also beginning to reveal evidence for global aspects of a population-based code. This review will summarize what we have learned so far from these animal-based studies about the way the mammalian brain processes the faces and the emotions they can communicate, as well as associated capacities such as how identity and emotion cues are dissociated and how face imagery might be generated. It will also try to highlight what questions and advances in knowledge still challenge us in order to provide a complete understanding of just how brain networks perform this complex and important social recognition task. PMID:17118930

Behavioural and neurophysiological evidence for face identity and face emotion processing in animals.

PubMed

Tate, Andrew J; Fischer, Hanno; Leigh, Andrea E; Kendrick, Keith M

2006-12-29

Visual cues from faces provide important social information relating to individual identity, sexual attraction and emotional state. Behavioural and neurophysiological studies on both monkeys and sheep have shown that specialized skills and neural systems for processing these complex cues to guide behaviour have evolved in a number of mammals and are not present exclusively in humans. Indeed, there are remarkable similarities in the ways that faces are processed by the brain in humans and other mammalian species. While human studies with brain imaging and gross neurophysiological recording approaches have revealed global aspects of the face-processing network, they cannot investigate how information is encoded by specific neural networks. Single neuron electrophysiological recording approaches in both monkeys and sheep have, however, provided some insights into the neural encoding principles involved and, particularly, the presence of a remarkable degree of high-level encoding even at the level of a specific face. Recent developments that allow simultaneous recordings to be made from many hundreds of individual neurons are also beginning to reveal evidence for global aspects of a population-based code. This review will summarize what we have learned so far from these animal-based studies about the way the mammalian brain processes the faces and the emotions they can communicate, as well as associated capacities such as how identity and emotion cues are dissociated and how face imagery might be generated. It will also try to highlight what questions and advances in knowledge still challenge us in order to provide a complete understanding of just how brain networks perform this complex and important social recognition task.

Reforms and emerging noncommunicable disease: some challenges facing a conflict-ridden country--the case of the Syrian Arab Republic.

PubMed

Sen, Kasturi; Al-Faisal, Waleed

2013-01-01

The past year witnessed considerable turbulence in the Arab world-in this case, Syria, a lower middle-income country with a record of a strong public health infrastructure. This paper explores the current challenges facing its health system from reforms, civil strife and international sanctions all of which we argue have serious implications for population health. The health sector in Syria was little known, and until recently, it was well integrated to provide preventive and specialized care when needed. Regionally, it was one of the few countries ready and capable of addressing the challenges of demographic and epidemiologic transition with a long-standing emphasis on primary care and prevention, unlike most countries of the region. This context has changed dramatically through the recent implementation of reforms and the current civil war. Changes to financing, management and the delivery of health service placed access to services in jeopardy, but now, these are compounded by the destruction from an intractable and violent conflict and international sanctions. This paper explores some of the combined effects of reforms, conflict and sanctions on population health. Copyright © 2013 John Wiley & Sons, Ltd.

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

From Theory to Practice: Facing Ethical Challenges as a Clinical Intern

ERIC Educational Resources Information Center

Hambrick, James P.; Pimentel, Sandra; Albano, Anne Marie

2009-01-01

Although formal ethics classes provide a basic foundation in managing ethical dilemmas, professionals often point to their experiences on internship as an important training ground for consolidation of their ethical development. Clinical interns face many personal and professional transitions that can lead to a number of ethical dilemmas.…

Key water issues now facing our nation

USGS Publications Warehouse

Hirsch, Robert M.; Miller, Timothy L.; Hamilton, Pixie A.; Gilliom, Robert J.

2008-01-01

Challenges to sustaining sufficient and high-quality water for human consumption, industry, farms, energy production, and ecosystem services continue to intensify in many parts of the Nation. We face four key water issues that call for support from the science and engineering communities.

Genetic strategies for reforestation in the face of global climate change

Treesearch

F. Thomas Ledig; J.H. Kitzmiller

1992-01-01

If global warming materializes as projected, natural or artificial regeneration of forests with local seed sources will become increasingly difficult. However, global warming is far from a certainty and predictions of its magnitude and timing vary at least twofold, In the face of such uncertainty, reforestation strategies should emphasize conservation, diversification...

Face matching in a long task: enforced rest and desk-switching cannot maintain identification accuracy

PubMed Central

Alenezi, Hamood M.; Fysh, Matthew C.; Johnston, Robert A.

2015-01-01

In face matching, observers have to decide whether two photographs depict the same person or different people. This task is not only remarkably difficult but accuracy declines further during prolonged testing. The current study investigated whether this decline in long tasks can be eliminated with regular rest-breaks (Experiment 1) or room-switching (Experiment 2). Both experiments replicated the accuracy decline for long face-matching tasks and showed that this could not be eliminated with rest or room-switching. These findings suggest that person identification in applied settings, such as passport control, might be particularly error-prone due to the long and repetitive nature of the task. The experiments also show that it is difficult to counteract these problems. PMID:26312179

“Members of the Same Club”: Challenges and Decisions Faced by US IRBs in Identifying and Managing Conflicts of Interest

PubMed Central

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. Methods I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. Results IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be “indirect financial” conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. Conclusions This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB

Institutional design and organizational practice for universal coverage in lesser-developed countries: challenges facing the Lao PDR.

PubMed

Ahmed, Shakil; Annear, Peter Leslie; Phonvisay, Bouaphat; Phommavong, Chansaly; Cruz, Valeria de Oliveira; Hammerich, Asmus; Jacobs, Bart

2013-11-01

There is now widespread acceptance of the universal coverage approach, presented in the 2010 World Health Report. There are more and more voices for the benefit of creating a single national risk pool. Now, a body of literature is emerging on institutional design and organizational practice for universal coverage, related to management of the three health-financing functions: collection, pooling and purchasing. While all countries can move towards universal coverage, lower-income countries face particular challenges, including scarce resources and limited capacity. Recently, the Lao PDR has been preparing options for moving to a single national health insurance scheme. The aim is to combine four different social health protection schemes into a national health insurance authority (NHIA) with a single national fund- and risk-pool. This paper investigates the main institutional and organizational challenges related to the creation of the NHIA. The paper uses a qualitative approach, drawing on the World Health Organization's institutional and Organizational Assessment for Improving and Strengthening health financing (OASIS) conceptual framework for data analysis. Data were collected from a review of key health financing policy documents and from 17 semi-structured key informant interviews. Policy makers and advisors are confronting issues related to institutional arrangements, funding sources for the authority and government support for subsidies to the demand-side health financing schemes. Compulsory membership is proposed, but the means for covering the informal sector have not been resolved. While unification of existing schemes may be the basis for creating a single risk pool, challenges related to administrative capacity and cross-subsidies remain. The example of Lao PDR illustrates the need to include consideration of national context, the sequencing of reforms and the time-scale appropriate for achieving universal coverage. Copyright © 2013 Elsevier Ltd. All

Social, Cultural, and Environmental Challenges Faced by Children on Antiretroviral Therapy in Zimbabwe: a Mixed-Method Study

PubMed Central

Macherera, Margaret; Moyo, Lindani; Ncube, Mkhanyiseli; Gumbi, Angella

2012-01-01

Objectives Despite the advent of antiretroviral therapy (ART), many children, particularly in the rural communities of Zimbabwe, remain vulnerable. The purpose of this study was to determine the factors and challenges facing children on antiretroviral therapy (ART) in Brunapeg area of Mangwe District, Zimbabwe. Methods A mixed-method approach involving interviewer-guided focus group discussions and piloted semi-structured questionnaires was utilized to collect data from different key population groups. The data obtained were analyzed through content coding procedures based on a set of predetermined themes of interest. Results A number of challenges emerged as barriers to the success of antiretroviral therapy for children. Primary care givers were less informed about HIV and AIDS issues for people having direct impact on the success of antiretroviral therapy in children whilst some were found to be taking the antiretroviral drugs meant for the children. It also emerged that some primary care givers were either too young or too old to care for the children while others had failed to disclose to the children why they frequently visited the Opportunistic Infections (OI) clinic. Most primary care givers were not the biological parents of the affected children. Other challenges included inadequate access to health services, inadequate food and nutrition and lack of access to clean water, good hygiene and sanitation. The lack of community support and stigma and discrimination affected their school attendance and hospital visits. All these factors contributed to non-adherence to antiretroviral drugs. Conclusions and Public Health Implications Children on ART in rural communities in Zimbabwe remain severely compromised and have unique problems that need multi-intervention strategies both at policy and programmatic levels. Effective mitigating measures must be fully established and implemented in rural communities of developing countries in the fight for universal

Safety Challenges and Improvement Strategies of Ethnic Minority Construction Workers: A Case Study in Hong Kong.

PubMed

Wu, Chunlin; Luo, Xiaowei; Wang, Tao; Wang, Yue; Sapkota, Bibek

2018-04-18

Due to cultural differences, ethnic minority construction workers are more difficult to manage and more vulnerable to accidents. This study aims to identify the major barriers faced by ethnic minority workers from their own perspectives and determine potential strategies to enhance safety climate of construction projects, thus ultimately improve their safety performance. A survey with modified Nordic safety climate questionnaire was conducted in a certain sub-contractor in Hong Kong. In-depth interviews, status quo description, major challenge investigation and safety knowledge tests were carried as well. The top three most important safety challenges identified are improper stereotypes from the whole industry, lack of opportunities for job assignment, and language barriers. To improve the safety performance, employers should allocate sufficient personal protective equipment and governments should organize unannounced site visits more frequently. Besides, the higher-level management should avoid giving contradictory instructions to foremen against to the standards of supervisors.

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

PubMed

Tosun, Jale

2017-05-23

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

Reflecting on the Challenges of Applied Theatre in Kenya

ERIC Educational Resources Information Center

Okuto, Maxwel; Smith, Bobby

2017-01-01

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

Strategies Used and Challenges Faced by a Breast Cancer Patient Navigator in an Urban Underserved Community

PubMed Central

Ferrante, Jeanne M.; Wu, Justine; Dicicco-Bloom, Barbara

2013-01-01

Patient navigation has been widely implemented by cancer care programs across the United States. While activities of navigators have been described elsewhere, little has been documented regarding specific strategies used or challenges experienced by navigators from their own perspectives. We describe the experience of an African American patient navigator who promoted breast cancer screening and facilitated diagnosis and treatment among inner-city mostly African American women in Newark, New Jersey. We conducted qualitative analysis of journal notes, log data, and in-depth interviews with the patient navigator. Strategies used by the patient navigator to develop trust and rapport included: (1) “meet patients where they are” (outreach is best performed in locations women frequent, such as hair salons); (2) being accessible (must be flexible and available by phone or in person to meet patient’s needs); and (3) “bring it down, sista” (must have “street credibility” in dress and language). Key challenges included experiencing threats to safety, setting boundaries, and facing and overcoming burnout. The patient navigator responded to these obstacles by creating new community linkages and resources and reaching out for emotional support from her mother and supervisor. Areas that need to be addressed further for future patient navigator programs include promoting safety in potentially dangerous neighborhoods and helping navigators set boundaries and avoid burnout. Further research into experiences of patient navigators in different settings is needed to build upon this preliminary data, and to consider character traits and attributes best suited for a patient navigator, as well as the support needed for this new health care worker. PMID:22046850

Face liveness detection using shearlet-based feature descriptors

NASA Astrophysics Data System (ADS)

Feng, Litong; Po, Lai-Man; Li, Yuming; Yuan, Fang

2016-07-01

Face recognition is a widely used biometric technology due to its convenience but it is vulnerable to spoofing attacks made by nonreal faces such as photographs or videos of valid users. The antispoof problem must be well resolved before widely applying face recognition in our daily life. Face liveness detection is a core technology to make sure that the input face is a live person. However, this is still very challenging using conventional liveness detection approaches of texture analysis and motion detection. The aim of this paper is to propose a feature descriptor and an efficient framework that can be used to effectively deal with the face liveness detection problem. In this framework, new feature descriptors are defined using a multiscale directional transform (shearlet transform). Then, stacked autoencoders and a softmax classifier are concatenated to detect face liveness. We evaluated this approach using the CASIA Face antispoofing database and replay-attack database. The experimental results show that our approach performs better than the state-of-the-art techniques following the provided protocols of these databases, and it is possible to significantly enhance the security of the face recognition biometric system. In addition, the experimental results also demonstrate that this framework can be easily extended to classify different spoofing attacks.

Addressing the empathy deficit: beliefs about the malleability of empathy predict effortful responses when empathy is challenging.

PubMed