A Policy-Based Approach to Technology Systems

ERIC Educational Resources Information Center

Kuhn, Robert M.; Brookes, Kimberly H.; Bellos, Nephellie

2008-01-01

Discussions with a central IT organization about integration with existing systems on campus, support costs for the new implementation, and total cost of ownership frequently become adversarial. Simmons College, a small college in Boston with an enrollment of approximately 1,900 undergraduate and 2,800 graduate students, reframed these issues in…

Diversity Issues and Business Education.

ERIC Educational Resources Information Center

Foxman, Ellen; And Others

1995-01-01

Thirty-two marketing textbooks were examined for content related to workforce diversity. Age was most frequently discussed at young/old extremes, although 53% of the population are in middle age groups. Racial/ethnic coverage was 60% about Hispanics, although African Americans have a larger population and Asians are the fastest growing group.…

Guidelines for the Analysis of Responsibility in Governmental Communication.

ERIC Educational Resources Information Center

Gouran, Dennis S.

This paper discusses specific issues involving governmental conduct in communication with the public, outlines a set of conditions that frequently stimulate social interest in governmental responsibility, and develops a corresponding set of guidelines for use in the evaluation of instances of questionable governmental conduct in communication.…

Cooperative Learning and Second-Language Teaching: Frequently-Asked Questions.

ERIC Educational Resources Information Center

Jacobs, George M.; Gilbert, Charles C.; Lopriore, Lucilla; Goldstein, Sue; Thiyagarajali, Rosy

1998-01-01

Summarizes a discussion about cooperative learning in second-language teaching by 45 teachers, highlighting six issues: how to cover the syllabus, how long cooperative groups should stay together, how cooperative learning is affected by competition in society, using cooperative learning with low language proficiency students, using cooperative…

Misinterpretations of the Second Fundamental Theorem of Welfare Economics: Barriers to Better Economic Education.

ERIC Educational Resources Information Center

Bryant, William D. A.

1994-01-01

Asserts that errors frequently are made in teaching about the second fundamental theorem of welfare economics. Describes how this issue usually is taught in undergraduate economics courses. Discusses how this interpretation contains errors and may hinder students' analysis of public policy regarding welfare systems. (CFR)

CALFED--An experiment in science and decisionmaking

USGS Publications Warehouse

Taylor, Kimberly A.; Jacobs, Katharine L.; Luoma, Samuel N.

2003-01-01

The CALFED Bay-Delta Program faces a challenging assignment: to develop a collaborative state-federal management plan for the complex river system and involve multiple stakeholders (primarily municipal, agricultural, and environmental entities) whose interests frequently are in direct conflict. Although many resource-management issues involve multiple stakeholders and conflict is integral to their discussion, the CALFED experience is unique because of its shared state and federal roles, the magnitude and significance of stakeholder participation, and the complexity of the scientific issues involved.

ALLOCATING ENVIRONMENTAL BURDENS ACROSS CO-PRODUCTS TO CREATE A LIFE CYCLE INVENTORY: IS THERE A BEST WAY?

EPA Science Inventory

Allocation methodology for creating life cycle inventories is frequently addressed, discussed and debated, yet the methodology continues to be in a state of flux. ISO 14041 puts perspective on the issues but its one-size fits all framework is being challenged. It is clear that ...

Addressing Shared Vulnerability for Comorbid PTSD and Chronic Pain: A Cognitive-Behavioral Perspective

ERIC Educational Resources Information Center

Asmundson, Gordon J. G.; Hadjistavropolous, Heather D.

2006-01-01

Posttraumatic stress disorder (PTSD) frequently co-occurs with other conditions and symptoms that can complicate assessment and treatment. Of these, chronic musculoskeletal pain and related avoidance behaviors are amongst the most common and, unfortunately, the most often overlooked. In this paper we discuss issues that warrant consideration in…

The Spacing Effect and Its Relevance to Second Language Acquisition

ERIC Educational Resources Information Center

Rogers, John

2017-01-01

This commentary discusses some theoretical and methodological issues related to research on the spacing effect in second language acquisition research (SLA). There has been a growing interest in SLA in how the temporal distribution of input might impact language development. SLA research in this area has frequently drawn upon the rich field of…

Lesbian Relationships--A Struggle Towards Couple Equality.

ERIC Educational Resources Information Center

Sang, Barbara E.

This paper explores some themes which emerge frequently in lesbian relationships as both members of the couple strive to realize their unique potential. Some of the areas discussed are: (1) roles and the decision making process; (2) emotional expectations; (3) time alone and time together; (4) issues that arise when both persons value their work;…

More than Talk: Co-Rumination among College Students

ERIC Educational Resources Information Center

Landphair, Juliette; Preddy, Teri

2012-01-01

Co-rumination, a social process between two friends, is defined as the frequent and excessive discussion of personal problems. Like body image and alcohol use, it is one of those complicated issues embedded in larger cultural realities, which makes it universally recognizable. On campus, co-rumination has deleterious side effects: it challenges…

Using and Developing with CD-Interactive: Frequently Asked Questions Are Answered.

ERIC Educational Resources Information Center

Lediaev, Lucy; van Sonderen, Lex

1994-01-01

Discusses Compact Disc-Interactive (CD-I) using a question-and-answer format. Highlights include development of the CD-I technology; where to purchase discs and players; compatibility with other CD-ROM drives; how to make discs; authoring systems versus custom programs; entertainment and educational applications; licensing issues; specifications;…

Frames and comparators: How might a debate on synthetic biology evolve?

PubMed

Torgersen, Helge; Schmidt, Markus

2013-04-01

A stimulated early public debate is frequently advocated when introducing an emerging technology like synthetic biology (SB). To debate a still quite abstract technology, participants functionally need a frame that determines which arguments are legitimate and which issues are relevant. Often, such frames are based on previous debates over other novel technologies. Three technologies currently provide frames for discussing SB: (green) biotechnology, nanotechnology and information technology. In the biotechnology debate, risk has long been emphasised over economic benefits. More recently, nanotechnology has been referred to mostly in terms of benefits, while risks tended to be an issue for scientific discourses. This has frequently been related to the many outreach activities around nanotechnology. Information technology, finally, has retained the image of being 'cool' and useful on a personal level. The technology itself is taken for granted and only the consequences of particular applications have been up for discussion. Upstream engagement exercises in SB will have to consider the comparator chosen more diligently, because it might influence the debate on SB 'out there' in the long run.

Frames and comparators: How might a debate on synthetic biology evolve?

PubMed Central

Torgersen, Helge; Schmidt, Markus

2013-01-01

A stimulated early public debate is frequently advocated when introducing an emerging technology like synthetic biology (SB). To debate a still quite abstract technology, participants functionally need a frame that determines which arguments are legitimate and which issues are relevant. Often, such frames are based on previous debates over other novel technologies. Three technologies currently provide frames for discussing SB: (green) biotechnology, nanotechnology and information technology. In the biotechnology debate, risk has long been emphasised over economic benefits. More recently, nanotechnology has been referred to mostly in terms of benefits, while risks tended to be an issue for scientific discourses. This has frequently been related to the many outreach activities around nanotechnology. Information technology, finally, has retained the image of being ‘cool’ and useful on a personal level. The technology itself is taken for granted and only the consequences of particular applications have been up for discussion. Upstream engagement exercises in SB will have to consider the comparator chosen more diligently, because it might influence the debate on SB ‘out there’ in the long run. PMID:23805003

Proceedings of the seventh Northern region paediatric colloquium.

PubMed

Barkla, Xanthe; Kaplan, Carole

2014-01-01

Ethical and legal dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are relevant to both the medical and legal professions. To this end, senior figures from the medical and legal professions in the Northern region have met on a regular basis in order to discuss anonymised case material. We report on the proceedings of the seventh such meeting. Six cases are described and key points arising from the subsequent discussion are presented.

Change Strategies and Associated Implementation Challenges: An Analysis of Online Counselling Sessions.

PubMed

Rodda, Simone N; Hing, Nerilee; Hodgins, David C; Cheetham, Alison; Dickins, Marissa; Lubman, Dan I

2017-09-01

Self-change is the most frequent way people limit or reduce gambling involvement and often the first choice of people experiencing gambling-related problems. Less well known is the range of change strategies gamblers use and how these are selected, initiated or maintained. This study examined change strategies discussed in counselling transcripts from 149 clients who accessed a national online gambling help service in Australia. Using thematic analysis, we identified the presence of six change strategies; cash control and financial management, social support, avoiding or limiting gambling, alternative activities, changing thoughts and beliefs, and self-assessment and monitoring. Four implementation issues were also identified; a mismatch between need and strategy selection or maintenance; importance and readiness versus the cost of implementation; poor or unplanned transitions between strategies; and failure to review the helpfulness of strategies resulting in premature abandonment or unhelpful prolonged application. This study is the first to identify change strategies discussed in online counselling sessions. This study suggests change strategies are frequently discussed in online counselling sessions and we identified multiple new actions associated with change strategies that had not previously been identified. However, multiple implementation issues were identified and further work is required to determine the helpfulness of change strategies in terms of their selection, initiation and maintenance.

Alignment issues, correlation techniques and their assessment for a visible light imaging-based 3D printer quality control system

NASA Astrophysics Data System (ADS)

Straub, Jeremy

2016-05-01

Quality control is critical to manufacturing. Frequently, techniques are used to define object conformity bounds, based on historical quality data. This paper considers techniques for bespoke and small batch jobs that are not statistical model based. These techniques also serve jobs where 100% validation is needed due to the mission or safety critical nature of particular parts. One issue with this type of system is alignment discrepancies between the generated model and the physical part. This paper discusses and evaluates techniques for characterizing and correcting alignment issues between the projected and perceived data sets to prevent errors attributable to misalignment.

A survey of sports medicine physicians regarding psychological issues in patient-athletes.

PubMed

Mann, Barton J; Grana, William A; Indelicato, Peter A; O'Neill, Daniel F; George, Steven Z

2007-12-01

To determine the extent to which sports medicine physicians encounter and discuss psychological issues among athletes they treat and to evaluate physicians' perceptions of the availability and efficacy of sport psychologists and other mental health resources. Cross-sectional study. A survey was sent via e-mail to all physician members of 4 prominent sports medicine professional associations: the American Orthopaedic Society for Sports Medicine, American College of Sports Medicine, American Medical Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. The extent to which respondents discuss psychological issues with athletes varied by subspecialty and by specific issues assessed. Fears about reinjury, fears related to surgery, and lack of patience with recovery/rehabilitation were the 3 most common injury-related topics discussed with patient-athletes. The 3 most common non-injury-related topics discussed were stress/pressure, anxiety, and burnout. Family practitioners were more likely to discuss injury-related psychological issues than were orthopaedic surgeons. Orthopaedic surgeons reported the lowest frequencies of discussing non-injury-related psychological issues. Only 19% of all respondents indicated there were adequate numbers of sport psychologists and other mental health professionals in their geographical area to treat the needs of athletes. Three quarters of respondents reported they rarely or never referred athletes to sport psychologists for injury-related issues, and two thirds indicated they rarely or never referred athletes to sport psychologists for non-injury-related problems. Respondents rated sport psychologists and athletic trainers/physical therapists to be moderately effective in working with athletes regarding psychological problems. Sports medicine physicians frequently encounter psychological issues with patient-athletes. There is a need for tools to facilitate assessment of these problems as well as greater communication between the mental health community and sports medicine physicians. In addition, knowledge of and access to professionals who are specifically trained to deal with the sometimes unique psychological needs of athletes should be improved.

Xerophthalmia and Blindness of Nutritional Origin in the Third World.

ERIC Educational Resources Information Center

Demaeyer, E. M.

1986-01-01

This journal issue focuses on problems caused by vitamin A deficiency and its effects on vision. Although these conditions are quite serious and widespread in some areas of the world, they can easily be treated by inexpensive means. The report begins with a discussion of xerophthalmia, the most frequent cause of blindness in preschool-age children…

The Core Principles of Extensive Reading in an EAP Writing Context

ERIC Educational Resources Information Center

Park, Jeongyeon; Ro, Eunseok

2015-01-01

In the first part of the discussion forum on extensive reading (ER) in "Reading in a Foreign Language" ("RFL") (April 2015 issue), many scholars in the field shared views regarding the core features to be considered when implementing ER, frequently referring to Day and Bamford's (1998, 2002) top 10 principles for teaching ER.…

Gender Mainstreaming: Myths and Measurement in Higher Education in Ghana and Tanzania

ERIC Educational Resources Information Center

Morley, Louise

2010-01-01

This article critically examines the concept of gender mainstreaming and raises questions about a series of category slippages in debates and discussions. Some key concerns are the way in which women are constructed as a unified analytical category, and how gender equality is frequently reduced to issues of representation. It also critically…

Laying the Theoretical and Practical Foundations for a New Elementary English Curriculum in Turkey: A Procedural Analysis

ERIC Educational Resources Information Center

Kirkgöz, Yasemin; Çelik, Servet; Arikan, Arda

2016-01-01

New educational curricula are regularly put into practice worldwide; and the issues related to curriculum design are frequently discussed from a pedagogical perspective. However, the processes involved in preparing a statewide English as a foreign language (EFL) curriculum are rarely elaborated from an inside view. As the experiences of program…

Gender Issues Embedded in the Experience of Student Teaching: Being Treated Like a Sex Object.

ERIC Educational Resources Information Center

Miller, Judith Harmon

1997-01-01

Women from three teacher education programs discussed their experiences as student teachers in high schools. Their stories highlighted frequent harassment of female student teachers by male students, and the fact that viewing women as sex objects was commonplace. Recommends incorporation of ideas from Carol Gilligan and others in student teaching…

Forensic psychiatric evaluations: an overview of methods, ethical issues, and criminal and civil assessments.

PubMed

Sher, Leo

2015-05-01

Forensic psychiatry is frequently defined as the branch of psychiatry that deals with issues arising in the interface between psychiatry and the law. Psychiatrists are called on by the legal system to provide testimony in a wide variety of cases, criminal and civil. In criminal cases, forensic psychiatrists may be asked to comment on the competence of a person to make decisions throughout all the phases of criminal investigation, trial, and punishment. These include the competence to stand trial, to plead guilty, to be sentenced, to waive appeal, and to be executed. In civil cases, forensic psychiatric experts are asked to evaluate a number of civil competences, including competence to make a will or contract or to make decisions about one's person and property. Psychiatrists are also called on to testify about many other issues related to civil cases. Forensic psychiatrists who work with children and adolescents are frequently involved in evaluations and testimonies concerning juvenile delinquency, child custody, termination of parental rights, and other issues. As such, forensic psychiatric experts have now developed into a reputable and well-known group of professionals. Forensic evaluation methods, ethical issues related to forensic psychiatric practice, and some common criminal and civil forensic psychiatric evaluations are discussed in this overview.

Forensic issues in medical evaluation: competency and end-of-life issues.

PubMed

Soliman, Sherif; Hall, Ryan C W

2015-01-01

Decision-making capacity is a common reason for psychiatric consultation that is likely to become more common as the population ages. Capacity assessments are frequently compromised by misconceptions, such as the belief that incapacity is permanent or that patients with dementia categorically lack capacity. This chapter will review the conceptual framework of decision-making capacity and discuss its application to medical decision-making. We will review selected developments in capacity assessment and recommend an approach to assessing decision-making capacity. We will discuss the unique challenges posed by end-of-life care, including determining capacity, identifying surrogate decision-makers, and working with surrogate decision-makers. We will discuss clinical and legal approaches to incapacity, including advance directives, surrogate decision-makers, and guardians. We will discuss the legal standards based on which surrogates make medical decisions and outline options for resolving disagreements between clinical staff and surrogate decision-makers. We will offer recommendations for approaching decision-making capacity assessments. © 2015 S. Karger AG, Basel.

Young People Have a Lot to Say ... with Trust, Time, and Tools: The Voices of Inuit Youth in Nunavik

ERIC Educational Resources Information Center

Garakani, Tatiana

2014-01-01

Young people's voices are frequently overlooked in discussions about education development and policy. This article draws on an ongoing participatory action research project (2011-2014) in Nunavik on student resilience and school perseverance. It examines ethical issues that have arisen during the research process, and highlights the strengths and…

Knowledge for a Common World? On the Place of Feminist Epistemology in Philosophy of Education

ERIC Educational Resources Information Center

Schumann, Claudia

2016-01-01

The paper discusses the place of feminist epistemology in philosophy of education. Against frequently raised criticisms, the paper argues that the issues raised by feminist standpoint theory lead neither to a reduction of questions of knowledge to questions of power or politics nor to the endorsement of relativism. Within the on-going discussion…

Munchausen syndrome: Playing sick or sick player

PubMed Central

Prakash, Jyoti; Das, R. C.; Srivastava, K.; Patra, P.; Khan, S. A.; Shashikumar, R.

2014-01-01

Munchausen syndrome is rare factitious disorder which entails frequent hospitalization, pathological lying and intentional production of symptoms for sick role. Management requires collateral history taking, sound clinical approach, exclusion of organicity and addressing psychological issues. A case which presented with unusual symptoms of similar dimension is discussed here. The case brings out finer nuances in evaluation and management of this entity. PMID:25535450

A model for architectural comparison

NASA Astrophysics Data System (ADS)

Ho, Sam; Snyder, Larry

1988-04-01

Recently, architectures for sequential computers became a topic of much discussion and controversy. At the center of this storm is the Reduced Instruction Set Computer, or RISC, first described at Berkeley in 1980. While the merits of the RISC architecture cannot be ignored, its opponents have tried to do just that, while its proponents have expanded and frequently exaggerated them. This state of affairs has persisted to this day. No attempt is made to settle this controversy, since indeed there is likely no one answer. A qualitative framework is provided for a rational discussion of the issues.

How the causes, consequences and solutions for problem gambling are reported in Australian newspapers: a qualitative content analysis.

PubMed

Miller, Helen E; Thomas, Samantha L; Robinson, Priscilla; Daube, Mike

2014-12-01

To inform public health approaches to problem gambling by examining how the news media covers problem gambling, with a particular focus on the causes, consequences and solutions to problem gambling, and the 'actors' and sources who influence media coverage. A qualitative content analysis guided by framing theory analysed coverage of problem gambling in Australian newspapers in the period 1 July 2011 to 30 June 2012. Solutions to problem gambling were more frequently discussed than causes and consequences. A focus on the responsibility of individuals was preferred to reporting that focused on broader social, ecological, and industry determinants of problem gambling. Reporting was highly politicised, with politicians frequently quoted and political issues frequently discussed. In contrast, the community sector, health professionals and problem gamblers were rarely quoted. This analysis has revealed the need for a more proactive, coordinated approach to the media by both public health researchers and health groups. The establishment of a gambling-specific coalition to push for evidence-based reform is recommended. © 2014 Public Health Association of Australia.

What about Sam--The Kid in the Corner Whose Voice Doesn't Come Out?--Tensions between Open Discussions and Inclusive Educational Opportunities for English Learners

ERIC Educational Resources Information Center

Gourd, Karen Miller

2016-01-01

This article identifies a tension between a teacher's intention and an English learner's interpretation of his experiences in a US high school English class for native users of English and English learners. The tension highlights two issues. First, democratic classroom practices, frequently advocated by second language acquisition theorists, may…

The Ethics of Clinical Trials Research in Severe Mood Disorders.

PubMed

Nugent, Allison C; Miller, Franklin G; Henter, Ioline D; Zarate, Carlos A

2017-07-01

Mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD), are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research. These include issues of consent and decision-making capacity, including patients' motivations for participating in research. We also address drug withdrawals, placebo controls, and the overall safety of research. Finally, we examine the extant literature for studies discussing potential indirect benefits of clinical trials research to participants. Taken together, the evidence suggests that clinical trials research incorporating drug withdrawals and placebo controls can be conducted safely and ethically, even in patients with severe or treatment-resistant mood disorders. In fact, given the dearth of effective treatment options for this population, it is our opinion that a moral imperative exists to extend the offer of research participation to severely ill or treatment-resistant groups. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Ethics and human rights issues experienced by nurses in leadership roles.

PubMed

Redman, Barbara A; Fry, Sara T

2003-01-01

The aims of this study were to identify (1) the ethics and human rights issues experienced by nurses in leadership roles (NLs); (2) how frequently these issue occurred in the NLs'practices; and (3) how disturbed the NLs were by the issues. Dillman's Total Design Method (1978) for mailed surveys guided the study design. Data analysis was performed on 470 questionnaires from New England RNs in nursing leadership roles. The most frequently experienced ethics and human rights issues during the previous 12 months were (1) protecting patient right and human dignity; (2) respecting or not respecting informed consent to treatment; (3) use or nonuse of physical or chemical restraints; (4) providing care with possible risks to the RN's health; (5) following or not following advance directives; and (6) staffing patterns that limit patient access to nursing care. The most disturbing ethics and human rights issues experienced by the NLs were staffing patterns that limited patient access to nursing care, prolonging the dying process with inappropriate measures, working with unethical, incompetent, or impaired colleagues, implementing managed care policies that threaten quality of care, not considering quality of the patient's life, and caring for patients and families who are uninformed or misinformed about treatment, prognosis, or medical alternatives. Nearly 39% of the NLs reported experiencing ethics and human rights issues one to four times a week or more, and more than 90% handled their most recent ethics issue by discussing it with nursing peers. Study findings have implications for ethics education and resource support for nurses in leadership roles, and for further research on how NLs handle ethics and human rights issues in the workplace.

Aquatic pollution, 2nd ed

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

Laws, E.A.

1993-01-01

This book systematically covers all aspects of water pollution in marine and freshwater systems. Didactic style, frequent use of case studies and an extensive bibliography facilitate understanding of fundamental concepts. Offers basic, relevant ecological and toxicological information. Straightforward presentation of the scientific aspects of environmental issues. Information updated, particularly the discussion of toxicology and the case studies of water pollution. Three new chapters on acid rain, groundwater pollution and plastics are added.

Communication and Information About "Safer Sex:" Intervention Issues Within Communities of African Migrants Living in Poorer Neighbourhoods in Portugal.

PubMed

de Matos, Margarida Gaspar; Gaspar, Tania; Simons-Morton, Bruce; Reis, Marta; Ramiro, Lúcia

2008-01-01

The aims of this study are to determine the influence of migrant status on sexual behavior and communication about "safer sex" and to identify ethnic-specific prevention issues. Data were obtained from a special administration of the Health Behavior in School-Aged Children Survey in a special sample of Portuguese schools located in low-income Lisbon neighborhoods with large proportions of African migrants.Survey participants included 919 6th, 8th and 10th graders (52.3% female), of whom 19.2% were migrant foreigners from African Portuguese-speaking countries, including Cape Verde (60.8%), Mozambique (1.6%), Angola (16.8%), S. Tomé (8%), and Guinea-Bissau (14.8%). Subsequently, four focus groups were held with adolescent who had participated in the survey (n = 45), three focus group with health and education professionals (n = 25), and one focus group with parents (n = 6).Compared with Portuguese adolescents, African migrant teens reported initial sexual intercourse at earlier ages, less frequent condom use, and less frequent and less comfortable communications with parents about sexual issues.Implications for selective prevention of STD are discussed and recommendations are made.

Medico-legal issues in cardiology.

PubMed

Abbott, Ryan; Cohen, Michael

2013-01-01

The aim of this article is to educate physicians about the current litigation climate in cardiology and cardiac surgery, with a focus on the most frequently litigated areas of practice, including failure to diagnose and treat myocardial infarction, coronary artery bypass graft surgery, percutaneous coronary intervention, and the use of tissue plasminogen activator. Empirical research on cardiology malpractice is presented, along with a sampling of up-to-date cases designed to illustrate common issues and important themes. The principles for reducing legal liability are also discussed, including the informed consent process, spoliation of records, and the role of documentation. Finally, practical recommendations are provided for cardiologists and cardiac surgeons to limit their legal liability.

Bench-to-bedside review: Dealing with increased intensive care unit staff turnover: a leadership challenge

PubMed Central

Laporta, Denny P; Burns, Judy; Doig, Chip J

2005-01-01

Critical care leaders frequently must face challenging situations requiring specific leadership and management skills for which they are, not uncommonly, poorly prepared. Such a fictitious scenario was discussed at a Canadian interdisciplinary critical care leadership meeting, whereby increasing intensive care unit (ICU) staff turnover had led to problems with staff recruitment. Participants discussed and proposed solutions to the scenario in a structured format. The results of the discussion are presented. In situations such as this, the ICU leader should first define the core problem, its complexity, its duration and its potential for reversibility. These factors often reside within workload and staff support issues. Some examples of core problems discussed that are frequently associated with poor retention and recruitment are a lack of a positive team culture, a lack of a favorable ICU image, a lack of good working relationships between staff and disciplines, and a lack of specific supportive resources. Several tools or individuals (typically outside the ICU environment) are available to help determine the core problem. Once the core problem is identified, specific solutions can be developed. Such solutions often require originality and flexibility, and must be planned, with specific short-term, medium-term and long-term goals. The ICU leader will need to develop an implementation strategy for these solutions, in which partners who can assist are identified from within the ICU and from outside the ICU. It is important that the leader communicates to all stakeholders frequently as the process moves forward. PMID:16277732

Bench-to-bedside review: dealing with increased intensive care unit staff turnover: a leadership challenge.

PubMed

Laporta, Denny P; Burns, Judy; Doig, Chip J

2005-10-05

Critical care leaders frequently must face challenging situations requiring specific leadership and management skills for which they are, not uncommonly, poorly prepared. Such a fictitious scenario was discussed at a Canadian interdisciplinary critical care leadership meeting, whereby increasing intensive care unit (ICU) staff turnover had led to problems with staff recruitment. Participants discussed and proposed solutions to the scenario in a structured format. The results of the discussion are presented. In situations such as this, the ICU leader should first define the core problem, its complexity, its duration and its potential for reversibility. These factors often reside within workload and staff support issues. Some examples of core problems discussed that are frequently associated with poor retention and recruitment are a lack of a positive team culture, a lack of a favorable ICU image, a lack of good working relationships between staff and disciplines, and a lack of specific supportive resources. Several tools or individuals (typically outside the ICU environment) are available to help determine the core problem. Once the core problem is identified, specific solutions can be developed. Such solutions often require originality and flexibility, and must be planned, with specific short-term, medium-term and long-term goals. The ICU leader will need to develop an implementation strategy for these solutions, in which partners who can assist are identified from within the ICU and from outside the ICU. It is important that the leader communicates to all stakeholders frequently as the process moves forward.

Gender and sexual health in clinical practice in Lebanon

PubMed Central

El-Kak, F.; Jurdi, R.; Kaddour, A.; Zurayk, H.

2006-01-01

This study examines the readiness of obstetricians/gynecologists (Ob/Gyns) in Lebanon to provide sexual consultation, their degree of comfort when discussing issues of sexual health, and their attitudes regarding assessment, treatment, and referral. Data on these concepts were collected through face-to-face interviews with 286 randomly selected Ob/Gyns. Most Ob/Gyns reported feeling comfortable discussing sexuality during consultations, which they attributed much more to professional experience than to training. Most Ob/Gyns reported giving proper time for management of sexual health issues and follow-up, as these issues are brought up frequently by their women clients. However, results suggest that only one-third (31%) of Lebanese Ob/Gyns nearly always take the initiative in asking patients about their sexual health. Moreover, almost 45% of participating Ob/Gyns did not recognize a strong relationship between reproductive health and sexual functioning. Gender was not found to be an important predictor for any of the indicators measured in the present study. Ob/Gyns in Lebanon are significant consultants on various sexual issues, and they need better postgraduate training, continuing medical education, and access to medical congress resources on the topic of sexuality and its relationship to reproductive health. PMID:15548405

Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

PubMed Central

2012-01-01

Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA). In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications. PMID:22731684

The myth of Jocasta and maternal narcissism.

PubMed

Butterfield, Ingrid

2012-04-01

This paper utilises the ancient Greek myth of Oedipus, and in particular the character's frequently overlooked mother Jocasta, to highlight some of the issues associated with maternal narcissism. A discussion of Jocasta forms the background to case studies where a mother's narcissism, along with an absent father, was pivotal to coping difficulties, which ultimately compelled the patient to seek therapy. Consideration of the Oedipus-Jocasta interpersonal dynamic can contribute to a greater understanding of these patients.

Visual impact of wind farms on cultural heritage: A Norwegian case study

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

Jerpasen, Gro B., E-mail: gro.jerpasen@niku.no; Larsen, Kari C., E-mail: kari.larsen@niku.n

2011-04-15

This paper discusses different approaches of how visual impact on cultural heritage can be methodologically improved within Environmental Impact Assessment (EIA). During the recent decade, visual impact on cultural heritage and heritage sites has become a more frequent but contentious issue in public and academic discussions. Yet, within EIA issues relating to heritage sites and visual impact are rarely debated or critically reflected upon. Today most methods and theories on visual impact and cultural heritage within EIA are transferred from disciplines such as landscape architecture, architecture and geography. The article suggests how working with the concepts and definitions of sitemore » and setting can be a methodological tool for delimiting and clarifying visual impact on cultural heritage sites. The article also presents ways of how public participation can be a tool to start exploring the field of what the visual impact on cultural heritage implies and how it effects upon our understanding and appreciation of heritage sites. Examples from a Norwegian case are taken as illustrations to highlight these issues.« less

Content Analysis of US News Stories About E-Cigarettes in 2015.

PubMed

Wackowski, Olivia A; Giovenco, Daniel P; Singh, Binu; Lewis, M Jane; Steinberg, Michael B; Delnevo, Cristine D

2017-08-03

Coverage of e-cigarettes in the news media may shape public perceptions about them but little is known about such news content. This content analysis characterized discussion of e-cigarettes in leading print and online US news sources in 2015. We searched Access World News and Factiva databases for e-cigarette-related news articles appearing in the top 30 circulating newspapers, 4 newswires, and 4 online news sources in the United States in 2015 (n = 295). Coders identified the presence of various e-cigarette topics (e.g. regulation), and benefit and risk statements. Nearly half of articles (45.1%) focused primarily on e-cigarette policy/regulatory issues, although e-cigarette prevalence (21.0%) and health effects (21.7%) were common main topics. Concerns about youth were frequently mentioned, including the rise in youth e-cigarette use (45.4%), gateway to smoking potential (33.9%) and appeal of flavors (22.4%). Youth e-cigarette prevalence was more frequently mentioned than adult prevalence in articles discussing FDA regulation (61% vs. 13.5%, respectively). News articles more frequently discussed potential e-cigarette risks or concerns (80%) than benefits (45.4%), such as smoking harm-reduction. Quoted physicians, researchers, and government representatives were more likely to refer to e-cigarette risks than benefits. In 2015, rising rates of e-cigarette use among youth and policy strategies to address e-cigarettes dominated US e-cigarette news stories, leading up to their FDA regulation in 2016. Statements about e-cigarettes' potential risks were frequently attributed to trusted sources such as physicians, and outnumbered claims about their harm-reduction benefits. Such coverage may impact e-cigarette risk perceptions, use intentions and policy support. In the year leading up to the FDA's Deeming Rule, concerns about youth use or potential use were frequently discussed in e-cigarette news. News articles more frequently discussed potential e-cigarette risks/concerns compared to potential harm-reduction benefits relative to tobacco cigarettes. While such coverage may inform the public about potential e-cigarette risks, they may also contribute to increasing perceptions that e-cigarettes are as harmful as tobacco cigarettes. E-cigarette risk and benefit statements were most frequently made by or attributed to researchers and physicians in articles, which is significant given that they may be particularly trusted sources of e-cigarette risk information. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Responding to home maintenance challenge scenarios: the role of selection, optimization, and compensation in aging-in-place.

PubMed

Kelly, Andrew John; Fausset, Cara Bailey; Rogers, Wendy; Fisk, Arthur D

2014-12-01

This study examined potential issues faced by older adults in managing their homes and their proposed solutions for overcoming hypothetical difficulties. Forty-four diverse, independently living older adults (66-85) participated in structured group interviews in which they discussed potential solutions to manage difficulties presented in four scenarios: perceptual, mobility, physical, and cognitive difficulties. The proposed solutions were classified using the Selection, Optimization, and Compensation (SOC) model. Participants indicated they would continue performing most tasks and reported a range of strategies to manage home maintenance challenges. Most participants reported that they would manage home maintenance challenges using compensation; the most frequently mentioned compensation strategy was using tools and technologies. There were also differences across the scenarios: Optimization was discussed most frequently with perceptual and cognitive difficulty scenarios. These results provide insights into supporting older adults' potential needs for aging-in-place and provide evidence of the value of the SOC model in applied research. © The Author(s) 2012.

Biocompatibility of Chitosan Carriers with Application in Drug Delivery

PubMed Central

Rodrigues, Susana; Dionísio, Marita; Remuñán López, Carmen; Grenha, Ana

2012-01-01

Chitosan is one of the most used polysaccharides in the design of drug delivery strategies for administration of either biomacromolecules or low molecular weight drugs. For these purposes, it is frequently used as matrix forming material in both nano and micron-sized particles. In addition to its interesting physicochemical and biopharmaceutical properties, which include high mucoadhesion and a great capacity to produce drug delivery systems, ensuring the biocompatibility of the drug delivery vehicles is a highly relevant issue. Nevertheless, this subject is not addressed as frequently as desired and even though the application of chitosan carriers has been widely explored, the demonstration of systems biocompatibility is still in its infancy. In this review, addressing the biocompatibility of chitosan carriers with application in drug delivery is discussed and the methods used in vitro and in vivo, exploring the effect of different variables, are described. We further provide a discussion on the pros and cons of used methodologies, as well as on the difficulties arising from the absence of standardization of procedures. PMID:24955636

Engaging novice researchers in the process and culture of science using a "Pass-the-Problem" case strategy.

PubMed

White, Harold B; Usher, David C

2015-01-01

Undergraduates having their first research experience frequently have little idea of what to expect. Institutions offering summer research experiences attempt to address this issue through programs that introduce students to the process and culture of science. However, didactic approaches frequently bore students who prefer more interactive sessions. We describe a "Pass-the-Problem" case study approach that engages groups of students in useful discussions about the research environment they are entering. The cases presented here include keeping a thorough laboratory notebook, balancing laboratory and personal time demands, anxiety about formal presentations, unexpected federal regulatory inspection, working in a lab with limited funds, being used as a technician rather than a researcher, frustration with failed experiments, effects of promotion and tenure on laboratory atmosphere, the importance of reading the research literature, and questioning a career in science. These cases alert students to different situations they might encounter and stimulate discussion about how to deal with them. © 2015 The International Union of Biochemistry and Molecular Biology.

The Cyber Defense (CyDef) Model for Assessing Countermeasure Capabilities.

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

Kimura, Margot; DeVries, Troy Robert; Gordon, Susanna P.

Cybersecurity is essential to maintaining operations, and is now a de facto cost of business. Despite this, there is little consensus on how to systematically make decisions about cyber countermeasures investments. Identifying gaps and determining the expected return on investment (ROI) of adding a new cybersecurity countermeasure is frequently a hand-waving exercise at best. Worse, cybersecurity nomenclature is murky and frequently over-loaded, which further complicates issues by inhibiting clear communication. This paper presents a series of foundational models and nomenclature for discussing cybersecurity countermeasures, and then introduces the Cyber Defense (CyDef) model, which provides a systematic and intuitive way formore » decision-makers to effectively communicate with operations and device experts.« less

Programmatic and economic challenges for commercial space processing

NASA Astrophysics Data System (ADS)

Overfelt, Tony; Watkins, John

1997-01-01

The International Space Station is the largest cooperative space project in history and is likely to be industry's most viable access to the low-g environment for long duration materials processing experiments. Such access will provide unique and competitive research capabilities to industry if private sector entities can commercially utilize the Space Station for their industrial projects. Although ``commercial utilization'' implies a variety of things to different people, the key industrial issues are frequent, reliable, and economical access to space as well as protection of private sector intellectual property rights. This paper discusses how these key issues will influence the programmatic and economic challenges for commercial space processing in the future Space Station era.

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Use of Administrative and Surveillance Databases.

PubMed

Drees, Marci; Gerber, Jeffrey S; Morgan, Daniel J; Lee, Grace M

2016-11-01

Administrative and surveillance data are used frequently in healthcare epidemiology and antimicrobial stewardship (HE&AS) research because of their wide availability and efficiency. However, data quality issues exist, requiring careful consideration and potential validation of data. This methods paper presents key considerations for using administrative and surveillance data in HE&AS, including types of data available and potential use, data limitations, and the importance of validation. After discussing these issues, we review examples of HE&AS research using administrative data with a focus on scenarios when their use may be advantageous. A checklist is provided to help aid study development in HE&AS using administrative data. Infect Control Hosp Epidemiol 2016;1-10.

Observations on streamwise vortices in laminar and turbulent boundary layers

NASA Technical Reports Server (NTRS)

Morkovin, M. V.

1979-01-01

The frequent but often unsuspected presence of streamwise vortices in nominally two dimensional laminar and turbulent boundary layers and some of their consequences are described. Since there is no body of systematic information on streamwise vortices imbedded in boundary layers, a number of issues concerning their occurrence and behavior are discussed in the form of a set of succinct observations. Desirable experimental and numerical research to remedy the current lack of knowledge is recommended.

Philosophy as news: bioethics, journalism and public policy.

PubMed

Goodman, K W

1999-04-01

News media accounts of issues in bioethics gain significance to the extent that the media influence public policy and inform personal decision making. The increasingly frequent appearance of bioethics in the news thus imposes responsibilities on journalists and their sources. These responsibilities are identified and discussed, as is (i) the concept of "news-worthiness" as applied to bioethics, (ii) the variable quality of bioethics reportage and (iii) journalists' reliance on ethicists to pass judgment. Because of the potential social and other benefits of high quality reporting on ethical issues, it is argued that journalists and their bioethics sources should explore and accommodate more productive relationships. An optimal journalism-ethics relationship will be one characterized by "para-ethics," in which journalistic constraints are noted but also in which issues and arguments are presented without oversimplification and credible disagreement is given appropriate attention.

Childhood discipline: challenges for clinicians and parents.

PubMed

Banks, J Burton

2002-10-15

Although childhood discipline is an important issue for parents, this topic is seldom emphasized by family physicians during well-child examinations. Behavior problems are relatively common but frequently under-recognized by physicians. Opportunities to counsel parents about safe, effective methods of discipline are therefore missed. Discipline should be instructive and age-appropriate and should include positive reinforcement for good behavior. Punishment is only one aspect of discipline and, in order to be effective, it must be prompt, consistent, and fair. Time-out is frequently used to correct younger children, but because it is often enforced improperly, it loses its effectiveness. Corporal punishment is a controversial but common form of discipline that is less effective than some other types of punishment. Its use is linked to child and spouse abuse, as well as to future substance use, violent crime, poor self-esteem, and depression. Despite the possible negative effects of corporal punishment, it is still widely accepted in our society. Since discipline plays an important role in the social and emotional development of children, physicians should be trained to discuss this issue with parents during routine well-child examinations.

Career, Family, and Institutional Variables in the Work Lives of Academic Women in the Chemical Sciences

NASA Astrophysics Data System (ADS)

Fassinger, Ruth E.; Scantlebury, Kathryn; Richmond, Geraldine

This article presents quantitative results of a study of 139 academic women in the chemical sciences who participated in a professional development program sponsored by the Committee on the Advancement of Women Chemists. The study investigated variables frequently examined in the vocational psychology of women: approaches to achievement, coping strategies, career advancement, the home-work interface, workplace climate, and mentoring. The article presents and discusses results in the context of unique issues faced by women in scientific careers.

Integrative Medicine for Insomnia.

PubMed

Zhou, Eric S; Gardiner, Paula; Bertisch, Suzanne M

2017-09-01

Difficulty initiating and/or maintaining sleep is a common issue. Patients experiencing insomnia symptoms frequently self-treat their symptoms with sleep medications. However, there remains concern regarding the short- and long-term health impacts of sleep medications. This article discusses the evidence supporting integrative approaches to insomnia treatment, including cognitive-behavioral therapy and mind-body therapies (mindfulness meditation, yoga, tai chi), as well as emerging data for use of other less well supported approaches (dietary supplements, acupuncture). Copyright © 2017 Elsevier Inc. All rights reserved.

Responsible authorship in engineering fields: an overview of current ethical challenges.

PubMed

Borenstein, Jason

2011-06-01

The primary aim of this article is to identify ethical challenges relating to authorship in engineering fields. Professional organizations and journals do provide crucial guidance in this realm, but this cannot replace the need for frequent and diligent discussions in engineering research communities about what constitutes appropriate authorship practice. Engineering researchers should seek to identify and address issues such as who is entitled to be an author and whether publishing their research could potentially harm the public.

Open questions in the management of nodular lymphocyte predominant hodgkin lymphoma.

PubMed

Tyran, Marguerite; Gonzague, Laurence; Bouabdallah, Reda; Resbeut, Michel

2014-01-01

Localized Nodular Lymphocyte Predominant Hodgkin Lymphoma is a rare disease with an overall good prognosis but frequent late relapses. Due to it's rarity there is no standard therapeutic approach and pathological diagnosis may be hard. In this paper we discuss the technical aspects of the radiation therapy and histological issues. The new fields reductions proposed for classical Hodgkin lymphoma cannot be applied to early stages Nodular Lymphocyte Predominant Hodgkin lymphomas which are usually treated with radiation therapy without systemic chemotherapy.

NCDC mass storage systems and technologies

NASA Technical Reports Server (NTRS)

Davis, Dick

1993-01-01

National Climatic Data Center (NCDC) data management issues are discussed, such as nature of holdings, history of the site, popularity of data sets, media/technology used for storage, volume distributed per month, mode of distribution, most frequently encountered problems, type of media requested/used, and evolution of media. Current holdings at NCDC are 107.8 terabytes of digital data and about 0.3 terabytes of manuscript data. The nexrad radar system is expected to generate approximately 88 terabytes per year by 1996.

Home intravenous therapy: Part I--Issues.

PubMed

McAbee, R R; Grupp, K; Horn, B

1991-01-01

Concerns related to providing home intravenous therapy were among the top ten clinical problems identified by Northwest Medicare-certified home care agencies in a 1986 survey. This paper addresses issues related to home intravenous therapy and provides lists of resources for the development of home intravenous therapy programs. Part I of the paper covers concerns related to intravenous therapy as expressed by home care agencies in the Northwest and synthesized the literature about home intravenous therapies. Survey results are presented, followed by a discussion of client and caregiver concerns. These include: discharge planning, client admission criteria and client and caregiver education. Standards, staffing, and staff education issues are discussed followed by sections on economics, marketing regulations and legal and ethical concerns. Finally, there is a discussion of issues related to specific types of intravenous therapies: parenteral nutrition, antibiotic therapy; chemotherapy; blood and blood component therapy and other less frequently used types of intravenous therapies. Each therapy is discussed with regard to complications, client and caregiver instruction and financial considerations. Part II of the paper is a resource guide which lists resources that agencies may use to develop a home intravenous therapy program. In the first section, national organizations and journals and books concerned with intravenous therapy are listed as well as journal articles, guidelines and guidebooks and client and provider educational materials. National and regional product and service representatives of intravenous therapy related companies are also listed. In the second section, addresses for the State Boards of Nursing are given for Alaska, Idaho, Montana, Oregon and Washington. Each state section includes a list of those agencies who indicated in the 1988 survey that they would be willing to share materials. In addition, product and service vendors of intravenous therapy supplies and equipment are listed for the State of Washington.

Review of guidelines and literature for handling missing data in longitudinal clinical trials with a case study.

PubMed

Liu, M; Wei, L; Zhang, J

2006-01-01

Missing data in clinical trials are inevitable. We highlight the ICH guidelines and CPMP points to consider on missing data. Specifically, we outline how we should consider missing data issues when designing, planning and conducting studies to minimize missing data impact. We also go beyond the coverage of the above two documents, provide a more detailed review of the basic concepts of missing data and frequently used terminologies, and examples of the typical missing data mechanism, and discuss technical details and literature for several frequently used statistical methods and associated software. Finally, we provide a case study where the principles outlined in this paper are applied to one clinical program at protocol design, data analysis plan and other stages of a clinical trial.

Hybrid Compounds as Anti-infective Agents.

PubMed

Sbaraglini, María Laura; Talevi, Alan

2017-01-01

Hybrid drugs are multi-target chimeric chemicals combining two or more drugs or pharmacophores covalently linked in a single molecule. In the field of anti-infective agents, they have been proposed as a possible solution to drug resistance issues, presumably having a broader spectrum of activity and less probability of eliciting high level resistance linked to single gene product. Although less frequently explored, they could also be useful in the treatment of frequently occurring co-infections. Here, we overview recent advances in the field of hybrid antimicrobials. Furthermore, we discuss some cutting-edge approaches to face the development of designed multi-target agents in the era of omics and big data, namely analysis of gene signatures and multitask QSAR models. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Translation of Japanese Noun Compounds at Super-Function Based MT System

NASA Astrophysics Data System (ADS)

Zhao, Xin; Ren, Fuji; Kuroiwa, Shingo

Noun compounds are frequently encountered construction in nature language processing (NLP), consisting of a sequence of two or more nouns which functions syntactically as one noun. The translation of noun compounds has become a major issue in Machine Translation (MT) due to their frequency of occurrence and high productivity. In our previous studies on Super-Function Based Machine Translation (SFBMT), we have found that noun compounds are very frequently used and difficult to be translated correctly, the overgeneration of noun compounds can be dangerous as it may introduce ambiguity in the translation. In this paper, we discuss the challenges in handling Japanese noun compounds in an SFBMT system, we present a shallow method for translating noun compounds by using a word level translation dictionary and target language monolingual corpus.

For Richer, for Poorer: Money as a Topic of Marital Conflict in the Home

PubMed Central

Papp, Lauren M.; Cummings, E. Mark; Goeke-Morey, Marcie C.

2011-01-01

Guided by a family stress perspective, we examined the hypothesis that discussing money would be associated with the handling of marital conflict in the home. Analyses were based on dyadic hierarchical linear modeling of 100 husbands’ and 100 wives’ diary reports of 748 conflict instances. Contrary to findings from previous laboratory-based surveys, spouses did not rate money as the most frequent source of marital conflict in the home. However, compared to non-money issues, marital conflicts about money were more pervasive, problematic, and recurrent, and remained unresolved, despite including more attempts at problem solving. Implications for professionals who assist couples in managing their relationships and family finances are discussed. PMID:22162622

For Richer, for Poorer: Money as a Topic of Marital Conflict in the Home.

PubMed

Papp, Lauren M; Cummings, E Mark; Goeke-Morey, Marcie C

2009-02-01

Guided by a family stress perspective, we examined the hypothesis that discussing money would be associated with the handling of marital conflict in the home. Analyses were based on dyadic hierarchical linear modeling of 100 husbands' and 100 wives' diary reports of 748 conflict instances. Contrary to findings from previous laboratory-based surveys, spouses did not rate money as the most frequent source of marital conflict in the home. However, compared to non-money issues, marital conflicts about money were more pervasive, problematic, and recurrent, and remained unresolved, despite including more attempts at problem solving. Implications for professionals who assist couples in managing their relationships and family finances are discussed.

A Study of Perceptions of Rights and Needs in Interpersonal Conflicts in Homosexual Relationships

ERIC Educational Resources Information Center

De Cecco, John P.; Shively, Michael G.

1978-01-01

Examines issues of rights and needs in interpersonal conflicts of couples of the same biological sex and sexual orientation. The right most frequently perceived as an issue was participation in decision making. The need most frequently perceived as an issue was power. Almost no conflicts were resolved through negotiation. (Author)

Chronic hyperkalemia in non-dialysis CKD: controversial issues in nephrology practice.

PubMed

De Nicola, Luca; Di Lullo, Luca; Paoletti, Ernesto; Cupisti, Adamasco; Bianchi, Stefano

2018-06-07

Chronic hyperkalemia is a major complication of chronic kidney disease (CKD) that occurs frequently, heralds poor prognosis, and necessitates careful management by the nephrologist. Current strategies aimed at prevention and treatment of hyperkalemia are still suboptimal, as evidenced by the relatively high prevalence of hyperkalemia in patients under stable nephrology care, and even in the ideal setting of randomized trials where best treatment and monitoring are mandatory. The aim of this review was to identify and discuss a range of unresolved issues related to the management of chronic hyperkalemia in non-dialysis CKD. The following topics of clinical interest were addressed: diagnosis, relationship with main comorbidities of CKD, therapy with inhibitors of the renin-angiotensin-aldosterone system, efficacy of current dietary and pharmacological treatment, and the potential role of the new generation of potassium binders. Opinion-based answers are provided for each of these controversial issues.

Selection bias in rheumatic disease research.

PubMed

Choi, Hyon K; Nguyen, Uyen-Sa; Niu, Jingbo; Danaei, Goodarz; Zhang, Yuqing

2014-07-01

The identification of modifiable risk factors for the development of rheumatic conditions and their sequelae is crucial for reducing the substantial worldwide burden of these diseases. However, the validity of such research can be threatened by sources of bias, including confounding, measurement and selection biases. In this Review, we discuss potentially major issues of selection bias--a type of bias frequently overshadowed by other bias and feasibility issues, despite being equally or more problematic--in key areas of rheumatic disease research. We present index event bias (a type of selection bias) as one of the potentially unifying reasons behind some unexpected findings, such as the 'risk factor paradox'--a phenomenon exemplified by the discrepant effects of certain risk factors on the development versus the progression of osteoarthritis (OA) or rheumatoid arthritis (RA). We also discuss potential selection biases owing to differential loss to follow-up in RA and OA research, as well as those due to the depletion of susceptibles (prevalent user bias) and immortal time bias. The lesson remains that selection bias can be ubiquitous and, therefore, has the potential to lead the field astray. Thus, we conclude with suggestions to help investigators avoid such issues and limit the impact on future rheumatology research.

Selection bias in rheumatic disease research

PubMed Central

Choi, Hyon K.; Nguyen, Uyen-Sa; Niu, Jingbo; Danaei, Goodarz; Zhang, Yuqing

2014-01-01

The identification of modifiable risk factors for the development of rheumatic conditions and their sequelae is crucial for reducing the substantial worldwide burden of these diseases. However, the validity of such research can be threatened by sources of bias, including confounding, measurement and selection biases. In this Review, we discuss potentially major issues of selection bias—a type of bias frequently overshadowed by other bias and feasibility issues, despite being equally or more problematic—in key areas of rheumatic disease research. We present index event bias (a type of selection bias) as one of the potentially unifying reasons behind some unexpected findings, such as the ‘risk factor paradox’—a phenomenon exemplified by the discrepant effects of certain risk factors on the development versus the progression of osteoarthritis (OA) or rheumatoid arthritis (RA). We also discuss potential selection biases owing to differential loss to follow-up in RA and OA research, as well as those due to the depletion of susceptibles (prevalent user bias) and immortal time bias. The lesson remains that selection bias can be ubiquitous and, therefore, has the potential to lead the field astray. Thus, we conclude with suggestions to help investigators avoid such issues and limit the impact on future rheumatology research. PMID:24686510

[Moral case deliberation: time for ethical reflection in the daily practice of mental health care].

PubMed

Vellinga, A; van Melle-Baaijens, E A H

2016-01-01

Nowadays, reflecting on ethics, which we choose to call moral case deliberation, is occurring more and more frequently in psychiatric institutions. We have personal experience of organising and supervising moral case deliberation in a large psychiatric institute and we can confirm the positive effects of moral case deliberation which have been reported in the literature. To describe a structured method for moral case deliberation which enables care-givers in health care and/or addiction care to reflect on moral dilemmas. We refer to the main findings in relevant literature and describe how we developed a structured method for implementing moral case deliberation. Our studies of the literature indicate that systematic reflection about ethical dilemmas can improve the quality of care and make care-givers more satisfied with their work. This is why we have developed our own method which is applicable particularly to psychiatric and/or addition care and which can be used systematically in discussions of moral dilemmas. Our method for discussing ethical issues works well in clinical practice, particularly when it is embedded in a multidisciplinary context. Of course, to ensure the continuity of the system, deliberation about moral and ethical issues needs to be financially safeguarded and embedded in the organisation. Discussion of moral issues improves the quality of care and increases care-givers' satisfaction with their work.

Perceptions and experiences of adolescents, parents and school administrators regarding adolescent-parent communication on sexual and reproductive health issues in urban and rural Uganda.

PubMed

Muhwezi, Wilson Winstons; Katahoire, Anne Ruhweza; Banura, Cecily; Mugooda, Herbert; Kwesiga, Doris; Bastien, Sheri; Klepp, Knut-Inge

2015-11-30

Evidence suggests that in spite of some adolescents being sexually active, many parents do not discuss sex-related issues with them due to lack of age-appropriate respectful vocabulary and skills. The likelihood of parent-adolescent communication improving sexual and reproductive health outcomes appears plausible. The desire to understand parent-adolescent communication and how to improve it for promotion of healthy sexual behaviours inspired this research. The paper is meant to describe perceptions of adolescents, parents and school administrators about parent-adolescent communication on sexual issues; describe the content of such communication and identify factors that influence this communication. The study was done among two urban and two rural secondary school students in their second year of education. Data were collected from 11 focus group discussions and 10 key Informants Interviews. Data management, analysis and interpretation followed thematic analysis principles. Illuminating verbatim quotations are used to illustrate findings. Parental warmth and acceptability of children was perceived by parents to be foundational for a healthy adolescent- parent communication. Perceptions of adolescents tended to point to more open and frequent communication with mothers than fathers and to cordial relationships with mothers. Fathers were perceived by adolescents to be strict, intimidating, unapproachable and unavailable. While adolescents tended to generally discuss sexual issues with mothers, male adolescents communicated less with anyone on sex, relationships and condoms. Much of the parent-adolescent communication was perceived to focus on sexually transmitted infections and body changes. Discussions of sex and dating with adolescents were perceived to be rare. Common triggers of sexuality discussions with female adolescents were; onset of menstruation and perceived abortion in the neighbourhood. Discussion with male adolescents, if it occurred was perceived to be triggered by parental suspicion of having female 'friends' or coming home late. Peers at school and mass media were perceived to the main source of sexuality information. Communication on sexuality issues between parents and their adolescent children was infrequent and critical elements like sex and specifics of protection against undesirable sexual behaviour consequences were avoided. Peers, schools and mass media should be creatively harnessed to improve parent-adolescent communication about sexuality issues.

Parents' views on childhood obesity: qualitative analysis of discussion board postings.

PubMed

Appleton, Jessica; Fowler, Cathrine; Brown, Nicola

2017-08-01

Childhood obesity is an increasing concern for parents and health professionals alike. Parents' perception of obesity as a current health issue for their children is important for the everyday parenting and health choices parents make. As parents are frequently going online to seek and exchange information about parenting and child health, asynchronous online discussion forums provide an opportunity to investigate their perceptions and concerns. Understanding parents' perceptions, beliefs and attitudes is important in any childhood obesity prevention and intervention. To explore parents' perceptions, perspectives and concerns regarding childhood obesity expressed on asynchronous online discussion forums. A qualitative descriptive approach using template analysis to analyse a novel data collection strategy of 34 purposefully sampled threads from two Australian-based asynchronous online discussion forums. Parents on the discussion forum displayed an understanding of childhood obesity as a public health concern, the discussion incorporated issues such as providing a healthy diet and lifestyle for children. Parents shared their own opinions and experiences that challenged or conceded to the status quo of the discussion. Parents discussed the role of health professionals in obesity prevention. There were varied opinions on the relevance of health professionals, particularly nurses, monitoring of growth and risk of obesity. This exploratory study highlights that parents perceive childhood obesity as an important public health concern, and that they understand the key public health messages of prevention and intervention. Yet, for many it is difficult to successfully implement these messages into their everyday lives. Health professionals need to play a key role in providing non-judgemental, innovative support and advice to parents to successfully implement prevention and intervention strategies.

Acute kidney injury in acute liver failure: a review.

PubMed

Moore, Joanna K; Love, Eleanor; Craig, Darren G; Hayes, Peter C; Simpson, Kenneth J

2013-11-01

Acute liver failure is a rare and often devastating condition consequent on massive liver cell necrosis that frequently affects young, previously healthy individuals resulting in altered cognitive function, coagulopathy and peripheral vasodilation. These patients frequently develop concurrent acute kidney injury (AKI). This abrupt and sustained decline in renal function, through a number of pathogenic mechanisms such as renal hypoperfusion, direct drug-induced nephrotoxicity or sepsis/systemic inflammatory response contributes to increased morbidity and is strongly associated with a worse prognosis. Improved understanding of the pathophysiology AKI in the context of acute liver failure may be beneficial in a number of areas; the development of new and sensitive biomarkers of renal dysfunction, refining prognosis and organ allocation, and ultimately leading to the development of novel treatment strategies, these issues are discussed in more detail in this expert review.

Nutritional supplements in age-related macular degeneration.

PubMed

Schmidl, Doreen; Garhöfer, Gerhard; Schmetterer, Leopold

2015-03-01

Age-related macular degeneration (AMD) is the most frequent cause of blindness in the Western World. While with new therapies that are directed towards vascular endothelial growth factor (VEGF), a potentially efficient treatment option for the wet form of the disease has been introduced, a therapeutic regimen for dry AMD is still lacking. There is evidence from several studies that oral intake of supplements is beneficial in preventing progression of the disease. Several formulations of micronutrients are currently available. The present review focuses on the role of supplements in the treatment and prevention of AMD and sums up the current knowledge about the most frequently used micronutrients. In addition, regulatory issues are discussed, and future directions for the role of supplementation in AMD are highlighted. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Voluntary euthanasia: ethical concepts and definitions.

PubMed

Sanders, K; Chaloner, C

Euthanasia is a highly emotive and contentious subject, giving rise to a great deal of debate. However, despite its frequent exposure in public and professional media, there appears to be a lack of clarity about the concepts and definitions used in the euthanasia debate. This suggests that discussions on this subject are inadequately informed and ineffectual. The ethical focus of the euthanasia debate concerns the moral legitimacy of 'voluntary euthanasia'. This article provides an overview and clarification of some of the key ethical issues at the centre of that debate.

A pathophysiologic approach to growth problems in children with attention-deficit/hyperactivity disorder.

PubMed

Tenore, Alfred; Tenore, Andrew

2012-12-01

In recent years there has been an increasing trend in the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) worldwide. One of the most frequently discussed side effects of these treatments is related to problems of growth. In order to better understand what ADHD is and the mechanisms by which it could affect growth, this article reviews relevant data from a clinical and neurophysiologic perspective to improve understanding of this controversial issue. Copyright © 2012 Elsevier Inc. All rights reserved.

Tumors of the Testis: Morphologic Features and Molecular Alterations.

PubMed

Howitt, Brooke E; Berney, Daniel M

2015-12-01

This article reviews the most frequently encountered tumor of the testis; pure and mixed malignant testicular germ cell tumors (TGCT), with emphasis on adult (postpubertal) TGCTs and their differential diagnoses. We additionally review TGCT in the postchemotherapy setting, and findings to be integrated into the surgical pathology report, including staging of testicular tumors and other problematic issues. The clinical features, gross pathologic findings, key histologic features, common differential diagnoses, the use of immunohistochemistry, and molecular alterations in TGCTs are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Beyond Controversies: Sexuality Education for Adolescents in India

PubMed Central

Khubchandani, Jagdish; Clark, Jeffrey; Kumar, Raman

2014-01-01

Sexuality education for adolescents is one of the most controversial topics in the field of child health. In the past decade, policymakers in India have also struggled with the issue and there has been greater public discourse. However, policymaking and public discussions on adolescent sexuality education are frequently fueled by religious, social, and cultural values, while receiving scant scientific attention. To meet the needs of an expanding young population in India, scientific evidence for best practices must be kept at the core of policymaking in the context of sexuality education for adolescents. PMID:25374847

Nutritional support of reptile patients.

PubMed

De Voe, Ryan S

2014-05-01

Providing nutritional support to reptile patients is a challenging and often misunderstood task. Ill reptiles are frequently anorexic and can benefit greatly from appropriate nutrition delivered via a variety of assist-feeding techniques. Neonatal reptiles can also be very challenging patients because many fail to thrive without significant efforts to establish normal feeding behaviors. This article presents ideas supporting the benefit of timely nutritional support as well as specific recommendations for implementation of assist feeding. Also discussed are a few nutritional issues that affect captive reptile species. Copyright © 2014 Elsevier Inc. All rights reserved.

A review of online social networking profiles by adolescents: implications for future research and intervention.

PubMed

Williams, Amanda L; Merten, Michael J

2008-01-01

This study explored content posted and interactions taking place on adolescent online social networking profiles. Although "blogging" continues to soar in popularity, with over half of teenagers online participating in some form, little research has comprehensively explored blog communication within the context of adolescent development. Content was qualitatively coded from 100 randomly selected profiles authored by adolescents between the ages of 16 and 18. Rich thematic elements were identified including family and social issues, risk behaviors, disclosure of personally identifiable information, and frequent peer interaction. Results indicate adolescent blogs frequently contain appropriate images, positive comments about parents and peers, athletics, a variety of risk behaviors, and sexual and profane language. In addition, school type was examined (public versus private, religious) as a potential factor in understanding the differences in content posted by adolescents; however, no significant differences were found. Implications for parental monitoring and intervention are discussed as well as direction for future research. Adolescents' online profiles contain a wealth of intimate, candid, and publicly available information on a wide range of social issues pertinent to adolescence that contribute to the understanding of adolescent development and well-being.

Quantum physics and the beam splitter mystery

NASA Astrophysics Data System (ADS)

Hénault, François

2015-09-01

Optical lossless beam splitters are frequently encountered in fundamental physics experiments regarding the nature of light, including "which-way" determination or the EPR paradox and their measurement apparatus. Although they look as common optical components at first glance, their behaviour remains somewhat mysterious since they apparently exhibit stand-alone particle-like features, and then wave-like characteristics when inserted into a Mach-Zehnder interferometer. In this communication are examined and discussed some basic properties of these beamssplitters, both from a classical optics and quantum physics point of view. Herein the most evident convergences and contradictions are highlighted, and the results of a few emblematic experiments demonstrating photon existence are discussed. Alternative empirical models are also proposed in order to shed light on some remaining issues.

[Medico-legal autopsy--selected legal issues: the autopsy protocol].

PubMed

Gaszczyk-Ozarowski, Zbigniew; Chowaniec, Czesław

2010-01-01

The majority of experts in the field of forensic medicine maintain that the minutes of the medicolegal autopsy should be taken by the forensic pathologist. The authors argue that it is the public prosecutor who is obliged to draw up the minutes, whereas the forensic pathologist issues the expert opinion. To support their stance, the authors make frequent references to several provisions of the Criminal Procedure Code of 1997. The authors also imply that due to organizational reasons and the ratio legis of the aforementioned code, the forensic pathologist should not be assigned the role of the minutes-taker, despite the lack of a specific exclusion rule governing such a case. Possible consequences caused by the lack of the properly drawn up minutes are briefly discussed as well.

Scaled CMOS Reliability and Considerations for Spacecraft Systems: Bottom-Up and Top-Down Perspective

NASA Technical Reports Server (NTRS)

White, Mark

2012-01-01

New space missions will increasingly rely on more advanced technologies because of system requirements for higher performance, particularly in instruments and high-speed processing. Component-level reliability challenges with scaled CMOS in spacecraft systems from a bottom-up perspective have been presented. Fundamental Front-end and Back-end processing reliability issues with more aggressively scaled parts have been discussed. Effective thermal management from system-level to the componentlevel (top-down) is a key element in overall design of reliable systems. Thermal management in space systems must consider a wide range of issues, including thermal loading of many different components, and frequent temperature cycling of some systems. Both perspectives (top-down and bottom-up) play a large role in robust, reliable spacecraft system design.

Similar challenges but different responses: Media coverage of measles vaccination in the UK and China.

PubMed

Ren, Jie; Peters, Hans Peter; Allgaier, Joachim; Lo, Yin-Yueh

2014-05-01

For several decades scholars have studied media reporting on scientific issues that involve controversy. Most studies so far have focused on the western world. This article tries to broaden the perspective by considering China and comparing it to a western country. A content analysis of newspaper coverage of vaccination issues in the UK and China shows, first, that the government-supported 'mainstream position' dominates the Chinese coverage while the British media frequently refer to criticism and controversy. Second, scientific expertise in the British coverage is represented by experts from the health and science sector but by experts from health agencies in the Chinese coverage. These results are discussed with respect to implications for risk communication and scientists' involvement in public communication.

Considering our methods: Methodological issues with rodent models of appetite and obesity research.

PubMed

Lutz, Thomas A

2018-08-01

A large number of animal models are currently used in appetite and obesity research. Because the worldwide incidence of obesity continues to climb, it is imperative that animal models sharing characteristics of human obesity and its co-morbidities be used appropriately in the quest for novel preventions or treatments. There is probably no animal model, at least in rodents, that recapitulates all aspects of "common" human obesity and its comorbidities, but rodent models allow insight into specific mechanisms of disease or its consequences. Frequently used obesity models can be partitioned into different categories, the major ones being a) based on mutations or manipulations of one or a few individual genes or b) those in genetically intact animals exposed to obesogenic environments such as, e.g., being maintained on high-fat diets or being raised in small litters. Characteristics of these models include distinct phenotypes of obesity, hyperphagia or changes in energy metabolism, and frequent comorbidities of obesity, like hyperglycemia, insulin resistance or diabetes-like syndromes. This review which is based on a presentation given during the Annual Meeting of the Society for the Study of Ingestive Behavior in July 2017 points out some observations and characteristics of rodent models in obesity and diabetes research. The choice of rodent models discussed here is subjective and based on the author's own experience or on fruitful discussions with colleagues about the pros and cons of specific models. Hence, this review, by no means, is meant to give a complete picture of rodent models used in this type of research, but the review tries to bring up some issues which, in the author's mind, may also be relevant for models not discussed here. For example, by discussing specific mouse and rat models, similarities and differences between mice and rats will be discussed that need to be considered to interpret experimental findings cautiously and in the context of the respective animal model. Knowing which animal model to use means, knowing its limitations. Copyright © 2018 Elsevier Inc. All rights reserved.

The relationship between press release and newspaper coverage of tobacco-related issues in South Korea.

PubMed

Cho, Kyung Sook; Yoon, Jangho

2017-08-01

This study investigates an association between press release and news media response on tobacco-related issues in South Korea. We retrieved 231 tobacco-related newspaper articles from all major dailies throughout the year 2005. In total, 37 press releases on tobacco-related issues and policies published by the Korea Ministry of Health and Welfare were obtained from the Ministry website. Content analysis and appropriate statistical tests were performed. Results from our content analysis suggest that producing more press releases on tobacco-related issues may result in a greater volume of newspaper articles, and that a press release on a new topical issue may effect more intense media coverage. Findings also show that when Korean newspaper articles overall held less favorable views of tobacco-related policies and programs in 2005, taxation was the most frequent theme with a non-positive opinion. Findings from our multivariate logistic regression models imply that a newspaper article with a source press release-especially about a new topical issue-is more likely than an article without a source press release to discuss tobacco-related issues more positively. Our findings suggest that a press release may serve as an effective media strategy for reaching out to the public by disseminating tobacco-control efforts and policies.

The role of ethics in information technology decisions: a case-based approach to biomedical informatics education.

PubMed

Anderson, James G

2004-03-18

The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.

Department of Defense Suicide Event Report (DoDSER) Calendar Year 2011 Annual Report

DTIC Science & Technology

2012-11-15

methods were most frequently drug overdose and use of military issue firearm. Drug and alcohol use during suicide events was less frequent among deployed...use of non-military issue firearms and hanging. Suicide attempt methods were most frequently drug overdose , harming oneself with a sharp or blunt...communicating intent to suicide (e.g., text). Prescription Overdose 176 40.00% 42.86% 39.13% 36 19.15% 21.94% 23.05% Used, no overdose 27

Dances With Denial: Have Medical Oncology Outpatients Conveyed Their End-of-Life Wishes and Do They Want To?

PubMed

Waller, Amy; Douglas, Charles; Sanson-Fisher, Rob; Zdenkowski, Nicholas; Pearce, Angela; Evans, Tiffany; Walsh, Justin

2018-05-01

Objectives: This study surveyed a sample of medical oncology outpatients to determine (1) the proportion who have already discussed and documented their end-of-life (EOL) wishes; (2) when and with whom they would prefer to convey their EOL wishes; (3) the EOL issues they would want to discuss; and (4) the association between perceived cancer status and advance care planning (ACP) participation. Methods: Adult medical oncology outpatients were approached in the waiting room of an Australian tertiary treatment center. Consenting participants completed a pen-and-paper survey assessing participation in ACP, preferences for conveying EOL wishes, timing of EOL discussions, and EOL issues they want to be asked about. Results: A total of 203 patients returned the survey (47% of eligible). EOL discussions occurred more frequently with support persons (47%) than with doctors (7%). Only 14% had recorded their wishes, and 45% had appointed an enduring guardian. Those who perceived their cancer as incurable were more likely to have participated in ACP. If facing EOL, patients indicated that they would want family involved in discussions (85%), to be able to write down EOL wishes (82%), and to appoint enduring guardians (91%). Many (45%) preferred the first discussion to happen when their disease became incurable. Slightly less than one-third thought discussions regarding EOL should be patient-initiated. Most agreed doctors should ask about preferred decision-making involvement (92%), how important it is that pain is managed well (95%), and how important it is to remain conscious (82%). Fewer (55%) wanted to be asked about the importance of care extending life. Conclusions: Many patients would like to have discussions regarding EOL care with their doctor and involve their support persons in this process. Only a small percentage of respondents had discussed EOL care with their doctors, recorded their wishes, or appointed an enduring guardian. The first step requires clinicians to ask whether an individual patient wishes to discuss EOL issues, in what format, and at what level of detail. Copyright © 2018 by the National Comprehensive Cancer Network.

The Inwood Astronomy Project: 100 Nights in Manhattan---An Outreach Initiative to Underserved Communities

NASA Astrophysics Data System (ADS)

Kendall, J. S.

2008-11-01

Observing the night sky in New York City is a challenge. However, there is a popular, and even club-going, interest in science in New York City. On the edges of that interest, most people that live in New York City have never had the opportunity to look through a telescope, particularly in underserved areas such as Northern Manhattan. The presenter discusses plans for frequent observing sessions utilizing the parks in New York City combined with public classes at the New York Public Library. Both observing sessions and classes will be held in the ethnically, racially and economically diverse Bronx and Manhattan neighborhoods of Washington Heights, Marble Hill and Inwood. Integration with area middle, elementary and high schools is also discussed. Particular issues surrounding publicity and the need for showmanship in an image-driven community with numerous entertainment opportunities are also discussed.

Educational Technology Research Journals: "International Journal of Computer-Supported Collaborative Learning," 2006-2014

ERIC Educational Resources Information Center

Howland, Shiloh M. J.; Martin, M. Troy; Bodily, Robert; Faulconer, Christian; West, Richard E.

2015-01-01

The authors analyzed all research articles from the first issue of the "International Journal of Computer-Supported Collaborative Learning" in 2006 until the second issue of 2014. They determined the research methodologies, most frequently used author-supplied keywords as well as two- and three-word phrases, and most frequently published…

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

PubMed

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

2014-09-01

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

Unfinished Business in Bereavement

PubMed Central

Klingspon, Kara L.; Holland, Jason M.; Neimeyer, Robert A.; Lichtenthal, Wendy G.

2016-01-01

Unfinished business (incomplete, unexpressed or unresolved relationship issues with the deceased) is frequently discussed as a risk factor for chronic and severe grief reactions. However, few empirical studies have examined this construct. The present study aimed to address this gap in the literature by examining the presence and severity of unfinished business as well as common themes of unfinished business reported in open-ended qualitative narratives among a sample of 224 bereaved individuals. In bivariate analyses, self-reported presence of unfinished business and the severity of distress due to unfinished business were both found to be associated with poorer bereavement outcomes. However, after controlling for potential confounds, distress related to unresolved issues with the deceased emerged as a more robust correlate of these outcomes. Qualitative responses were categorized, and the type of reported unfinished business was not significantly related to the degree of unfinished business distress or other bereavement outcomes. These findings provide preliminary justification for bereavement interventions that aim to ameliorate distress related to unresolved relational issues with the deceased. PMID:26057117

Unfinished Business in Bereavement.

PubMed

Klingspon, Kara L; Holland, Jason M; Neimeyer, Robert A; Lichtenthal, Wendy G

2015-01-01

Unfinished business (incomplete, unexpressed or unresolved relationship issues with the deceased) is frequently discussed as a risk factor for chronic and severe grief reactions. However, few empirical studies have examined this construct. The present study aimed to address this gap in the literature by examining the presence and severity of unfinished business as well as common themes of unfinished business reported in open-ended qualitative narratives among a sample of 224 bereaved individuals. In bivariate analyses, self-reported presence of unfinished business and the severity of distress due to unfinished business were both found to be associated with poorer bereavement outcomes. However, after controlling for potential confounds, distress related to unresolved issues with the deceased emerged as a more robust correlate of these outcomes. Qualitative responses were categorized, and the type of reported unfinished business was not significantly related to the degree of unfinished business distress or other bereavement outcomes. These findings provide preliminary justification for bereavement interventions that aim to ameliorate distress related to unresolved relational issues with the deceased.

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children.

PubMed

Penagini, Francesca; Mameli, Chiara; Fabiano, Valentina; Brunetti, Domenica; Dilillo, Dario; Zuccotti, Gian Vincenzo

2015-11-13

Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children.

Dietary Intakes and Nutritional Issues in Neurologically Impaired Children

PubMed Central

Penagini, Francesca; Mameli, Chiara; Fabiano, Valentina; Brunetti, Domenica; Dilillo, Dario; Zuccotti, Gian Vincenzo

2015-01-01

Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among the nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphagia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with cerebral palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastroesophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of entiepileptic medication altogether concur to determination of nutritional status. With the present review, the current literature is discussed and a practical approach for nutritional assessment in NI children is proposed. Early identification and intervention of nutritional issues of NI children with a multidisciplinary approach is crucial to improve the overall health and quality of life of these complex children. PMID:26580646

Applying a global justice lens to health systems research ethics: an initial exploration.

PubMed

Pratt, Bridget; Hyder, Adnan A

2015-03-01

Recent scholarship has considered what, if anything, rich people owe to poor people to achieve justice in global health and the implications of this for international research. Yet this work has primarily focused on international clinical research. Health systems research is increasingly being performed in low and middle income countries and is essential to reducing global health disparities. This paper provides an initial description of the ethical issues related to priority setting, capacity-building, and the provision of post-study benefits that arise during the conduct of such research. It presents a selection of issues discussed in the health systems research literature and argues that they constitute ethical concerns based on their being inconsistent with a particular theory of global justice (the health capability paradigm). Issues identified include the fact that priority setting for health systems research at the global level is often not driven by national priorities and that capacity-building efforts frequently utilize one-size-fits-all approaches.

Climate Change and Everyday Life: Repertoires children use to negotiate a socio-scientific issue

NASA Astrophysics Data System (ADS)

Byrne, Jenny; Ideland, Malin; Malmberg, Claes; Grace, Marcus

2014-06-01

There are only a few studies about how primary school students engage in socio-scientific discussions. This study aims to add to this field of research by focusing on how 9-10-year-olds in Sweden and England handle climate change as a complex environmental socio-scientific issue (SSI), within the context of their own lives and in relation to society at large. It focuses on how different interpretative repertoires were used by the students in discussions to legitimise or question their everyday lifestyles. They discussed four possible options that a government might consider to help reduce carbon dioxide production. Six main repertoires were identified: Everyday life, Self-Interest, Environment, Science and Technology, Society and Justice. The Everyday life repertoire was used when students related their discussion to their everyday lifestyles. Science and technology-related solutions were offered to maintain or improve things, but these were sometimes rather unrealistic. Arguments related to environment and health frequently appeared to have a superior status compared to the others. Findings also highlighted how conflicts between the students were actually productive by bringing in several perspectives to negotiate the solutions. These primary school students were, therefore, able to discuss and negotiate a complex real-world SSI. Students positioned themselves as active contributors to society, using their life experiences and limited knowledge to understand the problems that affected their everyday lives. Honing these skills within a school science community of practice could facilitate primary students' engagement with SSIs and empower them as citizens.

The Migraine-Ischemic Stroke Relation in Young Adults

PubMed Central

Pezzini, Alessandro; Del Zotto, Elisabetta; Giossi, Alessia; Volonghi, Irene; Costa, Paolo; Dalla Volta, Giorgio; Padovani, Alessandro

2011-01-01

In spite of the strong epidemiologic evidence linking migraine and ischemic stroke in young adults, the mechanisms explaining this association remain poorly understood. The observation that stroke occurs more frequently during the interictal phase of migraine prompts to speculation that an indirect relation between the two diseases might exist. In this regard, four major issues might be considered which may be summarized as follows: (1) the migraine-ischemic stroke relation is influenced by specific risk factors such as patent foramen ovale or endothelial dysfunction and more frequent in particular conditions like spontaneous cervical artery dissection; (2) migraine is associated with an increased prevalence of cardiovascular risk factors; (3) the link is caused by migraine-specific drugs; (4) migraine and ischemic vascular events are linked via a genetic component. In the present paper, we will review epidemiological studies, discuss potential mechanisms of migraine-induced stroke and comorbid ischemic stroke, and pose new research questions. PMID:21197470

Implementation of a low-cost Interim 21CFR11 compliance solution for laboratory environments.

PubMed

Greene, Jack E

2003-01-01

In the recent past, compliance with 21CFR11 has become a major buzzword within the pharmaceutical and biotechnology industries. While commercial solutions exist, implementation and validation are expensive and cumbersome. Frequent implementation of new features via point releases further complicates purchasing decisions by making it difficult to weigh the risk of non-compliance against the costs of too frequent upgrades. This presentation discusses a low-cost interim solution to the problem. While this solution does not address 100% of the issues raised by 21CFR11, it does implement and validate: (1) computer system security; (2) backup and restore ability on the electronic records store; and (3) an automated audit trail mechanism that captures the date, time and user identification whenever electronic records are created, modified or deleted. When coupled with enhanced procedural controls, this solution provides an acceptable level of compliance at extremely low cost.

End-of-life care in COPD: a survey carried out with Portuguese pulmonologists.

PubMed

Gaspar, C; Alfarroba, S; Telo, L; Gomes, C; Bárbara, C

2014-01-01

End-of-life (EoL) care is a major component in the management of patients with advanced COPD. Patient-physician communication is essential in this process. To evaluate the practice of Portuguese Pulmonologists in EoL communication and palliative care in COPD. An on-line survey was sent to physicians affiliated to the Portuguese Pneumology Society. We obtained 136 answers from 464 eligible participants (29.3%). About half of the physicians reported that they have rarely introduced EoL discussions with their COPD patients (48.5%). Most had never/rarely suggested decision-making on the use of invasive mechanical ventilation (68.4%). Discussions were described as occurring mostly during/after a major exacerbation (53.7%). Only 37.5% of participants reported treating dyspnoea with opioids frequently/always. Only 9.6% stated that they never/rarely treated anxiety/depression. Most participants perceive the discussion of EoL issues as being difficult/very difficult (89.0%). The reasons most frequently given were feeling that patients were not prepared for this discussion (70.0%), fear of taking away a patient's hope (58.0%) and lack of training (51.0%). Patient and medical staff EoL communication in COPD is still not good enough. Training in this area and the creation of formal protocols to initiate EoL have been identified as major factors for improvement. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

Information sources, awareness and preventive health behaviors in a population at risk of Arsenic exposure: The role of gender and social networks

PubMed Central

Távora, Renata; Nakano, Eduardo Yoshio; Castilhos, Zuleica Carmen

2017-01-01

The population of Paracatu is at risk of Arsenic (As) exposure associated with long-term exploration of the largest open pit gold mine in Brazil. As part of the interdisciplinary research “The Paracatu project: Arsenic environmental contamination and human health risks assessment in Paracatu-MG”, carried out between 2011 and 2013, we used data disaggregated by gender to identify the sources of As-related information being accessed by inhabitants of Paracatu and to examine if access to these sources was correlated to awareness of As health effects and adoption of behaviors to reduce risk of As exposure. Semi-structured, face-to-face interviews were carried out with 460 participants (294 women and 166 men) to collect data on respondent’s socio-demographic characteristics, use of mass media and social communication networks as sources of information on As issues, the trustworthiness of these information sources, awareness of As health effects, and adoption of behaviors to reduce As exposure. For both men and women, interpersonal communication was used and trusted more frequently than mass media to obtain information on As. Discussion of As issues occurred preferentially among individuals of the same gender and was associated with awareness of As health risks. There are marked differences in variables correlated with the adoption of behaviors to reduce the risk of As exposure between men and women. Discussing As issues with women was associated with adoption of risk-reduction practices for both genders. In contrast, men who discuss As issues with other men were less likely to adopt As exposure prevention behaviors. Finally, adoption was associated with awareness of As health effects for women, but this was not the case for men. Policy implications for decision makers, practitioners and researchers are discussed, based on concrete examples of how gender-specific approaches can effectively guide the formulation and implementation of health promotion campaigns and programs. PMID:29016663

Dare we speak of ethics? Attending to the unsayable amongst nurse leaders.

PubMed

Schick Makaroff, Kara; Storch, Janet; Newton, Lorelei; Fulton, Tom; Stevenson, Lynne

2010-09-01

There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. In this article we use an example of a participatory action research study of ethical practice in nursing to highlight some of the issues that are not frequently discussed and we identify the impact of things not-named. Further, we offer our insights to others who wish to be partners in research between academic and practice settings. These findings have wide implications for ameliorating misunderstandings that may develop between nurse leaders in light of collaborative research, as well as for participatory action research.

Social media for diabetes health education - inclusive or exclusive?

PubMed

Pal, B Rani

2014-01-01

Technological innovations are rising rapidly and are inevitably becoming part of the health care environment. Patients frequently access Social media as a forum for discussion of personal health issues; and healthcare providers are now considering ways of harnessing social media as a source of learning and teaching. This review highlights some of the complex issues of using social media as an opportunity for interaction between public- patient-healthcare staff; considers the impact of self- education and self-management for patients with diabetes, and explores some recent advances in delivering education for staff. When using any information technology, the emphasis should rely on being assessed rigorously to show it promotes health education safely, can be recognized as delivering up-to- date health information effectively, and should ensure there is no bias in selective communication, or disadvantage to isolated patient groups.

Designing a grounded theory study: some practicalities.

PubMed

McCallin, Antoinette M

2003-01-01

Grounded theory is an interpretative research methodology frequently used by social science researchers seeking to discover the underlying social processes shaping interaction. The methodology is useful to create knowledge about the behavioural patterns of a group. The aim of this paper was to discuss some practical issues that the prospective grounded theory researcher planning a small-scale project may consider. Discussion focuses on the basic premises, choosing a version of grounded theory, the research problem, the purpose of study, the research question and the place of the literature in a study. The specific skills required of the grounded theory researcher are considered and some cautions are exercised. The paper may assist student researchers in a critical care setting and may be of interest to their supervisors and experienced. grounded theory researchers.

Using public relations to promote health: a framing analysis of public relations strategies among health associations.

PubMed

Park, Hyojung; Reber, Bryan H

2010-01-01

This study explored health organizations' public relations efforts to frame health issues through their press releases. Content analysis of 316 press releases from three health organizations-the American Heart Association, the American Cancer Society, and the American Diabetes Association-revealed that they used the medical research frame most frequently and emphasized societal responsibility for health issues. There were differences, however, among the organizations regarding the main frames and health issues: the American Diabetes Association was more likely to focus on the issues related to social support and education, while the American Heart Association and the American Cancer Society were more likely to address medical research and scientific news. To demonstrate their initiatives for public health, all the organizations employed the social support/educational frame most frequently. Researchers and medical doctors frequently were quoted as trusted sources in the releases.

[Application of password manager software in health care].

PubMed

Ködmön, József

2016-12-01

When using multiple IT systems, handling of passwords in a secure manner means a potential source of problem. The most frequent issues are choosing the appropriate length and complexity, and then remembering the strong passwords. Password manager software provides a good solution for this problem, while greatly increasing the security of sensitive medical data. This article introduces a password manager software and provides basic information of the application. It also discusses how to select a really secure password manager software and suggests a practical application to efficient, safe and comfortable use for health care. Orv. Hetil., 2016, 157(52), 2066-2073.

[Ehlers Danlos type IV syndrome presenting with simultaneous dissection of both internal carotid and both vertebral arteries].

PubMed

Mondon, K; de Toffol, B; Georgesco, G; Cassarini, J-F; Machet, M-C; Cottier, J-P; Arbeille, B; Autret, A

2004-04-01

Dissection of cervical arteries is a frequent cause of stroke in young subjects. We report the case of a 34-year-old patient who experienced simultaneous dissection of both internal carotid arteries and both vertebral arteries leading to repeated motor deficit of the right half-body associated with persistent otalgia. Search for an etiology led to the diagnosis of Ehlers-Danlos syndrome type IV. Search for the cause of cervical artery dissection must consider connective tIssue disease, particularly vascular forms of Ehler-Danlos syndrome. Diagnostic, therapeutic as well as prognostic aspects are discussed.

Sexual orientation and differences in mental health, stress, and academic performance in a national sample of U.S. college students.

PubMed

Oswalt, Sara B; Wyatt, Tammy J

2011-01-01

This study examined the relationships of mental health issues and sexual orientation in a national sample of college students. Using the Fall 2009 American College Health Association-National College Health Assessment, responses from heterosexual, gay, lesbian, bisexual, and unsure students (N = 27,454) relating to mental health issues and impact of these issues on academics were examined. The findings indicate that gay, lesbian, bisexual, and unsure students consistently reported higher levels of mental health issues and a more frequent impact on academics because of these issues than heterosexual students. Bisexuals frequently reported higher levels than students identifying as gay, lesbian, and unsure.

Modelling Farm Animal Welfare

PubMed Central

Collins, Lisa M.; Part, Chérie E.

2013-01-01

Simple Summary In this review paper we discuss the different modeling techniques that have been used in animal welfare research to date. We look at what questions they have been used to answer, the advantages and pitfalls of the methods, and how future research can best use these approaches to answer some of the most important upcoming questions in farm animal welfare. Abstract The use of models in the life sciences has greatly expanded in scope and advanced in technique in recent decades. However, the range, type and complexity of models used in farm animal welfare is comparatively poor, despite the great scope for use of modeling in this field of research. In this paper, we review the different modeling approaches used in farm animal welfare science to date, discussing the types of questions they have been used to answer, the merits and problems associated with the method, and possible future applications of each technique. We find that the most frequently published types of model used in farm animal welfare are conceptual and assessment models; two types of model that are frequently (though not exclusively) based on expert opinion. Simulation, optimization, scenario, and systems modeling approaches are rarer in animal welfare, despite being commonly used in other related fields. Finally, common issues such as a lack of quantitative data to parameterize models, and model selection and validation are discussed throughout the review, with possible solutions and alternative approaches suggested. PMID:26487411

Drugs in the Brazilian print media: an exploratory survey of newspaper and magazine stories in the year 2000.

PubMed

Noto, Ana Regina; Pinsky, Ilana; Mastroianni, Fábio de Carvalho

2006-01-01

Print media is one of the key factors for defining public opinion and setting public policies regarding drugs. Therefore, surveying its content should provide us with a better understanding of the situation. The few existing surveys on this issue in Brazil point out discrepancies between print media and public health. The objective of the present survey is to enhance the analysis of drug-related stories in the Brazilian print media, based on a new time frame, in the year 2000. Major newspapers and magazines of all Brazilian state capitals have been surveyed throughout year 2000, with 4,669 stories presenting drugs as their main topic. A random sample of 964 stories underwent content analysis. Approximately half the stories (49.6%) dealt with smuggling- and repression-related issues. The remainder of the stories (50.4%) approached health, legislation, and public policy issues. Tobacco was the most widely discussed drug, with stories focusing mainly on damage caused by use and on measures for reducing consumption rates among the population. Articles about cocaine, also featured frequently in the print media, dealt mainly with the issues of drug dealing and of damage caused by cocaine use. Regarding marijuana, in addition to the law enforcement repressive approach, some articles dealt with decriminalization and therapeutic use. Articles about alcoholic beverages, featured less frequently in the print media, approached the subject matter from various angles. The number of stories on solvents and psychotropic medication was negligible. The results confirm discrepancies between print media coverage and epidemiology. They also indicate that each drug is approached differently, allowing for a better understanding of the "social climate" in Brazil regarding each drug. Of all possible social interventions for dealing with the issue repression stands out, whereas stories about treatment and damage reduction are relatively scarce. These findings suggest the need for improved communication between journalists and health professionals.

“We make choices we think are going to save us”: Debate and stance identification for online breast cancer CAM discussions

PubMed Central

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-01-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients’ conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients’ stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members’ stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients’ opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work. PMID:28967000

"We make choices we think are going to save us": Debate and stance identification for online breast cancer CAM discussions.

PubMed

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-04-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients' conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients' stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members' stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients' opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work.

World Health Assembly agendas and trends of international health issues for the last 43 years: analysis of World Health Assembly agendas between 1970 and 2012.

PubMed

Kitamura, Tomomi; Obara, Hiromi; Takashima, Yoshihiro; Takahashi, Kenzo; Inaoka, Kimiko; Nagai, Mari; Endo, Hiroyoshi; Jimba, Masamine; Sugiura, Yasuo

2013-05-01

To analyse the trends and characteristics of international health issues through agenda items of the World Health Assembly (WHA) from 1970 to 2012. Agendas in Committees A/B of the WHA were classified as Administrative or Technical and Health Matters. Agenda items of Health Matters were sorted into five categories by the WHO reform in the 65th WHA. The agenda items in each category and sub-category were counted. There were 1647 agenda items including 423 Health Matters, which were sorted into five categories: communicable diseases (107, 25.3%), health systems (81, 19.1%), noncommunicable diseases (59, 13.9%), preparedness surveillance and response (58, 13.7%), and health through the life course (36, 8.5%). Among the sub-categories, HIV/AIDS, noncommunicable diseases in general, health for all, millennium development goals, influenza, and international health regulations, were discussed frequently and appeared associated with the public health milestones, but maternal and child health were discussed three times. The number of the agenda items differed for each Director-General's term of office. The WHA agendas cover a variety of items, but not always reflect international health issues in terms of disease burden. The Member States of WHO should take their responsive roles in proposing more balanced agenda items. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Cybersex: the impact of a contemporary problem on the practices of marriage and family therapists.

PubMed

Goldberg, Peter D; Peterson, Brennan D; Rosen, Karen H; Sara, Mary Linda

2008-10-01

The number of people accessing the Internet for sexual purposes (cybersex) has increased dramatically over the last 10 years. However, little research has been conducted to determine how frequently clients present for treatment with cybersex-related issues. One hundred sixty-four clinical members of the American Association for Marriage and Family Therapy participated in the current study, which was conducted to identify the impacts of cybersex on MFTs' practices. Most respondents report seeing clients with cybersex-related issues, with client numbers increasing over the past 2 years. Although most respondents felt prepared to diagnose and treat adults with cybersex problems, half felt unprepared to diagnose and treat children. Lastly, most respondents reported that their required college courses were not helpful in preparing them to diagnose and treat cybersex-related problems. The implications of study findings are discussed.

Emerging legal concerns with chronic diseases in the Australian workplace: pre-employment medicals, functional capacity evaluations, workers' compensation and disability discrimination.

PubMed

Guthrie, Robert; Westaway, Jennifer

2009-05-01

Although considerable attention is paid to injury and disease sustained or contracted through work causes, by far the most prolific cause of diminished health in the Australian workplace is chronic illness, which is not caused by work but which may have significant effects upon the work environment. Employers' concerns in relation to loss of productivity through poor health are reflected in a number of practices such as pre-employment screening, on-the-job drug testing and other health and safety requirements. In turn, workers' concerns regarding discrimination, workers' compensation and privacy are frequently raised in relation to discussions on workplace fitness for work. This article reflects on the issues of chronic illness and the legal issues which arise through the interaction of employers' obligations for safety and efficiency and workers' concerns with fairness and privacy.

The informal curriculum - general practitioner perceptions of ethics in clinical practice.

PubMed

Sturman, Nancy J; Parker, Malcolm; van Driel, Mieke L

2012-12-01

Australian medical students should graduate with an understanding of the principles of medical law and ethics, and their application to clinical settings. Although student perspectives have been studied previously, the teacher experience of ethical issues also needs to be understood, particularly in the general practice setting. Interviews were conducted with a convenience sample of 13 general practitioner teachers. They were asked to reflect on common and/or important ethical issues in their day-to-day practice. An inductive thematic analysis of the data was performed by two investigators, who reached a consensus on major themes using an iterative, dialogic process. Participants reported negotiating ethical issues frequently. Major themes included patient-doctor relationships, professional differences, truth-telling, ethically 'grey' areas and the personal demands of ethical decision making. General practitioners in this study describe sometimes needing to apply judgement and compromise in situations involving legal or ethical issues, in order to act in the best interests of patients and to successfully negotiate the patient-doctor relationship. Students learning in this clinical context may perceive mixed messages and ethical lapses in these challenging 'grey' areas. The ethical acumen and emotional resilience of both students and clinical teachers may be enhanced by ongoing reflective discussion with colleagues.

Reassuring or risky: the presentation of seafood safety in the aftermath of the British Petroleum Deepwater Horizon Oil Spill.

PubMed

Greiner, Amelia L; Lagasse, Lisa P; Neff, Roni A; Love, David C; Chase, Rachel; Sokol, Natasha; Smith, Katherine Clegg

2013-07-01

The BP Deepwater Horizon Oil Spill was enormously newsworthy; coverage interlaced discussions of health, economic, and environmental impacts and risks. We analyzed 315 news articles that considered Gulf seafood safety from the year following the spill. We explored reporting trends, risk presentation, message source, stakeholder perspectives on safety, and framing of safety messages. Approximately one third of articles presented risk associated with seafood consumption as a standalone issue, rather than in conjunction with environmental or economic risks. Government sources were most frequent and their messages were largely framed as reassuring as to seafood safety. Discussions of prevention were limited to short-term, secondary prevention approaches. These data demonstrate a need for risk communication in news coverage of food safety that addresses the larger risk context, primary prevention, and structural causes of risk.

Sexual Health Care in Family Medicine

PubMed Central

Cohen, Gerald; Cohen, May

1985-01-01

Although patients frequently present with sexual concerns, family doctors generally do not handle them well. Sexual issues may present in many ways: as specific concerns; as a component of non-sexual complaints or as a factor in relationship or marital problems. The family doctor must include sexual enquiry and counselling as part of overall health care, and in the management of illnesses. In order to be effective counsellors, physicians must examine their own attitudes, and become knowledgeable about sexuality and myths influencing sexual behavior, and skillful at interviewing and sexual history-taking. The family doctor can become adept at giving patients permission to discuss their sexuality, and at providing information and strategies to enhance sensual enjoyment and communication with partners. Small group training sessions incorporating discussion and role-playing effectively teach physicians skills and strategies in sexual counselling. PMID:21274058

Ethical issues in primary health care: a survey of practitioners' perceptions.

PubMed

Robillard, H M; High, D M; Sebastian, J G; Pisaneschi, J I; Perritt, L J; Mahler, D M

1989-01-01

While most health care is provided at the primary care level, little research has been done to document the ethical issues of such care. A stratified random sample of 702 physicians, nurses, physical therapist, and physician assistants within one southeastern state was surveyed to determine the frequency of ethical issues in primary care. The most frequently occurring issue concerned moral decisions about the amount of time to spend with each patient. A comparison of physician and nonphysician professional groups revealed significant differences in frequencies of the issues. Age had a slight impact on the responses, while gender, religion, and region of practice had none. The study showed that the most frequently occurring issues are pragmatic, not dramatic, and center on patient self-determination, adequacy of care and professional responsibility, and distribution of resources.

Parent-teen communication about sex in urban Thai families.

PubMed

Rhucharoenpornpanich, Orratai; Chamratrithirong, Aphichat; Fongkaew, Warunee; Miller, Brenda A; Cupp, Pamela K; Rosati, Michael J; Byrnes, Hilary F; Atwood, Katharine A; Chookhare, Warunee

2012-01-01

This study describes sexual communication among Thai parents and their teens and identifies variables related to communication about sex in urban Thai families. Data were derived from 420 families whose teenage children ages 13-14 years were randomly selected using the probability proportional to size technique. Interviews were conducted with 1 parent and 1 teenage child in each family. In-depth interviews were also conducted in 30 parents and teens drawn from the same 420 families. Results showed that parents were most likely to talk with their teens about body changes and dating; however, less discussion about sex-related issues, birth control, and HIV/AIDS occurred. More daughters than sons reported frequent discussions with their parents about sex. Parents who believed their teens had been involved in sexual activity were more likely to talk about HIV/AIDS and the difficulty of teenagers having babies, instead of talking about sexual intercourse or when to start having sex. Multiple regression analysis indicated that gender of the child (female), parental religiosity, and parental perception of teen sexual activity were significant predictors of increased sexual communication in Thai families. The findings suggest a need for approaches designed to facilitate communication skills about sex-related issues among Thai parents.

Parent-Teen Communication about Sex in Urban Thai Families

PubMed Central

Rhucharoenpornpanich, Orratai; Chamratrithirong, Aphichat; Fongkaew, Warunee; Miller, Brenda A.; Cupp, Pamela K.; Roseti, Michael J.; Byrnes, Hilary F.; Atwood, Katharine; Chookhare, Warunee

2012-01-01

This study describes sexual communication among Thai parents and their teens and identifies variables related to communication about sex in urban Thai families. Data were derived from 420 families whose teenage children ages 13 – 14 were randomly selected using the probability proportional to size technique. Interviews were conducted with one parent and one teenage child in each family. In-depth interviews were also conducted in 30 parents and teens drawn from the same 420 families. Results showed that parents were most likely to talk with their teens about body changes and dating; however, less discussion about sex-related issues, birth control and HIV/AIDS occurred. More daughters than sons reported frequent discussions with their parents about sex. Parents who believed their teens had been involved in sexual activity were more likely to talk about HIV/AIDS and the difficulty of teenagers having babies, instead of talking about sexual intercourse or when to start having sex. Multiple regression analysis indicated that sex of the child (girls), parental religiosity and parental perception of teen sexual activity were significant predictors of increased sexual communication in Thai families. The findings suggest a need for approaches designed to facilitate communication skills about sex- related issues among Thai parents. PMID:22206411

Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations.

PubMed

Zada, Gabriel; Cavallo, Luigi M; Esposito, Felice; Fernandez-Jimenez, Julio Cesar; Tasiou, Anastasia; De Angelis, Michelangelo; Cafiero, Tullio; Cappabianca, Paolo; Laws, Edward R

2010-10-01

In addition to difficulties with anesthetic and medical management, transsphenoidal operations in patients with longstanding acromegaly are associated with inherent intraoperative challenges because of anatomical variations that occur frequently in these patients. The object of this study was to review the overall safety profile and anatomical/technical challenges associated with transsphenoidal surgery in patients with acromegaly. The authors performed a retrospective analysis of 169 patients who underwent endoscopic transsphenoidal operations for growth hormone-secreting adenomas to assess the incidence of surgical complications. A review of frequently occurring anatomical challenges and operative strategies employed during each phase of the operation to address these particular issues was performed. Of 169 cases reviewed, there was no perioperative mortality. Internal carotid artery injury occurred in 1 patient (0.6%) with complex sinus anatomy, who remained neurologically intact following endovascular unilateral carotid artery occlusion. Other complications included: significant postoperative epistaxis (5 patients [3%]), transient diabetes insipidus (5 patients [3%]), delayed symptomatic hyponatremia (4 patients [2%]), CSF leak (2 patients [1%]), and pancreatitis (1 patient [0.6%]). Preoperative considerations in patients with acromegaly should include a cardiopulmonary evaluation and planning regarding intubation and other aspects of the anesthetic technique. During the nasal phase of the transsphenoidal operation, primary challenges include maintaining adequate visualization and hemostasis, which is frequently compromised by redundant, edematous nasal mucosa and bony hypertrophy of the septum and the nasal turbinates. During the sphenoid phase, adequate bony removal, optimization of working space, and correlation of imaging studies to intraoperative anatomy are major priorities. The sellar phase is frequently challenged by increased sellar floor thickness, distinct patterns of tumor extension and bony invasion, and anatomical variations in the caliber and course of the internal carotid artery. Specific operative techniques for addressing each of these intraoperative challenges are discussed. Transsphenoidal surgery in patients with longstanding acromegaly frequently poses greater challenges than operations for other types of sellar lesions, yet these challenges may be safely and effectively overcome with the anticipation of specific issues and implementation of various intraoperative techniques.

Symptoms, Diagnosis & Treatment

MedlinePlus

... Bar Home Current Issue Past Issues Cover Story: Leukemia/Lymphoma Symptoms, Diagnosis & Treatment Past Issues / Summer 2008 Table of Contents For an enhanced version of this page please turn Javascript on. Leukemia Symptoms Frequent infections Fever and chills Anemia Easy ...

Fertility preservation counselling in Dutch Oncology Practice: Are nurses ready to assist physicians?

PubMed

Krouwel, E M; Nicolai, M P J; van Steijn-van Tol, A Q M J; Putter, H; Osanto, S; Pelger, R C M; Elzevier, H W

2017-11-01

Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended. © 2016 John Wiley & Sons Ltd.

Malignancy in Children with Trisomy 21

PubMed Central

Rabin, Karen R.; Whitlock, James A.

2009-01-01

Patients with Down syndrome (DS) display a unique spectrum of malignancies, with a 10 to 20-fold increased risk of acute leukemias, and a markedly decreased incidence of solid tumors. This review discusses current understanding of the basis for this distinctive pattern of cancer incidence, and the clinical and biologic features of the malignant disorders most frequent in DS: transient myeloproliferative disease, acute megakaryoblastic leukemia, and acute lymphoblastic leukemia. We also review distinctive pharmacogenetic issues, highlighting the differential chemosensitivity and toxicity profiles of DS patients compared to the general population; and epidemiologic studies of protective and adverse environmental risk factors for development of leukemia. PMID:19176633

E-suicide note: A newer trend and its medico-legal implications in India.

PubMed

Behera, C; Karthik, Krishna; Dogra, Td; Lalwani, S; Millo, T; Singh, Sr

2014-06-01

Rapid advancements of information and communication technology in the form of electronic mails, mobile phones, social networking sites, etc have an increasing impact on people's day to day life. It has been observed that these readily available applications are used frequently to express suicidal intentions. There are many studies on conventional handwritten suicide notes but suicide note in electronic format is an emerging issue and an under-researched phenomena. The authors have termed it as "E-suicide note" and discuss its medico-legal implications in India with examples from their observations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Fundamental Ethical Principles in Sports Medicine.

PubMed

Devitt, Brian M

2016-04-01

In sports medicine, the practice of ethics presents many unique challenges because of the unusual clinical environment of caring for players within the context of a team whose primary goal is to win. Ethical issues frequently arise because a doctor-patient-team triad often replaces the traditional doctor-patient relationship. Conflict may exist when the team's priority clashes with or even replaces the doctor's obligation to player well-being. Customary ethical norms that govern most forms of clinical practice, such as autonomy and confidentiality, are not easily translated to sports medicine. Ethical principles and examples of how they relate to sports medicine are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Promises and challenges of stem cell research for regenerative medicine.

PubMed

Power, Carl; Rasko, John E J

2011-11-15

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

Self-plagiarism in academic publishing: the anatomy of a misnomer.

PubMed

Andreescu, Liviu

2013-09-01

The paper discusses self-plagiarism and associated practices in scholarly publishing. It approaches at some length the conceptual issues raised by the notion of self-plagiarism. It distinguishes among and then examines the main families of arguments against self-plagiarism, as well as the question of possibly legitimate reasons to engage in this practice. It concludes that some of the animus frequently reserved for self-plagiarism may be the result of, among others, poor choice of a label, unwarranted generalizations as to its ill effects based on the specific experience (and goals) of particular disciplines, and widespread but not necessarily beneficial publishing practices.

Opioid Analgesics.

PubMed

Jamison, Robert N; Mao, Jianren

2015-07-01

Chronic pain is an international health issue of immense importance that is influenced by both physical and psychological factors. Opioids are useful in treating chronic pain but have accompanying complications. It is important for clinicians to understand the basics of opioid pharmacology, the benefits and adverse effects of opioids, and related problematic issues of tolerance, dependence, and opioid-induced hyperalgesia. In this article, the role of psychiatric comorbidity and the use of validated assessment tools to identify individuals who are at the greatest risk for opioid misuse are discussed. Additionally, interventional treatment strategies for patients with chronic pain who are at risk for opioid misuse are presented. Specific behavioral interventions designed to improve adherence with prescription opioids among persons treated for chronic pain, such as frequent monitoring, periodic urine screens, opioid therapy agreements, opioid checklists, and motivational counseling, are also reviewed. Use of state-sponsored prescription drug monitoring programs is also encouraged. Areas requiring additional investigation are identified, and the future role of abuse-deterrent opioids and innovative technology in addressing issues of opioid therapy and pain are presented. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Virtue theory and abortion.

PubMed

Hursthouse, Rosalind

1991-01-01

The sort of ethical theory derived from Aristotle, variously described as virtue ethics, virtue-based ethics, or neo-Aristotelianism, is becoming better known, and is now quite widely recognized as at least a possible rival to deontological and utilitarian theories. With recognition has come criticism, of varying quality. In this article I shall discuss nine separate criticisms that I have frequently encountered, most of which seem to me to betray an inadequate grasp either of the structure of virtue theory or of what would be involved in thinking about a real moral issue in its terms. In the first half I aim particularly to secure an understanding that will reveal that many of these criticisms are simply misplaced, and to articulate what I take to be the major criticism of virtue theory. I reject this criticism, but do not claim that it is necessarily misplaced. In the second half I aim to deepen that understanding and highlight the issues raised by the criticisms by illustrating what the theory looks like when it is applied to a particular issue, in this case, abortion.

Design and performance analysis of generalised integrator-based controller for grid connected PV system

NASA Astrophysics Data System (ADS)

Saxena, Hemant; Singh, Alka; Rai, J. N.

2018-07-01

This article discusses the design and control of a single-phase grid-connected photovoltaic (PV) system. A 5-kW PV system is designed and integrated at the DC link of an H-bridge voltage source converter (VSC). The control of the VSC and switching logic is modelled using a generalised integrator (GI). The use of GI or its variants such as second-order GI have recently evolved for synchronisation and are being used as phase locked loop (PLL) circuits for grid integration. Design of PLL circuits and the use of transformations such as Park's and Clarke's are much easier in three-phase systems. But obtaining in-phase and quadrature components becomes an important and challenging issue in single-phase systems. This article addresses this issue and discusses an altogether different application of GI for the design of compensator based on the extraction of in-phase and quadrature components. GI is frequently used as a PLL; however, in this article, it is not used for synchronisation purposes. A new controller has been designed for a single-phase grid-connected PV system working as a single-phase active compensator. Extensive simulation results are shown for the working of integrated PV system under different atmospheric and operating conditions during daytime as well as night conditions. Experimental results showing the proposed control approach are presented and discussed for the hardware set-up developed in the laboratory.

The experiences of frequent users of crisis helplines: A qualitative interview study.

PubMed

Middleton, Aves; Gunn, Jane; Bassilios, Bridget; Pirkis, Jane

2016-11-01

To understand why some users call crisis helplines frequently. Nineteen semi-structured telephone interviews were conducted with callers to Lifeline Australia who reported calling 20 times or more in the past month and provided informed consent. Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis was used to generate common themes. Approval was granted by The University of Melbourne Human Research Ethics Committee. Three overarching themes emerged from the data and included reasons for calling, service response and calling behaviours. Respondents called seeking someone to talk to, help with their mental health issues and assistance with negative life events. When they called, they found short-term benefits in the unrestricted support offered by the helpline. Over time they called about similar issues and described reactive, support-seeking and dependent calling behaviours. Frequent users of crisis helplines call about ongoing issues. They have developed distinctive calling behaviours which appear to occur through an interaction between their reasons for calling and the response they receive from the helpline. The ongoing nature of the issues prompting frequent users to call suggests that a service model that includes a continuity of care component may be more efficient in meeting their needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Navigating sticky areas in transdermal product development.

PubMed

Strasinger, Caroline; Raney, Sam G; Tran, Doanh C; Ghosh, Priyanka; Newman, Bryan; Bashaw, Edward D; Ghosh, Tapash; Shukla, Chinmay G

2016-07-10

The benefits of transdermal delivery over the oral route to combat such issues of low bioavailability and limited controlled release opportunities are well known and have been previously discussed by many in the field (Prausnitz et al. (2004) [1]; Hadgraft and Lane (2006) [2]). However, significant challenges faced by developers as a product moves from the purely theoretical to commercial production have hampered full capitalization of the dosage forms vast benefits. While different technical aspects of transdermal system development have been discussed at various industry meetings and scientific workshops, uncertainties have persisted regarding the pharmaceutical industry's conventionally accepted approach for the development and manufacturing of transdermal systems. This review provides an overview of the challenges frequently faced and the industry's best practices for assuring the quality and performance of transdermal delivery systems and topical patches (collectively, TDS). The topics discussed are broadly divided into the evaluation of product quality and the evaluation of product performance; with the overall goal of the discussion to improve, advance and accelerate commercial development in the area of this complex controlled release dosage form. Published by Elsevier B.V.

Building skills of recovering women drug users to reduce heterosexual AIDS transmission.

PubMed Central

Schilling, R F; el-Bassel, N; Schinke, S P; Gordon, K; Nichols, S

1991-01-01

Although most women infected with HIV are intravenous drug users, some contact the virus through sexual contact with IV drug users. To reach at-risk women, public health officials must develop a range of prevention strategies. One approach, skills training, holds promise as a means of altering risk-related sexual behavior. In this study, 91 women methadone patients were pretested and randomly assigned to an information-only control control group or a skills-building intervention group. Skills-building intervention consisted of five sessions of small groups in which participants identified their own high risk sexual behaviors, discussed their negative associations with condoms, and practiced skills which involved asking partners to use condoms. Compared with members of the control group, respondents in the intervention group reported that they initiated discussion of sexual issues with their partners more frequently, felt more comfortable talking with them about safer sex, and reported using and carrying condoms more frequently. The high rates of attendance and program retention by skills-building participants suggest that such groups may be supportive and useful in the design of risk reduction and drug abuse treatment programs. The modest outcomes of this study underscore the difficulty of altering risk behavior but also serve as a basis for future AIDS prevention studies. PMID:1905051

Towards the development of day one competences in veterinary behaviour medicine: survey of veterinary professionals experience in companion animal practice in Ireland.

PubMed

Golden, Olwen; Hanlon, Alison J

2018-01-01

Veterinary behaviour medicine should be a foundation subject of the veterinary curriculum because of its wide scope of applications to veterinary practice. Private practitioners are likely to be the primary source of information on animal behaviour for most pet owners, however studies indicate that behavioural issues are not frequently discussed during companion animal consultations and many practitioners lack confidence in dealing with behavioural problems, likely due to poor coverage of this subject in veterinary education.There is a need to identify learning outcomes to support day one competences in veterinary behaviour medicine and these should be informed by practice-based evidence. This study aimed to investigate the nature and frequency of behavioural queries experienced by veterinary professionals in Ireland, the provision of behavioural services at companion animal practices, behaviour referral practices and challenges associated with providing a behaviour service. Two online surveys were developed, one for private veterinary practitioners (PVP) and one for veterinary nurses (VN). Invitations to participate were distributed using contact details from the Premises Accreditation Scheme database on the Veterinary Council of Ireland website. Thirty-eight PVPs and 69 VNs completed the survey. Results indicated that less than half of companion animal practices offer behavioural consults and under a third of practices provide training and socialization events. Over half of the practices surveyed have referred cases to a behavioural specialist.The majority of respondents encountered behavioural queries weekly. Ninety-eight percent reported receiving queries regarding dog behaviour. Toilet training and unruly behaviour were two issues encountered frequently. Behavioural issues in cats were also common. House soiling and destructive behaviour were the problems most frequently encountered by respondents.The two most commonly cited barriers to providing behavioural consultations were lack of in-house or personal expertise, and that clients were not willing to pay for these services.Furthermore over half of all veterinary professionals surveyed indicated that they had received inadequate undergraduate training in veterinary behaviour medicine. Behavioural problems in companion animals can affect the quality of life of pets and their owners. Our survey findings indicate that many veterinary professionals frequently encounter behavioural problems and identify an opportunity for improved provision in behaviour medicine in veterinary education.

Past, present and future challenges in health care priority setting.

PubMed

Hall, William; Williams, Iestyn; Smith, Neale; Gold, Marthe; Coast, Joanna; Kapiriri, Lydia; Danis, M; Mitton, Craig

2018-05-21

Purpose Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a "magic bullet" is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues. Design/methodology/approach An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015. Findings "Decision-making frameworks" and "Engagement" were the two most frequently mentioned notable achievements. "Priority setting in practice" and "Awareness and education" were the two most frequently mentioned policy and practical challenges. "Priority setting in practice" and "Engagement" were the two most frequently mentioned areas in need of future research. Research limitations/implications Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly. Practical implications Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area. Originality/value Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges.

Drug use and sexual risk among gay and bisexual men who frequent party venues.

PubMed

Theodore, Peter S; Durán, Ron E; Antoni, Michael H

2014-11-01

Research connecting club drug use to risky sex among gay/bisexual men (GBM) contains methodological issues that have limited knowledge about the relative risks of distinct drugs. This paper reports drug use and sexual behavior data from 197 GBM who frequented at least one party venue within 3 months of participating. Alarming rates of drug use and unprotected anal intercourse (UAI) with casual sex-partners were reported in connection with time spent at a bar, club or circuit party. Structural equation modeling revealed that use of methamphetamine, gammahydroxybutrate (GHB), and/or ketamine (K), but not use of ecstasy, at a party venue helped explain likelihood of UAI with a casual sex-partner while under the influence of a drug during/following time partying (β = 0.41, p < .01). Findings suggest use of methamphetamine, GHB and/or K at party venues increases risk for subsequent UAI with casual sex-partners. Study implications, limitations, and recommendations for future research are discussed.

Barriers to and Facilitators of Antiretroviral Therapy Adherence in Nepal: A Qualitative Study

PubMed Central

Simkhada, Padam; Randall, Julian; Freeman, Jennifer V; van Teijlingen, Edwin

2012-01-01

Patient's adherence is crucial to get the best out of antiretroviral therapy (ART). This study explores in-depth the barriers to and facilitators of ART adherence among Nepalese patients and service providers prescribing ART. Face-to-face semi-structured interviews were conducted with 34 participants. Interviews were audio-taped, transcribed, and translated into English before being analyzed thematically. ART-prescribed patients described a range of barriers for failing to adhere to ART. Financial difficulties, access to healthcare services, frequent transport blockades, religious/ritual obstacles, stigma and discrimination, and side-effects were the most-frequently discussed barriers whereas trustworthy health workers, perceived health benefits, and family support were the most-reported facilitators. Understanding barriers and facilitators can help in the design of an appropriate and targeted intervention. Healthcare providers should address some of the practical and cultural issues around ART whilst policy-makers should develop appropriate social policy to promote adherence among ART-prescribed patients. PMID:23304907

[The medical social aspects of ambulatory medical care to victims of road traffic accidents].

PubMed

Gorbunkov, V Ia; Bugaev, D A; Derevianko, D V

2012-01-01

The article discusses the issues of the organization of medical care to victims of road traffic accidents. The analysis of primary appealability of patients to the first-aid center of Stavropol and Novorossiysk during 2008-2010 is presented. The sampling consisted of 904 cases of this kind of trauma. It is established that among victims of road traffic accident appealed to first-aid centers the pedestrians consist the major part. The traumas of limbs are among the most frequently occurred cases. The victims with cranio-cerebral injuries are among those who appealed most frequently for medical aid. Besides that in most cases (63.4%) the victims with cranio-cerebral injuries were transported not to the neurologic surgery clinic but to the first-aid center This action increased the number of transport stages and duration of time gap before specialized medical care was applied. The conclusion is made concerning the need of further development of out-patient urgent medical care to victims of road traffic accidents.

Mature aggressive B-cell lymphoma across age groups - molecular advances and therapeutic implications.

PubMed

Lange, Jonas; Lenz, Georg; Burkhardt, Birgit

2017-02-01

Mature B-cell lymphoma represents the most common type of Non-Hodgkin lymphoma, and different subtypes prevail at different patient ages. Areas covered: We review recent data on differences and commonalities in mature B-cell lymphoma occurring in adult and pediatric patients, with a special emphasis on molecular advances and therapeutic implications. To this end, we will discuss knowledge on diffuse large B-cell lymphoma and Burkitt lymphoma/leukemia, which are the most frequent subtypes in adult and pediatric patients, respectively, and on primary mediastinal B-cell lymphoma, which is a subtype of mature B-cell lymphoma occurring mainly in adolescents and young adults with a female predominance. Expert commentary: Molecular profiling has revealed molecular alterations that can be used to further classify the subtypes of mature B-cell lymphoma. These new subgroups frequently respond differentially to targeted therapeutic strategies. Future clinical trials utilizing new drugs will address this issue by combining clinical data and response assessment with a molecular workup of the corresponding lymphomas.

Quality-of-Life Priorities in Patients with Thyroid Cancer: A Multinational European Organisation for Research and Treatment of Cancer Phase I Study.

PubMed

Singer, Susanne; Husson, Olga; Tomaszewska, Iwona M; Locati, Laura D; Kiyota, Naomi; Scheidemann-Wesp, Ulrike; Hofmeister, Dirk; Winterbotham, Melanie; Brannan, Christine; Araújo, Cláudia; Gamper, Eva M; Kulis, Dagmara; Rimmele, Harald; Andry, Guy; Licitra, Lisa

2016-11-01

The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally, and to identify those with highest relevance to them in addition to the more general issues covered by the core European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30, which is widely used in research and in care and addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues that they would include in a thyroid cancer-specific QoL module. The literature search and expert discussion provided a list of 71 QoL issues that was rated by thyroid cancer patients (n = 110) from seven countries. All issues were of high priority to at least some of the patients. The most frequently selected issues were sudden attacks of tiredness, exhaustion, quality of sleep, employment, social support, fear of cancer progression, fear of second operation, difficulties swallowing, and globus sensation. Thyroid cancer patients cross-culturally rate fatigue-related issues as highly important for their QoL, calling for increased efforts to find successful treatments for this problem. Vocational rehabilitation is also highly relevant for them and should therefore be an important aim of multidisciplinary care. The third important area of concern is psychological issues, especially fear of progression and of additional treatments.

A quantitative content analysis of UK newsprint coverage of proposed legislation to prohibit smoking in private vehicles carrying children.

PubMed

Patterson, Chris; Semple, Sean; Wood, Karen; Duffy, Sheila; Hilton, Shona

2015-08-08

Mass media representations of health issues influence public perceptions of those issues. Despite legislation prohibiting smoking in public spaces, second-hand smoke (SHS) remains a health risk in the United Kingdom (UK). Further legislation might further limit children's exposure to SHS by prohibiting smoking in private vehicles carrying children. This research was designed to determine how UK national newspapers represented the debate around proposed legislation to prohibit smoking in private vehicles carrying children. Quantitative analysis of the manifest content of 422 articles about children and SHS published in UK and Scottish newspapers between 1st January 2003 and 16th February 2014. Researchers developed a coding frame incorporating emergent themes from the data. Each article was double-coded. The frequency of relevant articles rose and fell in line with policy debate events. Children were frequently characterised as victims of SHS, and SHS was associated with various health risks. Articles discussing legislation targeting SHS in private vehicles carrying children presented supportive arguments significantly more frequently than unsupportive arguments. The relatively positive representation of legislation prohibiting smoking in vehicles carrying children is favourable to policy advocates, and potentially indicative of likely public acceptance of legislation. Our findings support two lessons that public health advocates may consider: the utility of presenting children as a vulnerable target population, and the possibility of late surges in critical arguments preceding policy events.

Learning through loss: implementing lossography narratives in death education.

PubMed

Bolkan, Cory; Srinivasan, Erica; Dewar, Alexis R; Schubel, Stacey

2015-01-01

Students may have a greater willingness to discuss issues of death and loss through written assignments; however, there is little guidance for instructors regarding how to manage these sensitive assignments, nor how students benefit from them. The authors implemented and evaluated a "lossography" assignment in an undergraduate thanatology course in which students wrote about their losses and anonymously shared these narratives with their classmates. Although many themes of loss emerged, the most frequently reported significant loss was death of a grandparent. Additionally, most significant losses occurred in childhood/adolescence. Prominent themes related to student learning included gaining self-awareness, knowledge about grief responses, and compassion for others. Students (N = 64) also completed a survey reflecting on their course learning. Of all aspects of course delivery, 44% identified the lossography as the most beneficial, whereas 97% recommended this assignment for future students. The implications of the assignment for death education are also discussed.

Lack of Penetration in Friction Stir Welds: Effects on Mechanical Properties and NDE Feasibility

NASA Technical Reports Server (NTRS)

Kinchen, David G.; Adams, Glynn P.

2000-01-01

This presentation reviews the issue of lack of penetration (LOP) in Friction Stir Welding and the feasibility of using non-destructive tests to detect . Friction Stir Welding takes place in the solid phase below the melting point of the materials to be joined. It thus gives the ability to join materials which are difficult to fusion weld, for example 2000 and 7000 aluminium alloys. This process though can result in a lack of penetration, due to an incomplete penetration of the DXZ. This is frequently referred to as a "kissing bond", which requires micro examination to detect. The presentation then discusses the surface crack tension tests. It then reviews the simulated service test and results. It then discusses the feasibility of using non-destructive examination to detect LOP, the forms of test which can be used, and the results the tests.

Cell separation: Terminology and practical considerations

PubMed Central

Tomlinson, Sophie; Yang, Xuebin B; Kirkham, Jennifer

2013-01-01

Cell separation is a powerful tool in biological research. Increasing usage, particularly within the tissue engineering and regenerative medicine communities, means that researchers from a diverse range of backgrounds are utilising cell separation technologies. This review aims to offer potential solutions to cell sorting problems and to clarify common ambiguities in terminology and experimental design. The frequently used cell separation terms of ‘purity’, ‘recovery’ and ‘viability’ are discussed, and attempts are made to reach a consensus view of their sometimes ambiguous meanings. The importance of appropriate experimental design is considered, with aspects such as marker expression, tissue isolation and original cell population analysis discussed. Finally, specific technical issues such as cell clustering, dead cell removal and non-specific antibody binding are considered and potential solutions offered. The solutions offered may provide a starting point to improve the quality of cell separations achieved by both the novice and experienced researcher alike. PMID:23440031

The effect of workers' visibility on effectiveness of intervention programs: supervisory-based safety interventions.

PubMed

Luria, Gil; Zohar, Dov; Erev, Ido

2008-01-01

This paper discusses an organizational change intervention program targeting safety behaviors and addresses important considerations concerning the planning of organizational change. Using layout of the plant as a proxy for ease of daily leader-member interaction, the effect of workers' visibility on the effectiveness of supervisory-based safety (SBS) interventions is examined. Through a reinforcement-learning framework, it is suggested that visibility can affect supervisors' incentive to interact with subordinates regarding safety-related issues. Data were collected during SBS intervention studies in five manufacturing companies. Results suggest a reinforcement cycle model whereby increased visibility generates more frequent exchanges between supervisors and employees, resulting in improved safety behavior among employees. In turn, employees' safer behavior reinforces continued supervisory safety-related interaction. CONCLUSION AND IMPACT ON INDUSTRY: Visibility is an important moderator in supervisory based safety interventions, and can serve to increase workplace safety. Implications of these findings for safety are discussed.

Reassuring or Risky: The Presentation of Seafood Safety in the Aftermath of the British Petroleum Deepwater Horizon Oil Spill

PubMed Central

Lagasse, Lisa P.; Neff, Roni A.; Love, David C.; Chase, Rachel; Sokol, Natasha; Smith, Katherine Clegg

2013-01-01

The BP Deepwater Horizon Oil Spill was enormously newsworthy; coverage interlaced discussions of health, economic, and environmental impacts and risks. We analyzed 315 news articles that considered Gulf seafood safety from the year following the spill. We explored reporting trends, risk presentation, message source, stakeholder perspectives on safety, and framing of safety messages. Approximately one third of articles presented risk associated with seafood consumption as a standalone issue, rather than in conjunction with environmental or economic risks. Government sources were most frequent and their messages were largely framed as reassuring as to seafood safety. Discussions of prevention were limited to short-term, secondary prevention approaches. These data demonstrate a need for risk communication in news coverage of food safety that addresses the larger risk context, primary prevention, and structural causes of risk. PMID:23678933

Problems and issues in implementing innovative curriculum in the developing countries: the Pakistani experience.

PubMed

Ali, Syeda Kauser; Baig, Lubna A

2012-05-16

The Government of Pakistan identified 4 medical Colleges for introduction of COME, one from each province. Curriculum was prepared by the faculty of these colleges and launched in 2001 and despite concerted efforts could not be implemented. The purpose of this research was to identify the reasons for delay in implementation of the COME curriculum and to assess the understanding of the stakeholders about COME. Mixed methods study design was used for data collection. In-depth interviews, mail-in survey questionnaire, and focus group discussions were held with the representatives of federal and provincial governments, Principals of medical colleges, faculty and students of the designated colleges. Rigor was ensured through independent coding and triangulation of data. The reasons for delay in implementation differed amongst the policy makers and faculty and included thematic issues at the institutional, programmatic and curricular level. Majority (92% of the faculty) felt that COME curriculum couldn't be implemented without adequate infrastructure. The administrators were willing to provide financial assistance, political support and better coordination and felt that COME could improve the overall health system of the country whereas the faculty did not agree to it. The paper discusses the reasons of delay based on findings and identifies the strategies for curriculum change in established institutions. The key issues identified in our study included frequent transfer of faculty of the designated colleges and perceived lack of: Continuation at the policy making level. Communication between the stakeholders. Effective leadership.

Can we save large carnivores without losing large carnivore science?

USGS Publications Warehouse

Allen, Benjamin L.; Allen, Lee R.; Andrén, Henrik; Ballard, Guy; Boitani, Luigi; Engeman, Richard M.; Fleming, Peter J.S.; Haswell, Peter M.; Ford, Adam T.; Kowalczyk, Rafał; Mech, L. David; Linnell, John D.C.; Parker, Daniel M.

2017-01-01

Large carnivores are depicted to shape entire ecosystems through top-down processes. Studies describing these processes are often used to support interventionist wildlife management practices, including carnivore reintroduction or lethal control programs. Unfortunately, there is an increasing tendency to ignore, disregard or devalue fundamental principles of the scientific method when communicating the reliability of current evidence for the ecological roles that large carnivores may play, eroding public confidence in large carnivore science and scientists. Here, we discuss six interrelated issues that currently undermine the reliability of the available literature on the ecological roles of large carnivores: (1) the overall paucity of available data, (2) reliability of carnivore population sampling techniques, (3) general disregard for alternative hypotheses to top-down forcing, (4) lack of applied science studies, (5) frequent use of logical fallacies, and (6) generalisation of results from relatively pristine systems to those substantially altered by humans. We first describe how widespread these issues are, and given this, show, for example, that evidence for the roles of wolves (Canis lupus) and dingoes (Canis lupus dingo) in initiating trophic cascades is not as strong as is often claimed. Managers and policy makers should exercise caution when relying on this literature to inform wildlife management decisions. We emphasise the value of manipulative experiments and discuss the role of scientific knowledge in the decision-making process. We hope that the issues we raise here prompt deeper consideration of actual evidence, leading towards an improvement in both the rigour and communication of large carnivore science.

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

Brown, Carrie; LaRue, Anna; Pigman, Margaret

As more and more zero net energy (ZNE) buildings are built and monitored, we can learn from both careful case studies of individual projects as well as a broader perspective of trends over time. In a forum sponsored by Pacific Gas and Electric Company (PG&E), eight expert speakers discussed: results and lessons from monitoring occupied ZNE buildings; best practices for setting performance targets and getting actionable performance information, and; things that have surprised them about monitored ZNE buildings. This paper distills the content of the forum by laying out the most common hurdles that are encountered in setting up monitoringmore » projects, frequent performance issues that the monitoring uncovers, and lessons learned that can be applied to future projects.« less

State Bioenergy Primer: Information and Resources for States on Issues, Opportunities, and Options for Advancing Bioenergy

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

Byrnett, D. S.; Mulholland, D.; Zinsmeister, E.

One renewable energy option that states frequently consider to meet their clean energy goals is the use of biomass resources to develop bioenergy. Bioenergy includes bioheat, biopower, biofuels, and bioproducts. This document provides an overview of biomass feedstocks, basic information about biomass conversion technologies, and a discussion of benefits and challenges of bioenergy options. The Primer includes a step-wise framework, resources, and tools for determining the availability of feedstocks, assessing potential markets for biomass, and identifying opportunities for action at the state level. Each chapter contains a list of selected resources and tools that states can use to explore topicsmore » in further detail.« less

Lessons learned from the implementation of clinical messaging systems.

PubMed

Barnes, Mike

2007-10-11

The Regenstrief Institute has designed and implemented two clinical messaging systems over the past six years, both called DOCS4DOCS. These systems receive HL7 messages from data sources and deliver results to clinicians via the web, fax, or as HL7 directed to an EMR. This paper focuses on some of the lessons we have learned, both good and bad. We discuss important issues in clinical messaging including provider mapping, document delivery and duplicate prevention, creating uniform HL7 outbound feeds, user authentication, the problems of allowing Active-X controls, why automatic printing of documents is not important although a frequently requested feature, and assorted other pearls of wisdom we have acquired.

Lessons Learned from the Implementation of Clinical Messaging Systems

PubMed Central

Barnes, Mike

2007-01-01

The Regenstrief Institute has designed and implemented two clinical messaging systems over the past six years, both called DOCS4DOCS®. These systems receive HL7 messages from data sources and deliver results to clinicians via the web, fax, or as HL7 directed to an EMR. This paper focuses on some of the lessons we have learned, both good and bad. We discuss important issues in clinical messaging including provider mapping, document delivery and duplicate prevention, creating uniform HL7 outbound feeds, user authentication, the problems of allowing Active-X controls, why automatic printing of documents is not important although a frequently requested feature, and assorted other pearls of wisdom we have acquired. PMID:18693793

Narcolepsy in Adolescence—A Missed Diagnosis: A Case Report

PubMed Central

Gupta, Anoop K.; Sahoo, Swapnajeet

2017-01-01

ABSTRACT: Narcolepsy is an uncommon sleep cycle disorder with a usual onset in adolescence, but it is often misdiagnosed and underdiagnosed. Rarely is the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis seen in patients. The clinical characteristics of narcolepsy are often confused with many psychiatric and neurologic disorders. Lack of clinical awareness about narcolepsy leads to frequent prescriptions of antiepileptics and psychotropics, which can adversely affect the quality of life of children and adolescents. We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents. PMID:29616151

Narcolepsy in Adolescence-A Missed Diagnosis: A Case Report.

PubMed

Gupta, Anoop K; Sahoo, Swapnajeet; Grover, Sandeep

2017-01-01

Narcolepsy is an uncommon sleep cycle disorder with a usual onset in adolescence, but it is often misdiagnosed and underdiagnosed. Rarely is the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis seen in patients. The clinical characteristics of narcolepsy are often confused with many psychiatric and neurologic disorders. Lack of clinical awareness about narcolepsy leads to frequent prescriptions of antiepileptics and psychotropics, which can adversely affect the quality of life of children and adolescents. We report a case of an adolescent male who presented with all four cardinal symptoms of narcolepsy and had been misdiagnosed with epilepsy, psychosis, and depression. We discuss various issues regarding narcolepsy in children and adolescents.

If the face is familiar, the patient may be overusing healthcare.

PubMed

2014-01-01

Patients who use the healthcare system excessively, and often for avoidable issues, create a burden for hospitals and consume a significant portion of healthcare expenditures. Many frequent users have complex medical and psychosocial needs, are uninsured, or have behavioral health issues. Case managers should identify patients who are potential frequent utilizers and make sure they are connected with a primary care provider. Take the time to find out barriers to care and call in a social worker to help line up community resources.

Everyday ethics in internal medicine resident clinic: an opportunity to teach.

PubMed

Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Catherine Beach, Mary; Hughes, Mark T

2011-07-01

Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor-resident interactions. This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor-Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor-System Interaction (financial issues; doctor-system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. © Blackwell Publishing Ltd 2011.

Everyday ethics in internal medicine resident clinic: an opportunity to teach

PubMed Central

Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Beach, Mary Catherine; Hughes, Mark T

2011-01-01

OBJECTIVES Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor–resident interactions. METHODS This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. RESULTS Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor–Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor–System Interaction (financial issues; doctor–system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). CONCLUSIONS In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. PMID:21649704

Interim Exceptional Events Rule Frequently Asked Questions

EPA Pesticide Factsheets

Air agencies and other stakeholders have raised technical questions and issues related to implementation since the EPA promulgated the EER. This Question and Answer (Q&A) document is intended to respond to some of these frequently asked questions.

Psychosocial issues experienced by young women with breast cancer: the minority group with the majority of need.

PubMed

Ahmad, Saunia; Fergus, Karen; McCarthy, Molly

2015-09-01

The ways in which biological, social, and psychological factors characteristically unfold and interact for young women with breast cancer yields complex and acute challenges that are not clearly understood by all healthcare professionals. Better knowledge of the unique needs of young women with breast cancer would assist in matching younger women with the right services at the right time. Younger women (<50 years) represent a minority of breast cancer cases, yet they tend to be overrepresented with respect to demonstrating the poorest psychosocial adjustment during and following treatment. Concerns most frequently reported in this age group pertained to body image, sexual functioning, fertility, relationships, fear of cancer recurrence, and caring for children; failure of healthcare providers to initiate conversations to educate women about treatment side effects early on and/or safely discuss sensitive issues; lack of widespread availability of professional psychosocial programs that are tailored to the unique needs of this age group. Young women with breast cancer are at greater risk for psychosocial adjustment problems, yet their needs are often overlooked. Proactive discussions by healthcare providers early on in treatment, and referrals to relevant services as part of standard care are needed to mitigate younger women's concerns and reduce the likelihood of problems becoming longstanding.

Psychology teaching in nursing education: a review of and reflection on approaches, issues, and contemporary practice.

PubMed

de Vries, Jan M A; Timmins, Fiona

2012-11-01

This paper highlights the relevance of psychology for nurses and the issues around the inclusion of psychology as an essential part of nursing education. Considerable international variations in the extent to which psychology is incorporated in nursing education suggest a need for discussion and reflection on this topic. This paper aims to (a) examine and reflect on scholarly literature in English addressing psychology of nursing in education and (b) present and reflect on an example of psychology teaching in a school of nursing and midwifery in Ireland. A review of the literature took place, which included a search of various databases and an analysis of emerging psychology for nursing textbooks over the period 1906-2011. Findings were used as a framework for reflection on a local example. The literature review yielded numerous commentaries, discussion papers, textbook reviews and editorials but very few empirical studies. Three topics were identified as appearing most frequently in the literature: the relevance of psychology in the nursing curriculum; depth and content of coverage; and whether integrated or separate instruction of psychology should be chosen. Findings suggest that overall the relevance of psychology to nursing education is not contested, but debates have emerged regarding how best to approach and integrate psychology. The outcomes of these debates are mostly inconclusive at present. Educators are encouraged to become active in these discussions and reflections, which are hampered by lack of empirical evidence. Copyright © 2012 Elsevier Ltd. All rights reserved.

Working towards a consensus for antibody validation.

PubMed

Reiss, Peter D; Min, Danxi; Leung, Mei Y

2014-01-01

Commercial research antibodies are the most commonly used product in the life science tools market, and their applications represent a significant investment of time and resources for researchers. Frequently however, the quality of antibodies does not meet the expectations of consumers, causing loss of valuable time and money. This can delay research efforts and scientific discovery, or even lead to false, irreproducible results to be published in the scientific literature. This raises the question of whether there should be universal standards for validating antibodies.   During the 1 (st) International Antibody Validation Forum, hosted by St John's Laboratory Ltd on October 15 (th) 2014 at Queen Mary University of London, scientists from academia and industry presented data highlighting quality issues arising from lack of antibody validation. While the forum identified significant current problems in the antibody market, it also discussed future opportunities for improved quality and transparency by encouraging data disclosure and data sharing. This article highlights the key issues and conclusions reached at the forum.

Impairment of Sexual Life in 3,485 Dermatological Outpatients From a Multicentre Study in 13 European Countries.

PubMed

Sampogna, Francesca; Abeni, Damiano; Gieler, Uwe; Tomas-Aragones, Lucía; Lien, Lars; Titeca, Géraldine; Jemec, Gregor B E; Misery, Laurent; Szabó, Csanád; Linder, M Dennis; Evers, Andrea W M; Halvorsen, Jon Anders; Balieva, Flora; Szepietowski, Jacek C; Romanov, Dmitry V; Marron, Servando E; Altunay, Ilknur K; Finlay, Andrew Y; Salek, Sam S; Kupfer, Jörg; Dalgard, Florence

2017-04-06

Skin conditions may have a strong impact on patients' sexual life, and thus influence personal relationships. Sexual issues are difficult to discuss directly in clinical practice, and a mediated instrument may be useful to capture such information. In this study item 9 of the Dermatology Life Quality Index was used to collect information on sexual impact of several skin conditions in 13 European countries. Among 3,485 patients, 23.1% reported sexual problems. The impairment was particularly high in patients with hidradenitis suppurativa, prurigo, blistering disorders, psoriasis, urticaria, eczema, infections of the skin, or pruritus. Sexual impact was strongly associated with depression, anxiety, and suicidal ideation. It was generally more frequent in younger patients and was positively correlated with clinical severity and itch. It is important to address the issue of sexual well-being in the evaluation of patients with skin conditions, since it is often linked to anxiety, depression, and even suicidal ideation.

Historical and cultural aspects of man's relationship with addictive drugs

PubMed Central

Crocq, Marc-Antoine

2007-01-01

Our taste for addictive psychoactive substances is attested to in the earliest human records. Historically, psychoactive substances have been used by (i) priests in religious ceremonies (eg, amanita muscaria); (ii) healers for medicinal purposes (eg, opium); or (iii) the general population in a socially approved way (eg, alcohol, nicotine, and caffeine). Our forebears refined more potent compounds and devised faster routes of administration, which contributed to abuse. Pathological use was described as early as classical Antiquity. The issue of loss of control of the substance, heralding today's concept of addiction, was already being discussed in the 17th century. The complex etiology of addiction is reflected in the frequent pendulum swings between opposing attitudes on issues that are still currently being debated, such as: is addiction a sin or a disease; should treatment be moral or medical; is addiction caused by the substance; the individual's vulnerability and psychology, or social factors; should substances be regulated or freely available. PMID:18286796

Metal losses in pyrometallurgical operations - A review.

PubMed

Bellemans, Inge; De Wilde, Evelien; Moelans, Nele; Verbeken, Kim

2018-05-01

Nowadays, a higher demand on a lot of metals exists, but the quantity and purity of the ores decreases. The amount of scrap, on the other hand, increases and thus, recycling becomes more important. Besides recycling, it is also necessary to improve and optimize existing processes in extractive and recycling metallurgy. One of the main difficulties of the overall-plant recovery are metal losses in slags, in both primary and secondary metal production. In general, an increased understanding of the fundamental mechanisms governing these losses could help further improve production efficiencies. This review aims to summarize and evaluate the current scientific knowledge concerning metal losses and pinpoints the knowledge gaps. First, the industrial importance and impact of metal losses in slags will be illustrated by several examples from both ferrous and non-ferrous industries. Throughout the remainder of this review, the main focus will be put on the particular issues in copper industry. In a second section, the different types of metal losses in slags will be discussed. Generally, metal losses in slags can be subdivided into two types: chemical losses and physical losses. The fundamental insights concerning the responsible mechanisms will be discussed for each type. Subsequently, an overview of the most frequently used techniques for research investigations of the losses will be given. In a fourth section, a more detailed overview will be given on the post-processing treatment of metal-containing slags, i.e. performing slag cleaning operations. The most frequently applied methods will be discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

78 FR 72122 - Draft Emergency Preparedness Frequently Asked Questions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0262] Draft Emergency Preparedness Frequently Asked... of guidance documents related to the development and maintenance of emergency preparedness program... the interpretation or applicability of emergency preparedness guidance issued or endorsed by the NRC...

Sturge-Weber syndrome: ear, nose, and throat issues and neurologic status.

PubMed

Irving, Natasha D; Lim, Jae Hyung; Cohen, Bernard; Ferenc, Lisa M; Comi, Anne M

2010-10-01

The pathophysiology of Sturge-Weber syndrome is poorly understood, and ear, nose, and throat involvement is possible. These issues can result in frequent illnesses or airway obstruction, affecting patients' neurologic status. Patients with definite brain involvement who reported potential ear, nose, and throat issues on intake questionnaires underwent retrospective reviews of their medical records. We examined the relationships between these issues, secondary surgical interventions, and patients' neurologic status. The most common complaints involved the sinuses and frequent ear infections. Six patients underwent placement of ear tubes, leading to improvements in migraines and stroke-like episodes in one patient, and improved seizure control in four others. Obstructive sleep apnea was confirmed in three patients who underwent sleep studies. Tonsil or adenoid removal occurred in another three patients. Surgery resulted in marked improvements regarding excessive drooling, daytime sleepiness, and breathing problems. These findings suggest that ear, nose, and throat problems occur frequently in patients with Sturge-Weber Syndrome, and when repeated ear infections are associated with uncontrolled seizures, early placement of ear tubes may be beneficial. Furthermore, patients with facial tissue hypertrophy may be at risk for obstructive sleep apnea, and should be appropriately evaluated. Copyright © 2010 Elsevier Inc. All rights reserved.

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

PubMed

Mitchell, Theresa; Carroll, Jude

2008-02-01

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

The nature of international health security.

PubMed

Chiu, Ya-Wen; Weng, Yi-Hao; Su, Yi-Yuan; Huang, Ching-Yi; Chang, Ya-Chen; Kuo, Ken N

2009-01-01

Health issues occasionally intersect security issues. Health security has been viewed as an essential part of human security. Policymakers and health professionals, however, do not share a common definition of health security. This article aims to characterize the notions of health security in order to clarify what constitutes the nexus of health and security. The concept of health security has evolved over time so that it encompasses many entities. Analyzing the health reports of four multilateral organizations (the United Nations, World Health Organization, Asia-Pacific Economic Cooperation, and the European Union) produced eight categories of most significant relevance to contemporary health security, allowing comparison of the definitions. The four categories are: emerging diseases; global infectious disease; deliberate release of chemical and biological materials; violence, conflict, and humanitarian emergencies. Two other categories of common concern are natural disasters and environmental change, as well as chemical and radioactive accidents. The final two categories, food insecurity and poverty, are discussed less frequently. Nevertheless, food security is emerging as an increasingly important issue in public health. Health security is the first line of defence against health emergencies. As globalization brings more complexities, dealing with the increased scale and extent of health security will require greater international effort and political support.

Frequent callers to crisis helplines: who are they and why do they call?

PubMed

Spittal, Matthew J; Fedyszyn, Izabela; Middleton, Aves; Bassilios, Bridget; Gunn, Jane; Woodward, Alan; Pirkis, Jane

2015-01-01

Frequent callers present a challenge for crisis helplines, which strive to achieve optimal outcomes for all callers within finite resources. This study aimed to describe frequent callers to Lifeline (the largest crisis helpline in Australia) and compare them with non-frequent callers, with a view to furthering knowledge about models of service delivery that might meet the needs of frequent callers. Lifeline provided an anonymous dataset on calls made between December 2011 and May 2013. We assumed calls from the same (encrypted) phone number were made by the same person, and aggregated call level data up to the person level. Individuals who made 0.667 calls per day in any period from 1 week to the full 549 days for which we had data (i.e. 4.7 calls in 7 days, 20 calls in 30 days, 40 calls in 60 days, etc.) were regarded as frequent callers. Our analysis dataset included 411,725 calls made by 98,174 individuals, 2594 (2.6%) of whom met our definition of frequent callers. We identified a number of predictors of being a frequent caller, including being male or transgender, and never having been married. The odds increased with age until 55-64 years, and then declined. Suicidality, self-harm, mental health issues, crime, child protection and domestic violence issues all predicted being a frequent caller. Collectively, frequent callers have a significant impact on crisis lines, and solutions need to be found for responding to them that are in everybody's best interests (i.e. the frequent callers themselves, other callers, telephone crisis supporters who staff crisis lines, and those who manage crisis lines). In striking this balance, the complex and multiple needs of frequent callers must be taken into account. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Ethical Issues in Expert Opinions and Testimony.

ERIC Educational Resources Information Center

Weed, Roger O.

2000-01-01

This article provides an overview of ethical issues in private for-profit practice, with particular focus on expert testimony, using examples from a sample of claims filed with the National Association of Rehabilitation Professionals in the Private Sector and malpractice insurance companies. Complaints most frequently involve issues related to…

Frequently Asked Questions about Rare Diseases

MedlinePlus

... New Horizons and Research Patient Management Policy and Ethics Issues Quick Links for Patient Care Education All About ... Genome Exhibition Talking Glossary: English Talking Glossary: Español Issues ... Contacts Media Resources NHGRI-Related News Journal Articles ...

Frequently Asked Questions about Genetic Disorders

MedlinePlus

... New Horizons and Research Patient Management Policy and Ethics Issues Quick Links for Patient Care Education All About ... Genome Exhibition Talking Glossary: English Talking Glossary: Español Issues ... Contacts Media Resources NHGRI-Related News Journal Articles ...

Conveying empathy to hospice family caregivers: Team responses to caregiver empathic communication

PubMed Central

Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Rankin, Anna; Shaunfield, Sara; Kruse, Robin L.

2012-01-01

Objective The goal of this study was to explore empathic communication opportunities presented by family caregivers and responses from interdisciplinary hospice team members. Methods Empathic opportunities and hospice team responses were analyzed from biweekly web-based videoconferences between family caregivers and hospice teams. The authors coded the data using the Empathic Communication Coding System (ECCS) and identified themes within and among the coded data. Results Data analysis identified 270 empathic opportunity-team response sequences. Caregivers expressed statements of emotion and decline most frequently. Two-thirds of the hospice team responses were implicit acknowledgments of caregiver statements and only one-third of the team responses were explicit recognitions of caregiver empathic opportunities. Conclusion Although hospice team members frequently express emotional concerns with family caregivers during one-on-one visits, there is a need for more empathic communication during team meetings that involve caregivers. Practice implications Hospice clinicians should devote more time to discussing emotional issues with patients and their families to enhance patient-centered hospice care. Further consideration should be given to training clinicians to empathize with patients and family caregivers. PMID:22554387

Conveying empathy to hospice family caregivers: team responses to caregiver empathic communication.

PubMed

Wittenberg-Lyles, Elaine; Debra, Parker Oliver; Demiris, George; Rankin, Anna; Shaunfield, Sara; Kruse, Robin L

2012-10-01

The goal of this study was to explore empathic communication opportunities presented by family caregivers and responses from interdisciplinary hospice team members. Empathic opportunities and hospice team responses were analyzed from bi-weekly web-based videoconferences between family caregivers and hospice teams. The authors coded the data using the Empathic Communication Coding System (ECCS) and identified themes within and among the coded data. Data analysis identified 270 empathic opportunity-team response sequences. Caregivers expressed statements of emotion and decline most frequently. Two-thirds of the hospice team responses were implicit acknowledgements of caregiver statements and only one-third of the team responses were explicit recognitions of caregiver empathic opportunities. Although hospice team members frequently express emotional concerns with family caregivers during one-on-one visits, there is a need for more empathic communication during team meetings that involve caregivers. Hospice clinicians should devote more time to discussing emotional issues with patients and their families to enhance patient-centered hospice care. Further consideration should be given to training clinicians to empathize with patients and family caregivers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Frequently asked questions about in vivo chlorophyll fluorescence: practical issues.

PubMed

Kalaji, Hazem M; Schansker, Gert; Ladle, Richard J; Goltsev, Vasilij; Bosa, Karolina; Allakhverdiev, Suleyman I; Brestic, Marian; Bussotti, Filippo; Calatayud, Angeles; Dąbrowski, Piotr; Elsheery, Nabil I; Ferroni, Lorenzo; Guidi, Lucia; Hogewoning, Sander W; Jajoo, Anjana; Misra, Amarendra N; Nebauer, Sergio G; Pancaldi, Simonetta; Penella, Consuelo; Poli, DorothyBelle; Pollastrini, Martina; Romanowska-Duda, Zdzislawa B; Rutkowska, Beata; Serôdio, João; Suresh, Kancherla; Szulc, Wiesław; Tambussi, Eduardo; Yanniccari, Marcos; Zivcak, Marek

2014-11-01

The aim of this educational review is to provide practical information on the hardware, methodology, and the hands on application of chlorophyll (Chl) a fluorescence technology. We present the paper in a question and answer format like frequently asked questions. Although nearly all information on the application of Chl a fluorescence can be found in the literature, it is not always easily accessible. This paper is primarily aimed at scientists who have some experience with the application of Chl a fluorescence but are still in the process of discovering what it all means and how it can be used. Topics discussed are (among other things) the kind of information that can be obtained using different fluorescence techniques, the interpretation of Chl a fluorescence signals, specific applications of these techniques, and practical advice on different subjects, such as on the length of dark adaptation before measurement of the Chl a fluorescence transient. The paper also provides the physiological background for some of the applied procedures. It also serves as a source of reference for experienced scientists.

Opioids in the Frame of New Psychoactive Substances Network: A Complex Pharmacological and Toxicological Issue.

PubMed

Ventura, Ludovic; Carvalho, Felix; Dinis-Oliveira, Ricardo Jorge

2018-01-01

New psychoactive substances (NPS), often referred to as "legal highs" or "designer drugs", are derivatives and analogues of existing psychoactive drugs that are introduced in the recreational market to circumvent existing legislation on drugs of abuse. This systematic review aims to gather the state of the art regarding chemical, molecular pharmacology and toxicological information of opioid class of NPS. Chemical, pharmacological, toxicological and clinical effects of opioid class of NPS were searched in books and in PubMed (U.S. National Library of Medicine) without a limiting period. Within this class, fentanyl analogues are among the most frequently abused and pose several clinical concerns and therefore will be thoroughly discussed. Other opioid sub-categories of NPS frequently misused include AH-7921, MT-45, U-47700, U-50488, desomorphine, mitragynine, tramadol, tapentadol, salvinorin A and its analogue herkinorin. Due to inefficient monitoring techniques, as well as limited knowledge regarding the acute and long-term effects of opioids NPS, further clinical and forensic toxicological studies are required. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Palliative Care Office Hours for Patients with Hematologic Malignancies: An Innovative Model for Symptom Management and Education.

PubMed

Foxwell, Anessa M; Moyer, Mary E; Casarett, David J; O'Connor, Nina R

2017-10-01

Palliative care programs are experiencing rapid growth, with demand for consults surpassing staffing. Innovative models are needed to equip nonpalliative care providers to manage basic palliative care issues. To develop a novel program of palliative care office hours for hematologic oncology advanced practice providers, and to evaluate its impact on palliative care consult volume and composition. A palliative care nurse practitioner or pharmacist was available for weekday office hours to all inpatient hematologic oncology advanced practice providers at an academic medical center to offer advice on pain, nonpain symptoms, and psychosocial distress. A retrospective study looking at outcome measures after six months of office hour utilization and palliative care consults from the hematologic oncology services. Palliative care office hours had a mean duration of 16 minutes per day (range 5 to 55). A mean of 11 patients were discussed per week (range 4 to 20). Pain, nausea, and anxiety were the issues most frequently raised. Of 299 patients discussed during office hours, 44 (14.7%) subsequently required a full palliative care consult. Overall, palliative care consults from the hematologic oncology services decreased from 19.6% to 10.2% of admissions (87/445 vs. 61/594, p < 0.001) with an increase in consults for goals of care. Office hours are an efficient way to address palliative care needs when demand for palliative care consults exceeds capacity. Office hours may serve an educational function as well, enabling primary teams to manage basic palliative care issues with increasing independence over time.

Legal issues for transgender people: a review of persistent threats.

PubMed

Green, Jamison

2017-10-01

Background The legal status of transgender (trans) people is in constant flux. Over the past 70 years, gradually increasing transgender visibility, national and global advocacy, and, more recently, widespread Internet access, communication, and broadening support from allies, have all contributed to successful campaigns that have improved transgender lives and legitimised transgender. Still, traumatic interactions with the legal system or policing agencies remain plentiful. This is a very general overview of the most common legal issues confronting trans people. It aims to inform medical and mental health providers about the trepidation with which their patients and clients must engage legal systems, and the scope of their concerns, which ultimately affect their health. This review relies upon reports generated by advocacy organisations based on population surveys in several countries, the projects undertaken by legal and human rights advocacy groups, the topics most frequently discussed in academic texts examining transgender legal issues, and draws upon the author's personal advocacy experience. The most complicated and persistent issues are identity recognition, family law and relationship issues, adverse discrimination and anti-transgender violence and its aftermath. Criminal law, almost universally, treats trans people according to the lowest common denominator, their genital status, which supposedly supports expediency and "safety". Global legal and human rights efforts remain desperately needed to lift transgender people from the margins of society and provide them with equal opportunities to lead healthy and fulfilling lives. Access to appropriate and meaningful health care is a crucial element necessary to affirm the humanity of any person.

Some letters on Jewish Medical Ethics.

PubMed

Jakobovits, I

1983-08-01

Specializing in Jewish Medical Ethics--a term, I believe, first used as the title of my doctor's thesis (1955) subsequently condensed and revised in book form (1959)--I frequently receive inquiries from individuals and organizations seeking guidance on the Jewish attitude to moral issues in medicine. After a review of my voluminous correspondence on many phases of this subject, I have made a small selection on a variety of topics. The correspondence on the last of the four topics, 'Medical Experimentation on Animals', is the longest, because it contains an element of polemics. Since this might make it of special interest to the Journal's readers, and since this subject is infrequently discussed in the literature of Medical Ethics, I decided to include it in this brief selection.

Parent-child incest that extends into adulthood: a survey of international press reports, 2007-2011.

PubMed

Middleton, Warwick

2013-01-01

Although the subject of ongoing incestuous abuse during adulthood has never been addressed in a systematic way in the professional literature, accounts of such cases have been appearing for many years. The Josef Fritzl case added a new impetus to reporting such abuses in the popular press. The current study presents 44 such cases from 24 countries that appeared in English-language press accounts over 5 years commencing January 2007. These cases are discussed in light of the minimal coverage of such issues in the professional literature. The results of this study suggest that cases of enduring incest are not rare and typically incorporate decades of sexual abuse, frequently result in pregnancies, and commonly incorporate ongoing violence and death threats.

Ber-H2 (CD30) immunohistochemical staining in malignant melanoma.

PubMed

Polski, J M; Janney, C G

1999-09-01

Malignant melanoma can be included in the differential diagnosis of Hodgkin's disease, anaplastic large cell lymphoma, or embryonal carcinoma These malignancies express CD30, a marker of diagnostic value. A retrospective immunohistochemical study was undertaken to determine the frequency of immunoreactivity of Ber-H2 (anti-CD30 monoclonal antibody) in malignant melanoma Archival paraffin-embedded tissue from 24 primary and metastatic lesions was used. No Ber-H2 labeling was observed in the majority of the studied cases. Variable weak cytoplasmic staining was present in only one case. The findings are compared with the previous reports claiming frequent CD30 expression in malignant melanoma. We discuss issues pertaining to the interpretation of the Ber-H2 IHC staining in formalin-fixed, paraffin-embedded tissue.

Statistical properties of exciton fine structure splitting and polarization angles in quantum dot ensembles

NASA Astrophysics Data System (ADS)

Gong, Ming; Hofer, B.; Zallo, E.; Trotta, R.; Luo, Jun-Wei; Schmidt, O. G.; Zhang, Chuanwei

2014-05-01

We develop an effective model to describe the statistical properties of exciton fine structure splitting (FSS) and polarization angle in quantum dot ensembles (QDEs) using only a few symmetry-related parameters. The connection between the effective model and the random matrix theory is established. Such effective model is verified both theoretically and experimentally using several rather different types of QDEs, each of which contains hundreds to thousands of QDs. The model naturally addresses three fundamental issues regarding the FSS and polarization angels of QDEs, which are frequently encountered in both theories and experiments. The answers to these fundamental questions yield an approach to characterize the optical properties of QDEs. Potential applications of the effective model are also discussed.

The use of phenobarbital and other anti-seizure drugs in newborns.

PubMed

El-Dib, Mohamed; Soul, Janet S

2017-10-01

Neonatal seizures constitute the most frequent presenting neurologic sign encountered in the neonatal intensive care unit. Despite limited efficacy and safety data, phenobarbital continues to be used near-universally as the first-line anti-seizure drug (ASD) in neonates. The choice of second-line ASDs varies by provider and institution, and is still not supported by sufficient scientific evidence. In this review, we discuss the available evidence supporting the efficacy, mechanism of action, potential adverse effects, key pharmacokinetic characteristics such as interaction with therapeutic hypothermia, logistical issues, and rationale for use of neonatal ASDs. We describe the widely used neonatal ASDs, namely phenobarbital, phenytoin, midazolam, and levetiracetam, in addition to potential ASDs, including lidocaine, topiramate, and bumetanide. Copyright © 2017. Published by Elsevier Ltd.

Neurodevelopmental assessment after anesthesia in childhood: review of the literature and recommendations.

PubMed

Beers, Sue R; Rofey, Dana L; McIntyre, Katie A

2014-09-01

Preclinical studies have established that anesthesia is toxic to the brain in neonatal animals, but scant research investigates the neurodevelopmental effects of exposure to anesthesia. In this article, we discuss the issue of outcome measurement of children after anesthesia administered between infancy and approximately 4 years of age. Recent studies are reviewed with the goal of understanding the contributions and limitations of the extant literature with respect to neurodevelopmental outcome. A review of school-based information (academic achievement and learning disability characterization), which are most frequently applied to measure cognitive outcome in cohort studies, is provided. The strengths and limitations of this literature is reviewed, followed by a discussion of how future trials investigating neurodevelopmental outcome after anesthesia might be improved by procedures designed specifically to assess the status of the central nervous system. Neuropsychological assessment is described and proposed as a way to increase the validity and sensitivity of forthcoming studies that intend to evaluate the short- and long-term effects of exposure to anesthesia during infancy and early childhood.

On a path towards long-term sampling following the Deepwater Horizon: Initial insights

NASA Astrophysics Data System (ADS)

Reddy, C. M.

2012-12-01

During the past two decades in the United States, few areas contaminated from an oil spill have been revisited on the time scales from months to years. The lack of sampling is a missed opportunity to shine light on long-term processes, evaluate recovery, identify compounds most likely to persist, and apply new chemical and biological techniques. To address this issue, my laboratory has begun a land-based effort to collect oiled samples from the Gulf of Mexico beaches from the Deepwater Horizon disaster. Each sample is archived, analyzed, and available for others via an online repository. Detailed analysis of many of these samples has already been fruitful on determining the fate of the spilled oil, which will be discussed. This meeting is an ideal time to discuss strategies for long-term sampling and archiving. With support from the Gulf Research Initiative for the next nine years, the opportunities to use these samples will be frequent.

Partnership in research: a tandem of opportunities and constraints.

PubMed

Ducharme, Francine

2003-01-01

Partnership is a term that is occurring more and more frequently in the research lexicon, an approach that is gradually becoming a sine qua non in the field of health and healthcare research in Canada. The purpose of this article is to share thoughts and experiences regarding research carried out in partnership. The relevance and necessity of partnerships in strategic health research will be examined, and the contribution of partnerships to the development and "re-centring" of intra- and interdisciplinary knowledge and knowledge transfer will be discussed. Based on the nursing and related-fields literature, the key elements of partnership, and the advantages and disadvantages of this strategy to pursuing research projects will be presented. An important issue in a professional discipline such as nursing will be discussed, i.e. the intra-disciplinary partnership between researchers and clinicians. Strategies that could enhance this particular type of partnership and avenues for catalyzing the synergy that must perforce develop, over the coming years, will be proposed.

Use of antidepressants for major depressive disorder in children and adolescents: clinical considerations.

PubMed

Picouto, María Dolores; Braquehais, María Dolores

2013-01-01

Major depressive disorder (MDD) is a frequent condition among children and, especially, among adolescents. However, its clinical presentation usually differs from that of adults. It is also associated with other diagnoses and with an increased morbidity and mortality. However, MDD in this population remains underrecognized and undertreated. Antidepressants (ATDs) are chosen when psychoeducational, psychosocial and/or psychotherapeutic approaches have failed. ATDs are generally used in severe cases, and are always combined with psychological treatments. The objective of this work is to discuss the role of ATD in child and adolescent MDD. We focus on the recommendations of the most cited and updated clinical guidelines and discuss some controversial aspects with regards efficacy and safety issues that have been raised based on the information obtained from clinical trials. Finally, we offer some practical recommendations for clinicians. All these findings also pose some doubt on the hypothesis of MDD as a homogeneous phenomenon during the human life cycle.

Security of electronic mental health communication and record-keeping in the digital age.

PubMed

Elhai, Jon D; Frueh, B Christopher

2016-02-01

The mental health field has seen a trend in recent years of the increased use of information technology, including mobile phones, tablets, and laptop computers, to facilitate clinical treatment delivery to individual patients and for record keeping. However, little attention has been paid to ensuring that electronic communication with patients is private and secure. This is despite potentially deleterious consequences of a data breach, which are reported in the news media very frequently in modern times. In this article, we present typical security concerns associated with using technology in clinical services or research. We also discuss enhancing the privacy and security of electronic communication with clinical patients and research participants. We offer practical, easy-to-use software application solutions for clinicians and researchers to secure patient communication and records. We discuss such issues as using encrypted wireless networks, secure e-mail, encrypted messaging and videoconferencing, privacy on social networks, and others. © Copyright 2015 Physicians Postgraduate Press, Inc.

Overcoming challenges: life with an ostomy.

PubMed

Popek, Sarah; Grant, Marcia; Gemmill, Robin; Wendel, Christopher S; Mohler, M Jane; Rawl, Susan M; Baldwin, Carol M; Ko, Clifford Y; Schmidt, C Max; Krouse, Robert S

2010-11-01

Studies have demonstrated decreased health-related quality of life in patients with stomas. Using US Department of Veterans Affairs electronic medical records, veterans with stomas were surveyed using the City of Hope Quality of Life-Ostomy questionnaire. Focus groups were conducted segregated by type of stoma (ileostomy vs colostomy) and quality-of-life score (high vs low). Qualitative analysis was performed on the basis of the City of Hope Quality of Life for Ostomates format of health-related quality of life (physical, psychological, social, and spiritual). The findings of the colostomy focus groups are reported. Two new domains emerged: colostomy specific and health care specific. The most common domains discussed were colostomy specific, psychological, and social. The most frequently discussed colostomy-specific theme was effective and ineffective solutions to colostomy care. Family and spousal relationships were the main theme from the psychological category. The predominant social issue was sexual relationships. Awareness of patients' social, psychological, and medical status allows surgeons to identify those likely to have problems and devote resources to those veterans. Published by Elsevier Inc.

Structural Priming and Frequency Effects Interact in Chinese Sentence Comprehension

PubMed Central

Wei, Hang; Dong, Yanping; Boland, Julie E.; Yuan, Fang

2016-01-01

Previous research in several European languages has shown that the language processing system is sensitive to both structural frequency and structural priming effects. However, it is currently not clear whether these two types of effects interact during online sentence comprehension, especially for languages that do not have morphological markings. To explore this issue, the present study investigated the possible interplay between structural priming and frequency effects for sentences containing the Chinese ambiguous construction V NP1 de NP2 in a self-paced reading experiment. The sentences were disambiguated to either the more frequent/preferred NP structure or the less frequent VP structure. Each target sentence was preceded by a prime sentence of three possible types: NP primes, VP primes, and neutral primes. When the ambiguous construction V NP1 de NP2 was disambiguated to the dispreferred VP structure, participants experienced more processing difficulty following an NP prime relative to following a VP prime or a neutral baseline. When the ambiguity was resolved to the preferred NP structure, prime type had no effect. These results suggest that structural priming in comprehension is modulated by the baseline frequency of alternative structures, with the less frequent structure being more subject to structural priming effects. These results are discussed in the context of the error-based, implicit learning account of structural priming. PMID:26869954

Frequent Questions about Starting-up New Composite Wood Mills and the Use of Experimental Products and Resins

EPA Pesticide Factsheets

The following frequently asked questions (FAQs) address issues relating to starting-up new doestice composite wood mills and the use of experimental product and resin systems under the Formaldehyde Emission Standards for Composite Wood Products final rule

Frequently Asked Questions on Starting-up New Composite Wood Mills and the Use of Experimental Products and Resins

EPA Pesticide Factsheets

The following frequently asked questions (FAQs) address issues relating to starting-up new doestice composite wood mills and the use of experimental product and resin systems under the Formaldehyde Emission Standards for Composite Wood Products final rule

Environmental Behavior's Dirty Secret: The Prevalence of Waste Management in Discussions of Environmental Concern and Action

NASA Astrophysics Data System (ADS)

Gould, Rachelle K.; Ardoin, Nicole M.; Biggar, Matt; Cravens, Amanda E.; Wojcik, Deb

2016-08-01

Humankind and the planet face many thorny environmentally related challenges that require a range of responses, including changing behaviors related to transportation, eating habits, purchasing, and myriad other aspects of life. Using data from a 1201-person survey and 14 Community Listening Sessions (CLSs), we explore people's perceptions of and actions taken to protect the environment. Our data indicate a striking prevalence of waste management-related actions. Survey respondents described actions and concerns related to trash, recycling, and composting as the most common environmental behaviors; similarly, participants in CLSs discussed waste-related topics, for which we did not prompt, as frequently as those topics for which we specifically prompted. Explanations for this prevalence emerging from the data include (1) the nature of waste-related behaviors (concrete, supported by infrastructure, simple, compatible with lifestyle); (2) norms and social dynamics (family interactions, feelings of belonging/participation, government policy); and (3) internal psychological processes (internalized norms and environmental concern). We also found that many waste-related discussions were relatively superficial, focusing on immediate waste-related issues (e.g., litter or recycling) rather than larger issues such as consumption. Our results may provide insight into future efforts to encourage pro-environmental behavior. Given that most pro-environmental behavior involves tasks more complex and lifestyle-changing than those related to simple aspects of waste management, we suggest focusing on the latter two intertwined categories that our data suggest are important: encouraging social dynamics and related development of norms concerning environmental behavior (category 2), and fostering internalized norms and environmental concern (category 3).

Environmental Behavior's Dirty Secret: The Prevalence of Waste Management in Discussions of Environmental Concern and Action.

PubMed

Gould, Rachelle K; Ardoin, Nicole M; Biggar, Matt; Cravens, Amanda E; Wojcik, Deb

2016-08-01

Humankind and the planet face many thorny environmentally related challenges that require a range of responses, including changing behaviors related to transportation, eating habits, purchasing, and myriad other aspects of life. Using data from a 1201-person survey and 14 Community Listening Sessions (CLSs), we explore people's perceptions of and actions taken to protect the environment. Our data indicate a striking prevalence of waste management-related actions. Survey respondents described actions and concerns related to trash, recycling, and composting as the most common environmental behaviors; similarly, participants in CLSs discussed waste-related topics, for which we did not prompt, as frequently as those topics for which we specifically prompted. Explanations for this prevalence emerging from the data include (1) the nature of waste-related behaviors (concrete, supported by infrastructure, simple, compatible with lifestyle); (2) norms and social dynamics (family interactions, feelings of belonging/participation, government policy); and (3) internal psychological processes (internalized norms and environmental concern). We also found that many waste-related discussions were relatively superficial, focusing on immediate waste-related issues (e.g., litter or recycling) rather than larger issues such as consumption. Our results may provide insight into future efforts to encourage pro-environmental behavior. Given that most pro-environmental behavior involves tasks more complex and lifestyle-changing than those related to simple aspects of waste management, we suggest focusing on the latter two intertwined categories that our data suggest are important: encouraging social dynamics and related development of norms concerning environmental behavior (category 2), and fostering internalized norms and environmental concern (category 3).

The effect of including a 'psychooncological statement' in the discharge summary on patient-physician communication: a randomized controlled trial.

PubMed

Book, Katrin; Dinkel, Andreas; Henrich, Gerhard; Stuhr, Claudia; Peuker, Mareike; Härtl, Kristin; Brähler, Elmar; Herschbach, Peter

2013-12-01

The objective of this study is to determine whether the inclusion of a 'psychooncological statement' (PO-statement) in the discharge summary enhances patient-physician communication about psychosocial issues across the inpatient and outpatient sector. A total of 1416 cancer patients were randomly assigned to the intervention (with PO-statement in the discharge summary) or control group (discharge summary without PO-statement). Shortly before discharge from the hospital (T1), patients from the intervention group were screened for psychosocial distress. Based on the electronic clinical documentation system, screening results were subsequently integrated into the discharge summary, which automatically generated a PO-statement. To determine the effect of the PO-statement, patients as well as their primary care physicians (n = 596) were asked during follow-up care (T2) whether psychosocial distress was discussed during the last consultation. Including a PO-statement in the discharge summary did not result in more frequent discussions about psychosocial issues compared with the control group from the patients' and physicians' perspectives. Instead, discussions about psychosocial well-being were significantly associated with women of the patient (p = <0.001) and the physician (p = 0.011), medical discipline (gynecologists; p = 0.002), cancer diagnosis (gynecological cancer; p = 0.002), metastases (p = <0.001), professional training of patients (none, p = 0.026), and psychosocial qualification of physicians (p = 0.018). Written information on psychosocial distress in the discharge summary alone does not affect communication. Copyright © 2013 John Wiley & Sons, Ltd.

A Cross-Cultural Study on Behaviors When Death Is Approaching in East Asian Countries: What Are the Physician-Perceived Common Beliefs and Practices?

PubMed

Cheng, Shao-Yi; Suh, Sang-Yeon; Morita, Tatsuya; Oyama, Yasuhiro; Chiu, Tai-Yuan; Koh, Su Jin; Kim, Hyun Sook; Hwang, Shinn-Jang; Yoshie, Taeko; Tsuneto, Satoru

2015-09-01

The primary aim of this study was to explore common beliefs and practices when death is approaching in East-Asian countries. A cross-sectional survey was performed involving palliative care physicians in Japan, Korea, and Taiwan. Measurement outcomes were physician-perceived frequencies of the following when patient death was approaching: (1) reluctance to take part in end-of-life discussions, (2) role of family members, (3) home death, and (4) circumstances surrounding death. A total of 505, 211, and 207 responses were obtained from Japanese, Korea, and Taiwan physicians, respectively. While 50% of the Japanese physicians reported that they often or very often experienced families as being reluctant to discuss end-of-life issues, the corresponding figures were 59% in Korea and 70% in Taiwan. Two specific reasons to avoid end-of-life discussion, "bad things happen after you say them out loud" and "a bad life is better than a good death" were significantly more frequently observed in Taiwan. Prioritizing the oldest of the family in breaking bad news and having all family members present at the time of death were significantly more frequently observed in Korea and Taiwan. Half of Taiwanese physicians reported they often or very often experienced the patients/family wanted to go back home to die because the soul would not be able to return from the hospital. In all countries, more than 70% of the physicians reported certain family members were expected to care for the patient at home. At the time of death, while no Japanese physicians stated that they often experienced patients wanted a religious person to visit, the corresponding figure in Korean and Taiwan was about 40%. Uncovered expression of emotion was significantly frequently observed in Korean and Taiwan, and 42% of the Japanese physicians reported family members cleaned the dead body of the patient themselves. There seem to be significant intercountry differences in beliefs and practices when death is approaching in East Asian countries. Future studies on direct observations of patients and families are needed.

A Cross-Cultural Study on Behaviors When Death Is Approaching in East Asian Countries

PubMed Central

Cheng, Shao-Yi; Suh, Sang-Yeon; Morita, Tatsuya; Oyama, Yasuhiro; Chiu, Tai-Yuan; Koh, Su Jin; Kim, Hyun Sook; Hwang, Shinn-Jang; Yoshie, Taeko; Tsuneto, Satoru

2015-01-01

Abstract The primary aim of this study was to explore common beliefs and practices when death is approaching in East-Asian countries. A cross-sectional survey was performed involving palliative care physicians in Japan, Korea, and Taiwan. Measurement outcomes were physician-perceived frequencies of the following when patient death was approaching: (1) reluctance to take part in end-of-life discussions, (2) role of family members, (3) home death, and (4) circumstances surrounding death. A total of 505, 211, and 207 responses were obtained from Japanese, Korea, and Taiwan physicians, respectively. While 50% of the Japanese physicians reported that they often or very often experienced families as being reluctant to discuss end-of-life issues, the corresponding figures were 59% in Korea and 70% in Taiwan. Two specific reasons to avoid end-of-life discussion, “bad things happen after you say them out loud” and “a bad life is better than a good death” were significantly more frequently observed in Taiwan. Prioritizing the oldest of the family in breaking bad news and having all family members present at the time of death were significantly more frequently observed in Korea and Taiwan. Half of Taiwanese physicians reported they often or very often experienced the patients/family wanted to go back home to die because the soul would not be able to return from the hospital. In all countries, more than 70% of the physicians reported certain family members were expected to care for the patient at home. At the time of death, while no Japanese physicians stated that they often experienced patients wanted a religious person to visit, the corresponding figure in Korean and Taiwan was about 40%. Uncovered expression of emotion was significantly frequently observed in Korean and Taiwan, and 42% of the Japanese physicians reported family members cleaned the dead body of the patient themselves. There seem to be significant intercountry differences in beliefs and practices when death is approaching in East Asian countries. Future studies on direct observations of patients and families are needed. PMID:26426631

Parent-child communication about sexual and reproductive health: evidence from the Brong Ahafo region, Ghana.

PubMed

Manu, Abubakar A; Mba, Chuks Jonathan; Asare, Gloria Quansah; Odoi-Agyarko, Kwasi; Asante, Rexford Kofi Oduro

2015-03-07

Young people aged 10-24 years represent one-third of the Ghanaian population. Many are sexually active and are at considerable risk of negative health outcomes due to inadequate sexual and reproductive health knowledge. Although growing international evidence suggests that parent-child sexual communication has positive influence on young people's sexual behaviours, this subject has been poorly studied among Ghanaian families. This study explored the extent and patterns of parent-child sexual communication, and the topics commonly discussed by parents. A cross-sectional design was used to sample 790 parent-child dyads through a two-stage cluster sampling technique with probability proportional to size. Interviewer-administered questionnaire method was used to gather quantitative data on parent-child communication about sex. Twenty sexual topics were investigated to describe the patterns and frequency of communication. The Pearson's chi-square and z-test for two-sample proportions were used to assess sexual communication differences between parents and young people. Qualitative data were used to flesh-out relevant issues which standard questionnaire could not cover satisfactorily. About 82.3% of parents had at some point in time discussed sexual and reproductive health issues with their children; nonetheless, the discussions centered on a few topics. Whereas child-report indicated that 78.8% of mothers had discussed sexual communication with their children, 53.5% of fathers had done so. Parental discussions on the 20 sexual topics ranged from 5.2%-73.6%. Conversely, young people's report indicates that mother-discussed topics ranged between 1.9%-69.5%, while father-discussed topics ranged from 0.4% to 46.0%. Sexual abstinence was the most frequently discussed topic (73.6%), followed by menstruation 63.3% and HIV/AIDS 61.5%; while condom (5.2%) and other contraceptive use (9.3%) were hardly discussed. The most common trigger of communication cited by parent-child dyads was parent's own initiation (59.1% vs. 62.6% p=0.22). Parents in the Brong Ahafo region of Ghana do talk to children about sex, but their conversations cover limited topics. While abstinence is the most widely discussed sexual topic, condoms and contraception were rarely discussed. Sex educational programmes ought to encourage parents to expand sexual communication to cover more topics.

Frequently Asked Questions on Starting-up New Domestic Composite Wood Mills and the Use of Experimental Products and Resins

EPA Pesticide Factsheets

The following frequently asked questions (FAQs) address issues relating to starting-up new doestice composite wood mills and the use of experimental product and resin systems under the Formaldehyde Emission Standards for Composite Wood Products final rule

Detecting Item Drift in Large-Scale Testing

ERIC Educational Resources Information Center

Guo, Hongwen; Robin, Frederic; Dorans, Neil

2017-01-01

The early detection of item drift is an important issue for frequently administered testing programs because items are reused over time. Unfortunately, operational data tend to be very sparse and do not lend themselves to frequent monitoring analyses, particularly for on-demand testing. Building on existing residual analyses, the authors propose…

A relational perspective on autonomy for older adults residing in nursing homes.

PubMed

Sherwin, Susan; Winsby, Meghan

2011-06-01

To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent's deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. © 2010 Blackwell Publishing Ltd.

A relational perspective on autonomy for older adults residing in nursing homes

PubMed Central

Sherwin, Susan; Winsby, Meghan

2011-01-01

Abstract Aim  To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Background  Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. Methods  We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. Conclusion  We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent’s deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. PMID:21029285

Promoting social responsibility amongst health care users: medical tourists' perspectives on an information sheet regarding ethical concerns in medical tourism.

PubMed

Adams, Krystyna; Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory

2013-12-06

Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants' desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision. The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry.

Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

PubMed Central

2013-01-01

Background Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism. Results According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants’ desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision. Conclusions The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry. PMID:24314027

Measure Guideline: Guidance on Taped Insulating Sheathing Drainage Planes

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

Grin, A.; Lstiburek, J.

This guide provides information and recommendations to the following groups: insulation contractors; general contractors; builders; home remodelers; mechanical contractors; and homeowners, as a guide to the work that needs to be done. The order of work completed during home construction and retrofit improvements is important. Health and safety issues must be addressed first and are more important than durability issues. And durability issues are more important than saving energy. Not all techniques can apply to all houses. Special conditions will require special action. Some builders or homeowners will wish to do more than the important but basic retrofit strategies outlinedmore » by this guide. The following are best practice and product recommendations from the interviewed contractors and homebuilders who collectively have a vast amount of experience. Three significant items were discussed with the group which are required to make taped insulating sheathing a simple, long term, and durable drainage plane: 1. Horizontal joints should be limited or eliminated wherever possible; 2. Where a horizontal joint exists use superior materials; 3. Frequent installation inspection and regular trade training are required to maintain proper installation. Section 5 of this measure guideline contains the detailed construction procedure for the three recommended methods to effectively seal the joints in exterior insulating sheathing to create a simple, long term, and durable drainage plane.« less

A qualitative exploration of perceived key knowledge and skills in end-of-life care in dementia patients among medical, nursing, and pharmacy students.

PubMed

Nguyen, Christopher M; Jansen, Bannin De Witt; Hughes, Carmel M; Rasmussen, Wendy; Weckmann, Michelle T

2015-01-01

The steady increase in the number of people living and dying with dementia, coupled with the recent focus on quality of care, has highlighted the importance of dementia training for health care professionals. This exploratory study aimed to discover which skills health care students felt were important in providing quality end-of-life care to dementia patients. Ninety-four medicine, nursing, and pharmacy students participated in a larger study using open-ended and closed questions to explore attitudes related to caring for dementia patients at the end of life. This study looks at the student responses to an open-ended question regarding the skills and knowledge they believe are needed to provide end-of-life care to dementia patients. Individual responses were reviewed by the researchers, coded into key issues, and tabulated for frequency of occurrences and group differences. Several common issues emerged: knowledge, patience, empathy, understanding, family involvement, compassion, medication knowledge, respect/patient autonomy, communication, quality of life, and patient education. Significant differences were observed among the participant groups on the following issues: Patience and understanding (pharmacy students mentioned these issues less frequently than medical and nursing students), compassion (medical students mentioned this issue more frequently than pharmacy students), and medication knowledge (pharmacy students mentioned this issue more frequently than medical and nursing students). Different health care disciplines (in-training) value different skill sets for the provision of dementia care at the end-of-life. As health care education for dementia patients at the end of life is expanded, it will be important to understand which skills both patients and health care students value.

Cooperation in marine affairs: Evidence from the Gulf of Thailand

NASA Astrophysics Data System (ADS)

Harakunarak, Ampai

1998-12-01

This study argues that the evolving process of interstate cooperation based upon power interests could operate regardless of the formal or expressed will of governments to make binding agreements. The study developed a comprehensive model for interstate cooperation in which state interests were part of conditions for the mutual problem-solving process. The model was then tested against three marine issues in the Gulf of Thailand: offshore hydrocarbon development associated with maritime boundary delimitation, marine fisheries, and marine pollution. Literature review, newspapers and periodicals, on-line databases, and unstructured interviews were primary sources of data. The analysis found that consultation accounted for cooperative interaction among the realist Gulf of Thailand states. Evidence from three tested marine issues suggested that frequent contact and subsequent effects of a greater exchange of knowledge and information can at least stabilize relationships between the states. Informality and non-binding nature of the interactive process offered the states the needed flexibility in designing and implementing effective marine management in the Gulf of Thailand. The study discussed a modified realist framework and some implications for a future study of informal regimes and compliance with interstate agreements.

Computational aspects in mechanical modeling of the articular cartilage tissue.

PubMed

Mohammadi, Hadi; Mequanint, Kibret; Herzog, Walter

2013-04-01

This review focuses on the modeling of articular cartilage (at the tissue level), chondrocyte mechanobiology (at the cell level) and a combination of both in a multiscale computation scheme. The primary objective is to evaluate the advantages and disadvantages of conventional models implemented to study the mechanics of the articular cartilage tissue and chondrocytes. From monophasic material models as the simplest form to more complicated multiscale theories, these approaches have been frequently used to model articular cartilage and have contributed significantly to modeling joint mechanics, addressing and resolving numerous issues regarding cartilage mechanics and function. It should be noted that attentiveness is important when using different modeling approaches, as the choice of the model limits the applications available. In this review, we discuss the conventional models applicable to some of the mechanical aspects of articular cartilage such as lubrication, swelling pressure and chondrocyte mechanics and address some of the issues associated with the current modeling approaches. We then suggest future pathways for a more realistic modeling strategy as applied for the simulation of the mechanics of the cartilage tissue using multiscale and parallelized finite element method.

Tobacco control and gender in south-east Asia. Part II: Singapore and Vietnam.

PubMed

Morrow, Martha; Barraclough, Simon

2003-12-01

In the World Health Organization's Western Pacific Region, being born male is the single greatest risk marker for tobacco use. While the literature demonstrates that risks associated with tobacco use may vary according to sex, gender refers to the socially determined roles and responsibilities of men and women, who initiate, continue and quit using tobacco for complex and often different reasons. Cigarette advertising frequently appeals to gender roles. Yet tobacco control policy tends to be gender-blind. Using a broad, gender-sensitivity framework, this contradiction is explored in four Western Pacific countries. Part I of the study presented the rationale, methodology and design of the study, discussed issues surrounding gender and tobacco, and analysed developments in Malaysia and the Philippines (see the previous issue of this journal). Part II deals with Singapore and Vietnam. In all four countries gender was salient for the initiation and maintenance of smoking. Yet, with a few exceptions, gender was largely unrecognized in control policy. Suggestions for overcoming this weakness in order to enhance tobacco control are made.

Brain Modules, Personality Layers, Planes of Being, Spiral Structures, and the Equally Implausible Distinction between TCI-R "Temperament" and "Character" Scales: A Reply to Cloninger.

PubMed

Farmer, Richard F; Goldberg, Lewis R

2008-09-01

In this reply we address comments by Cloninger (this issue) related to our report (Farmer & Goldberg, this issue) on the psychometric properties of the revised Temperament and Character Inventory (TCI-R) and a short inventory derivative, the TCI-140. Even though Cloninger's psychobiological model has undergone substantial theoretical modifications, the relevance of these changes for the evaluation and use of the TCI-R remains unclear. Aspects of TCI-R assessment also appear to be theoretically and empirically incongruent with Cloninger's assertion that TCI-R personality domains are non-linear and dynamic in nature. Several other core assumptions from the psychobiological model, including this most recent iteration, are non-falsifiable, inconsistently supported, or have no apparent empirical basis. Although researchers using the TCI and TCI-R have frequently accepted the temperament/character distinction and associated theoretical ramifications, for example, we find little overall support for the differentiation of TCI-R domains into these two basic categories. The implications of these observations for TCI-R assessment are briefly discussed.

Infections are a global issue: infection addresses global issues.

PubMed

Grobusch, M P; Calleri, G; Bogner, J R

2012-12-01

Infections are of unifying global concern, despite regional differences in disease epidemiology, clinical appearance and the instruments to tackle them. The primary aim of Infection is "to be a forum for the presentation and discussion of clinically relevant information on infectious diseases… from all over the world". To that end, and as a reflection of the global burden of infectious diseases, we intend to increase the number of high-quality contributions from authors addressing the aetiology, pathogenesis, diagnosis and treatment of infectious diseases from outside Europe and the affluent North (Chang et al. Infection 40:359-365, 2012; Misra et al. Infection 40:125-130, 2012). The Editorial Board of Infection envisages the journal as an interface between where infectious diseases meet and mix between "North and South"--i.e., the field of travel medicine--frequently functioning as a sentinel for altered/novel disease activities that are encountered as imported conditions. With the change in generation on the Editorial Board, Infection aims to expand the areas of tropical medicine, travel medicine and global health with its own section editors (GC and MPG). Contributions from outside Europe are actively encouraged.

A qualitative description of service providers' experiences of ethical issues in HIV care.

PubMed

Sabone, Motshedisi B; Mogobe, Keitshokile Dintle; Matshediso, Ellah; Shaibu, Sheila; Ntsayagae, Esther I; Corless, Inge B; Cuca, Yvette P; Holzemer, William L; Dawson-Rose, Carol; Baez, Solymar S Soliz; Rivero-Mendz, Marta; Webel, Allison R; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Wantland, Dean; Nicholas, Patrice K; Lingren, Teri; Portillo, Carmen J; Sefcik, Elizabeth; Long-Middleton, Ellen

2018-01-01

Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care.

[Students Having Parents with Mental Health Issues and Teachers' Mental Health Literacy].

PubMed

Bruland, Dirk; Kornblum, Katharina; Harsch, Stefanie; Bröder, Janine; Okan, Orkan; Bauer, Ullrich

2017-12-01

Students Having Parents with Mental Health Issues and Teachers' Mental Health Literacy Mental health issues of parents of school children often negatively affects the children as well, including their school performance and social behavior in the school setting. Teachers are then required to take actions with regards to supporting children in their coping with and mastering of their home situation and their responds to educational demands. As such, schools' and teachers' actions can either support affected children and fulfill a protective function or respond inappropriately, with negative impact on the affected children. Although the societal discussion about and acceptance of mental illnesses have increased in recent years, scientific knowledge on how well teachers are prepared for meeting the needs of affected students remains insufficient. Therefore, this research study examines teachers' attitudes towards, knowledge about, and competencies regarding children affected by a mentally ill parent. 15 in-depth interviews and 3 focus groups (n = 11) with teachers from primary and secondary schools were conducted and systematically analyzed. Although burdens in the family are perceived as major influences on children's school day and performance, teachers report to not feel sufficiently prepared for and uncertain about supporting and coping with the special needs of affected students. Instead they report to "learn from a case to case" basis. Recognizing the family situation of children with mentally ill parents is reported to be especially difficult for teachers. Responding inadequately and insensitive to the needs of affected children was perceived as a serious burden for teachers themselves. While schools can function as entry points to professional social help systems, teachers frequently reported barriers and challenges in accessing, communicating, and collaborating with these systems. The practical implications of these results regarding the "Mental Health Literacy" of teachers are being discussed.

The entry-level occupational therapy clinical doctorate: advantages, challenges, and international issues to consider.

PubMed

Brown, Ted; Crabtree, Jeffrey L; Mu, Keli; Wells, Joe

2015-04-01

Internationally, occupational therapy education has gone through several paradigm shifts during the last few decades, moving from certificate to diploma to bachelors to masters and now in some instances to clinical doctorate as the entry-level professional credential to practice. In the United States there is a recommendation under consideration by the American Occupational Therapy Association (AOTA) that by 2025, all occupational therapy university programs will move to the clinical doctorate level. It should be noted, however, that the AOTA Board can only make recommendations and it is the Accreditation Council for Occupational Therapy Education (ACOTE) who has regulatory authority to approve such a change. What are the potential implications for the profession, our clients, and funders of occupational therapy services? What are the primary drivers for the move towards the clinical doctorate being the educational entry point? Is the next step in the evolution of occupational therapy education globally a shift to the entry-level clinical doctorate? This article reviews current literature and discusses issues about the occupational therapy entry-level clinical doctorate. The published evidence available about the occupational therapy entry-level clinical doctorate is summarized and the perceived or frequently cited pros and cons of moving to the clinical doctorate as the singular entry point to occupational therapy practice are considered. The potential impacts of the introduction of the clinical doctorate as the entry-to-practice qualification across the United States on the occupational therapy community internationally will be briefly discussed. If the United States moves toward the entry-level clinical doctorate as the only educational starting point for the profession, will other jurisdictions follow suit? Further discourse and investigation of this issue both inside and outside of the United States is needed so that informed decisions can be made.

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review

PubMed Central

Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo

2017-01-01

Background The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. Aim The goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. Methods A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. Results The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. Discussion The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues cannot be managed without a careful consideration for the complexity of contexts in which nutrition-related interventions are expected to be implemented. These interventions engage a variety of actors with diverse perspectives and interests. We discuss these challenges and also comment on the importance of considering ethical impacts in the monitoring and evaluation of such interventions. Conclusion General ethical frameworks or recommendations–although useful–cannot be expected to provide policy makers, implementators and other public health personnel with sufficient practical ethical guidance as they cannot consider and anticipate the particularities of all specific nutrition-related public health interventions and the complexity of the contexts in which they are implemented. Further research is needed in order to develop more targeted ethical frameworks. PMID:29073186

Using the Emanuel et al. framework to assess ethical issues raised by a biomedical research ethics committee in South Africa.

PubMed

Tsoka-Gwegweni, Joyce M; Wassenaar, Douglas R

2014-12-01

The Emanuel, Wendler, and Grady framework was designed as a universal tool for use in many settings including developing countries. However, it is not known whether the work of African health research ethics committees (RECs) is compatible with this framework. The absence of any normative or empirical weighting of the eight principles within this framework suggests that different health RECs may raise some ethical issues more frequently than others when reviewing protocols. We used the Emanuel et al. framework to assess, code, and rank the most frequent ethical issues considered by a biomedical REC during review of research protocols for the years 2008 to 2012. We extracted data from the recorded minutes of a South African biomedical REC for the years 2008 to 2012, designed the data collection sheet according to the Emanuel et al. framework, and removed all identifiers during data processing and analysis. From the 98 protocols that we assessed, the most frequent issues that emerged were the informed consent, scientific validity, fair participant selection, and ongoing respect for participants. This study represents the first known attempt to analyze REC responses/minutes using the Emanuel et al. framework, and suggests that this framework may be useful in describing and categorizing the core activities of an REC. © The Author(s) 2014.

Engaging Novice Researchers in the Process and Culture of Science Using a "Pass-the-Problem" Case Strategy

ERIC Educational Resources Information Center

White, Harold B., III; Usher, David C.

2015-01-01

Undergraduates having their first research experience frequently have little idea of what to expect. Institutions offering summer research experiences attempt to address this issue through programs that introduce students to the process and culture of science. However, didactic approaches frequently bore students who prefer more interactive…

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

PubMed

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

2014-08-01

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

An overview of health control in Croatian aquaculture.

PubMed

Oraić, D; Zrncić, S

2005-08-01

Aquaculture is an important segment of Croatian fishing industry with long tradition of carp and rainbow trout farming as well as marine aquaculture represented by shellfish (flat oyster and mussels), sea bass and sea bream cultivation and Atlantic bluefin tuna fattening. The fish and shellfish diseases survey is regulated by "Decree on the measures of animal health protection against infectious and parasite diseases" issued yearly by Ministry of Agriculture. This report derives from systematic clinical, parasitological, pathoanatomical, histopathological, bacteriological and virological monitoring of cultivated fish and shellfish on larger part of production during last several years. Among pathological conditions recognised on our farms, some specific viruses, bacteria and parasites represent frequently established causative nosologic agents. The overview of the main diseases with economic impact to the cultivation will be discussed in this paper.

Syndromic Disorders with Short Stature

PubMed Central

Şıklar, Zeynep; Berberoğlu, Merih

2014-01-01

Short stature is one of the major components of many dysmorphic syndromes. Growth failure may be due to a wide variety of mechanisms, either related to the growth hormone (GH)/insulin-like growth factor axis or to underlying unknown pathologies. In this review, the relatively more frequently seen syndromes with short stature (Noonan syndrome, Prader-Willi syndrome, Silver-Russell syndrome and Aarskog-Scott syndrome) were discussed. These disorders are associated with a number of endocrinopathies, as well as with developmental, systemic and behavioral issues. At present, GH therapy is used in most syndromic disorders, although long-term studies evaluating this treatment are insufficient and some controversies exist with regard to GH dose, optimal age to begin therapy and adverse effects. Before starting GH treatment, patients with syndromic disorders should be evaluated extensively. PMID:24637303

Case history: improved maxillary growth and development following digit sucking elimination and orofacial myofunctional therapy.

PubMed

Green, Shari

2013-11-01

Orofacial myologists are frequently called upon to address retained oral habit concerns. During this process, current I.A.O.M. recommended treatment includes addressing tongue, lip, and jaw rest posture concerns. Following digit sucking remediation, we may also be called upon to address these rest posture issues, and tongue thrust more aggressively together. In this process, facial growth and development and jaw structure may coincidentally improve as a result of 'nature taking its course' by addressing both swallow AND rest posture. In a select subset of clients, dramatic improvements may occur if the timing is right. This article discusses one such case that appears to have yielded a significant improvement in oral postures influencing improved facial and oral growth and development.

[Safety and efficacy of ketamine for pain relief].

PubMed

Niesters, Marieke; Dahan, Albert; van Kleef, Maarten

2016-01-01

Intravenous ketamine treatment is frequently used for the management of chronic pain, especially in those patients who do not benefit from other therapies. In this commentary we discuss the efficacy of ketamine for relief of chronic pain and ketamine's safety profile. A review of the literature indicates that only a few studies show that intravenous ketamine has analgesic effects that persist beyond the infusion period, an effect that occurs in about two-thirds of patients. Ketamine has multiple safety issues, ranging from psychotomimetic and schizotypal symptoms, sympathetic stimulation, tachycardia and hypertension, and damage to the liver and the urogenital tract. Damage to the urogenital tract seems to be restricted to individuals who chronically abuse ketamine. We indicate the need for large randomized trials in which ketamine is compared with an 'active' placebo.

Argument Diagramming: The Araucaria Project

NASA Astrophysics Data System (ADS)

Rowe, Glenn; Reed, Chris

Formal arguments, such as those used in science, medicine and law to establish a conclusion by providing supporting evidence, are frequently represented by diagrams such as trees and graphs. We describe the software package Araucaria which allows textual arguments to be marked up and represented as standard, Toulmin or Wigmore diagrams. Since each of these diagramming techniques was devised for a particular domain or argumentation, we discuss some of the issues involved in translating between diagrams. The exercise of translating between different diagramming types illustrates that any one diagramming system often cannot capture all of the nuances inherent in an argument. Finally, we describe some areas, such as critical thinking courses in colleges and universities and the analysis of evidence in court cases, where Araucaria has been put to practical use.

Conducting qualitative research in audiology: a tutorial.

PubMed

Knudsen, Line V; Laplante-Lévesque, Ariane; Jones, Lesley; Preminger, Jill E; Nielsen, Claus; Lunner, Thomas; Hickson, Louise; Naylor, Graham; Kramer, Sophia E

2012-02-01

Qualitative research methodologies are being used more frequently in audiology as it allows for a better understanding of the perspectives of people with hearing impairment. This article describes why and how international interdisciplinary qualitative research can be conducted. This paper is based on a literature review and our recent experience with the conduction of an international interdisciplinary qualitative study in audiology. We describe some available qualitative methods for sampling, data collection, and analysis and we discuss the rationale for choosing particular methods. The focus is on four approaches which have all previously been applied to audiologic research: grounded theory, interpretative phenomenological analysis, conversational analysis, and qualitative content analysis. This article provides a review of methodological issues useful for those designing qualitative research projects in audiology or needing assistance in the interpretation of qualitative literature.

An Industrial Perspective on Environmentally Assisted Cracking of Some Commercially Used Carbon Steels and Corrosion-Resistant Alloys

NASA Astrophysics Data System (ADS)

Ashida, Yugo; Daigo, Yuzo; Sugahara, Katsuo

2017-08-01

Commercial metals and alloys like carbon steels, stainless steels, and nickel-based super alloys frequently encounter the problem of environmentally assisted cracking (EAC) and resulting failure in engineering components. This article aims to provide a perspective on three critical industrial applications having EAC issues: (1) corrosion and cracking of carbon steels in automotive applications, (2) EAC of iron- and nickel-based alloys in salt production and processing, and (3) EAC of iron- and nickel-based alloys in supercritical water. The review focuses on current industrial-level understanding with respect to corrosion fatigue, hydrogen-assisted cracking, or stress corrosion cracking, as well as the dominant factors affecting crack initiation and propagation. Furthermore, some ongoing industrial studies and directions of future research are also discussed.

Canadian Aboriginal people's experiences with HIV/AIDS as portrayed in selected English language Aboriginal media (1996-2000).

PubMed

Clarke, Juanne N; Friedman, Daniela B; Hoffman-Goetz, Laurie

2005-05-01

This paper describes the portrayal of HIV/AIDS in 14 mass print newspapers directed towards the Canadian Aboriginal population and published between 1996 and 2000. Based on qualitative content analysis the research examines both manifest and latent meanings. Manifest results of this study indicate that women and youth are under represented as persons with HIV/AIDS. The latent results note the frequent references to Aboriginal culture, and the political and economic position of Aboriginal Canadians when discussing the disease, the person with the disease, the fear of the disease and the reaction of the community to the person with the disease. Unlike mainstream media where the medical frame is dominant, HIV/AIDS are here contextualized by culture, identity, spirituality and political-economic issues.

Practical solutions.

PubMed

Midgley, M

1989-01-01

A British philosopher writes on the necessity of altering stereotypes within and without the animal rights movement if its goals are to be defined and achieved. Midgley devotes the first half of her essay to a discussion of the difficulties of effecting any social change due to conflict between extremist reformers and nominal reformers. The former often are led to an abstract, negative, and impractical absolutism, and the latter frequently are paralyzed by respectability and lose the desire to effect change. Midgley then outlines the difficulties society has in reconciling a two centuries old trend toward compassionate, humanitarian thinking with the controversial subject of animal welfare. She argues that such issues as animal farming, fur-wearing, and animal experimentation cannot be addressed by adherence to impractical stereotypes held by animal welfarists, scientists, and the rest of society.

A unique funding opportunity for public health in Texas.

PubMed

Schlenker, Thomas; Huber, Carol A

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.

When and how should I tell? Personal disclosure of a schizophrenia diagnosis in the context of intimate relationships.

PubMed

Seeman, Mary V

2013-03-01

Clinicians are frequently asked for advice on what to tell prospective marriage partners about a history of mental illness. The aim of this paper is to develop guidelines for disclosure. An electronic search was conducted of the stigma, secrecy, communication, sociology, and matchmaking literatures as they pertain to mental illness, especially to schizophrenia. The conclusion was that pre-existing psychiatric conditions must be shared with prospective marriage partners once these partners have proven trustworthy. The recommendation is that disclosure be done in stages and that discussions continue, with attempts made to address all relevant issues and address the partner's concerns. Although schizophrenia does not define who a person is, the diagnosis and its implications are important and need to be shared with prospective marriage partners.

The Evaluations of Swine Flu Magnitudes in TV News: A Comparative Analysis of Paired Influenza Pandemics.

PubMed

Pan, Po-Lin; Meng, Juan

2015-01-01

This study examined how major TV news networks covered two flu pandemics in 1976 and 2009 in terms of news frames, mortality exemplars, mortality subject attributes, vaccination, evaluation approaches, and news sources. Results showed that the first pandemic was frequently framed with the medical/scientific and political/legal issues, while the second pandemic was emphasized with the health risk issue in TV news. Both flu pandemics were regularly reported with mortality exemplars, but the focus in the first pandemic was on the flu virus threat and vaccination side effects, while the vaccination shortage was frequently revealed in the second outbreak.

Physicians' self-reported practice behaviour regarding fertility-related discussions in paediatric oncology in Sweden.

PubMed

Armuand, G M; Nilsson, J; Rodriguez-Wallberg, K A; Malmros, J; Arvidson, J; Lampic, C; Wettergren, L

2017-10-01

The aim of this study was to investigate practice behaviours of Swedish physicians with regard to discussing the impact of cancer treatment on fertility with paediatric oncology patients and their parents, and to identify factors associated with such discussions. A cross-sectional survey study was conducted targeting all physicians in Sweden working in paediatric oncology care settings. Participants responded to a questionnaire measuring practice behaviour, attitudes, barriers, and confidence in knowledge. Multivariable logistic regression was used to determine factors associated with seldom discussing fertility. More than half of the physicians routinely talked with their patients/parents about the treatment's potential impact on fertility (male patients: 62%; female patients: 57%; P = 0.570). Factors associated with less frequently discussing fertility with patients/parents were working at a non-university hospital (male patients: OR 11.49, CI 1.98-66.67; female patients: OR 33.18, CI 4.06-271.07), concerns that the topic would cause worry (male patients: OR 8.23, CI 1.48-45.89; female patients: OR 12.38, CI 1.90-80.70), and perceiving the parents as anxious (male patients: OR 7.18, CI 1.20-42.85; female patients: OR 11.65, CI 1.32-103.17). Based on our findings, we recommend structured training in how to communicate about fertility issues in stressful situations, which in turn might increase fertility-related discussions in paediatric oncology. © 2017 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

Survey of advertising for nutritional supplements in health and bodybuilding magazines.

PubMed

Philen, R M; Ortiz, D I; Auerbach, S B; Falk, H

1992-08-26

The use of food supplements by the general public is poorly quantified, and little information on this subject is available in the medical literature. We surveyed 12 recent issues of popular health and bodybuilding magazines (1) to quantify the number of advertisements for food supplements, the number of products advertised, and the number and type of ingredients in these products; (2) to identify the purported health benefits of these products; and (3) as a preliminary effort to identify areas for future research. We counted 89 brands, 311 products, and 235 unique ingredients, the most frequent of which were unspecified amino acids; the most frequently promoted health benefit was muscle growth. We also found many unusual or unidentifiable ingredients, and 22.2% of the products had no ingredients listed in their advertisements. Health professionals may not be aware of how popular food supplements are or of a particular supplement's potential effects or side effects. In addition, patients may be reluctant to discuss their use of these products with traditional medical practitioners. We recommend that routine history taking include specific questions about patients' use of food supplements and that any possible adverse effects or side effects be reported to public health authorities.

Mortality in epilepsy.

PubMed

Hitiris, Nikolas; Mohanraj, Rajiv; Norrie, John; Brodie, Martin J

2007-05-01

All studies report an increased mortality risk for people with epilepsy compared with the general population. Population-based studies have demonstrated that the increased mortality is often related to the cause of the epilepsy. Common etiologies include neoplasia, cerebrovascular disease, and pneumonia. Deaths in selected cohorts, such as sudden unexpected death in epilepsy (SUDEP), status epilepticus (SE), suicides, and accidents are more frequently epilepsy-related. SUDEP is a particular cause for concern in younger people, and whether and when SUDEP should be discussed with patients with epilepsy remain problematic issues. Risk factors for SUDEP include generalized tonic-clonic seizures, increased seizure frequency, concomitant learning disability, and antiepileptic drug polypharmacy. The overall incidence of SE may be increasing, although case fatality rates remain constant. Mortality is frequently secondary to acute symptomatic disorders. Poor compliance with treatment in patients with epilepsy accounts for a small proportion of deaths from SE. The incidence of suicide is increased, particularly for individuals with epilepsy and comorbid psychiatric conditions. Late mortality figures in patients undergoing epilepsy surgery vary and are likely to reflect differences in case selection. Future studies of mortality should be prospective and follow agreed guidelines to better quantify risk and causation in individual populations.

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Can price or cost be an issue in discussions? 636.508... TRAFFIC OPERATIONS DESIGN-BUILD CONTRACTING Discussions, Proposal Revisions and Source Selection § 636.508 Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

Supporting Middle School Students Whose Parents Are Deployed: Challenges and Strategies for Schools

ERIC Educational Resources Information Center

Williams, Brenda

2013-01-01

Middle school students from military families face unique challenges, especially when their parents are deployed. Among the challenges they experience are frequent relocations; issues that affect academic achievement; uncertainty; and changes in roles, responsibilities, and relationships at home. Reunification involves issues of the returning…

Teaching Controversial Environmental Issues: Neutrality and Balance in the Reality of the Classroom

ERIC Educational Resources Information Center

Cotton, Deborah R. E.

2006-01-01

Background: Environmental issues are frequently controversial and involve conflicting interests and values. Much environmental education literature explicitly encourages teachers to promote pro-environmental attitudes and behaviours amongst their students, despite evidence that teacher support for such a policy is ambiguous at best. The literature…

Psychological Impact of Migration on Latinas: Implications for Psychotherapeutic Practice.

ERIC Educational Resources Information Center

Espin, Oliva M.

1987-01-01

Examines the psychological implications of the migratory process on Latin American women in the United States, addressing issues of gender roles, acculturation, language, loss, and grief, that are frequently presented by Latinas in psychotherapy. Interprets these issues as reflective of stresses created by the migratory process, and suggests ways…

Our Better Angels

ERIC Educational Resources Information Center

Barbieri, Richard

2013-01-01

In the Winter 2013 issue of "Independent School," Richard Barbieri considered some of the distressing news about humanity being discovered by various physical and social scientists. Barbieri asserts in this issue that there are countervailing views and discoveries about our minds and our mores, enough for us to hope for the frequent, if…

Counselling Intervention for Family Security

ERIC Educational Resources Information Center

Fareo, Dorcas Oluremi

2015-01-01

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

32 CFR 536.35 - Unique issues related to environmental claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Unique issues related to environmental claims. 536.35 Section 536.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... geographical jurisdiction over the claim and USARCS. Claims for personal injury from contamination frequently...

32 CFR 536.35 - Unique issues related to environmental claims.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Unique issues related to environmental claims. 536.35 Section 536.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS... geographical jurisdiction over the claim and USARCS. Claims for personal injury from contamination frequently...

At Issue: Academic Integrity, an Annotated Bibliography

ERIC Educational Resources Information Center

Pricer, Wayne F.

2009-01-01

Academic integrity is central to the heart of any academic institution, yet the topic is a complex one. This bibliography addresses the subjects of copyright and plagiarism. Resources for exploring common campus copyright and fair use issues seek to answer common, frequently misunderstood questions such as what exactly does "copyright" mean? What…

77 FR 26052 - Invesco Total Property Market Income Fund, et al.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... price of such Fund's common shares at a particular point in time, or a fixed percentage of NAV at a... broker, dealer, bank or other person (``financial intermediary'') holds common shares issued by a Fund in... outstanding common shares as frequently as monthly in any one taxable year, and as frequently as distributions...

A Case Study on the Influence of Frequent Superintendent Turnover on the Culture of a K-12 Suburban School District

ERIC Educational Resources Information Center

Velazquez, Victoria C.

2017-01-01

The role of school superintendents is varied and complex. Further complicating this role is the issue of frequent superintendent turnover. While there is ample research addressing the links between superintendents and student achievement, superintendents' relationships with school boards and the shortage of qualified superintendents across the…

Long-term forest ecosystem research: a programmatic view

Treesearch

Wayne Swank; James Vose

2010-01-01

Long-term research provides the building blocks of knowledge needed to address natural resource and environmental issues. "Long-term" has frequently been considered to span decades with a time frame that usually encompasses at least one generation of scientists and frequently two or more generations. In the rich history of forest science, the origin of long-...

The missions and means framework as an ontology

NASA Astrophysics Data System (ADS)

Deitz, Paul H.; Bray, Britt E.; Michaelis, James R.

2016-05-01

The analysis of warfare frequently suffers from an absence of logical structure for a] specifying explicitly the military mission and b] quantitatively evaluating the mission utility of alternative products and services. In 2003, the Missions and Means Framework (MMF) was developed to redress these shortcomings. The MMF supports multiple combatants, levels of war and, in fact, is a formal embodiment of the Military Decision-Making Process (MDMP). A major effect of incomplete analytic discipline in military systems analyses is that they frequently fall into the category of ill-posed problems in which they are under-specified, under-determined, or under-constrained. Critical context is often missing. This is frequently the result of incomplete materiel requirements analyses which have unclear linkages to higher levels of warfare, system-of-systems linkages, tactics, techniques and procedures, and the effect of opposition forces. In many instances the capabilities of materiel are assumed to be immutable. This is a result of not assessing how platform components morph over time due to damage, logistics, or repair. Though ill-posed issues can be found many places in military analysis, probably the greatest challenge comes in the disciplines of C4ISR supported by ontologies in which formal naming and definition of the types, properties, and interrelationships of the entities are fundamental to characterizing mission success. Though the MMF was not conceived as an ontology, over the past decade some workers, particularly in the field of communication, have labelled the MMF as such. This connection will be described and discussed.

Why people use herbal medicine: insights from a focus-group study in Germany.

PubMed

Welz, Alexandra N; Emberger-Klein, Agnes; Menrad, Klaus

2018-03-15

The use of herbal medicine, as one element of complementary and alternative medicine, is increasing worldwide. Little is known about the reasons for and factors associated with its use. This study derives insights for the use of herbal medicine in Germany regarding the usage aims, role played by the type of illness, reasons for preferred usage and sources of information. Using a qualitative methodological approach, six focus groups (n = 46) were conducted. Two groups with young, middle-aged and elderly participants, respectively. After audiotaping and verbatim transcription, the data were analysed with a qualitative content analysis. We found that treating illnesses was the most frequently discussed aim for using herbal medicine over all age groups. Preventing illnesses and promoting health were less frequently mentioned overall, but were important for elderly people. Discussions on herbal medicine were associated with either mild/moderate diseases or using herbal medicine as a starting treatment before applying conventional medicine. In this context, participants emphasized the limits of herbal medicine for severe illnesses. Dissatisfaction with conventional treatment, past good experiences, positive aspects associated with herbal medicine, as well as family traditions were the most commonly-mentioned reasons why herbal medicine was preferred as treatment. Concerning information sources, independent reading and family traditions were found to be equally or even more important than consulting medicinal experts. Although herbal medicine is used mostly for treating mild to moderate illnesses and participants were aware of its limits, the combination of self-medication, non-expert consultation and missing risk awareness of herbal medicine is potentially harmful. This is particularly relevant for elderly users as, even though they appeared to be more aware of health-related issues, they generally use more medicine compared to younger ones. In light of our finding that dissatisfaction with conventional medicine was the most important reason for a preferred use of herbal medicine, government bodies, doctors, and pharmaceutical companies need to be aware of this problem and should aim to establish a certain level of awareness among users concerning this issue.

Factors affecting parent-adolescent discussion on reproductive health issues in Harar, eastern Ethiopia: a cross-sectional study.

PubMed

Yadeta, Tesfaye Assebe; Bedane, Haji Kedir; Tura, Abera Kenay

2014-01-01

Open family discussion on reproductive health (RH) issues often leads to increased awareness on RH matters and reduces risky behaviors among adolescents. This study was conducted to assess factors affecting parent-adolescent discussion on RH issues in Harar, Ethiopia. A cross-sectional survey using face to face interview supplemented with focus group discussion (FGD) was conducted on 751 randomly selected parents of 10-19-year-old adolescents. Data was analyzed using SPSS version 15. More than one-fourth (28.76%) of parents reported discussing RH issues with their adolescents during the last six months. In the logistic regression, parents who have demonstrated good RH knowledge and positive attitude towards RH were almost six times and seventy percent (AOR 5.69, 95% CI: 3.67-8.82; AOR 1.70, 95% CI: 1.08-2.68) higher in discussing RH with their adolescents than their counterparts, respectively. Parent-adolescent discussion about RH issues rarely occurs and is bounded by lack of knowledge, sociocultural norms, and parental concern that discussion would encourage premarital sex. Reproductive health programs should target on improving awareness of parents and addressing sociocultural norms surrounding reproductive health issues.

Focus Group Study Exploring Factors Related to Frequent Sickness Absence.

PubMed

Notenbomer, Annette; Roelen, Corné A M; van Rhenen, Willem; Groothoff, Johan W

2016-01-01

Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD-R) model as theoretical framework. Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. The JD-R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance.

The critical appraisal of the papers published in the "iranian journal of psychiatry and behavioral sciences", 2007-2010.

PubMed

Kosaryan, Mehrnoosh; Rabiei, Khadijeh

2013-01-01

This study has been done in order to evaluate the papers published in the "Iranian Journal of Psychiatry and Behavioral Sciences" from 2007 to 2010. A questionnaire was developed according to the design, evidence level, and recommendations to write scientific papers. Validity was achieved by consulting experts. Reliability was tested by re-evaluation of 7 randomly selected papers, one month after the first evaluation by Pearson correlation coefficient (r = 0.8). Different parts of the paper, including title, abstract, introduction, materials and methods, results, discussion, and references, were evaluated by a total of 47 questions. Each required item was judged as: appropriate, partially appropriate, not appropriate, and not applicable. SPSS software was used for descriptive analysis. From spring 2007 to summer 2010, 7 issues with 72 papers were published. The most frequent problem in the title was that one could not understand the design of the research by reading it. In the abstract part, in 90% of papers, time and setting of research were not mentioned. Statistical test was not mentioned in 70%, and reliability of the questionnaires was not mentioned in 70% of papers. The discussion part was the hardest part to judge and had few inappropriate issues, such as unnecessary repetition of introduction and/or results; in 20% of papers the conclusion was not appropriate based on the research design. The evaluated papers had strong points, yet more effort is needed for them to approach excellence. None.

Communication Skills for Patient Engagement: Argumentation Competencies As Means to Prevent or Limit Reactance Arousal, with an Example from the Italian Healthcare System

PubMed Central

Bigi, Sarah

2016-01-01

The paper discusses the role of argumentative competencies for the achievement of patient engagement through communication in doctor-patient consultations. The achievement of patient engagement is being proposed by recent studies as a condition that can facilitate in particular patient adherence, which involves behavior change. One obstacle to behavior change that has been observed is reactance, i.e., resistance to persuasive messages when a threat to freedom is perceived. In the medical field, reactance theory has been mostly applied in the field of mental health, less frequently to understand non-adherence in general. However, a few studies have revealed that reactance can actually explain in part the motives behind non-adherence. These studies propose that the arousal of reactance could be limited or prevented by adopting relational measures aimed at giving patients the feeling that they still hold some control over the process of care and that the “impositions” on their freedoms are acceptable because they have had the opportunity to decide about them. However, they do not discuss how these strategies should be operationalized at the dialogical level. A debated issue in the study of reactance is the role played by knowledge. It seems that pure information regarding an issue is likely to represent a threat in itself. Complementary to this is the finding that quality of argument does not impact on the degree of reactance. These findings pose a problem in view of the goal of patient education, itself considered as a necessary premise for any process of patient engagement and adherence. It seems necessary to move away from a conception of education as mere transmission of information and look for more effective ways of transferring knowledge to patients. With regard to this issue, the paper argues that useful insights can be found in studies on science education, in which it is shown experimentally that argumentative processes favor learning and understanding. Drawing on previous studies and taking an interdisciplinary perspective on the issue, the paper brings into the discussion on engagement concepts developed in the field of argumentation theory, showing how the suggestions for avoiding reactance could be realized dialogically. PMID:27729890

Simple Gifts: Ethical Issues in the Conduct of Person-Based Composition Research.

ERIC Educational Resources Information Center

Anderson, Paul V.

1998-01-01

Discusses ethical issues involved with person-based research. Discusses the ethical discourse embodied in the "Nuremberg Code," federal regulations, and the "Belmont Report." Discusses several specific issues in research ethics to illustrate how this discourse provides new ways of thinking about what must be done to treat…

Motivating a Productive Discussion of Normative Issues through Debates

ERIC Educational Resources Information Center

Hennessey, Jessica

2014-01-01

In this article, the author presents a way of using in-class debates to discuss contentious issues and help students develop critical thinking skills. Three elements were incorporated into an undergraduate public finance course: a presentation of ethical approaches in order to formally discuss normative issues, class debates which required…

Hospital consultants breaking bad news with simulated patients: an analysis of communication using the Roter Interaction Analysis System.

PubMed

Vail, Laura; Sandhu, Harbinder; Fisher, Joanne; Cooke, Heather; Dale, Jeremy; Barnett, Mandy

2011-05-01

To explore how experienced clinicians from wide ranging specialities deliver bad news, and to investigate the relationship between physician characteristics and patient centredness. Consultations involving 46 hospital consultants from 22 different specialties were coded using the Roter Interaction Analysis System. Consultants mainly focussed upon providing biomedical information and did not discuss lifestyle and psychosocial issues frequently. Doctor gender, age, place of qualification, and speciality were not significantly related to patient centredness. Hospital consultants from wide ranging specialities tend to adopt a disease-centred approach when delivering bad news. Consultant characteristics had little impact upon patient centredness. Further large-scale studies are needed to examine the effect of doctor characteristics on behaviour during breaking bad news consultations. It is possible to observe breaking bad news encounters by video-recording interactions between clinicians and simulated patients. Future training programmes should focus on increasing patient-centred behaviours which include actively involving patients in the consultation, initiating psychosocial discussion, and providing patients with opportunities to ask questions. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Mining Twitter to Assess the Public Perception of the “Internet of Things”

PubMed Central

Yoshigoe, Kenji; Hicks, Amanda; Yuan, Jiawei; He, Zhe; Xie, Mengjun; Guo, Yi; Prosperi, Mattia; Salloum, Ramzi; Modave, François

2016-01-01

Social media analysis has shown tremendous potential to understand public's opinion on a wide variety of topics. In this paper, we have mined Twitter to understand the public's perception of the Internet of Things (IoT). We first generated the discussion trends of the IoT from multiple Twitter data sources and validated these trends with Google Trends. We then performed sentiment analysis to gain insights of the public’s attitude towards the IoT. As anticipated, our analysis indicates that the public's perception of the IoT is predominantly positive. Further, through topic modeling, we learned that public tweets discussing the IoT were often focused on business and technology. However, the public has great concerns about privacy and security issues toward the IoT based on the frequent appearance of related terms. Nevertheless, no unexpected perceptions were identified through our analysis. Our analysis was challenged by the limited fraction of tweets relevant to our study. Also, the user demographics of Twitter users may not be strongly representative of the population of the general public. PMID:27391760

Transportation or CT scanners: a theory and method of health resources allocation.

PubMed Central

Greenwald, H P; Woodward, J M; Berg, D H

1979-01-01

Cost containment and access to appropriate care are the two most frequently discussed issues in contemporary health policy. Conceiving of the health services available in specific regions as "packages" of diverse items, the authors of this article consider the economic trade-offs among the various resources needed for appropriate care. In the discussion that follows, we examine the trade-offs between two divergent offering of the health care system: high technology medicine and support services. Specifically, we examine several strategies designed to achieve an optimal mix of investments in CT scanners and transportation resources in the South Chicago region. Using linear programming as a method for examining these options, the authors found that 1) the proper location of CT scanners is as important for cost containment as optimal number, and 2) excess capacity in the utilization of a single resource--CT scanners--need not imply inefficiency in the overall delivery of the service. These findings help demonstrate the importance of viewing health care as a package of interrelated services, both for achieving cost containment and for providing access to appropriate care. PMID:391772

Interdisciplinary periodontics: the multidisciplinary approach to the planning and treatment of complex cases.

PubMed

Lyons, Karl M; Darby, Ivan

2017-06-01

Periodontics cannot be practiced in isolation as frequently many patients have multiple dental needs or medical health issues requiring management. In addition, pathology may manifest in the periodontal tissues, and the onset and progression of periodontitis can be affected by systemic conditions, such as diabetes, and vice versa. The focus of this volume of Periodontology 2000 is interdisciplinary periodontics, and the articles included discuss the interactions and the interrelationshipbetween periodontal tissues/periodontal diseases and endodontics, fixed prosthodontics, implant dentistry, esthetics, gerodontology, radiology, orthodontics, pediatric dentistry, oral and maxillofacial surgery, oral pathology, special needs dentistry and general medicine. Previous volumes of Periodontology 2000 have covered some of the interactions between periodontal diseases and other dental disciplines, especially implant dentistry, 'and the interaction between periodontal disease and systemic disease', but there has not been a volume on interdisciplinary periodontics. The intention therefore is to show how and why periodontics should be interdisciplinary, as well as the benefits of an interdisciplinary approach; in addition, the potential consequences of using a discipline in isolation are discussed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Mining Twitter to Assess the Public Perception of the "Internet of Things".

PubMed

Bian, Jiang; Yoshigoe, Kenji; Hicks, Amanda; Yuan, Jiawei; He, Zhe; Xie, Mengjun; Guo, Yi; Prosperi, Mattia; Salloum, Ramzi; Modave, François

2016-01-01

Social media analysis has shown tremendous potential to understand public's opinion on a wide variety of topics. In this paper, we have mined Twitter to understand the public's perception of the Internet of Things (IoT). We first generated the discussion trends of the IoT from multiple Twitter data sources and validated these trends with Google Trends. We then performed sentiment analysis to gain insights of the public's attitude towards the IoT. As anticipated, our analysis indicates that the public's perception of the IoT is predominantly positive. Further, through topic modeling, we learned that public tweets discussing the IoT were often focused on business and technology. However, the public has great concerns about privacy and security issues toward the IoT based on the frequent appearance of related terms. Nevertheless, no unexpected perceptions were identified through our analysis. Our analysis was challenged by the limited fraction of tweets relevant to our study. Also, the user demographics of Twitter users may not be strongly representative of the population of the general public.

Ceramic Top Coats of Plasma-Sprayed Thermal Barrier Coatings: Materials, Processes, and Properties

NASA Astrophysics Data System (ADS)

Bakan, Emine; Vaßen, Robert

2017-08-01

The ceramic top coat has a major influence on the performance of the thermal barrier coating systems (TBCs). Yttria-partially-stabilized zirconia (YSZ) is the top coat material frequently used, and the major deposition processes of the YSZ top coat are atmospheric plasma spraying and electron beam physical vapor deposition. Recently, also new thermal spray processes such as suspension plasma spraying or plasma spray-physical vapor deposition have been intensively investigated for TBC top coat deposition. These new processes and particularly the different coating microstructures that can be deposited with them will be reviewed in this article. Furthermore, the properties and the intrinsic-extrinsic degradation mechanisms of the YSZ will be discussed. Following the TBC deposition processes and standard YSZ material, alternative ceramic materials such as perovskites and hexaaluminates will be summarized, while properties of pyrochlores with regard to their crystal structure will be discussed more in detail. The merits of the pyrochlores such as good CMAS resistance as well as their weaknesses, e.g., low fracture toughness, processability issues, will be outlined.

Disparities in breast cancer care and research: report from a Breast Cancer Research Foundation sponsored workshop, 9-10 October 2014.

PubMed

Canin, Beverly; Freund, Karen M; Ganz, Patricia A; Hershman, Dawn L; Paskett, Electra D

2015-01-01

The purpose of this workshop was to bring together diverse stakeholders from the breast cancer research community to discuss critical issues related to disparities in breast cancer care and to identify potential strategies for reducing disparities and inequities in care through research. The workshop format included a series of formal content presentations, participation in break out groups that focused on specific topics highlighted in the content presentations, reporting back of findings and a facilitated discussion that focused on shaping a research agenda. The workshop members concluded that numerous groups of women are at increased risk for disparities in breast cancer care: many patients and survivors suffer disproportionately from inadequate access to high-quality diagnosis and treatment, resulting in more frequent and severe adverse outcomes from the disease. Research on breast cancer disparities provides a major opportunity for reducing the burden of breast cancer. Thus, it is important for the Breast Cancer Research Foundation and other research funders to consider how to best promote research focused on ensuring breast cancer health equity.

Australian and U.S. news media portrayal of sharks and their conservation.

PubMed

Muter, Bret A; Gore, Meredith L; Gledhill, Katie S; Lamont, Christopher; Huveneers, Charlie

2013-02-01

Investigation of the social framing of human-shark interactions may provide useful strategies for integrating social, biological, and ecological knowledge into national and international policy discussions about shark conservation. One way to investigate social opinion and forces related to sharks and their conservation is through the media's coverage of sharks. We conducted a content analysis of 300 shark-related articles published in 20 major Australian and U.S. newspapers from 2000 to 2010. Shark attacks were the emphasis of over half the articles analyzed, and shark conservation was the primary topic of 11% of articles. Significantly more Australian articles than U.S. articles treated shark attacks (χ(2) = 3.862; Australian 58% vs. U.S. 47%) and shark conservation issues (χ(2) = 6.856; Australian 15% vs. U.S. 11%) as the primary article topic and used politicians as the primary risk messenger (i.e., primary person or authority sourced in the article) (χ(2) = 7.493; Australian 8% vs. U.S. 1%). However, significantly more U.S. articles than Australian articles discussed sharks as entertainment (e.g., subjects in movies, books, and television; χ(2) = 15.130; U.S. 6% vs. Australian 1%) and used scientists as the primary risk messenger (χ(2) = 5.333; U.S. 25% vs. Australian 15%). Despite evidence that many shark species are at risk of extinction, we found that most media coverage emphasized the risks sharks pose to people. To the extent that media reflects social opinion, our results highlight problems for shark conservation. We suggest that conservation professionals purposefully and frequently engage with the media to highlight the rarity of shark attacks, discuss preventative measures water users can take to reduce their vulnerability to shark encounters, and discuss conservation issues related to local and threatened species of sharks. When integrated with biological and ecological data, social-science data may help generate a more comprehensive perspective and inform conservation practice. © 2012 Society for Conservation Biology.

The role of tramadol in pain management in Latin America: a report by the Change Pain Latin America Advisory Panel.

PubMed

Santos Garcia, Joäo Batista; Lech, Osvandré; Campos Kraychete, Durval; Rico, María Antonieta; Hernández-Castro, John Jairo; Colimon, Frantz; Guerrero, Carlos; Sempértegui Gallegos, Manuel; Lara-Solares, Argelia; Flores Cantisani, José Alberto; Amescua-Garcia, César; Guillén Núñez, María Del Rocío; Berenguel Cook, María Del Rosario; Jreige Iskandar, Aziza; Bonilla Sierra, Patricia

2017-09-01

Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strategies in this region. During its seventh meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled. Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, effects of restrictions on its availability and use, and consequent impact on pain care quality. The experts agreed that tramadol is used to treat a wide spectrum of non-oncological pain conditions (e.g. post-surgical, musculoskeletal, post-traumatic, neuropathic, fibromyalgia), as well as cancer pain. Its relevance when treating special patient groups (e.g. the elderly) is recognized. The main reasons for tramadol's high significance as a treatment option are: its broad efficacy, an inconspicuous safety profile and its availability, considering that access to strong analgesics - mainly controlled drugs (classical opioids) - is highly restricted in some countries. The CPLA also agreed that tramadol is well tolerated, without the safety issues associated with long-term nonsteroidal anti-inflammatory drug (NSAID) use, with fewer opioid-like side effects than classical opioids and lower abuse risk. In Latin America, tramadol is a valuable and frequently used medication for treating moderate to severe pain. More stringent regulations would have significant impact on its availability, especially for outpatients. This could cause regression to older and frequently inadequate pain management methods, resulting in unnecessary suffering for many Latin American patients.

Capacity Evaluations of Psychiatric Patients Requesting Assisted Death in the Netherlands

PubMed Central

Doernberg, Samuel N.; Peteet, John R.; Kim, Scott Y.H.

2016-01-01

Objective Euthanasia or physician-assisted suicide (EAS) of psychiatric patients is legal in some countries but remains controversial. This study examined a frequently raised concern about the practice: how physicians address the issue of decision-making capacity of persons requesting psychiatric EAS. Methods A review of psychiatric EAS case summaries published by the Dutch Regional Euthanasia Review Committees. Directed content analysis using a capacity-specific 4 abilities model (understanding of facts, applying those facts to self, weighing/reasoning, and evidencing choice) was used to code texts discussing capacity. 66 cases from 2011-2014 were reviewed. Results In 55% (36 of 66) of cases the capacity-specific discussion consisted of only global judgments of patients’ capacity, even in patients with psychotic disorders. 32% (21 of 66) of cases included evidentiary statements regarding capacity-specific abilities; only 5 cases (8%) mentioned all four abilities. Physicians frequently stated that psychosis or depression did or did not impact capacity but provided little explanation regarding their judgments. Physicians in 8 cases (12%) disagreed about capacity; even when no explanation is given for the disagreement, the review committees generally accepted the judgment of the physician performing EAS. In one case, the physicians noted that not all capacity-specific abilities were intact but deemed the patient capable. Conclusion Case summaries of psychiatric EAS in the Netherlands do not show that a high threshold of capacity is required for granting EAS. Although this may reflect limitations in documentation, it likely represents a practice that reflects the normative position of the review committees. PMID:27590345

Techniques: Integrating the National Issues Forums into ABE Programs.

ERIC Educational Resources Information Center

Colhapp, Barbara Jones

1989-01-01

This article discusses the National Issues Forum (NIF), a national, nonpartisan program designed to encourage citizen discussion of important public issues. The programs try to recreate the town meeting concept of reaching consensus on public issues. Short workbooks are available on two reading levels for issues such as the superpowers, crime,…

Ethical issues associated with in-hospital emergency from the Medical Emergency Team's perspective: a national survey.

PubMed

Cabrini, Luca; Giannini, Alberto; Pintaudi, Margherita; Semeraro, Federico; Radeschi, Giulio; Borga, Sara; Landoni, Giovanni; Troiano, Herbert; Luchetti, Marco; Pellis, Thomas; Ristagno, Giuseppe; Minoja, Giulio; Mazzon, Davide; Alampi, Daniela

2016-01-01

Medical Emergency Teams (METs) are frequently involved in ethical issues associated to in-hospital emergencies, like decisions about end-of-life care and intensive care unit (ICU) admission. MET involvement offers both advantages and disadvantages, especially when an immediate decision must be made. We performed a survey among Italian intensivists/anesthesiologists evaluating MET's perspective on the most relevant ethical aspects faced in daily practice. A questionnaire was developed on behalf of the Italian scientific society of anesthesia and intensive care (SIAARTI) and administered to its members. Decision making criteria applied by respondents when dealing with ethical aspects, the estimated incidence of conflicts due to ethical issues and the impact on the respondents' emotional and moral distress were explored. The questionnaire was completed by 327 intensivists/anesthesiologists. Patient life-expectancy, wishes, and the quality of life were the factors most considered for decisions. Conflicts with ward physicians were reported by most respondents; disagreement on appropriateness of ICU admission and family unpreparedness to the imminent patient death were the most frequent reasons. Half of respondents considered that in case of conflicts the final decision should be made by the MET. Conflicts were generally recognized as causing increased and moral distress within the MET members. Few respondents reported that dedicated protocols or training were locally available. Italian intensivists/anesthesiologists reported that ethical issues associated with in-hospital emergencies are occurring commonly and are having a significant negative impact on MET well-being. Conflicts with ward physicians happen frequently. They also conveyed that hospitals don't offer ethics training and have no protocols in place to address ethical issues.

Navigating "thorny" issues

NASA Astrophysics Data System (ADS)

Hutchinson, Kashema; Gilbert, Aderinsola; Malyukova, Anna

2016-09-01

In their article Mindfulness and discussing ` thorny' issues in the classroom Konstantinos Alexakos et al. (Cult Stud Sci Educ, 2016. doi: 10.1007/s11422-015-9718-0) describe "thorny" issues as "difficult topics to discuss because they are more personal to some perhaps even cause pain and violence." As women from different backgrounds, we engage in a metalogue, which expands on our thoughts and emotions the thorny issues evoked. Our discussion is grounded in theoretical frameworks of mindfulness, wellness, and safe space for learning. We also reflect on our experiences of facing some of the thorny issues in our academic and personal lives. Having trust and respect for one another and being aware of thorny issues allows for a meaningful conversation about the complexity and nuances involved in discussing difficult topics in a classroom setting.

On Learning to Teach Fat Feminism

ERIC Educational Resources Information Center

Boling, Patricia

2011-01-01

As a feminist theorist who frequently teaches theorizing that starts from embodied experience, the author has begun to incorporate fat feminism into her teaching. As a neophyte and a relatively thin woman, she has been self-conscious about broaching issues related to fat bodies in her teaching, even though they clearly raise important issues about…

Neuromotor Issues in the Learning and Control of Golf Skill

ERIC Educational Resources Information Center

Knight, Christopher A.

2004-01-01

Theoretical and practical issues related to the neuromotor control of a golf swing are presented in this paper. The typical strategy for golf training consists of high volume repetition with an emphasis on a large variety of isolated swing characteristics. The student is frequently instructed to maintain consistent performance in each swing with…

Models of Classroom Management as Applied to the Secondary Classroom

ERIC Educational Resources Information Center

Malmgren, Kimber W.; Trezek, Beverly J.; Paul, Peter V.

2005-01-01

Difficulty managing behavior in the classroom is frequently cited as a source of frustration for teachers and a common reason why new teachers leave the profession (Ingersoll 2001, 2003). Concerted attention to issues of classroom management is important to the health of education; attention to these issues at the middle and secondary education…

Characteristics of Individuals with Toileting Problems and Intellectual Disability Using the "Profile of Toileting Issues" ("POTI")

ERIC Educational Resources Information Center

Matson, Johnny L.; Horovitz, Max; Sipes, Megan

2011-01-01

The prevalence of toileting problems was assessed in 153 adults with intellectual disability (ID) using the "Profile of Toileting Issues" ("POTI") and comparisons were made based on various demographic variables. The most frequently endorsed problems were "has toileting accidents during the day," "has toileting…

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

ERIC Educational Resources Information Center

Fareo, Dorcas Oluremi

2015-01-01

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

From Understanding to Deference: Laypersons' and Medical Students' Views on Conflicts within Medicine

ERIC Educational Resources Information Center

Bromme, Rainer; Thomm, Eva; Wolf, Veronika

2015-01-01

When making personally relevant decisions (e.g. on health-related issues), laypersons have to deal increasingly with science-based knowledge claims that are frequently not only inconsistent if not contradictory but also beyond their own everyday understanding. Nevertheless, they need to reason about these issues. The present interview study…

Book of Solutions: Frequent Questions on Concepts, Issues and Strategies for the Education of Language Minority Children.

ERIC Educational Resources Information Center

Berube, Barney; And Others

Responses to over 100 of the most frequently-asked questions about the education of language-minority students are presented for Maine school personnel. The book has 12 sections. The first lists and defines common acronyms, and the second addresses various aspects of student evaluation, including: identification of limited-English-proficient (LEP)…

Strategies for preventing respiratory syncytial virus.

PubMed

Forbes, Michael

2008-12-01

Prevention of respiratory syncytial virus (RSV) infection-crucial for decreasing the burden associated with this disease-is discussed. Predictable outbreaks of RSV occur annually throughout the U.S. During these outbreaks, RSV infection spreads readily among children through close contact with infected individuals or contact with contaminated surfaces or objects. RSV is the leading cause of infant hospitalization and is associated with life-changing and life-threatening complications. Prevention is important for reducing the associated morbidity and mortality. The American Academy of Pediatrics (AAP) has outlined ways to prevent RSV transmission. According to the AAP, frequent hand washing is the most important strategy for reducing the burden of RSV disease. Other methods for controlling nosocomial spread of RSV include the use of gloves, frequent glove changes, and isolating or cohorting patients. General prevention measures that can be undertaken by family members include smoking cessation, breastfeeding, and avoiding situations, whenever possible, where exposure to RSV cannot be controlled. Passive immunoprophylaxis with palivizumab, the only agent approved by the FDA, reduces hospitalization in high-risk children. Palivizumab is currently the only agent approved by the FDA for the prevention of RSV infections in high-risk children. Not every child is equally at risk for serious RSV disease, and immunoprophylaxis is indicated only for certain high-risk children. The AAP has issued specific guidelines for RSV immunoprophylaxis with palivizumab. Other therapies are emerging for the prevention of RSV, including a new, enhanced-potency, humanized RSV monoclonal antibody and several different types of vaccines. RSV causes an annual, predictable epidemic. Treatment remains exclusively supportive. Prevention remains the cornerstone of disease management. The AAP has issued guidelines to protect those at high risk.

European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Neurological Impairment.

PubMed

Romano, Claudio; van Wynckel, Myriam; Hulst, Jessie; Broekaert, Ilse; Bronsky, Jiri; Dall'Oglio, Luigi; Mis, Nataša F; Hojsak, Iva; Orel, Rok; Papadopoulou, Alexandra; Schaeppi, Michela; Thapar, Nikhil; Wilschanski, Michael; Sullivan, Peter; Gottrand, Frédéric

2017-08-01

Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to support the recommendations where no randomized controlled trials were available.

A Pharmacovigilance Study in First Episode of Psychosis: Psychopharmacological Interventions and Safety Profiles in the PEPs Project

PubMed Central

Bioque, Miquel; Llerena, Adrián; Cabrera, Bibiana; Mezquida, Gisela; Lobo, Antonio; González-Pinto, Ana; Díaz-Caneja, Covadonga M.; Corripio, Iluminada; Aguilar, Eduardo J.; Bulbena, Antoni; Castro-Fornieles, Josefina; Vieta, Eduard; Lafuente, Amàlia; Mas, Sergi; Parellada, Mara; Saiz-Ruiz, Jerónimo; Cuesta, Manuel J.

2016-01-01

Background: The characterization of the first episode of psychosis and how it should be treated are principal issues in actual research. Realistic, naturalistic studies are necessary to represent the entire population of first episode of psychosis attended in daily practice. Methods: Sixteen participating centers from the PEPs project recruited 335 first episode of psychosis patients, aged 7 to 35 years. This article describes and discusses the psychopharmacological interventions and safety profiles at baseline and during a 60-day pharmacovigilance period. Results: The majority of first episode of psychosis patients received a second-generation antipsychotic (96.3%), orally (95%), and in adjusted doses according to the product specifications (87.2%). A total of 24% were receiving an antipsychotic polytherapy pattern at baseline, frequently associated with lower or higher doses of antipsychotics than the recommended ones. Eight patients were taking clozapine, all in monotherapy. Males received higher doses of antipsychotic (P=.043). A total of 5.2% of the patients were being treated with long-acting injectable antipsychotics; 12.2% of the patients received anticholinergic drugs, 12.2% antidepressants, and 13.7% mood stabilizers, while almost 40% received benzodiazepines; and 35.52% reported at least one adverse drug reaction during the pharmacovigilance period, more frequently associated with higher antipsychotic doses and antipsychotic polytherapy (85.2% vs 45.5%, P<.001). Conclusions: These data indicate that the overall pharmacologic prescription for treating a first episode of psychosis in Spain follows the clinical practice guideline recommendations, and, together with security issues, support future research of determinate pharmacological strategies for the treatment of early phases of psychosis, such as the role of clozapine, long-acting injectable antipsychotics, antipsychotic combination, and the use of benzodiazepines. PMID:26506856

Building America Case Study: Measure Guideline: Guidance on Taped Insulating Sheathing Drainage Planes (Fact Sheet)

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

Not Available

This guide provides information and recommendations to the following groups: Insulation contractors, General contractors, Builders, Home remodelers, Mechanical contractors, and Homeowners as a guide to the work that needs to be done. The order of work completed during home construction and retrofit improvements is important. Health and safety issues must be addressed first and are more important than durability issues. And durability issues are more important than saving energy. Not all techniques can apply to all houses. Special conditions will require special action. Some builders or homeowners will wish to do more than the important but basic retrofit strategies outlinedmore » by this guide. The following are best practice and product recommendations from the interviewed contractors and home builders who collectively have a vast amount of experience. Three significant items were discussed with the group which are required to make taped insulating sheathing a simple, long term, and durable drainage plane: 4. Horizontal joints should be limited or eliminated wherever possible 5. Where a horizontal joint exists use superior materials 6. Frequent installation inspection and regular trade training are required to maintain proper installation Section 5 of this measure guideline contains the detailed construction procedure for the three recommended methods to effectively seal the joints in exterior insulating sheathing to create a simple, long term, and durable drainage plane.« less

The Potential Role of Social Media Platforms in Community Awareness of Antibiotic Use in the Gulf Cooperation Council States: Luxury or Necessity?

PubMed

Zowawi, Hosam Mamoon; Abedalthagafi, Malak; Mar, Florie A; Almalki, Turki; Kutbi, Abdullah H; Harris-Brown, Tiffany; Harbarth, Stephan; Balkhy, Hanan H; Paterson, David L; Hasanain, Rihab Abdalazez

2015-10-15

The increasing emergence and spread of antimicrobial resistance (AMR) is a serious public health issue. Increasing the awareness of the general public about appropriate antibiotic use is a key factor for combating this issue. Several public media campaigns worldwide have been launched; however, such campaigns can be costly and the outcomes are variable and difficult to assess. Social media platforms, including Twitter, Facebook, and YouTube, are now frequently utilized to address health-related issues. In many geographical locations, such as the countries of the Gulf Cooperation Council (GCC) States (Saudi Arabia, United Arab Emirates, Kuwait, Oman, Qatar, and Bahrain), these platforms are becoming increasingly popular. The socioeconomic status of the GCC states and their reliable communication and networking infrastructure has allowed the penetration and scalability of these platforms in the region. This might explain why the Saudi Ministry of Health is using social media platforms alongside various other media platforms in a large-scale public awareness campaign to educate at-risk communities about the recently emerged Middle East respiratory syndrome coronavirus (MERS-CoV). This paper discusses the potential for using social media tools as cost-efficient and mass education platforms to raise awareness of appropriate antibiotic use in the general public and in the medical communities of the Arabian Peninsula.

The Potential Role of Social Media Platforms in Community Awareness of Antibiotic Use in the Gulf Cooperation Council States: Luxury or Necessity?

PubMed Central

Zowawi, Hosam Mamoon; Abedalthagafi, Malak; Mar, Florie A; Almalki, Turki; Kutbi, Abdullah H; Harris-Brown, Tiffany; Harbarth, Stephan; Balkhy, Hanan H; Paterson, David L

2015-01-01

The increasing emergence and spread of antimicrobial resistance (AMR) is a serious public health issue. Increasing the awareness of the general public about appropriate antibiotic use is a key factor for combating this issue. Several public media campaigns worldwide have been launched; however, such campaigns can be costly and the outcomes are variable and difficult to assess. Social media platforms, including Twitter, Facebook, and YouTube, are now frequently utilized to address health-related issues. In many geographical locations, such as the countries of the Gulf Cooperation Council (GCC) States (Saudi Arabia, United Arab Emirates, Kuwait, Oman, Qatar, and Bahrain), these platforms are becoming increasingly popular. The socioeconomic status of the GCC states and their reliable communication and networking infrastructure has allowed the penetration and scalability of these platforms in the region. This might explain why the Saudi Ministry of Health is using social media platforms alongside various other media platforms in a large-scale public awareness campaign to educate at-risk communities about the recently emerged Middle East respiratory syndrome coronavirus (MERS-CoV). This paper discusses the potential for using social media tools as cost-efficient and mass education platforms to raise awareness of appropriate antibiotic use in the general public and in the medical communities of the Arabian Peninsula. PMID:26471079

Monitoring injury reporting in selected Australian media: a potential advocacy strategy?

PubMed

Stoneham, Melissa; Boss, Andrea; Daube, Mike

2013-04-01

This review of injury articles describes how selected primary print media sources in Australia report injury events and explores how this may impact on public perception of the injury risk and the opportunities it may present to health professionals. Media articles specific to injury, compiled by the Public Health Advocacy Institute of Western Australia (PHAIWA) through their MediaWatch service during 2011, were collated and analysed. Articles were gathered from The West Australian, The Australian and The Sunday Times newspapers and ABC Online. Each article was categorised into injury topics and target groups, and preventive strategies were identified. Of the 546 articles that contained injury as a key word, 424 articles were used for the present study. The majority of articles related to community-based injuries (65%) and the most frequent reported injury was violence and assault. The results also indicate that although there is regular media reporting on injury issues, only one-fifth of reports discuss possible preventive measures. Selected Australian newspapers and the ABC Online are important and low-cost sources of injury-related information for the general public and can impact how the public perceives injury. It is important for public health professionals to embrace media advocacy strategies to assist in influencing and setting local public policy. So what? Public attitudes and understanding of issues are influenced by media coverage. Media monitoring is one tool to track what media sources are reporting about public health issues, the industry and stakeholders. Influencing the quantity and quality of media coverage is critical to advancing healthy public policy, particularly when advocating for prevention strategies to be reported and acted upon. Advocacy is an important health promotion strategy; it is therefore important for health professionals to understand media advocacy and position public health issues as societal issues with policy solutions.

Attitudes to lifestyle risk factors for coronary heart disease amongst South Asians in Leicester: a focus group study.

PubMed

Farooqi, A; Nagra, D; Edgar, T; Khunti, K

2000-08-01

South Asians have a significantly higher risk of mortality from coronary heart disease (CHD) compared with the general population in the UK. There is a lack of evidence on attitudes to and knowledge of risk factors for CHD amongst South Asians. Such information is important for the provision of effective health promotion services. The aim of the study was to identify key issues relating to knowledge of and attitudes to lifestyle risk factors for CHD amongst South Asians aged over 40 years in Leicester, UK. A qualitative focus group analysis was carried out using randomly selected South Asians from GP lists and South Asians attending community centres. Group discussions were taped, translated and transcribed. The transcripts were analysed using qualitative methodology to identify key issues and themes. Participants expressed a range of attitudes to and different levels of knowledge of lifestyle risk factors for CHD. Barriers to improving lifestyle with respect to diet and exercise were identified; these included lack of information (e.g. of how to cook traditional Indian food more healthily) and cultural barriers, such as lack of women-only exercise facilities. Participants perceived stress as an important cause of CHD, and stress directly related to ethnic minority status was described frequently. Language was identified as a key barrier to accessing health services. Health professionals need to provide individually tailored health promotion for South Asians which avoids stereotyping, but recognizes potential cultural obstacles to change. The issue of stress amongst South Asians requires more research and needs to be recognized as an important issue by health professionals. South Asians still face problems accessing health and leisure services due to language and cultural issues.

Subject descriptions, control groups, and research designs in published studies of language-impaired children.

PubMed

Schmitt, J F; Meline, T J

1990-12-01

We reviewed the 1983-1988 issues of six journals that frequently publish papers including specifically language-impaired (LI) subjects. A total of 92 research reports provided data for our review. The research reports included experimental studies, ex post facto studies, and intervention studies. These studies represent a broad spectrum of the theoretical and empirical foundations of knowledge regarding LI children. The analysis of the published research centered on subject descriptions and the use of control groups. A descriptive analysis of the data showed few consistent trends among the studies with respect to subject selection, subject description, and the number and types of control groups. We discuss the importance of more complete subject descriptions in studies of LI children as well as the importance of the choice of matching criteria for control groups in between-subjects designs.

The content of recurrent dreams in young adolescents

PubMed Central

Gauchat, Aline; Séguin, Jean R.; McSween-Cadieux, Esther; Zadra, Antonio

2015-01-01

Studies on children’s recurrent dreams have been largely anecdotal and based on adults’ recollections of dreams experienced during childhood. We collected 102 reports of recurrent dreams from a sample of young adolescents aged between 11 and 15 years and scored the narratives using a range of content measures, including in relation to the threat simulation theory (TST) of dreaming. The most frequently reported themes involved confrontations with monsters or animals, followed by physical aggressions, falling and being chased. Recurrent dreams were more likely to include negative content elements than positive elements. Only half of the recurrent dreams contained threatening elements and their analysis provided mixed support for the TST. Differences between the content of recurrent dreams reported by young adolescent versus adults are discussed as are possible sex effects and key issues that remain to be addressed by future research. PMID:26366465

Quaternary of Himalaya

NASA Astrophysics Data System (ADS)

Srivastava, Pradeep; Singh, Vimal

2017-05-01

Tectonically active Himalayan mountains evolves via feedbacks from deep earth and surface processes; the complex interaction of various processes results into the landscape which is dynamic both at longer and shorter time scales. The extreme hydrological events that possibly ride over a long term climate cycle bring the changes in the landscape that impact human societies more closely. These events in the Himalaya frequently cause huge damage to economy and human lives. The geologist community under the umbrella of Himalaya-Karakorum-Tibet (HKT) workshop in its 30th edition convened a special session and deliberated on the subject. This special issue "Quaternary of Himalaya" is an outcome of papers presented and discussion held during this session; it consists of 18 papers in three sub-themes (i) Extreme Events in Himalaya (ii) Paleoglaciation in Himalaya and (iii) Expressions of climate and neotectonics in Himalaya.

A Unique Funding Opportunity for Public Health in Texas

PubMed Central

Schlenker, Thomas; Huber, Carol A.

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the “Triple Aim” goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation. PMID:25423061

A Review of the Korean Cultural Syndrome Hwa-Byung: Suggestions for Theory and Intervention

PubMed Central

Lee, Jieun; Wachholtz, Amy; Choi, Keum-Hyeong

2014-01-01

The purpose of this paper is to review Hwa-Byung, a cultural syndrome specific to Koreans and Korean immigrants. Hwa-Byung is a unique diagnosis and differs from other DSM disorders. However, Hwa-Byung has frequent comorbidity with other DSM disorders such as anger disorders, generalized anxiety disorder, and major depressive disorder. There are several risk factors for Hwa-Byung including psychosocial stress caused by marital conflicts and conflicts with their in-laws. Previous interventions of the Hwa-Byung syndrome were based primarily on the medical model. Therefore, based on previous research, we present a new ecological model of Hwa-Byung. We also recommend some areas of future research as well as present some limitations of our ecological model. Finally, we discuss some treatment issues, particularly for Korean women in the United States. PMID:25408922

IgE-mediated food allergy in children.

PubMed

Longo, Giorgio; Berti, Irene; Burks, A Wesley; Krauss, Baruch; Barbi, Egidio

2013-11-16

Food allergy is a serious health issue affecting roughly 4% of children, with a substantial effect on quality of life. Prognosis is good for the most frequent allergens with almost all children outgrowing their allergy. However, the long-term implications for disease burden are substantial for children with persistent allergies (eg, peanuts, tree nuts, fish, and shellfish) and for those with high concentrations of milk, egg, and wheat IgE. Antigen avoidance has been the time-honoured approach both for prevention and treatment. However, findings from studies done in the past 5 years show that early contact with food can induce tolerance and desensitisation to foods. We review the epidemiology, natural history, and management of food allergy, and discuss the areas of controversy and future directions in research and clinical practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

The benefits of frequent positive affect: does happiness lead to success?

PubMed

Lyubomirsky, Sonja; King, Laura; Diener, Ed

2005-11-01

Numerous studies show that happy individuals are successful across multiple life domains, including marriage, friendship, income, work performance, and health. The authors suggest a conceptual model to account for these findings, arguing that the happiness-success link exists not only because success makes people happy, but also because positive affect engenders success. Three classes of evidence--crosssectional, longitudinal, and experimental--are documented to test their model. Relevant studies are described and their effect sizes combined meta-analytically. The results reveal that happiness is associated with and precedes numerous successful outcomes, as well as behaviors paralleling success. Furthermore, the evidence suggests that positive affect--the hallmark of well-being--may be the cause of many of the desirable characteristics, resources, and successes correlated with happiness. Limitations, empirical issues, and important future research questions are discussed.

Alternatives to those artificial FD&C food colorants.

PubMed

Wrolstad, Ronald E; Culver, Catherine A

2012-01-01

Replacement of artificial food dyes with natural colorants is a current marketing trend, notwithstanding the fact that neither the United States nor the European Union (EU) has defined natural with respect to food colors. Consumer groups have concerns over the safety of synthetic colorants, and in addition, many of the naturally derived colorants provide health benefits. Food scientists frequently have the assignment of replacing artificial colorants with natural alternatives. This can be challenging, as naturally derived colorants are usually less stable, and all desired hues might, in fact, not be obtainable. In this review, the chemical and physical properties, limitations, and more suitable applications for those colorants that are legally available as substitutes for the synthetic colorants are summarized. Issues and challenges for certain foods are discussed, and in addition, colorants that may be available in the future are briefly described.

[Pandemic without drama. Influenza vaccination and Asian flu in Germany].

PubMed

Witte, Wilfried

2013-01-01

The history of the 1957/58 Asian flu in Germany is systematically presented for the first time. The focus is on flu vaccination, which is discussed as a yardstick of the perception of the pandemic. International expertise on influenza virology was predominantly based in Anglo-Saxon countries. German microbiologists issued no clear recommendation for preventative vaccination until 1960. Instead, quinine was relied upon as the traditional medicinal prophylaxis. Antibiotics were more frequently administered. In East Germany, little fuss was made over the Asian flu. In line with the authorities' social hygiene orientation, vaccination was accepted as a matter of principle. In the Federal Republic and West Berlin, the population rejected the vaccination largely. It was seen as a scandal that many employees were on sick leave because of the flu, thus adversely affecting the economy.

GTAG: architecture and design of miniature transmitter with position logging for radio telemetry

NASA Astrophysics Data System (ADS)

Řeřucha, Šimon; Bartonička, Tomáš; Jedlička, Petr

2011-10-01

The radio telemetry is a well-known technique used within zoological research to exploit the behaviour of animal species. A usage of GPS for a frequent and precise position recording gives interesting possibility for a further enhancement of this method. We present our proposal of an architecture and design concepts of telemetry transmitter with GPS module, called GTAG, that is suited for study of the Egyptian fruit bat (Rousettus aegyptiacus). The model group we study set particular constrains, especially the weight limit (9 g) and prevention of any power resources recharging technique. We discuss the aspect of physical realization and the energyconsumption issues. We have developed a reference implementation that has been already deployed during telemetry sessions and we evaluate the experience and compare the estimated performance of our device to a real data.

Using Issues-Based Art Education to Facilitate Middle School Students' Learning in Racial Issues

ERIC Educational Resources Information Center

Li, Dan

2018-01-01

Issues-based art education encourages students to express their perspectives on different social issues through art making. In this article, the author discusses racial issues with middle school students through contemporary artwork discussion and hands-on poster making. The difficulties that students encounter in their poster making session will…

Focus Group Study Exploring Factors Related to Frequent Sickness Absence

PubMed Central

van Rhenen, Willem

2016-01-01

Introduction Research investigating frequent sickness absence (3 or more episodes per year) is scarce and qualitative research from the perspective of frequent absentees themselves is lacking. The aim of the current study is to explore awareness, determinants of and solutions to frequent sickness absence from the perspective of frequent absentees themselves. Methods We performed a qualitative study of 3 focus group discussions involving a total of 15 frequent absentees. Focus group discussions were audiotaped and transcribed verbatim. Results were analyzed with the Graneheim method using the Job Demands Resources (JD–R) model as theoretical framework. Results Many participants were not aware of their frequent sickness absence and the risk of future long-term sickness absence. As determinants, participants mentioned job demands, job resources, home demands, poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Managing these factors and improving communication (skills) were regarded as solutions to reduce frequent sickness absence. Conclusions The JD–R model provided a framework for determinants of and solutions to frequent sickness absence. Additional determinants were poor health, chronic illness, unhealthy lifestyles, and diminished feeling of responsibility to attend work in cases of low job resources. Frequent sickness absence should be regarded as a signal that something is wrong. Managers, supervisors, and occupational health care providers should advise and support frequent absentees to accommodate job demands, increase both job and personal resources, and improve health rather than express disapproval of frequent sickness absence and apply pressure regarding work attendance. PMID:26872050

Doctors discussing religion and spirituality: A systematic literature review.

PubMed

Best, Megan; Butow, Phyllis; Olver, Ian

2016-04-01

Discussion of religion and/or spirituality in the medical consultation is desired by patients and known to be beneficial. However, it is infrequent. We aimed to identify why this is so. We set out to answer the following research questions: Do doctors report that they ask their patients about religion and/or spirituality and how do they do it? According to doctors, how often do patients raise the issue of religion and/or spirituality in consultation and how do doctors respond when they do? What are the known facilitators and barriers to doctors asking their patients about religion and/or spirituality? A mixed qualitative/quantitative review was conducted to identify studies exploring the physician's perspective on discussion of religion and/or spirituality in the medical consultation. We searched nine databases from inception to January 2015 for original research papers reporting doctors' views on discussion of religion and/or spirituality in medical consultations. Papers were assessed for quality using QualSyst and results were reported using a measurement tool to assess systematic review guidelines. Overall, 61 eligible papers were identified, comprising over 20,044 physician reports. Religion and spirituality are discussed infrequently by physicians although frequency increases with terminal illness. Many physicians prefer chaplain referral to discussing religion and/or spirituality with patients themselves. Such discussions are facilitated by prior training and increased physician religiosity and spirituality. Insufficient time and training were the most frequently reported barriers. This review found that physician enquiry into the religion and/or spirituality of patients is inconsistent in frequency and nature and that in order to meet patient needs, barriers to discussion need to be overcome. © The Author(s) 2015.

The Impact of Personality Factors and Preceding User Comments on the Processing of Research Findings on Deep Brain Stimulation: A Randomized Controlled Experiment in a Simulated Online Forum.

PubMed

Feinkohl, Insa; Flemming, Danny; Cress, Ulrike; Kimmerle, Joachim

2016-03-03

Laypeople frequently discuss medical research findings on Web-based platforms, but little is known about whether they grasp the tentativeness that is inherent in these findings. Potential influential factors involved in understanding medical tentativeness have hardly been assessed to date. The research presented here aimed to examine the effects of personality factors and of other users' previous contributions in a Web-based forum on laypeople's understanding of the tentativeness of medical research findings, using the example of research on deep brain stimulation. We presented 70 university students with an online news article that reported findings on applying deep brain stimulation as a novel therapeutic method for depression, which participants were unfamiliar with. In a randomized controlled experiment, we manipulated the forum such that the article was either accompanied by user comments that addressed the issue of tentativeness, by comments that did not address this issue, or the article was accompanied by no comments at all. Participants were instructed to write their own individual user comments. Their scientific literacy, epistemological beliefs, and academic self-efficacy were measured. The outcomes measured were perceived tentativeness and tentativeness addressed in the participants' own comments. More sophisticated epistemological beliefs enhanced the perception of tentativeness (standardized β=.26, P=.034). Greater scientific literacy (stand. β=.25, P=.025) and greater academic self-efficacy (stand. β=.31, P=.007) were both predictors of a more extensive discussion of tentativeness in participants' comments. When forum posts presented in the experiment addressed the issue of tentativeness, participants' subsequent behavior tended to be consistent with what they had read in the forum, F2,63=3.66; P=.049, ηp(2)=.092. Students' understanding of the tentativeness of research findings on deep brain stimulation in an online forum is influenced by a number of character traits and by the previous comments that were contributed to the forum by other users. There is potential for targeted modification of traits such as scientific literacy, epistemological beliefs, and academic self-efficacy to foster critical thinking in laypeople who take part in online discussions of medical research findings.

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

PubMed

Hurlimann, Thierry; Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo; Godard, Béatrice

2017-01-01

The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues cannot be managed without a careful consideration for the complexity of contexts in which nutrition-related interventions are expected to be implemented. These interventions engage a variety of actors with diverse perspectives and interests. We discuss these challenges and also comment on the importance of considering ethical impacts in the monitoring and evaluation of such interventions. General ethical frameworks or recommendations-although useful-cannot be expected to provide policy makers, implementators and other public health personnel with sufficient practical ethical guidance as they cannot consider and anticipate the particularities of all specific nutrition-related public health interventions and the complexity of the contexts in which they are implemented. Further research is needed in order to develop more targeted ethical frameworks.

Belonging and community: understandings of "home" and "friends" among the English poor, 1750-1850.

PubMed

Snell, K D M

2012-01-01

This article is based on unique ‘narratives of the poor’, that is, letters from poor people to their parishes of settlement, petitions to the London Refuge of the Destitute, and letters from mothers to the London Foundling Hospital, with supportive evidence from newspapers. These display fundamental concepts among the English poor, who were often poorly literate, and who comprised the majority of the population. Discussion focuses upon their understandings of ‘home’, ‘belonging’, ‘friends’, and ‘community’. These key concepts are related here to modern discussions, to set important concerns into historical perspective. ‘Friends’, valuably studied by sociologists such as Pahl, had a wide meaning in the past. ‘Home’ meant (alongside abode) one's parish of legal settlement, where one was entitled to poor relief under the settlement/poor laws. This was where one ‘belonged’. Ideas of ‘community’ were held and displayed even at a distance, among frequently migrant poor, who wrote to their parishes showing strong ties of attachment, right, and local obligation. This discussion explores these issues in connection with belonging and identity. It elucidates the meaning and working of poor law settlement, and is also an exploration of popular mentalities and the semi-literate ways in which these were expressed.

Patient perspectives on fluid management in chronic hemodialysis.

PubMed

Smith, Kimberly; Coston, Melinda; Glock, Kimberly; Elasy, Tom A; Wallston, Kenneth A; Ikizler, T Alp; Cavanaugh, Kerri L

2010-09-01

We sought to describe the perspectives and experiences of chronic hemodialysis (CHD) patients regarding self-care and adherence to fluid restrictions. Semistructured focus groups. Two outpatient hemodialysis centers. Nineteen patients on chronic hemodialysis. Patients were asked a series of open-ended questions to encourage discussion about the management of fluid restriction within the broad categories of general knowledge, knowledge sources or barriers, beliefs and attitudes, self-efficacy, emotion, and self-care skills. We analyzed session transcripts using the theoretical framework of content analysis to identify themes generated by the patients. Patients discussed both facilitators and barriers to fluid restriction, which we categorized into six themes: knowledge, self-assessment, psychological factors, social, physical, and environmental. Psychological factors were the most common barriers to fluid restriction adherence, predominantly involving lack of motivation. Knowledge was the most discussed facilitator with accurate self-assessment, positive psychological factors, and supportive social contacts also playing a role. Dialysis providers were most commonly described as the source of dialysis information (54%), but learning through personal experience was also frequently noted (28%). Interventions to improve fluid restriction adherence of chronic hemodialysis patients should target motivational issues, assess and improve patient knowledge, augment social support, and facilitate accurate self-assessment of fluid status. (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Ongoing strategies and updates on pain management in gynecologic oncology patients.

PubMed

Hacker, Kari E; Reynolds, R Kevin; Uppal, Shitanshu

2018-05-01

The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered. In this review, we discuss the various etiologies of pain experienced by gynecologic oncology patients and discuss modalities frequently used to treat this pain. We highlight strategies to reduce the number of opioids prescribed and focus on incorporating non-opioid pain relief management principles in this review. We also discuss the mechanisms and etiology of various types of pain, with a focus on multimodal treatment strategies including preoperative counseling, strategies to identify individuals at risk of developing opioid dependence, and the role of symptom management and palliative care teams. Finally, we provide a blueprint for gynecologic oncology practices to develop their practice-specific pain management contracts to engage patients in a meaningful conversation around the addictive potential of opioids. Copyright © 2018 Elsevier Inc. All rights reserved.

Nanocarrier for poorly water-soluble anticancer drugs--barriers of translation and solutions.

PubMed

Narvekar, Mayuri; Xue, Hui Yi; Eoh, June Young; Wong, Ho Lun

2014-08-01

Many existing chemotherapeutic drugs, repurposed drugs and newly developed small-molecule anticancer compounds have high lipophilicity and low water-solubility. Currently, these poorly water-soluble anticancer drugs (PWSAD) are generally solubilized using high concentrations of surfactants and co-solvents, which frequently lead to adverse side effects. In recent years, researchers have been actively exploring the use of nanotechnology as an alternative to the solvent-based drug solubilization approach. Several classes of nanocarrier systems (lipid-based, polymer-based and albumin-based) are widely studied for encapsulation and delivery of the existing and new PWSAD. These nanocarriers were also shown to offer several additional advantages such as enhanced tumour accumulation, reduced systemic toxicity and improved therapeutic effectiveness. In this article, the recent nanotechnological advances in PWSAD delivery will be reviewed. The barriers commonly encountered in the development of PWSAD nanoformulations (e.g. formulation issues and nanotoxicity issues) and the strategies to overcome these barriers will also be discussed. It is our goal to provide the pharmaceutical scientists and clinicians with more in-depth information about the nanodelivery approach, thus, more efficacious and safe PWSAD nanoformulations can be developed with improved translational success.

Ensuring safe international trade: how are the roles and responsibilities evolving and what will the situation be in ten years' time?

PubMed

Brückner, G K

2011-04-01

The roles of the international standard-setting bodies that are mandated to facilitate safe trade, such as the World Organisation for Animal Health (OIE), the Codex Alimentarius Commission, the International Plant Protection Convention and the World Trade Organization, are well documented, as are the roles of the international organisations responsible for global health issues: the OIE, the World Health Organization and the Food and Agriculture Organization of the United Nations. However, developments in international trade, such as accelerating globalisation and the frequent emergence and re-emergence of diseases affecting both humans and animals, have brought new challenges and the need to reconsider the future roles of such organisations. New participants and new demands have also emerged to challenge these mandates, leading to potential areas of conflict. The need for countries to establish themselves as new trade partners, or to strengthen their positions while still maintaining safe trade, poses a challenge to standard-setting organisations, which must meet these demands while still remaining sensitive to the needs of developing countries. In this paper, the author describes and discusses some of these challenges and suggests how international organisations could evolve to confront such issues.

Necrotizing fasciitis: case series and review of the literature on clinical and medico-legal diagnostic challenges.

PubMed

Fais, Paolo; Viero, Alessia; Viel, Guido; Giordano, Renzo; Raniero, Dario; Kusstatscher, Stefano; Giraudo, Chiara; Cecchetto, Giovanni; Montisci, Massimo

2018-04-07

Necrotizing fasciitis (NF) is a life-threatening infection of soft tissues spreading along the fasciae to the surrounding musculature, subcutaneous fat and overlying skin areas that can rapidly lead to septic shock and death. Due to the pandemic increase of medical malpractice lawsuits, above all in Western countries, the forensic pathologist is frequently asked to investigate post-mortem cases of NF in order to determine the cause of death and to identify any related negligence and/or medical error. Herein, we review the medical literature dealing with cases of NF in a post-mortem setting, present a case series of seven NF fatalities and discuss the main ante-mortem and post-mortem diagnostic challenges of both clinical and forensic interests. In particular, we address the following issues: (1) origin of soft tissue infections, (2) micro-organisms involved, (3) time of progression of the infection to NF, (4) clinical and histological staging of NF and (5) pros and cons of clinical and laboratory scores, specific forensic issues related to the reconstruction of the ideal medical conduct and the evaluation of the causal value/link of any eventual medical error.

Health technology assessment of utilization, practice and ethical issues of self-pay services in the German ambulatory health care setting.

PubMed

Hunger, Theresa; Schnell-Inderst, Petra; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe

2014-02-01

The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI). A systematic literature search in electronic databases and a structured internet search on stakeholder websites with qualitative and quantitative information synthesis. Of 1,345 references, we included 64 articles. Between 19 and 53 % of insured persons received self-pay service offers from their physician; 16-19 % actively requested such services. Intraocular pressure measurement was the most common service, followed by ultrasound investigations. There is a major discussion about ELSI in the context of individual health services. Self-pay services are common medical procedures in Germany. However, the empirical evidence is limited in quality and extent, even for the most frequently provided services. Transparency of their provision should be increased and independent evidence-based patient information should be supplied.

Magnetic properties evolution of a high permeability nanocrystalline FeCuNbSiB during thermal ageing

NASA Astrophysics Data System (ADS)

Lekdim, Atef; Morel, Laurent; Raulet, Marie-Ange

2017-07-01

It is found to be one of the major issues while designing an aircraft, mass and volume have to be reduced in order to achieve energy efficiency. This leads to a high compactness of the electrical components which enables them to withstand at high temperatures. The magnetic components which are responsible for the electrical energy conversion, therefore exposed to high temperatures in working conditions. Their thermal ageing becomes a serious problem and deserves a particular attention. The FeCuNbSiB nanocrystalline materials have been selected for this ageing study because they are used in power electronic systems very frequently. The objective of the study is based on monitoring the magnetic characteristics under the condition of several continuous thermal ageing (100, 150, 200 and 240 °C). An important, experimental work of magnetic characterization is being done through a specific monitoring protocol and X-ray diffraction (XRD) along with magnetostriction measurements was carried out to support the study of the evolution of the anisotropy energies with aging. The latter is discussed in this paper to explain and give the hypothesis about the aging phenomena. Contribution to the topical issue "Electrical Engineering Symposium (SGE 2016)", edited by Adel Razek

Reflections on relevance: Psychotherapy and Psychosomatics in 2004.

PubMed

Balon, Richard

2005-01-01

Relevance of an article is a highly desirable yet hardly predictable quality at the time of its publication. Article relevance is frequently measured by the impact factor of the journal where the article is published. Furthermore, impact factor, citation index and citation analysis are used as a measure of research progress and scientific wealth of a nation. The wisdom and significance of this approach to relevance is debatable and thus discussed here. In 2004, Psychotherapy and Psychosomatics published a variety of articles which, in the author's view, are clinically relevant. Several selected clinically relevant issues reviewed in this article include: the conceptualization of fibromyalgia as a stress disorder; the psychosocial impact and psychosocial interventions in cancer; the impact of alexithymia on patient care; the possible relationship between depression and nutrition (namely intake of folate and pyridoxal phosphate); the significance of hypercoagulability in panic-like anxiety; the questionable value of single isomer drugs, and the relevance and adequacy of clinimetrics versus psychometrics in clinical research. The reviewed issues seem to be relevant to clinical practice, research or both, but also to our critical thinking, and the critical review of the developments in psychiatry and psychology. Copyright 2005 S. Karger AG, Basel.

Entitlement to Sickness Benefits in Sweden: The Social Insurance Officers Experiences

PubMed Central

Söderberg, Elsy; Müssener, Ulrika

2008-01-01

Background: Social insurance offices (SIOs) handle a wide range of complex assessments of the entitlement to sickness benefits for an increasing number of clients on sick leave and consequently, the demands on the SIOs have increased considerably. Aim: To gain deeper knowledge of the problems experienced by the SIOs in their work associated with entitlement to sickness benefits. Method: A descriptive and explorative qualitative approach was used to analyse data from two focus-group interviews, including six participants in each group. Results: The participants discussed different dilemmas in regard to; physicians’ responsibility for issuing sickness certificates, interactions with the insured individuals, disclosure of decisions, communications with medical consultants, documentation of sickness benefit claims, threats in the workplace, as well as their own competence. The SIOs regarded incomplete information on sickness certificates as a main problem, because they frequently had to contact the client and the physicians who issued the certificates in order to obtain further details, leading to delays in the decision-making whether to grant sickness benefits. Conclusions: More knowledge regarding SIOs work is required to improve the methods used in the sickness insurance system and to ensure adequate training of new staff members. PMID:21572827

Case analysis online: a strategic management case model for the health industry.

PubMed

Walsh, Anne; Bearden, Eithne

2004-01-01

Despite the plethora of methods and tools available to support strategic management, the challenge for health executives in the next century will relate to their ability to access and interpret data from multiple and intricate communication networks. Integrated digital networks and satellite systems will expand the scope and ease of sharing information between business divisions, and networked systems will facilitate the use of virtual case discussions across universities. While the internet is frequently used to support clinical decisions in the healthcare industry, few executives rely upon the internetfor strategic analysis. Although electronic technologies can easily synthesize data from multiple information channels, research as well as technical issues may deter their application in strategic analysis. As digital models transform access to information, online models may become increasingly relevant in designing strategic solutions. While there are various pedagogical models available to support the strategic management process, this framework was designed to enhance strategic analysis through the application of technology and electronic research. A strategic analysis framework, which incorporated internet research and case analysis in a strategic managementcourse, is described alongwith design and application issues that emerged during the case analysis process.

Association between litterers' profile and littering behavior: A chi-square approach

NASA Astrophysics Data System (ADS)

Asmui, Mas'udah; Zaki, Suhanom Mohd; Wahid, Sharifah Norhuda Syed; Mokhtar, Noorsuraya Mohd; Harith, Siti Suhaila

2017-05-01

Littering is not a novelty, yet a prolonged issue. The solutions have been discussed for a long time; however this issue still remains unresolved. Littering is commonly associated with littering behavior and awareness. The littering behavior is normally influenced by the litter profile such as gender, family income, education level and age. Jengka Street market, which is located in Pahang, is popularly known as a trade market. It offers diversities of wet and dry goods and is awaited by local residents and tourists. This study analyzes association between litterers' profile and littering behavior. Littering behavior is measured based on factors of trash bin facilities, awareness campaign and public littering behavior. 114 respondents were involved in this study with 62 (54.39%) are female aged more than 18 years old and majority of these female respondents are diploma holders. In addition, 78.95% of the respondents have family income below than RM3,000.00 per month. Based on the data analysis, it was found that first-time visitors littered higher than frequent visitors, lack of providing trash bin facilities contributes to positive littering behavior and there is a significant association between litterers' age and littering behavior by using chi-square approach.

Ebola Virus Training: A Needs Assessment and Gap Analysis.

PubMed

Yeskey, Kevin; Hughes, Joseph; Galluzzo, Betsy; Jaitly, Nina; Remington, James; Weinstock, Deborah; Lee Pearson, Joy; Rosen, Jonathan D

In response to the 2014 Ebola virus disease outbreak, the Worker Training Program embarked on an assessment of existing training for those at risk for exposure to the virus. Searches of the recent peer-reviewed literature were conducted for descriptions of relevant training. Federal guidance issued during 2015 was also reviewed. Four stakeholder meetings were conducted with representatives from health care, academia, private industry, and public health to discuss issues associated with ongoing training. Our results revealed few articles about training that provided sufficient detail to serve as models. Training programs struggled to adjust to frequently updated federal guidance. Stakeholders commented that most healthcare training focused solely on infection control, and there was an absence of employee health-related training for non-healthcare providers. Challenges to ongoing training included funding and organizational complacency. Best practices were noted where management and employees planned training cooperatively and where infection control, employee health, and hospital emergency managers worked together on the development of protective guidance. We conclude that sustainable training for infectious disease outbreaks requires annual funding, full support from organizational management, input from all stakeholders, and integration of infection control, emergency management, and employee health when implementing guidance and training.

Occupational health and safety among commercial sex workers.

PubMed

Ross, Michael W; Crisp, Beth R; Månsson, Sven-Axel; Hawkes, Sarah

2012-03-01

The concept of occupational health and safety (OHS) for commercial sex workers has rarely been investigated, perhaps because of the often informal nature of the workplace, the associated stigma, and the frequently illegal nature of the activity. We reviewed the literature on health, occupational risks, and safety among commercial sex workers. Cultural and local variations and commonalities were identified. Dimensions of OHS that emerged included legal and policing risks, risks associated with particular business settings such as streets and brothels, violence from clients, mental health risks and protective factors, alcohol and drug use, repetitive strain injuries, sexually transmissible infections, risks associated with particular classes of clients, issues associated with male and transgender commercial sex workers, and issues of risk reduction that in many cases are associated with lack of agency or control, stigma, and legal barriers. We further discuss the impact and potential of OHS interventions for commercial sex workers. The OHS of commercial sex workers covers a range of domains, some potentially modifiable by OHS programs and workplace safety interventions targeted at this population. We argue that commercial sex work should be considered as an occupation overdue for interventions to reduce workplace risks and enhance worker safety.

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 23 Highways 1 2012-04-01 2012-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

23 CFR 636.508 - Can price or cost be an issue in discussions?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Can price or cost be an issue in discussions? 636.508 Section 636.508 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND... Can price or cost be an issue in discussions? You may inform an offeror that its price is considered...

Everyday Ethics: Ethical Issues and Stress in Nursing Practice

PubMed Central

Ulrich, Connie M.; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-01-01

Aim This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analyzed using descriptive statistics, cross-tabulations and Pearson correlations. Results A total of 422 questionnaires were used in the analysis. The five most frequently-occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. PMID:20735502

Everyday ethics: ethical issues and stress in nursing practice.

PubMed

Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

'Is it normal to feel these questions ...?': a content analysis of the health concerns of adolescent girls writing to a magazine.

PubMed

Kang, Melissa; Cannon, Bianca; Remond, Louise; Quine, Susan

2009-06-01

There is a mismatch between presenting concerns of adolescents to GPs and behaviours that lead to adolescent morbidity and mortality. Better understanding of health concerns of this target group would enhance communication between health professionals and adolescent patients. To explore and categorize the health concerns of adolescent girls sending unsolicited emails to a teenage girls' magazine. We conducted a content analysis of 1000 systematic randomly selected unsolicited emails submitted to the health column of an Australian adolescent girls' magazine over a 6-month period. Three main foci of concern were identified: Context of Concern, Health Issue of Concern and Advice Sought for Concern. Within Health Issue of Concern, there were five categories: body (47.5%), sex (31.9%), relationship (14.7%), mind (4.7%) and violence and/or safety (1.2%). Concerns within the body and sex categories ranged enormously, but frequently expressed intimate descriptions of anatomy, feelings, sexual practices and relationships. Many concerns occurred in the context of adolescents' relationships with others. The proportion of concerns about physical or psychological symptoms or health issues commonly associated with the adolescent age group (such as health risk behaviours, mental health, pregnancy and sexually transmitted infections) was relatively small. GPs and other health professionals might engage more readily with adolescent patients with a deeper understanding of the concerns that adolescents have about their bodies, relationships and overall health. Seemingly 'trivial' issues, such as normal puberty, could be used as discussion triggers in health consultations to help alleviate anxiety and build rapport.

Multidisciplinary study on anthropogenic landslides in Nepal

NASA Astrophysics Data System (ADS)

Puglia, Christopher; Derron, Marc-Henri; Nicolet, Pierrick; Sudmeier-Rieux, Karen; Jaboyedoff, Michel; Devkota, Sanjay

2013-04-01

Nepal is a country in which shallow landslide is a frequent phenomenon. Monsoon is the main triggering factor but anthropogenic influence is often significant too. Indeed, many infrastructures, such as roads or water pipes, are not built in a rigorous way because of a lack of funds and knowledge. In the present study we examine the technical, social and economic issues of landslide management for two sites in Nepal. The first site is located in Sanusiruwari VDC (Sindhupalchock district, central Nepal) and the second one in Namadi VDC (Ramecchap district, central Nepal). Both sites are affected by landslides induced by the construction of hydropower plants. These landslides may threaten the viability of the hydropower plants. At both sites the problems are quite similar, but the first site project is a private one and the second one is a public one implemented by the United Nations Development Programme (UNDP). For both sites, bioengineering methods using Vetiver (Vetyveria zizanioides) plantations is the main stabilization measure. To follow the progression of both landslides, fieldwork observations were conducted before and after the 2012 rainy season, including photogrammetric and distancemeter acquisitions. Main issues were discussed with communities and stakeholders of the hydropower projects through interviews and participatory risk mapping. Main issues include: lack of communication between the project managers and communities leading to conflict and the lack of maintenance of the bio-engineering sites, leading to less effective Vetiver growth and slope stabilization. Comparing the landslide management (technical, social and economic) of the two projects allows to point out some specific issues within an integrated risk perspective.

Disassembling archeology, reassembling the modern world.

PubMed

Carruthers, William; Van Damme, Stéphane

2017-09-01

This article provides a substantive discussion of the relevance of the history of archeology to the history of science. At the same time, the article introduces the papers contained in this special issue as exemplars of this relevance. To make its case, the article moves through various themes in the history of archeology that overlap with key issues in the history of science. The article discusses the role and tension of regimes of science in antiquarian and archeological practices, and also considers issues of scale and place, particularly in relation to the field. Additionally, the piece attends to issues of professionalization and the constitution of an archeological public, at the same time as discussing issues of empire, colonialism, and the circulation of knowledge. Meanwhile, enriching discussions within and beyond the history of science, the article discusses the history of archeology and its relationship with museums, collecting, and material culture and materiality. Finally, the piece discusses the relationship of the history of archeology with wider discussions about scientific ethics. In conclusion, the article questions whether we should speak of 'the history of archeology' at all.

Knowledge Is Power: The Issue of Censorship in Middle Grades Literacy Instruction

ERIC Educational Resources Information Center

Whitney, Jennifer D.

2007-01-01

Book challenges have become more and more frequent in recent years. In particular, those books that address issues most relevant to preteens and teenagers seem to be the object of many challenges. Many of the hundreds of challenged works represent literary classics and high-quality writing for young audiences. Teachers, administrators and other…

Child Care Issues Impacting Welfare Reform in the Rural South.

ERIC Educational Resources Information Center

Ghazvini, Alisa S.; Mullis, Ann K.; Mullis, Ronald L.; Park, Jennifer J.

1999-01-01

Access to affordable, quality child care is a major barrier to successful employment for many families. About one-fifth of families return to welfare within a few months of leaving, with lack of accessible child care and transportation being the most frequently cited reasons. These issues are likely to be compounded in the rural South. Information…

Space station human productivity study. Volume 4: Issues

NASA Technical Reports Server (NTRS)

1985-01-01

The 305 Issues contained represent topics recommended for study in order to develop requirements in support of space station crew performance/productivity. The overall subject matter, space station elements affecting crew productivity, was organized into a coded subelement listing, which is included for the reader's reference. Each issue is numbered according to the 5-digit topical coding scheme. The requirements column on each Issue page shows a cross-reference to the unresolved requirement statement(s). Because topical overlaps were frequently encountered, many initial Issues were consolidated. Apparent gaps, therefore, may be accounted for by an Issue described within a related subelement. A glossary of abbreviations used throughout the study documentation is also included.

Religion and attitudes toward abortion and abortion policy in Brazil.

PubMed

Ogland, Curtis P; Verona, Ana Paula

2011-01-01

This study examines the association between religion and attitudes toward the practice of abortion and abortion policy in Brazil. Drawing upon data from the 2002 Brazilian Social Research Survey (BSRS), we test a number of hypotheses with regard to the role of religion on opposition to the practice of abortion and its legalization. Findings indicate that frequently attending Pentecostals demonstrate the strongest opposition to the practice of abortion and both frequently attending Pentecostals and Catholics demonstrate the strongest opposition to its legalization. Additional religious factors, such as a commitment to biblical literalism, were also found to be significantly associated with opposition to both abortion issues. Ultimately, the findings have implications for the future of public policy on abortion and other contentious social issues in Brazil.

Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States, 1998-2012.

PubMed

McGinty, Emma E; Kennedy-Hendricks, Alene; Baller, Julia; Niederdeppe, Jeff; Gollust, Sarah; Barry, Colleen L

2016-04-01

Opioid analgesic abuse is a complex and relatively new public health problem, and to date little is known about how the news media frame the issue. To better understand how this issue has been framed in public discourse, an analysis was conducted of the volume and content of news media coverage of opioid analgesic abuse over a 15-year period from 1998 to 2012 (N=673 news stories). A 70-item structured coding instrument was used to measure items in four domains that prior research suggests can influence public attitudes about health and social issues: causes, solutions, and consequences of the problem and individual depictions of persons who abuse opioid analgesics. Although experts have deemed opioid analgesic abuse a public health crisis, results of our study suggest that the news media more often frame the problem as a criminal justice issue. The most frequently mentioned cause of the problem was illegal drug dealing, and the most frequently mentioned solutions were law enforcement solutions designed to arrest and prosecute the individuals responsible for diverting opioid analgesics onto the illegal market. Prevention-oriented approaches, such as prescription drug-monitoring programs, were mentioned more frequently in the latter years of the study period, but less than 5% of news stories overall mentioned expanding substance abuse treatment, and even fewer mentioned expanding access to evidence-based medication-assisted treatments, such as buprenorphine. Findings underscore the need for a concerted effort to reframe opioid analgesic abuse as a treatable condition addressable via well-established public and behavioral health approaches.

Measuring Graduation and Attrition at Ontario Colleges: A Discussion of Measurement Issues and Their Usefulness as Indicators of Student Success.

ERIC Educational Resources Information Center

Donner, Arthur; Lazar, Fred

This report discusses measurement issues and their usefulness as indicators of student success at the Colleges of Applied Arts and Technology of Ontario. The following sections are included: (1) executive summary; (2) introduction; (3) retention rates, which discusses a number of issues associated with defining and measuring graduation rates; (4)…

Problems and Issues for the Classroom: What Works in Generating Class Discussions Using the Method of Shared Inquiry.

ERIC Educational Resources Information Center

Wallace, Robert L.

1997-01-01

Potential extinction of the human smallpox virus lies in the hands of a few scientists and policymakers. Whether this decision should be made can serve as an excellent issue for extended, focused classroom discussion. Outlines the history of smallpox, illustrates the debate, and describes preparation needed before discussing the issue. Also…

Current Issues: Critical Issues Confronting the Nation and the World. 1990 Edition.

ERIC Educational Resources Information Center

Close Up Foundation, Arlington, VA.

This annual publication seeks to inform interested readers about issues currently confronting the United States. The introductory section briefly discusses the 101st Congress, members of the Bush administration, and the Supreme Court. The federal budget process is also discussed in this section. The section on domestic policy issues contains the…

Teaching Gender Issues in Storytelling and in the College Teaching Class.

ERIC Educational Resources Information Center

Hanson, Trudy L.

An instructor, who teaches both graduate and undergraduate courses in storytelling, incorporates discussions of gender issues throughout the semester in various ways. In one course, class discussions are used to raise issues of the origin of Grimm's fairy tales and of story variants. Students are also encouraged to choose gender issues in…

Clinical guide to fertility preservation in hematopoietic cell transplant recipients

PubMed Central

Joshi, S; Savani, BN; Chow, EJ; Gilleece, MH; Halter, J; Jacobsohn, DA; Pidala, J; Quinn, GP; Cahn, J-Y; Jakubowski, AA; Kamani, NR; Lazarus, HM; Rizzo, JD; Schouten, HC; Socie, G; Stratton, P; Sorror, ML; Warwick, AB; Wingard, JR; Loren, AW; Majhail, NS

2014-01-01

With broadening indications, more options for hematopoietic cell transplantation (HCT) and improvement in survival, the number of long-term HCT survivors is expected to increase steadily. Infertility is a frequent problem that long-term HCT survivors and their partners face and it can negatively impact on the quality of life. The most optimal time to address fertility issues is before the onset of therapy for the underlying disease; however, fertility preservation should also be addressed before HCT in all children and patients of reproductive age, with referral to a reproductive specialist for patients interested in fertility preservation. In vitro fertilization (IVF) and embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking are acceptable methods for fertility preservation in adult women/pubertal females. Sperm banking is the preferred method for adult men/pubertal males. Frequent barriers to fertility preservation in HCT recipients may include the perception of lack of time to preserve fertility given an urgency to move ahead with transplant, lack of patient–physician discussion because of several factors (for example, time constraints, lack of knowledge), inadequate access to reproductive specialists, and costs and lack of insurance coverage for fertility preservation. There is a need to raise awareness in the medical community about fertility preservation in HCT recipients. PMID:24419521

Integrated disease management: a critical review of foreign and Portuguese experience.

PubMed

Coelho, Anabela; Leone, Cláudia; Ribeiro, Vanessa; Sá Moreira, Pedro; Dussault, Gilles

2014-01-01

The present article reviews findings from empirical evaluations of integrated disease management programmes. The objective is to provide insights on integration levels, priority interventions and their effect on patient outcomes. The literature review identified 1 251 articles, published from 2006 to 2011. Upon a detailed screening 61 articles were selected for bibliometric analysis and critical discussion. Among several findings, it can be noted that United States of America is the country with the highest amount of published evidence on the subject under study. The most frequently referred disease is diabetes mellitus and the main reported issue of integrated disease management is self-management support. The majority of the studies were developed and exclusively managed by managed care organizations, organized family doctors or hospitals. From a total of 360 interventions reported in studies, patient interventions are the most frequently used across all disease groups, followed by professional interventions. To monitor the effectiveness of the disease programmes, the most frequently used outcomes are patient physiological measures, service use and patient health status. Every country has its own way to implement the integrated disease management strategy. The focus of practice lies on patient empowerment, particularly through self-management. Physiological measures and service use are the outcomes with the highest rate of assessment, which are also the indicators that show higher impact among all integrated disease management programmes. The Portuguese health care system still faces challenges in the coordination and integration of care for patients with chronic disease thus improvements at integrated disease management programmes should be incorporate.

GunderKids: Design of a Clinical Care Management Program for Parents With Substance Abuse and Their Newborn Children with a Focus on Preventing Child Abuse.

PubMed

Budzak-Garza, Ann E; Allmon Dixson, Allison L; Holzer, Renee A; Lillard-Pierce, Kaitlin E; Devine, Carolynn J

2018-03-01

In response to an increased need to care for babies born to mothers with substance abuse issues, we developed GunderKids, a care management program that provides integrated medical care beyond standard-of-care, well-child appointments for these socially complex families. The program incorporates frequent visits to the pediatrician and the care team, which includes pediatric nurses, a pediatric social worker, and a child psychologist. Enrollment is voluntary. Each visit addresses parenting challenges, home environment, basic needs, safety issues, and maintenance of sobriety, as well as child development and health issues. We found that mothers and fathers (or parents) welcome intense support following delivery, appreciate the relationship that is built with the care team, and prefer frequent visits at the medical center over in-home visits, which they perceive as potentially intrusive. We describe here the planning and implementation of the program, as well as insights gained in our first year. Copyright© Wisconsin Medical Society.

Methodological Issues and Practices in Qualitative Research.

ERIC Educational Resources Information Center

Bradley, Jana

1993-01-01

Discusses methodological issues concerning qualitative research and describes research practices that qualitative researchers use to address these methodological issues. Topics discussed include the researcher as interpreter, the emergent nature of qualitative research, understanding the experience of others, trustworthiness in qualitative…

Department of Defense Suicide Event Report (DoDSER) Calendar Year 2010 Annual Report

DTIC Science & Technology

2011-09-01

n = 69, 24.56%). Drug overdose was the most frequent method for suicide attempt (n = 496, 57.47%), followed by injury with a sharp or blunt object...who died by suicide were non-military issue firearm use and hanging. Suicide attempt methods were most often drug overdose , harming oneself with a...military issue firearm use. Suicide attempt methods were most often drug overdose and use of military issue firearm. Drug and alcohol use was less

77 FR 41403 - Meetings of the Local Government Advisory Committee and the Small Communities Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... Tuesday, July 31, 2012, 1 p.m.-2 p.m. (EDT). The Committee will discuss air quality issues, water quality.... (EDT). The Committee will discuss air quality issues, water quality issues, environmental justice and...

Transitions.

ERIC Educational Resources Information Center

Nathanson, Jeanne H., Ed.

1993-01-01

This theme issue on transitions for individuals with disabilities contains nine papers discussing transition programs and issues. "Transition Issues for the 1990s," by Michael J. Ward and William D. Halloran, discusses self-determination, school responsibility for transition, continued educational engagement of at-risk students, and service…

A review of statistical issues with progression-free survival as an interval-censored time-to-event endpoint.

PubMed

Sun, Xing; Li, Xiaoyun; Chen, Cong; Song, Yang

2013-01-01

Frequent rise of interval-censored time-to-event data in randomized clinical trials (e.g., progression-free survival [PFS] in oncology) challenges statistical researchers in the pharmaceutical industry in various ways. These challenges exist in both trial design and data analysis. Conventional statistical methods treating intervals as fixed points, which are generally practiced by pharmaceutical industry, sometimes yield inferior or even flawed analysis results in extreme cases for interval-censored data. In this article, we examine the limitation of these standard methods under typical clinical trial settings and further review and compare several existing nonparametric likelihood-based methods for interval-censored data, methods that are more sophisticated but robust. Trial design issues involved with interval-censored data comprise another topic to be explored in this article. Unlike right-censored survival data, expected sample size or power for a trial with interval-censored data relies heavily on the parametric distribution of the baseline survival function as well as the frequency of assessments. There can be substantial power loss in trials with interval-censored data if the assessments are very infrequent. Such an additional dependency controverts many fundamental assumptions and principles in conventional survival trial designs, especially the group sequential design (e.g., the concept of information fraction). In this article, we discuss these fundamental changes and available tools to work around their impacts. Although progression-free survival is often used as a discussion point in the article, the general conclusions are equally applicable to other interval-censored time-to-event endpoints.

Design considerations and rationale of a multi-center trial to sustain weight loss: the Weight Loss Maintenance Trial.

PubMed

Brantley, Phillip; Appel, Lawrence; Hollis, Jack; Stevens, Victor; Ard, Jamy; Champagne, Catherine; Elmer, Patricia; Harsha, David; Myers, Valerie; Proschan, Michael; William, Vollmer; Svetkey, Laura

2008-01-01

The Weight Loss Maintenance Trial (WLM) is a multi-center, randomized, controlled trial that compares the effects of two 30-month maintenance interventions, i.e., Personal Contact (PC) and Interactive Technology (IT) to a self-directed usual care control group (SD), in overweight or obese individuals who are at high risk for cardiovascular disease. This paper provides an overview of the design and methods, and design considerations and lessons learned from this trial. All participants received a 6-month behavioral weight loss program consisting of weekly group sessions. Participants who lost 4 kg were randomized to one of three conditions (PC, IT, or SD). The PC condition provided monthly contacts with an interventionist primarily via telephone and quarterly face-to-face visits. The IT condition provided frequent, individualized contact through a tailored, website system. Both the PC and IT maintenance programs encouraged the DASH dietary pattern and employed theory-based behavioral techniques to promote maintenance. Design considerations included choice of study population, frequency and type of intervention visits, and choice of primary outcome. Overweight or obese persons with CVD risk factors were studied. The pros and cons of studying this population while excluding others are presented. We studied intervention contact strategies that made fewer demands on participant time and travel, while providing frequent opportunities for interaction. The primary outcome variable for the trial was change in weight from randomization to end of follow-up (30 months). Limits to generalizability are discussed. Individuals in need of weight loss strategies may have been excluded due to barriers associated with internet use. Other participants may have been excluded secondary to a comorbid condition. This paper highlights the design and methods of WLM and informs readers of discussions of critical issues and lessons learned from the trial.

Frequently Asked Questions about Population.

ERIC Educational Resources Information Center

California Journal of Science Education, 2000

2000-01-01

Emphasizes the issue of human population growth. Provides information on current demographic trends; their social, economic, and environmental impacts; and Zero Population Growth's (ZPG) position on several controversial topics. (ASK)

Ethical issues relating to renal transplantation from prediabetic living donor

PubMed Central

2014-01-01

Background In Mexico, diabetes mellitus is the main cause of end − stage kidney disease, and some patients may be transplant candidates. Organ supply is limited because of cultural issues. And, there is a lack of standardized clinical guidelines regarding organ donation. These issues highlight the tension surrounding the fact that living donors are being selected despite being prediabetic. This article presents, examines and discusses using the principles of non-maleficience, autonomy, justice and the constitutionally guaranteed right to health, the ethical considerations that arise from considering a prediabetic person as a potential kidney donor. Discussion Diabetes is an absolute contraindication for donating a kidney. However, the transplant protocols most frequently used in Mexico do not consider prediabetes as exclusion criteria. In prediabetic persons there are well known metabolic alterations that may compromise the long − term outcomes of the transplant if such donors are accepted. Even so, many of them are finally included because there are not enough donor candidates. Both, families and hospitals face the need to rapidly accept prediabetic donors before the clinical conditions of the recipient and the evolution of the disease exclude him/her as a transplant candidate; however, when using a kidney potentially damaged by prediabetes, neither the donor’s nor the recipient’s long term health is usually considered. Considering the ethical implication as well as the clinical and epidemiological evidence, we conclude that prediabetic persons are not suitable candidates for kidney donation. This recommendation should be taken into consideration by Mexican health institutions who should rewrite their transplant protocols. Summary We argue that the decision to use a kidney from a living donor known to be pre-diabetic or from those persons with family history of T2DM, obesity, hypertension, or renal failure, should be considered unethical in Mexico if the donor bases the decision to donate on socially acceptable norms rather than informed consent as understood in modern medicine. PMID:24935278

Homeless Veterans' Use of Peer Mentors and Effects on Costs and Utilization in VA Clinics.

PubMed

Yoon, Jean; Lo, Jeanie; Gehlert, Elizabeth; Johnson, Erin E; O'Toole, Thomas P

2017-06-01

The study compared health care utilization and costs among homeless veterans randomly assigned to peer mentors or usual care and described contacts with peer mentors. Homeless patients at four Department of Veterans Affairs clinics were randomly assigned to a peer mentor (N=195) or to usual care (N=180). Administrative data on utilization and costs over a six-month follow-up were combined with peer mentors' reports of patient contacts. Most patients (87%) in the peer mentor group had at least one peer contact. Patients in this group spent the largest proportions of time discussing housing and health issues with peer mentors and had more outpatient encounters than those in usual care, although differences were not significant. No other between-group differences were found in utilization or costs. Although significant impacts of peer mentors on health care patterns or costs were not detected, some patients had frequent contact with peer mentors.

A media information analysis for implementing effective countermeasure against harmful rumor

NASA Astrophysics Data System (ADS)

Nagao, Mitsuyoshi; Suto, Kazuhiro; Ohuchi, Azuma

2010-04-01

When large scale earthquake occurred, the word of "harmful rumor" came to be frequently heard. The harmful rumor means an economic damage which is caused by the action that people regard actually safe foods or areas as dangerous and then abort consumption or sightseeing. In the case of harmful rumor caused by earthquake, especially, tourism industry receives massive economic damage. Currently, harmful rumor which gives substantial economic damage have become serious social issue which must be solved. In this paper, we propose a countermeasure method for harmful rumor on the basis of media trend in order to implement speedy recovery from harmful rumor. Here, we investigate the amount and content of information which is transmitted to the general public by the media when an earthquake occurred. In addition, the media information in three earthquakes is treated as instance. Finally, we discuss an effective countermeasure method for dispeling harmful rumor through these analysis results.

A Mobile and Intelligent Patient Diary for Chronic Disease Self-Management.

PubMed

Van Woensel, William; Roy, Patrice C; Abidi, Samina R; Abidi, Syed S R

2015-01-01

By involving patients in their own long-term care, patient self-management approaches aim to increase self-sufficiency and reduce healthcare costs. For example, electronic patient diaries enable patients to collect health data autonomously, increasing self-reliance and reducing strain on health professionals. By deploying patient diaries on mobile platforms, health data collection can occur at any time and place, increasing the mobility of chronic patients who typically need to enter health data frequently. Importantly, an opportunity also arises for mobile clinical decision support, where health feedback is directly issued to patients without relying on connectivity or remote servers. Regardless of the specific self-management strategy, patient and healthcare provider adoption are crucial. Tailoring the system towards the particular patient and toward institution-specific clinical pathways is essential to increasing acceptance. In this paper we discuss a mobile patient diary realizing both the opportunities and challenges of mobile deployment.

Social anxiety and mental health service use among Asian American high school students

PubMed Central

Brice, Chad; Warner, Carrie Masia; Okazaki, Sumie; Ma, Pei-Wen Winnie; Sanchez, Amanda; Esseling, Petra; Lynch, Chelsea

2014-01-01

Asian American adults endorse more symptoms of social anxiety (SA) on self-report measures than European Americans, but demonstrate lower prevalence rates of social anxiety disorder in epidemiological studies. These divergent results create ambiguity concerning the mental health needs of Asian Americans. The present study is the first to investigate this issue in adolescents through assessment of self-reported SA in Asian American high school students. Parent and self-ratings of impairment related to SA and self-reported mental health service use for SA were also measured. Asian American students endorsed a greater number of SA symptoms and scored in the clinical range more frequently than other ethnic groups. Also, Asian American and Latino students endorsed more school impairment related to SA than other ethnic groups. No differences in parent-reported impairment or service utilization were identified. Implications for future research and treatment for SA among Asian American adolescents are discussed. PMID:25300193

Measure Guideline: Guidance on Taped Insulating Sheathing Drainage Planes

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

Grin, A.; Lstiburek, J.

The goal of this research is to provide durable and long-term water management solutions using exterior insulating sheathing as part of the water management system. It is possible to tape or seal the joints in insulating sheathing to create a drainage plane and even an air control layer. There exists the material durability component of the tape as well as the system durability component being the taped insulating sheathing as the drainage plane. This measure guideline provides best practice and product recommendations from the interviewed contractors and homebuilders who collectively have a vast amount of experience. Three significant issues weremore » discussed with the group, which are required to make taped insulating sheathing a simple, long-term, and durable drainage plane: horizontal joints should be limited or eliminated wherever possible; where a horizontal joint exists use superior materials; and frequent installation inspection and regular trade training are required to maintain proper installation.« less

The content of recurrent dreams in young adolescents.

PubMed

Gauchat, Aline; Séguin, Jean R; McSween-Cadieux, Esther; Zadra, Antonio

2015-12-01

Studies on children's recurrent dreams have been largely anecdotal and based on adults' recollections of dreams experienced during childhood. We collected 102 reports of recurrent dreams from a sample of young adolescents aged between 11 and 15years and scored the narratives using a range of content measures, including in relation to the threat simulation theory (TST) of dreaming. The most frequently reported themes involved confrontations with monsters or animals, followed by physical aggressions, falling and being chased. Recurrent dreams were more likely to include negative content elements than positive elements. Only half of the recurrent dreams contained threatening elements and their analysis provided mixed support for the TST. Differences between the content of recurrent dreams reported by young adolescent versus adults are discussed as are possible sex effects and key issues that remain to be addressed by future research. Copyright © 2015 Elsevier Inc. All rights reserved.

A matter of motion or an emotional matter? Management of depression in Parkinson's disease.

PubMed

Lagopoulos, Jim; Malhi, Gin S; Ivanovski, Belinda; Cahill, Catherine M; Morris, John G L

2005-11-01

Depression is one of the most frequent comorbidities occurring in Parkinson's disease, affecting up to 50% of patients. Depression is associated with severe negative symptoms and has been shown to contribute to an increased rate of decline of both cognitive and motor function, profoundly impacting on the patient's quality of life. The symptoms of depression overlap with the motor features of Parkinson's disease, making detection difficult. Moreover, the lack of specialized screening tools means that depression remains undiagnosed and untreated in a high percentage of patients. However, depression in Parkinson's disease, when identified early, can be effectively treated with a variety of antidepressant medications, improving quality of life and preserving daily function. The focus of this review is to provide an overview of current knowledge regarding depression in Parkinson's disease, followed by a practical discussion addressing the issues of the detection, diagnosis and treatment.

In Search of Rationality in Human Longevity and Immortality

PubMed Central

Bhar, Gopal C.

2016-01-01

The human body is machine-like, but self-moving, self-regulating, and self-adjusting, governed by willpower and intelligence. Aging of the body is basically a maintenance problem and so it could perhaps be postponed by thorough and frequent maintenance. Aging brings on a cascade of ills and health problems leading to deterioration of physical, mental, emotional, and social dimensions of life. This paper deals with solution of the problem philosophically in the light of Indian scriptures without entering into traditional bioethical issues. With a meaningful reason for existence, life can be extended. Examining the scientific perspectives on aging, some common manipulations for its extension are discussed. These are calorie restriction, vitamin and antioxidant treatment, exercise and hormonal interventions, etc. Finally, the question of longevity is explored through pursuance of eternal value-based activity and spirituality in the tradition of Indian heritage. PMID:28031631

Immunotoxins: magic bullets or misguided missiles?

PubMed

Vitetta, E S; Thorpe, P E; Uhr, J W

1993-05-01

Thirteen years have passed since specific in vitro and in vivo killing of tumour cells by immunotoxins was first described. Why, then, has it taken so long to determine whether these drugs will have a major impact on the treatment of cancer, AIDS and autoimmune disease? The answer is that the transfer of basic discoveries to the clinic is a slow, multistep, interdisciplinary process. Thus, immunotoxin molecules must be designed and redesigned by the basic scientist depending on the efficacy and toxicity shown in vitro and in relevant experimental models. Next, each version must be evaluated by clinicians in humans through a lengthy process (1-3 years) in which the dose regimen is optimized and in which new problems and issues frequently emerge. These problems must again be modelled and studied in animals before additional clinical trials are initiated. In this article, Ellen Vitetta and colleagues discuss both basic and clinical aspects of the development of immunotoxin therapy.

Balancing equity and efficiency in the Dutch basic benefits package using the principle of proportional shortfall.

PubMed

van de Wetering, E J; Stolk, E A; van Exel, N J A; Brouwer, W B F

2013-02-01

Economic evaluations are increasingly used to inform decisions regarding the allocation of scarce health care resources. To systematically incorporate societal preferences into these evaluations, quality-adjusted life year gains could be weighted according to some equity principle, the most suitable of which is a matter of frequent debate. While many countries still struggle with equity concerns for priority setting in health care, the Netherlands has reached a broad consensus to use the concept of proportional shortfall. Our study evaluates the concept and its support in the Dutch health care context. We discuss arguments in the Netherlands for using proportional shortfall and difficulties in transitioning from principle to practice. In doing so, we address universal issues leading to a systematic consideration of equity concerns for priority setting in health care. The article thus has relevance to all countries struggling with the formalization of equity concerns for priority setting.

Workplace aggression: beginning a dialogue.

PubMed

McLemore, Monica R

2006-08-01

The June 2005 Clinical Journal of Oncology Nursing editorial titled "Communication: Whose Problem Is It?" (Griffin-Sobel, 2005) was written to begin a dialogue about a phenomenon frequently experienced yet rarely discussed: workplace aggression, also known as disruptive behavior. Prompted by a groundbreaking study published in the American Journal of Nursing by Rosenstein and O'Daniel (2005), the editorial challenged oncology nurses to begin to fix problems of communication. After reflecting on both of the articles and considering my own experience as a nurse manager, clinician, and scholar, I decided to explore the topic as it relates to nurse-to-nurse workplace aggression. The following is a summary of interviews with nurse managers, nurse practitioners, and nurse scientists about root causes and effective strategies to manage these sometimes complicated situations. This article is meant to continue the dialogue about the very sensitive issue. Confidentiality has been maintained, and I welcome your comments.

Social Anxiety and Mental Health Service Use Among Asian American High School Students.

PubMed

Brice, Chad; Masia Warner, Carrie; Okazaki, Sumie; Ma, Pei-Wen Winnie; Sanchez, Amanda; Esseling, Petra; Lynch, Chelsea

2015-10-01

Asian American adults endorse more symptoms of social anxiety (SA) on self-report measures than European Americans, but demonstrate lower prevalence rates of SA disorder in epidemiological studies. These divergent results create ambiguity concerning the mental health needs of Asian Americans. The present study is the first to investigate this issue in adolescents through assessment of self-reported SA in Asian American high school students. Parent and self-ratings of impairment related to SA and self-reported mental health service use for SA were also measured. Asian American students endorsed a greater number of SA symptoms and scored in the clinical range more frequently than other ethnic groups. Also, Asian American and Latino students endorsed more school impairment related to SA than other ethnic groups. No differences in parent-reported impairment or service utilization were identified. Implications for future research and treatment for SA among Asian American adolescents are discussed.

Performances of Machine Learning Algorithms for Binary Classification of Network Anomaly Detection System

NASA Astrophysics Data System (ADS)

Nawir, Mukrimah; Amir, Amiza; Lynn, Ong Bi; Yaakob, Naimah; Badlishah Ahmad, R.

2018-05-01

The rapid growth of technologies might endanger them to various network attacks due to the nature of data which are frequently exchange their data through Internet and large-scale data that need to be handle. Moreover, network anomaly detection using machine learning faced difficulty when dealing the involvement of dataset where the number of labelled network dataset is very few in public and this caused many researchers keep used the most commonly network dataset (KDDCup99) which is not relevant to employ the machine learning (ML) algorithms for a classification. Several issues regarding these available labelled network datasets are discussed in this paper. The aim of this paper to build a network anomaly detection system using machine learning algorithms that are efficient, effective and fast processing. The finding showed that AODE algorithm is performed well in term of accuracy and processing time for binary classification towards UNSW-NB15 dataset.

Strain, Negative Emotions, and Level of Criminality Among Chinese Incarcerated Women.

PubMed

Sun, Ivan Y; Luo, Haishan; Wu, Yuning; Lin, Wen-Hsu

2016-05-01

General strain theory (GST) has been one of the most frequently tested criminological theories. According to GST, strain tends to generate negative emotions, which create pressures for corrective action, such as crime and delinquency. Although GST has received strong empirical support, one under-addressed issue is the lack of diversity in sampling population in assessing the generalizability of the theory. Using survey data collected from 335 incarcerated women in four Chinese prisons, this study examined the impact of strain and negative emotions on the level of female criminality. The strain variable, physical abuse, and discrimination, exerted a positive effect on female inmates' levels of criminality, whereas negative emotions were not significantly related to female criminality. Two control variables, age of current offense and educational attainment, were predictive of female criminality, with younger and less-educated women having more serious criminality. Implications for future research and policy are discussed. © The Author(s) 2015.

Adolescents' reasoning about parental gender roles.

PubMed

Brose, Sara J; Conry-Murray, Clare; Turiel, Elliot

2013-01-01

In an examination of how adolescents reason about several factors related to division of childcare labor, 38 adolescents, including 20 girls (M age = 16.36 years, SD = .50) and 18 boys (M age = 16.59 years, SD = .62) were interviewed about conflicts between a mother and a father over which parent should stay home with the child, the authority of the father, and similar issues in a traditional culture. The relative income of each parent was varied. Participants considered the needs of the child most when reasoning about infants, and the right to work most frequently when reasoning about preschoolers (p < .001, eta2 = .35). The majority (71%) did not endorse the husband's authority over the wife. However, boys were more likely than girls to emphasize the mother's responsibility to the child over her right to work (p < .01, eta2 = .23). Implications for gender equity and adolescents' future goals were discussed.

[Medycyna Pracy: the scopus-based analysis of citations].

PubMed

Przyłuska, Jolanta

2006-01-01

Medycyna Pracy, a Polish bimonthly published since 1950, forms a long-standing documentation of studies carried out in the area of workers' health protection. The journal is primarily addressed to occupational health physicians and work hygiene specialists in Poland. It is indexed by numerous foreign information services (e.g., MEDLINE, EMBASE, BIOSIS PREVIEWS, BIOLOGICAL ABSTRACTS, SCOPUS) and thus promotes Polish research in occupational medicine throughout the world. The quantitative analysis for the years 1996-2005, grounded on the SCOPUS database, presents an average number of citations concerning a given volume, frequency of citations, articles most frequently cited, and countries, in which articles published in Medycyna Pracy have been referred to. A growing number of citations observed in the recent years signify the importance of issues investigated and discussed in the journal as well as its role in the world-wide circulation of scientific information.

Forensic trace DNA: a review

PubMed Central

2010-01-01

DNA analysis is frequently used to acquire information from biological material to aid enquiries associated with criminal offences, disaster victim identification and missing persons investigations. As the relevance and value of DNA profiling to forensic investigations has increased, so too has the desire to generate this information from smaller amounts of DNA. Trace DNA samples may be defined as any sample which falls below recommended thresholds at any stage of the analysis, from sample detection through to profile interpretation, and can not be defined by a precise picogram amount. Here we review aspects associated with the collection, DNA extraction, amplification, profiling and interpretation of trace DNA samples. Contamination and transfer issues are also briefly discussed within the context of trace DNA analysis. Whilst several methodological changes have facilitated profiling from trace samples in recent years it is also clear that many opportunities exist for further improvements. PMID:21122102

Distal technologies and type 1 diabetes management.

PubMed

Duke, Danny C; Barry, Samantha; Wagner, David V; Speight, Jane; Choudhary, Pratik; Harris, Michael A

2018-02-01

Type 1 diabetes requires intensive self-management to avoid acute and long-term health complications. In the past two decades, substantial advances in technology have enabled more effective and convenient self-management of type 1 diabetes. Although proximal technologies (eg, insulin pumps, continuous glucose monitors, closed-loop and artificial pancreas systems) have been the subject of frequent systematic and narrative reviews, distal technologies have received scant attention. Distal technologies refer to electronic systems designed to provide a service remotely and include heterogeneous systems such as telehealth, mobile health applications, game-based support, social platforms, and patient portals. In this Review, we summarise the empirical literature to provide current information about the effectiveness of available distal technologies to improve type 1 diabetes management. We also discuss privacy, ethics, and regulatory considerations, issues of global adoption, knowledge gaps in distal technology, and recommendations for future directions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of Hydrologic and Meteorological Impacts on Dengue Fever Incidences in Southern Taiwan using Time- Frequency Method

NASA Astrophysics Data System (ADS)

Tsai, Christina; Yeh, Ting-Gu

2017-04-01

Extreme weather events are occurring more frequently as a result of climate change. Recently dengue fever has become a serious issue in southern Taiwan. It may have characteristic temporal scales that can be identified. Some researchers have hypothesized that dengue fever incidences are related to climate change. This study applies time-frequency analysis to time series data concerning dengue fever and hydrologic and meteorological variables. Results of three time-frequency analytical methods - the Hilbert Huang transform (HHT), the Wavelet Transform (WT) and the Short Time Fourier Transform (STFT) are compared and discussed. A more effective time-frequency analysis method will be identified to analyze relevant time series data. The most influential time scales of hydrologic and meteorological variables that are associated with dengue fever are determined. Finally, the linkage between hydrologic/meteorological factors and dengue fever incidences can be established.

Hydride ions in oxide hosts hidden by hydroxide ions

PubMed Central

Hayashi, Katsuro; Sushko, Peter V.; Hashimoto, Yasuhiro; Shluger, Alexander L.; Hosono, Hideo

2014-01-01

The true oxidation state of formally ‘H−’ ions incorporated in an oxide host is frequently discussed in connection with chemical shifts of 1H nuclear magnetic resonance spectroscopy, as they can exhibit values typically attributed to H+. Here we systematically investigate the link between geometrical structure and chemical shift of H− ions in an oxide host, mayenite, with a combination of experimental and ab initio approaches, in an attempt to resolve this issue. We demonstrate that the electron density near the hydrogen nucleus in an OH− ion (formally H+ state) exceeds that in an H− ion. This behaviour is the opposite to that expected from formal valences. We deduce a relationship between the chemical shift of H− and the distance from the H− ion to the coordinating electropositive cation. This relationship is pivotal for resolving H− species that are masked by various states of H+ ions. PMID:24662678

Introduction: From pathogenesis to therapy, deep endometriosis remains a source of controversy.

PubMed

Donnez, Jacques

2017-12-01

Deep endometriosis remains a source of controversy. A number of theories may explain its pathogenesis and many arguments support the hypothesis that genetic or epigenetic changes are a prerequisite for development of lesions into deep endometriosis. Deep endometriosis is frequently responsible for pelvic pain, dysmenorrhea, and/or deep dyspareunia, but can also cause obstetrical complications. Diagnosis may be improved by high-quality imaging. Therapeutic approaches are a source of contention as well. In this issue's Views and Reviews, medical and surgical strategies are discussed, and it is emphasized that treatment should be designed according to a patient's symptoms and individual needs. It is also vital that referral centers have the knowledge and experience to treat deep endometriosis medically and/or surgically. The debate must continue because emerging trends in therapy need to be followed and investigated for optimal management. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

CE: Epilepsy Update, Part 1: Refining Our Understanding of a Complex Disease.

PubMed

Smith, Gigi; Wagner, Janelle L; Edwards, Jonathan C

2015-05-01

Epilepsy is a serious, common neurologic disease that affects people of all ages. As underscored in the 2012 Institute of Medicine report Epilepsy Across the Spectrum: Promoting Health and Understanding, the millions of people living with epilepsy in the United States face the challenges of seeking out high-quality, coordinated health care and community services; overcoming epilepsy misinformation and stigma; and finding understanding and support in their communities. This article, the first in a two-part series, discusses new research that has increased our understanding of epilepsy's etiology and pathophysiology, new definitions that are changing the ways we evaluate and treat this disease, conditions that frequently present with epilepsy, and psychosocial challenges faced by people with epilepsy. Part 2, which will appear in next month's issue, reviews comprehensive nursing care and evidence-based treatment for epilepsy and presents resources for people with epilepsy and their families.

Guide to Rebuilding Public Sector Services in Stability Operations: A Role for the Military

DTIC Science & Technology

2009-10-01

economic growth. Each topic discussion focuses on the key issues, trade-offs faced in addressing those issues in stability operations, and recommended...top-down versus bottom-up planning. As discussed above, countries have a long-term development framework that expresses broad national strategy for...SERVICES This section discusses a relatively narrow range of issues and potential actions in rebuilding government, focusing on government’s provision

Climate Prediction Center - 6-10 and 8-14 Day Prognostic Discussions

Science.gov Websites

About Us Our Mission Who We Are Contact Us CPC Information CPC Web Team 6-10 Day outlooks are issued DISCUSSIONS FOR 6 TO 10 AND 8 TO 14 DAY OUTLOOKS NWS CLIMATE PREDICTION CENTER COLLEGE PARK MD 300 PM EDT SAT CONSISTENCY ISSUES. IN THESE CASES, FORECASTS ARE MANUALLY DRAWN BUT A FULL DISCUSSION IS NOT ISSUED. THE

Early Childhood Programs and Policy in the Northwest and Hawaii: Early Childhood Policy Issues and Options.

ERIC Educational Resources Information Center

Conklin, Nancy Faires; And Others

Discussed are early childhood policy issues and options for Alaska, Hawaii, Idaho, Montana, Oregon, and Washington. Section I explores federal and state directions in terms of levels of policy making, federal and state issues, and interested parties. Section II focuses on policy issues in its discussions of the political climate, long-term…

Addressing changed sexual functioning in cancer patients: A cross-sectional survey among Dutch oncology nurses.

PubMed

Krouwel, E M; Nicolai, M P J; van Steijn-van Tol, A Q M J; Putter, H; Osanto, S; Pelger, R C M; Elzevier, H W

2015-12-01

In most types of cancer, the disease and its treatment can result in altered sexual function (SF). Oncology nurses are strategically placed to address SF since they have frequent patient interaction. Our aim was to establish their knowledge about and attitudes to SF in oncology care and identify their perceived barriers to addressing the subject. A 37-item questionnaire was administered during the 2012 Dutch Oncology Nursing Congress and mailed to 241 Dutch oncology nursing departments. The majority of 477 nurses (87.6%) agreed that discussing SF is their responsibility. Discussing SF routinely is performed by 33.4% of these nurses, consultations mainly consisted of mentioning treatment side-effects affecting SF (71.3%). There were significant differences depending on experience, knowledge, age, academic degree and department policy. Nurses ≤44 years old (p < 0.001), with <10 years oncology experience (p = 0.001), insufficient knowledge (p < 0.001), no academic degree (p < 0.001), and in whose department policy was lacking or inadequate (p < 0.001), were less comfortable discussing SF. Barriers included lack of training, presence of a third party and no angle or motive for initiating discussion. Findings suggest oncology nurses consider counselling on sexual issues to be an important responsibility, in line with discussing other side-effects caused by the disease or its treatment. Nevertheless, cancer patients may not routinely be receiving a sexual health evaluation by oncology nurses. Results emphasize the potential benefit of providing knowledge, including practical training and a complete department protocol. Copyright © 2015 Elsevier Ltd. All rights reserved.

The ethical implications of genetic testing in the classroom.

PubMed

Taylor, Ann T S; Rogers, Jill Cellars

2011-07-01

The development of classroom experiments where students examine their own DNA is frequently described as an innovative teaching practice. Often these experiences involve students analyzing their genes for various polymorphisms associated with disease states, like an increased risk for developing cancer. Such experiments can muddy the distinction between classroom investigation and medical testing. Although the goals and issues surrounding classroom genotyping do not directly align with those of clinical testing, instructors can use the guidelines and standards established by the medical genetics community when evaluating the ethics of human genotyping. We developed a laboratory investigation and discussion which allowed undergraduate science students to explore current DNA manipulation techniques to isolate their p53 gene, followed by a dialogue probing the ethical implications of examining their sample for various polymorphisms. Students never conducted genotyping on their samples because of the ethical concerns presented in this paper, so the discussion replaced the actual genetic testing in the class. A science faculty member led the laboratory portion, while a genetic counselor facilitated the discussion of the ethical concepts underlying genetic counseling: autonomy, beneficence, confidentiality, and justice. In their final papers, students demonstrated an understanding of the practice guidelines established by the genetics community and acknowledged the ethical considerations inherent in p53 genotyping. Given the burgeoning market for personalized medicine, teaching undergraduates about the psychosocial and ethical dimensions of human genetic testing is important and timely. Moreover, incorporating a genetic counselor in the classroom discussion provided a rich and dynamic discussion of human genetic testing. Copyright © 2011 Wiley Periodicals, Inc.

Navigating "Thorny" Issues

ERIC Educational Resources Information Center

Hutchinson, Kashema; Gilbert, Aderinsola; Malyukova, Anna

2016-01-01

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

Google and Women's Health-Related Issues: What Does the Search Engine Data Reveal?

PubMed

Baazeem, Mazin; Abenhaim, Haim

2014-01-01

Identifying the gaps in public knowledge of women's health related issues has always been difficult. With the increasing number of Internet users in the United States, we sought to use the Internet as a tool to help us identify such gaps and to estimate women's most prevalent health concerns by examining commonly searched health-related keywords in Google search engine. We collected a large pool of possible search keywords from two independent practicing obstetrician/gynecologists and classified them into five main categories (obstetrics, gynecology, infertility, urogynecology/menopause and oncology), and measured the monthly average search volume within the United States for each keyword with all its possible combinations using Google AdWords tool. We found that pregnancy related keywords were less frequently searched in general compared to other categories with an average of 145,400 hits per month for the top twenty keywords. Among the most common pregnancy-related keywords was "pregnancy and sex' while pregnancy-related diseases were uncommonly searched. HPV alone was searched 305,400 times per month. Of the cancers affecting women, breast cancer was the most commonly searched with an average of 247,190 times per month, followed by cervical cancer then ovarian cancer. The commonly searched keywords are often issues that are not discussed in our daily practice as well as in public health messages. The search volume is relatively related to disease prevalence with the exception of ovarian cancer which could signify a public fear.

One more chemo or one too many? Defining the limits of treatment and innovation in medical oncology.

PubMed

Baszanger, Isabelle

2012-09-01

During the past few years, debates have frequently erupted in oncology journals regarding the question of whether to prolong or end treatment. These debates have been informed by developments from both within and outside the field. Within Bioethics, some writers have put forward a number of principles for judging the legitimacy of medical interventions, notably that of patient autonomy. Broad social and political developments have also profoundly affected medical practices at the end of life. Though therapeutic options have evolved, whether to stop or to pursue treatment in the face of certain death has been a central issue in medical oncology since the early 1950s. A critical appraisal of the history of this issue can help us to better understand the tangled relationship(s) between innovation, "cure," death, and the symptoms and subjective experiences of sufferers. This paper addresses an aspect of this complex problem, namely how limits are established regarding both treatment and therapeutic innovation near the end of life. Utilizing a grounded theory and situational analysis approach it traces how the issues at stake were defined and the ways in which the dilemma was progressively transformed as a result of the combined effects of a proliferating number of stakeholders, molecules, instruments, and techniques. It discusses three different moments, as they epitomize how the links between chemotherapy and palliation were construed through the evolving forms of clinical research and innovative therapies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Granular Materials and Risks in ISRU

NASA Technical Reports Server (NTRS)

Behringer, Robert P.; Wilki8nson, R. Allen

2004-01-01

Working with soil, sand, powders, ores, cement and sintered bricks, excavating, grading construction sites, driving off-road, transporting granules in chutes and pipes, sifting gravel, separating solids from gases, and using hoppers are so routine that it seems straightforward to execute these operations on the Moon and Mars as we do on Earth. We discuss how little these processes are understood and point out the nature of trial-and-error practices that are used in today s massive over-design. Nevertheless, such designs have a high failure rate. Implementation and extensive incremental scaling up of industrial processes are routine because of the inadequate predictive tools for design. We present a number of pragmatic scenarios where granular materials play a role, the risks involved, what some of the basic issues are, and what understanding is needed to greatly reduce the risks. This talk will focus on a particular class of granular flow issues, those that pertain to dense materials, their physics, and the failure problems associated with them. In particular, key issues where basic predictability is lacking include stability of soils for the support of vehicles and facilities, ability to control the flow of dense materials (jamming and flooding/unjamming at the wrong time), the ability to predict stress profiles (hence create reliable designs) for containers such as bunkers or silos. In particular, stress fluctuations, which are not accounted for in standard granular design models, can be very large as granular materials flows, and one result is frequent catastrophic failure of granular devices.

Granular Materials and Risks In ISRU

NASA Technical Reports Server (NTRS)

Behringer, Robert P.; Wilkinson, R. Allen

2004-01-01

Working with soil, sand, powders, ores, cement and sintered bricks, excavating, grading construction sites, driving off-road, transporting granules in chutes and pipes, sifting gravel, separating solids from gases, and using hoppers are so routine that it seems straightforward to execute these operations on the Moon and Mars as we do on Earth. We discuss how little these processes are understood and point out the nature of trial-and-error practices that are used in today's massive over-design. Nevertheless, such designs have a high failure rate. Implementation and extensive incremental scaling up of industrial processes are routine because of the inadequate predictive tools for design. We present a number of pragmatic scenarios where granular materials play a role, the risks involved, what some of the basic issues are, and what understanding is needed to greatly reduce the risks. This talk will focus on a particular class of granular flow issues, those that pertain to dense materials, their physics, and the failure problems associated with them. In particular, key issues where basic predictability is lacking include stability of soils for the support of vehicles and facilities, ability to control the flow of dense materials (jamming and flooding/unjamming at the wrong time), the ability to predict stress profiles (hence create reliable designs) for containers such as bunkers or silos. In particular, stress fluctuations, which are not accounted for in standard granular design models, can be very large as granular materials flows, and one result is frequent catastrophic failure of granular devices.

Healthcare transition in persons with intellectual disabilities: general issues, the Maastricht model, and Prader-Willi syndrome.

PubMed

Schrander-Stumpel, Constance T R M; Sinnema, Margje; van den Hout, Lieke; Maaskant, Marian A; van Schrojenstein Lantman-de Valk, Henny M J; Wagemans, Annemieke; Schrander, Jaap J P; Curfs, Leopold M G

2007-08-15

In current healthcare, transitional healthcare is a very important and timely issue. Thanks to the major advances made in medical care and technology, many children with childhood onset diseases and/or genetic syndromes survive to adulthood. These children are at risk of not being provided with adequate healthcare as they reach adulthood. Healthcare transition is an essential part of healthcare provision, referred to as the shift from one type of healthcare to another. In Maastricht, we developed a transition/out clinic led by a medical doctor specialized in persons with intellectual disability (ID), together with a clinical geneticist. We aim to coordinate healthcare issues based on guidelines if available. Also questions concerning living, daily activities, relations, sexuality, and sterilization can be discussed. The aging process of persons with ID has been a topic of interest in recent years. Little is known about the aging process of people with specific syndromes, except for persons with Down syndrome. We present some data of a recent questionnaire study in persons with Prader-Willi syndrome. In only 50% in persons with a clinical diagnosis genetic test results could be reported. The majority of persons were obese. Diabetes mellitus, hypertension, skin problems, sleep apnea, and hormonal problems like osteoporosis and hypothyroidism were common. Psychiatric problems were frequent, especially in the persons with uniparental disomy. Osteoporosis and sleep apnoea seem to be underestimated. Further longitudinal research is necessary for a better understanding of the aging process in PWS. (c) 2007 Wiley-Liss, Inc.

Prevalent Health Concerns Among African American Women Belonging to a National Volunteer Service Organization (The Links, Incorporated).

PubMed

Asiedu, Gladys B; Hayes, Sharonne N; Williams, Karen Patricia; Bondaryk, Matthew R; Halyard, Michele Y; Parker, Monica W; Balls-Berry, Joyce E; Pinn, Vivian W; Breitkopf, Carmen Radecki

2017-02-01

African American women bear a disproportionate burden of cardiovascular disease (CVD) and cancer. The purpose of this study was to identify prevalent health concerns among African American women who are members of The Links, Incorporated (Links), a large national service organization with health programming for communities of color. Survey data (n = 391) were collected during the 2012 Links National Assembly. Twenty-six health issues were presented within five groups: cancer, CVD, pulmonary disease, chronic conditions, and behavioral health. For each issue, women indicated if it was a concern for "you/your family" or "the African American community" via check-boxes. Differences in the proportions for "you/your family" and "the African American community" were evaluated using the McNemar test. Hypertension was the most frequently endorsed concern for you/your family (79 %); 73 % indicated this was a concern for the African American community. Sickle cell anemia was the most frequently endorsed concern for the African American community (77 %). Melanoma was the least endorsed health issue overall (15 % you/your family, 55 % community). Breast was the most frequently endorsed cancer concern, while lung was among the least. For 23 out of 26 health issues, the proportion concerned was greater for the "African American community" than for "you/your family" (all p < 0.05). CVD and breast cancer were salient concerns; both are topics for which national awareness campaigns and Links health programming exist. Comparatively lower concern was observed for melanoma, a cancer with known survival disparities, and for lung cancer, a leading cause of death in women.

Stroke care in Central Eastern Europe: current problems and call for action.

PubMed

Lenti, Laura; Brainin, Michael; Titianova, Ekaterina; Morovic, Sandra; Demarin, Vida; Kalvach, Pavel; Skoloudik, David; Kobayashi, Adam; Czlonkowska, Anna; Muresanu, Dafin F; Shekhovtsova, Ksenia; Skvortsova, Veronica I; Sternic, Nadezda; Beslac Bumbasirevic, Ljiljana; Svigelj, Viktor; Turcani, Peter; Bereczki, Dániel; Csiba, László

2013-07-01

Stroke is a major medical problem and one of the leading causes of mortality and disability all over in Europe. However, there are significant East-West differences in stroke care as well as in stroke mortality and morbidity rates. Central and Eastern European countries that formerly had centralized and socialist health care systems have serious and similar problems in organizing health and stroke care 20 years after the political transition. In Central and Eastern Europe, stroke is more frequent, the mortality rate is higher, and the victims are younger than in Western Europe. High-risk patients live in worse environmental conditions, and the socioeconomic consequences of stroke further weaken the economic development of these countries. To address these issues, a round table conference was organized. The main aim of this conference was to discuss problems to be solved related to acute and chronic stroke care in Central and Eastern European countries, and also, to exchange ideas on possible solutions. In this article, the discussed problems and possible solutions will be summarized, and introduce 'The Budapest Statement of Stroke Experts of Central and Eastern European countries'. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Assessment of neuropsychiatric symptoms in dementia: toward improving accuracy

PubMed Central

Stella, Florindo

2013-01-01

The issue of this article concerned the discussion about tools frequently used tools for assessing neuropsychiatric symptoms of patients with dementia, particularly Alzheimer's disease. The aims were to discuss the main tools for evaluating behavioral disturbances, and particularly the accuracy of the Neuropsychiatric Inventory – Clinician Rating Scale (NPI-C). The clinical approach to and diagnosis of neuropsychiatric syndromes in dementia require suitable accuracy. Advances in the recognition and early accurate diagnosis of psychopathological symptoms help guide appropriate pharmacological and non-pharmacological interventions. In addition, recommended standardized and validated measurements contribute to both scientific research and clinical practice. Emotional distress, caregiver burden, and cognitive impairment often experienced by elderly caregivers, may affect the quality of caregiver reports. The clinician rating approach helps attenuate these misinterpretations. In this scenario, the NPI-C is a promising and versatile tool for assessing neuropsychiatric syndromes in dementia, offering good accuracy and high reliability, mainly based on the diagnostic impression of the clinician. This tool can provide both strategies: a comprehensive assessment of neuropsychiatric symptoms in dementia or the investigation of specific psychopathological syndromes such as agitation, depression, anxiety, apathy, sleep disorders, and aberrant motor disorders, among others. PMID:29213846

Issues in conducting cross-cultural research: implementation of an agreed international protocol [corrected] designed by the WHOQOL Group for the conduct of focus groups eliciting the quality of life of older adults.

PubMed

Hawthorne, Graeme; Davidson, Natasha; Quinn, Kathryn; McCrate, Farah; Winkler, Ines; Lucas, Ramona; Kilian, Reinhold; Molzahn, Anita

2006-09-01

Multi-centre and cross-cultural research require the use of common protocols if the results are to be either pooled or compared. All too often adherence to protocols is not discussed in reports and where it is reported poor adherence is frequently noted. This paper discusses the use of international guidelines developed by WHOQOL Field Centres to conduct and report focus groups aimed at eliciting key concepts of quality of life among older adults. This was the first step in the development of the WHOQOL-OLD instrument. Although there was overall adherence to the agreed guidelines, there were some differences in the level of reporting, even after participating Field Centres had the opportunity to explain their reports. The reasons for these discrepancies are reported. It is concluded that because of local situations, it is difficult to achieve identical implementation of multi-centre cross-cultural protocols and that the highest standards of auditing are required if findings are to be compared. Suggestions for how such protocols can be improved are given.

Implementing the work disability prevention paradigm among therapists in Hong Kong: facilitators and barriers.

PubMed

Szeto, Grace P Y; Cheng, Andy S K; Lee, Edwin W C; Schonstein, Eva; Gross, Douglas P

2011-03-01

This is a discussion paper to examine the issues surrounding management of work-related injuries by physiotherapists and occupational therapists in Hong Kong. Therapists working in public hospitals are faced with managing injured workers with limited resources and this frequently results in suboptimal outcomes. In this paper, five experienced therapists critically reviewed the current practices in the physiotherapy and occupational therapy professions in Hong Kong, with regard to managing patients with work injuries. In many hospitals, therapists still practice with a disease-based model focusing on symptom relief and restoration of general physical function. We collated information about current programs initiated by physiotherapists and occupational therapists to provide more strategic intervention strategies for early screening of high-risk patients and adaptive biopsychosocial interventions targeting return-to-work outcomes. Clinical and system-level barriers and facilitators of a major paradigm shift towards work disability prevention are discussed. Physiotherapists and occupational therapists need to develop more strategic collaborations and actively voice out the need for major systematic changes within the local healthcare system, in order to provide a more effective management approach in line with the concept of Work Disability Prevention.

Acute and chronic pseudo-obstruction: a current update.

PubMed

Bernardi, Maria-Pia; Warrier, Satish; Lynch, A Craig; Heriot, Alexander G

2015-10-01

Acute colonic pseudo-obstruction (ACPO) and chronic intestinal pseudo-obstruction (CIPO) are distinct clinical entities in which patients present similarly with symptoms of a mechanical obstruction without an occlusive lesion. Unfortunately, they also share the issues related to a delay in diagnosis, including inappropriate management and poor outcomes. Advancements have been made in our understanding of the aetiologies of both conditions. Several predisposing factors linked to critical illness have been implicated in ACPO. CIPO is a functional motility disorder, historically misdiagnosed, with unnecessary surgery being performed in many patients with dire consequences. This review discusses the pathophysiology, clinical and diagnostic features, and treatment of each. For ACPO, a safer pharmacological approach to treatment is presented in a modified up-to-date algorithm. The importance of CIPO as a differential diagnosis when seeing patients with recurrent admissions for abdominal pain and distention is also discussed, as well as specific indications for surgery. While surgery is often a last resort, the role of the surgeon in the management of both ACPO and CIPO cannot be undervalued. By characterizing each condition in a common review, the knowledge gleaned aims to optimize outcomes for these frequently complex patients. © 2015 Royal Australasian College of Surgeons.

An advisory program for first- and second-year medical students: the Weill Cornell experience

PubMed Central

Drusin, Lewis M.; Gerber, Linda M.; Miller, Carlyle H.; Storey-Johnson, Carol L.; Ballard, Bruce L.

2013-01-01

Purpose First-year students negotiate new professional culture with a certain amount of excitement and anxiety. There are different approaches for offering guidance. In this study, the authors present Weill Cornell Medical College's experience with an advising program for first- and second-year students. Methods Fifty faculty advisors were each assigned 1–3 first-year students who they would follow for 2 years. The responsibilities were outlined to both faculty and students. The program was evaluated using an anonymous questionnaire. Results For the two classes surveyed (2011 and 2012), most students met their advisors once. For both classes, the most frequently discussed issues were general adjustment to medical school, academic life, and the professional life of the advisor. Summer research and career opportunities were also discussed. Most students were satisfied with the advising program. Satisfaction increased with an increase in visits. Most students who did not meet their advisors established an advisor relationship on their own. Conclusions An advising program was established at Weill Cornell Medical College that satisfied most of the students. It is important to evaluate its format regularly, from both student and advisor perspectives, in order to ensure its continued success. PMID:24290314

Congenital malformations and genetic diseases in comic books.

PubMed

Mégarbané, A; Adib, S M

2003-01-01

Medical syndromes have often been represented in fine arts, but rarely have clinical diagnoses been discussed in comic book characters. Since their first appearance in Europe in the middle of the 19th century and in America in 1895, comic books have been considered as "the 9th art". In many comic books, the appearance and/or the behavior of central or support characters are suggestive of already well-defined medical disorders. The representation of five particular groups or clinical features: mental retardation, abnormal stature, abnormal hair, obesity, and cranial malformations is discussed from mostly European comic series. Whether comic authors intended to describe specific clinical entities while drawing their characters or whether such situations appeared by mere luck, is open to debate. In many series from the first half of the 20th century characters with remarkable clinical features were also painted as psycho-social deviants. Such stereotypes are found much less frequently nowadays. Writers of comic books, realizing the major impact of their work especially in adolescent age groups, have increasingly been using their series to actually promote issues of equity and well being for physically or mentally impaired people.

The pathogenicity of Aspergillus fumigatus, drug resistance, and nanoparticle delivery.

PubMed

Szalewski, David A; Hinrichs, Victoria S; Zinniel, Denise K; Barletta, Raúl G

2018-03-27

The genus Aspergillus includes fungal species that cause major health issues of significant economic importance. These microorganisms are also the culprit for production of carcinogenic aflatoxins in grain storages, contaminating crops, and economically straining the production process. Aspergillus fumigatus is a very important pathogenic species, being responsible for high human morbidity and mortality on a global basis. The prevalence of these infections in immunosuppressed individuals is on the rise, and physicians struggle with the diagnosis of these deadly pathogens. Several virulence determinants facilitate fungal invasion and evasion of the host immune response. Metabolic functions are also important for virulence and drug resistance, since they allow fungi to obtain nutrients for their own survival and growth. Following a positive diagnostic identification, mortality rates remain high due, in part, to emerging resistance to frequently used antifungal drugs. In this review, we discuss the role of the main virulence, drug target, and drug resistance determinants. We conclude with the review of new technologies being developed to treat aspergillosis. In particular, microsphere and nanoparticle delivery systems are discussed in the context of improving drug bioavailability. Aspergillus will likely continue to cause problematic infections in immunocompromised patients, so it is imperative to improve treatment options.

On the acoustics of ancient Greek and Roman theaters.

PubMed

Farnetani, Andrea; Prodi, Nicola; Pompoli, Roberto

2008-09-01

The interplay of architecture and acoustics is remarkable in ancient Greek and Roman theaters. Frequently they are nowadays lively performance spaces and the knowledge of the sound field inside them is still an issue of relevant importance. Even if the transition from Greek to Roman theaters can be described with a great architectural detail, a comprehensive and objective approach to the two types of spaces from the acoustical point of view is available at present only as a computer model study [P. Chourmouziadou and J. Kang, "Acoustic evolution of ancient Greek and Roman theaters," Appl. Acoust. 69, re (2007)]. This work addresses the same topic from the experimental point of view, and its aim is to provide a basis to the acoustical evolution from Greek to Roman theater design. First, by means of in situ and scale model measurements, the most important features of the sound field in ancient theaters are clarified and discussed. Then it has been possible to match quantitatively the role of some remarkable architectural design variables with acoustics, and it is seen how this criterion can be used effectively to define different groups of ancient theaters. Finally some more specific wave phenomena are addressed and discussed.

Trends in the evolution of life, brains and intelligence

NASA Astrophysics Data System (ADS)

Rospars, Jean-Pierre

2013-07-01

The f I term of Drake's equation - the fraction of life-bearing planets on which `intelligent' life evolved - has been the subject of much debate in the last few decades. Several leading evolutionary biologists have endorsed the thesis that the probability of intelligent life elsewhere in the universe is vanishingly small. A discussion of this thesis is proposed here that focuses on a key issue in the debate: the existence of evolutionary trends, often presented as trends towards higher complexity, and their possible significance. The present state of knowledge on trends is reviewed. Measurements of quantitative variables that describe important features of the evolution of living organisms - their hierarchical organization, size and biodiversity - and of brains - their overall size, the number and size of their components - in relation to their cognitive abilities, provide reliable evidence of the reality and generality of evolutionary trends. Properties of trends are inferred and frequent misinterpretations (including an excessive stress on mere `complexity') that prevent the objective assessment of trends are considered. Finally, several arguments against the repeatability of evolution to intelligence are discussed. It is concluded that no compelling argument exists for an exceedingly small probability f I. More research is needed before this wide-ranging negative conclusion is accepted.

A Special Issue on Piaget: Issues and Experiments.

ERIC Educational Resources Information Center

Bryant, Peter, Ed.

1982-01-01

Contains 15 articles investigating and discussing issues generated by Piaget's theory of cognitive development. Discusses and examines questions related to object permanence, transitivity, conservation and the concept of necessity as these relate to children. Deals with the origins and causes of development, logical development, social and…

Thomas Jefferson, Page Design, and Desktop Publishing.

ERIC Educational Resources Information Center

Hartley, James

1991-01-01

Discussion of page design for desktop publishing focuses on the importance of functional issues as opposed to aesthetic issues, and criticizes a previous article that stressed aesthetic issues. Topics discussed include balance, consistency in text structure, and how differences in layout affect the clarity of "The Declaration of…

Design issues for LISA inertial sensors

NASA Astrophysics Data System (ADS)

Vitale, Stefano; Speake, Clive

1998-12-01

In this paper we discuss a few design issues of the inertial sensor for LISA. These issues include the role of the stiffness and the losses that are introduced by the readout and by other parasitic sources. A possible plan for testing those effects on ground is also discussed.

Patient Discussion About Sexual Health With Health Care Providers After Cancer-A National Survey.

PubMed

Ben Charif, Ali; Bouhnik, Anne-Déborah; Courbiere, Blandine; Rey, Dominique; Préau, Marie; Bendiane, Marc-Karim; Peretti-Watel, Patrick; Mancini, Julien

2016-11-01

A discussion about sexuality should become a routine part of the personalized care pathway for patients with cancer. To assess rates of patient discussion about sexuality with health care providers after cancer. We used data from the representative French nationwide 2012 VICAN survey, which included 4,349 adults 18 to 82 years old who were still alive 2 years after diagnosis at 12 cancer sites. Self-reported rates of discussion about sexuality with health care providers were assessed, and associated factors were tested after systematic adjustment for a sexual health indicator (created from six items of the Relationship and Sexuality Scale). Of 4,181 respondents to the question on a discussion about sexuality, 54.7% reported that nobody had proposed a discussion to them, 21.9% did not want any discussion, and 23.4% had had a discussion. Women had less discussion about sexuality with health care providers (11.1% vs 36.7% of men, P < .001) and were more likely to request a discussion at their own initiative (62.9% vs 48.0% of men, P < .001). Discussion about sexuality was more frequent with patients with prostate (56.3%) and cervical (39.6%) cancer, but increasing age was associated with a greater reluctance to discuss this issue (odds ratio = 1.17, 95% CI = 1.04-1.2). The likelihood of discussion increased with severe sexual problems, radiotherapy, general sequelae, having an information-seeker profile, previous professional psychological help, and initial treatment in private centers. Patients initially wishing for psychological help were more likely to desire a discussion about sexuality. Sexuality receives little attention in French patients with cancer. Inequalities in the discussion about sexuality were observed in relation to the type of care center where the patient was initially managed. Information on supportive interventions, including more systematic referral for professional psychological help, should be developed to facilitate discussion and should be offered to all patients, irrespective of severity of sexual problems, age, sex, cancer site, and care center. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Twelve mortal sins of the turbulence propagation science

NASA Astrophysics Data System (ADS)

Charnotskii, Mikhail

2011-09-01

In this review paper we discuss a series of typical mistakes and omissions that are made by engineers and scientists involved in the theoretical research and modeling of the optical propagation through atmospheric turbulence. We show how the use of the oversimplified Gaussian spectral model of turbulence delivers the completely erroneous results for the beam wander. We address a series of common omissions related to calculations of the average beam intensity: unnecessary use of the approximations when rigorous result is available, invalid application of the RMS beam size to the turbulence-distorted beams, overlooking the simple theoretical result - average beam intensity is a convolution with the turbulent Point Spread Function (PSF). We discuss the meaning and potential dangers of the use of the quadratic structure function for modeling of the turbulent perturbations. We will also address the issues related to the energy conservation principle and reciprocity that have very important consequences for the turbulence propagation, but are frequently overlooked in the current literature. We discuss a series of misconceptions that very common in of the Scintillation Index (SI) calculations. We will clarify the infamous misunderstanding of the Rytov's approximation: vanishing scintillation at the beam focus, and show the correct weak and strong scintillation solutions for the SI at the beam focus. We discuss the flaws of the Fried model of the short-term PSF, and direct to the more accurate PSF model. We will briefly review the propagation of the polarized optical waves through turbulence and discuss the inadequacy of the recently published calculations of the electromagnetic beams calculations. We discuss some common errors in representation of the calculation results for the non-Kolmogorov turbulence.

Career Issues and Laboratory Climates: Different Challenges and Opportunities for Women Engineers and Scientists (survey of Fiscal Year 1997 Powre Awardees)

NASA Astrophysics Data System (ADS)

Rosser, Sue V.; Zieseniss, Mireille

A survey of fiscal year 1997 POWRE (Professional Opportunities for Women in Research and Education) awardees from the National Science Foundation revealed that women engineers and scientists face similar issues, challenges, and opportunities and think that the laboratory climate has similar impacts on their careers. Separating responses of women scientists from those of women engineers revealed that 70% of both groups listed balancing work with family responsibilities as the most difficult issue. Discrepancies in percentages of women, coupled with differences among disciplinary and subdisciplinary cultures within science, engineering, mathematics, and technology fields, complicate work climates and their impact on women's careers. More frequently than women scientists, women engineers listed issues such as (a) low numbers of women leading to isolation, (b) lack of camaraderie and mentoring, (c) gaining credibility/respect from peers and administrators, (d) time management, (e) prioritizing responsibilities due to disproportionate demands, and (f) learning the rules of the game to survive in a male-dominated environment. Women engineers also listed two positive issues more frequently than women scientists: active recruitment/more opportunities for women and impact of successful women in the profession. The small number of women engineers may explain these results and suggests that it may be inappropriate to group them with other women scientists for analysis, programs, and policies.

Components of Comprehensive School and School District Emergency Management Plans. Helpful Hints for School Emergency Management. Volume 2, Issue 2, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. This issue describes and contains a checklist that can assist schools and school districts in developing a new emergency management plan or refreshing their current one. To use the checklist, individuals should consider…

May It Please the Court: Two Legal Cases to Teach Students about Social Media Based Terminations of Employment

ERIC Educational Resources Information Center

O'Connor, Kimberly W.; Schmidt, Gordon B.

2015-01-01

Recent data suggest that 83% of individuals, aged 18 to 29 years, frequent social media sites (Drouin et al., 2015). This statistic confirms the need for universities to teach important issues regarding personal social media usage to students. At the forefront of these issues is how personal social media usage can affect students' future…

Opportunity to discuss ethical issues during clinical learning experience.

PubMed

Palese, Alvisa; Gonella, Silvia; Destrebecq, Anne; Mansutti, Irene; Terzoni, Stefano; Morsanutto, Michela; Altini, Pietro; Bevilacqua, Anita; Brugnolli, Anna; Canzan, Federica; Ponte, Adriana Dal; De Biasio, Laura; Fascì, Adriana; Grosso, Silvia; Mantovan, Franco; Marognolli, Oliva; Nicotera, Raffaela; Randon, Giulia; Tollini, Morena; Saiani, Luisa; Grassetti, Luca; Dimonte, Valerio

2018-01-01

Undergraduate nursing students have been documented to experience ethical distress during their clinical training and felt poorly supported in discussing the ethical issues they encountered. Research aims: This study was aimed at exploring nursing students' perceived opportunity to discuss ethical issues that emerged during their clinical learning experience and associated factors. An Italian national cross-sectional study design was performed in 2015-2016. Participants were invited to answer a questionnaire composed of four sections regarding: (1) socio-demographic data, (2) previous clinical learning experiences, (3) current clinical learning experience quality and outcomes, and (4) the opportunity to discuss ethical issues with nurses in the last clinical learning experience (from 0 - 'never' to 3 - 'very much'). Participants and research context: Participants were 9607 undergraduate nursing students who were attending 95 different three-year Italian baccalaureate nursing programmes, located at 27 universities in 15 Italian regions. Ethical considerations: This study was conducted in accordance with the Human Subject Research Ethics Committee guidelines after the research protocol was approved by an ethics committee. Overall, 4707 (49%) perceived to have discussed ethical issues 'much' or 'very much'; among the remaining, 3683 (38.3%) and 1217 (12.7%) students reported the perception of having discussed, respectively, 'enough' or 'never' ethical issues emerged in the clinical practice. At the multivariate logistic regression analysis explaining 38.1% of the overall variance, the factors promoting ethical discussion were mainly set at the clinical learning environment levels (i.e. increased learning opportunities, self-directed learning, safety and nursing care quality, quality of the tutorial strategies, competences learned and supervision by a clinical nurse). In contrast, being male was associated with a perception of less opportunity to discuss ethical issues. Nursing faculties should assess the clinical environment prerequisites of the settings as a context of student experience before deciding on their accreditation. Moreover, the nursing faculty and nurse managers should also enhance competence with regard to discussing ethical issues with students among clinical nurses by identifying factors that hinder this learning opportunity in daily practice.

Frequently Asked Questions | Cancer Trends Progress Report

Cancer.gov

The Cancer Trends Progress Report, first issued in 2001, summarizes our nation's advances against cancer in relation to Healthy People targets set forth by the Department of Health and Human Services.

Improving the University Tutorial.

ERIC Educational Resources Information Center

Stanton, Harry E.

1982-01-01

Frequently, tutorial or seminar members take no part in discussion, a feature considered essential to this teaching method. Tutors may be largely responsible by dominating discussion. Student participation can be increased by varying teaching methods; reducing discussion group size, brainstorming, idea development techniques, and student…

Review of various approaches for assessing public health risks in regulatory decision making: choosing the right approach for the problem.

PubMed

Dearfield, Kerry L; Hoelzer, Karin; Kause, Janell R

2014-08-01

Stakeholders in the public health risk analysis community can possess differing opinions about what is meant by "conduct a risk assessment." In reality, there is no one-size-fits-all risk assessment that can address all public health issues, problems, and regulatory needs. Although several international and national organizations (e.g., Codex Alimentarius Commission, Office International des Epizooties, Food and Agricultural Organization, World Health Organization, National Research Council, and European Food Safety Authority) have addressed this issue, confusion remains. The type and complexity of a risk assessment must reflect the risk management needs to appropriately inform a regulatory or nonregulatory decision, i.e., a risk assessment is ideally "fit for purpose" and directly applicable to risk management issues of concern. Frequently however, there is a lack of understanding by those not completely familiar with risk assessment regarding the specific utility of different approaches for assessing public health risks. This unfamiliarity can unduly hamper the acceptance of risk assessment results by risk managers and may reduce the usefulness of such results for guiding public health policies, practices, and operations. Differences in interpretation of risk assessment terminology further complicate effective communication among risk assessors, risk managers, and stakeholders. This article provides an overview of the types of risk assessments commonly conducted, with examples primarily from the food and agricultural sectors, and a discussion of the utility and limitations of these specific approaches for assessing public health risks. Clarification of the risk management issues and corresponding risk assessment design needs during the formative stages of the risk analysis process is a key step for ensuring that the most appropriate assessment of risk is developed and used to guide risk management decisions.

Guaranteed Access to Campus Network Resources: Policies and Issues.

ERIC Educational Resources Information Center

Hassler, Ardoth A.

1998-01-01

Reports on a options and issues discussion at a December 1997 Orlando (Florida) meeting of CAUSE97 on providing access to campus technology resources. Options discussed included departmentally and/or university-owned modems, third-party provider contracts, and using wireless access. Issues included providing authentication, assuring network…

Rural Communities and Rural Social Issues: Priorities for Research.

ERIC Educational Resources Information Center

Black, Alan; Duff, John; Saggers, Sherry; Baines, Patricia

This report recommends priorities for research into rural communities and rural social issues in Australia, based on an extensive literature review, surveys of policymaking agencies and researchers, and discussion at a national workshop in May 1999. Chapters 1-2 outline the study's background, purpose, and methodology; discuss issues in the…

To know or not to know? Not the only question in familial breast cancer risk communication

PubMed Central

Maddock, C; Schrijvers, D; Turco, MRD; Marotti, L; Sullivan, R

2011-01-01

Background Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in females, 5–10% of these breast cancers occur in women because of an inherited mutation. The term ‘risk’ in relation to familial cancer can have multiple meanings for both clinicians and patients. Failing to identify and address this may impair effective communication and informed decision making and adversely affect the quality of patient care. The aim of this research for the Eurocancercoms project was to explore patients' experience of risk communication in breast cancer and to investigate a mechanism for sharing these experiences using a filmed round-table discussion (RTD). Methods A filmed RTD with six women who had experience of, or some connection with familial breast cancer was conducted. Criteria for inclusion included a willingness and ability to participate in the discussion in English and to be prepared for the discussion to be hosted online with opportunities for others to view and comment. Results The main findings are presented as key themes and issues arising from the RTD. There was consistency in the group on the need for improvements to the risk communication process as a whole and in particular around onward diffusion of information i.e. ‘Telling the family’. There were differences regarding ‘wanting to know’ their genetic status. Conclusions The perception of cancer risk in the narratives stems not only from the way risks are stated, but from family history, personal experiences, cultural norms and beliefs and therefore a multifaceted approach to risk communication addressing these issues is necessary to ensure the patient fully understands the potential risks. There is a balance when attending to patient's information needs, as to what level and amount of information is required by the individual at a particular time and communicators need to be able to tailor information accordingly. PMID:22276070

Forum on the future of academic medicine: Session VI--Issues of change and quality in U.S. health care.

PubMed

Iglehart, J

1999-07-01

The sixth meeting of the AAMC's Forum on the Future of Academic Medicine, on September 10, 1998, opened with a talk by Paul B. Ginsburg, PhD, president of the Center for Studying Health System Change (HSC). He described a major longitudinal study by the HSC of the changing U.S. health care system and reviewed some preliminary findings on topics such as the variety of ways communities are responding to relatively uniform forces driving health care markets; the reasons that uninsured individuals have a much harder time securing needed care in some communities than in others; the changing role of employers as sponsors of workers' insurance; consumers' frequently limited knowledge of their health care plans; the continuing importance consumers attach to having access to a broad choice of providers and the effects of this on the marketplace (e.g., broadening of networks); the different organizational models of care that are evolving; and the changing relationships between primary care physicians and specialists. The second presentation was by Janet M. Corrigan, MD, MBA, who served as executive director of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. She discussed the commission's findings about the state of quality in the health care industry and the commission's strategy to address serious shortcomings (e.g., unevenness of quality; avoidable errors; misuse of services). She also commented on the exponential increase in medical knowledge and the need for systems to help practitioners obtain and use it, and discussed the quality of care inside and outside managed care settings (about the same). Both Dr. Ginsburg and Dr. Corrigan discussed how some of the issues and findings they presented apply to academic medical centers, and responded to penetrating questions and statements of forum members.

Patient-Reported Outcomes Are Changing the Landscape in Oncology Care: Challenges and Opportunities for Payers

PubMed Central

Zagadailov, Erin; Fine, Michael; Shields, Alan

2013-01-01

Background A patient-reported outcome (PRO) is a subjective report that comes from a patient without interpretation by a clinician. Because of the increasingly significant role of PROs in the development and evaluation of new medicines, the US Food and Drug Administration (FDA) issued a formal guidance to describe how PRO instruments will be reviewed and evaluated with respect to claims in approved medical product labeling. Meanwhile, PROs continue to appear in oncology clinical trials more frequently; however, it is unclear how payers and policymakers can use PRO data in the context of decision-making for cancer treatments. Objective The objective of this article is to discuss the challenges and opportunities of incorporating oncology-related PRO data into payer decision-making. Discussion Payer concerns with PRO instruments are often related to issues regarding measurement, relevance, quality, and interpretability of PROs. Payers may dismiss PROs that do not independently predict improved outcomes. The FDA guidance released in 2009 demonstrates, as evidenced by the case of ruxolitinib, how PRO questionnaires can be generated in a relevant, trustworthy, and meaningful way, which provides an opportunity for payers and policy decision makers to focus on how to use PRO data in their decision-making. This is particularly relevant in oncology, where a recent and sizable number of clinical trials include PRO measures. Conclusion As an increasing number of oncology medications enter the market with product labeling claims that contain PRO data, payers will need to better familiarize themselves with the opportunities associated with PRO questionnaires when making coverage decisions. PRO measures will continue to provide valuable information regarding the risk–benefit profile of novel agents. As such, PRO measures may provide evidence that should be considered in payers' decisions and discussions; however, the formal role of PROs and the pertinence of PROs in decision-making has yet to be understood. PMID:24991362

In and across bureaucracy: structural and administrative issues for the tobacco endgame.

PubMed

Isett, Kimberley R

2013-05-01

This article assesses the structural choices for the proposed tobacco endgame strategies. I focus on the issues associated with particular structural choices for the location of the implementation. Specifically, I discuss issues related to implementation of the endgame within a specific single agency, and issues related to a more widespread, broad implementation involving several agencies. Where appropriate, I provide examples of how the dynamics discussed would apply to particular endgame strategies. Issues related to design, administration, authority and finances are raised.

In and across bureaucracy: structural and administrative issues for the tobacco endgame

PubMed Central

Isett, Kimberley R

2013-01-01

This article assesses the structural choices for the proposed tobacco endgame strategies. I focus on the issues associated with particular structural choices for the location of the implementation. Specifically, I discuss issues related to implementation of the endgame within a specific single agency, and issues related to a more widespread, broad implementation involving several agencies. Where appropriate, I provide examples of how the dynamics discussed would apply to particular endgame strategies. Issues related to design, administration, authority and finances are raised. PMID:23591514

Fertility During Marital Disruption

ERIC Educational Resources Information Center

Rindfuss, Ronald R.; Bumpass, Larry L.

1977-01-01

Childbirth during marital disruption is found to be a surprisingly frequent occurrence. Both prevalence of intermarital fertility and social policy issues which are involved suggest this phenomenon may be similar in importance to illegitimacy. (Author)

Depression and College Students

MedlinePlus

... depression and other mental health issues? Reference Share Depression and College Students Download PDF Download ePub Order ... Answers to college students’ frequently asked questions about depression Feeling moody, sad, or grouchy? Who doesn’t ...

Project financing of district heating/cooling systems

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

Feldman, R.D.

1986-03-01

Two issues are discussed in detail: the project finance joint venture and technology transfers. An increase if the frequency of these issues has been served in project financings. An understanding of these issues is necessary to structure project financings of alternate energy projects in the future. Capitalization needs are outlined, and typical provisions of a joint finance structure are outlined. The issue of exclusivity as it applies to technology transfers is discussed.

National Training Center Performance Trends for the Maneuver Operating System: Relationship to Training Doctrine

DTIC Science & Technology

1988-04-01

Action Reviews (AAR) after each exercise . This information is synthesized in the THP, as is a sumary of Performance Trends for the entire fourteen...most frequently to least frequently commented upon across THPs. The actual number of times an issue was commented upon, either postively or...positions". "Dispersion of the positions" was some- times inadequate and units "failed to reinforce their positions with obstacles". "Utilization of

Trends affecting the future of vaccine development and delivery: The role of demographics, regulatory science, the anti-vaccine movement, and vaccinomics

PubMed Central

Poland, Gregory A.; Jacobson, Robert M.; Ovsyannikova, Inna G.

2009-01-01

Important scientific, cultural, temporal, and secular issues impact the development of, and delivery of vaccines. In this paper we discuss the impact of demographics, regulatory science, the anti-vaccine movement, and finally the impact of the new biology and individualized medicine, which we call vaccinomics, on vaccine development and delivery. A description of the issues and how they have, are, or should be impacting vaccinology is provided, and hopefully will result in increased attention and discussion among vaccinologists. These issues have been under-valued, under-discussed, and in some cases, ignored. We hope that discussion of these issues will result in changes in how we develop, and how we communicate those developments, to the public. PMID:19200833

Review on the Role of Planetary Factors on Habitability.

PubMed

Kereszturi, A; Noack, L

2016-11-01

In this work various factors on the habitability were considered, focusing on conditions irrespective of the central star's radiation, to see the role of specific planetary body related effects. These so called planetary factors were evaluated to identify those trans-domain issues where important information is missing but good chance exit to be filled by new knowledge that might be gained in the next decade(s). Among these strategic knowledge gaps, specific issues are listed, like occurrence of radioactive nucleides in star forming regions, models to estimate the existence of subsurface liquid water from bulk parameters plus evolutionary context of the given system, estimation on the existence of redox gradient depending on the environment type etc. These issues require substantial improvement of modelling and statistical handling of various cases, as "planetary environment types". Based on our current knowledge it is probable that subsurface habitability is at least as frequent, or more frequent than surface habitability. Unfortunately it is more difficult from observations to infer conditions for subsurface habitability, but specific argumentation might help with indirect ways, which might result in new methods to approach habitability in general.

Patient priorities and needs for diabetes care among urban African American adults.

PubMed

Batts, M L; Gary, T L; Huss, K; Hill, M N; Bone, L; Brancati, F L

2001-01-01

This study was conducted to determine diabetes care priorities and needs in a group of urban African American adults with type 2 diabetes mellitus. One hundred nineteen African American adults with type 2 diabetes, aged 35 to 75, received behavioral/educational interventions from a nurse case manager, a community health worker, or both. Priorities and needs were assessed during 3 intervention visits. The most frequently reported priorities for diabetes care were glucose self-monitoring (61%), medication adherence (47%), and healthy eating (36%). The most frequently addressed diabetes needs were glucose self-monitoring and medication adherence. Most of the intervention visits (77%) addressed non-diabetes-related health issues such as cardiovascular disease (36%) and social issues such as family responsibilities (30%). Participants' self-reported priorities for diabetes care directly reflected the diabetes needs addressed. Needs beyond the focus of traditional diabetes care (social issues and insurance) are important to address in urban African Americans with type 2 diabetes. Interventions designed to address comprehensive health and social needs should be included in treatment and educational plans for this population.

Symptoms and Warning Signs

MedlinePlus

... Signs Past Issues / Spring 2008 Table of Contents Anorexia Nervosa emaciation (extremely thin from lack of nutrition) relentless ... from diuretic abuse severe dehydration from purging Binge Eating Disorder frequently eating large amounts of food (binge-eating) ...

Music, affect, method, data: reflections on the Carroll versus Kivy debate.

PubMed

Konecni, Vladimir J

2013-01-01

The comprehensive exchange between Noel Carroll and Peter Kivy, which took place in 2007, addressed key issues in the relationship between music and affect. More than in any prior philosophical debate on this topic, experimental psychologists' methods and data played a significant role. However, to a nontrivial extent, the findings-perhaps especially the dubious-were misconstrued or misused, usually without acknowledging the existence of contrary data-based opinion within the psychology of music itself. Therefore, one objective of the present article is to identify the specific problematic features and shed light on the broader context shared by the two disciplines. A complementary goal is to examine contributions to philosophers' transgressions by music psychologists' insufficiently conscientious reporting, frequent overgeneralizations, and unawareness of philosophers' critical arguments. Another objective is to examine the current status of key concepts-the relevant music, basic emotions, mood, expression, induction, movement and dance, and methods (including introspection and experimental procedures)-thus perhaps enabling the discussion of music and affect to proceed with fewer misunderstandings. Finally, the article moves beyond the initial debate and builds on a remarkable agreement of philosophical and psychological opinion on a key issue (the induction of non-basic emotions by absolute music) to reach a new conceptual ground.

A horizon scan of future threats and opportunities for pollinators and pollination.

PubMed

Brown, Mark J F; Dicks, Lynn V; Paxton, Robert J; Baldock, Katherine C R; Barron, Andrew B; Chauzat, Marie-Pierre; Freitas, Breno M; Goulson, Dave; Jepsen, Sarina; Kremen, Claire; Li, Jilian; Neumann, Peter; Pattemore, David E; Potts, Simon G; Schweiger, Oliver; Seymour, Colleen L; Stout, Jane C

2016-01-01

Background. Pollinators, which provide the agriculturally and ecologically essential service of pollination, are under threat at a global scale. Habitat loss and homogenisation, pesticides, parasites and pathogens, invasive species, and climate change have been identified as past and current threats to pollinators. Actions to mitigate these threats, e.g., agri-environment schemes and pesticide-use moratoriums, exist, but have largely been applied post-hoc. However, future sustainability of pollinators and the service they provide requires anticipation of potential threats and opportunities before they occur, enabling timely implementation of policy and practice to prevent, rather than mitigate, further pollinator declines. Methods.Using a horizon scanning approach we identified issues that are likely to impact pollinators, either positively or negatively, over the coming three decades. Results.Our analysis highlights six high priority, and nine secondary issues. High priorities are: (1) corporate control of global agriculture, (2) novel systemic pesticides, (3) novel RNA viruses, (4) the development of new managed pollinators, (5) more frequent heatwaves and drought under climate change, and (6) the potential positive impact of reduced chemical use on pollinators in non-agricultural settings. Discussion. While current pollinator management approaches are largely driven by mitigating past impacts, we present opportunities for pre-emptive practice, legislation, and policy to sustainably manage pollinators for future generations.

Physician-assisted suicide and/or euthanasia: Pragmatic implications for palliative care [corrected].

PubMed

Hudson, Peter; Hudson, Rosalie; Philip, Jennifer; Boughey, Mark; Kelly, Brian; Hertogh, Cees

2015-10-01

Despite the availability of palliative care in many countries, legalization of euthanasia and physician-assisted suicide (EAS) continues to be debated-particularly around ethical and legal issues--and the surrounding controversy shows no signs of abating. Responding to EAS requests is considered one of the most difficult healthcare responsibilities. In the present paper, we highlight some of the less frequently discussed practical implications for palliative care provision if EAS were to be legalized. Our aim was not to take an explicit anti-EAS stance or expand on findings from systematic reviews or philosophical and ethico-legal treatises, but rather to offer clinical perspectives and the potential pragmatic implications of legalized EAS for palliative care provision, patients and families, healthcare professionals, and the broader community. We provide insights from our multidisciplinary clinical experience, coupled with those from various jurisdictions where EAS is, or has been, legalized. We believe that these issues, many of which are encountered at the bedside, must be considered in detail so that the pragmatic implications of EAS can be comprehensively considered. Increased resources and effort must be directed toward training, research, community engagement, and ensuring adequate resourcing for palliative care before further consideration is given to allocating resources for legalizing euthanasia and physician-assisted suicide.

A horizon scan of future threats and opportunities for pollinators and pollination

PubMed Central

Dicks, Lynn V.; Paxton, Robert J.; Baldock, Katherine C.R.; Barron, Andrew B.; Chauzat, Marie-Pierre; Freitas, Breno M.; Goulson, Dave; Jepsen, Sarina; Kremen, Claire; Li, Jilian; Neumann, Peter; Pattemore, David E.; Potts, Simon G.; Schweiger, Oliver; Seymour, Colleen L.; Stout, Jane C.

2016-01-01

Background. Pollinators, which provide the agriculturally and ecologically essential service of pollination, are under threat at a global scale. Habitat loss and homogenisation, pesticides, parasites and pathogens, invasive species, and climate change have been identified as past and current threats to pollinators. Actions to mitigate these threats, e.g., agri-environment schemes and pesticide-use moratoriums, exist, but have largely been applied post-hoc. However, future sustainability of pollinators and the service they provide requires anticipation of potential threats and opportunities before they occur, enabling timely implementation of policy and practice to prevent, rather than mitigate, further pollinator declines. Methods.Using a horizon scanning approach we identified issues that are likely to impact pollinators, either positively or negatively, over the coming three decades. Results.Our analysis highlights six high priority, and nine secondary issues. High priorities are: (1) corporate control of global agriculture, (2) novel systemic pesticides, (3) novel RNA viruses, (4) the development of new managed pollinators, (5) more frequent heatwaves and drought under climate change, and (6) the potential positive impact of reduced chemical use on pollinators in non-agricultural settings. Discussion. While current pollinator management approaches are largely driven by mitigating past impacts, we present opportunities for pre-emptive practice, legislation, and policy to sustainably manage pollinators for future generations. PMID:27602260

Indigence and access to health care in sub-Saharan Africa.

PubMed

Stierle, F; Kaddar, M; Tchicaya, A; Schmidt-Ehry, B

1999-01-01

Access to health care services for the poor and indigent is hampered by current policies of health care financing in sub-Saharan Africa. This paper reviews the issue as it is discussed in the international literature. No real strategies seem to exist for covering the health care of the indigent. Frequently, definitions of poverty and indigence are imprecise, the assessment of indigence is difficult for conceptual and technical reasons, and, therefore, the actual extent of indigence in Africa is not well known. Explicit policies rarely exist, and systematic evaluation of experiences is scarce. Results in terms of adequately identifying the indigent, and of mechanisms to improve indigents' access to health care, are rather deceiving. Policies to reduce poverty, and improve indigents' access to health care, seem to pursue strategies of depoliticizing the issue of social injustice and inequities. The problem is treated in a 'technical' manner, identifying and implementing 'operational' measures of social assistance. This approach, however, cannot resolve the problem of social exclusion, and, consequently, the problem of excluding large parts of African populations from modern health care. Therefore, this approach has to be integrated into a more 'political' approach which is interested in the process of impoverishment, and which addresses the macro-economic and social causes of poverty and inequity.

A Comprehensive Study of Data Collection Schemes Using Mobile Sinks in Wireless Sensor Networks

PubMed Central

Khan, Abdul Waheed; Abdullah, Abdul Hanan; Anisi, Mohammad Hossein; Bangash, Javed Iqbal

2014-01-01

Recently sink mobility has been exploited in numerous schemes to prolong the lifetime of wireless sensor networks (WSNs). Contrary to traditional WSNs where sensory data from sensor field is ultimately sent to a static sink, mobile sink-based approaches alleviate energy-holes issues thereby facilitating balanced energy consumption among nodes. In mobility scenarios, nodes need to keep track of the latest location of mobile sinks for data delivery. However, frequent propagation of sink topological updates undermines the energy conservation goal and therefore should be controlled. Furthermore, controlled propagation of sinks' topological updates affects the performance of routing strategies thereby increasing data delivery latency and reducing packet delivery ratios. This paper presents a taxonomy of various data collection/dissemination schemes that exploit sink mobility. Based on how sink mobility is exploited in the sensor field, we classify existing schemes into three classes, namely path constrained, path unconstrained, and controlled sink mobility-based schemes. We also organize existing schemes based on their primary goals and provide a comparative study to aid readers in selecting the appropriate scheme in accordance with their particular intended applications and network dynamics. Finally, we conclude our discussion with the identification of some unresolved issues in pursuit of data delivery to a mobile sink. PMID:24504107

Recent aspects of uranium toxicology in medical geology.

PubMed

Bjørklund, Geir; Albert Christophersen, Olav; Chirumbolo, Salvatore; Selinus, Olle; Aaseth, Jan

2017-07-01

Uranium (U) is a chemo-toxic, radiotoxic and even a carcinogenic element. Due to its radioactivity, the effects of U on humans health have been extensively investigated. Prolonged U exposure may cause kidney disease and cancer. The geological distribution of U radionuclides is still a great concern for human health. Uranium in groundwater, frequently used as drinking water, and general environmental pollution with U raise concerns about the potential public health problem in several areas of Asia. The particular paleo-geological hallmark of India and other Southern Asiatic regions enhances the risk of U pollution in rural and urban communities. This paper highlights different health and environmental aspects of U as well as uptake and intake. It discusses levels of U in soil and water and the related health issues. Also described are different issues of U pollution, such as U and fertilizers, occupational exposure in miners, use and hazards of U in weapons (depleted U), U and plutonium as catalysts in the reaction between DNA and H 2 O 2, and recycling of U from groundwater to surface soils in irrigation. For use in medical geology and U research, large databases and data warehouses are currently available in Europe and the United States. Copyright © 2017 Elsevier Inc. All rights reserved.

Public trust and confidence in legal authorities: What do majority and minority group members want from the law and legal institutions?

PubMed

Tyler, T R

2001-01-01

Discussions of public trust and confidence in the police and the courts often assume that the key to public feelings is the public's evaluation of the outcomes that the public receives from these legal authorities. In the case of the courts, discontent is often assumed to be linked to issues of cost and delay-instrumental concerns about the outcomes delivered to the public by the courts. In the case of the police, the inability to effectively control crime is frequently seen as driving public evaluations. This article presents an alternative procedural justice based model that links public trust and confidence to views about the manner in which legal authorities treat the public. Drawing upon psychological research about public evaluations of institutions and authorities it is argued that the key issue that shapes public views is a process based evaluation of the fairness of the procedures that the police and courts use to exercise their authority. Analyses from several studies exploring the basis of public views support this procedural justice based model of public evaluation. In addition, the results provide suggestions about the elements of procedures that are central to public judgments about their fairness. Copyright 2001 John Wiley & Sons, Ltd.

Policies for implementing network firewalls

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

Brown, C.D.

1994-05-01

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

Developing High Quality Decision-Making Discussions about Biological Conservation in a Normal Classroom Setting

ERIC Educational Resources Information Center

Grace, Marcus

2009-01-01

The conservation of biodiversity is an important socio-scientific issue that is often regarded as a precondition to sustainable development. The foundation for citizens' understanding of conservation issues can be laid down in formal school education. This research focuses on decision-making discussions about biological conservation issues among…

Legal and Ethical Issues in Evaluating Abortion Services.

ERIC Educational Resources Information Center

Ferris, Lori E.

2000-01-01

Focuses on ethical and legal issues that arose in the evaluation of abortion services. Discusses the development of decision rules and tradeoffs in dealing with these issues to reach rational and objective decisions. Places the discussion in the context of balancing usefulness and propriety with respect to informed consent and privacy and makes…

Ethical Issues in Health Services: A Report and Annotated Bibliography.

ERIC Educational Resources Information Center

Carmody, James

This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…

The National Issues Forums: Promoting Democracy in Libraries.

ERIC Educational Resources Information Center

Castelli, Jim

1992-01-01

Explains the National Issues Forums (NIF), a nonpartisan program of public-issue discussions designed to enable citizens to have a more effective voice in U.S. politics. The role of libraries in the NIF is discussed; resources the NIF provides are described; and public relations benefits to libraries that participate are considered. (LRW)

Communicative Language Testing: Current Issues and Future Research

ERIC Educational Resources Information Center

Harding, Luke

2014-01-01

This article discusses a range of current issues and future research possibilities in Communicative Language Testing (CLT) using, as its departure point, the key questions which emerged during the CLT symposium at the 2010 Language Testing Forum. The article begins with a summary of the 2010 symposium discussion in which three main issues related…

Research on Building Education and Workforce Capacity in Systems Engineering

DTIC Science & Technology

2012-01-31

Professional Ethics Since one goal of RT-19A is to understand how best to increase the number of schools offering systems engineering capstone courses...project evaluation plan  Developed and issued the request for proposals and selection process (an independent review team and rubric) for...faculty members from both institutions talk frequently to share ideas, compare progress and clarify any issues . Auburn recruited faculty only, so

Plausible Reasoning in Tactical Planning.

DTIC Science & Technology

1987-04-01

different contexts and tasks that give rise to mappings, and the set of issues and different resolutions to these issues that have been proposed in the...humans use in reasoning about the wo~ ld ( Polya , 1958; Collins, 1978a). Our work attempts to formalize the plausible inferences that frequently occur in...are interconnected by traces. Each hierarchy represents knowledge about a class of concepts arranged in a tree structure according to some viewpoint

Audit of rabies post-exposure prophylaxis in England and Wales in 1990 and 2000.

PubMed

Hossain, J; Crowcroft, N S; Lea, G; Brown, D; Mortimer, P P

2004-06-01

The objectives were to compare rabies post-exposure prophylaxis issued by the Public Health Laboratory Service (PHLS) in 1990 and in 2000, to evaluate their appropriateness, and to make recommendations for future issue of rabies post-exposure prophylaxis in England and Wales. The method was to review all rabies vaccine and immunoglobulin issues by PHLS in 1990 and 2000 with evaluation against Department of Health recommendations. The PHLS issued prophylaxis to 656 people in 1990 and 295 people in 2000. The fall is attributable to control measures in Western Europe leading to a lower risk of exposure in countries in the region. Vaccine was still issued for exposures in countries with a category of 'no risk' (15 individuals) including rabies immunoglobulin in six cases. Immunoglobulin was frequently not issued for exposures in high-risk countries but the reasons were not always evident from the information provided; in many cases treatment had probably been started abroad. Delay before contacting the PHLS fell between 1990 and 2000 (p = 0.003). Dogs continue to be the most common animal exposure reported, and their rabies status is generally unknown. The most frequent site of bite was the leg. Prophylaxis was issued for exposure to some animals which have never been known to transmit rabies. Successful control measures in Europe have reduced the need for rabies prophylaxis in UK residents who travel abroad. More detailed information should be collected in future on aspects such as pre-exposure vaccination and treatment started abroad to facilitate future audit of appropriateness of treatment. A repeat audit should be carried out to evaluate the impact of a death from European Bat Lyssavirus 2 infection in a UK bat handler in November 2002.

Policy Options for Education Reform: A Policy Analysis Paper. Discussion Draft.

ERIC Educational Resources Information Center

Hansen, Kenneth H.

This document examines approaches to educational reform currently under consideration in the Pacific Northwest and discusses policy issues involved with these reform efforts. The introduction discusses broad-scale policy issues, including the setting of priorities amid the diversity of reforms, the clarifying of beliefs and selection of changes…

78 FR 4391 - North Pacific Fishery Management Council; Public Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

...); Initial review of AFA Vessel Replacement GOA Sideboards. 4. GOA Trawl Issues: Discussion paper on Central Gulf of Alaska (CGOA) Trawl Economic Data Collection; Discussion paper on CGOA Trawl Catch Shares... paper on Bristol Bay red king crab. 3. Groundfish Issues: Discussion paper on crab bycatch limits in...

Scaling Cross Sections for Ion-atom Impact Ionization

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

Igor D. Kaganovich; Edward Startsev; Ronald C. Davidson

2003-06-06

The values of ion-atom ionization cross sections are frequently needed for many applications that utilize the propagation of fast ions through matter. When experimental data and theoretical calculations are not available, approximate formulas are frequently used. This paper briefly summarizes the most important theoretical results and approaches to cross section calculations in order to place the discussion in historical perspective and offer a concise introduction to the topic. Based on experimental data and theoretical predictions, a new fit for ionization cross sections is proposed. The range of validity and accuracy of several frequently used approximations (classical trajectory, the Born approximation,more » and so forth) are discussed using, as examples, the ionization cross sections of hydrogen and helium atoms by various fully stripped ions.« less

Playing with Pain.

ERIC Educational Resources Information Center

McKinney-Browning, Mabel C.

1983-01-01

The uncommonly high injury rate among professional football players has given rise to a range of sports-related legal issues. Three football professionals and two lawyers discuss the issues in a round-table discussion. (RM)

Navigation in the electronic health record: A review of the safety and usability literature.

PubMed

Roman, Lisette C; Ancker, Jessica S; Johnson, Stephen B; Senathirajah, Yalini

2017-03-01

Inefficient navigation in electronic health records has been shown to increase users' cognitive load, which may increase potential for errors, reduce efficiency, and increase fatigue. However, navigation has received insufficient recognition and attention in the electronic health record (EHR) literature as an independent construct and contributor to overall usability. Our aims in this literature review were to (1) assess the prevalence of navigation-related topics within the EHR usability and safety research literature, (2) categorize types of navigation actions within the EHR, (3) capture relationships between these navigation actions and usability principles, and (4) collect terms and concepts related to EHR navigation. Our goal was to improve access to navigation-related research in usability. We applied scoping literature review search methods with the assistance of a reference librarian to identify articles published since 1996 that reported evaluation of the usability or safety of an EHR user interface via user test, analytic methods, or inspection methods. The 4336 references collected from MEDLINE, EMBASE, Engineering Village, and expert referrals were de-duplicated and screened for relevance, and navigation-related concepts were abstracted from the 21 articles eligible for review using a standard abstraction form. Of the 21 eligible articles, 20 (95%) mentioned navigation in results and discussion of usability evaluations. Navigation between pages of the EHR was the more frequently documented type of navigation (86%) compared to navigation within a single page (14%). Navigation actions (e.g., scrolling through a medication list) were frequently linked to specific usability heuristic violations, among which flexibility and efficiency of use, recognition rather than recall, and error prevention were most common. Discussion of navigation was prevalent in results across all types of evaluation methods among the articles reviewed. Navigating between multiple screens was frequently identified as a usability barrier. The lack of standard terminology created some challenges to identifying and comparing articles. We observed that usability researchers are frequently capturing navigation-related issues even in articles that did not explicitly state navigation as a focus. Capturing and synthesizing the literature on navigation is challenging because of the lack of uniform vocabulary. Navigation is a potential target for normative recommendations for improved interaction design for safer systems. Future research in this domain, including development of normative recommendations for usability design and evaluation, will be facilitated by development of a standard terminology for describing EHR navigation. Copyright © 2017 Elsevier Inc. All rights reserved.

Summary of panel session 3 -- Environmental issues affecting CCT deployment

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

Hausker, K.

1997-12-31

The panelists discussed a variety of environmental issues that affect CCT deployment, and more broadly speaking, power development in general. The issues were both international and domestic in nature. The author summarizes the issues discussed. A summary is also presented which highlights ideas from the panelists that could be characterized as solutions to the demand for improved environmental performance and the surrounding uncertainties. The author offers some personal comments and observations.

Discussing end-of-life issues with terminally ill cancer patients and their carers: a qualitative study.

PubMed

Clayton, Josephine M; Butow, Phyllis N; Arnold, Robert M; Tattersall, Martin H N

2005-08-01

Discussing end-of-life issues is of key importance to terminally ill cancer patients and their families, and a challenging topic for both health professionals and patients/carers. There is a lack of research evidence in the literature to guide clinical practice. The objective of this study was to explore the optimal content and phrasing of information when discussing the dying process and end-of-life issues with terminally ill cancer patients and their carers. We conducted focus groups and individual interviews with 19 palliative care patients and 24 carers from three palliative care services in Sydney, and 22 palliative care health professionals from around Australia. The focus groups and individual interviews were audiotaped and fully transcribed. Further focus groups and/or individual interviews were conducted until no additional topics were raised. Participants' narratives were analysed using qualitative methodology. Distinct content areas emerged for discussing end-of-life issues: treatment decisions at the end-of-life; potential future symptoms; preferences for place of death; the process of dying; what needs to be done immediately after death; and existential issues. When discussing the process of dying participants recommended: exploring the persons' fears about dying and dispelling myths; describing the final days and the likely unconscious period; and the reduced need for food and fluids. Many participants identified the dilemma regarding whether to discuss potential complications around the time of death. This paper provides strategies, words and phrases which may inform discussions about the process of dying and end-of-life issues. Further research is needed to determine the generalizability of these findings.

The Impact of Personality Factors and Preceding User Comments on the Processing of Research Findings on Deep Brain Stimulation: A Randomized Controlled Experiment in a Simulated Online Forum

PubMed Central

Feinkohl, Insa; Flemming, Danny; Cress, Ulrike

2016-01-01

Background Laypeople frequently discuss medical research findings on Web-based platforms, but little is known about whether they grasp the tentativeness that is inherent in these findings. Potential influential factors involved in understanding medical tentativeness have hardly been assessed to date. Objective The research presented here aimed to examine the effects of personality factors and of other users’ previous contributions in a Web-based forum on laypeople’s understanding of the tentativeness of medical research findings, using the example of research on deep brain stimulation. Methods We presented 70 university students with an online news article that reported findings on applying deep brain stimulation as a novel therapeutic method for depression, which participants were unfamiliar with. In a randomized controlled experiment, we manipulated the forum such that the article was either accompanied by user comments that addressed the issue of tentativeness, by comments that did not address this issue, or the article was accompanied by no comments at all. Participants were instructed to write their own individual user comments. Their scientific literacy, epistemological beliefs, and academic self-efficacy were measured. The outcomes measured were perceived tentativeness and tentativeness addressed in the participants’ own comments. Results More sophisticated epistemological beliefs enhanced the perception of tentativeness (standardized β=.26, P=.034). Greater scientific literacy (stand. β=.25, P=.025) and greater academic self-efficacy (stand. β=.31, P=.007) were both predictors of a more extensive discussion of tentativeness in participants’ comments. When forum posts presented in the experiment addressed the issue of tentativeness, participants’ subsequent behavior tended to be consistent with what they had read in the forum, F 2,63=3.66; P=.049, ηp 2=.092. Conclusions Students’ understanding of the tentativeness of research findings on deep brain stimulation in an online forum is influenced by a number of character traits and by the previous comments that were contributed to the forum by other users. There is potential for targeted modification of traits such as scientific literacy, epistemological beliefs, and academic self-efficacy to foster critical thinking in laypeople who take part in online discussions of medical research findings. PMID:26940848

THE EVOLUTION OF THE JOURNAL OF APPLIED ORAL SCIENCE: A BIBLIOMETRIC ANALYSIS

PubMed Central

Ferraz, Valéria Cristina Trindade; Amadei, José Roberto Plácido; Santos, Carlos Ferreira

2008-01-01

The purpose of this study was to make a brief diagnosis of the evolution of the Journal of Applied Oral Science (JAOS) between 2005 and 2007, by reviewing quantitative and qualitative aspects of the articles published in the JAOS within this period. All articles published in the JAOS in the time span established for this survey were analyzed retrospectively and a discussion was undertaken on the data referring to the main bibliometric indexes of production, authorship, bibliographic sources of the published articles, and the most frequently cited scientific journals in the main dental research fields. A total of 247 papers authored and coauthored by 1,139 contributors were reviewed, most of them being original research articles. The number of authors per article was 4.61 on the average. Regarding the geographic distribution, the authors represented almost all of the Brazilian States. Most published articles belonged to the following dental research fields: Endodontics, Restorative Dentistry, Dental Materials and Prosthodontics. The ranking of the most frequently cited scientific journals included the most reputable publications in these dental research fields. In conclusion, between 2005 and 2007, the JAOS either maintained or improved considerably its bibliometric indexes. The analysis of the data retrieved in this study allowed evaluating the journal's current management strategies, and identifying important issues that will help outlining the future directions for the internationalization of this journal. PMID:19082402

Human exposure to airborne fungi from genera used as biocontrol agents in plant production.

PubMed

Madsen, Anne Mette; Hansen, Vinni Mona; Meyling, Nicolai Vitt; Eilenberg, Jørgen

2007-01-01

The fungi Trichoderma harzianum, T. polysporum, T. viride, Paeciliomyces fumosoroseus, P. lilacinus, Verticillium/lecanicillium lecanii, Ulocladium oudemansii, U. atrum and Beauveria bassiana are used or considered to be used for biocontrol of pests and plant diseases. Human exposure to these fungi in environments where they may naturally occur or are used as biocontrol agents has not been directly investigated to date. This review aims to provide an overview of the current knowledge of human exposure to fungi from the relevant genera. The subject of fungal taxonomy due to the rapid development of this issue is also discussed. B. bassiana, V. lecanii, T. harzianum, T. polysporum, P. lilacinus and U. oudemansii were infrequently present in the air and thus people in general seem to be seldom exposed to these fungi. However, when V. lecanii was present, high concentrations were measured. Fungi from the genera Trichoderma, Paecilomyces and Ulocladium were rarely identified to the species level and sometimes high concentrations were reported. T. viride and U. atrum were detected frequently in different environments and sometimes with a high frequency of presence in samples. Thus, people seem to be frequently exposed to these fungi. Sequence data have led to recent revisions of fungal taxonomy, and in future studies it is important to specify the taxonomy used for identification, thus making comparisons possible.

Trading forest carbon - OSU

EPA Science Inventory

Issues associate with trading carbon sequestered in forests are discussed. Scientific uncertainties associated with carbon measurement are discussed with respect to proposed accounting procedures. Major issues include: (1) Establishing baselines. (2) Determining additivity from f...

Near-Centenarian Makes Friends Quickly in New Home

MedlinePlus

... Senior Living Near-Centenarian Makes Friends Quickly in New Home Past Issues / Summer 2009 Table of Contents ... 2008. Alice has already made friends at her new home. Frequent luncheon partners and home residents Beatrice ...

Being research-savvy in acute care settings.

PubMed

Bridges, Jackie

2017-04-28

We are good at reinventing the wheel in older people's nursing, where we often find ourselves struggling with the same practice issues regardless of care setting. Frequently, the starting point is to develop a local solution.

Defense.gov Special Report: Travels With Hagel

Science.gov Websites

History Frequently Asked Questions Available jobs with DOD Top Issues Targeted Operations Against ISIL Connected Icon: Facebook Facebook Icon: Twitter Twitter Icon: YouTube YouTube Icon: Google Plus Google

Issues and Directions from a Review of the Australian Apprenticeship and Traineeship Literature. Australian Apprenticeships.

ERIC Educational Resources Information Center

Saunders, S.

This paper synthesizes issues and directions that a review of Australian apprenticeship and traineeship literature suggested. An overview discusses the paper's basis, which was a survey of 125 Australian references from 1985-99. Chapter 2 categorizes issues into seven groups, discusses them, and draws out salient themes. (The groups concerned…

Teacher College Students' Views of Controversial Environmental Issues: Ambivalence and Readiness to Adopt a Stance

ERIC Educational Resources Information Center

Weinberger, Yehudith; Dreyfus, Amos

2013-01-01

One of the most important goals of discussing controversial issues in the classroom is to educate students to possess an inclination towards reason, open mindedness and fairness. However, research tends to show that teachers are not adequately trained to lead fruitful discussions about controversial issues and do not possess the necessary skills…

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

Treesearch

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

2009-01-01

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

A Discussion about Ionising and Non-Ionising Radiation and the Critical Issue of Mobile Phones

ERIC Educational Resources Information Center

Kontomaris, Stylianos-Vasileios; Malamou, Anna

2018-01-01

Electromagnetic radiation is one of the most important issues affecting peoples' lives today. The misunderstanding of students and the general population of the effects of electromagnetic radiation is a problem which must be eliminated. Thus, a discussion about ionising and non-ionising radiation focusing on the crucial issue of radiation emitted…

Equity in Education: A Balancing Act.

ERIC Educational Resources Information Center

Richardson, Lynnette, Ed.; Hines, Mack T., III, Ed.

The issues surrounding equity in education are complex and varied. Recently the focus has shifted to students at risk. This paper discusses four specific issues that have affected school learning for at-risk students over the last 50 years. Issue 1, equity and youth at risk, discusses the home and family life of at-risk students and its…

Water Planning in the States of the Upper Basin of the Colorado River.

ERIC Educational Resources Information Center

Mann, Dean E.

1978-01-01

Discussion of issues involved in water planning of the upper basin of the Colorado River: attitudes toward water planning, agricultural leisure and environmental issues, pollution, and energy issues. Various sections are devoted to Indian interests and the interests of Utah, Wyoming, Colorado, and New Mexico. Final section discusses the future of…

Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review.

PubMed

Rasoal, Dara; Skovdahl, Kirsti; Gifford, Mervyn; Kihlgren, Annica

2017-12-01

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a "bottom-up" perspective might give healthcare personnel opportunities to think and reflect more than a "top-down" perspective. A "bottom-up" approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a "top-down" approach risks removing such moral responsibility.

How to make experience your company's best teacher.

PubMed

Kleiner, A; Roth, G

1997-01-01

In our personal life, experience is often the best teacher. Not so in corporate life. After a major event--a product failure, a downsizing crisis, or a merger--many companies stumble along, oblivious to the lessons of the past. Mistakes get repeated, but smart decisions do not. Most important, the old ways of thinking are never discussed, so they are still in place to spawn new mishaps. Individuals will often tell you that they understand what went wrong (or right). Yet their insights are rarely shared openly. And they are analyzed and internalized by the company even less frequently. Why? Because managers have few tools with which to capture institutional experience, disseminate its lessons, and translate them into effective action. In an effort to solve this problem, a group of social scientists, business managers, and journalists at MIT have developed and tested a tool called the learning history. It is a written narrative of a company's recent critical event, nearly all of it presented in two columns. In one column, relevant episodes are described by the people who took part in them, were affected by them, or observed them. In the other, learning historians--trained outsiders and knowledgeable insiders--identify recurrent themes in the narrative, pose questions, and raise "undiscussable" issues. The learning history forms the basis for group discussions, both for those involved in the event and for others who also might learn from it. The authors believe that this tool--based on the ancient practice of community storytelling--can build trust, raise important issues, transfer knowledge from one part of a company to another, and help build a body of generalizable knowledge about management.

Vaccines are different: A systematic review of budget impact analyses of vaccines.

PubMed

Loze, Priscilla Magalhaes; Nasciben, Luciana Bertholim; Sartori, Ana Marli Christovam; Itria, Alexander; Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho

2017-05-15

Several countries require manufacturers to present a budget impact analysis (BIA), together with a cost-effectiveness analysis, to support national funding requests. However, guidelines for conducting BIA of vaccines are scarce. To analyze the methodological approaches used in published budget impact analysis (BIA) of vaccines, discussing specific methodological issues related to vaccines. This systematic review of the literature on BIA of vaccines was carried out in accordance with the Centre for Reviews and Dissemination - CRD guidelines. We searched multiple databases: MedLine, Embase, Biblioteca Virtual de Saúde (BVS), Cochrane Library, DARE Database, NHS Economic Evaluation Database (NHS EED), HTA Database (via Centre for Reviews and Dissemination - CRD), and grey literature. Two researchers, working independently, selected the studies and extracted the data. The methodology quality of individual studies was assessed using the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. A qualitative narrative synthesis was conducted. Twenty-two studies were reviewed. The most frequently evaluated vaccines were pneumococcal (41%), influenza (23%) and rotavirus (18%). The target population was stated in 21 studies (95%) and the perspective was clear in 20 (91%). Only 36% reported the calculations used to complete the BIA, 27% informed the total and disaggregated costs for each time period, and 9% showed the change in resource use for each time period. More than half of the studies (55%, n=12) reported less than 50% of the items recommended in the checklist. The production of BIA of vaccines has increased from 2009. The report of the methodological steps was unsatisfactory, making it difficult to assess the validity of the results presented. Vaccines specific issues should be discussed in international guidelines for BIA of vaccines, to improve the quality of the studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Genetic technology: Promises and problems

NASA Technical Reports Server (NTRS)

Frankel, M. S.

1975-01-01

Issues concerning the use of genetic technology are discussed. Some areas discussed include treating genetic disease, prenatal diagnosis and selective abortion, screening for genetic disease, and genetic counseling. Policy issues stemming from these capabilities are considered.

Breathe Deeply.

ERIC Educational Resources Information Center

Milshtein, Amy

2000-01-01

Discusses the special indoor air quality issues confronting school gyms, locker rooms, and pools; and explores ways to keep the indoor environment healthy. Included are discussions of mold and fungus control and air issues stemming from indoor pools. (GR)

CRIS Case Study Materials in Ethical Decision Making.

ERIC Educational Resources Information Center

Blanning, James R.

Designed for secondary-level classroom discussion, these materials contain nine, short case studies of ethical dilemmas. The cast studies focus mainly on incidents and issues relevant to high school students. Discussion questions for each case study require students to examine the case, discuss the issue, and make an ethical decision about how…

A Qualitative Analysis of the Lesbian Connection's Discussion Forum

ERIC Educational Resources Information Center

Erwin,Terry McVannel

2006-01-01

Letters submitted to the discussion forum of the Lesbian Connection between 2000 and 2002 were analyzed to identify issues of importance to lesbians. The analysis revealed 5 discussion categories: (a) isolation, safety, and aging; (b) children; (c) lesbian relationships and sexuality; (d) physical and mental health; and (e) political issues. The…

Sexual Orientation Disclosure in Primary Care Settings by Gay, Bisexual, and Other Men Who Have Sex with Men in a Canadian City.

PubMed

Coleman, Todd A; Bauer, Greta R; Pugh, Daniel; Aykroyd, Gloria; Powell, Leanne; Newman, Rob

2017-02-01

Sexual orientation affects individuals' health histories and is fundamental to providers' understanding of patients as a whole. Gay, bisexual, and other men who have sex with men (GB-MSM) are vulnerable to certain health conditions, including HIV. The aim of this exploratory analysis was to examine factors associated with sexual orientation disclosure and communication with providers about GB-MSM health issues and to discuss implications. We conducted a cross-sectional internet survey of GB-MSM (n = 202) in London-Middlesex, Ontario, Canada; analyses were limited to those with a regular primary care provider (n = 173). Blockwise regression models explored demographic, psychosocial, and healthcare-related factors associated with sexual orientation disclosure and physician-patient communication about GB-MSM-related health. Just over seventy-one percent (71.1%) of participants reported that their primary care provider (PCP) knew their sexual orientation, and 44.5% had talked to them about GB-MSM health. Overt negative comments or being refused care based on sexual orientation occurred infrequently, although 26.6% reported their provider had assumed they were heterosexual. Being married to or living common-law with another man, more frequent experiences of homosexual prejudice, and higher quality assessment of provider's communication skills were associated with the PCP knowing respondents' sexual orientation. Greater internalized homonegativity was associated with not talking to a PCP about GB-MSM-related health issues. More frequent experiences of homosexual prejudice, higher assessment of provider communication, and having prior negative experiences with a PCP were significantly associated with talking to a PCP about GB-MSM health. The majority of our sample disclosed their sexual orientation; however, not all patients voluntarily disclose. Medical training and education in Canada, where specific rights protections exist for sexual orientation minority populations, should emphasize awareness of essential patient health information. Training should include information about GB-MSM health and building a foundation on how to speak with GB-MSM patients nonjudgmentally.

National GAP Conference 2007-Discussion Groups Report

USGS Publications Warehouse

Ratz, Joan M.; Lamb, Berton Lee

2010-01-01

We led two discussion groups during the 2007 National GAP Conference. These discussion groups provided information to help develop a survey of National Gap Analysis Program (GAP) data users. One group discussed technical issues, and the second group discussed the use of GAP data for decisionmaking. Themes emerging from the technical issues group included concerns about data quality, need for information on how to use data, and passive data distribution. The decisionmaking discussion included a wide range of topics including the need to understand presentation of information, the need to connect with and understand users of data, the revision of GAP's mission, and the adaptability of products and data. The decisionmaking group also raised concerns regarding technical issues. One conclusion is that a deep commitment to ongoing information transfer and support is a key component of success for the GAP program.

Mindfulness and discussing "thorny" issues in the classroom

NASA Astrophysics Data System (ADS)

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

2016-09-01

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

Ethical and Legal Issues in Biobanking for Genomic Research in Nigeria

PubMed Central

Akintola, Simisola. O.

2013-01-01

The pursuit of genomic research and biobanking has raised concerns and discussions about the ethical and legal implications. Given the specific challenges that surround such enterprise in low and middle income countries, it is pertinent to examine them in the light of the advent of Biobanking and Genomic research in Nigeria. In this paper I discuss the issues and suggest model solutions derived from advanced jurisdictions. These ethical and legal issues are discussed within the context of the legal system of a typical African country whose jurisprudence derives from that of its erstwhile colonial master, the United Kingdom. This includes issues relating to law and human rights, informed consent, native and customary law. PMID:24353984

Oral contraception and adolescent women with insulin-dependent diabetes mellitus: risks, benefits, and implications for practice.

PubMed

Betschart, J

1996-01-01

Healthcare providers who work with adolescents with diabetes are in an ideal position to provide education and support regarding contraceptive issues. Diabetes educators and other health professionals who counsel teens focus on other aspects of diabetes care and management but frequently do not address sexual issues or assess contraceptive practices. The purpose of this paper is to review oral contraceptive issues for teens with diabetes and to provide practice implications for health professionals who are in a favorable position to influence the quality of diabetes and general health care for these adolescents.

‘The body we leave behind’: a qualitative study of obstacles and opportunities for increasing uptake of male circumcision among Tanzanian Christians

PubMed Central

Downs, Jennifer A; Fuunay, Lucas D; Fuunay, Mary; Mbago, Mary; Mwakisole, Agrey; Peck, Robert N; Downs, David J

2013-01-01

Objectives Male circumcision (MC) reduces HIV infection by approximately 60% among heterosexual men and is recommended by the WHO for HIV prevention in sub-Saharan Africa. In northwest Tanzania, over 60% of Muslims but less than 25% of Christian men are circumcised. We hypothesised that the decision to circumcise may be heavily influenced by religious identity and that specific religious beliefs may offer both obstacles and opportunities to increasing MC uptake, and conducted focus group discussions to explore reasons for low rates of MC among Christian church attenders in the region. Design Qualitative study using focus group discussions and interpretative phenomenological analysis. Setting Discussions took place at churches in both rural and urban areas of the Mwanza region of northwest Tanzania. Participants We included 67 adult Christian churchgoers of both genders in a total of 10 single-gender focus groups. Results Christians frequently reported perceiving MC as a Muslim practice, as a practice for the sexually promiscuous, or as unnecessary since they are taught to focus on ‘circumcision of the heart’. Only one person had ever heard MC discussed at church, but nearly all Christian parishioners were eager for their churches to address MC and felt that MC could be consistent with their faith. Conclusions Christian religious beliefs among Tanzanian churchgoers provide both obstacles and opportunities for increasing uptake of MC. Since half of adults in sub-Saharan Africa identify themselves as Christians, addressing these issues is critical for MC efforts in this region. PMID:23793672

Investigating change in a nursing context.

PubMed

Sheehan, J

1990-07-01

This paper focuses on 'why', 'what' and 'how' issues as they relate to the investigation of change in a nursing context. The why issues revolve around the need for change, and evolutionary and revolutionary change are discussed. Next the what issues are discussed and some variables involved in the change process are identified, and the role of change agents is outlined. Change strategies such as the power-coercive, the rational-empirical and the normative-re-education are discussed. Finally, the potential of action research in the context of bringing about change is advanced.

Online Discussion on #KidneyStones: A Longitudinal Assessment of Activity, Users and Content.

PubMed

Salem, Johannes; Borgmann, Hendrik; Bultitude, Matthew; Fritsche, Hans-Martin; Haferkamp, Axel; Heidenreich, Axel; Miernik, Arkadiusz; Neisius, Andreas; Knoll, Thomas; Thomas, Christian; Tsaur, Igor

2016-01-01

Twitter is a popular microblogging platform for the rapid dissemination of information and reciprocal exchange in the urological field. We aimed to assess the activity, users and content of the online discussion, #KidneyStones, on Twitter. We investigated the Symplur Signals analytics tool for Twitter data distributed via the #KidneyStones hashtag over a one year period. Activity analysis reflected overall activity and tweet enhancements. We assessed users' geolocations and performed an influencer analysis. Content analysis included the most frequently used words, tweet sentiment and shares for top tweets. 3,426 users generated over 10,333 tweets, which were frequently accompanied by links (49%), mentions (30%) and photos (13%). Users came from 106 countries across the globe and were most frequently from North America (63%) and Europe (16%). Individual and organisational healthcare professionals made up 56% of the influencers of the Twitter discussion on #KidneyStones. Besides the words 'kidney' (used 4,045 times) and 'stones' (3,335), 'pain' (1,233), 'urine' (1,158), and 'risk' (1,023) were the most frequently used words. 56% of tweets had a positive sentiment. The median (range) number of shares was 85 (62-587) for the top 10 links, 45.5 (17-94) for the top 10 photos, and 44 (22-95) for the top 10 retweets. The rapidly growing Twitter discussion on #KidneyStones engaged multiple stakeholders in the healthcare sector on a global scale and reached both professionals and laypeople. When used effectively and responsibly, the Twitter platform could improve prevention and medical care of kidney stone patients.

EPA Team Helps Water Systems Comply with New Bacteria Monitoring Rule

EPA Pesticide Factsheets

An EPA team issued nearly 200 Administrative Orders in support of Pennsylvania and Virginia to ensure that small public water systems followed new requirements for more frequent bacteria monitoring of their water supplies.

A discussion about ionising and non-ionising radiation and the critical issue of mobile phones

NASA Astrophysics Data System (ADS)

Kontomaris, Stylianos-Vasileios; Malamou, Anna

2018-01-01

Electromagnetic radiation is one of the most important issues affecting peoples’ lives today. The misunderstanding of students and the general population of the effects of electromagnetic radiation is a problem which must be eliminated. Thus, a discussion about ionising and non-ionising radiation focusing on the crucial issue of radiation emitted by mobile phones is presented.

Calibration of decadal ensemble predictions

NASA Astrophysics Data System (ADS)

Pasternack, Alexander; Rust, Henning W.; Bhend, Jonas; Liniger, Mark; Grieger, Jens; Müller, Wolfgang; Ulbrich, Uwe

2017-04-01

Decadal climate predictions are of great socio-economic interest due to the corresponding planning horizons of several political and economic decisions. Due to uncertainties of weather and climate, forecasts (e.g. due to initial condition uncertainty), they are issued in a probabilistic way. One issue frequently observed for probabilistic forecasts is that they tend to be not reliable, i.e. the forecasted probabilities are not consistent with the relative frequency of the associated observed events. Thus, these kind of forecasts need to be re-calibrated. While re-calibration methods for seasonal time scales are available and frequently applied, these methods still have to be adapted for decadal time scales and its characteristic problems like climate trend and lead time dependent bias. Regarding this, we propose a method to re-calibrate decadal ensemble predictions that takes the above mentioned characteristics into account. Finally, this method will be applied and validated to decadal forecasts from the MiKlip system (Germany's initiative for decadal prediction).

Mass media and risk factors for cancer: the under-representation of age.

PubMed

Macdonald, Sara; Cunningham, Yvonne; Patterson, Chris; Robb, Katie; Macleod, Una; Anker, Thomas; Hilton, Shona

2018-04-26

Increasing age is a risk factor for developing cancer. Yet, older people commonly underestimate this risk, are less likely to be aware of the early symptoms, and are more likely to be diagnosed with advanced stage cancer. Mass media are a key influence on the public's understanding health issues, including cancer risk. This study investigates how news media have represented age and other risk factors in the most common cancers over time. Eight hundred articles about the four most common cancers (breast, prostate, lung and colorectal) published within eight UK national newspapers in 2003, 2004, 2013 and 2014 were identified using the Nexis database. Relevant manifest content of articles was coded quantitatively and subjected to descriptive statistical analysis in SPSS to identify patterns across the data. Risk was presented in half of the articles but this was rarely discussed in any depth and around a quarter of all articles introduced more than one risk factor, irrespective of cancer site. Age was mentioned as a risk factor in approximately 12% of all articles and this varied by cancer site. Age was most frequently reported in relation to prostate cancer and least often in articles about lung cancer. Articles featuring personal narratives more frequently focused on younger people and this was more pronounced in non-celebrity stories; only 15% of non-celebrity narratives were about people over 60. Other common risks discussed were family history and genetics, smoking, diet, alcohol, and environmental factors. Family history and genetics together featured as the most common risk factors. Risk factor reporting varied by site and family history was most commonly associated with breast cancer, diet with bowel cancer and smoking with lung cancer. Age and older adults were largely obscured in media representation of cancer and cancer experience. Indeed common risk factors in general were rarely discussed in any depth. Our findings will usefully inform the development of future cancer awareness campaigns and media guidelines. It is important that older adults appreciate their heightened risk, particularly in the context of help-seeking decisions.

Does Question Wording Predict Support for the Affordable Care Act? An Analysis of Polling During the Implementation Period, 2010-2016.

PubMed

Holl, Kristen; Niederdeppe, Jeff; Schuldt, Jonathon P

2018-07-01

The Patient Protection and Affordable Care Act (ACA) continues to be the subject of fierce political debate in the United States. Drawing on issue framing theory, together with research on wording effects in survey responding, we tested how common differences in the wording of ACA surveys relate to apparent public support for the law. We report on a content analysis of N = 376 U.S. national opinion surveys fielded during a more than six-year period, beginning 23 March 2010 (when President Obama signed the bill into law) and ending 8 November 2016 (Election Day), and use ordinary least squares (OLS) regression models to predict public support for the law as a function of variation in question wording. We coded questions gauging general sentiment toward the law for differences in issue labeling (e.g., Obamacare, Affordable Care Act), whether or not they referenced particular political entities (e.g., President Obama, Congress) or segments of the public (e.g., You, Your Family), various opinion metrics (e.g., Support, Favor), and different response options (e.g., Repeal, Expand) which we used to model aggregate levels of support. The results revealed several key differences in question wording-for example, generic references to the Healthcare Law were employed much more frequently than Obamacare or Affordable Care Act-a number of which reliably predicted aggregate levels of public support. The discussion considers possible explanations for these patterns and reiterates the value of attending to questionnaire design features when interpreting survey data about politically contentious health policy issues.

Form and function in the Lower Palaeolithic: history, progress, and continued relevance.

PubMed

Key, Alastair; Stephen, Lycett

2017-12-30

Percussively flaked stone artefacts constitute a major source of evidence relating to hominin behavioural strategies and are, essentially, a product or byproduct of a past individual's decision to create a tool with respect to some broader goal. Moreover, it has long been noted that both differences and recurrent regularities exist within and between Palaeolithic stone artefact forms. Accordingly, archaeologists have frequently drawn links between form and functionality, with functional objectives and performance often being regarded consequential to a stone tool's morphological properties. Despite these factors, extensive reviews of the related concepts of form and function with respect to the Lower Palaeolithic remain surprisingly sparse. We attempt to redress this issue. First we stress the historical place of form-function concepts, and their role in establishing basic ideas that echo to this day. We then highlight methodological and conceptual progress in determining artefactual function in more recent years. Thereafter, we evaluate four specific issues that are of direct consequence for evaluating the ongoing relevance of form-function concepts, especially with respect to their relevance for understanding human evolution more generally. Our discussion highlights specifically how recent developments have been able to build on a long historical legacy, and demonstrate that direct, indirect, experimental, and evolutionary perspectives intersect in crucial ways, with each providing specific but essential insights for ongoing questions. We conclude by emphasising that our understanding of these issues and their interaction, has been, and will be, essential to accurately interpret the Lower Palaeolithic archaeological record, tool-form related behaviours of Lower Palaeolithic hominins, and their consequences for (and relationship to) wider questions of human evolution.

Google and Women’s Health-Related Issues: What Does the Search Engine Data Reveal?

PubMed Central

Baazeem, Mazin

2014-01-01

Objectives Identifying the gaps in public knowledge of women’s health related issues has always been difficult. With the increasing number of Internet users in the United States, we sought to use the Internet as a tool to help us identify such gaps and to estimate women’s most prevalent health concerns by examining commonly searched health-related keywords in Google search engine. Methods We collected a large pool of possible search keywords from two independent practicing obstetrician/gynecologists and classified them into five main categories (obstetrics, gynecology, infertility, urogynecology/menopause and oncology), and measured the monthly average search volume within the United States for each keyword with all its possible combinations using Google AdWords tool. Results We found that pregnancy related keywords were less frequently searched in general compared to other categories with an average of 145,400 hits per month for the top twenty keywords. Among the most common pregnancy-related keywords was “pregnancy and sex’ while pregnancy-related diseases were uncommonly searched. HPV alone was searched 305,400 times per month. Of the cancers affecting women, breast cancer was the most commonly searched with an average of 247,190 times per month, followed by cervical cancer then ovarian cancer. Conclusion The commonly searched keywords are often issues that are not discussed in our daily practice as well as in public health messages. The search volume is relatively related to disease prevalence with the exception of ovarian cancer which could signify a public fear. PMID:25422723

Phytoremediation: Risk or benefit?

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

Beath, J.M.; Allen, B.J.

1999-07-01

The proposed use of phytoremediation at an increasing variety of contaminated sites has resulted in concerns by regulating agencies that a successful removal of constituents from contaminated sludge or soil by plants might result in the unwanted transfer of these constituents to the food chain. As part of the basis for a corrective measures study for a potential remedy, this pathway may need to be evaluated. Different constituents of concern result in different transport issues. For volatile compounds, the evolution of gases from plants as part of evapotranspiration may be an issue. This paper discusses the risks associated with polycyclicmore » aromatic hydrocarbons (PAHs) that are frequently present at hazardous waste surface impoundments for which phytoremediation may have attractive cost advantages over conventional closure methods. Central to an analysis of potential uptake effects is an evaluation of constituent transport, exposure pathway and toxicity. Methods by which each of these can be estimated are presented. Regulatory frameworks under which these evaluations may be performed at the state level are still evolving, in fact Texas issued new proposed regulatory language pertaining to ecological risk as this paper was going to print. The attractiveness of phytoremediation in a RCRA setting is greater if a phytoremediation-based cover can be substituted for a traditional RCRA landfill cap. At the federal level some flexibility has now been provided, but it must be adopted by RCRA- delegated states to be useful. Alternatively, a demonstration that the phytoremediation-based cover somehow meets the RCRA closure design criteria for caps must be made. Work to make this kind of demonstration compelling is underway under the oversight of EPA.« less

Computational intelligence in earth sciences and environmental applications: issues and challenges.

PubMed

Cherkassky, V; Krasnopolsky, V; Solomatine, D P; Valdes, J

2006-03-01

This paper introduces a generic theoretical framework for predictive learning, and relates it to data-driven and learning applications in earth and environmental sciences. The issues of data quality, selection of the error function, incorporation of the predictive learning methods into the existing modeling frameworks, expert knowledge, model uncertainty, and other application-domain specific problems are discussed. A brief overview of the papers in the Special Issue is provided, followed by discussion of open issues and directions for future research.

Discussing Ethical Issues in the Classroom: Leveraging Pedagogical Moments that May Otherwise Undermine Important Discussions

ERIC Educational Resources Information Center

Simpson, Douglas J.; Hull, William J., Jr.

2011-01-01

The authors identify, examine, and clarify three kinds of hindrances (dismissive/evasive tactics, logical stoppers, and ad hominem arguments) to teaching about ethical issues in P-12 schools. In discussing these three types of obstacles, they stress that the barriers themselves provide both challenges and opportunities for teachers. Indeed, they…

Discussing Sexual Identities with Pre-Service Primary School English-Language Teachers from a Spanish Context

ERIC Educational Resources Information Center

Barozzi, Stefano; Guijarro Ojeda, Juan Ramon

2014-01-01

This article is based on a discussion with seven voluntary Spanish pre-service primary school English-language teachers on queer issues. The focus group followed a questionnaire on their knowledge and understanding of sexual identity issues in education. The facilitated discussion enabled the participants to be better prepared on the subject. At…

76 FR 18757 - Monthly Public Meetings of the Local Government Advisory Committee's Small Community Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-05

..., via teleconference calls, to discuss EPA regulation, policy, and the significant environmental issues... Subcommittee members to work together and discuss relevant issues, as well as allow an opportunity for the...

75 FR 14602 - Guidance for Industry on Drug-Induced Liver Injury: Premarketing Clinical Evaluation; Opening of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-26

... and 25, 2010, to discuss and debate issues contained in the published guidance document. The purpose... specific debate and discussion some controversial issues such as: Whether indications of cholestasis...

Issues in the Management of Distance Education.

ERIC Educational Resources Information Center

Murgatroyd, Stephen; Woudstra, Andrew

1989-01-01

Examines key issues facing administrators at Athabasca University and discusses their implications for distance education organizations. Topics discussed include strategic planning; accountability and cost effectiveness; consortia and cooperation; instructional design; managing technological innovation; marketing; quality assurance; and…

Understanding and Developing Controversial Issues in College Courses.

ERIC Educational Resources Information Center

Payne, Brian K.; Gainey, Randy R.

2003-01-01

Discusses common controversial issues in different college disciplines, such as the death penalty and drug legalization. Also suggests useful methods for encouraging enlightening discussions, such as verbal and physical cues, student-centered activities, and text selection. (SLD)

First International Conference on Ada (R) Programming Language Applications for the NASA Space Station, volume 1

NASA Technical Reports Server (NTRS)

Bown, Rodney L. (Editor)

1986-01-01

Topics discussed include: test and verification; environment issues; distributed Ada issues; life cycle issues; Ada in Europe; management/training issues; common Ada interface set; and run time issues.

[Trends in nursing research in Korea: research trends for studies published from the inaugural issue to 2010 in the Journal of Korean Academy of Nursing and the journals published by member societies under Korean Academy of Nursing Science].

PubMed

Choe, Myoung Ae; Kim, Nam Cho; Kim, Kyung Mi; Kim, Sung Jae; Park, Kyung Sook; Byeon, Young Soon; Shin, Sung Rae; Yang, Soo; Lee, Kyung Sook; Lee, Eun Hyun; Lee, In Sook; Lee, Tae Wha; Cho, Myung Ok; Kim, Jin Hak

2014-10-01

The purpose of this study was to identify trends for studies published in the Journal of Korean Academy of Nursing and journals published by member societies from inaugural issues to 2010. A total of 6890 studies were analyzed using descriptive statistics. Quantitative studies accounted for 83.6% while qualitative studies accounted for 14.4%. Most frequently used research designs were quasi-experimental (91.1%) for experimental research and survey (85.2%) for non-experimental research. Most frequent study participants were healthy people (35.8%), most frequent nursing interventions, nursing skills (53.5%), and 39.8% used knowledge, attitude and behavior outcomes for dependent variables. Most frequently used keyword was elderly. Survey studies decreased from 1991 to 2010 by approximately 50%, while qualitative studies increased by about 20%. True experimental research (1.2%) showed no significant changes. Studies focusing on healthy populations increased from 2001-2005 (37.5%) to 2006-2010 (41.0%). From 1970 to 2010, studies using questionnaire accounted for over 50% whereas physiological measurement, approximately 5% only. Experimental studies using nursing skill interventions increased from 1970-1980 (30.4%) to 2006-2010 (64.0%). No significant changes were noted in studies using knowledge, attitude and behavior (39.9%) as dependent variables. The results suggest that further expansion of true experimental, qualitative studies and physiological measurements are needed.