Hypertension in Developing Countries: A Major Challenge for the Future.

PubMed

Mohsen Ibrahim, M

2018-05-01

Outline recent epidemiologic data regarding hypertension in developing countries, distinguish differences from developed countries, and identify challenges in management and future perspectives. Increased sugar intake, air and noise pollution, and low birth weight are emerging hypertension risk factors. The major challenges in management are difficulties in accurate diagnosis of hypertension and adequate blood pressure control. In contrast to developed countries, hypertension prevalence rates are on the rise in developing countries with no improvement in awareness or control rates. The increasing burden of hypertension is largely attributable to behavioral factors, urbanization, unhealthy diet, obesity, social stress, and inactivity. Health authorities, medical societies, and drug industry can collaborate to improve hypertension control through education programs, public awareness campaigns, legislation to limit salt intake, encourage generic drugs, development and dissemination of national guidelines, and involving nurses and pharmacists in hypertension management. More epidemiologic data are needed in the future to identify reasons behind increased prevalence and poor blood pressure control and examine trends in prevalence, awareness, treatment, and control. National programs for better hypertension control based on local culture, economic characteristics, and available resources in the population are needed. The role of new tools for hypertension management should be tested in developing world.

Mr. Spock and Gaan: Alien Perspectives on the Future.

ERIC Educational Resources Information Center

Roddenberry, Gene

1985-01-01

The creator of Star Trek uses two fictional characters to explain a few offbeat--but effective--ways of thinking about the future. Those capable of using an extraterrestrial's eyes as an exercise, as a challenge, as an exciting game, improve on their ability to estimate where today may be taking us. (Author)

The future water environment--using scenarios to explore the significant water management challenges in England and Wales to 2050.

PubMed

Henriques, C; Garnett, K; Weatherhead, E K; Lickorish, F A; Forrow, D; Delgado, J

2015-04-15

Society gets numerous benefits from the water environment. It is crucial to ensure that water management practices deliver these benefits over the long-term in a sustainable and cost-effective way. Currently, hydromorphological alterations and nutrient enrichment pose the greatest challenges in European water bodies. The rapidly changing climatic and socio-economic boundary conditions pose further challenges to water management decisions and the achievement of policy goals. Scenarios are a strategic tool useful in conducting systematic investigations of future uncertainties pertaining to water management. In this study, the use of scenarios revealed water management challenges for England and Wales to 2050. A set of existing scenarios relevant to river basin management were elaborated through stakeholder workshops and interviews, relying on expert knowledge to identify drivers of change, their interdependencies, and influence on system dynamics. In a set of four plausible alternative futures, the causal chain from driving forces through pressures to states, impacts and responses (DPSIR framework) was explored. The findings suggest that scenarios driven by short-term economic growth and competitiveness undermine current environmental legislative requirements and exacerbate the negative impacts of climate change, producing a general deterioration of water quality and physical habitats, as well as reduced water availability with adverse implications for the environment, society and economy. Conversely, there are substantial environmental improvements under the scenarios characterised by long-term sustainability, though achieving currently desired environmental outcomes still poses challenges. The impacts vary across contrasting generic catchment types that exhibit distinct future water management challenges. The findings suggest the need to address hydromorphological alterations, nutrient enrichment and nitrates in drinking water, which are all likely to be exacerbated in the future. Future-proofing river basin management measures that deal with these challenges is crucial moving forward. The use of scenarios to future-proof strategy, policy and delivery mechanisms is discussed to inform next steps. Copyright © 2014 Elsevier B.V. All rights reserved.

Lessons Learned from the Evolution of an Academic Community Partnership: Creating "Patient Voices".

PubMed

Chambers, Meghan K; Ireland, Anna; D'Aniello, Rona; Lipnicki, Stephanie; Glick, Myron; Tumiel-Berhalter, Laurene

2015-01-01

Long-term partners received federal funding to develop the Patient Voices Network, a partnership of safety-net family practices and their patients to develop health improvement strategies. The scope and structure of the newly funded grant presented unexpected challenges that threatened the future of the partnership.Purpose of Article: To present a case study of the evolution of an existing partnership and offer lessons learned along with recommendations for future partnerships. Federal funding formalized the partnership in a way that required looking at it through a new lens. Leadership, programmatic, personnel, and financial challenges emerged. Short-term and long-term strategies were applied to address evolving needs. This case study demonstrates how federal funding raises the bar for academic-community partnerships and how challenges can be worked through, particularly if the partnership embraces the key principles of community-based participatory research (CBPR). Recommendations have been applied successfully to future initiatives.

The past, present, and future of urgent matters: lessons learned from a decade of emergency department flow improvement.

PubMed

McClelland, Mark Stephen; Lazar, Danielle; Sears, Vickie; Wilson, Marcia; Siegel, Bruce; Pines, Jesse M

2011-12-01

Over the past decade, emergency departments (ED) have encountered major challenges due to increased crowding and a greater public focus on quality measurement and quality improvement. Responding to these challenges, many EDs have worked to improve their processes and develop new and innovative models of care delivery. Urgent Matters has contributed to ED quality and patient flow improvement by working with hospitals throughout the United States. Recognizing that EDs across the country are struggling with many of the same issues, Urgent Matters-a program funded by the Robert Wood Johnson Foundation (RWJF)-has sought to identify, develop, and disseminate innovative approaches, interventions, and models to improve ED flow and quality. Using a variety of techniques, such as learning networks (collaboratives), national conferences, e-newsletters, webinars, best practices toolkits, and social media, Urgent Matters has served as a thought leader and innovator in ED quality improvement initiatives. The Urgent Matters Seven Success Factors were drawn from the early work done by program participants and propose practical guidelines for implementing and sustaining ED improvement activities. This article chronicles the history, activities, lessons learned, and future of the Urgent Matters program. © 2011 by the Society for Academic Emergency Medicine.

Application of Landscape Mosaic Technology to Complement Coral Reef Resource Mapping and Monitoring

DTIC Science & Technology

2010-10-01

irregular shapes pose a challenge for divers trying to delimit live tissue boundaries. Future improvements in the 3D representation of benthic mosaics...benthic habitats can be especially challenging when the spatial extent of injuries exceeds tens of square meters. These large injuries are often too...the impacts of severe physical disturbance on coral reefs can be especially challenging when large-scale modifications to the reef structure takes

How will climate novelty influence ecological forecasts? Using the Quaternary to assess future reliability.

PubMed

Fitzpatrick, Matthew C; Blois, Jessica L; Williams, John W; Nieto-Lugilde, Diego; Maguire, Kaitlin C; Lorenz, David J

2018-03-23

Future climates are projected to be highly novel relative to recent climates. Climate novelty challenges models that correlate ecological patterns to climate variables and then use these relationships to forecast ecological responses to future climate change. Here, we quantify the magnitude and ecological significance of future climate novelty by comparing it to novel climates over the past 21,000 years in North America. We then use relationships between model performance and climate novelty derived from the fossil pollen record from eastern North America to estimate the expected decrease in predictive skill of ecological forecasting models as future climate novelty increases. We show that, in the high emissions scenario (RCP 8.5) and by late 21st century, future climate novelty is similar to or higher than peak levels of climate novelty over the last 21,000 years. The accuracy of ecological forecasting models is projected to decline steadily over the coming decades in response to increasing climate novelty, although models that incorporate co-occurrences among species may retain somewhat higher predictive skill. In addition to quantifying future climate novelty in the context of late Quaternary climate change, this work underscores the challenges of making reliable forecasts to an increasingly novel future, while highlighting the need to assess potential avenues for improvement, such as increased reliance on geological analogs for future novel climates and improving existing models by pooling data through time and incorporating assemblage-level information. © 2018 John Wiley & Sons Ltd.

Education for Tomorrow or Education for the Individual: What Works for the Future?

ERIC Educational Resources Information Center

Stephenson, Elspeth

2016-01-01

This theoretical paper explores current literature relative to challenges faced by early childhood teachers in relation to the increasing accountability to improve measureable literacy and numeracy skills in young children. This sits within a context which has a developing focus on preparing children for the role they will play in future society.…

Aerodynamics for Revolutionary Air Vehicles

NASA Technical Reports Server (NTRS)

Sellers, William L., III; Singer, Bart A.; Leavitt, Laurence D.

2003-01-01

Aeronautics research has seriously declined partly because of the perception that it is a mature science and only incremental improvements are possible. Recent aeronautics roadmapping activities at NASA Langley paint a different picture of the future. Breakthroughs are still felt to be possible if we expand the current design space of today's vehicles and optimize the airspace and vehicles as a system. The paper describes some of the challenges that the aircraft and airline industry face. These challenges include political, technical and environmental issues. Examples of the opportunities and technologies that could provide a different vision for the future are discussed.

Gene therapy for inherited retinal degenerations: initial successes and future challenges

NASA Astrophysics Data System (ADS)

Gupta, Priya R.; Huckfeldt, Rachel M.

2017-10-01

Inherited retinal degenerations are a clinically and genetically heterogeneous group of conditions that have historically shared an untreatable course. In recent years, however, a wide range of therapeutic strategies have demonstrated efficacy in preclinical studies and entered clinical trials with a common goal of improving visual function for patients affected with these conditions. Gene therapy offers a particularly elegant and precise opportunity to target the causative genetic mutations underlying these monogenic diseases. The present review will provide an overview of gene therapy with particular emphasis on key clinical results to date and challenges for the future.

DNA origami nanopores: developments, challenges and perspectives

NASA Astrophysics Data System (ADS)

Hernández-Ainsa, Silvia; Keyser, Ulrich F.

2014-11-01

DNA nanotechnology has enabled the construction of DNA origami nanopores; synthetic nanopores that present improved capabilities for the area of single molecule detection. Their extraordinary versatility makes them a new and powerful tool in nanobiotechnology for a wide range of important applications beyond molecular sensing. In this review, we briefly present the recent developments in this emerging field of research. We discuss the current challenges and possible solutions that would enhance the sensing capabilities of DNA origami nanopores. Finally, we anticipate novel avenues for future research and highlight a range of exciting ideas and applications that could be explored in the near future.

All That Glitters: A Glimpse into the Future of Cancer Screening

Cancer.gov

Developing new screening approaches and rigorously establishing their validity is challenging. Researchers are actively searching for new screening tests that improve the benefits of screening while limiting the harms.

Critical Assessment of Small Molecule Identification 2016: automated methods.

PubMed

Schymanski, Emma L; Ruttkies, Christoph; Krauss, Martin; Brouard, Céline; Kind, Tobias; Dührkop, Kai; Allen, Felicity; Vaniya, Arpana; Verdegem, Dries; Böcker, Sebastian; Rousu, Juho; Shen, Huibin; Tsugawa, Hiroshi; Sajed, Tanvir; Fiehn, Oliver; Ghesquière, Bart; Neumann, Steffen

2017-03-27

The fourth round of the Critical Assessment of Small Molecule Identification (CASMI) Contest ( www.casmi-contest.org ) was held in 2016, with two new categories for automated methods. This article covers the 208 challenges in Categories 2 and 3, without and with metadata, from organization, participation, results and post-contest evaluation of CASMI 2016 through to perspectives for future contests and small molecule annotation/identification. The Input Output Kernel Regression (CSI:IOKR) machine learning approach performed best in "Category 2: Best Automatic Structural Identification-In Silico Fragmentation Only", won by Team Brouard with 41% challenge wins. The winner of "Category 3: Best Automatic Structural Identification-Full Information" was Team Kind (MS-FINDER), with 76% challenge wins. The best methods were able to achieve over 30% Top 1 ranks in Category 2, with all methods ranking the correct candidate in the Top 10 in around 50% of challenges. This success rate rose to 70% Top 1 ranks in Category 3, with candidates in the Top 10 in over 80% of the challenges. The machine learning and chemistry-based approaches are shown to perform in complementary ways. The improvement in (semi-)automated fragmentation methods for small molecule identification has been substantial. The achieved high rates of correct candidates in the Top 1 and Top 10, despite large candidate numbers, open up great possibilities for high-throughput annotation of untargeted analysis for "known unknowns". As more high quality training data becomes available, the improvements in machine learning methods will likely continue, but the alternative approaches still provide valuable complementary information. Improved integration of experimental context will also improve identification success further for "real life" annotations. The true "unknown unknowns" remain to be evaluated in future CASMI contests. Graphical abstract .

Community challenges in biomedical text mining over 10 years: success, failure and the future.

PubMed

Huang, Chung-Chi; Lu, Zhiyong

2016-01-01

One effective way to improve the state of the art is through competitions. Following the success of the Critical Assessment of protein Structure Prediction (CASP) in bioinformatics research, a number of challenge evaluations have been organized by the text-mining research community to assess and advance natural language processing (NLP) research for biomedicine. In this article, we review the different community challenge evaluations held from 2002 to 2014 and their respective tasks. Furthermore, we examine these challenge tasks through their targeted problems in NLP research and biomedical applications, respectively. Next, we describe the general workflow of organizing a Biomedical NLP (BioNLP) challenge and involved stakeholders (task organizers, task data producers, task participants and end users). Finally, we summarize the impact and contributions by taking into account different BioNLP challenges as a whole, followed by a discussion of their limitations and difficulties. We conclude with future trends in BioNLP challenge evaluations. Published by Oxford University Press 2015. This work is written by US Government employees and is in the public domain in the US.

To Plan or Not to Plan, That Is the Question

ERIC Educational Resources Information Center

Dolph, David A.

2016-01-01

Strategic planning is a process utilized by numerous organizations, including K-12 school boards, intent on improvement and reform. A thoughtful strategic planning process can help develop a board's desired future driven by goals and strategies aimed at progress. However, improvement processes such as strategic planning are challenging. In fact,…

Hyper-Spectral Networking Concept of Operations and Future Air Traffic Management Simulations

NASA Technical Reports Server (NTRS)

Davis, Paul; Boisvert, Benjamin

2017-01-01

The NASA sponsored Hyper-Spectral Communications and Networking for Air Traffic Management (ATM) (HSCNA) project is conducting research to improve the operational efficiency of the future National Airspace System (NAS) through diverse and secure multi-band, multi-mode, and millimeter-wave (mmWave) wireless links. Worldwide growth of air transportation and the coming of unmanned aircraft systems (UAS) will increase air traffic density and complexity. Safe coordination of aircraft will require more capable technologies for communications, navigation, and surveillance (CNS). The HSCNA project will provide a foundation for technology and operational concepts to accommodate a significantly greater number of networked aircraft. This paper describes two of the HSCNA projects technical challenges. The first technical challenge is to develop a multi-band networking concept of operations (ConOps) for use in multiple phases of flight and all communication link types. This ConOps will integrate the advanced technologies explored by the HSCNA project and future operational concepts into a harmonized vision of future NAS communications and networking. The second technical challenge discussed is to conduct simulations of future ATM operations using multi-bandmulti-mode networking and technologies. Large-scale simulations will assess the impact, compared to todays system, of the new and integrated networks and technologies under future air traffic demand.

Open Education 2030: Planning the Future of Adult Learning in Europe

ERIC Educational Resources Information Center

Castaño Muñoz, Jonatan; Redecker, Christine; Vuorikari, Riina; Punie, Yves

2013-01-01

Adult learning and open education have become key elements on the European Agenda. This paper presents the first results of a foresight activity that aims to contribute to an understanding of how "Opening up Education" can improve adult learning in Europe in the future. It argues that to open up adult learning two main challenges must be…

Enhancing Community-Based Participatory Research Partnerships Through Appreciative Inquiry.

PubMed

Paige, Ciara; Peters, Ruth; Parkhurst, Malia; Beck, Leah Leilani; Hui, Brian; May, Vanessa Tui; Tanjasiri, Sora Park

2015-01-01

Challenges in community-based participatory research (CBPR) partnerships often pertain to trust and power, dilemmas posed by funding sources, and equitable community participation. Although challenges in CBPR can be welcomed because they present opportunities for growth and development of partnerships, tools are needed to facilitate issue identification and resolution. Moreover, such tools need to align with CBPR principles involving equal feedback among partners to improve the partnership and its outcomes. To describe how appreciative inquiry (AI) was used as an evaluation tool to contribute to the strengthening of empowerment of ongoing and future community-university relationships in CBPR collaborations. AI was applied at the end of a community-university partnership to promote breast and cervical cancer screening among Tongan women in Southern California. Through individual interviews and group discussion, tensions were identified and discussed in light of partnership and community strengths. Through AI, program staff emphasized community and university strengths of shared key values related to the program and aspects of program management that enabled them to contribute to successful program outcomes. They also discussed the following challenges: 1) approach of partners, 2) role definition, and 3) and time span of program development and implementation. Based on these discussions, recommendations were made to overcome current challenges and improve ongoing and future CBPR collaborations. The AI process helped the partners recommit to collaborate with each other, renewed their excitement about working together, and assisted with reclarification of their roles to inform future collaborations.

Enhancing Community-Based Participatory Research Partnerships Through Appreciative Inquiry

PubMed Central

Paige, Ciara; Peters, Ruth; Parkhurst, Malia; Beck, Leah Leilani; Hui, Brian; May, Vanessa Tui’one; Tanjasiri, Sora Park

2016-01-01

Background Challenges in community-based participatory research (CBPR) partnerships often pertain to trust and power, dilemmas posed by funding sources, and equitable community participation. Although challenges in CBPR can be welcomed because they present opportunities for growth and development of partnerships, tools are needed to facilitate issue identification and resolution. Moreover, such tools need to align with CBPR principles involving equal feedback among partners to improve the partnership and its outcomes. Objective To describe how appreciative inquiry (AI) was used as an evaluation tool to contribute to the strengthening of empowerment of ongoing and future community–university relationships in CBPR collaborations. Methods AI was applied at the end of a community–university partnership to promote breast and cervical cancer screening among Tongan women in Southern California. Through individual interviews and group discussion, tensions were identified and discussed in light of partnership and community strengths. Results Through AI, program staff emphasized community and university strengths of shared key values related to the program and aspects of program management that enabled them to contribute to successful program outcomes. They also discussed the following challenges: 1) approach of partners, 2) role definition, and 3) and time span of program development and implementation. Based on these discussions, recommendations were made to overcome current challenges and improve ongoing and future CBPR collaborations. Conclusions The AI process helped the partners recommit to collaborate with each other, renewed their excitement about working together, and assisted with reclarification of their roles to inform future collaborations. PMID:26548798

Bleak Present, Bright Future: Online Episodic Future Thinking, Scarcity, Delay Discounting, and Food Demand.

PubMed

Sze, Yan Yan; Stein, Jeffrey S; Bickel, Warren K; Paluch, Rocco A; Epstein, Leonard H

2017-07-01

Obesity is associated with steep discounting of the future and increased food reinforcement. Episodic future thinking (EFT), a type of prospective thinking, has been observed to reduce delay discounting (DD) and improve dietary decision making. In contrast, negative income shock (i.e., abrupt transitions to poverty) has been shown to increase discounting and may worsen dietary decision-making. Scalability of EFT training and protective effects of EFT against simulated negative income shock on DD and demand for food were assessed. In two experiments we showed online-administered EFT reliably reduced DD. Furthermore, EFT reduced DD and demand for fast foods even when challenged by negative income shock. Our findings suggest EFT is a scalable intervention that has implications for improving public health by reducing discounting of the future and demand for high energy dense food.

Earth Observing System (EOS) Aqua and Aura Space Weather Effects on Operational Collision Avoidance

NASA Technical Reports Server (NTRS)

Guit, Bill

2017-01-01

This presentation will describe recent EOS Aqua and Aura operational collision avoidance experience during periods of solar and geomagnetic storm activity. It will highlight challenges faced by the operations team during short-notice, high-risk predicted close approaches. The presentation will highlight the evolution of the operational collision avoidance process for the EOS Aqua and Aura missions. The presentation will highlight operational challenges that have occurred, process improvements that have been implemented and identify potential future challenges.

Vulnerable Population Challenges in the Transformation of Cancer Care.

PubMed

Meneses, Karen; Landier, Wendy; Dionne-Odom, J Nicholas

2016-05-01

To consider current trends and future strategies that will bring about change in cancer care delivery for vulnerable populations. Institute of Medicine reports, literature review, clinical practice observations and experiences. Vulnerable populations are older adults, both minorities and the underserved, children, and individuals at end of life. These groups pose unique challenges that require health system changes and innovative nursing models to assure access to patient-centered care in the future. In the future, attention to the needs of vulnerable populations, the growing aging cancer population and the improved outcomes in the pediatric and adolescent cancer population will all require new nursing services and models of care. System changes where nursing roles are critical to support the transition to earlier palliative care are projected. Copyright © 2016 Elsevier Inc. All rights reserved.

Air Traffic Services Performance Plan for Fiscal Years 2000-2002

DOT National Transportation Integrated Search

1999-10-01

Each year, Air Traffic Services (ATS) executives and staff assess the : organization's performance and actions taken to improve aviation services : during the previous 12 months, and evaluate the current and future challenges : facing its customers. ...

The Challenge of the Future. Future Trends in Adult and Continuing Technical and Vocational Education. An International Symposium (Berlin, Germany, October 16-20, 1995).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Hamburg (Germany). Inst. for Education.

This report on an international symposium on the strengthening of the development and improvement of vocational education begins with a description of UNEVOC, the International Project on Technical and Vocational Education. Section 2 presents discussions of the following topics: adult and continuing technical and vocational education and its…

Improving the Odds for America's Children: Future Directions in Policy and Practice

ERIC Educational Resources Information Center

McCartney, Kathleen, Ed.; Yoshikawa, Hirokazu, Ed.; Forcier, Laurie B., Ed.

2014-01-01

This landmark volume commemorates the fortieth anniversary of the Children's Defense Fund, which has been an uncompromising champion of American youth for all of those years. Yet the book looks not to the past but at our current circumstances--and at the challenges we must meet now and in the future on behalf of our young people. The book examines…

Future challenges in communication for promoting ORT--an overview.

PubMed

Dobe, M

2003-06-01

Oral rehydration therapy (ORT) is a cheap and simple intervention aimed to prevent mortality and morbidity associated with dehydration due to diarrhoea. ORT promotion strategies through programme communication, social mobilisation and social marketing, and advocacy efforts have yielded substantial improvement in the scenario. However, it has also taught us lessons and suggested changes in communication strategies to make the promotion efforts more effective in future.

Strong Performers and Successful Reformers in Education: Education Policy Advice for Greece

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2011

2011-01-01

The future of Greece's well-being will depend on improving educational performance to boost productivity and improve social outcomes. In the current economic context, with the need to get best value for spending, Greece must and can address inefficiencies in its education system. The challenges are significant. For example, Greece lags behind many…

Towards the Third Wave of School Effectiveness and Improvement in Hong Kong: Internal, Interface and Future.

ERIC Educational Resources Information Center

Cheng, Yin Cheong

This presentation reports on three waves of reform efforts for school effectiveness and improvement in Hong Kong, and analyzes related challenges and issues with the hope of drawing international implications for ongoing research and reform efforts in different parts of the world. These three waves represent paradigm shifts and different…

Identifying the challenges and facilitators of implementing a COPD care bundle.

PubMed

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges.

The EuPA Biobank Initiative: Meeting the future challenges of biobanking in proteomics & systems medicine.

PubMed

Wheelock, Åsa M; Paulson, Linda; Litton, Jan-Eric

2015-09-08

In this News & Reviews Discussion, the recently launched EuPA (European Proteomics Association) Biobank Initiative is introduced in the context of current and future challenges in biobanking. The purpose of the initiative is to provide a forumand knowledge platform for integrating the extensive experiences collected by the EuPA community, and link it to the European and international biobanking communities at large. The specific impact of providing a forum and easy access to this type of information to the EuPA community is the potential of improving the quality of future sample collections and biobanks, the quality of the research produced from these sample collections, as well as the output and productivity from existing biobanks. The underutilization of biobanks has recently been identified as an emerging issue of biobankingworldwide. Measures to improve our ability to locate and access appropriate sample collections for a wide range of research purposes may enhance both the scientific quality and biobank sustainability, thereby contributing to the important task of moving our research beyond basic findings and mere publications, into clinical practice. This manuscript is intended as a Discussion piece, and represents a recollection of the presentation under the “EuPA Initiative” session at HUPO/EuPA 2014 in Madrid. The launch of the EuPA (European Proteomics Association) Biobank Initiative in the context of current and future challenges in biobanking is discussed. The purpose of the initiative is to provide a forum and knowledge base for integrating the extensive experiences collected by the EuPA community, and link it to the European and international biobanking communities at large. The specific impact of providing a forumand easy access to this type of information to the EuPA community is the potential of improving the quality of future sample collections and biobanks, the quality of the research produced from these sample collections, aswell as the output and productivity fromexisting biobanks. The underutilization of biobanks has recently been identified as a challenge to the well-being and economic sustainability of biobanking worldwide. Measures to improve our ability to localize and access appropriate sample collections for validation studies and other research purposes is thus of benefit bothto scientific quality and biobank sustainability, thereby contributing to the important task of moving our research beyond basic findings and mere publications, into clinical practice. This article is part of a Special Issue entitled: HUPO 2014.

On the Edge: Three Years after the Report of the Commission on the Future of the North Carolina Community College System.

ERIC Educational Resources Information Center

MDC, Inc., Chapel Hill, NC.

In 1989, the Commission on the Future of the North Carolina Community College System adopted a series of recommendations to improve the operation, funding, and economic and social returns of the state's community colleges. This report looks at each of the major challenges of the Commission, reviews trends and developments that may have altered the…

Melanoma central nervous system metastases: current approaches, challenges, and opportunities

PubMed Central

Cohen, Justine V.; Tawbi, Hussain; Margolin, Kim A.; Amravadi, Ravi; Bosenberg, Marcus; Brastianos, Priscilla K.; Chiang, Veronica L.; de Groot, John; Glitza, Isabella C.; Herlyn, Meenhard; Holmen, Sheri L.; Jilaveanu, Lucia B.; Lassman, Andrew; Moschos, Stergios; Postow, Michael A.; Thomas, Reena; Tsiouris, John A.; Wen, Patrick; White, Richard M.; Turnham, Timothy; Davies, Michael A.; Kluger, Harriet M.

2017-01-01

Summary Melanoma central nervous system metastases are increasing, and the challenges presented by this patient population remain complex. In December 2015, the Melanoma Research Foundation and the Wistar Institute hosted the First Summit on Melanoma Central Nervous System (CNS) Metastases in Philadelphia, Pennsylvania. Here, we provide a review of the current status of the field of melanoma brain metastasis research; identify key challenges and opportunities for improving the outcomes in patients with melanoma brain metastases; and set a framework to optimize future research in this critical area. PMID:27615400

Advancements in the oral delivery of Docetaxel: challenges, current state-of-the-art and future trends

PubMed Central

Sohail, Muhammad Farhan; Rehman, Mubashar; Sarwar, Hafiz Shoaib; Naveed, Sara; Salman, Omer; Bukhari, Nadeem Irfan; Hussain, Irshad; Webster, Thomas J; Shahnaz, Gul

2018-01-01

The oral delivery of cancer chemotherapeutic drugs is challenging due to low bioavailability, gastrointestinal side effects, first-pass metabolism and P-glycoprotein efflux pumps. Thus, chemotherapeutic drugs, including Docetaxel, are administered via an intravenous route, which poses many disadvantages of its own. Recent advances in pharmaceutical research have focused on designing new and efficient drug delivery systems for site-specific targeting, thus leading to improved bioavailability and pharmacokinetics. A decent number of studies have been reported for the safe and effective oral delivery of Docetaxel. These nanocarriers, including liposomes, polymeric nanoparticles, metallic nanoparticles, hybrid nanoparticles, dendrimers and so on, have shown promising results in research papers and clinical trials. The present article comprehensively reviews the research efforts made so far in designing various advancements in the oral delivery of Docetaxel. Different strategies to improve oral bioavailability, prevent first-pass metabolism and inhibition of efflux pumping leading to improved pharmacokinetics and anticancer activity are discussed. The final portion of this review article presents key issues such as safety of nanomaterials, regulatory approval and future trends in nanomedicine research. PMID:29922053

Advancements in the oral delivery of Docetaxel: challenges, current state-of-the-art and future trends.

PubMed

Sohail, Muhammad Farhan; Rehman, Mubashar; Sarwar, Hafiz Shoaib; Naveed, Sara; Salman, Omer; Bukhari, Nadeem Irfan; Hussain, Irshad; Webster, Thomas J; Shahnaz, Gul

2018-01-01

The oral delivery of cancer chemotherapeutic drugs is challenging due to low bioavailability, gastrointestinal side effects, first-pass metabolism and P-glycoprotein efflux pumps. Thus, chemotherapeutic drugs, including Docetaxel, are administered via an intravenous route, which poses many disadvantages of its own. Recent advances in pharmaceutical research have focused on designing new and efficient drug delivery systems for site-specific targeting, thus leading to improved bioavailability and pharmacokinetics. A decent number of studies have been reported for the safe and effective oral delivery of Docetaxel. These nanocarriers, including liposomes, polymeric nanoparticles, metallic nanoparticles, hybrid nanoparticles, dendrimers and so on, have shown promising results in research papers and clinical trials. The present article comprehensively reviews the research efforts made so far in designing various advancements in the oral delivery of Docetaxel. Different strategies to improve oral bioavailability, prevent first-pass metabolism and inhibition of efflux pumping leading to improved pharmacokinetics and anticancer activity are discussed. The final portion of this review article presents key issues such as safety of nanomaterials, regulatory approval and future trends in nanomedicine research.

Designing PISA-Like Mathematics Tasks In Indonesia: Experiences and Challenges

NASA Astrophysics Data System (ADS)

Zulkardi, Z.; Kohar, A. W.

2018-01-01

The insignificant improvement of Indonesian students in PISA mathematics survey triggered researchers in Indonesia to develop PISA-like mathematics tasks. Some development studies have been conducted to produce valid and practical PISA-like problems that potentially effect on improving students’ mathematical literacy. This article describes the experiences of Indonesian task designers in developing PISA-like mathematics tasks as well as the potential future studies regarding to mathematical literacy as challenges for policy makers, researchers, and practitioners to improve students’ mathematical literacy in Indonesia. The results of this research indicate the task designers to consider domains of PISA like: context, mathematical content, and process as the first profiles of their missions. Our analysis shows that the designers mostly experienced difficulties regarding to the authenticity of context use and language structure. Interestingly, many of them used a variety of local wisdom in Indonesia as contexts for designing PISA-like tasks. In addition, the products developed were reported to be potentially effects on students’ interest and elicit students’ mathematical competencies as mentioned in PISA framework. Finally, this paper discusses future studies such as issues in bringing PISA task into an instructional practice.

Michigan sub-state area long range plans : final summary report

DOT National Transportation Integrated Search

1995-09-01

Extensive change will mark the future of transportation in Michigan. To meet this challenge, the Michigan Department of Transportation (M.DOT) embarked upon the creation of a statewide plan to chart improvements to the transportation system and to de...

University Continuing Education in Canada: Current Challenges and Future Opportunities.

ERIC Educational Resources Information Center

Brooke, Michael, Ed.; Waldron, Mark, Ed.

This book contains the following papers about the role and activities of Canada's universities in continuing education: "Introduction" (Brooke, Waldron); "Continuing Education and the Canadian Mosaic" (Selman); "Philosophical Issues in Continuing Education" (Selman); "Improving Support Services for Adult…

Long-Term Preservation of NASA Heliophysics Data and Access: Where We Were and Where We're Going

NASA Technical Reports Server (NTRS)

McGuire, Robert E.

2011-01-01

The importance of ensuring preservation and useful access to the unique science potential of past, present and future NASA solar and space physics (i.e. heliophysics) data has been recognized since the inception of NASA but remains challenging. In this talk, I will briefly review the history of this topic and and then discuss the present NASA model for heliophysics science data management, including key current resources for finding and using data projects like the Space Physics Data Facility. I will highlight expected future directions, building on working elements of the present program and exploiting new technology, to further improve the data environment, address existing issues and anticipate emerging challenges.

Challenges and changes: Immunization program managers share perspectives in a 2012 national survey about the US immunization system since the H1N1 pandemic response

PubMed Central

Seib, Katherine; Chamberlain, Allison; Wells, Katelyn; Curran, Eileen; Whitney, Ellen AS; Orenstein, Walter A; Hinman, Alan R; Omer, Saad B

2014-01-01

In mid-2012 we conducted survey of immunization program managers (IPMs) for the purpose of describing relationships between immunization programs and emergency preparedness programs, IPM's perceptions of challenges encountered and changes made or planned in programmatic budgeting, vaccine allocation and pandemic plans as a result of the H1N1 vaccination campaign. Over 95% of IPMs responded (61/64) to the survey. IPMs reported that a primary budget-related challenge faced during H1N1 included staff-related restrictions that limited the ability to hire extra help or pay regular staff overtime resulting in overworked regular staff. Other budget-related challenges related to operational budget shortfalls and vaccine procurement delays. IPMs described overcoming these challenges by increasing staff where possible, using executive order or other high-level support by officials to access emergency funds and make policy changes, as well as expedite hiring and spending processes according to their pandemic influenza plan or by direction from leadership. Changes planned for response to future pandemic vaccine allocation strategies were to “tailor the strategy to the event” taking into account disease virulence, vaccine production rates and public demand, having flexible vaccine allocation strategies, clarifying priority groups for vaccine receipt to providers and the public, and having targeted clinics such as through pharmacies or schools. Changes already made to pandemic plans were improving strategies for internal and external communication, improving vaccine allocation efficiency, and planning for specific scenarios. To prepare for future pandemics, programs should ensure well-defined roles, collaborating during non-emergency situations, sustaining continuity in preparedness funding, and improved technologies. PMID:25483633

Computer-aided detection system for lung cancer in computed tomography scans: Review and future prospects

PubMed Central

2014-01-01

Introduction The goal of this paper is to present a critical review of major Computer-Aided Detection systems (CADe) for lung cancer in order to identify challenges for future research. CADe systems must meet the following requirements: improve the performance of radiologists providing high sensitivity in the diagnosis, a low number of false positives (FP), have high processing speed, present high level of automation, low cost (of implementation, training, support and maintenance), the ability to detect different types and shapes of nodules, and software security assurance. Methods The relevant literature related to “CADe for lung cancer” was obtained from PubMed, IEEEXplore and Science Direct database. Articles published from 2009 to 2013, and some articles previously published, were used. A systemic analysis was made on these articles and the results were summarized. Discussion Based on literature search, it was observed that many if not all systems described in this survey have the potential to be important in clinical practice. However, no significant improvement was observed in sensitivity, number of false positives, level of automation and ability to detect different types and shapes of nodules in the studied period. Challenges were presented for future research. Conclusions Further research is needed to improve existing systems and propose new solutions. For this, we believe that collaborative efforts through the creation of open source software communities are necessary to develop a CADe system with all the requirements mentioned and with a short development cycle. In addition, future CADe systems should improve the level of automation, through integration with picture archiving and communication systems (PACS) and the electronic record of the patient, decrease the number of false positives, measure the evolution of tumors, evaluate the evolution of the oncological treatment, and its possible prognosis. PMID:24713067

Computer-aided detection system for lung cancer in computed tomography scans: review and future prospects.

PubMed

Firmino, Macedo; Morais, Antônio H; Mendoça, Roberto M; Dantas, Marcel R; Hekis, Helio R; Valentim, Ricardo

2014-04-08

The goal of this paper is to present a critical review of major Computer-Aided Detection systems (CADe) for lung cancer in order to identify challenges for future research. CADe systems must meet the following requirements: improve the performance of radiologists providing high sensitivity in the diagnosis, a low number of false positives (FP), have high processing speed, present high level of automation, low cost (of implementation, training, support and maintenance), the ability to detect different types and shapes of nodules, and software security assurance. The relevant literature related to "CADe for lung cancer" was obtained from PubMed, IEEEXplore and Science Direct database. Articles published from 2009 to 2013, and some articles previously published, were used. A systemic analysis was made on these articles and the results were summarized. Based on literature search, it was observed that many if not all systems described in this survey have the potential to be important in clinical practice. However, no significant improvement was observed in sensitivity, number of false positives, level of automation and ability to detect different types and shapes of nodules in the studied period. Challenges were presented for future research. Further research is needed to improve existing systems and propose new solutions. For this, we believe that collaborative efforts through the creation of open source software communities are necessary to develop a CADe system with all the requirements mentioned and with a short development cycle. In addition, future CADe systems should improve the level of automation, through integration with picture archiving and communication systems (PACS) and the electronic record of the patient, decrease the number of false positives, measure the evolution of tumors, evaluate the evolution of the oncological treatment, and its possible prognosis.

Multidisciplinary lung cancer meetings: improving the practice of radiation oncology and facing future challenges.

PubMed

Campbell, Belinda A; Ball, David; Mornex, Françoise

2015-02-01

Clinical guidelines widely recognize the importance of multidisciplinary meetings (MDM) in the optimal care of lung cancer patients. The published literature suggest that dedicated Lung Cancer MDM lead to increased treatment utilization rates and improved survival outcomes for patients with lung cancer. For radiation oncologists, Lung Cancer MDM have been proven to support evidence-based practice and improve the utilization of radiotherapy. Lung Cancer MDM also allow for education and promotion of specialty radiotherapy services. The fast pace of modern medicine is also presenting new challenges for the multidisciplinary lung cancer team, and technological advances are likely to lead to new changes in the structure of traditional Lung Cancer MDM. © 2015 Asian Pacific Society of Respirology.

Encouraging consumption of water in school and child care settings: access, challenges, and strategies for improvement.

PubMed

Patel, Anisha I; Hampton, Karla E

2011-08-01

Children and adolescents are not consuming enough water, instead opting for sugar-sweetened beverages (sodas, sports and energy drinks, milks, coffees, and fruit-flavored drinks with added sugars), 100% fruit juice, and other beverages. Drinking sufficient amounts of water can lead to improved weight status, reduced dental caries, and improved cognition among children and adolescents. Because children spend most of their day at school and in child care, ensuring that safe, potable drinking water is available in these settings is a fundamental public health measure. We sought to identify challenges that limit access to drinking water; opportunities, including promising practices, to increase drinking water availability and consumption; and future research, policy efforts, and funding needed in this area.

Composting technology in waste stabilization: On the methods, challenges and future prospects.

PubMed

Onwosi, Chukwudi O; Igbokwe, Victor C; Odimba, Joyce N; Eke, Ifeanyichukwu E; Nwankwoala, Mary O; Iroh, Ikemdinachi N; Ezeogu, Lewis I

2017-04-01

Composting technology has become invaluable in stabilization of municipal waste due to its environmental compatibility. In this review, different types of composting methods reportedly applied in waste management were explored. Further to that, the major factors such as temperature, pH, C/N ratio, moisture, particle size that have been considered relevant in the monitoring of the composting process were elucidated. Relevant strategies to improve and optimize process effectiveness were also addressed. However, during composting, some challenges such as leachate generation, gas emission and lack of uniformity in assessing maturity indices are imminent. Here in, these challenges were properly addressed and some strategies towards ameliorating them were proffered. Finally, we highlighted some recent technologies that could improve composting. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

None

Since its creation in 1946, Argonne National Laboratory has addressed the nation’s most pressing challenges in science, energy, the environment, and national security. United by a common goal – to improve the world – Argonne continues to drive the scientific and technological breakthroughs needed to ensure a sustainable future.

Soil agroecosystem health: current challenges and future opportunities

USDA-ARS?s Scientific Manuscript database

Soil health is a broad concept that emphasizes the ecological importance of soils, including sustained plant and animal productivity, human health, and environmental quality. In the United States, soil degradation and associated water quality problems have been widely documented. Improvement and mai...

Treading lightly on shifting ground: The direction and motivation of future geological research

USGS Publications Warehouse

Witt, A.C.

2011-01-01

The future of the geosciences and geological research will involve complex scientific challenges, primarily concerning global and regional environmental issues, in the next 20-30 years. It is quite reasonable to suspect, based on current political and socioeconomic events, that young geoscientists will be faced with and involved in helping to resolve some well defined problems: water and energy security, the effects of anthropogenic climate change, coastal sea level rise and development, and the mitigation of geohazards. It is how we choose to approach these challenges that will define our future. Interdisciplinary applied research, improved modeling and prediction augmented with faster and more sophisticated computing, and a greater role in creating and guiding public policy, will help us achieve our goals of a cleaner and safer Earth environment in the next 30 years. In the far future, even grander possibilities for eliminating the risk of certain geohazards and finding sustainable solutions to our energy needs can be envisioned. Looking deeper into the future, the possibilities for geoscience research push the limits of the imagination.

Planetary exploration with optical imaging systems review: what is the best sensor for future missions

NASA Astrophysics Data System (ADS)

Michaelis, H.; Behnke, T.; Bredthauer, R.; Holland, A.; Janesick, J.; Jaumann, R.; Keller, H. U.; Magrin, D.; Greggio, D.; Mottola, Stefano; Thomas, N.; Smith, P.

2017-11-01

When we talk about planetary exploration missions most people think spontaneously about fascinating images from other planets or close-up pictures of small planetary bodies such as asteroids and comets. Such images come in most cases from VIS/NIR- imaging- systems, simply called `cameras', which were typically built by institutes in collaboration with industry. Until now, they have nearly all been based on silicon CCD sensors, they have filter wheels and have often high power-consuming electronics. The question is, what are the challenges for future missions and what can be done to improve performance and scientific output. The exploration of Mars is ongoing. NASA and ESA are planning future missions to the outer planets like to the icy Jovian moons. Exploration of asteroids and comets are in focus of several recent and future missions. Furthermore, the detection and characterization of exo-planets will keep us busy for next generations. The paper is discussing the challenges and visions of imaging sensors for future planetary exploration missions. The focus of the talk is monolithic VIS/NIR- detectors.

Using Classroom Management to Improve Preschoolers' Social and Emotional Skills: Final Impact and Implementation Findings from the Foundations of Learning Demonstration in Newark and Chicago

ERIC Educational Resources Information Center

Morris, Pamela; Lloyd, Chrishana M.; Millenky, Megan; Leacock, Nicole; Raver, C. Cybele; Bangser, Michael

2013-01-01

Investments in early childhood programs are widely viewed as a promising strategy to improve the future educational achievement of disadvantaged young children. However, it can be difficult for teachers to maintain program quality if children in the classroom display challenging behaviors. For example, when some children act out aggressively or…

Citrus Genomics

PubMed Central

Talon, Manuel; Gmitter Jr., Fred G.

2008-01-01

Citrus is one of the most widespread fruit crops globally, with great economic and health value. It is among the most difficult plants to improve through traditional breeding approaches. Currently, there is risk of devastation by diseases threatening to limit production and future availability to the human population. As technologies rapidly advance in genomic science, they are quickly adapted to address the biological challenges of the citrus plant system and the world's industries. The historical developments of linkage mapping, markers and breeding, EST projects, physical mapping, an international citrus genome sequencing project, and critical functional analysis are described. Despite the challenges of working with citrus, there has been substantial progress. Citrus researchers engaged in international collaborations provide optimism about future productivity and contributions to the benefit of citrus industries worldwide and to the human population who can rely on future widespread availability of this health-promoting and aesthetically pleasing fruit crop. PMID:18509486

Mapping remote and multidisciplinary learning barriers: lessons from challenge-based innovation at CERN

NASA Astrophysics Data System (ADS)

Jensen, Matilde Bisballe; Utriainen, Tuuli Maria; Steinert, Martin

2018-01-01

This paper presents the experienced difficulties of students participating in the multidisciplinary, remote collaborating engineering design course challenge-based innovation at CERN. This is with the aim to identify learning barriers and improve future learning experiences. We statistically analyse the rated differences between distinct design activities, educational background and remote vs. co-located collaboration. The analysis is based on a quantitative and qualitative questionnaire (N = 37). Our analysis found significant ranking differences between remote and co-located activities. This questions whether the remote factor might be a barrier for the originally intended learning goals. Further a correlation between analytical and converging design phases was identified. Hence, future facilitators are suggested to help students in the transition from one design phase to the next rather than only teaching methods in the individual design phases. Finally, we discuss how educators address the identified learning barriers when designing future courses including multidisciplinary or remote collaboration.

Recent improvements in oily wastewater treatment: Progress, challenges, and future opportunities.

PubMed

Jamaly, Sanaa; Giwa, Adewale; Hasan, Shadi Wajih

2015-11-01

Oily wastewater poses significant threats to the soil, water, air and human beings because of the hazardous nature of its oil contents. The objective of this review paper is to highlight the current and recently developed methods for oily wastewater treatment through which contaminants such as oil, fats, grease, and inorganics can be removed for safe applications. These include electrochemical treatment, membrane filtration, biological treatment, hybrid technologies, use of biosurfactants, treatment via vacuum ultraviolet radiation, and destabilization of emulsions through the use of zeolites and other natural minerals. This review encompasses innovative and novel approaches to oily wastewater treatment and provides scientific background for future work that will be aimed at reducing the adverse impact of the discharge of oily wastewater into the environment. The current challenges affecting the optimal performance of oily wastewater treatment methods and opportunities for future research development in this field are also discussed. Copyright © 2015. Published by Elsevier B.V.

Seasonal Drought Prediction: Advances, Challenges, and Future Prospects

NASA Astrophysics Data System (ADS)

Hao, Zengchao; Singh, Vijay P.; Xia, Youlong

2018-03-01

Drought prediction is of critical importance to early warning for drought managements. This review provides a synthesis of drought prediction based on statistical, dynamical, and hybrid methods. Statistical drought prediction is achieved by modeling the relationship between drought indices of interest and a suite of potential predictors, including large-scale climate indices, local climate variables, and land initial conditions. Dynamical meteorological drought prediction relies on seasonal climate forecast from general circulation models (GCMs), which can be employed to drive hydrological models for agricultural and hydrological drought prediction with the predictability determined by both climate forcings and initial conditions. Challenges still exist in drought prediction at long lead time and under a changing environment resulting from natural and anthropogenic factors. Future research prospects to improve drought prediction include, but are not limited to, high-quality data assimilation, improved model development with key processes related to drought occurrence, optimal ensemble forecast to select or weight ensembles, and hybrid drought prediction to merge statistical and dynamical forecasts.

The Role of Latin America’s Land and Water Resources for Global Food Security: Environmental Trade-Offs of Future Food Production Pathways

PubMed Central

Flachsbarth, Insa; Willaarts, Bárbara; Xie, Hua; Pitois, Gauthier; Mueller, Nathaniel D.; Ringler, Claudia; Garrido, Alberto

2015-01-01

One of humanity’s major challenges of the 21st century will be meeting future food demands on an increasingly resource constrained-planet. Global food production will have to rise by 70 percent between 2000 and 2050 to meet effective demand which poses major challenges to food production systems. Doing so without compromising environmental integrity is an even greater challenge. This study looks at the interdependencies between land and water resources, agricultural production and environmental outcomes in Latin America and the Caribbean (LAC), an area of growing importance in international agricultural markets. Special emphasis is given to the role of LAC’s agriculture for (a) global food security and (b) environmental sustainability. We use the International Model for Policy Analysis of Agricultural Commodities and Trade (IMPACT)—a global dynamic partial equilibrium model of the agricultural sector—to run different future production scenarios, and agricultural trade regimes out to 2050, and assess changes in related environmental indicators. Results indicate that further trade liberalization is crucial for improving food security globally, but that it would also lead to more environmental pressures in some regions across Latin America. Contrasting land expansion versus more intensified agriculture shows that productivity improvements are generally superior to agricultural land expansion, from an economic and environmental point of view. Finally, our analysis shows that there are trade-offs between environmental and food security goals for all agricultural development paths. PMID:25617621

The role of Latin America's land and water resources for global food security: environmental trade-offs of future food production pathways.

PubMed

Flachsbarth, Insa; Willaarts, Bárbara; Xie, Hua; Pitois, Gauthier; Mueller, Nathaniel D; Ringler, Claudia; Garrido, Alberto

2015-01-01

One of humanity's major challenges of the 21st century will be meeting future food demands on an increasingly resource constrained-planet. Global food production will have to rise by 70 percent between 2000 and 2050 to meet effective demand which poses major challenges to food production systems. Doing so without compromising environmental integrity is an even greater challenge. This study looks at the interdependencies between land and water resources, agricultural production and environmental outcomes in Latin America and the Caribbean (LAC), an area of growing importance in international agricultural markets. Special emphasis is given to the role of LAC's agriculture for (a) global food security and (b) environmental sustainability. We use the International Model for Policy Analysis of Agricultural Commodities and Trade (IMPACT)-a global dynamic partial equilibrium model of the agricultural sector-to run different future production scenarios, and agricultural trade regimes out to 2050, and assess changes in related environmental indicators. Results indicate that further trade liberalization is crucial for improving food security globally, but that it would also lead to more environmental pressures in some regions across Latin America. Contrasting land expansion versus more intensified agriculture shows that productivity improvements are generally superior to agricultural land expansion, from an economic and environmental point of view. Finally, our analysis shows that there are trade-offs between environmental and food security goals for all agricultural development paths.

Functional flexible and wearable supercapacitors

NASA Astrophysics Data System (ADS)

Huang, Yan; Zhi, Chunyi

2017-07-01

Substantial effort has been devoted to endowing flexible and wearable supercapacitors with desirable functions and solving urgent concerns regarding their practical application, particularly materials selection, air permeability, self-healability, shape memory, integration, and modularization. This gives rise to challenges with regard to both suitable materials and device fabrication. This review highlights the current state-of-the-art of these supercapacitors pertinent to materials, fabrication strategies, and performance. Challenges and solutions are also discussed to further improve their practicality. The aim of this review is to make a timely summary of this emerging field and discuss future opportunities and challenges.

A Psychosocial Approach to Understanding Underground Spaces

PubMed Central

Lee, Eun H.; Christopoulos, George I.; Kwok, Kian W.; Roberts, Adam C.; Soh, Chee-Kiong

2017-01-01

With a growing need for usable land in urban areas, subterranean development has been gaining attention. While construction of large underground complexes is not a new concept, our understanding of various socio-cultural aspects of staying underground is still at a premature stage. With projected emergence of underground built environments, future populations may spend much more of their working, transit, and recreational time in underground spaces. Therefore, it is essential to understand the challenges and advantages that such environments have to improve the future welfare of users of underground spaces. The current paper discusses various psycho-social aspects of underground spaces, the impact they can have on the culture shared among the occupants, and possible solutions to overcome some of these challenges. PMID:28400744

Safe and Secure Virtualization: Answers for IMA next Generation and Beyond

NASA Astrophysics Data System (ADS)

Almeida, Jose; Vatrinet, Francis

2010-08-01

This paper presents some of the challenges the aerospace industry is facing for the future and explains why and how a safe and secured virtualization technology can help solving these challenges Efforts around the next generation of IMA have already started, like the European FP7 funded project SCARLETT or the IDEE5 project and many avionics players and working groupware focused on how the new technologies like SMP capabilities introduced in latest CPU architectures, can help increasing system performances in future avionics system. We present PikeOS, a separation micro-kernel, which applies the state-of-the-art techniques and widely recognized standards such as ARINC 653 and MILS in order to guarantee safety and security properties, and still improve overall performance.

A Psychosocial Approach to Understanding Underground Spaces.

PubMed

Lee, Eun H; Christopoulos, George I; Kwok, Kian W; Roberts, Adam C; Soh, Chee-Kiong

2017-01-01

With a growing need for usable land in urban areas, subterranean development has been gaining attention. While construction of large underground complexes is not a new concept, our understanding of various socio-cultural aspects of staying underground is still at a premature stage. With projected emergence of underground built environments, future populations may spend much more of their working, transit, and recreational time in underground spaces. Therefore, it is essential to understand the challenges and advantages that such environments have to improve the future welfare of users of underground spaces. The current paper discusses various psycho-social aspects of underground spaces, the impact they can have on the culture shared among the occupants, and possible solutions to overcome some of these challenges.

Identifying the challenges and facilitators of implementing a COPD care bundle

PubMed Central

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Background Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. Methods An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Results Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Conclusions Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges. PMID:25478183

Laboratory medicine: challenges and opportunities.

PubMed

Bossuyt, Xavier; Verweire, Kurt; Blanckaert, Norbert

2007-10-01

Technologic innovations have substantially improved the productivity of clinical laboratories, but the services provided by clinical laboratories are increasingly becoming commoditized. We reflect on how current developments may affect the future of laboratory medicine and how to deal with these changes. We argue that to be prepared for the future, clinical laboratories should enhance efficiency and reduce costs by forming alliances and networks; consolidating, integrating, or outsourcing; and more importantly, create additional value by providing knowledge services related to in vitro diagnostics.

Psychological Interventions for Cancer Patients to Enhance the Quality of Life.

ERIC Educational Resources Information Center

Andersen, Barbara L.

1992-01-01

Reviews experimental and quasi-experimental studies of psychological interventions designed to help individuals diagnosed with cancer reduce emotional distress, enhance coping, and improve their adjustment to the illness. Treatment components and mechanisms are discussed. Future research directions and challenges to scientific advance are…

Defense Acquisition Workforce: Actions Needed to Guide Planning Efforts and Improve Workforce Capability

DTIC Science & Technology

2015-12-01

positions. However, 6 of the 13 acquisition career fields, including 3 priority career fields—contracting, business and engineering—did not meet growth...the competency assessment process and challenges. The leaders we interviewed were from the business ; program management; contracting; engineering...Complete Assessments to Improve Future Civilian Strategic Workforce Plans, GAO-12- 1014 (Washington, D.C.: September 27, 2012). 5GAO, High-Risk Series: An

Maintenance of Certification and the Challenge of Professionalism.

PubMed

Nichols, David G

2017-05-01

Board certification has been part of the social contract in which physicians commit to maintaining up-to-date scientific knowledge and improving the quality of patient care. However, the maintenance of certification program has been controversial. This review summarizes the philosophical underpinnings, published literature, recent improvements, and future directions of the American Board of Pediatrics maintenance of certification program. Copyright © 2017 by the American Academy of Pediatrics.

Adapting the Army’s Training and Leader Development Programs for Future Challenges

DTIC Science & Technology

2013-01-01

development information from the insti- tutional domain. • Collective training support products are proposed improvements in the primary prod- ucts...not to argue for a totally centralized approach. Decentralized initiatives are ben- eficial , and training program managers and executors should continue...institution that helps improve policy and decisionmaking through research and analysis. This electronic document was made available from www.rand.org as a

Encouraging Consumption of Water in School and Child Care Settings: Access, Challenges, and Strategies for Improvement

PubMed Central

Hampton, Karla E.

2011-01-01

Children and adolescents are not consuming enough water, instead opting for sugar-sweetened beverages (sodas, sports and energy drinks, milks, coffees, and fruit-flavored drinks with added sugars), 100% fruit juice, and other beverages. Drinking sufficient amounts of water can lead to improved weight status, reduced dental caries, and improved cognition among children and adolescents. Because children spend most of their day at school and in child care, ensuring that safe, potable drinking water is available in these settings is a fundamental public health measure. We sought to identify challenges that limit access to drinking water; opportunities, including promising practices, to increase drinking water availability and consumption; and future research, policy efforts, and funding needed in this area. PMID:21680941

The challenge of education and learning in the developing world.

PubMed

Kremer, Michael; Brannen, Conner; Glennerster, Rachel

2013-04-19

Across many different contexts, randomized evaluations find that school participation is sensitive to costs: Reducing out-of-pocket costs, merit scholarships, and conditional cash transfers all increase schooling. Addressing child health and providing information on how earnings rise with education can increase schooling even more cost-effectively. However, among those in school, test scores are remarkably low and unresponsive to more-of-the-same inputs, such as hiring additional teachers, buying more textbooks, or providing flexible grants. In contrast, pedagogical reforms that match teaching to students' learning levels are highly cost effective at increasing learning, as are reforms that improve accountability and incentives, such as local hiring of teachers on short-term contracts. Technology could potentially improve pedagogy and accountability. Improving pre- and postprimary education are major future challenges.

Plant genetics, sustainable agriculture and global food security.

PubMed

Ronald, Pamela

2011-05-01

The United States and the world face serious societal challenges in the areas of food, environment, energy, and health. Historically, advances in plant genetics have provided new knowledge and technologies needed to address these challenges. Plant genetics remains a key component of global food security, peace, and prosperity for the foreseeable future. Millions of lives depend upon the extent to which crop genetic improvement can keep pace with the growing global population, changing climate, and shrinking environmental resources. While there is still much to be learned about the biology of plant-environment interactions, the fundamental technologies of plant genetic improvement, including crop genetic engineering, are in place, and are expected to play crucial roles in meeting the chronic demands of global food security. However, genetically improved seed is only part of the solution. Such seed must be integrated into ecologically based farming systems and evaluated in light of their environmental, economic, and social impacts-the three pillars of sustainable agriculture. In this review, I describe some lessons learned, over the last decade, of how genetically engineered crops have been integrated into agricultural practices around the world and discuss their current and future contribution to sustainable agricultural systems.

Priorities for children and young people - opportunities and challenges for children and young people's nurses.

PubMed

Smith, Fiona

2016-05-09

Across Europe children's nurses today face many challenges, including rising childhood obesity, the soaring incidence of issues with the mental health of children and young people, the effects of social media, child maltreatment and the impact of poverty, war and conflict on children and families. There are opportunities for children's nurses to undertake new roles and to influence both policy and practice to improve the health outcomes of children and young people, and thereby the future health of the population.

Group visits for chronic illness management: implementation challenges and recommendations.

PubMed

Jones, Katherine R; Kaewluang, Napatsawan; Lekhak, Nirmala

2014-01-01

The group visit approach to improve chronic illness self-management appears promising in terms of selected outcomes, but little information is available about best ways to organize and implement group visits. This literature review of 84 articles identified group visit implementation challenges, including lack of a group visit billing code, inadequate administrative support and resources, difficult participant recruitment and retention, and logistical issues such as space and scheduling. Recommendations for future implementation initiatives were also abstracted from the literature. Patients and providers can benefit from well-planned and well-conducted group visits. These benefits include greater patient and provider satisfaction, reduced overall utilization, improved clinical outcomes, and greater provider efficiency and productivity.

NASA Fixed Wing Project: Green Technologies for Future Aircraft Generation

NASA Technical Reports Server (NTRS)

DelRosario, Ruben

2014-01-01

The NASA Fundamental Aeronautics Fixed Wing (FW) Project addresses the comprehensive challenge of enabling revolutionary energy efficiency improvements in subsonic transport aircraft combined with dramatic reductions in harmful emissions and perceived noise to facilitate sustained growth of the air transportation system. Advances in multidisciplinary technologies and the development of unconventional aircraft systems offer the potential to achieve these improvements. The presentation will highlight the FW Project vision of revolutionary systems and technologies needed to achieve the challenging goals of aviation. Specifically, the primary focus of the FW Project is on the N+3 generation that is, vehicles that are three generations beyond the current state of the art, requiring mature technology solutions in the 2025-30 timeframe.

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

PubMed

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

Lessons learned from a practice-based, multi-site intervention study with nurse participants

PubMed Central

Friese, Christopher R.; Mendelsohn-Victor, Kari; Ginex, Pamela; McMahon, Carol M.; Fauer, Alex J.; McCullagh, Marjorie C.

2016-01-01

Purpose To identify challenges and solutions to the efficient conduct of a multi-site, practice-based randomized controlled trial to improve nurses’ adherence to personal protective equipment use in ambulatory oncology settings. Design The Drug Exposure Feedback and Education for Nurses’ Safety (DEFENS) study is a clustered, randomized, controlled trial. Participating sites are randomized to web-based feedback on hazardous drug exposures in the sites plus tailored messages to address barriers versus a control intervention of a web-based continuing education video. Approach The study principal investigator, the study coordinator, and two site leaders identified challenges to study implementation and potential solutions, plus potential methods to prevent logistical challenges in future studies. Findings Noteworthy challenges included variation in human subjects protection policies, grants and contracts budgeting, infrastructure for nursing-led research, and information technology variation. Successful strategies included scheduled web conferences, site-based study champions, site visits by the principal investigator, and centrally-based document preparation. Strategies to improve efficiency in future studies include early and continued engagement with contract personnel in sites, and proposed changes to the common rule concerning human subjects. The DEFENS study successfully recruited 393 nurses across 12 sites. To date, 369 have completed surveys and 174 nurses have viewed educational materials. Conclusions Multi-site studies of nursing personnel are rare and challenging to existing infrastructure. These barriers can be overcome with strong engagement and planning. Clinical Relevance Leadership engagement, onsite staff support, and continuous communication can facilitate successful recruitment to a workplace-based randomized, controlled behavioral trial. PMID:28098951

Distribution and the Free Enterprise System

ERIC Educational Resources Information Center

Wardlow, Erwin E.

1975-01-01

The author, president of the S. S. Kresge Company, advocates the opportunities and challenges of careers in retailing. Improving communications between the field of marketing and distributive education will be important in preparing future retailers or distribution managers for the constant change and intense competition of the business world. (EA)

Humic products in agriculture: Potential benefits and research challenges-a review

USDA-ARS?s Scientific Manuscript database

Humic products have been used in cropland agriculture for several decades, but lack of widespread credibility has restricted their use to small proportions of farmers. To improve the credibility of humic products, we identify four knowledge gaps and propose pathways of future action to close these g...

Preparation of biobased sponges from un-tanned hides

USDA-ARS?s Scientific Manuscript database

One of our research endeavors to address ongoing challenges faced by the U.S. hide and leather industries is to develop innovative uses and novel biobased products from hides to improve prospective markets and to secure a viable future for hides and leather industries. We had previously investigate...

The New Literacies of Online Reading Comprehension: Future Directions

ERIC Educational Resources Information Center

Coiro, Julie

2012-01-01

Research in four areas has the potential to dramatically improve how practitioners address the challenges of integrating digital texts and tasks into their literacy curriculum. Advances in defining and measuring key components of online reading comprehension are rapidly emerging. In addition, instructional models, such as Internet reciprocal…

The Future of Higher Education in Nigeria: Global Challenges and Opportunities

ERIC Educational Resources Information Center

Oni, Adesoji A.; Alade, Ibiwumi A.

2008-01-01

Among the numerous components of development of higher education are; growth in quantity, quality, relevance and diversity of curriculum [programme and courses]; widening of access and broadening of equity, innovation in teaching methods and techniques; improvement in the quantity and quality of research activities; more and better community…

Integrated Decision Support, Sensor Networks and Adaptive Control for Wireless Site-specific Sprinkler Irrigation

USDA-ARS?s Scientific Manuscript database

The development of site-specific sprinkler irrigation water management systems will be a major factor in future efforts to improve the various efficiencies of water-use and to support a sustainable irrigated environment. The challenge is to develop fully integrated management systems with supporting...

Integrated decision support, sensor networks and adaptive control for wireless site-specific sprinkler irrigation

USDA-ARS?s Scientific Manuscript database

The development of site-specific sprinkler irrigation water management systems will be a major factor in future efforts to improve the various efficiencies of water-use and to support a sustainable irrigated environment. The challenge is to develop fully integrated management systems with supporting...

Leadership and Futuring: Making Visions Happen

ERIC Educational Resources Information Center

Hoyle, John R.

2006-01-01

Well-educated, charismatic leaders who can improve systems to enrich the lives of others are needed today more than ever. In this updated edition, John Hoyle identifies vision, motivation, flexibility, and openness to invention and opportunity as key characteristics of effective leaders, and challenges school administrators to think outside the…

Virtual Modeling for Cities of the Future. State-Of Art and Virtual Modeling for Cities of the Future. State-Of Art AN

NASA Astrophysics Data System (ADS)

Valencia, J.; Muñoz-Nieto, A.; Rodriguez-Gonzalvez, P.

2015-02-01

3D virtual modeling, visualization, dissemination and management of urban areas is one of the most exciting challenges that must face geomatics in the coming years. This paper aims to review, compare and analyze the new technologies, policies and software tools that are in progress to manage urban 3D information. It is assumed that the third dimension increases the quality of the model provided, allowing new approaches to urban planning, conservation and management of architectural and archaeological areas. Despite the fact that displaying 3D urban environments is an issue nowadays solved, there are some challenges to be faced by geomatics in the coming future. Displaying georeferenced linked information would be considered the first challenge. Another challenge to face is to improve the technical requirements if this georeferenced information must be shown in real time. Are there available software tools ready for this challenge? Are they useful to provide services required in smart cities? Throughout this paper, many practical examples that require 3D georeferenced information and linked data will be shown. Computer advances related to 3D spatial databases and software that are being developed to convert rendering virtual environment to a new enriched environment with linked information will be also analyzed. Finally, different standards that Open Geospatial Consortium has assumed and developed regarding the three-dimensional geographic information will be reviewed. Particular emphasis will be devoted on KML, LandXML, CityGML and the new IndoorGML.

Creating the Future: A 2020 Vision and Plan for Library Service in New York State. Recommendations of the New York State Regents Advisory Council on Libraries to the New York State Board of Regents

ERIC Educational Resources Information Center

New York State Education Department, 2016

2016-01-01

In April 2010, the New York State Board of Regents challenged the library community to rethink the State's vast array of library services to ensure that they are aligned with modern expectations and the expanded functions needed in today's society, operate with improved efficiency, and are prepared for the future as an essential and vibrant part…

Remote sensing and disease control in China: past, present and future

PubMed Central

2013-01-01

Satellite measurements have distinct advantages over conventional ground measurements because they can collect the information repeatedly and automatically. Since 1970 globally and 1985 in China, the availability of remote sensing (RS) techniques has steadily grown and they are becoming increasingly important to improve our understanding of human health. This paper gives the first detailed overview on the developments of RS applications for disease control in China. The problems, challenges and future directions are also discussed with an aim of guiding prospective studies. PMID:23311958

Modeling of Photoionized Plasmas

NASA Technical Reports Server (NTRS)

Kallman, Timothy R.

2010-01-01

In this paper I review the motivation and current status of modeling of plasmas exposed to strong radiation fields, as it applies to the study of cosmic X-ray sources. This includes some of the astrophysical issues which can be addressed, the ingredients for the models, the current computational tools, the limitations imposed by currently available atomic data, and the validity of some of the standard assumptions. I will also discuss ideas for the future: challenges associated with future missions, opportunities presented by improved computers, and goals for atomic data collection.

Energy harvesting for the implantable biomedical devices: issues and challenges.

PubMed

Hannan, Mahammad A; Mutashar, Saad; Samad, Salina A; Hussain, Aini

2014-06-20

The development of implanted devices is essential because of their direct effect on the lives and safety of humanity. This paper presents the current issues and challenges related to all methods used to harvest energy for implantable biomedical devices. The advantages, disadvantages, and future trends of each method are discussed. The concept of harvesting energy from environmental sources and human body motion for implantable devices has gained a new relevance. In this review, the harvesting kinetic, electromagnetic, thermal and infrared radiant energies are discussed. Current issues and challenges related to the typical applications of these methods for energy harvesting are illustrated. Suggestions and discussion of the progress of research on implantable devices are also provided. This review is expected to increase research efforts to develop the battery-less implantable devices with reduced over hole size, low power, high efficiency, high data rate, and improved reliability and feasibility. Based on current literature, we believe that the inductive coupling link is the suitable method to be used to power the battery-less devices. Therefore, in this study, the power efficiency of the inductive coupling method is validated by MATLAB based on suggested values. By further researching and improvements, in the future the implantable and portable medical devices are expected to be free of batteries.

Energy harvesting for the implantable biomedical devices: issues and challenges

PubMed Central

2014-01-01

The development of implanted devices is essential because of their direct effect on the lives and safety of humanity. This paper presents the current issues and challenges related to all methods used to harvest energy for implantable biomedical devices. The advantages, disadvantages, and future trends of each method are discussed. The concept of harvesting energy from environmental sources and human body motion for implantable devices has gained a new relevance. In this review, the harvesting kinetic, electromagnetic, thermal and infrared radiant energies are discussed. Current issues and challenges related to the typical applications of these methods for energy harvesting are illustrated. Suggestions and discussion of the progress of research on implantable devices are also provided. This review is expected to increase research efforts to develop the battery-less implantable devices with reduced over hole size, low power, high efficiency, high data rate, and improved reliability and feasibility. Based on current literature, we believe that the inductive coupling link is the suitable method to be used to power the battery-less devices. Therefore, in this study, the power efficiency of the inductive coupling method is validated by MATLAB based on suggested values. By further researching and improvements, in the future the implantable and portable medical devices are expected to be free of batteries. PMID:24950601

Improving Scotland's health: time for a fresh approach?

PubMed

Stone, D H

2012-05-01

Scotland's health remains the worst in the UK. There are several probable reasons for this. Of those that are amenable to change, health improvement policy has been excessively preoccupied with targeting individuals perceived to be 'at risk' rather than adopting a whole population perspective. Environmental as opposed to behavioural approaches to health improvement have been relatively neglected. To meet the challenge of Scotland's poor health more effectively in the future, new strategic thinking is necessary. Three initial steps are required: recognize that current approaches are inadequate and that fresh ideas are needed; identify the principles that should underlie future strategy development; translate these principles into achievable operational objectives. Five principles of a revitalized strategy to improve the health of Scotland in the future are proposed. These are start early and sustain effort; create a healthy and safe environment; reduce geographical as well as social inequalities in health; adopt an evidence-based approach to public health interventions; use epidemiology to assess need, plan interventions and monitor progress. These principles may then be translated into achievable operational policy and practice objectives.

BRAF inhibitors: the current and the future.

PubMed

Zhang, Weijiang

2015-08-01

The introduction of BRAF inhibitors (BRAFi), vemurafenib and dabrafenib, revolutionized BRAFV600-mutated metastatic melanoma treatment with improved response rate and overall survival compared to standard chemotherapy. However, the mechanism related cutaneous toxicity remains a concern. In addition, intrinsic and acquired resistance remain the key challenges in BRAFi therapy. Extensive efforts to elucidate the mechanisms have led to an improved understanding of disease biology and resulted in exploration of multiple new therapeutic options. While the future looks bright with multiple new therapeutic strategies in exploration and possible new generations of BRAFi, there are questions remaining to be answered to enable more efficient use of BRAFi in cancer therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

2015 Summer Design Challenge: Team A&E (2241) Additively Manufactured Discriminator.

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

Miller, Sarah E.; Moore, Brandon James

Current discriminator designs are based on historical designs and traditional manufacturing methods. The goal of this project was to form non-traditional groups to create novel discriminator designs by taking advantage of additive manufacturing. These designs would expand current discriminator designs and provide insight on the applicability of additive manufacturing for future projects. Our design stretched the current abilities of additive manufacturing and noted desired improvements for the future. Through collaboration with NSC, we noted several additional technologies which work well with additive manufacturing such as topology optimization and CT scanning and determined how these technologies could be improved to bettermore » combine with additive manufacturing.« less

Michigan's Education Achievement Authority and the Future of Public Education in Detroit: The Challenge of Aligning Policy Design and Policy Goals. Working Paper #43

ERIC Educational Resources Information Center

Mason, Mary L.; Arsen, David

2014-01-01

As the City of Detroit emerges from municipal bankruptcy, the imperative for school improvement takes on an urgency rarely witnessed in a U.S. city. If the city is to experience the redevelopment boom that many now anticipate, its public schools must improve. While a variety of different reform strategies are possible, the establishment of a…

Challenges and perspectives for improved management of HIV/Mycobacterium tuberculosis co-infection.

PubMed

Sester, M; Giehl, C; McNerney, R; Kampmann, B; Walzl, G; Cuchí, P; Wingfield, C; Lange, C; Migliori, G B; Kritski, A L; Meyerhans, A

2010-12-01

HIV and Mycobacterium tuberculosis (MTB) are two widespread and highly successful microbes whose synergy in pathogenesis has created a significant threat for human health globally. In acknowledgement of this fact, the European Union (EU) has funded a multinational support action, the European Network for global cooperation in the field of AIDS and TB (EUCO-Net), that brings together experts from Europe and those regions that bear the highest burden of HIV/MTB co-infection. Here, we summarise the main outcome of the EUCO-Net project derived from an expert group meeting that took place in Stellenbosch (South Africa) (AIDS/TB Workshop on Research Challenges and Opportunities for Future Collaboration) and the subsequent discussions, and propose priority areas for research and concerted actions that will have impact on future EU calls.

Team-Based Care with Pharmacists to Improve Blood Pressure: a Review of Recent Literature.

PubMed

Kennelty, Korey A; Polgreen, Linnea A; Carter, Barry L

2018-01-18

We review studies published since 2014 that examined team-based care strategies and involved pharmacists to improve blood pressure (BP). We then discuss opportunities and challenges to sustainment of team-based care models in primary care clinics. Multiple studies presented in this review have demonstrated that team-based care including pharmacists can improve BP management. Studies highlighted the cost-effectiveness of a team-based pharmacy intervention for BP control in primary care clinics. Little information was found on factors influencing sustainability of team-based care interventions to improve BP control. Future work is needed to determine the best populations to target with team-based BP programs and how to implement team-based approaches utilizing pharmacists in diverse clinical settings. Future studies need to not only identify unmet clinical needs but also address reimbursement issues and stakeholder engagement that may impact sustainment of team-based care interventions.

Fifteen years of quantitative trait loci studies in fish: challenges and future directions.

PubMed

Ashton, David T; Ritchie, Peter A; Wellenreuther, Maren

2017-03-01

Understanding the genetic basis of phenotypic variation is a major challenge in biology. Here, we systematically evaluate 146 quantitative trait loci (QTL) studies on teleost fish over the last 15 years to investigate (i) temporal trends and (ii) factors affecting QTL detection and fine-mapping. The number of fish QTL studies per year increased over the review period and identified a cumulative number of 3632 putative QTLs. Most studies used linkage-based mapping approaches and were conducted on nonmodel species with limited genomic resources. A gradual and moderate increase in the size of the mapping population and a sharp increase in marker density from 2011 onwards were observed; however, the number of QTLs and variance explained by QTLs changed only minimally over the review period. Based on these findings, we discuss the causative factors and outline how larger sample sizes, phenomics, comparative genomics, epigenetics and software development could improve both the quantity and quality of QTLs in future genotype-phenotype studies. Given that the technical limitations on DNA sequencing have mostly been overcome in recent years, a renewed focus on these and other study design factors will likely lead to significant improvements in QTL studies in the future. © 2016 John Wiley & Sons Ltd.

Symposium: Animal welfare challenges for today and tomorrow.

PubMed

Vizzier Thaxton, Yvonne; Christensen, Karen D; Mench, Joy A; Rumley, Elizabeth R; Daugherty, Christine; Feinberg, Bruce; Parker, Molly; Siegel, Paul; Scanes, Colin G

2016-09-01

The increasing separation of the public from production agriculture means there is often a lack of knowledge among consumers about current production practices and a perception that increased productivity and economic efficiency are necessarily associated with a decline in animal welfare. A symposium was organized to present information about animal welfare issues and the challenges they pose for both scientists and the poultry and allied industries. Companion papers provide information about understanding public attitudes and physiological/immunological approaches to welfare assessment, while this paper outlines current and future challenges to egg and meat production and industry responses to those challenges. For broiler chickens, increases in growth rate result in corollary increases in metabolic heat generation and water consumption, leading to the need for continuing improvements in housing, ventilation, and litter management. Stocking densities, lighting programs, muscle myopathies, and use of antibiotics are also areas that require research attention. In the layer industry, the key challenge is housing, with the industry undergoing a shift from conventional cage housing to alternatives like enriched colonies or cage-free. While these alternative systems have hen welfare advantages, there are also welfare disadvantages that require the development of mitigation strategies, and it is also essential to address associated issues including economic, environmental, egg safety, and worker health impacts. Concerns on the horizon include euthanasia of surplus male chicks and spent hens as well as beak-trimming. The humaneness of slaughter methods is an important welfare and consumer confidence issue, and the current regulations for poultry slaughter in the USA are discussed and compared to those for livestock. The poultry and allied industries, including retailers, are responding to these concerns by consulting with experts, developing science-based animal care standards and auditing programs, strengthening training and oversight programs, promoting research, and improving communication channels. In future, intensifying multi-disciplinary research efforts and developing mechanisms to improve communication between scientists and stakeholders, including the public, will be critical to addressing these issues. © 2016 Poultry Science Association Inc.

Challenges faced in long term ventricular assist device support.

PubMed

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

2016-08-01

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

Political economy challenges in nutrition.

PubMed

Balarajan, Yarlini; Reich, Michael R

2016-11-05

Historically, implementing nutrition policy has confronted persistent obstacles, with many of these obstacles arising from political economy sources. While there has been increased global policy attention to improving nutrition in recent years, the difficulty of translating this policy momentum into results remains. We present key political economy themes emanating from the political economy of nutrition literature. Together, these interrelated themes create a complex web of obstacles to moving nutrition policy forward. From these themes, we frame six political economy challenges facing the implementation of nutrition policy today. Building awareness of the broader political and economic issues that shape nutrition actions and adopting a more systematic approach to political economy analysis may help to mitigate these challenges. Improving nutrition will require managing the political economy challenges that persist in the nutrition field at global, national and subnational levels. We argue that a "mindshift" is required to build greater awareness of the broader political economy factors shaping the global nutrition landscape; and to embed systematic political economy analysis into the work of stakeholders navigating this field. This mindshift may help to improve the political feasibility of efforts to reform nutrition policy and implementation-and ensure that historical legacies do not continue to shape the future.

[Long-term care in Europe. Challenges and strategies in nursing staff management].

PubMed

Kuhlmann, E; Larsen, C

2013-08-01

Across Europe, long-term care (LTC) is one of the most challenging areas of social policy. Despite a growing awareness of the problems and improved data, current institutional reforms are an ineffective response to demographic change. This article aims to provide an overview of the challenges of future nursing and care staff in LTC in Europe, and to discuss the German case in a wider European context. We focus on the nursing workforce and on the link between current and prospective analyses on the demand and offer of LTC services and LTC professionals/nursing staff. We draw on a secondary analysis of the literature and public statistics, especially OECD data. The European comparison shows a high variation in the future demand for LTC. In Germany, a number of problematic trends create a negative scenario: the growing demand for LTC meets with a decrease in nursing staff on the supply side. We conclude by suggesting intervention strategies that may reduce this negative scenario.

Understanding Suicide Risk within the Research Domain Criteria (RDoC) Framework: Insights, Challenges, and Future Research Considerations

PubMed Central

Glenn, Catherine R.; Cha, Christine B.; Kleiman, Evan M.; Nock, Matthew K.

2016-01-01

Suicide is a leading cause of death worldwide. Prior research has focused primarily on sociodemographic and psychiatric risk factors with little improvement in the prediction or prevention of suicidal behavior over time. The Research Domain Criteria (RDoC) may be an especially useful framework for advancing research in this area. This paper provides a brief and broad overview of research on suicidal behavior relating to each of the RDoC domains—highlighting the RDoC construct(s) where research has focused, construct(s) where research is lacking, and suggestions for future research directions. We also discuss major challenges for suicide research within the RDoC framework, including the intersection of RDoC domains, interaction of domains with the environment, incorporation of developmental stage, integration of distal and proximal processes, and inclusion of suicide-specific constructs. We conclude by underscoring important considerations for future research aimed at using the RDoC framework to study suicidal behavior and other forms of psychopathology. PMID:28670505

Better futures: a randomized field test of a model for supporting young people in foster care with mental health challenges to participate in higher education.

PubMed

Geenen, Sarah; Powers, Laurie E; Phillips, Lee Ann; Nelson, May; McKenna, Jessica; Winges-Yanez, Nichole; Blanchette, Linda; Croskey, Adrienne; Dalton, Lawrence D; Salazar, Amy; Swank, Paul

2015-04-01

The purpose of the study was to conduct a preliminary efficacy evaluation of the Better Futures model, which is focused on improving the postsecondary preparation and participation of youth in foster care with mental health challenges. Sixty-seven youth were randomized to either a control group that received typical services or an intervention group, which involved participation in a Summer Institute, individual peer coaching, and mentoring workshops. Findings indicate significant gains for the intervention group on measures of postsecondary participation, postsecondary and transition preparation, hope, self-determination, and mental health empowerment, as compared to the control group. Youth in the intervention group also showed positive trends in the areas of mental health recovery, quality of life, and high school completion. Implications for future research and practice are discussed, while emphasizing the capacities of youth in foster care with mental health conditions to successfully prepare for and participate fully in high education.

[Quality improvement potential in the pharmaceutical industry].

PubMed

Nusser, Michael

2007-01-01

The performance of the German pharmaceutical industry, future challenges and obstacles to quality improvement are assessed from a systems-of-innovation perspective, using appropriate innovation indicators. The current close-to-market performance indicators paint an unfavourable picture. Early R&D indicators (e.g., publications, patents), however, reveal a positive trend. A lot of obstacles to quality improvements are identified with respect to knowledge base, knowledge/technology transfer, industrial R&D processes, capital markets, market attractiveness and both regulatory and political framework conditions. On this basis, recommendations will finally be derived to improve quality in the pharmaceutical industry.

Design or "Design"--Envisioning a Future Design Education

ERIC Educational Resources Information Center

Sless, David

2012-01-01

Challenging the common grand vision of Design, this article considers "design" as a humble re-forming process based on evidence to substantiate its results. The designer is likened to a tinker who respects previous iterations of a design and seeks to retain what is useful while improving its performance. A design process is offered,…

Software Carpentry: lessons learned

PubMed Central

Wilson, Greg

2016-01-01

Since its start in 1998, Software Carpentry has evolved from a week-long training course at the US national laboratories into a worldwide volunteer effort to improve researchers' computing skills. This paper explains what we have learned along the way, the challenges we now face, and our plans for the future. PMID:24715981

Evidence-Based Practice in the United States: Challenges, Progress, and Future Directions

PubMed Central

Correa-de-Araujo, Rosaly

2016-01-01

Scientific literature demonstrates that advances in evidence-based nursing have improved systems of care and women’s health outcomes. Experts agree that nurses worldwide can play a key role in building such evidence and working with interdisciplinary health care teams and systems to accelerate its implementation. PMID:26473771

Distance-Learning for Advanced Military Education: Using Wargame Simulation Course as an Example

ERIC Educational Resources Information Center

Keh, Huan-Chao; Wang, Kuei-Min; Wai, Shu-Shen; Huang, Jiung-yao; Hui, Lin; Wu, Ji-Jen

2008-01-01

Distance learning in advanced military education can assist officers around the world to become more skilled and qualified for future challenges. Through well-chosen technology, the efficiency of distance-learning can be improved significantly. In this paper we present the architecture of Advanced Military Education-Distance Learning (AME-DL)…

Equal Opportunity in Higher Education: The Past and Future of California's Proposition 209

ERIC Educational Resources Information Center

Grodsky, Eric, Ed.; Kurlaender, Michal, Ed.

2010-01-01

This timely book examines issues pertaining to equal opportunity--affirmative action, challenges to it, and alternatives for improving opportunities for underrepresented groups--in higher education today. Its starting point is California's Proposition 209, which ended race-based affirmative action in public education and the workplace in 1996. The…

Ready, Steady, Go! Strategies to Improve Texans' Financial Readiness to Pay for College

ERIC Educational Resources Information Center

Helmcamp, Leslie

2011-01-01

Texas faces numerous challenges, but also abundant opportunities to build the middle class and increase prosperity. Unfortunately, too many Texans are sidelined, lacking access to opportunities to learn, earn, and save to secure a prosperous future for themselves and their families. A college education provides opportunities for Texans to obtain…

Ahead of the Curve: State Success in the Developmental Education Initiative

ERIC Educational Resources Information Center

Altstadt, David

2012-01-01

Building on their work through Achieving the Dream, six states and 15 community colleges joined the Developmental Education Initiative (DEI) in 2009 to take on one of higher education's most daunting challenges: improving the success of students who enter community college academically underprepared. The states and Jobs for the Future, which…

Teacher-to-Parent Communication Techniques after a One-Hour Training Session: An Action Science Project

ERIC Educational Resources Information Center

Whichard-Bond, LaTisha Tawanda

2013-01-01

The commitment to improve the education of all students has become a national priority. Preparing students for the challenges of the future, however, is not the responsibility of schools alone (N. Carey, L. Lewis, & E. Farris, "Parent Involvement in Children's Education: Efforts by Public Elementary School," 1998). Schools…

Using Education to Bring Climate Change Adaptation to Pacific Communities

ERIC Educational Resources Information Center

Vize, Sue

2012-01-01

Traditional communities remain a dominant feature in the Pacific and are key players in land and sea management. Fostering improved climate literacy is therefore essential to equip communities to respond to the current and future challenges posed by climate change in the region. Increased understanding and development of skills to respond to the…

Public Funding of Primary Education in Kenya: Recent Tends, Challenges, and Implications for the Future.

ERIC Educational Resources Information Center

Mukudi, Edith

1999-01-01

Kenyan primary education is plagued by problems of high attrition and gender and regional disparities in access and achievement. Poverty, institutionalized corruption, and declining public funding are primary factors. More funding is needed for teacher salaries, infrastructure development, and improved educational access. (Contains 23 references.)…

Complete to Compete: Common College Completion Metrics. Technical Guide

ERIC Educational Resources Information Center

Reyna, Ryan; Reindl, Travis; Witham, Keith; Stanley, Jeff

2010-01-01

Improved college completion rates are critical to the future of the United States, and states must have better data to understand the nature of the challenges they confront or target areas for policy change. The 2010-2011 National Governors Association (NGA) Chair's initiative, "Complete to Compete", recommends that all states collect data from…

State-of-the-art developments in the field of electroactive polymers

NASA Technical Reports Server (NTRS)

Vinogradov, Aleksandra; Su, Ji; Jenkins, Christopher; Bar-Cohen, Yoseph

2005-01-01

The paper presents a brief review in the field of electroactive polymers. it outlines the main classes of electroactive polymers, their properties and applications. Current efforts to synthesize electroactive polymers with novel or improved characteristics along with the challenges, opportunities and future research directions in the subject area are discussed.

The physical properties, morphology and viscoelasticity of biobased sponges prepared from un-tanned hides

USDA-ARS?s Scientific Manuscript database

One of our research endeavors to address ongoing challenges faced by the U.S. hide and leather industries is to develop innovative uses and novel biobased products from hides to improve prospective markets and to secure a viable future for hides and leather industries. We had previously investigate...

The Future of Marketing Education: A Practitioner's Perspective

ERIC Educational Resources Information Center

Finch, David; Nadeau, John; O'Reilly, Norm

2013-01-01

Drawing on the marketing literature, as well as the views of both marketing educators and current marketers in Canada, a survey was conducted of marketing practitioners to determine their top priorities for improvement in marketing education, as well as the key challenges in need of attention. An importance-performance analysis was carried out on…

The Baccalaureate in the California Community College: Current Challenges & Future Prospects

ERIC Educational Resources Information Center

Gándara, Patricia; Cuellar, Marcela

2016-01-01

Concerns over the United States' global standing have spurred a national focus on improving postsecondary attainment. At the same time, many sectors of the economy find they have difficulty recruiting highly trained individuals to fill the good jobs that exist; jobs like nursing, respiratory care, dental hygiene, and various mid-level management…

Is Personalized Learning the Future of School?

ERIC Educational Resources Information Center

Paz-Albo, Jesús

2017-01-01

This article describes an innovative teaching approach that can offer the changes needed for school improvement. When entering an Education: Basic and Interactive (EBI) classroom, one will see students focused on accomplishing self-guided tasks and eager to move on to the next challenge in their self-paced learning. The EBI Project described here…

Investing in the Future: Automation Marketplace 2009

ERIC Educational Resources Information Center

Breeding, Marshall

2009-01-01

In a year where the general economy presented enormous challenges, libraries continued to make investments in automation, especially in products that help improve what and how they deliver to their end users. Access to electronic content remains a key driver. In response to anticipated needs for new approaches to library automation, many companies…

Prevention of Teacher Burnout: The Challenge of the Future.

ERIC Educational Resources Information Center

Matthews, Doris B.; And Others

Strategies that may be used by schools to prevent teacher burnout suggested in this paper are: (1) increasing staff input in decision making; (2) improving the work environment; (3) increasing the flexibility of the school structure; (4) providing opportunities for individual time-out; (5) increasing the sense of individual work significance; and…

Recommended Research Directions for Improving the Validation of Complex Systems Models.

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

Vugrin, Eric D.; Trucano, Timothy G.; Swiler, Laura Painton

Improved validation for models of complex systems has been a primary focus over the past year for the Resilience in Complex Systems Research Challenge. This document describes a set of research directions that are the result of distilling those ideas into three categories of research -- epistemic uncertainty, strong tests, and value of information. The content of this document can be used to transmit valuable information to future research activities, update the Resilience in Complex Systems Research Challenge's roadmap, inform the upcoming FY18 Laboratory Directed Research and Development (LDRD) call and research proposals, and facilitate collaborations between Sandia and externalmore » organizations. The recommended research directions can provide topics for collaborative research, development of proposals, workshops, and other opportunities.« less

Ideas for Future GPS Timing Improvements

NASA Technical Reports Server (NTRS)

Hutsell, Steven T.

1996-01-01

Having recently met stringent criteria for full operational capability (FOC) certification, the Global Positioning System (GPS) now has higher customer expectations than ever before. In order to maintain customer satisfaction, and the meet the even high customer demands of the future, the GPS Master Control Station (MCS) must play a critical role in the process of carefully refining the performance and integrity of the GPS constellation, particularly in the area of timing. This paper will present an operational perspective on several ideas for improving timing in GPS. These ideas include the desire for improving MCS - US Naval Observatory (USNO) data connectivity, an improved GPS-Coordinated Universal Time (UTC) prediction algorithm, a more robust Kalman Filter, and more features in the GPS reference time algorithm (the GPS composite clock), including frequency step resolution, a more explicit use of the basic time scale equation, and dynamic clock weighting. Current MCS software meets the exceptional challenge of managing an extremely complex constellation of 24 navigation satellites. The GPS community will, however, always seek to improve upon this performance and integrity.

Improvement of industrially important microbial strains by genome shuffling: Current status and future prospects.

PubMed

Magocha, Tinashe Archbold; Zabed, H; Yang, Miaomiao; Yun, Junhua; Zhang, Huanhuan; Qi, Xianghui

2018-06-01

The growing demand for biotechnological products against limited metabolic capacity of industrially used microorganisms has led to an increased interest on strain-improvement over the last several decades, which aimed to enhance metabolite yield, substrate uptake and tolerance of the strains. Among a few techniques of strain-improvement, genome shuffling is the most recent and promising approach used for rapid strain-improvement that can yield a new strain by combining whole genomes of multi-parental microorganisms using the principles of protoplast fusion. Genome shuffling has brought a major breakthrough in the strain-improvement concept as it is found to be effective and reliable for expressing complex phenotypes. This review will discuss the technical aspects and applications of genome shuffling for various industrial strains to present its current status and recent progress. In the concluding remarks, a summary will be presented focusing on the major challenges and future outlooks of this technology. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adapted recreational and sports programs for children with disabilities: A decade of experience.

PubMed

Moberg-Wolff, Elizabeth; Kiesling, Sarah

2008-01-01

To identify and describe community based adapted sports and recreational programs (SARPs) for children with physically disabilities, documenting program types, benefits, challenges, growth and/or decline, and lessons they have learned over a 10-year period. In 1996, a total of 277 children's hospitals and freestanding rehabilitation hospitals stating that they provided pediatric rehabilitation services were contacted and asked to provide information regarding adapted recreational and sports programs in their region. Seventy-nine SARPs were identified, contacted, and survyed about programming, benefits and challenges they faced. They were then re-surveyed in 2006 for comparison data. Ten years ago, the average SARP served 25 or fewer clients and was led by a therapeutic recreation specialist with assistance from volunteers. Most programs had been in place for 5 years or more, met weekly for 2-3 hours, and were recreational in orientation. Activities varied, with basketball, aquatics, horseback riding and snow skiing being most common. Fund-raisers and grants supported most programs, and securing funding was their greatest challenge. Participant benefits noted by programs included improved socialization, enhanced physical fitness, increased self esteem, improved therapeutic skills (ADL's, transfers, etc.), enhanced cognition, expanded client independence, improved community relations, and enhanced leisure skills. Ten years later, the majority of SARPs noted similar benefits, and reported an increase in number of participants despite continued challenges with funding and staffing. Leadership and mentorship by those with disabilities was still very low, but community awareness of the abilities of those with disabilities had increased. Adapted sports and recreation programs surveyed in 1996 and again in 2006, report overall that their health is good, and many have retained the same programming, financial support mechanisms, leadership and participant mix over the years. Many have increased athlete participation despite financial challenges being a predominant concern. They report that their staying power is dependent on many factors, including leadership, participant referrals, an ample supply of volunteers, and consistent community and financial support. They feel that their success is important to the physical and psychological well-being of individuals with disabilities and that an increased focus on corporate sponsorship, participation and mentorship by those with disabilities may assist with future growth. Increased school involvement, development of more competitive vs. recreational programs, and improved research documenting the physical and psychological benefits of adapted sports programs were also recommended to improve future SARP stability.

Bordetella pertussis pathogenesis: current and future challenges.

PubMed

Melvin, Jeffrey A; Scheller, Erich V; Miller, Jeff F; Cotter, Peggy A

2014-04-01

Pertussis, also known as whooping cough, has recently re-emerged as a major public health threat despite high levels of vaccination against the aetiological agent Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into B. pertussis virulence-factor function. We also discuss the changing epidemiology of pertussis and the challenges facing vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies.

Bordetella pertussis pathogenesis: current and future challenges

PubMed Central

Melvin, Jeffrey A.; Scheller, Erich V.; Miller, Jeff F.; Cotter, Peggy A.

2014-01-01

Pertussis, or whooping cough, has recently reemerged as a major public health threat despite high levels of vaccination against the etiological agent, Bordetella pertussis. In this Review, we describe the pathogenesis of this disease, with a focus on recent mechanistic insights into virulence factor function. We also discuss the changing epidemiology of pertussis and the challenges of vaccine development. Despite decades of research, many aspects of B. pertussis physiology and pathogenesis remain poorly understood. We highlight knowledge gaps that must be addressed to develop improved vaccines and therapeutic strategies. PMID:24608338

Computing in high-energy physics

DOE PAGES

Mount, Richard P.

2016-05-31

I present a very personalized journey through more than three decades of computing for experimental high-energy physics, pointing out the enduring lessons that I learned. This is followed by a vision of how the computing environment will evolve in the coming ten years and the technical challenges that this will bring. I then address the scale and cost of high-energy physics software and examine the many current and future challenges, particularly those of management, funding and software-lifecycle management. Lastly, I describe recent developments aimed at improving the overall coherence of high-energy physics software.

New paradigms and future challenges in Radiation Oncology: An Update of Biological Targets and Technology*

PubMed Central

Liauw, Stanley L.; Connell, Philip P.; Weichselbaum, Ralph R.

2013-01-01

The primary objective of radiation oncology is to exploit the biological interaction of radiation within tissue to promote tumor death while minimizing damage to surrounding normal tissue. The clinical delivery of radiation relies on principles of radiation physics that define how radiation energy is deposited in the body, as well as technology that facilitates accurate tumor targeting. This review will summarize the current landscape of recent biological and technological advances in radiation oncology, describe the challenges that exist, and offer potential avenues for improvement. PMID:23427246

Computing in high-energy physics

NASA Astrophysics Data System (ADS)

Mount, Richard P.

2016-04-01

I present a very personalized journey through more than three decades of computing for experimental high-energy physics, pointing out the enduring lessons that I learned. This is followed by a vision of how the computing environment will evolve in the coming ten years and the technical challenges that this will bring. I then address the scale and cost of high-energy physics software and examine the many current and future challenges, particularly those of management, funding and software-lifecycle management. Finally, I describe recent developments aimed at improving the overall coherence of high-energy physics software.

Computing in high-energy physics

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

Mount, Richard P.

I present a very personalized journey through more than three decades of computing for experimental high-energy physics, pointing out the enduring lessons that I learned. This is followed by a vision of how the computing environment will evolve in the coming ten years and the technical challenges that this will bring. I then address the scale and cost of high-energy physics software and examine the many current and future challenges, particularly those of management, funding and software-lifecycle management. Lastly, I describe recent developments aimed at improving the overall coherence of high-energy physics software.

Learning from the Past, Looking to the Future: Modeling Social Unrest in Karachi, Pakistan

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

Olson, Jarrod; Kurzrok, Andrew J.; Hund, Gretchen

Social unrest represents a major challenge for policy makers around the globe, as it can quickly escalate from small scale disturbances to highly public protests, riots and even civil war. This research was motivated by a need to understand social instability and to unpack the comments made during a spring 2013 conference hosted by Pacific Northwest National Laboratory’s Center for Global Security and the U.S. Institute for Peace, where policymakers noted that models considering social instability are often not suitable for decision-making. This analysis shows that existing state level models of instability could be improved in spatial scale to themore » city level, even without significantly improved data access. Better data would make this analysis more complete and likely improve the quality of the model. Another challenge with incorporating modeling into decision-making is the need to understand uncertainty in a model. Policy makers are frequently tasked with making decisions without a clear outcome, so characterization of uncertainty is critical. This report describes the work and findings of the project. It took place in three phases: a literature review of social stability research, a “hindsight scan” that looked at historical data, and a “foresight scan” looking at future scenarios.« less

Improving early cycle economic evaluation of diagnostic technologies.

PubMed

Steuten, Lotte M G; Ramsey, Scott D

2014-08-01

The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increase the return on investment as well as patient and societal impact. This paper describes examples of 'early cycle economic evaluations' as applied to diagnostic technologies and highlights challenges in its real-time application. It shows that especially in the field of diagnostics, with rapid technological developments and a changing regulatory climate, early cycle economic evaluation can have a guiding role to improve the efficiency of the diagnostics innovation process. In the next five years the attention will move beyond the methodological and analytic challenges of early cycle economic evaluation towards the challenge of effectively applying it to improve diagnostic research and development and patient value. Future work in this area should therefore be 'strong on principles and soft on metrics', that is, the metrics that resonate most clearly with the various decision makers in this field.

[Pneumonia -- historical development, current status, future prospects].

PubMed

Welte, T

2010-09-01

Pneumonia is one of the oldest and best known diseases in mankind. Morbidity and mortality of this disease are remarkable. This has not been changed with the development of modern antibiotic therapy. On the contrary new challenges have arisen, more elderly and comorbid patients are involved and an increase in antibiotic resistance has appeared. An improvement in diagnosis and the introduction of risk stratification approaches has led to a standardisation in therapy. Vaccination strategies for special pathogens like S. PNEUMONIAE have reduced the burden of disease. For decades research was focused on the development of new antibiotics. The failure of this strategy has directed more attention to the host-pathogen interaction. Modulation of innate immunity is one of the key issues to overcome the future challenges in this field. Copyright Georg Thieme Verlag KG Stuttgart . New York.

Future Perfect? The Future of the Social Sciences in Public Health

PubMed Central

Shelton, Rachel C.; Hatzenbuehler, Mark L.; Bayer, Ronald; Metsch, Lisa R.

2018-01-01

This is a critical and perhaps unprecedented time for the social sciences in public health. While there are many opportunities for the social sciences to continue making transformative contributions to improve population health, there are significant challenges in doing so, particularly in a rapidly changing political landscape. Such challenges are both external (e.g., congressional calls for reducing social science funding) and internal (e.g., scholars criticizing the social sciences for being stagnant and siloed). This paper highlights four key tensions that the field is grappling with and that have direct implications for how to train the next generation of social scientists in public health. We also discuss how departmental and institutional decisions made in response to these tensions will determine how the social sciences in public health are ultimately recognized, sustained, and advanced. PMID:29376047

Future Perfect? The Future of the Social Sciences in Public Health.

PubMed

Shelton, Rachel C; Hatzenbuehler, Mark L; Bayer, Ronald; Metsch, Lisa R

2017-01-01

This is a critical and perhaps unprecedented time for the social sciences in public health. While there are many opportunities for the social sciences to continue making transformative contributions to improve population health, there are significant challenges in doing so, particularly in a rapidly changing political landscape. Such challenges are both external (e.g., congressional calls for reducing social science funding) and internal (e.g., scholars criticizing the social sciences for being stagnant and siloed). This paper highlights four key tensions that the field is grappling with and that have direct implications for how to train the next generation of social scientists in public health. We also discuss how departmental and institutional decisions made in response to these tensions will determine how the social sciences in public health are ultimately recognized, sustained, and advanced.

Accelerating the Translation of Nanomaterials in Biomedicine

PubMed Central

Mitragotri, Samir; Anderson, Daniel G.; Chen, Xiaoyuan; Chow, Edward K.; Ho, Dean; Kabanov, Alexander V.; Karp, Jeffrey M.; Kataoka, Kazunori; Mirkin, Chad A.; Petrosko, Sarah Hurst; Shi, Jinjun; Stevens, Molly M.; Sun, Shouheng; Teoh, Sweehin; Venkatraman, Subbu S.; Xia, Younan; Wang, Shutao; Gu, Zhen; Xu, Chenjie

2017-01-01

Due to their size and tailorable physicochemical properties, nanomaterials are an emerging class of structures utilized in biomedical applications. There are now many prominent examples of nanomaterials being used to improve human health, in areas ranging from imaging and diagnostics to therapeutics and regenerative medicine. An overview of these examples reveals several common areas of synergy and future challenges. This Nano Focus discusses the current status and future potential of promising nanomaterials and their translation from the laboratory to the clinic, by highlighting a handful of successful examples. PMID:26115196

Psychiatric epidemiology: selected recent advances and future directions.

PubMed Central

Kessler, R. C.

2000-01-01

Reviewed in this article are selected recent advances and future challenges for psychiatric epidemiology. Major advances in descriptive psychiatric epidemiology in recent years include the development of reliable and valid fully structured diagnostic interviews, the implementation of parallel cross-national surveys of the prevalences and correlates of mental disorders, and the initiation of research in clinical epidemiology. Remaining challenges include the refinement of diagnostic categories and criteria, recognition and evaluation of systematic underreporting bias in surveys of mental disorders, creation and use of accurate assessment tools for studying disorders of children, adolescents, the elderly, and people in less developed countries, and setting up systems to carry out small area estimations for needs assessment and programme planning. Advances in analytical and experimental epidemiology have been more modest. A major challenge is for psychiatric epidemiologists to increase the relevance of their analytical research to their colleagues in preventative psychiatry as well as to social policy analysts. Another challenge is to develop interventions aimed at increasing the proportion of people with mental disorders who receive treatment. Despite encouraging advances, much work still needs to be conducted before psychiatric epidemiology can realize its potential to improve the mental health of populations. PMID:10885165

Challenges faced in daily life by persons with type 2 diabetes: A meta-synthesis.

PubMed

Inga-Britt, Lindh; Kerstin, Blomqvist

2018-01-01

Objectives To derive improved understanding of the implicit meanings of challenges in daily life from the perspective of persons with type 2 diabetes. Methods A meta-synthesis was conducted with an interpretive and constructivist approach. Four databases were searched for articles published between 2007 and 2011, producing 37 articles for analysis. Van Deurzen's life world theory was applied as an analytic grid. Results Challenges in daily life with type 2 diabetes could be understood as living in a tension between opposing forces, implying a struggle with inevitable paradoxes: living in the present and for the future, trusting oneself while relying on others, and being normal while feeling changed and different. Discussion This synthesis adds knowledge to previous understanding of living with type 2 diabetes, revealing the complexity of daily life when struggling with a lifelong illness. Person-centred care could be used to understand what challenges diabetes may cause in family and working life and the ambivalent feelings the illness can lead to. Future research is needed to implement and evaluate a person-centred care in practice. Since new qualitative research is continuously added to this topic, metasyntheses should be undertaken regularly.

Physics, Physicists and Revolutionary Capabilities for the Intelligence Community

NASA Astrophysics Data System (ADS)

Porter, Lisa

2009-05-01

Over the past several decades, physicists have made seminal contributions to technological capabilities that have enabled the U.S. intelligence community to provide unexpected and unparalleled information to our nation's decision makers and help dispel the cloud of uncertainty they face in dealing with crises and challenges around the world. As we look to the future, we recognize that the ever-quickening pace of changes in the world and the threats we must confront demand continued innovation and improvement in the capabilities needed to provide the information on which our leaders depend. This talk will focus on some of the major technological challenges that the intelligence community faces in the coming years, and the many ways that physicists can help to overcome those challenges. The potential impact of physicists on the future capabilities of the US intelligence community is huge. In addition to the more obvious and direct impact through research in areas ranging from novel sensors to quantum information science, the unique approach physicists bring to a problem can also have an indirect but important effect by influencing how challenges in areas ranging from cybersecurity to advanced analytics are approached and solved. Several examples will be given.

Using Promotores Programs to Improve Latino Health Outcomes: Implementation Challenges for Community-based Nonprofit Organizations

PubMed Central

Twombly, Eric C.; Holtz, Kristen D.; Stringer, Kimberly

2012-01-01

Promotores are community lay health workers, who provide outreach and services to Latinos. Little research on the promotores programs exists and the focus of this article is to identify the challenges faced by community-based nonprofits when implementing promotores programs. To explore this type of program telephone interviews were conducted with ten promotores academic experts and nonprofit executives. The results suggest that implementation challenges fall into three major categories: the lack of standardized information on promotores programs, labor issues, and organizational costs. Future recommendations are made which highlight promotores recruitment and retention strategies, and the development of a clearinghouse of programmatic implementation information for community-based nonprofits. PMID:23188929

Virtual reality in surgical training.

PubMed

Lange, T; Indelicato, D J; Rosen, J M

2000-01-01

Virtual reality in surgery and, more specifically, in surgical training, faces a number of challenges in the future. These challenges are building realistic models of the human body, creating interface tools to view, hear, touch, feel, and manipulate these human body models, and integrating virtual reality systems into medical education and treatment. A final system would encompass simulators specifically for surgery, performance machines, telemedicine, and telesurgery. Each of these areas will need significant improvement for virtual reality to impact medicine successfully in the next century. This article gives an overview of, and the challenges faced by, current systems in the fast-changing field of virtual reality technology, and provides a set of specific milestones for a truly realistic virtual human body.

Evaluating teams in extreme environments: from issues to answers.

PubMed

Bishop, Sheryl L

2004-07-01

The challenge to effectively evaluating teams in extreme environments necessarily involves a wide range of physiological, psychological, and psychosocial factors. The high reliance on technology, the growing frequency of multinational and multicultural teams, and the demand for longer duration missions all further compound the complexity of the problem. The primary goal is the insurance of human health and well-being with expectations that such priorities will naturally lead to improved chances for performance and mission success. This paper provides an overview of some of the most salient immediate challenges for selecting, training, and supporting teams in extreme environments, gives exemplars of research findings concerning these challenges, and discusses the need for future research.

New strategies for improving stem cell therapy in ischemic heart disease.

PubMed

Huang, Peisen; Tian, Xiaqiu; Li, Qing; Yang, Yuejin

2016-11-01

Stem cell therapy is a promising approach to the treatment of ischemic heart disease via replenishing cell loss after myocardial infarction. Both preclinical studies and clinical trials have indicated that cardiac function improved consistently, but very modestly after cell-based therapy. This mainly attributed to low cell survival rate, engraftment and functional integration, which became the major challenges to regenerative medicine. In recent years, several new cell types have been developed to regenerate cardiomyocytes and novel delivery approaches helped to increase local cell retention. New strategies, such as cell pretreatment, gene-based therapy, tissue engineering, extracellular vesicles application and immunologic regulation, have surged and brought about improved cell survival and functional integration leading to better therapeutic effects after cell transplantation. In this review, we summarize these new strategies targeting at challenges of cardiac regenerative medicine and discuss recent evidences that may hint their effectiveness in the future clinical settings.

Quality, risk management and governance in mental health: an overview.

PubMed

Callaly, Tom; Arya, Dinesh; Minas, Harry

2005-03-01

To consider the origin, current emphasis and relevance of the concepts of quality, risk management and clinical governance in mental health. Increasingly, health service boards and management teams are required to give attention to clinical governance rather than corporate governance alone. Clinical governance is a unifying quality concept that aims to produce a structure and systems to assure and improve the quality of clinical services by promoting an integrated and organization-wide approach towards continuous quality improvement. Many psychiatrists will find the reduction in clinical autonomy, the need to consider the welfare of the whole population as well as the individual patient for whom they are responsible, and the requirement that they play a part in a complex systems approach to quality improvement to be a challenge. Avoiding or ignoring this challenge will potentially lead to conflict with modern management approaches and increased loss of influence on future developments in mental health services.

Global quality imaging: improvement actions.

PubMed

Lau, Lawrence S; Pérez, Maria R; Applegate, Kimberly E; Rehani, Madan M; Ringertz, Hans G; George, Robert

2011-05-01

Workforce shortage, workload increase, workplace changes, and budget challenges are emerging issues around the world, which could place quality imaging at risk. It is important for imaging stakeholders to collaborate, ensure patient safety, improve the quality of care, and address these issues. There is no single panacea. A range of improvement measures, strategies, and actions are required. Examples of improvement actions supporting the 3 quality measures are described under 5 strategies: conducting research, promoting awareness, providing education and training, strengthening infrastructure, and implementing policies. The challenge is to develop long-term, cost-effective, system-based improvement actions that will bring better outcomes and underpin a sustainable future for quality imaging. In an imaging practice, these actions will result in selecting the right procedure (justification), using the right dose (optimization), and preventing errors along the patient journey. To realize this vision and implement these improvement actions, a range of expertise and adequate resources are required. Stakeholders should collaborate and work together. In today's globalized environment, collaboration is strength and provides synergy to achieve better outcomes and greater success. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Exploring Bim for Operational Integrated Asset Management - a Preliminary Study Utilising Real-World Infrastructure Data

NASA Astrophysics Data System (ADS)

Boyes, G. A.; Ellul, C.; Irwin, D.

2017-10-01

The use of 3D information models within collaborative working environments and the practice of Building Information Modelling (BIM) are becoming more commonplace within infrastructure projects. Currently used predominantly during the design and construction phase, the use of BIM is capable in theory of providing the information at handover that will satisfy the Asset Information Requirements (AIRs) of the future Infrastructure Manager (IM). One particular challenge is establishing a link between existing construction-centric information and the asset-centric information needed for future operations. Crossrail, a project to build a new high-frequency railway underneath London, is handling many such challenges as they prepare to handover their digital information to the future operator, in particular the need to provide a two-way link between a federated 3D CAD model and an object-relational Asset Information Management System (AIMS). This paper focusses on the potential for improved Asset Management (AM) by integrating BIM and GIS systems and practices, and makes a preliminary report on how 3D spatial queries can be used to establish a two-way relational link between two information systems (3D geometry and asset lists), as well as the challenges being overcome to transform the data to be suitable for AM.

Tolerating Uncertainty: Perceptions of the Future for Ageing Parent Carers and Their Adult Children with Intellectual Disabilities.

PubMed

Pryce, Laura; Tweed, Alison; Hilton, Amanda; Priest, Helena M

2017-01-01

Improved life expectancy means that more adults with intellectual disabilities are now living with ageing parents. This study explored older families' perceptions of the future. Semi-structured interviews were conducted with nine older parents and three adults with intellectual disabilities and analysed to produce an explanatory thematic framework. 'Tolerating uncertainty' was the major theme in participants' attempts to manage anxieties about the future, encompassing sub-themes of 'accepting the parenting role', 'facing challenges', 'being supported/isolated', 'positive meaning making', 're-evaluating as time moves on' and 'managing future thinking'. Some participants expressed preferences for their future which were in contrast to their parents' views, and provide a unique perspective that has often been neglected in prior research. This research has found commonalities in how families tolerate the uncertainty of the future, but also unique differences that require tailored interventions and prospective action by services. © 2015 John Wiley & Sons Ltd.

The Agricultural Model Intercomparison and Improvement Project (AgMIP): Progress and Preliminary Results

NASA Astrophysics Data System (ADS)

Rosenzweig, C.

2011-12-01

The Agricultural Model Intercomparison and Improvement Project (AgMIP) is a distributed climate-scenario simulation exercise for historical model intercomparison and future climate change conditions with participation of multiple crop and agricultural trade modeling groups around the world. The goals of AgMIP are to improve substantially the characterization of risk of hunger and world food security due to climate change and to enhance adaptation capacity in both developing and developed countries. Recent progress and the current status of AgMIP will be presented, highlighting three areas of activity: preliminary results from crop pilot studies, outcomes from regional workshops, and emerging scientific challenges. AgMIP crop modeling efforts are being led by pilot studies, which have been established for wheat, maize, rice, and sugarcane. These crop-specific initiatives have proven instrumental in testing and contributing to AgMIP protocols, as well as creating preliminary results for aggregation and input to agricultural trade models. Regional workshops are being held to encourage collaborations and set research activities in motion for key agricultural areas. The first of these workshops was hosted by Embrapa and UNICAMP and held in Campinas, Brazil. Outcomes from this meeting have informed crop modeling research activities within South America, AgMIP protocols, and future regional workshops. Several scientific challenges have emerged and are currently being addressed by AgMIP researchers. Areas of particular interest include geospatial weather generation, ensemble methods for climate scenarios and crop models, spatial aggregation of field-scale yields to regional and global production, and characterization of future changes in climate variability.

Reading the Future: NLS Partnerships Help Canadians Meet the Challenges of a Changing World.

ERIC Educational Resources Information Center

National Literacy Secretariat, Ottawa (Ontario).

Canada's National Literacy Secretariat (NLS) develops innovative partnerships to involve voluntary and national organizations, governments, business, and labor in a national effort to make Canada a more literate society. The two main objectives of the NLS are to promote a variety of opportunities for people to improve their reading and writing…

Development of an Effective School-Based Financial Management Profile in Malaysia: The Delphi Method Application

ERIC Educational Resources Information Center

Radzi, Norfariza Mohd; Ghani, Muhammad Faizal A.; Siraj, Saedah

2015-01-01

The agenda for national development requires a persistent improvement in education as a tool for creating knowledgeable human capital, highly skilled labour, a high technology society and ultimately a highly civilized nation for the future challenging world. It requires considerable financial and technical investment as well as effective and…

Response to Intervention in Canada: Definitions, the Evidence Base, and Future Directions

ERIC Educational Resources Information Center

McIntosh, Kent; MacKay, Leslie D.; Andreou, Theresa; Brown, Jacqueline A.; Mathews, Susanna; Gietz, Carmen; Bennett, Joanna L.

2011-01-01

Based on challenges with the traditional model of school psychology, response to intervention (RTI) has been advanced as a model of special education eligibility decision making and service delivery that may address the drawbacks of the traditional models of assessment and result in improved outcomes for students. In this article, the RTI model is…

The Student Homelessness Crisis and the Role of School Psychology: Missed Opportunities, Room for Improvement, and Future Directions

ERIC Educational Resources Information Center

Sulkowski, Michael L.

2016-01-01

Affecting more than 1 million youth, student homelessness is growing at an unprecedented rate in the United States. This is alarming because homeless students face significant barriers to their academic success and positive life outcomes. Unfortunately, despite the significant risks and challenges they face, homeless students often are overlooked…

Visual Scaling to Improve Organizational Decisions in Educator Preparation: Effectively Comparing Apples and Oranges

ERIC Educational Resources Information Center

Francis, Raymond W.; Deschaine, Mark E.

2018-01-01

One of the largest challenges in educator preparation in higher education is the effective use of data for actionable and meaningful decision making about programs for current and future educators, administrators, and educational leaders. Within programs there are many types of students. These may include elementary, secondary, special education,…

Present Problems and Future Challenges of the Korea National Open University. ZIFF Papiere 113.

ERIC Educational Resources Information Center

Kim, Jae-Woong

Korea National Open University (KNOU) opened in 1972 as a correspondence college designed to improve adult learners' preparation for Korea's college examination. KNOU has been redefined as "an institution for adults who are deprived, by various reasons, of higher education opportunities and is now playing a major role in developing lifelong…

The Effectiveness of an Embedded Approach to Practicum Experiences in Educational Leadership: Program Candidates' Perspectives

ERIC Educational Resources Information Center

Chandler, Mary; Chan, Tak Cheung; Jiang, Binbin

2013-01-01

This study examined how effective an embedded practicum experience in an educational leadership program in a Southeastern University is in serving the purpose of preparing educational leaders to meet future challenges. Findings of this study confirm practicum areas that met the educational demands and highlight areas that need improvement to…

Design and sampling plan optimization for RT-qPCR experiments in plants: a case study in blueberry

USDA-ARS?s Scientific Manuscript database

The qPCR assay has become a routine technology in plant biotechnology and agricultural research. It is unlikely to be technically improved in the near future, but there are still challenges which center around minimizing the variability in results and transparency when reporting technical data in su...

The Equity Challenge in China's Higher Education Finance Policy

ERIC Educational Resources Information Center

Sun, Fengshou; Barrientos, Armando

2009-01-01

Sustaining China's rapid economic growth in the future will come to depend in large part on the quantity and quality of the human resources it can mobilize. The paper considers the prospects for higher education financing, and highlights the importance of improving equity in access to higher education as a precondition for a sustainable expansion…

Anterior eye segment drug delivery systems: current treatments and future challenges.

PubMed

Molokhia, Sarah A; Thomas, Samuel C; Garff, Kevin J; Mandell, Kenneth J; Wirostko, Barbara M

2013-03-01

New technologies for delivery of drugs, such as small molecules and biologics, are of growing interest among clinical and pharmaceutical researchers for use in treating anterior segment eye disease. The challenge is to deliver effective drugs at therapeutic concentrations to the targeted ocular tissue with minimal side effects. To achieve this, a better understanding of the unmet needs, what is required of the various methods of delivery to achieve successful delivery, and the potential challenges of anterior segment drug delivery is necessary and the primarily aim of this review. This review covers the various physiological and anatomical barriers that exist for effective delivery to the targeted tissue of the eye, the pathological conditions of the anterior segment, and the unmet needs for treatment of these ocular diseases. Second, it reviews the novel delivery technologies that have the potential to maintain and/or improve the drug's therapeutic index and improving both patient adherence for chronic therapy and potential patient outcomes. This review bridges the pharmaceutical and clinical research/challenges and provides a detailed overview of anterior segment drug delivery accomplishments thus far, for researchers and clinicians.

Development in Geared Turbofan Aeroengine

NASA Astrophysics Data System (ADS)

Mohd Tobi, A. L.; Ismail, A. E.

2016-05-01

This paper looks into the implementation of epicyclic gear system to the aeroengine in order to increase the efficiency of the engine. The improvement made is in the direction of improving fuel consumption, reduction in pollutant gasses and perceived noise. Introduction of epicyclic gear system is capable to achieve bypass ratio of up to 15:1 with the benefits of weight and noise reduction. Radical new aircraft designs and engine installation are being studied to overcome some of the challenges associated with the future geared turbofan and open-rotor engine.

Two Decades of Enhancing Children’s Environmental Health Protection at the U.S. Environmental Protection Agency

PubMed Central

Firestone, Michael; Berger, Martha; Foos, Brenda; Etzel, Ruth

2016-01-01

Summary: This article provides an overview of public health efforts by the U.S. Environmental Protection Agency (EPA) during the past two decades to protect children’s health from environmental hazards. It highlights examples of concrete steps and accomplishments toward improving environmental protection and health outcomes achieved through public policy, rules and regulations, increased scientific understanding, and public health messaging. Additionally, examples of future challenges for better understanding and improving children’s environmental health are discussed. PMID:27905272

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

Rios-Torres, Jackeline; Malikopoulos, Andreas A.

Connected and automated vehicles (CAVs) have the potential to improve safety by reducing and mitigating traffic accidents. They can also provide opportunities to reduce transportation energy consumption and emissions by improving traffic flow. Vehicle communication with traffic structures and traffic lights can allow individual vehicles to optimize their operation and account for unpredictable changes. This paper summarizes the developments and the research trends in coordination with the CAVs that have been reported in the literature to date. In conclusion, remaining challenges and potential future research directions are also discussed.

Midwifery: "at the edge of history".

PubMed

Dahlen, H

2006-03-01

The paper focuses on possible future pathways in maternity care for midwives and nations to consider. The paper blends personal and professional experiences to outline priority areas facing midwives in the future. It begins by examining maternal mortality and morbidity in the developing world and considering the potential of the ten high priority action messages (1997) in helping to improve the plight of women and children in the future. The paper then examines major issues facing midwives in the developed world including: the way birth is viewed; the medical-midwifery divide; marketing midwifery; and finally the challenge of dealing with fear around birth. The third part of the paper examines a part of society where the two worlds meet and there are issues from both the developed and developing world to consider. The paper focuses on women from culturally and linguistically diverse communities, Aboriginal and Torres Strait Islander women and women birthing in remote and rural areas. By looking at these three worlds separately the paper examines different concerns facing midwives in the future but also draws on common issues that face us all as citizens of this planet and particularly as predominantly women. The paper challenges midwives to be politically active and dare to change the world.

Mind the Gap

PubMed Central

Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-01-01

Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

Evaluation of quality improvement programmes

PubMed Central

Ovretveit, J; Gustafson, D

2002-01-01



 In response to increasing concerns about quality, many countries are carrying out large scale programmes which include national quality strategies, hospital programmes, and quality accreditation, assessment and review processes. Increasing amounts of resources are being devoted to these interventions, but do they ensure or improve quality of care? There is little research evidence as to their effectiveness or the conditions for maximum effectiveness. Reasons for the lack of evaluation research include the methodological challenges of measuring outcomes and attributing causality to these complex, changing, long term social interventions to organisations or health systems, which themselves are complex and changing. However, methods are available which can be used to evaluate these programmes and which can provide decision makers with research based guidance on how to plan and implement them. This paper describes the research challenges, the methods which can be used, and gives examples and guidance for future research. It emphasises the important contribution which such research can make to improving the effectiveness of these programmes and to developing the science of quality improvement. PMID:12486994

A Priority-Based View of Future Challenges in International Nuclear Safeguards.

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

Matteucci, Kayla

The international nuclear safeguards community is faced with a host of challenges in the coming years, many of which have been outlined but have not been described in terms of their urgency. Literature regarding safeguards challenges is either broad and devoid of any reference to prioritization or tailored to a specific problem and removed from the overall goals of the safeguards community. For example, developing new methods of environmental sampling, improving containment and surveillance (C/S) technologies to increase efficiency and decrease inspection time, advancing nuclear material accountancy (NMA) techniques, and planning safeguards approaches for new types of nuclear facilities aremore » all important. They have not, however, been distinctly prioritized at a high level within the safeguards community. Based on a review of existing literature and interviews with experts on these upcoming challenges, this paper offers a high-level summary of present and future priorities in safeguards, with attention both to what is feasible and to what is most imperative. In doing so, the paper addresses the potential repercussions for failing to prioritize, with a focus on the risk of diversion of nuclear material. Within the context of shifts in the American political landscape, and keeping in mind that nonproliferation issues may take a backseat to others in the near future, a prioritized view of safeguards objectives will be vital. In the interest of expanding upon this work, the paper offers several potential conceptual models for prioritization which can be explored in greater depth upon further research.« less

Membranes for bioelectrochemical systems: challenges and research advances.

PubMed

Dhar, Bipro Ranjan; Lee, Hyung-Sool

2013-01-01

Increasing energy demand has been a big challenge for current society, as the fossil fuel sources are gradually decreasing. Hence, development of renewable and sustainable energy sources for the future is considered one of the top priorities in national strategic plans. Bioenergy can meet future energy requirements - renewability, sustainability, and even carbon-neutrality. Bioenergy production from wastes and wastewaters is especially attractive because of dual benefits of energy generation and contaminant stabilization. There are several bioenergy technologies using wastes and wastewaters as electron donor, which include anaerobic digestion, dark biohydrogen fermentation, biohydrogen production using photosynthetic microorganisms, and bioelectrochemical systems (BESs). Among them BES seems to be very promising as we can produce a variety of value-added products from wastes and wastewaters, such as electric power, hydrogen gas, hydrogen peroxide, acetate, ethanol etc. Most ofthe traditional BES uses a membrane to separate the anode and cathode chamber, which is essential for improving microbial metabolism on the anode and the recovery of value-added products on the cathode. Performance of BES lacking a membrane can be seriously deteriorated, due to oxygen diffusion or substantial loss of synthesized products. For this reason, usage of a membrane seems essential to facilitate BES performance. However, a membrane can bring several technical challenges to BES application compared to membrane-less BES. These challenges include poor proton permeability, substrate loss, oxygen back diffusion, pH gradient, internal resistance, biofouling, etc. This paper aims to review the major technical barriers associated with membranes and future research directions for their application in BESs.

An Advanced Framework for Improving Situational Awareness in Electric Power Grid Operation

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

Chen, Yousu; Huang, Zhenyu; Zhou, Ning

With the deployment of new smart grid technologies and the penetration of renewable energy in power systems, significant uncertainty and variability is being introduced into power grid operation. Traditionally, the Energy Management System (EMS) operates the power grid in a deterministic mode, and thus will not be sufficient for the future control center in a stochastic environment with faster dynamics. One of the main challenges is to improve situational awareness. This paper reviews the current status of power grid operation and presents a vision of improving wide-area situational awareness for a future control center. An advanced framework, consisting of parallelmore » state estimation, state prediction, parallel contingency selection, parallel contingency analysis, and advanced visual analytics, is proposed to provide capabilities needed for better decision support by utilizing high performance computing (HPC) techniques and advanced visual analytic techniques. Research results are presented to support the proposed vision and framework.« less

Biologic Treatments for Sports Injuries II Think Tank—Current Concepts, Future Research, and Barriers to Advancement, Part 2

PubMed Central

Murray, Iain R.; LaPrade, Robert F.; Musahl, Volker; Geeslin, Andrew G.; Zlotnicki, Jason P.; Mann, Barton J.; Petrigliano, Frank A.

2016-01-01

Rotator cuff tears are common and result in considerable morbidity. Tears within the tendon substance or at its insertion into the humeral head represent a considerable clinical challenge because of the hostile local environment that precludes healing. Tears often progress without intervention, and current surgical treatments are inadequate. Although surgical implants, instrumentation, and techniques have improved, healing rates have not improved, and a high failure rate remains for large and massive rotator cuff tears. The use of biologic adjuvants that contribute to a regenerative microenvironment have great potential for improving healing rates and function after surgery. This article presents a review of current and emerging biologic approaches to augment rotator cuff tendon and muscle regeneration focusing on the scientific rationale, preclinical, and clinical evidence for efficacy, areas for future research, and current barriers to advancement and implementation. PMID:27099865

Ureteral Stents. New Materials and Designs

NASA Astrophysics Data System (ADS)

Monga, Manoj

2008-09-01

Issues of stent migration and challenges of stent placement can be addressed adequately with current stent designs and materials, and an emphasis on precision in technique. Future changes in ureteral stents will need to maintain the current standard that has been set with existing devices in these regards. In contrast, new advances are sorely needed in encrustation and infection associated with ureteral stents. The main target for future development in ureteral stent materials lies in a biodegradable stent that degrades either on demand or degrades reliably within one-month with predictable degradation patterns that do not predispose to urinary obstruction, discomfort or need for secondary procedures. The main target for future development in ureteral stent design is improved patient comfort.

Shaping the Future of Research: a perspective from junior scientists

PubMed Central

MacKellar, Drew C.; Mazzilli, Sarah A.; Pai, Vaibhav P.; Goodwin, Patricia R.; Walsh, Erica M.; Robinson-Mosher, Avi; Bowman, Thomas A.; Kraemer, James; Erb, Marcella L.; Schoenfeld, Eldi; Shokri, Leila; Jackson, Jonathan D.; Islam, Ayesha; Mattozzi, Matthew D.; Krukenberg, Kristin A.; Polka, Jessica K.

2015-01-01

The landscape of scientific research and funding is in flux as a result of tight budgets, evolving models of both publishing and evaluation, and questions about training and workforce stability. As future leaders, junior scientists are uniquely poised to shape the culture and practice of science in response to these challenges. A group of postdocs in the Boston area who are invested in improving the scientific endeavor, planned a symposium held on October 2 nd and 3 rd, 2014, as a way to join the discussion about the future of US biomedical research. Here we present a report of the proceedings of participant-driven workshops and the organizers’ synthesis of the outcomes. PMID:25653845

BSN completion barriers, challenges, incentives, and strategies.

PubMed

Duffy, Marie T; Friesen, Mary Ann; Speroni, Karen Gabel; Swengros, Diane; Shanks, Laura A; Waiter, Pamela A; Sheridan, Michael J

2014-04-01

The objectives of this study were to explore RN perceptions regarding barriers/challenges and incentives/supports for BSN completion and identify recommendations to increase RN BSN completion. The Institute of Medicine's 2011 The Future of Nursing report recommended the proportion of RNs with a BSN increase to 80% by 2020. This qualitative study included 41 RNs who participated in 1 of 6 focus groups based on their BSN completion status. Primary themes were sacrifices, barriers/challenges, incentives/supports, value, how to begin, and pressure. Primary BSN completion barriers/challenges were work-life balance and economic issues. Incentives/supports identified were financial compensation, assistance from employer and academic institution, and encouragement from family. Institutional strategies recommended for increasing BSN completion rates were improved access to education and financial support facilitated by collaboration between hospitals and academic institutions. Exploring RN barriers/challenges and incentives/supports for BSN completion can lead to implementation of institutional strategies, such as tuition reimbursement and academic collaboration.

Isolated thoughts and feelings and unsolved concerns: adolescents' and parents' perspectives on living with type 1 diabetes - a qualitative study using visual storytelling.

PubMed

Castensøe-Seidenfaden, Pernille; Teilmann, Grete; Kensing, Finn; Hommel, Eva; Olsen, Birthe Susanne; Husted, Gitte Reventlov

2017-10-01

To explore and describe the experiences of adolescents and their parents living with type 1 diabetes, to identify their needs for support to improve adolescents' self-management skills in the transition from child- to adulthood. Adolescents with type 1 diabetes often experience deteriorating glycaemic control and distress. Parents are important in adolescents' ability to self-manage type 1 diabetes, but they report anxiety and frustrations. A better understanding of the challenges adolescents and parents face, in relation to the daily self-management of type 1 diabetes, is important to improve clinical practice. A qualitative explorative study using visual storytelling as part of individual interviews. A purposive sample of nine adolescents and their parents (seven mothers, six fathers) took photographs illustrating their experiences living with type 1 diabetes. Subsequently, participants were interviewed individually guided by participants' photographs and a semistructured interview guide. Interviews were analysed using thematic analysis. Four major themes were consistent across adolescents and their parents: (1) striving for safety, (2) striving for normality, (3) striving for independence and (4) worrying about future. Although adolescents and parents had same concerns and challenges living with type 1 diabetes, they were experienced differently. Their thoughts and feelings mostly remained isolated and their concerns and challenges unsolved. The concerns and challenges adolescents and their parents face in the transition from child- to adulthood are still present despite new treatment modalities. Parents are fundamental in supporting the adolescents' self-management-work; however, the parties have unspoken concerns and challenges. Healthcare providers should address the parties' challenges and concerns living with type 1 diabetes to diminish worries about future including fear of hypoglycaemia, the burden of type 1 diabetes and the feeling of being incompetent in diabetes self-management. It is important to focus on supporting both adolescents and their parents, and to provide a shared platform for communication. © 2016 John Wiley & Sons Ltd.

The road ahead: comprehensive and innovative approaches for improving safety and preventing child maltreatment fatalities.

PubMed

Chahine, Zeinab; Sanders, David

2013-01-01

This article presents a high-level overview of the complex issues, opportunities, and challenges involved in improving child safety and preventing child maltreatment fatalities. It emphasizes that improving measurement and classification is critical to understanding and preventing child maltreatment fatalities. It also stresses the need to reframe child maltreatment interventions from a public health perspective. The article draws on the lessons learned from state-of-the-art safety engineering innovations, research, and other expert recommendations presented in this special issue that can inform future policy and practice direction in this important area.

Enabling catalytic oxidation of Li2O2 at the liquid-solid interface: the evolution of an aprotic Li-O2 battery.

PubMed

Feng, Ningning; He, Ping; Zhou, Haoshen

2015-02-01

We show that by using a suitable soluble redox mediator, the charging overpotential can be reduced and the round-trip efficiency can be improved in an aprotic Li-O2 battery. Not only do we explore a new redox couple, 10-methyl-10H-phenothiazine, as a soluble catalyst that improves the electrochemical performance, but we also propose possible challenges that need to be overcome for the future improvement of aprotic Li-O2 batteries. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The central role of agricultural water-use productivity in sustainable water management (Invited)

NASA Astrophysics Data System (ADS)

Gleick, P. H.

2013-12-01

As global and regional populations continue to rise for the next several decades, the need to grow more food will worsen old -- and produce new -- challenges for water resources. Expansion of irrigated agriculture is slowing due to constraints on land and water, and as a result, some have argued that future new food demands will only be met through improvements in agricultural productivity on existing irrigated and rainfed cropland, reductions in field losses and food waste, and social changes such as dietary preferences. This talk will address the central role that improvements in water-use productivity can play in the food/water/population nexus. In particular, the ability to grow more food with less water will have a great influence on whether future food demands will be met successfully. Such improvements can come about through changes in technology, regulatory systems, economic incentives and disincentives, and education of water users. Example of potential savings from three different strategies to improve agricultural water productivity in California. (From Pacific Institute).

SAMPL4 & DOCK3.7: lessons for automated docking procedures

NASA Astrophysics Data System (ADS)

Coleman, Ryan G.; Sterling, Teague; Weiss, Dahlia R.

2014-03-01

The SAMPL4 challenges were used to test current automated methods for solvation energy, virtual screening, pose and affinity prediction of the molecular docking pipeline DOCK 3.7. Additionally, first-order models of binding affinity were proposed as milestones for any method predicting binding affinity. Several important discoveries about the molecular docking software were made during the challenge: (1) Solvation energies of ligands were five-fold worse than any other method used in SAMPL4, including methods that were similarly fast, (2) HIV Integrase is a challenging target, but automated docking on the correct allosteric site performed well in terms of virtual screening and pose prediction (compared to other methods) but affinity prediction, as expected, was very poor, (3) Molecular docking grid sizes can be very important, serious errors were discovered with default settings that have been adjusted for all future work. Overall, lessons from SAMPL4 suggest many changes to molecular docking tools, not just DOCK 3.7, that could improve the state of the art. Future difficulties and projects will be discussed.

The Future of Health Care in the Kurdistan Region - Iraq: Toward an Effective, High-Quality System with an Emphasis on Primary Care.

PubMed

Moore, Melinda; Anthony, C Ross; Lim, Yee-Wei; Jones, Spencer S; Overton, Adrian; Yoong, Joanne K

2014-01-01

At the request of the Kurdistan Regional Government (KRG), RAND researchers undertook a yearlong analysis of the health care system in the Kurdistan Region of Iraq, with a focus on primary care. RAND staff reviewed available literature on the Kurdistan Region and information relevant to primary care; interviewed a wide range of policy leaders, health practitioners, patients, and government officials to gather information and understand their priorities; collected and studied all available data related to health resources, services, and conditions; and projected future supply and demand for health services in the Kurdistan Region; and laid out the health financing challenges and questions. In this volume, the authors describe the strengths of the health care system in the Kurdistan Region as well as the challenges it faces. The authors suggest that a primary care-oriented health care system could help the KRG address many of these challenges. The authors discuss how such a system might be implemented and financed, and they make recommendations for better utilizing resources to improve the quality, access, effectiveness, and efficiency of primary care.

A review of biomaterials in bone defect healing, remaining shortcomings and future opportunities for bone tissue engineering

PubMed Central

Winkler, T.; Sass, F. A.; Schmidt-Bleek, K.

2018-01-01

Despite its intrinsic ability to regenerate form and function after injury, bone tissue can be challenged by a multitude of pathological conditions. While innovative approaches have helped to unravel the cascades of bone healing, this knowledge has so far not improved the clinical outcomes of bone defect treatment. Recent findings have allowed us to gain in-depth knowledge about the physiological conditions and biological principles of bone regeneration. Now it is time to transfer the lessons learned from bone healing to the challenging scenarios in defects and employ innovative technologies to enable biomaterial-based strategies for bone defect healing. This review aims to provide an overview on endogenous cascades of bone material formation and how these are transferred to new perspectives in biomaterial-driven approaches in bone regeneration. Cite this article: T. Winkler, F. A. Sass, G. N. Duda, K. Schmidt-Bleek. A review of biomaterials in bone defect healing, remaining shortcomings and future opportunities for bone tissue engineering: The unsolved challenge. Bone Joint Res 2018;7:232–243. DOI: 10.1302/2046-3758.73.BJR-2017-0270.R1.

Current status and challenges for automotive battery production technologies

NASA Astrophysics Data System (ADS)

Kwade, Arno; Haselrieder, Wolfgang; Leithoff, Ruben; Modlinger, Armin; Dietrich, Franz; Droeder, Klaus

2018-04-01

Production technology for automotive lithium-ion battery (LIB) cells and packs has improved considerably in the past five years. However, the transfer of developments in materials, cell design and processes from lab scale to production scale remains a challenge due to the large number of consecutive process steps and the significant impact of material properties, electrode compositions and cell designs on processes. This requires an in-depth understanding of the individual production processes and their interactions, and pilot-scale investigations into process parameter selection and prototype cell production. Furthermore, emerging process concepts must be developed at lab and pilot scale that reduce production costs and improve cell performance. Here, we present an introductory summary of the state-of-the-art production technologies for automotive LIBs. We then discuss the key relationships between process, quality and performance, as well as explore the impact of materials and processes on scale and cost. Finally, future developments and innovations that aim to overcome the main challenges are presented.

Health and Aging Policy Fellows Program: Shaping a Healthy Future for Older Americans.

PubMed

Pincus, Harold Alan; Pike, Kathleen M; Spaeth-Rublee, Brigitta; Elinson, Lynn

2017-09-01

As the size of the elderly population increases, so do the challenges of and barriers to high-quality, affordable health care. The Health and Aging Policy Fellows (HAPF) Program is designed to provide health and aging professionals with the skills and experience to help lead the effort in reducing these barriers and shaping a healthy and productive future for older Americans. Since its inception in 2008, the program has affected not only the fellows who participate, but also the field of health and aging policy. Work needs to be done to sustain this program so that more fellows can participate and sound policies for the elderly population can continue to be shaped and improved. This report describes the HAPF Program, including its background (rationale, description, partners, progress, effect), lessons learned, challenges and solutions, and policy implications. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Climate change, resource use and food security in midcentury under a range of plausible scenarios

NASA Astrophysics Data System (ADS)

Wiebe, K.

2016-12-01

Achieving and maintaining food security at local, national and global scales is challenged by changes in population, income and climate, among other socioeconomic and biophysical drivers. Assessing these challenges and possible solutions over the coming decades requires a systematic and multidisciplinary approach. The Global Futures and Strategic Foresight program, a CGIAR initiative led by the International Food Policy Research Institute in collaboration with the 14 other CGIAR research centers, is working to improve tools and conduct ex ante assessments of promising technologies, investments and policies under alternative global futures to inform decision making in the CGIAR and its partners. Alternative socioeconomic and climate scenarios are explored using an integrated system of climate, water, crop and economic models. This presentation will share findings from recent projections of food production and prices to 2050 at global and regional scales, together with their potential implications for land and water use, food security, nutrition and health.

Supersonic Retropropulsion Technology Development in NASA's Entry, Descent, and Landing Project

NASA Technical Reports Server (NTRS)

Edquist, Karl T.; Berry, Scott A.; Rhode, Matthew N.; Kelb, Bil; Korzun, Ashley; Dyakonov, Artem A.; Zarchi, Kerry A.; Schauerhamer, Daniel G.; Post, Ethan A.

2012-01-01

NASA's Entry, Descent, and Landing (EDL) space technology roadmap calls for new technologies to achieve human exploration of Mars in the coming decades [1]. One of those technologies, termed Supersonic Retropropulsion (SRP), involves initiation of propulsive deceleration at supersonic Mach numbers. The potential benefits afforded by SRP to improve payload mass and landing precision make the technology attractive for future EDL missions. NASA's EDL project spent two years advancing the technological maturity of SRP for Mars exploration [2-15]. This paper summarizes the technical accomplishments from the project and highlights challenges and recommendations for future SRP technology development programs. These challenges include: developing sufficiently large SRP engines for use on human-scale entry systems; testing and computationally modelling complex and unsteady SRP fluid dynamics; understanding the effects of SRP on entry vehicle stability and controllability; and demonstrating sub-scale SRP entry systems in Earth's atmosphere.

Reducing myocardial infarct size: challenges and future opportunities

PubMed Central

Bulluck, Heerajnarain; Yellon, Derek M; Hausenloy, Derek J

2016-01-01

Despite prompt reperfusion by primary percutaneous coronary intervention (PPCI), the mortality and morbidity of patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) remain significant with 9% death and 10% heart failure at 1 year. In these patients, one important neglected therapeutic target is ‘myocardial reperfusion injury’, a term given to the cardiomyocyte death and microvascular dysfunction which occurs on reperfusing ischaemic myocardium. A number of cardioprotective therapies (both mechanical and pharmacological), which are known to target myocardial reperfusion injury, have been shown to reduce myocardial infarct (MI) size in small proof-of-concept clinical studies—however, being able to demonstrate improved clinical outcomes has been elusive. In this article, we review the challenges facing clinical cardioprotection research, and highlight future therapies for reducing MI size and preventing heart failure in patients presenting with STEMI at risk of myocardial reperfusion injury. PMID:26674987

Decision strategies for handling the uncertainty of future extreme rainfall under the influence of climate change.

PubMed

Gregersen, I B; Arnbjerg-Nielsen, K

2012-01-01

Several extraordinary rainfall events have occurred in Denmark within the last few years. For each event, problems in urban areas occurred as the capacity of the existing drainage systems were exceeded. Adaptation to climate change is necessary but also very challenging as urban drainage systems are characterized by long technical lifetimes and high, unrecoverable construction costs. One of the most important barriers for the initiation and implementation of the adaptation strategies is therefore the uncertainty when predicting the magnitude of the extreme rainfall in the future. This challenge is explored through the application and discussion of three different theoretical decision support strategies: the precautionary principle, the minimax strategy and Bayesian decision support. The reviewed decision support strategies all proved valuable for addressing the identified uncertainties, at best applied together as they all yield information that improved decision making and thus enabled more robust decisions.

A survey of life support system automation and control

NASA Technical Reports Server (NTRS)

Finn, Cory K.

1993-01-01

The level of automation and control necessary to support advanced life support systems for use in the manned space program is steadily increasing. As the length and complexity of manned missions increase, life support systems must be able to meet new space challenges. Longer, more complex missions create new demands for increased automation, improved sensors, and improved control systems. It is imperative that research in these key areas keep pace with current and future developments in regenerative life support technology. This paper provides an overview of past and present research in the areas of sensor development, automation, and control of life support systems for the manned space program, and it discusses the impact continued research in several key areas will have on the feasibility, operation, and design of future life support systems.

Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions.

PubMed

Trusty, Phillip M; Slesnick, Timothy C; Wei, Zhenglun Alan; Rossignac, Jarek; Kanter, Kirk R; Fogel, Mark A; Yoganathan, Ajit P

2018-04-01

The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed. Future efforts to automate the surgical planning process will reduce the individual expertise needed and encourage use in the clinic by clinicians. As post-operative physiologic predictions improve, Fontan surgical planning will become an more effective tool to accurately model patient-specific hemodynamics.

Prognostics and Health Management of Wind Turbines -- Current Status and Future Opportunities

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

Sheng, Shuangwen

The global wind industry has seen tremendous growth during the past two decades. However, the industry is challenged by premature component failures, which lead to increased turbine downtime and subsequently, cost of energy for wind power. To mitigate the impacts from these failures, the wind industry has been exploring various areas for improvements ranging from product design, new materials or lubricants, to operation and maintenance (O&M) practices. Condition-based maintenance or prognostics and health management (PHM) has been explored as one enabling technology for improving O&M practices. This chapter provides a brief overview of wind turbine PHM with a focus onmore » operational data mining and condition monitoring of drivetrains. Some future research and development opportunities in wind turbine PHM are also briefly discussed.« less

Cost collection and analysis for health economic evaluation.

PubMed

Smith, Kristine A; Rudmik, Luke

2013-08-01

To improve the understanding of common health care cost collection, estimation, analysis, and reporting methodologies. Ovid MEDLINE (1947 to December 2012), Cochrane Central register of Controlled Trials, Database of Systematic Reviews, Health Technology Assessment, and National Health Service Economic Evaluation Database. This article discusses the following cost collection methods: defining relevant resources, quantification of consumed resources, and resource valuation. It outlines the recommendations for cost reporting in economic evaluations and reviews the techniques on how to handle cost data uncertainty. Last, it discusses the controversial topics of future costs and patient productivity losses. Health care cost collection and estimation can be challenging, and an organized approach is required to optimize accuracy of economic evaluation outcomes. Understanding health care cost collection and estimation techniques will improve both critical appraisal and development of future economic evaluations.

Future Directions in Tactical Vertical Lift

DTIC Science & Technology

2010-04-29

The Aviation Science and Technology Challenge • OSD Future Vertical Lift • Transition to the Future AGENDA UNCLASSIFIED UNCLASSIFIED 4 Yourfilename.ppt...distributed, non-contiguous operations Joint Future Operational Environment The S&T Challenge Increased reliance on force projection by Aviation...UNCLASSIFIED UNCLASSIFIED 7 Yourfilename.ppt The S&T Challenge • “Army Aviation is the service’s most requested asset around the globe, ….. some units

Nanomedicine applications in orthopedic medicine: state of the art

PubMed Central

Mazaheri, Mozhdeh; Eslahi, Niloofar; Ordikhani, Farideh; Tamjid, Elnaz; Simchi, Abdolreza

2015-01-01

The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges. PMID:26451110

Nanomedicine applications in orthopedic medicine: state of the art.

PubMed

Mazaheri, Mozhdeh; Eslahi, Niloofar; Ordikhani, Farideh; Tamjid, Elnaz; Simchi, Abdolreza

2015-01-01

The technological and clinical need for orthopedic replacement materials has led to significant advances in the field of nanomedicine, which embraces the breadth of nanotechnology from pharmacological agents and surface modification through to regulation and toxicology. A variety of nanostructures with unique chemical, physical, and biological properties have been engineered to improve the functionality and reliability of implantable medical devices. However, mimicking living bone tissue is still a challenge. The scope of this review is to highlight the most recent accomplishments and trends in designing nanomaterials and their applications in orthopedics with an outline on future directions and challenges.

Studying depression using imaging and machine learning methods.

PubMed

Patel, Meenal J; Khalaf, Alexander; Aizenstein, Howard J

2016-01-01

Depression is a complex clinical entity that can pose challenges for clinicians regarding both accurate diagnosis and effective timely treatment. These challenges have prompted the development of multiple machine learning methods to help improve the management of this disease. These methods utilize anatomical and physiological data acquired from neuroimaging to create models that can identify depressed patients vs. non-depressed patients and predict treatment outcomes. This article (1) presents a background on depression, imaging, and machine learning methodologies; (2) reviews methodologies of past studies that have used imaging and machine learning to study depression; and (3) suggests directions for future depression-related studies.

Challenging the current approaches to multiple myeloma- and other cancer-related bone diseases: from bisphosphonates to targeted therapy.

PubMed

Kleber, Martina; Udi, Josefina; Metzke, Barbara; Terpos, Evangelos; Roodmann, G David; Morgan, Gareth; Dispenzieri, Angela; Einsele, Hermann; Wäsch, Ralph; Engelhardt, Monika

2012-06-01

An international myeloma meeting entitled "Challenging the current approaches to multiple myeloma- and other cancer-related bone diseases: from bisphosphonates to targeted therapy" was held in Freiburg, Germany in July 2011 to discuss novel insights into and approaches to myeloma bone disease and other bone-seeking tumors. This review briefly summarizes the most prominent data of the meeting and current literature on our understanding of bone disease, the role of imaging techniques, operative interventions and systemic bone-seeking treatment, all of which should further improve our future therapeutic choices.

Geriatric restorative care - the need, the demand and the challenges

PubMed Central

Nadig, Roopa R; Usha, G; Kumar, Vinod; Rao, Raghoothama; Bugalia, Anupriya

2011-01-01

Increased life expectancy is causing an explosion of the aging population that will continue now and in the foreseeable future. Improved quality of life at old age will demand tooth retention and consequently the need for restorative care. Retaining teeth disease free and maintaining them amidst multitude of risk factors associated with old age, is a multi- faceted challenge. This review article discusses the etiology of various dental diseases seen in older dentate population and their management keeping in mind the special needs of these matured people, so as to render a professional service that is sensitive and caring. PMID:22025819

Advanced model-based FDIR techniques for aerospace systems: Today challenges and opportunities

NASA Astrophysics Data System (ADS)

Zolghadri, Ali

2012-08-01

This paper discusses some trends and recent advances in model-based Fault Detection, Isolation and Recovery (FDIR) for aerospace systems. The FDIR challenges range from pre-design and design stages for upcoming and new programs, to improvement of the performance of in-service flying systems. For space missions, optimization of flight conditions and safe operation is intrinsically related to GNC (Guidance, Navigation & Control) system of the spacecraft and includes sensors and actuators monitoring. Many future space missions will require autonomous proximity operations including fault diagnosis and the subsequent control and guidance recovery actions. For upcoming and future aircraft, one of the main issues is how early and robust diagnosis of some small and subtle faults could contribute to the overall optimization of aircraft design. This issue would be an important factor for anticipating the more and more stringent requirements which would come in force for future environmentally-friendlier programs. The paper underlines the reasons for a widening gap between the advanced scientific FDIR methods being developed by the academic community and technological solutions demanded by the aerospace industry.

Workshop on challenges, insights, and future directions for mouse and humanized models in cancer immunology and immunotherapy: a report from the associated programs of the 2016 annual meeting for the Society for Immunotherapy of cancer.

PubMed

Zloza, Andrew; Karolina Palucka, A; Coussens, Lisa M; Gotwals, Philip J; Headley, Mark B; Jaffee, Elizabeth M; Lund, Amanda W; Sharpe, Arlene H; Sznol, Mario; Wainwright, Derek A; Wong, Kwok-Kin; Bosenberg, Marcus W

2017-09-19

Understanding how murine models can elucidate the mechanisms underlying antitumor immune responses and advance immune-based drug development is essential to advancing the field of cancer immunotherapy. The Society for Immunotherapy of Cancer (SITC) convened a workshop titled, "Challenges, Insights, and Future Directions for Mouse and Humanized Models in Cancer Immunology and Immunotherapy" as part of the SITC 31st Annual Meeting and Associated Programs on November 10, 2016 in National Harbor, MD. The workshop focused on key issues in optimizing models for cancer immunotherapy research, with discussions on the strengths and weaknesses of current models, approaches to improve the predictive value of mouse models, and advances in cancer modeling that are anticipated in the near future. This full-day program provided an introduction to the most common immunocompetent and humanized models used in cancer immunology and immunotherapy research, and addressed the use of models to evaluate immune-targeting therapies. Here, we summarize the workshop presentations and subsequent panel discussion.

The Future of the Small Rural Grocery Store: A Qualitative Exploration.

PubMed

Pinard, Courtney A; Fricke, Hollyanne E; Smith, Teresa M; Carpenter, Leah R; Yaroch, Amy L

2016-11-01

Rural communities face unique challenges to and opportunities for offering more healthful foods and are often understudied in comparison to their urban counterparts. The purpose of this study was to conduct a qualitative assessment of rural storeowners' perceptions of their communities, their business practices, and factors that influences their viability, sustainability, and ability to support healthy food choices. We conducted interviews with storeowners (N = 15) in small stores in rural Nebraska and explored perceptions of business practices, role in the community, and consumer demand for more healthful foods. The storeowners reported strategies they employ to remain competitive, such as selling alcohol and tobacco, focusing on customer service, and ensuring quality of products. Manufacturer and distributor agreements often put constraints on their business models. Key challenges reported included a dwindling population and competition with larger chains in neighboring towns set in a sparsely populated landscape. Goals for the future included expanding equipment, largely to offer more prepared foods. This study adds to the literature around food access in rural communities, and can inform future implementation strategies to work with storeowners to improve healthy food access.

Healthy and sustainable diets for future generations.

PubMed

Green, Hilary; Broun, Pierre; Cook, Douglas; Cooper, Karen; Drewnowski, Adam; Pollard, Duncan; Sweeney, Gary; Roulin, Anne

2018-07-01

Global food systems will face unprecedented challenges in the coming years. They will need to meet the nutritional needs of a growing population and feed an expanding demand for proteins. This is against a backdrop of increasing environmental challenges (water resources, climate change, soil health) and the need to improve farming livelihoods. Collaborative efforts by a variety of stakeholders are needed to ensure that future generations have access to healthy and sustainable diets. Food will play an increasingly important role in the global discourse on health. These topics were explored during Nestlé's second international conference on 'Planting Seeds for the Future of Food: The Agriculture, Nutrition and Sustainability Nexus', which took place in July 2017. This article discusses some of the key issues from the perspective of three major stakeholder groups, namely farming/agriculture, the food industry and consumers. © 2018 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. © 2018 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Recent advances and future challenges in cancer immunotherapy.

PubMed

Okuyama, Namiko; Tamada, Koji; Tamura, Hideto

2016-01-01

Remarkable advances have been made in cancer immunotherapy. Recent treatment strategies, especially chimeric antigen receptor-T (CAR-T) cell therapy and immune checkpoint inhibitors, reportedly achieve higher objective responses and better survival rates than previous immunotherapies for patients with treatment-resistant malignancies, creating a paradigm shift in cancer treatment. Several clinical trials of cancer immunotherapy for patients with various malignancies are ongoing. However, those with certain malignancies, such as low-immunogenic cancers, cannot be successfully treated with T-cell immunotherapy, and subsets of immunotherapy-treated patients relapse, meaning that more effective immunotherapeutic strategies are needed for such patients. Furthermore, the safety, convenience, and cost of cancer immunotherapy need to be improved in the near future. Herein, we discuss recent advances and future challenges in cancer immunotherapy, i.e., the identification of neoantigens for the development of individualized immunotherapies, the development of new CAR-T cell therapies, including so-called armored CAR-T cells that can induce greater clinical effects and thereby achieve longer survival, the development of off-the-shelf treatment regimens using non-self cells or cell lines, and effective cancer immunotherapy combinations.

CNS drug development in Europe--past progress and future challenges.

PubMed

Nutt, David J; Attridge, Jim

2014-01-01

Despite enormous progress in defining, diagnosing and treating mental disorders, EU health systems face a mounting challenge in responding to 'unmet need'. Mental illnesses produce a societal burden that exceeds that for either cancers or cardiovascular conditions. Leveraging advances in science and medicine to make available new innovative medicines is a key component in responding to this challenge. The dominant paradigm has been, is and will continue to be, one of incremental progress. Better medicines for depression, anxiety and psychoses in the working age population would add great value to patients and improve labour productivity. But psychotropic medicines face exceptional challenges in demonstrating their added value, due to uncertainty in patient diagnosis, selecting treatments and ensuring adherence. Also, there are major difficulties in estimating costs. Advances in understanding brain processes, identifying biomarkers and neuro-imaging techniques promise far more effective 'diagnostic-therapeutic' treatments and improved patient outcomes in the future. Currently there are valuable incremental innovations in late development, which may well fail to recover their R&D costs, because of very low reimbursed prices. This will send a signal to innovators not to persist with product development in this area. Recently several leading companies have withdrawn from R&D in these mental disorders. This is a worrying development since building the capabilities to succeed in any disease sector takes many years and, once dismantled, they cannot easily be re-established. Three policy interventions could improve innovation incentives: Further 'push' incentives under i) and streamlining under ii) alone will not reverse the decline in investment incentives. An EU consensus, based upon an innovation model which encompasses the Research, Development and Market phases as a single cyclical process, which addresses the weak 'market pull incentives' under iii) is needed. There is a very real risk that without such an integrated approach to policy reforms, innovation in psychotropic medicines will become a 'desert' in the same way that it did for antibiotics in the 1990's. Copyright © 2013 Elsevier Inc. All rights reserved.

Forest genetics research at the University of Michigan

Treesearch

Burton V. Barnes

1970-01-01

The purpose of the research program, as evidenced by results as well as current research and future direction, is to add to the knowledge of the ecology and genetics of forest trees. Although we are interested in the practical gains that are possible and being realized in practical tree improvement, our contribution is in basic studies that stimulate and challenge...

Changing the Introductory IS Course to Improve Future Enrollments: An Irish Perspective

ERIC Educational Resources Information Center

Whelan, Eoin; Firth, David

2012-01-01

A significant challenge facing the IS discipline worldwide is the reversal of the low numbers of students currently enrolling in IS courses. While there is a growing body of literature which offers various insights into the IS enrollment crisis, almost all of this work is either from U.S. scholars or based on findings from U.S. universities. This…

Teacher Self-Efficacy and the Civic Knowledge of Secondary Social Studies Teachers in a Large Urban School District: A Policy Study

ERIC Educational Resources Information Center

Holt, Dennis

2009-01-01

This policy study contributed to an understanding of the types of professional growth activities that improve teacher self-confidence to teach challenging subjects and helped determine the future allocation of resources relative to teaching secondary social studies in Hillsborough County Public Schools (HCPS), the eighth largest school district in…

Policy Meets Pathways: A State Policy Agenda for Transformational Change. DesignForScale Series

ERIC Educational Resources Information Center

Couturier, Lara K.

2014-01-01

A new national report released by Jobs for the Future (JFF) says that a decade of interventions and improvements have fallen short because states and campuses have not taken large enough steps to address their biggest challenge--helping the 12.8 million students enrolled in community colleges earn postsecondary degrees and credentials to find good…

Directionally Solidified Eutectic Ceramics for Multifunctional Aerospace Applications

DTIC Science & Technology

2009-06-01

Solidified Alumina - Titania Composites", Key Engineering Materials, 290 (2005) pp 199 - 202. PEER REVIEWED CONFERENCE PROCEEDINGS 22. A. Sayir, S...RESPONSIBLE PERSON 19b. TELEPHONE NUMBER (Include area code) 1 Progress Report for 2006 For the Grant Directionally Solidified Eutectic Ceramics ...incorporating structural ceramics in future aerospace applications: (1) the challenges associated with ceramics are improving strength, toughness and

Institutional Transformation Model

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

2015-10-19

Reducing the energy consumption of large institutions with dozens to hundreds of existing buildings while maintaining and improving existing infrastructure is a critical economic and environmental challenge. SNL's Institutional Transformation (IX) work integrates facilities and infrastructure sustainability technology capabilities and collaborative decision support modeling approaches to help facilities managers at Sandia National Laboratories (SNL) simulate different future energy reduction strategies and meet long term energy conservation goals.

Educational Leadership: Policy Dimensions in the 21st Century. Educational Policy in the 21st Century, Volume 1.

ERIC Educational Resources Information Center

Jones, Bruce Anthony, Ed.

The essays provided in this book shed light on and initiate debates about important policy issues associated with education reform and improvement. The authors do this by linking conceptual frameworks to past research, analyzing these challenges, and speculating about the contours of future research and school practice. Part 1, Educational…

Fifteen Years after the Surgeon General's Report: Challenges, Changes, and Future Directions in Physical Education

ERIC Educational Resources Information Center

Bryan, Charity L.; Sims, Sandra K.; Hester, Donna J.; Dunaway, Donna L.

2013-01-01

Great anticipation surrounded the release of the first ever Surgeon General's report on physical activity and health in 1996. The report stated that physical activity can contribute significantly to overall levels of health and the quality of life for all Americans. However, since the report's release, little has improved in the health status of…

Learners' Ensemble Based Security Conceptual Model for M-Learning System in Malaysian Higher Learning Institution

ERIC Educational Resources Information Center

Mahalingam, Sheila; Abdollah, Faizal Mohd; Sahib, Shahrin

2014-01-01

M-Learning has a potential to improve efficiency in the education sector and has a tendency to grow advance and transform the learning environment in the future. Yet there are challenges in many areas faced when introducing and implementing m-learning. The learner centered attribute in mobile learning implies deployment in untrustworthy learning…

Genomic Selection Improves Heat Tolerance in Dairy Cattle

PubMed Central

Garner, J. B.; Douglas, M. L.; Williams, S. R. O; Wales, W. J.; Marett, L. C.; Nguyen, T. T. T.; Reich, C. M.; Hayes, B. J.

2016-01-01

Dairy products are a key source of valuable proteins and fats for many millions of people worldwide. Dairy cattle are highly susceptible to heat-stress induced decline in milk production, and as the frequency and duration of heat-stress events increases, the long term security of nutrition from dairy products is threatened. Identification of dairy cattle more tolerant of heat stress conditions would be an important progression towards breeding better adapted dairy herds to future climates. Breeding for heat tolerance could be accelerated with genomic selection, using genome wide DNA markers that predict tolerance to heat stress. Here we demonstrate the value of genomic predictions for heat tolerance in cohorts of Holstein cows predicted to be heat tolerant and heat susceptible using controlled-climate chambers simulating a moderate heatwave event. Not only was the heat challenge stimulated decline in milk production less in cows genomically predicted to be heat-tolerant, physiological indicators such as rectal and intra-vaginal temperatures had reduced increases over the 4 day heat challenge. This demonstrates that genomic selection for heat tolerance in dairy cattle is a step towards securing a valuable source of nutrition and improving animal welfare facing a future with predicted increases in heat stress events. PMID:27682591

The Genetics of Non-conventional Wine Yeasts: Current Knowledge and Future Challenges.

PubMed

Masneuf-Pomarede, Isabelle; Bely, Marina; Marullo, Philippe; Albertin, Warren

2015-01-01

Saccharomyces cerevisiae is by far the most widely used yeast in oenology. However, during the last decade, several other yeasts species has been purposed for winemaking as they could positively impact wine quality. Some of these non-conventional yeasts (Torulaspora delbrueckii, Metschnikowia pulcherrima, Pichia kluyveri, Lachancea thermotolerans, etc.) are now proposed as starters culture for winemakers in mixed fermentation with S. cerevisiae, and several others are the subject of various studies (Hanseniaspora uvarum, Starmerella bacillaris, etc.). Along with their biotechnological use, the knowledge of these non-conventional yeasts greatly increased these last 10 years. The aim of this review is to describe the last updates and the current state-of-art of the genetics of non-conventional yeasts (including S. uvarum, T. delbrueckii, S. bacillaris, etc.). We describe how genomics and genetics tools provide new data into the population structure and biodiversity of non-conventional yeasts in winemaking environments. Future challenges will lie on the development of selection programs and/or genetic improvement of these non-conventional species. We discuss how genetics, genomics and the advances in next-generation sequencing will help the wine industry to develop the biotechnological use of non-conventional yeasts to improve the quality and differentiation of wines.

Pathway analyses and understanding disease associations

PubMed Central

Liu, Yu; Chance, Mark R

2013-01-01

High throughput technologies have been applied to investigate the underlying mechanisms of complex diseases, identify disease-associations and help to improve treatment. However it is challenging to derive biological insight from conventional single gene based analysis of “omics” data from high throughput experiments due to sample and patient heterogeneity. To address these challenges, many novel pathway and network based approaches were developed to integrate various “omics” data, such as gene expression, copy number alteration, Genome Wide Association Studies, and interaction data. This review will cover recent methodological developments in pathway analysis for the detection of dysregulated interactions and disease-associated subnetworks, prioritization of candidate disease genes, and disease classifications. For each application, we will also discuss the associated challenges and potential future directions. PMID:24319650

Becoming Earth Independent: Human-Automation-Robotics Integration Challenges for Future Space Exploration

NASA Technical Reports Server (NTRS)

Marquez, Jessica J.

2016-01-01

Future exploration missions will require NASA to integrate more automation and robotics in order to accomplish mission objectives. This presentation will describe on the future challenges facing the human operator (astronaut, ground controllers) as we increase the amount of automation and robotics in spaceflight operations. It will describe how future exploration missions will have to adapt and evolve in order to deal with more complex missions and communication latencies. This presentation will outline future human-automation-robotic integration challenges.

The internal challenges of medical informatics.

PubMed

Gell, G

1997-03-01

Haux's [7] basic assumption that the object of medical informatics is: "... to assure and to improve the quality of healthcare as well as the quality of research and education in medicine and in the health sciences ..." is taken as a starting point to discuss the three main topics: What is the meaning of medical informatics (i.e. what should be the main activities of medical informatics to bring maximum benefit to medicine)? What are the achievements and failures of medical informatics today (again considering the impact on the quality of healthcare)? What are the main challenges? Concerning the definition of medical informatics it is argued that one should not hide the link to basic informatics and, for that matter to computers, completely behind abstract definitions. After an analysis of the purposes of the definition of a discipline, a differentiated definition of the scope of medical informatics, rather general when concerning the field of scientific interest, more focused when concerning the practical (constructive) applications, is proposed. Contrasting Haux's chapter on achievements of medical informatics we concentrate on and analyse non fulfilled promises of medical informatics to derive lessons for the future and to propose 'generic' (or core) tasks of medical informatics to meet the challenges of the future. A set of 'internal challenges' of medical informatics to change priorities and attitudes within the discipline is put forward to enable medical informatics to meet the 'external challenges' listed by Haux.

Human Hemato-Lymphoid System Mice: Current Use and Future Potential for Medicine

PubMed Central

Rongvaux, Anthony; Takizawa, Hitoshi; Strowig, Till; Willinger, Tim; Eynon, Elizabeth E.

2014-01-01

To directly study complex human hemato-lymphoid system physiology and respective system-associated diseases in vivo, human-to-mouse xenotransplantation models for human blood and blood-forming cells and organs have been developed over the past three decades. We here review the fundamental requirements and the remarkable progress made over the past few years in improving these systems, the current major achievements reached by use of these models, and the future challenges to more closely model and study human health and disease and to achieve predictive preclinical testing of both prevention measures and potential new therapies. PMID:23330956

Regenerative Chemical Biology: Current Challenges and Future Potential

PubMed Central

Ao, Ada; Hao, Jijun; Hong, Charles C.

2011-01-01

The enthusiasm surrounding the clinical potential of embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) is tempered by the fact that key issues regarding their safety, efficacy, and long-term benefits have thus far been suboptimal. Small molecules can potentially relieve these problems at major junctions of stem cell biology and regenerative therapy. In this review, we will introduce recent advances in these important areas and the first-generation of small molecules used in the regenerative context. Current chemical biology studies will provide the archetype for future interdisciplinary collaborations, and improve clinical benefits of cell-based therapies. PMID:21513877

Overview of Maternal, Neonatal and Child Deaths in South Africa: Challenges, Opportunities, Progress and Future Prospects

PubMed Central

Mabaso, Musawenkosi H L; Ndaba, Thoko; Mkhize-Kwitshana, Zilungile L

2014-01-01

Background: The fact that most sub-Saharan Africa countries including South Africa (SA) are not on track to meet the 2015 target of improving maternal, neonate and child health (MNCH) is a major public health concern. The aim of this paper to give an overview of the current state of MNC deaths in SA, their relative causes, highlight challenges, existing opportunities, progress made and future prospects. Methods: The overview involved a synthesis and review of recent data and information from key national representative peer reviewed articles and grey literature from the National Department of Health and related stakeholder reports. Results: Since 1990 the situation in SA aroused a lot of research interest in tracing the historical context of the problem, evaluating progress made and actions for improving MNCH. In 2009 the SA government established three national committees for confidential enquiry on MNC deaths. Multifactorial systems’ related challenges were identified. Subsequently, the new National Strategic Plan for MNC and Women’s Health and Nutrition has, in addition to provision of comprehensive interventions, been linked and aligned with efforts to strengthen the health systems particularly through the re-engineering of the Primary Health Care (PHC) services and district health systems. Conclusion and Global Health Implications: The overview gives an insight of the process that has influenced MNCH policy and programs in the country. The SA experience and current MNCH situation may be different compared to other African countries, however, the political commitment and government stewardship coupled with critical and yet complimentary research is exemplary, especially, given several global and regional plans and commitments to improve MNCH in the continent. PMID:27621971

Sustaining Work Participation Across the Life Course.

PubMed

Pransky, Glenn S; Fassier, Jean-Baptise; Besen, Elyssa; Blanck, Peter; Ekberg, Kerstin; Feuerstein, Michael; Munir, Fehmidah

2016-12-01

Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.

Addressing challenges of training a new generation of clinician-innovators through an interdisciplinary medical technology design program: Bench-to-Bedside.

PubMed

Loftus, Patrick D; Elder, Craig T; D'Ambrosio, Troy; Langell, John T

2015-01-01

Graduate medical education has traditionally focused on training future physicians to be outstanding clinicians with basic and clinical science research skills. This focus has resulted in substantial knowledge gains, but a modest return on investment based on direct improvements in clinical care. In today's shifting healthcare landscape, a number of important challenges must be overcome to not only improve the delivery of healthcare, but to prepare future physicians to think outside the box, focus on and create healthcare innovations, and navigate the complex legal, business and regulatory hurdles of bringing innovation to the bedside. We created an interdisciplinary and experiential medical technology design competition to address these challenges and train medical students interested in moving new and innovative clinical solutions to the forefront of medicine. Medical students were partnered with business, law, design and engineering students to form interdisciplinary teams focused on developing solutions to unmet clinical needs. Over the course of six months teams were provided access to clinical and industry mentors, $500 prototyping funds, development facilities, and non-mandatory didactic lectures in ideation, design, intellectual property, FDA regulatory requirements, prototyping, market analysis, business plan development and capital acquisition. After four years of implementation, the program has supported 396 participants, seen the development of 91 novel medical devices, and launched the formation of 24 new companies. From our perspective, medical education programs that develop innovation training programs and shift incentives from purely traditional basic and clinical science research to also include high-risk innovation will see increased student engagement in improving healthcare delivery and an increase in the quality and quantity of innovative solutions to medical problems being brought to market.

Current Space Station Experiments Investigating Component Level Electronics Repair

NASA Technical Reports Server (NTRS)

Easton, John W.; Struk, Peter M.

2010-01-01

The Soldering in a Reduced Gravity Experiment (SoRGE) and Component Repair Experiment (CRE)-1 are tests performed on the International Space Station to determine the techniques, tools, and training necessary to allow future crews to perform manual electronics repairs at the component level. SoRGE provides information on the formation and internal structure of through-hole solder joints, illustrating the challenges and implications of soldering in reduced gravity. SoRGE showed a significant increase in internal void defects for joints formed in low gravity compared to normal gravity. Methods for mitigating these void defects were evaluated using a modified soldering process. CRE-1 demonstrated the removal, cleaning, and replacement of electronics components by manual means on functional circuit boards. The majority of components successful passed a post-repair functional test demonstrating the feasibility of component-level repair within the confines of a spacecraft. Together, these tasks provide information to recommend material and tool improvements, training improvements, and future work to help enable electronics repairs in future space missions.

NASA Fixed Wing Project: Green Technologies for Future Aircraft Generation

NASA Technical Reports Server (NTRS)

Del Rosario, Ruben; Koudelka, John M.; Wahls, Rich; Madavan, Nateri

2014-01-01

Commercial aviation relies almost entirely on subsonic fixed wing aircraft to constantly move people and goods from one place to another across the globe. While air travel is an effective means of transportation providing an unmatched combination of speed and range, future subsonic aircraft must improve substantially to meet efficiency and environmental targets.The NASA Fundamental Aeronautics Fixed Wing (FW) Project addresses the comprehensive challenge of enabling revolutionary energy efficiency improvements in subsonic transport aircraft combined with dramatic reductions in harmful emissions and perceived noise to facilitate sustained growth of the air transportation system. Advanced technologies and the development of unconventional aircraft systems offer the potential to achieve these improvements. Multidisciplinary advances are required in aerodynamic efficiency to reduce drag, structural efficiency to reduce aircraft empty weight, and propulsive and thermal efficiency to reduce thrust-specific energy consumption (TSEC) for overall system benefit. Additionally, advances are required to reduce perceived noise without adversely affecting drag, weight, or TSEC, and to reduce harmful emissions without adversely affecting energy efficiency or noise.The paper will highlight the Fixed Wing project vision of revolutionary systems and technologies needed to achieve these challenging goals. Specifically, the primary focus of the FW Project is on the N+3 generation; that is, vehicles that are three generations beyond the current state of the art, requiring mature technology solutions in the 2025-30 timeframe

Remote sensing of ecosystem health: opportunities, challenges, and future perspectives.

PubMed

Li, Zhaoqin; Xu, Dandan; Guo, Xulin

2014-11-07

Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1) scale issue; (2) transportability issue; (3) data availability; and (4) uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges.

Managing Earth's Future: Global Self-Restraint for the Common Good or Domination by Incentive and Power?

NASA Astrophysics Data System (ADS)

Anbar, A. D.; Hartnett, H. E.; Rowan, L. R.; Caldeira, K.

2016-12-01

We are global in our impacts, yet local in our thoughts and feelings. The daunting challenge facing Homo sapiens is learning to cooperate at global scale for the common good. Since the invention of the steam engine, we have been developing ever more efficient ways of generating consumer products. Some of the wealth generated by these more efficient technologies was reinvested into additional capital infrastructure, such as factories and machines. We thus expanded capacity to offer goods and services to insatiable consumers, expanding the ability to extract and transform natural resources into both valuable goods and services and dangerous pollution. Improvements in medical technologies led to quasi-exponential population growth, mirroring and multiplying the quasi-exponential growth in per capita consumption. This quasi-exponential growth is starting to reach boundaries, but these boundaries are not sending signals to the market that would allow a laissez faire approach to work. The central question is: How can we continue improving well-being while diminishing material flows associated with environmental pollution? Globally, if we do not place constraints on ourselves, nature will impose constraints on us. We can impose constraints on ourselves to protect us from what nature would otherwise to do to us. To have a sustainable future, we would need to level off population at the lowest feasible levels. The difference between a future population of 6 billion and 16 billion is a half-child per family less-or-more than the central projection of demographers. Empowering women with education and technology has proven to be a most effective strategy at reducing population growth. To have a sustainable future, we would need strong disincentives on environmental damage, especially from long-lived wastes such as carbon dioxide. It is of course a huge political challenge to get such disincentives in place. If we fail to get these global self-protective guardrails established, planetary management will be largely reactive, driven by competition among those with incentive and power. With better policies in place, we can look forward to a future of continuous innovation and ever-improving well-being, with stable populations and diminishing environmental impact.

Introduction to the supplement.

PubMed

Rappuoli, Rino

2015-06-08

In July of 2014, a symposium entitled "Enhancing Vaccine Immunity and Value" was held in Siena, Italy. The focus of the symposium was on how to best meet the challenge of developing and implementing vaccines for future disease targets. Vaccination has been responsible for averting estimated 3 billion cases of disease and more than 500 million lives to date through the prevention of infectious diseases. This has largely been responsible for dramatic increases in life span in developed countries. However, with the demographics of the world's population are changing, with many adults now surviving into their 80s, we now face the challenge of protecting the aging and other underserved populations not only against infectious diseases but also against cancer and other chronic conditions that occur in older adults. To face this challenge, we must harness new technologies derived from recent advances in the fields of immunology, structural biology, synthetic biology and genomics that promise a revolution in the vaccine field. Specifically, vaccine adjuvants have the potential to harness the immune system to provide protection against new types of diseases, improve protection in young children and expand this protection to adults and the elderly. However, in order to succeed, we need to overcome the non-technical challenges that could limit the implementation of innovative vaccines, including controversies regarding the safety of adjuvants, increasing regulatory complexity, the inadequate methods used to assess the value of novel vaccines, and the resulting industry alienation from future investment. In this supplement, we have assembled manuscripts from lectures and discussions of the symposium last July that addressed two related questions: how to improve vaccine efficacy using breakthrough technologies and how to capture the full potential of novel vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

The National Cancer Institute-American Society of Clinical Oncology Cancer Trial Accrual Symposium: summary and recommendations.

PubMed

Denicoff, Andrea M; McCaskill-Stevens, Worta; Grubbs, Stephen S; Bruinooge, Suanna S; Comis, Robert L; Devine, Peggy; Dilts, David M; Duff, Michelle E; Ford, Jean G; Joffe, Steven; Schapira, Lidia; Weinfurt, Kevin P; Michaels, Margo; Raghavan, Derek; Richmond, Ellen S; Zon, Robin; Albrecht, Terrance L; Bookman, Michael A; Dowlati, Afshin; Enos, Rebecca A; Fouad, Mona N; Good, Marjorie; Hicks, William J; Loehrer, Patrick J; Lyss, Alan P; Wolff, Steven N; Wujcik, Debra M; Meropol, Neal J

2013-11-01

Many challenges to clinical trial accrual exist, resulting in studies with inadequate enrollment and potentially delaying answers to important scientific and clinical questions. The National Cancer Institute (NCI) and the American Society of Clinical Oncology (ASCO) cosponsored the Cancer Trial Accrual Symposium: Science and Solutions on April 29-30, 2010 to examine the state of accrual science related to patient/community, physician/provider, and site/organizational influences, and identify new interventions to facilitate clinical trial enrollment. The symposium featured breakout sessions, plenary sessions, and a poster session including 100 abstracts. Among the 358 attendees were clinical investigators, researchers of accrual strategies, research administrators, nurses, research coordinators, patient advocates, and educators. A bibliography of the accrual literature in these three major areas was provided to participants in advance of the meeting. After the symposium, the literature in these areas was revisited to determine if the symposium recommendations remained relevant within the context of the current literature. Few rigorously conducted studies have tested interventions to address challenges to clinical trials accrual. Attendees developed recommendations for improving accrual and identified priority areas for future accrual research at the patient/community, physician/provider, and site/organizational levels. Current literature continues to support the symposium recommendations. A combination of approaches addressing both the multifactorial nature of accrual challenges and the characteristics of the target population may be needed to improve accrual to cancer clinical trials. Recommendations for best practices and for future research developed from the symposium are provided.

Supporting Greenhouse Gas Management Strategies with Observations and Analysis - Challenges and Opportunities

NASA Astrophysics Data System (ADS)

Butler, J. H.; Tarasova, O. A.

2014-12-01

Climate-change challenges facing society in the 21st century require an improved understanding of the global carbon-cycle and of the impacts and feedbacks of past, present, and future emissions of carbon-cycle gases. Global society faces a major challenge of reducing greenhouse gas emissions to virtually zero, most notably those of CO2, while at the same time facing variable and potentially overwhelming Earth System feedbacks. How it goes about this will depend upon the nature of impending international agreements, national laws, regional strategies, and social and economic forces. The challenge to those making observations to support, inform, or verify these reduction efforts, or to address potential Earth System feedbacks, lies in harmonizing a diverse array of observations and observing systems. Doing so is not trivial. Providing coherent, regional-scale information from these observations also requires improved modelling and ensemble reanalysis, but in the end such information must be relevant and reasonably certain. The challenge to us is to ensure a globally coherent observing and analysis system to supply the information that society will need to succeed. Policy-makers, scientists, government agencies, and businesses will need the best information available for decision-making and any observing and analysis system ultimately must be able to provide a coherent story over decades.

Advanced technology payoffs for future rotorcraft, commuter aircraft, cruise missile, and APU propulsion systems

NASA Technical Reports Server (NTRS)

Turk, M. A.; Zeiner, P. K.

1986-01-01

In connection with the significant advances made regarding the performance of larger gas turbines, challenges arise concerning the improvement of small gas turbine engines in the 250 to 1000 horsepower range. In response to these challenges, the NASA/Army-sponsored Small Engine Component Technology (SECT) study was undertaken with the objective to identify the engine cycle, configuration, and component technology requirements for the substantial performance improvements desired in year-2000 small gas turbine engines. In the context of this objective, an American turbine engine company evaluated engines for four year-2000 applications, including a rotorcraft, a commuter aircraft, a supersonic cruise missile, and an auxiliary power unit (APU). Attention is given to reference missions, reference engines, reference aircraft, year-2000 technology projections, cycle studies, advanced engine selections, and a technology evaluation.

The urban harvest approach as framework and planning tool for improved water and resource cycles.

PubMed

Leusbrock, I; Nanninga, T A; Lieberg, K; Agudelo-Vera, C M; Keesman, K J; Zeeman, G; Rijnaarts, H H M

2015-01-01

Water and resource availability in sufficient quantity and quality for anthropogenic needs represents one of the main challenges in the coming decades. To prepare for upcoming challenges such as increased urbanization and climate change related consequences, innovative and improved resource management concepts are indispensable. In recent years we have developed and applied the urban harvest approach (UHA). The UHA aims to model and quantify the urban water cycle on different temporal and spatial scales. This approach allowed us to quantify the impact of the implementation of water saving measures and new water treatment concepts in cities. In this paper we will introduce the UHA and its application for urban water cycles. Furthermore, we will show first results for an extension to energy cycles and highlight future research items (e.g. nutrients, water-energy-nexus).

Child Community Mental Health Services in Asia Pacific and Singapore’s REACH Model

PubMed Central

Lim, Choon Guan; Loh, Hannah; Renjan, Vidhya; Tan, Jason; Fung, Daniel

2017-01-01

In recent decades, there have been concerted efforts to improve mental health services for youths alongside the challenges of rising healthcare costs and increasing demand for mental health needs. One important phenomenon is the shift from traditional clinic-based care to community-based mental health services to improve accessibility to services and provide patient-centred care. In this article, we discuss the child and adolescent community mental health efforts within the Asia-Pacific region. We also discuss Singapore’s community and school-based mental health service, known as the Response, Early Intervention and Assessment in Community Mental Health (REACH). This article discusses how REACH has evolved over the years in response to the changing needs of youths in Singapore. Finally, we discuss the current challenges and future directions for youth mental health care. PMID:28984830

Future Orientation in Times of Threat and Challenge: How Resilient Adolescents Construct Their Future

ERIC Educational Resources Information Center

Seginer, Rachel

2008-01-01

Drawing on the importance of future orientation for adolescent development this analysis presents a model describing how future orientation is affected by high challenge (or resilience) in the face of political violence. The analysis consists of three parts. The first two present future orientation conceptualization and the psychological processes…

Renewable Electricity Futures Study. Volume 1: Exploration of High-Penetration Renewable Electricity Futures

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

Mai, T.; Wiser, R.; Sandor, D.

2012-06-01

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%-90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT).« less

A History of Neonatal Medicine—Past Accomplishments, Lessons Learned, and Future Challenges: Part II—The 1990s, the New Millennium, Future Challenges

PubMed Central

Lussky, Richard C.; Cifuentes, Raul F.; Siddappa, Ashajyothi M.

2005-01-01

This is the second of two articles reviewing the history of newborn medicine. This article will discuss recent accomplishments in the field of newborn medicine, current health outcome data, and future challenges facing the fields of neonatal and perinatal medicine. PMID:23118634

Multi-model and multi-scenario assessments of Asian water futures: The Water Futures and Solutions (WFaS) initiative

NASA Astrophysics Data System (ADS)

Satoh, Yusuke; Kahil, Taher; Byers, Edward; Burek, Peter; Fischer, Günther; Tramberend, Sylvia; Greve, Peter; Flörke, Martina; Eisner, Stephanie; Hanasaki, Naota; Magnuszewski, Piotr; Nava, Luzma Fabiola; Cosgrove, William; Langan, Simon; Wada, Yoshihide

2017-07-01

This paper presents one of the first quantitative scenario assessments for future water supply and demand in Asia to 2050. The assessment, developed by the Water Futures and Solutions (WFaS) initiative, uses the latest set of global climate change and socioeconomic scenarios and state-of-the-art global hydrological models. In Asia, water demand for irrigation, industry, and households is projected to increase substantially in the coming decades (30-40% by 2050 compared to 2010). These changes are expected to exacerbate water stress, especially in the current hotspots such as north India and Pakistan, and north China. By 2050, 20% of the land area in the Asia-Pacific region, with a population of 1.6-2 billion, is projected to experience severe water stress. We find that socioeconomic changes are the main drivers of worsening water scarcity in Asia, with climate change impacts further increasing the challenge into the 21st century. Moreover, a detailed basin-level analysis of the hydro-economic conditions of 40 Asian basins shows that although the coping capacity of all basins is expected to improve due to gross domestic product (GDP) growth, some basins continuously face severe water challenges. These basins will potentially be home to up to 1.6 billion people by mid-21st century.

Climate change and forests of the future: Managing in the face of uncertainty

USGS Publications Warehouse

Millar, C.I.; Stephenson, N.L.; Stephens, S.L.

2007-01-01

We offer a conceptual framework for managing forested ecosystems under an assumption that future environments will be different from present but that we cannot be certain about the specifics of change. We encourage flexible approaches that promote reversible and incremental steps, and that favor ongoing learning and capacity to modify direction as situations change. We suggest that no single solution fits all future challenges, especially in the context of changing climates, and that the best strategy is to mix different approaches for different situations. Resources managers will be challenged to integrate adaptation strategies (actions that help ecosystems accommodate changes adaptively) and mitigation strategies (actions that enable ecosystems to reduce anthropogenic influences on global climate) into overall plans. Adaptive strategies include resistance options (forestall impacts and protect highly valued resources), resilience options (improve the capacity of ecosystems to return to desired conditions after disturbance), and response options (facilitate transition of ecosystems from current to new conditions). Mitigation strategies include options to sequester carbon and reduce overall greenhouse gas emissions. Priority-setting approaches (e.g., triage), appropriate for rapidly changing conditions and for situations where needs are greater than available capacity to respond, will become increasingly important in the future. ?? 2007 by the Ecological Society of America.

Considerations on Caring for Caregivers in an Aging Society.

PubMed

Sinha, Dr Samir K

2015-01-01

While it is anticipated that healthcare systems around the world will continue to rely heavily on family members and friends to provide unpaid care especially to meet the needs of our aging population, current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. This paper builds on Williams et al's assertion that many current assumptions and issues around caregivers need to be challenged and addressed if we are to expect their future support. Indeed, with the pool of available caregivers expected to actually shrink in the future, this paper therefore examines four key policy issues in greater depth that we can address to enable individuals to age in place and others to maintain and take on caregiving roles. Through the establishment of policies that support robust and longterm capacity planning; make clear what care recipients and caregivers can expect to receive in the form of government supports; appreciate the increasing diversity that is occurring among those taking on caregiving roles and those requiring care; and recognize the need to invest in strategies that combat social isolation, we may not only improve our future health and well-being but ensure we are also enabled to care for ourselves as we age.

Innovative technology conserves resources and generates savings: a case study from the Sunnybrook Regional Processing Centre.

PubMed

Karim, Abdool Z

2009-01-01

The regional processing centre at Sunnybrook Health Sciences Centre recently faced the substantial challenge of increasing cleaning capacity to meet the current workload and anticipated future demand without increasing its operating budget. The solution, upgrading its cleaning and decontamination system to a highly automated system, met both objectives. An analysis of the impact of the change found that the new system provided additional benefits, including improved productivity and cleaning quality; decreased costs; reduced water, electricity and chemical use; improved worker safety and morale; and decreased overtime. Investing in innovative technology improved key departmental outcomes while meeting institutional environmental and cost savings objectives.

An evidence-based approach to organization evaluation and change in human service organizations evaluation and program planning.

PubMed

Schalock, Robert L; Lee, Tim; Verdugo, Miguel; Swart, Kees; Claes, Claudia; van Loon, Jos; Lee, Chun-Shin

2014-08-01

The work described in this article focuses primarily on how human service organizations can use an evidence-based, self-assessment approach to organization evaluation to facilitate continuous quality improvement and organization change. Real-life examples are presented, strengths and challenges discussed, and future conceptual and measurement issues identified. Copyright © 2014 Elsevier Ltd. All rights reserved.

State Education Agencies Overlooked in Education Reform? Talent Is the First Place to Start. 2011 PIE Network Summit Policy Briefs

ERIC Educational Resources Information Center

Campbell, Christine; DeArmond, Michael

2011-01-01

State education agencies have been tasked with an immense productivity challenge--increasing student outcomes on fewer funds for the unforeseeable future. The federal government has expected more from states over the last few decades in improving district and school performance: however, there were minimal gains even when states had more money.…

A Multi-Method Qualitative Study of a New Teacher Inservice Training Program to Improve Teaching in a Primary School

ERIC Educational Resources Information Center

James, Diann C.

2017-01-01

The purpose of this multi-method qualitative study was to collect data for a future development of an in-service training program for new teachers employed by Lake Forest Academy (pseudonym). New teachers of children with special educational needs faced challenges teaching in this Middle East country in addition to those faced by the new general…

Increasing Literacy in Quantitative Methods: The Key to the Future of Canadian Psychology

PubMed Central

Counsell, Alyssa; Cribbie, Robert A.; Harlow, Lisa. L.

2016-01-01

Quantitative methods (QM) dominate empirical research in psychology. Unfortunately most researchers in psychology receive inadequate training in QM. This creates a challenge for researchers who require advanced statistical methods to appropriately analyze their data. Many of the recent concerns about research quality, replicability, and reporting practices are directly tied to the problematic use of QM. As such, improving quantitative literacy in psychology is an important step towards eliminating these concerns. The current paper will include two main sections that discuss quantitative challenges and opportunities. The first section discusses training and resources for students and presents descriptive results on the number of quantitative courses required and available to graduate students in Canadian psychology departments. In the second section, we discuss ways of improving quantitative literacy for faculty, researchers, and clinicians. This includes a strong focus on the importance of collaboration. The paper concludes with practical recommendations for improving quantitative skills and literacy for students and researchers in Canada. PMID:28042199

IPECAD5--Fifth International Pharmaco-Economic Conference on Alzheimer's Disease.

PubMed

Gustavsson, A; Jonsson, L; Fillit, H; Johansson, G; Wimo, A; Winblad, B

2010-05-01

The Fifth International Pharmaco-Economic Conference on Alzheimer's Disease was held in New York, on March 27-29 in 2008. The attendees included researchers and key opinion leaders within the academia, pharmaceutical industry, patient organizations and regulatory bodies, collecting the worldwide leading expertise in Alzheimer research today. A summary of the presentations and conclusions from the discussions are presented in this publication. Pharmaco-economics need to play a leading role in developing and communicating evidence of the value of anti-dementia drugs, now and in the future. For the development of evidence, the challenges include transparency and standardization of costs of care assessment, improved diagnostics for identifying target patient groups, improved endpoints for assessing outcomes and improved models for assessing the long term consequences of competing treatment strategies. For the communication of evidence, the challenge lies in convincing decision makers to recognize the integrated burden of the disease, including its interaction with co-morbidities and burden on caregivers, and to consider the consequences of competing treatment strategies from a societal perspective.

Increasing Literacy in Quantitative Methods: The Key to the Future of Canadian Psychology.

PubMed

Counsell, Alyssa; Cribbie, Robert A; Harlow, Lisa L

2016-08-01

Quantitative methods (QM) dominate empirical research in psychology. Unfortunately most researchers in psychology receive inadequate training in QM. This creates a challenge for researchers who require advanced statistical methods to appropriately analyze their data. Many of the recent concerns about research quality, replicability, and reporting practices are directly tied to the problematic use of QM. As such, improving quantitative literacy in psychology is an important step towards eliminating these concerns. The current paper will include two main sections that discuss quantitative challenges and opportunities. The first section discusses training and resources for students and presents descriptive results on the number of quantitative courses required and available to graduate students in Canadian psychology departments. In the second section, we discuss ways of improving quantitative literacy for faculty, researchers, and clinicians. This includes a strong focus on the importance of collaboration. The paper concludes with practical recommendations for improving quantitative skills and literacy for students and researchers in Canada.

Quality improvement in medical education: current state and future directions.

PubMed

Wong, Brian M; Levinson, Wendy; Shojania, Kaveh G

2012-01-01

During the last decade, there has been a drive to improve the quality of patient care and prevent the occurrence of avoidable errors. This review describes current efforts to teach or engage trainees in patient safety and quality improvement (QI), summarises progress to date, as well as successes and challenges, and lists our recommendations for the next steps that will shape the future of patient safety and QI in medical education. Trainees encounter patient safety and QI through three main groups of activity. First are formal curricula that teach concepts or methods intended to facilitate trainees' participation in QI activities. These curricula increase learner knowledge and may improve clinical processes, but demonstrate limited capacity to modify learner behaviours. Second are educational activities that impart specific skills related to safety or quality which are considered to represent core doctor competencies (e.g. effective patient handover). These are frequently taught effectively, but without emphasis on the general safety or quality principles that inform the relevant skills. Third are real-life QI initiatives that involve trainees as active or passive participants. These innovative approaches expose trainees to safety and quality by integrating QI activities into trainees' day-to-day work. However, this integration can be challenging and can sometimes result in tension with broader educational goals. To prepare the next generation of doctors to make meaningful contributions to the quality mission, we propose the following call to action. Firstly, a major effort to build faculty capacity, especially among teachers of QI, should be instigated. Secondly, accreditation standards and assessment methods, both during training and at end-of-training certification examinations, should explicitly target these competencies. Finally, and perhaps most importantly, we must refocus our attention at all levels of training and instil fundamental, collaborative, open-minded behaviours so that future clinicians are primed to promote a culture of safer, higher-quality care. © Blackwell Publishing Ltd 2012.

A qualitative understanding of the effects of reusable sanitary pads and puberty education: implications for future research and practice.

PubMed

Hennegan, Julie; Dolan, Catherine; Steinfield, Laurel; Montgomery, Paul

2017-06-27

The management of menstruation has come to the fore as a barrier to girls' education attainment in low income contexts. Interventions have been proposed and piloted, but the emerging nature of the field means limited evidence is available to understand their pathways of effect. This study describes and compares schoolgirls' experiences of menstruation in rural Uganda at the conclusion of a controlled trial of puberty education and sanitary pad provision to elucidate pathways of effect in the interventions. Semi-structured interviews were undertaken with schoolgirls who participated in the Menstruation and the Cycle of Poverty trial concurrent with the final set of quantitative surveys. A framework approach and cross-case analysis were employed to describe and compare the experiences of 27 menstruating girls across the four intervention conditions; education (n = 8), reusable sanitary pads (n = 8), education with reusable sanitary pads (n = 6), and control (n = 5). Themes included: menstrual hygiene, soiling, irritation and infection, physical experience, knowledge of menstruation, psychological, social and cultural factors, and support from others. Those receiving reusable pads experienced improvements in comfort and reliability. This translated into reduced fears around garment soiling and related school absenteeism. Other menstrual hygiene challenges of washing, drying and privacy remained prominent. Puberty education improved girls' confidence to discuss menstruation and prompted additional support from teachers and peers. Findings have important implications for the development and evaluation of future interventions. Results suggest the provision of menstrual absorbents addresses one core barrier to menstrual health, but that interventions addressing broader needs such as privacy may improve effectiveness. Puberty education sessions should increase attention to body awareness and include strategies to address a wider range of practical menstrual challenges, including pain management. Interviews revealed possibilities for improving quantitative surveys in future research. Pan-African Clinical Trials Registry PACTR201503001044408.

Robotics and neurosurgery.

PubMed

Nathoo, Narendra; Pesek, Todd; Barnett, Gene H

2003-12-01

Ultimately, neurosurgery performed via a robotic interface will serve to improve the standard of a neurosurgeon's skills, thus making a good surgeon a better surgeon. In fact, computer and robotic instrumentation will become allies to the neurosurgeon through the use of these technologies in training, diagnostic, and surgical events. Nonetheless, these technologies are still in an early stage of development, and each device developed will entail its own set of challenges and limitations for use in clinical settings. The future operating room should be regarded as an integrated information system incorporating robotic surgical navigators and telecontrolled micromanipulators, with the capabilities of all principal neurosurgical concepts, sharing information, and under the control of a single person, the neurosurgeon. The eventual integration of robotic technology into mainstream clinical neurosurgery offers the promise of a future of safer, more accurate, and less invasive surgery that will result in improved patient outcome.

Lignin conversion: Opportunities and challenges for the integrated biorefinery

DOE PAGES

Xie, Shangxian; Ragauskas, Arthur J.; Yuan, Joshua S.

2016-06-21

The utilization of lignin for fungible fuels and products represents one of the most imminent challenges in the modern biorefinery because most of the bioprocesses for lignocellulosic biofuels results in a lignin-containing waste stream. Considering lignin's abundance and relatively high energy content, this waste stream can be used as a feedstock for value-added products to improve the sustainability and economic feasibility of the biorefinery. Bioconversion of lignin with microbes recently emerged as an alternative lignin-valorization approach with significant potential. Typically, the microbial bioconversion of lignin requires three major steps: lignin depolymerization, aromatic compounds catabolism, and target product biosynthesis. In thismore » review, we summarize the most recent advances in lignin bioconversion to address the challenges in each of the three steps. In conclusion, we further discuss strategies and perspectives for future research to address the challenges in bioconversion of lignin.« less

Lignin conversion: Opportunities and challenges for the integrated biorefinery

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

Xie, Shangxian; Ragauskas, Arthur J.; Yuan, Joshua S.

The utilization of lignin for fungible fuels and products represents one of the most imminent challenges in the modern biorefinery because most of the bioprocesses for lignocellulosic biofuels results in a lignin-containing waste stream. Considering lignin's abundance and relatively high energy content, this waste stream can be used as a feedstock for value-added products to improve the sustainability and economic feasibility of the biorefinery. Bioconversion of lignin with microbes recently emerged as an alternative lignin-valorization approach with significant potential. Typically, the microbial bioconversion of lignin requires three major steps: lignin depolymerization, aromatic compounds catabolism, and target product biosynthesis. In thismore » review, we summarize the most recent advances in lignin bioconversion to address the challenges in each of the three steps. In conclusion, we further discuss strategies and perspectives for future research to address the challenges in bioconversion of lignin.« less

Grand Challenges of Advanced Computing for Energy Innovation Report from the Workshop Held July 31-August 2, 2012

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

Larzelere, Alex R.; Ashby, Steven F.; Christensen, Dana C.

2013-03-06

On July 31-August 2 of 2012, the U.S. Department of Energy (DOE) held a workshop entitled Grand Challenges of Advanced Computing for Energy Innovation. This workshop built on three earlier workshops that clearly identified the potential for the Department and its national laboratories to enable energy innovation. The specific goal of the workshop was to identify the key challenges that the nation must overcome to apply the full benefit of taxpayer-funded advanced computing technologies to U.S. energy innovation in the ways that the country produces, moves, stores, and uses energy. Perhaps more importantly, the workshop also developed a set ofmore » recommendations to help the Department overcome those challenges. These recommendations provide an action plan for what the Department can do in the coming years to improve the nation’s energy future.« less

A Direct Assessment of “Obesogenic” Built Environments: Challenges and Recommendations

PubMed Central

Gasevic, Danijela; Vukmirovich, Ina; Yusuf, Salim; Teo, Koon; Chow, Clara; Dagenais, Gilles; Lear, Scott A.

2011-01-01

This paper outlines the challenges faced during direct built environment (BE) assessments of 42 Canadian communities of various income and urbanization levels. In addition, we recommend options for overcoming such challenges during BE community assessments. Direct BE assessments were performed utilizing two distinct audit methods: (1) modified version of Irvine-Minnesota Inventory in which a paper version of an audit tool was used to assess BE features and (2) a Physical Activity and Nutrition Features audit tool, where the presence and positions of all environmental features of interest were recorded using a Global-Positioning-System (GPS) unit. This paper responds to the call for the need of creators and users of environmental audit tools to share experiences regarding the usability of tools for BE assessments. The outlined BE assessment challenges plus recommendations for overcoming them can help improve and refine the existing audit tools and aid researchers in future assessments of the BE. PMID:22174727

Dealing with ethical challenges: a focus group study with professionals in mental health care.

PubMed

Molewijk, Bert; Hem, Marit Helene; Pedersen, Reidar

2015-01-16

Little is known about how health care professionals deal with ethical challenges in mental health care, especially when not making use of a formal ethics support service. Understanding this is important in order to be able to support the professionals, to improve the quality of care, and to know in which way future ethics support services might be helpful. Within a project on ethics, coercion and psychiatry, we executed a focus group interview study at seven departments with 65 health care professionals and managers. We performed a systematic and open qualitative analysis focusing on the question: 'How do health care professionals deal with ethical challenges?' We deliberately did not present a fixed definition or theory of ethical challenge. We categorized relevant topics into three subthemes: 1) Identification and presence of ethical challenges; 2) What do the participants actually do when dealing with an ethical challenge?; and 3) The significance of facing ethical challenges. Results varied from dealing with ethical challenges every day and appreciating it as a positive part of working in mental health care, to experiencing ethical challenges as paralyzing burdens that cause a lot of stress and hinder constructive team cooperation. Some participants reported that they do not have the time and that they lack a specific methodology. Quite often, informal and retrospective ad-hoc meetings in small teams were organized. Participants struggled with what makes a challenge an ethical challenge and whether it differs from a professional challenge. When dealing with ethical challenges, a number of participants experienced difficulties handling disagreement in a constructive way. Furthermore, some participants plead for more attention for underlying intentions and justifications of treatment decisions. The interviewed health care professionals dealt with ethical challenges in many different ways, often in an informal, implicit and reactive manner. This study revealed nine different categories of what health care professionals implicitly or explicitly conceive as 'ethical challenges'. Future research should focus on how ethics support services, such as ethics reflection groups or moral case deliberation, can be of help with respect to dealing with ethical challenges and value disagreements in a constructive way.

Renewable Electricity Futures Study. Volume 4: Bulk Electric Power Systems: Operations and Transmission Planning

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

Milligan, M.; Ela, E.; Hein, J.

2012-06-01

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%-90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT).« less

Renewable Electricity Futures Study. Volume 3: End-Use Electricity Demand

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

Hostick, D.; Belzer, D.B.; Hadley, S.W.

2012-06-01

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%-90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT).« less

Renewable Electricity Futures Study. Volume 2: Renewable Electricity Generation and Storage Technologies

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

Augustine, C.; Bain, R.; Chapman, J.

2012-06-01

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%-90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT).« less

Renewable Electricity Futures Study. Executive Summary

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

Mai, T.; Sandor, D.; Wiser, R.

2012-12-01

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%-90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT).« less

Community Health Workers in the United States: Challenges in Identifying, Surveying, and Supporting the Workforce.

PubMed

Sabo, Samantha; Allen, Caitlin G; Sutkowi, Katherine; Wennerstrom, Ashley

2017-12-01

Community health workers (CHWs) are members of a growing profession in the United States. Studying this dynamic labor force is challenging, in part because its members have more than 100 different job titles. The demand for timely, accurate information about CHWs is increasing as the profession gains recognition for its ability to improve health outcomes and reduce costs. Although numerous surveys of CHWs have been conducted, the field lacks well-delineated methods for gaining access to this hard-to-identify workforce. We outline methods for surveying CHWs and promising approaches to engage the workforce and other stakeholders in conducting local, state, and national studies. We also highlight successful strategies to overcome challenges in CHW surveys and future directions for surveying the field.

Heparin Characterization: Challenges and Solutions

NASA Astrophysics Data System (ADS)

Jones, Christopher J.; Beni, Szabolcs; Limtiaco, John F. K.; Langeslay, Derek J.; Larive, Cynthia K.

2011-07-01

Although heparin is an important and widely prescribed pharmaceutical anticoagulant, its high degree of sequence microheterogeneity and size polydispersity make molecular-level characterization challenging. Unlike nucleic acids and proteins that are biosynthesized through template-driven assembly processes, heparin and the related glycosaminoglycan heparan sulfate are actively remodeled during biosynthesis through a series of enzymatic reactions that lead to variable levels of O- and N-sulfonation and uronic acid epimers. As summarized in this review, heparin sequence information is determined through a bottom-up approach that relies on depolymerization reactions, size- and charge-based separations, and sensitive mass spectrometric and nuclear magnetic resonance experiments to determine the structural identity of component oligosaccharides. The structure-elucidation process, along with its challenges and opportunities for future analytical improvements, is reviewed and illustrated for a heparin-derived hexasaccharide.

Drugs for Neglected Diseases initiative model of drug development for neglected diseases: current status and future challenges.

PubMed

Ioset, Jean-Robert; Chang, Shing

2011-09-01

The Drugs for Neglected Diseases initiative (DNDi) is a patients' needs-driven organization committed to the development of new treatments for neglected diseases. Created in 2003, DNDi has delivered four improved treatments for malaria, sleeping sickness and visceral leishmaniasis. A main DNDi challenge is to build a solid R&D portfolio for neglected diseases and to deliver preclinical candidates in a timely manner using an original model based on partnership. To address this challenge DNDi has remodeled its discovery activities from a project-based academic-bound network to a fully integrated process-oriented platform in close collaboration with pharmaceutical companies. This discovery platform relies on dedicated screening capacity and lead-optimization consortia supported by a pragmatic, structured and pharmaceutical-focused compound sourcing strategy.

Insights from Parents about Caring for a Child with Birth Defects

PubMed Central

Lemacks, Jodi; Fowles, Kristin; Mateus, Amanda; Thomas, Kayte

2013-01-01

Birth defects affect 1 in 33 babies. Having a child with a birth defect impacts the whole family. Parents of children who have birth defects face unique challenges and desire to make life better for their kids. They also want to help to prevent birth defects in the future. Some of the challenges parents face involve communication with healthcare professionals, quality of life issues, creating awareness and advocating for research and funding, finding resources and support, and helping teens transition to appropriate, specialized adult care. This paper addresses these issues and their sub-issues, provides examples, and makes suggestions for improvement and research. PMID:23965922

St. Michael's Improvement Program - A Collaborative Approach to Sustainable Cost Savings.

PubMed

Trafford, Anne; Jane, Danielle

2017-01-01

In response to a challenging financial environment and increasing patient demand, St. Michael's Hospital needed to find long-term sustainable solutions to continue to provide high-quality patient care and invest in key priorities. By conducting Operational Reviews in focused areas, the hospital achieved $7.4 million of in-year savings in the first year, found standardizations, process efficiencies and direct cost savings that positioned itself for success in future funding models. Initiatives were grounded in evidence and relied heavily on the effective execution by the leadership, front-line staff and physicians. As organizations face similar challenges, this journey can provide key learnings.

Business involvement in science education

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

Winter, P.

1995-12-31

Science and math education in grades K through 12 directly affects America`s ability to meet tomorrow`s challenges. If America is to stay competitive in the world, we will need highly qualified scientists and engineers in industry and government and at universities. Jobs of the future will require greater technical and mathematical literacy than jobs of the past. Our goal is both to improve the quality of science education and to encourage more students to pursue science careers. General Atomics, a privately held research and development company, has joined the growing list of businesses that are committed to helping educators preparemore » students to meet these challenges.« less

Long-range strategic planning: a case study.

PubMed

Moller-Tiger, D

1999-05-01

In highly competitive healthcare markets, integrated delivery systems (IDSs) that have exhausted traditional means of maintaining market competitiveness are challenged to identify effective new strategies that will ensure market success in an uncertain future. Finding itself facing this challenge, Legacy Health System, a Portland, Oregon-based IDS, undertook an innovative, long-range, strategic-planning initiative based on an evaluation of key market trends. Legacy discovered that it might benefit from making some changes in the way it approached its mission. These changes included focusing on specific customer segments, developing products and services aimed at those customers, and broadening physician and insurer relationships to enhance service and improve customers' access to health care.

A Fuzzy Expert System for Fault Management of Water Supply Recovery in the ALSS Project

NASA Technical Reports Server (NTRS)

Tohala, Vapsi J.

1998-01-01

Modeling with a new software is a challenge. CONFIG is a challenge and is design to work with many types of systems in which discrete and continuous processes occur. The CONFIG software was used to model the two subsystem of the Water Recovery system: ICB and TFB. The model worked manually only for water flows with further implementation to be done in the future. Activities in the models are stiff need to be implemented based on testing of the hardware for phase III. More improvements to CONFIG are in progress to make it a more user friendly software.

The paradox of homeless youth pregnancy: a review of challenges and opportunities.

PubMed

Begun, Stephanie

2015-01-01

Compared to their housed counterparts, homeless youth become pregnant at exceptionally high rates. Causes of such pregnancies are multifaceted, while a paradoxically high proportion of these pregnancies are intended. This review discusses causes and risk factors associated with homeless youth pregnancies, and notes experiences of pregnancy decision-making discord, challenges encountered during and following pregnancy, and difficulties faced by homeless youth when or if they become parents. Because homeless youth face a wide array of unique risks, future research would benefit from exploring alternative approaches to prevention to reduce pregnancies and improve sexual and reproductive health outcomes among this population.

Therapeutic Genome Editing: Prospects and Challenges

PubMed Central

Cox, David Benjamin Turitz; Platt, Randall Jeffrey; Zhang, Feng

2015-01-01

Recent advances in the development of genome editing technologies based on programmable nucleases have significantly improved our ability to make precise changes in the genomes of eukaryotic cells. Genome editing is already broadening our ability to elucidate the contribution of genetics to disease by facilitating the creation of more accurate cellular and animal models of pathological processes. A particularly tantalizing application of programmable nucleases is the potential to directly correct genetic mutations in affected tissues and cells to treat diseases that are refractory to traditional therapies. Here we discuss current progress towards developing programmable nuclease-based therapies as well as future prospects and challenges. PMID:25654603

The development and piloting of the REnal specific Advanced Communication Training (REACT) programme to improve Advance Care Planning for renal patients.

PubMed

Bristowe, Katherine; Shepherd, Kate; Bryan, Liz; Brown, Heather; Carey, Irene; Matthews, Beverley; O'Donoghue, Donal; Vinen, Katie; Murtagh, Fliss E M

2014-04-01

In recent years, the End-Stage Kidney Disease population has increased and is ever more frail, elderly and co-morbid. A care-focused approach needs to be incorporated alongside the disease focus, to identify those who are deteriorating and improve communication about preferences and future care. Yet many renal professionals feel unprepared for such discussions. To develop and pilot a REnal specific Advanced Communication Training (REACT) programme to address the needs of End-Stage Kidney Disease patients and renal professionals. Two-part study: (1) development of the REnal specific Advanced Communication Training programme informed by multi-professional focus group and patient survey and (2) piloting of the programme. The REnal specific Advanced Communication Training programme was piloted with 16 participants (9 renal nurses/health-care assistants and 7 renal consultants) in two UK teaching hospitals. The focus group identified the need for better information about end-of-life phase, improved awareness of patient perspectives, skills to manage challenging discussions, 'hands on' practice in a safe environment and follow-up to discuss experiences. The patient survey demonstrated a need to improve communication about concerns, treatment plans and decisions. The developed REnal specific Advanced Communication Training programme was acceptable and feasible and was associated with a non-significant increase in confidence in communicating about end-of-life issues (pre-training: 6.6/10, 95% confidence interval: 5.7-7.4; post-training: 6.9/10, 95% confidence interval: 6.1-7.7, unpaired t-test - p = 0.56), maintained at 3 months. There is a need to improve end-of-life care for End-Stage Kidney Disease patients, to enable them to make informed decisions about future care. Challenges include prioritising communication training among service providers.

Tackling the challenges of matching biomedical ontologies.

PubMed

Faria, Daniel; Pesquita, Catia; Mott, Isabela; Martins, Catarina; Couto, Francisco M; Cruz, Isabel F

2018-01-15

Biomedical ontologies pose several challenges to ontology matching due both to the complexity of the biomedical domain and to the characteristics of the ontologies themselves. The biomedical tracks in the Ontology Matching Evaluation Initiative (OAEI) have spurred the development of matching systems able to tackle these challenges, and benchmarked their general performance. In this study, we dissect the strategies employed by matching systems to tackle the challenges of matching biomedical ontologies and gauge the impact of the challenges themselves on matching performance, using the AgreementMakerLight (AML) system as the platform for this study. We demonstrate that the linear complexity of the hash-based searching strategy implemented by most state-of-the-art ontology matching systems is essential for matching large biomedical ontologies efficiently. We show that accounting for all lexical annotations (e.g., labels and synonyms) in biomedical ontologies leads to a substantial improvement in F-measure over using only the primary name, and that accounting for the reliability of different types of annotations generally also leads to a marked improvement. Finally, we show that cross-references are a reliable source of information and that, when using biomedical ontologies as background knowledge, it is generally more reliable to use them as mediators than to perform lexical expansion. We anticipate that translating traditional matching algorithms to the hash-based searching paradigm will be a critical direction for the future development of the field. Improving the evaluation carried out in the biomedical tracks of the OAEI will also be important, as without proper reference alignments there is only so much that can be ascertained about matching systems or strategies. Nevertheless, it is clear that, to tackle the various challenges posed by biomedical ontologies, ontology matching systems must be able to efficiently combine multiple strategies into a mature matching approach.

Diagnosis of Ebola Virus Disease: Past, Present, and Future

PubMed Central

Brooks, Tim J. G.

2016-01-01

SUMMARY Laboratory diagnosis of Ebola virus disease plays a critical role in outbreak response efforts; however, establishing safe and expeditious testing strategies for this high-biosafety-level pathogen in resource-poor environments remains extremely challenging. Since the discovery of Ebola virus in 1976 via traditional viral culture techniques and electron microscopy, diagnostic methodologies have trended toward faster, more accurate molecular assays. Importantly, technological advances have been paired with increasing efforts to support decentralized diagnostic testing capacity that can be deployed at or near the point of patient care. The unprecedented scope of the 2014-2015 West Africa Ebola epidemic spurred tremendous innovation in this arena, and a variety of new diagnostic platforms that have the potential both to immediately improve ongoing surveillance efforts in West Africa and to transform future outbreak responses have reached the field. In this review, we describe the evolution of Ebola virus disease diagnostic testing and efforts to deploy field diagnostic laboratories in prior outbreaks. We then explore the diagnostic challenges pervading the 2014-2015 epidemic and provide a comprehensive examination of novel diagnostic tests that are likely to address some of these challenges moving forward. PMID:27413095

Evolving Applications, Technological Challenges and Future Opportunities in Neuromodulation: Proceedings of the Fifth Annual Deep Brain Stimulation Think Tank

PubMed Central

Ramirez-Zamora, Adolfo; Giordano, James J.; Gunduz, Aysegul; Brown, Peter; Sanchez, Justin C.; Foote, Kelly D.; Almeida, Leonardo; Starr, Philip A.; Bronte-Stewart, Helen M.; Hu, Wei; McIntyre, Cameron; Goodman, Wayne; Kumsa, Doe; Grill, Warren M.; Walker, Harrison C.; Johnson, Matthew D.; Vitek, Jerrold L.; Greene, David; Rizzuto, Daniel S.; Song, Dong; Berger, Theodore W.; Hampson, Robert E.; Deadwyler, Sam A.; Hochberg, Leigh R.; Schiff, Nicholas D.; Stypulkowski, Paul; Worrell, Greg; Tiruvadi, Vineet; Mayberg, Helen S.; Jimenez-Shahed, Joohi; Nanda, Pranav; Sheth, Sameer A.; Gross, Robert E.; Lempka, Scott F.; Li, Luming; Deeb, Wissam; Okun, Michael S.

2018-01-01

The annual Deep Brain Stimulation (DBS) Think Tank provides a focal opportunity for a multidisciplinary ensemble of experts in the field of neuromodulation to discuss advancements and forthcoming opportunities and challenges in the field. The proceedings of the fifth Think Tank summarize progress in neuromodulation neurotechnology and techniques for the treatment of a range of neuropsychiatric conditions including Parkinson's disease, dystonia, essential tremor, Tourette syndrome, obsessive compulsive disorder, epilepsy and cognitive, and motor disorders. Each section of this overview of the meeting provides insight to the critical elements of discussion, current challenges, and identified future directions of scientific and technological development and application. The report addresses key issues in developing, and emphasizes major innovations that have occurred during the past year. Specifically, this year's meeting focused on technical developments in DBS, design considerations for DBS electrodes, improved sensors, neuronal signal processing, advancements in development and uses of responsive DBS (closed-loop systems), updates on National Institutes of Health and DARPA DBS programs of the BRAIN initiative, and neuroethical and policy issues arising in and from DBS research and applications in practice. PMID:29416498

Evolving Applications, Technological Challenges and Future Opportunities in Neuromodulation: Proceedings of the Fifth Annual Deep Brain Stimulation Think Tank.

PubMed

Ramirez-Zamora, Adolfo; Giordano, James J; Gunduz, Aysegul; Brown, Peter; Sanchez, Justin C; Foote, Kelly D; Almeida, Leonardo; Starr, Philip A; Bronte-Stewart, Helen M; Hu, Wei; McIntyre, Cameron; Goodman, Wayne; Kumsa, Doe; Grill, Warren M; Walker, Harrison C; Johnson, Matthew D; Vitek, Jerrold L; Greene, David; Rizzuto, Daniel S; Song, Dong; Berger, Theodore W; Hampson, Robert E; Deadwyler, Sam A; Hochberg, Leigh R; Schiff, Nicholas D; Stypulkowski, Paul; Worrell, Greg; Tiruvadi, Vineet; Mayberg, Helen S; Jimenez-Shahed, Joohi; Nanda, Pranav; Sheth, Sameer A; Gross, Robert E; Lempka, Scott F; Li, Luming; Deeb, Wissam; Okun, Michael S

2017-01-01

The annual Deep Brain Stimulation (DBS) Think Tank provides a focal opportunity for a multidisciplinary ensemble of experts in the field of neuromodulation to discuss advancements and forthcoming opportunities and challenges in the field. The proceedings of the fifth Think Tank summarize progress in neuromodulation neurotechnology and techniques for the treatment of a range of neuropsychiatric conditions including Parkinson's disease, dystonia, essential tremor, Tourette syndrome, obsessive compulsive disorder, epilepsy and cognitive, and motor disorders. Each section of this overview of the meeting provides insight to the critical elements of discussion, current challenges, and identified future directions of scientific and technological development and application. The report addresses key issues in developing, and emphasizes major innovations that have occurred during the past year. Specifically, this year's meeting focused on technical developments in DBS, design considerations for DBS electrodes, improved sensors, neuronal signal processing, advancements in development and uses of responsive DBS (closed-loop systems), updates on National Institutes of Health and DARPA DBS programs of the BRAIN initiative, and neuroethical and policy issues arising in and from DBS research and applications in practice.

EPA Leadership on Science, Innovation, and Decision Support Tools for Addressing Current and Future Challenges.

PubMed

Hecht, Alan D; Ferster, Aaron; Summers, Kevin

2017-10-16

When the U.S. Environmental Protection Agency (EPA) was established nearly 50 years ago, the nation faced serious threats to its air, land, and water, which in turn impacted human health. These threats were effectively addressed by the creation of EPA (in 1970) and many subsequent landmark environmental legislations which in turn significantly reduced threats to the Nation's environment and public health. A key element of historic legislation is research aimed at dealing with current and future problems. Today we face national and global challenges that go beyond classic media-specific (air, land, water) environmental legislation and require an integrated paradigm of action and engagement based on (1) innovation based on science and technology, (2) stakeholder engagement and collaboration, and (3) public education and support. This three-pronged approach recognizes that current environmental problems, include social as well as physical and environmental factors, are best addressed through collaborative problem solving, the application of innovation in science and technology, and multiple stakeholder engagement. To achieve that goal, EPA's Office of Research and Development (ORD) is working directly with states and local communities to develop and apply a suite of accessible decision support tools (DST) that aim to improve environmental conditions, protect human health, enhance economic opportunity, and advance a resilient and sustainability society. This paper showcases joint EPA and state actions to develop tools and approaches that not only meet current environmental and public health challenges, but do so in a way that advances sustainable, healthy, and resilient communities well into the future. EPA's future plans should build on current work but aim to effectively respond to growing external pressures. Growing pressures from megatrends are a major challenge for the new Administration and for cities and states across the country. The recent hurricanes hitting Texas and the Gulf Coast, part of the increase in extreme weather events, make it clear that building resilient infrastructure is a crucial step to sustainability.

Gravitational wave searches using the DSN (Deep Space Network)

NASA Technical Reports Server (NTRS)

Nelson, S. J.; Armstrong, J. W.

1988-01-01

The Deep Space Network Doppler spacecraft link is currently the only method available for broadband gravitational wave searches in the 0.01 to 0.001 Hz frequency range. The DSN's role in the worldwide search for gravitational waves is described by first summarizing from the literature current theoretical estimates of gravitational wave strengths and time scales from various astrophysical sources. Current and future detection schemes for ground based and space based detectors are then discussed. Past, present, and future planned or proposed gravitational wave experiments using DSN Doppler tracking are described. Lastly, some major technical challenges to improve gravitational wave sensitivities using the DSN are discussed.

Precise and traceable carbon isotope ratio measurements by multicollector ICP-MS: what next?

PubMed

Santamaria-Fernandez, Rebeca

2010-06-01

This article reviews recent developments in the use of multicollector inductively coupled plasma mass spectrometry (MC-ICP-MS) to provide high-precision carbon isotope ratio measurements. MC-ICP-MS could become an alternative method to isotope ratio mass spectrometry (IRMS) for rapid carbon isotope ratio determinations in organic compounds and characterisation and certification of isotopic reference materials. In this overview, the advantages, drawbacks and potential of the method for future applications are critically discussed. Furthermore, suggestions for future improvements in terms of precision and sensitivity are made. No doubt, this is an exciting analytical challenge and, as such, hurdles will need to be cleared.

Home geriatric physiological measurements.

PubMed

Tamura, Toshiyo

2012-10-01

In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the 'smart-house' project. This review concludes by discussing future challenges of the future aged society.

Renewable Electricity Futures Study. Volume 1. Exploration of High-Penetration Renewable Electricity Futures

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

Hand, M. M.; Baldwin, S.; DeMeo, E.

2012-06-15

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%–90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT). Learn more at the RE Futures website. http://www.nrel.gov/analysis/re_futures/« less

Print quality challenges for the next decade

NASA Astrophysics Data System (ADS)

Meyer, John D.

1990-07-01

The decade of the eighties has seen a remarkable transformation in the performance and capabilities of shared and personal printers. Dramatic gains have been made in four key areas: cost, throughput, reliability and most significantly, print quality. The improvements in text print quality due to algorithmic fonts and increased resolution have been pivotal in the creation of the desktop publishing market. Electronic pre-press systems now include hardware to receive Postscript files accompanied by color originals for scanning and separation. These systems have application in the commercial printing of a wide variety of material e.g. books, magazines, brochures, newspapers. The vision of the future of hardcopy now embraces the full spectrum from typeset text to full color reproduction of natural images due to the advent of grayscale and color capability in printer technology. This will place increased demands for improvements in print quality, particularly in the use of grayscale and color. This paper gives an overview of the challenges which must be met and discusses data communication standards and print quality measurement techniques as a means of meeting these challenges for both color and black and white output.

The Health Behaviour in School-aged Children: WHO Collaborative Cross-National (HBSC) study: origins, concept, history and development 1982-2008.

PubMed

Currie, Candace; Nic Gabhainn, Saoirse; Godeau, Emmanuelle

2009-09-01

This paper traces the history of the HBSC study from its origins in the early 1980's to the present day describing how it was first conceptualised scientifically and how this influenced issues of study design. The challenges of managing a cross-national study are explained as are changes and adaptations over time with growth of the study from 3 to over forty country members. The key partnership with the World Health Organisation and its benefits are presented. With developments in scientific management and theoretical perspectives, HBSC has made a substantial contribution to the area of youth health. The last decade has seen increased dissemination to policy makers and evidence that scientific information arising from the study has influenced strategic policy development and practical health improvement programmes. This paper considers some of the key success factors and challenges for the study as it attempts to maximise its scientific output and channels the research findings into health improvement for young people. Future challenges for the study are also considered.

Safety of disease-modifying drugs for multiple sclerosis in pregnancy: current challenges and future considerations for effective pharmacovigilance.

PubMed

Lu, Ellen; Wang, Bing Wei; Guimond, Colleen; Synnes, Anne; Sadovnick, A Dessa; Dahlgren, Leanne; Traboulsee, Anthony; Tremlett, Helen

2013-03-01

When contemplating a pregnancy, women treated for multiple sclerosis (MS) with a disease-modifying drug must decide to discontinue their medication before conception or risk exposing their unborn child to potential drug toxicity. Few studies exist as reference for patients and physicians, and of those available, the majority are less than ideal due to real-world constraints, ethical issues and methodological shortcomings. The authors provide a brief summary of existing animal and human data with current recommendations regarding the safety of IFN-β, glatiramer acetate, natalizumab, mitoxantrone, fingolimod and teriflunomide during pregnancy and lactation in women with MS. We also assess the quality, strengths and limitations of the existing studies including challenges with study design. The investigation of outcomes such as spontaneous abortion and congenital anomalies are highlighted with potential methodological improvements for future studies on drug safety in pregnancy suggested. The authors explore the pharmacokinetics and pharmacodynamics of the MS disease-modifying drugs for their possible mechanistic role in fetal harm and discuss the potential role of clinical trials. Future pharmacovigilance studies should continue to pursue multicenter collaboration with an emphasis on appropriate study design.

Implementation successes and challenges in participating in a pragmatic study to improve colon cancer screening: perspectives of health center leaders.

PubMed

Coronado, Gloria D; Schneider, Jennifer L; Petrik, Amanda; Rivelli, Jennifer; Taplin, Stephen; Green, Beverly B

2017-09-01

Little is known about the challenges faced by community clinics who must address clinical priorities first when participating in pragmatic studies. We report on implementation challenges faced by the eight community health centers that participated in Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), a large comparative effectiveness cluster-randomized trial to evaluate a direct-mail program to increase the rate of colorectal cancer (CRC) screening. We conducted interviews, at the onset of implementation and 1 year later, with center leaders to identify challenges with implementing and sustaining an electronic medical record (EMR)-driven mailed program to increase CRC screening rates. We used the Consolidated Framework for Implementation Research to thematically analyze the content of meeting discussions and identify anticipated and experienced challenges. Common early concerns were patients' access to colonoscopy, patients' low awareness of CRC screening, time burden on clinic staff to carry out the STOP CRC program, inability to accurately identify eligible patients, and incompatibility of the program's approach with the patient population or organizational culture. Once the program was rolled out, time burden remained a primary concern and new organizational capacity and EMR issues were raised (e.g., EMR staffing resources and turnover in key leadership positions). Cited program successes were improved CRC screening processes and rates, more patients reached, reduced costs, and improved patient awareness, engagement, or satisfaction. These findings may inform any clinic considering mailed fecal testing programs and future pragmatic research efforts in community health centers.

Veterinary teaching hospitals: current challenges and pathways for the future.

PubMed

Hubbell, John A E

2008-01-01

University-based veterinary teaching hospitals must change to maintain their viability. A number of factors both internal and external to universities and the veterinary profession have contributed to the need for change. A task force formed by the Association of American Veterinary Medical Colleges and the American Association of Veterinary Clinicians was convened to identify the issues and propose individual and collective strategies for the future. Primary issues include a shortage of faculty and staff, the nature of the case load, the need for fiscal management strategies, and the need to manage stakeholder expectations. The majority of the proposed strategies for the future will be managed individually by the colleges. Proposed collective strategies center on increasing the number of specialists and improving recruitment and retention of faculty and staff.

Predicting item popularity: Analysing local clustering behaviour of users

NASA Astrophysics Data System (ADS)

Liebig, Jessica; Rao, Asha

2016-01-01

Predicting the popularity of items in rating networks is an interesting but challenging problem. This is especially so when an item has first appeared and has received very few ratings. In this paper, we propose a novel approach to predicting the future popularity of new items in rating networks, defining a new bipartite clustering coefficient to predict the popularity of movies and stories in the MovieLens and Digg networks respectively. We show that the clustering behaviour of the first user who rates a new item gives insight into the future popularity of that item. Our method predicts, with a success rate of over 65% for the MovieLens network and over 50% for the Digg network, the future popularity of an item. This is a major improvement on current results.

Prediction in complex systems: The case of the international trade network

NASA Astrophysics Data System (ADS)

Vidmer, Alexandre; Zeng, An; Medo, Matúš; Zhang, Yi-Cheng

2015-10-01

Predicting the future evolution of complex systems is one of the main challenges in complexity science. Based on a current snapshot of a network, link prediction algorithms aim to predict its future evolution. We apply here link prediction algorithms to data on the international trade between countries. This data can be represented as a complex network where links connect countries with the products that they export. Link prediction techniques based on heat and mass diffusion processes are employed to obtain predictions for products exported in the future. These baseline predictions are improved using a recent metric of country fitness and product similarity. The overall best results are achieved with a newly developed metric of product similarity which takes advantage of causality in the network evolution.

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

Widergren, Steven E.; Knight, Mark R.; Melton, Ronald B.

The Interoperability Strategic Vision whitepaper aims to promote a common understanding of the meaning and characteristics of interoperability and to provide a strategy to advance the state of interoperability as applied to integration challenges facing grid modernization. This includes addressing the quality of integrating devices and systems and the discipline to improve the process of successfully integrating these components as business models and information technology improve over time. The strategic vision for interoperability described in this document applies throughout the electric energy generation, delivery, and end-use supply chain. Its scope includes interactive technologies and business processes from bulk energy levelsmore » to lower voltage level equipment and the millions of appliances that are becoming equipped with processing power and communication interfaces. A transformational aspect of a vision for interoperability in the future electric system is the coordinated operation of intelligent devices and systems at the edges of grid infrastructure. This challenge offers an example for addressing interoperability concerns throughout the electric system.« less

Hypertrophic scarring: the greatest unmet challenge following burn injury

PubMed Central

Finnerty, Celeste C; Jeschke, Marc G; Branski, Ludwik K; Barret, Juan P.; Dziewulski, Peter; Herndon, David N

2017-01-01

Summary Improvements in acute burn care have enabled patients to survive massive burns which would have once been fatal. Now up to 70% of patients develop hypertrophic scars following burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. The current approach is to optimise the healing potential of the burn wound using targeted wound care and surgery in order to minimise the development of hypertrophic scarring. This approach often fails, and modulation of established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventative and therapeutic strategies. PMID:27707499

Biochemical and physiological MR imaging of skeletal muscle at 7 tesla and above.

PubMed

Chang, Gregory; Wang, Ligong; Cárdenas-Blanco, Arturo; Schweitzer, Mark E; Recht, Michael P; Regatte, Ravinder R

2010-06-01

Ultra-high field (UHF; >or=7 T) magnetic resonance imaging (MRI), with its greater signal-to-noise ratio, offers the potential for increased spatial resolution, faster scanning, and, above all, improved biochemical and physiological imaging of skeletal muscle. The increased spectral resolution and greater sensitivity to low-gamma nuclei available at UHF should allow techniques such as (1)H MR spectroscopy (MRS), (31)P MRS, and (23)Na MRI to be more easily implemented. Numerous technical challenges exist in the performance of UHF MRI, including changes in relaxation values, increased chemical shift and susceptibility artifact, radiofrequency (RF) coil design/B (1)(+) field inhomogeneity, and greater RF energy deposition. Nevertheless, the possibility of improved functional and metabolic imaging at UHF will likely drive research efforts in the near future to overcome these challenges and allow studies of human skeletal muscle physiology and pathophysiology to be possible at >or=7 T.

Spiral counter-current chromatography: Design, development, application, and challenges.

PubMed

Huang, Xin-Yi; Sun, Xiao-Ming; Pei, Dong; Di, Duo-Long

2017-01-01

Depending on the rapid growth in the radial gradient of the centrifugal force, spiral counter-current chromatography can greatly improve the retention of stationary phase, especially for the aqueous two-phase systems with ultra-polar and high viscosity that are not well retained in the conventional multilayer coils counter-current chromatography. As a result, it is an attractive and alternative technology that is suited for separation of hydrophilic compounds and has led to many exciting progress in recent years. This review presents the recent advances and applications of spiral counter-current chromatography, including its major benefits and limitations, some novel methods to improve the separation efficiency and its applications in separation of real samples. In addition, the remaining challenges and future perspectives on development of spiral counter-current chromatography also are proposed in this article. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed

Tozzi, Alberto E; Gesualdo, Francesco; D'Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges.

Can Digital Tools Be Used for Improving Immunization Programs?

PubMed Central

Tozzi, Alberto E.; Gesualdo, Francesco; D’Ambrosio, Angelo; Pandolfi, Elisabetta; Agricola, Eleonora; Lopalco, Pierluigi

2016-01-01

In order to successfully control and eliminate vaccine-preventable infectious diseases, an appropriate vaccine coverage has to be achieved and maintained. This task requires a high level of effort as it may be compromised by a number of barriers. Public health agencies have issued specific recommendations to address these barriers and therefore improve immunization programs. In the present review, we characterize issues and challenges of immunization programs for which digital tools are a potential solution. In particular, we explore previously published research on the use of digital tools in the following vaccine-related areas: immunization registries, dose tracking, and decision support systems; vaccine-preventable diseases surveillance; surveillance of adverse events following immunizations; vaccine confidence monitoring; and delivery of information on vaccines to the public. Subsequently, we analyze the limits of the use of digital tools in such contexts and envision future possibilities and challenges. PMID:27014673

Developing the evidence base for adult social care practice: The NIHR School for Social Care Research

PubMed Central

Knapp, Martin; Manthorpe, Jill; Mehta, Angela; Challis, David; Glendinning, Caroline; Hastings, Gill; Mansell, Jim; Netten, Ann

2011-01-01

In a foreword to Shaping the Future of Care Together, Prime Minister Gordon Brown says that a care and support system reflecting the needs of our times and meeting our rising aspirations is achievable, but ‘only if we are prepared to rise to the challenge of radical reform’. A number of initiatives will be needed to meet the challenge of improving social care for the growing older population. Before the unveiling of the green paper, The National Institute for Health Research (NIHR) announced that it has provided £15m over a five-year period to establish the NIHR School for Social Care Research. The School’s primary aim is to conduct or commission research that will help to improve adult social care practice in England. The School is seeking ideas for research topics, outline proposals for new studies and expert advice in developing research methods. PMID:22003363

Current challenges in organic photovoltaic solar energy conversion.

PubMed

Schlenker, Cody W; Thompson, Mark E

2012-01-01

Over the last 10 years, significant interest in utilizing conjugated organic molecules for solid-state solar to electric conversion has produced rapid improvement in device efficiencies. Organic photovoltaic (OPV) devices are attractive for their compatibility with low-cost processing techniques and thin-film applicability to flexible and conformal applications. However, many of the processes that lead to power losses in these systems still remain poorly understood, posing a significant challenge for the future efficiency improvements required to make these devices an attractive solar technology. While semiconductor band models have been employed to describe OPV operation, a more appropriate molecular picture of the pertinent processes is beginning to emerge. This chapter presents mechanisms of OPV device operation, based on the bound molecular nature of the involved transient species. With the intention to underscore the importance of considering both thermodynamic and kinetic factors, recent progress in elucidating molecular characteristics that dictate photovoltage losses in heterojunction organic photovoltaics is also discussed.

Saudi Vigilance Program: Challenges and lessons learned.

PubMed

Alharf, Adel; Alqahtani, Nasser; Saeed, Ghazi; Alshahrani, Ali; Alshahrani, Mubarak; Aljasser, Nasser; Alquwaizani, Mohammed; Bawazir, Saleh

2018-03-01

Pharmacovigilance is vital to public health. Adopting a robust spontaneous reporting system for adverse drug events can counteract most hazards that arise from utilizing medicinal products. Prior to the establishment of the Saudi Food and Drug Authority (SFDA), the number of pharmacovigilance-related activities in Saudi Arabia was limited. In 2009, the SFDA established the National Pharmacovigilance and Drug Safety Center (Saudi Vigilance). The pharmacovigilance system has remarkably improved during the past few years. Several initiatives have been taken to improve the program's performance. These initiatives include initiation of pharmacovigilance guidelines, enhancement of communication and reporting tools, training sessions for concerned staff and healthcare providers, and compliance from stakeholders. This review article provides an overview of what the Saudi Vigilance program is, focusing on the scope, mission and vision, hierarchy, operational themes, and overall work processes. Additionally, we will shed light on the challenges we encountered during the early phase and on our future plans.

The Future of Asset Management for Human Space Exploration: Supply Classification and an Integrated Database

NASA Technical Reports Server (NTRS)

Shull, Sarah A.; Gralla, Erica L.; deWeck, Olivier L.; Shishko, Robert

2006-01-01

One of the major logistical challenges in human space exploration is asset management. This paper presents observations on the practice of asset management in support of human space flight to date and discusses a functional-based supply classification and a framework for an integrated database that could be used to improve asset management and logistics for human missions to the Moon, Mars and beyond.

Experiencing the Needs and Challenges of ELLs: Improving Knowledge and Efficacy of Pre-Service Teachers through the Use of a Language Immersion Simulation

ERIC Educational Resources Information Center

Wright-Maley, Cory; Green, Jennifer D.

2015-01-01

Pre-service teachers need to understand how to support ELLs in their future classrooms, yet evidence suggests that pre-service ELL training may not be as effective as we need it to be. One promising strategy for increasing pre-service teachers' efficacy and knowledge around teaching ELLs is through a shock-and-show simulation. This strategy…

Perspectives on Defense Futures: National Developments in Europe

DTIC Science & Technology

1986-04-01

little danger of coming apart at the seam in the next 10 years, fiscal constraints on improving defenses will be a dominant environmental factor and...a source of further intra- Alliance frictions. European maritime forces, in particular, will feel the effects of a fiscally corseted planning...EXECUTIVE SUMMARY EUROPE IN THE LATE 198Qs sets the context with a brief survey of the political, fiscal , and force modernization challenges

How to Excel at Research Computing in Times of Diminishing Resources, Growing Demand, and Expanding Possibilities. A Report on the ECAR Annual Meeting. Research Bulletin

ERIC Educational Resources Information Center

Grajek, Susan

2014-01-01

For three days in January 2014, more than a hundred thought leaders met in Tempe, Arizona, to discuss the present and future challenges and opportunities for IT's support of research. Recommendations to improve institutions' support of scientific and humanities research included shaping central IT's role as an aggregator; ensuring that central IT…

Biomedical Simulation: Evolution, Concepts, Challenges and Future Trends.

PubMed

Sá-Couto, Carla; Patrão, Luís; Maio-Matos, Francisco; Pêgo, José Miguel

2016-12-30

Biomedical simulation is an effective educational complement for healthcare training, both at undergraduate and postgraduate level. It enables knowledge, skills and attitudes to be acquired in a safe, educationally orientated and efficient manner. In this context, simulation provides skills and experience that facilitate the transfer of cognitive, psychomotor and proper communication competences, thus changing behavior and attitudes, and ultimately improving patient safety. Beyond the impact on individual and team performance, simulation provides an opportunity to study organizational failures and improve system performance. Over the last decades, simulation in healthcare had a slow but steady growth, with a visible maturation in the last ten years. The simulation community must continue to provide the core leadership in developing standards. There is a need for strategies and policy development to ensure its coordinated and cost-effective implementation, applied to patient safety. This paper reviews the evolutionary movements of biomedical simulation, including a review of the Portuguese initiatives and nationwide programs. For leveling knowledge and standardize terminology, basic but essential concepts in clinical simulation, together with some considerations on assessment, validation and reliability are presented. The final sections discuss the current challenges and future initiatives and strategies, crucial for the integration of simulation programs in the greater movement toward patient safety.

The Genetics of Non-conventional Wine Yeasts: Current Knowledge and Future Challenges

PubMed Central

Masneuf-Pomarede, Isabelle; Bely, Marina; Marullo, Philippe; Albertin, Warren

2016-01-01

Saccharomyces cerevisiae is by far the most widely used yeast in oenology. However, during the last decade, several other yeasts species has been purposed for winemaking as they could positively impact wine quality. Some of these non-conventional yeasts (Torulaspora delbrueckii, Metschnikowia pulcherrima, Pichia kluyveri, Lachancea thermotolerans, etc.) are now proposed as starters culture for winemakers in mixed fermentation with S. cerevisiae, and several others are the subject of various studies (Hanseniaspora uvarum, Starmerella bacillaris, etc.). Along with their biotechnological use, the knowledge of these non-conventional yeasts greatly increased these last 10 years. The aim of this review is to describe the last updates and the current state-of-art of the genetics of non-conventional yeasts (including S. uvarum, T. delbrueckii, S. bacillaris, etc.). We describe how genomics and genetics tools provide new data into the population structure and biodiversity of non-conventional yeasts in winemaking environments. Future challenges will lie on the development of selection programs and/or genetic improvement of these non-conventional species. We discuss how genetics, genomics and the advances in next-generation sequencing will help the wine industry to develop the biotechnological use of non-conventional yeasts to improve the quality and differentiation of wines. PMID:26793188

Learning clinically useful information from images: Past, present and future.

PubMed

Rueckert, Daniel; Glocker, Ben; Kainz, Bernhard

2016-10-01

Over the last decade, research in medical imaging has made significant progress in addressing challenging tasks such as image registration and image segmentation. In particular, the use of model-based approaches has been key in numerous, successful advances in methodology. The advantage of model-based approaches is that they allow the incorporation of prior knowledge acting as a regularisation that favours plausible solutions over implausible ones. More recently, medical imaging has moved away from hand-crafted, and often explicitly designed models towards data-driven, implicit models that are constructed using machine learning techniques. This has led to major improvements in all stages of the medical imaging pipeline, from acquisition and reconstruction to analysis and interpretation. As more and more imaging data is becoming available, e.g., from large population studies, this trend is likely to continue and accelerate. At the same time new developments in machine learning, e.g., deep learning, as well as significant improvements in computing power, e.g., parallelisation on graphics hardware, offer new potential for data-driven, semantic and intelligent medical imaging. This article outlines the work of the BioMedIA group in this area and highlights some of the challenges and opportunities for future work. Copyright © 2016 Elsevier B.V. All rights reserved.

In vivo models in breast cancer research: progress, challenges and future directions

PubMed Central

Holen, Ingunn; Speirs, Valerie; Morrissey, Bethny

2017-01-01

ABSTRACT Research using animal model systems has been instrumental in delivering improved therapies for breast cancer, as well as in generating new insights into the mechanisms that underpin development of the disease. A large number of different models are now available, reflecting different types and stages of the disease; choosing which one to use depends on the specific research question(s) to be investigated. Based on presentations and discussions from leading experts who attended a recent workshop focused on in vivo models of breast cancer, this article provides a perspective on the many varied uses of these models in breast cancer research, their strengths, associated challenges and future directions. Among the questions discussed were: how well do models represent the different stages of human disease; how can we model the involvement of the human immune system and microenvironment in breast cancer; what are the appropriate models of metastatic disease; can we use models to carry out preclinical drug trials and identify pathways responsible for drug resistance; and what are the limitations of patient-derived xenograft models? We briefly outline the areas where the existing breast cancer models require improvement in light of the increased understanding of the disease process, reflecting the drive towards more personalised therapies and identification of mechanisms of drug resistance. PMID:28381598

Financial Risk Reduction and Management of Water Reservoirs Using Forecasts: A Case for Pernambuco, Brazil

NASA Astrophysics Data System (ADS)

Kumar, I.; Josset, L.; e Silva, E. C.; Possas, J. M. C.; Asfora, M. C.; Lall, U.

2017-12-01

The financial health and sustainability, ensuring adequate supply, and adapting to climate are fundamental challenges faced by water managers. These challenges are worsened in semi-arid regions with socio-economic pressures, seasonal supply of water, and projected increase in intensity and frequency of droughts. Over time, probabilistic rainfall forecasts are improving and for water managers, it could be key in addressing the above challenges. Using forecasts can also help make informed decisions about future infrastructure. The study proposes a model to minimize cost of water supply (including cost of deficit) given ensemble forecasts. The model can be applied to seasonal to annual ensemble forecasts, to determine the least cost solution. The objective of the model is to evaluate the resiliency and cost associated to supplying water. A case study is conducted in one of the largest reservoirs (Jucazinho) in Pernambuco state, Brazil, and four other reservoirs, which provide water to nineteen municipalities in the Jucazinho system. The state has been in drought since 2011, and the Jucazinho reservoir, has been empty since January 2017. The importance of climate adaptation along with risk management and financial sustainability are important to the state as it is extremely vulnerable to droughts, and has seasonal streamflow. The objectives of the case study are first, to check if streamflow forecasts help reduce future supply costs by comparing k-nearest neighbor ensemble forecasts with a fixed release policy. Second, to determine the value of future infrastructure, a new source of supply from Rio São Francisco, considered to mitigate drought conditions. The study concludes that using forecasts improve the supply and financial sustainability of water, by reducing cost of failure. It also concludes that additional infrastructure can help reduce the risks of failure significantly, but does not guarantee supply during prolonged droughts like the one experienced currently.

A systematic review of cost-effectiveness modeling of pharmaceutical therapies in neuropathic pain: variation in practice, key challenges, and recommendations for the future.

PubMed

Critchlow, Simone; Hirst, Matthew; Akehurst, Ron; Phillips, Ceri; Philips, Zoe; Sullivan, Will; Dunlop, Will C N

2017-02-01

Complexities in the neuropathic-pain care pathway make the condition difficult to manage and difficult to capture in cost-effectiveness models. The aim of this study is to understand, through a systematic review of previous cost-effectiveness studies, some of the key strengths and limitations in data and modeling practices in neuropathic pain. Thus, the aim is to guide future research and practice to improve resource allocation decisions and encourage continued investment to find novel and effective treatments for patients with neuropathic pain. The search strategy was designed to identify peer-reviewed cost-effectiveness evaluations of non-surgical, pharmaceutical therapies for neuropathic pain published since January 2000, accessing five key databases. All identified publications were reviewed and screened according to pre-defined eligibility criteria. Data extraction was designed to reflect key data challenges and approaches to modeling in neuropathic pain and based on published guidelines. The search strategy identified 20 cost-effectiveness analyses meeting the inclusion criteria, of which 14 had original model structures. Cost-effectiveness modeling in neuropathic pain is established and increasing across multiple jurisdictions; however, amongst these studies, there is substantial variation in modeling approach, and there are common limitations. Capturing the effect of treatments upon health outcomes, particularly health-related quality-of-life, is challenging, and the health effects of multiple lines of ineffective treatment, common for patients with neuropathic pain, have not been consistently or robustly modeled. To improve future economic modeling in neuropathic pain, further research is suggested into the effect of multiple lines of treatment and treatment failure upon patient outcomes and subsequent treatment effectiveness; the impact of treatment-emergent adverse events upon patient outcomes; and consistent and appropriate pain measures to inform models. The authors further encourage transparent reporting of inputs used to inform cost-effectiveness models, with robust, comprehensive and clear uncertainty analysis and, where feasible, open-source modeling is encouraged.

Renewable Electricity Futures Study. Volume 2. Renewable Electricity Generation and Storage Technologies

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

Augustine, Chad; Bain, Richard; Chapman, Jamie

2012-06-15

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%–90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT). Learn more at the RE Futures website. http://www.nrel.gov/analysis/re_futures/« less

Renewable Electricity Futures Study. Volume 3. End-Use Electricity Demand

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

Hostick, Donna; Belzer, David B.; Hadley, Stanton W.

2012-06-15

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%–90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT). Learn more at the RE Futures website. http://www.nrel.gov/analysis/re_futures/« less

Renewable Electricity Futures Study. Volume 4: Bulk Electric Power Systems. Operations and Transmission Planning

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

Milligan, Michael; Ela, Erik; Hein, Jeff

2012-06-15

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a futuremore » through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%–90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT). Learn more at the RE Futures website. http://www.nrel.gov/analysis/re_futures/« less

[Innovations in vaccinology: challenge and opportunities for Africa].

PubMed

Diop, Doudou; Sanicas, Melvin

2017-01-01

Immunization is undoubtedly one of the most effective and most cost-effective health interventions. Vaccines continue to revolutionize our ability to prevent diseases and improve health. With all the technological advances, we are able to extend the benefits of vaccines to more people and to provide better protection from life-threatening infectious diseases. Nevertheless, thanks to the unceasing implementation of novel microbial strains on a worldwide basis, research in vaccinology must innovate continuously. African countries have made great progress in increasing routine immunization coverage rates and in introducing newly developed vaccines. New types of vaccines associated with vectorization, administration and specific licensing tools as well as with adjuvants designed to finely modulate immune responses are expected to be achieved in the near future. African countries need to work to develop a regional approach to respond effectively to the many challenges. Providing better information, implementing healthcare personnel vaccinology training programs and well targeted research projects are the keys to future achievements in the field.

Enhancing metaproteomics-The value of models and defined environmental microbial systems

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

Herbst, Florian-Alexander; Lünsmann, Vanessa; Kjeldal, Henrik

Metaproteomicsthe large-scale characterization of the entire protein complement of environmental microbiota at a given point in timehas provided new features to study complex microbial communities in order to unravel these black boxes. Some new technical challenges arose that were not an issue for classical proteome analytics before that could be tackled by the application of different model systems. Here, we review different current and future model systems for metaproteome analysis. We introduce model systems for clinical and biotechnological research questions including acid mine drainage, anaerobic digesters, and activated sludge, following a short introduction to microbial communities and metaproteomics. Model systemsmore » are useful to evaluate the challenges encountered within (but not limited to) metaproteomics, including species complexity and coverage, biomass availability, or reliable protein extraction. Moreover, the implementation of model systems can be considered as a step forward to better understand microbial community responses and ecological functions of single member organisms. In the future, improvements are necessary to fully explore complex environmental systems by metaproteomics.« less

Enhancing metaproteomics-The value of models and defined environmental microbial systems

DOE PAGES

Herbst, Florian-Alexander; Lünsmann, Vanessa; Kjeldal, Henrik; ...

2016-01-21

Metaproteomicsthe large-scale characterization of the entire protein complement of environmental microbiota at a given point in timehas provided new features to study complex microbial communities in order to unravel these black boxes. Some new technical challenges arose that were not an issue for classical proteome analytics before that could be tackled by the application of different model systems. Here, we review different current and future model systems for metaproteome analysis. We introduce model systems for clinical and biotechnological research questions including acid mine drainage, anaerobic digesters, and activated sludge, following a short introduction to microbial communities and metaproteomics. Model systemsmore » are useful to evaluate the challenges encountered within (but not limited to) metaproteomics, including species complexity and coverage, biomass availability, or reliable protein extraction. Moreover, the implementation of model systems can be considered as a step forward to better understand microbial community responses and ecological functions of single member organisms. In the future, improvements are necessary to fully explore complex environmental systems by metaproteomics.« less

[The strict sense nursing postgraduation in Brazil: advances and perspectives].

PubMed

Scochi, Carmen Gracinda Silvan; Munari, Denize Bouttelet; Gelbcke, Francine Lima; Erdmann, Alacoque Lorenzini; de Gutiérrez, Maria Gaby Rivero; Rodrigues, Rosalina Aparecida Partezani

2013-09-01

Nursing is a specific field of knowledge and social practice that has been consolidated and strengthened as science. In Brazil, it has been developed due to the increase and qualification of strict sense post-graduate programs. This study aims to present a historical review of the strict sense post-graduate nursing courses in Brazil and to reflect on their evolution, progress, challenges and future perspectives. It explores the creation of strict sense post-graduate courses, highlighting the movement to build a culture of academic and professional post-graduation in nursing. The historical path of their consolidation, expansion, conquest of excellence and international visibility over four decades, and the challenges and future perspectives are showed. It is found that the post-graduate programs in the field has contributed to the advancement and consolidation of scientific, technological knowledge and innovation in nursing and health care, having as philosophy the respect for diversity and the free exchange of ideas, the improvement of quality of life and health, and the effectiveness of citizenship.

Challenges and future in vaccines, drug development, and immunomodulatory therapy.

PubMed

Kling, Heather M; Nau, Gerard J; Ross, Ted M; Evans, Thomas G; Chakraborty, Krishnendu; Empey, Kerry M; Flynn, JoAnne L

2014-08-01

Pulmonary diseases and infections are among the top contributors to human morbidity and mortality worldwide, and despite the successful history of vaccines and antimicrobial therapeutics, infectious disease still presents a significant threat to human health. Effective vaccines are frequently unavailable in developing countries, and successful vaccines have yet to be developed for major global maladies, such as tuberculosis. Furthermore, antibiotic resistance poses a growing threat to human health. The "Challenges and Future in Vaccines, Drug Development, and Immunomodulatory Therapy" session of the 2013 Pittsburgh International Lung Conference highlighted several recent and current studies related to treatment and prevention of antibiotic-resistant bacterial infections, highly pathogenic influenza, respiratory syncytial virus, and tuberculosis. Research presented here focused on novel antimicrobial therapies, new vaccines that are either in development or currently in clinical trials, and the potential for immunomodulatory therapies. These studies are making important contributions to the areas of microbiology, virology, and immunology related to pulmonary diseases and infections and are paving the way for improvements in the efficacy of vaccines and antimicrobials.

Exploring Nursing Students' Experiences of Learning Using Phenomenography: A Literature Review.

PubMed

Barry, Sinead; Ward, Louise; Walter, Ruby

2017-10-01

The purpose of this extensive international and national literature review was to explore how phenomenography identifies nursing students' experiences of learning within preregistration (or prelicensure) nursing education. Data were collected utilizing a comprehensive search of electronic databases. Full text, peer-reviewed, and scholarly articles published in English using the search terms phenomengraph*, nurs*, student, education, and learning were reviewed. Two discreet themes emerged exploring students' experiences of learning within preregistration nursing education: (a) Phenomenography was a beneficial method to expose variation in students' understandings of a challenging concept or topic and (b) phenomenography was beneficial to evaluate teaching methods in attempt to improve student learning of challenging and complex concepts. On the basis of these findings, future research utilizing phenomenography within nursing education has potential to uncover variation in students' understandings of mental health, with future consideration of implications to nursing curriculum design and development. [J Nurs Educ. 2017;56(10):591-598.]. Copyright 2017, SLACK Incorporated.

Empowering patients through social media: the benefits and challenges.

PubMed

Househ, Mowafa; Borycki, Elizabeth; Kushniruk, Andre

2014-03-01

This article explores the range of social media platforms used by patients and examines the benefits and challenges of using these tools from a patient perspective. A literature review was performed to investigate the use of social media technology by patients. The MEDLINE database was searched using the terms "social media" and "patient." The search was conducted in September 2012 and yielded 765 abstracts. Initially, 63 abstracts were selected. All articles dating from 2004 through 2012 were included. Only 12 articles were found to be relevant for the purposes of the review. The results of this research found that there appears to be an increase in the use of social media by patients across the healthcare spectrum. The research indicates a promising future for the use of social media by patients; however, evidence related to the efficacy and effectiveness of social media is currently limited. Various challenges have also been identified relating to privacy and security concerns, usability, the manipulation of identity, and misinformation. The use of social media technology is an emerging trend for patients who are seeking health information. Conclusions are that such technology holds promise for improving patient engagement and empowerment and community building. Social media has a future in healthcare, especially with regard to patient engagement and empowerment; however, there are several challenges to overcome before the technology can achieve its potential.

Lessons learnt from 12 oral cholera vaccine campaigns in resource-poor settings.

PubMed

Hsiao, Amber; Desai, Sachin N; Mogasale, Vittal; Excler, Jean-Louis; Digilio, Laura

2017-04-01

Improving water and sanitation is the preferred choice for cholera control in the long-term. Nevertheless, vaccination is an available tool that has been shown to be a cost-effective option for cholera prevention in endemic countries or during outbreaks. In 2011 the first low-cost oral cholera vaccine for international use was given prequalification by the World Health Organization (WHO). To increase and prioritize use of the vaccine, WHO created a global stockpile in 2013 from which countries may request oral cholera vaccine for reactive campaigns. WHO has issued specific guidelines for applying for the vaccine, which was previously in short supply (despite prequalification for a second oral vaccine in 2015). The addition of a third WHO-prequalified oral cholera vaccine in 2016 is expected to increase the global stockpile considerably and alleviate supply issues. However, prioritization and best use of the vaccine (e.g. how, when and where to use) will remain challenges. We describe 12 past oral cholera vaccine campaigns, conducted in settings with varying burdens of cholera. These case studies illustrate three key challenges faced in the use of the oral cholera vaccines: regulatory hurdles, cold chain logistics and vaccine coverage and uptake. To pave the way for the introduction of current and future oral cholera vaccines, we discuss operational challenges and make recommendations for future research with respect to each of these challenges.

Remote Sensing of Ecosystem Health: Opportunities, Challenges, and Future Perspectives

PubMed Central

Li, Zhaoqin; Xu, Dandan; Guo, Xulin

2014-01-01

Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1) scale issue; (2) transportability issue; (3) data availability; and (4) uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges. PMID:25386759

Lessons learnt from 12 oral cholera vaccine campaigns in resource-poor settings

PubMed Central

Desai, Sachin N; Mogasale, Vittal; Excler, Jean-Louis; Digilio, Laura

2017-01-01

Abstract Improving water and sanitation is the preferred choice for cholera control in the long-term. Nevertheless, vaccination is an available tool that has been shown to be a cost-effective option for cholera prevention in endemic countries or during outbreaks. In 2011 the first low-cost oral cholera vaccine for international use was given prequalification by the World Health Organization (WHO). To increase and prioritize use of the vaccine, WHO created a global stockpile in 2013 from which countries may request oral cholera vaccine for reactive campaigns. WHO has issued specific guidelines for applying for the vaccine, which was previously in short supply (despite prequalification for a second oral vaccine in 2015). The addition of a third WHO-prequalified oral cholera vaccine in 2016 is expected to increase the global stockpile considerably and alleviate supply issues. However, prioritization and best use of the vaccine (e.g. how, when and where to use) will remain challenges. We describe 12 past oral cholera vaccine campaigns, conducted in settings with varying burdens of cholera. These case studies illustrate three key challenges faced in the use of the oral cholera vaccines: regulatory hurdles, cold chain logistics and vaccine coverage and uptake. To pave the way for the introduction of current and future oral cholera vaccines, we discuss operational challenges and make recommendations for future research with respect to each of these challenges. PMID:28479625

Developing Interdisciplinary Workforce to Meet Future Aerospace Challenges

NASA Technical Reports Server (NTRS)

Misra, Ajay

2017-01-01

The presentation will focus on the importance of interdisciplinary research for addressing future aerospace challenges. Examples of current research activities at NASA's Glenn Research Center will be provided to illustrate the importance of interdisciplinary research. Challenges with conducting interdisciplinary research will be discussed.

A survey on the coordination of connected and automated vehicles at intersections and merging at highway on-ramps

DOE PAGES

Rios-Torres, Jackeline; Malikopoulos, Andreas A.

2016-09-07

Connected and automated vehicles (CAVs) have the potential to improve safety by reducing and mitigating traffic accidents. They can also provide opportunities to reduce transportation energy consumption and emissions by improving traffic flow. Vehicle communication with traffic structures and traffic lights can allow individual vehicles to optimize their operation and account for unpredictable changes. This paper summarizes the developments and the research trends in coordination with the CAVs that have been reported in the literature to date. In conclusion, remaining challenges and potential future research directions are also discussed.

Beacon communities aim to use health information technology to transform the delivery of care.

PubMed

Maxson, Emily R; Jain, Sachin H; McKethan, Aaron N; Brammer, Craig; Buntin, Melinda Beeuwkes; Cronin, Kelly; Mostashari, Farzad; Blumenthal, David

2010-09-01

The Beacon Community Program, authorized under the 2009 American Recovery and Reinvestment Act (ARRA), aims to demonstrate the potential for health information technology to enable local improvements in health care quality, cost efficiency, and population health. If successful, these communitywide efforts will yield important lessons that will assist other communities seeking to harness technology to achieve and sustain health care improvements. This paper highlights key programmatic details that reflect the meaningful use of technology in the fifteen Beacon communities. It describes the innovations they propose and provides insight into current and future challenges.

Specific environmental release categories--A tool for improving chemical safety assessment in the EC--report of a multi-stakeholder workshop.

PubMed

Sättler, Daniel; Schnöder, Frank; Aust, Nannett; Ahrens, Andreas; Bögi, Christian; Traas, Theo; Tolls, Johannes

2012-10-01

In April 2011, experts from industry and authorities met for a workshop to discuss experience and future developments regarding the use of specific environmental release categories (SPERCs) in chemicals safety assessment (CSA) under the European Chemicals Regulation Registration, Evaluation and Authorization of Chemicals (REACH). This article provides a summary of the workshop. It briefly explains what a SPERC is, why SPERCs are needed, where the challenges of the concept are, and what improvements are needed to make SPERCs a useful tool for assessments under REACH. Copyright © 2012 SETAC.

Future developments in health care performance management

PubMed Central

Crema, Maria; Verbano, Chiara

2013-01-01

This paper highlights the challenges of performance management in health care, wherein multiple different objectives have to be pursued. The literature suggests starting with quality performance, following the sand cone theory, but considering a multidimensional concept of health care quality. Moreover, new managerial approaches coming from an industrial context and adapted to health care, such as lean management and risk management, can contribute to improving quality performance. Therefore, the opportunity to analyze them arises from studying their overlaps and links in order to identify possible synergies and to investigate the opportunity to develop an integrated methodology enabling improved performance. PMID:24255600

The Australian and New Zealand regional neurology training survey.

PubMed

McAulay-Powell, C; Ranta, A

2016-06-01

There is inequitably poorer access to specialist neurologists in regional areas. Recruitment could be improved if more neurology trainees chose to spend some time at regional training sites, which they currently appear to avoid for unclear reasons. We surveyed neurology advanced trainees to assess their attitudes and perceptions about regional training. Aside from innate geographical challenges, there are concerning negative perceptions of the impact of regional training on future metropolitan employment prospects. Minimisation of bias against regional trainees or even rewarding regional exposure would likely improve regional trainee and subsequent specialist recruitment. © 2016 Royal Australasian College of Physicians.

Planning for Crew Exercise for Future Deep Space Mission Scenarios

NASA Technical Reports Server (NTRS)

Moore, Cherice; Ryder, Jeff

2015-01-01

Providing the necessary exercise capability to protect crew health for deep space missions will bring new sets of engineering and research challenges. Exercise has been found to be a necessary mitigation for maintaining crew health on-orbit and preparing the crew for return to earth's gravity. Health and exercise data from Apollo, Space Lab, Shuttle, and International Space Station missions have provided insight into crew deconditioning and the types of activities that can minimize the impacts of microgravity on the physiological systems. The hardware systems required to implement exercise can be challenging to incorporate into spaceflight vehicles. Exercise system design requires encompassing the hardware required to provide mission specific anthropometrical movement ranges, desired loads, and frequencies of desired movements as well as the supporting control and monitoring systems, crew and vehicle interfaces, and vibration isolation and stabilization subsystems. The number of crew and operational constraints also contribute to defining the what exercise systems will be needed. All of these features require flight vehicle mass and volume integrated with multiple vehicle systems. The International Space Station exercise hardware requires over 1,800 kg of equipment and over 24 m3 of volume for hardware and crew operational space. Improvements towards providing equivalent or better capabilities with a smaller vehicle impact will facilitate future deep space missions. Deep space missions will require more understanding of the physiological responses to microgravity, understanding appropriate mitigations, designing the exercise systems to provide needed mitigations, and integrating effectively into vehicle design with a focus to support planned mission scenarios. Recognizing and addressing the constraints and challenges can facilitate improved vehicle design and exercise system incorporation.

The National Cancer Institute–American Society of Clinical Oncology Cancer Trial Accrual Symposium: Summary and Recommendations

PubMed Central

Denicoff, Andrea M.; McCaskill-Stevens, Worta; Grubbs, Stephen S.; Bruinooge, Suanna S.; Comis, Robert L.; Devine, Peggy; Dilts, David M.; Duff, Michelle E.; Ford, Jean G.; Joffe, Steven; Schapira, Lidia; Weinfurt, Kevin P.; Michaels, Margo; Raghavan, Derek; Richmond, Ellen S.; Zon, Robin; Albrecht, Terrance L.; Bookman, Michael A.; Dowlati, Afshin; Enos, Rebecca A.; Fouad, Mona N.; Good, Marjorie; Hicks, William J.; Loehrer, Patrick J.; Lyss, Alan P.; Wolff, Steven N.; Wujcik, Debra M.; Meropol, Neal J.

2013-01-01

Introduction: Many challenges to clinical trial accrual exist, resulting in studies with inadequate enrollment and potentially delaying answers to important scientific and clinical questions. Methods: The National Cancer Institute (NCI) and the American Society of Clinical Oncology (ASCO) cosponsored the Cancer Trial Accrual Symposium: Science and Solutions on April 29-30, 2010 to examine the state of accrual science related to patient/community, physician/provider, and site/organizational influences, and identify new interventions to facilitate clinical trial enrollment. The symposium featured breakout sessions, plenary sessions, and a poster session including 100 abstracts. Among the 358 attendees were clinical investigators, researchers of accrual strategies, research administrators, nurses, research coordinators, patient advocates, and educators. A bibliography of the accrual literature in these three major areas was provided to participants in advance of the meeting. After the symposium, the literature in these areas was revisited to determine if the symposium recommendations remained relevant within the context of the current literature. Results: Few rigorously conducted studies have tested interventions to address challenges to clinical trials accrual. Attendees developed recommendations for improving accrual and identified priority areas for future accrual research at the patient/community, physician/provider, and site/organizational levels. Current literature continues to support the symposium recommendations. Conclusions: A combination of approaches addressing both the multifactorial nature of accrual challenges and the characteristics of the target population may be needed to improve accrual to cancer clinical trials. Recommendations for best practices and for future research developed from the symposium are provided. PMID:24130252

Mind the Gap: Current Challenges and Future State of Heart Failure Care.

PubMed

McDonald, Michael A; Ashley, Euan A; Fedak, Paul W M; Hawkins, Nathaniel; Januzzi, James L; McMurray, John J V; Parikh, Victoria N; Rao, Vivek; Svystonyuk, Daniyil; Teerlink, John R; Virani, Sean

2017-11-01

The past decade has seen many advances in the management of heart failure (HF) that have improved survival and quality of life for patients living with this condition. A number of gaps remain in our understanding of the pathophysiology of HF, and the application of emerging treatment strategies is an exciting but daunting challenge. It is possible that advances in genetic evaluation of cardiomyopathy will provide a more refined approach to characterizing HF syndromes, whereas large-scale clinical trials on the horizon should further clarify the role of novel pharmacologic agents and invasive therapies. Cardiac repair and regeneration hold great promise, but a number of pragmatic issues will limit clinical application in the near term. Replacing cardiac function with ventricular assist devices represents significant progress in the management of advanced disease; however, unacceptable rates of complications and costs need to be addressed before broader use in the general HF population is feasible. The ability to personalize care is limited, and the optimal model of disease management in the Canadian context remains uncertain. The emergence of biomarker-guided management and remote monitoring technologies might facilitate a more personalized approach to care in an effort to maintain health and stability and to prevent worsening HF. Ultimately, a greater understanding of how and when to intervene in the setting of acute HF should translate into improved outcomes for the highest-risk subgroup of patients. This review highlights key challenges in the management of HF and highlights the progress toward an ideal future state. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Biological strategies for enhanced hydrolysis of lignocellulosic biomass during anaerobic digestion: Current status and future perspectives.

PubMed

Shrestha, Shilva; Fonoll, Xavier; Khanal, Samir Kumar; Raskin, Lutgarde

2017-12-01

Lignocellulosic biomass is the most abundant renewable bioresource on earth. In lignocellulosic biomass, the cellulose and hemicellulose are bound with lignin and other molecules to form a complex structure not easily accessible to microbial degradation. Anaerobic digestion (AD) of lignocellulosic biomass with a focus on improving hydrolysis, the rate limiting step in AD of lignocellulosic feedstocks, has received considerable attention. This review highlights challenges with AD of lignocellulosic biomass, factors contributing to its recalcitrance, and natural microbial ecosystems, such as the gastrointestinal tracts of herbivorous animals, capable of performing hydrolysis efficiently. Biological strategies that have been evaluated to enhance hydrolysis of lignocellulosic biomass include biological pretreatment, co-digestion, and inoculum selection. Strategies to further improve these approaches along with future research directions are outlined with a focus on linking studies of microbial communities involved in hydrolysis of lignocellulosics to process engineering. Copyright © 2017 Elsevier Ltd. All rights reserved.

Scabies in animals and humans: history, evolutionary perspectives, and modern clinical management.

PubMed

Currier, Russell W; Walton, Shelley F; Currie, Bart J

2011-08-01

Scabies, a mite infestation frequently sexually transmitted, dates back to antiquity but remains a challenging parasite for study in clinical practice and community settings. Its history is one of centuries of slow progress to recognize the mite and to finally establish its nexus to the clinical syndrome of pruritis with several protean manifestations and different epidemiological patterns. Contemporary methods of management are briefly reviewed, with the future promise of improved evolutionary knowledge associated with the advent of molecular and genetic technology. Current information indicates that humans and earlier protohumans were most likely the source of animal scabies, first of dogs, and later of other species with subsequent spread to wildlife. Morphologically identical variants of Sarcoptes scabiei are nonetheless host specific, as determined by recent DNA studies, and invite future investigations into the dynamics of this troublesome sexually transmissible agent, with the goal of improved recognition and control. © 2012 New York Academy of Sciences.

Systems Engineering and Integration (SE and I)

NASA Technical Reports Server (NTRS)

Chevers, ED; Haley, Sam

1990-01-01

The issue of technology advancement and future space transportation vehicles is addressed. The challenge is to develop systems which can be evolved and improved in small incremental steps where each increment reduces present cost, improves, reliability, or does neither but sets the stage for a second incremental upgrade that does. Future requirements are interface standards for commercial off the shelf products to aid in the development of integrated facilities; enhanced automated code generation system slightly coupled to specification and design documentation; modeling tools that support data flow analysis; and shared project data bases consisting of technical characteristics cast information, measurement parameters, and reusable software programs. Topics addressed include: advanced avionics development strategy; risk analysis and management; tool quality management; low cost avionics; cost estimation and benefits; computer aided software engineering; computer systems and software safety; system testability; and advanced avionics laboratories - and rapid prototyping. This presentation is represented by viewgraphs only.

Mechanistic and Technical Challenges in Studying the Human Microbiome and Cancer Epidemiology.

PubMed

Verma, Mukesh

2017-04-01

This article reviews the significance of the microbiome in cancer epidemiology, mechanistic and technical challenges in the field, and characterization of the microbiome in different tumor types to identify biomarkers of risk, progression, and prognosis. Publications on the microbiome and cancer epidemiology were reviewed to analyze sample collection and processing, microbiome taxa characterization by 16S ribosomal RNA sequencing, and microbiome metabolite characterization (metabotyping) by nuclear magnetic resonance and mass spectrometry. The analysis identified methodology types, research design, sample types, and issues in integrating data from different platforms. Aerodigestive cancer epidemiology studies conducted by different groups demonstrated the significance of microbiome information in developing approaches to improve health. Challenges exist in sample preparation and processing (eg, standardization of methods for collection and analysis). These challenges relate to technology, data integration from "omics" studies, inherent bias in primer selection during 16S ribosomal RNA sequencing, the need for large consortia with well-characterized biospecimens, cause and effect issues, resilience of microbiota to exposure events (requires longitudinal studies), and expanding studies for fungal and viral diversity (most studies used bacterial 16S ribosomal RNA sequencing for microbiota characterization). Despite these challenges, microbiome and cancer epidemiology studies are significant and may facilitate cancer risk assessment, diagnosis, and prognosis. In the future, clinical trials likely will use microbiota modifications to improve the efficacy of existing treatments.

Mechanistic and Technical Challenges in Studying the Human Microbiome and Cancer Epidemiology

PubMed Central

2016-01-01

This article reviews the significance of the microbiome in cancer epidemiology, mechanistic and technical challenges in the field, and characterization of the microbiome in different tumor types to identify biomarkers of risk, progression, and prognosis. Publications on the microbiome and cancer epidemiology were reviewed to analyze sample collection and processing, microbiome taxa characterization by 16S ribosomal RNA sequencing, and microbiome metabolite characterization (metabotyping) by nuclear magnetic resonance and mass spectrometry. The analysis identified methodology types, research design, sample types, and issues in integrating data from different platforms. Aerodigestive cancer epidemiology studies conducted by different groups demonstrated the significance of microbiome information in developing approaches to improve health. Challenges exist in sample preparation and processing (eg, standardization of methods for collection and analysis). These challenges relate to technology, data integration from “omics” studies, inherent bias in primer selection during 16S ribosomal RNA sequencing, the need for large consortia with well-characterized biospecimens, cause and effect issues, resilience of microbiota to exposure events (requires longitudinal studies), and expanding studies for fungal and viral diversity (most studies used bacterial 16S ribosomal RNA sequencing for microbiota characterization). Despite these challenges, microbiome and cancer epidemiology studies are significant and may facilitate cancer risk assessment, diagnosis, and prognosis. In the future, clinical trials likely will use microbiota modifications to improve the efficacy of existing treatments. PMID:27121074

Critical analysis of 3-D organoid in vitro cell culture models for high-throughput drug candidate toxicity assessments.

PubMed

Astashkina, Anna; Grainger, David W

2014-04-01

Drug failure due to toxicity indicators remains among the primary reasons for staggering drug attrition rates during clinical studies and post-marketing surveillance. Broader validation and use of next-generation 3-D improved cell culture models are expected to improve predictive power and effectiveness of drug toxicological predictions. However, after decades of promising research significant gaps remain in our collective ability to extract quality human toxicity information from in vitro data using 3-D cell and tissue models. Issues, challenges and future directions for the field to improve drug assay predictive power and reliability of 3-D models are reviewed. Copyright © 2014 Elsevier B.V. All rights reserved.

The future of the CAVE

NASA Astrophysics Data System (ADS)

Defanti, Thomas A.; Acevedo, Daniel; Ainsworth, Richard A.; Brown, Maxine D.; Cutchin, Steven; Dawe, Gregory; Doerr, Kai-Uwe; Johnson, Andrew; Knox, Chris; Kooima, Robert; Kuester, Falko; Leigh, Jason; Long, Lance; Otto, Peter; Petrovic, Vid; Ponto, Kevin; Prudhomme, Andrew; Rao, Ramesh; Renambot, Luc; Sandin, Daniel J.; Schulze, Jurgen P.; Smarr, Larry; Srinivasan, Madhu; Weber, Philip; Wickham, Gregory

2011-03-01

The CAVE, a walk-in virtual reality environment typically consisting of 4-6 3 m-by-3 m sides of a room made of rear-projected screens, was first conceived and built in 1991. In the nearly two decades since its conception, the supporting technology has improved so that current CAVEs are much brighter, at much higher resolution, and have dramatically improved graphics performance. However, rear-projection-based CAVEs typically must be housed in a 10 m-by-10 m-by-10 m room (allowing space behind the screen walls for the projectors), which limits their deployment to large spaces. The CAVE of the future will be made of tessellated panel displays, eliminating the projection distance, but the implementation of such displays is challenging. Early multi-tile, panel-based, virtual-reality displays have been designed, prototyped, and built for the King Abdullah University of Science and Technology (KAUST) in Saudi Arabia by researchers at the University of California, San Diego, and the University of Illinois at Chicago. New means of image generation and control are considered key contributions to the future viability of the CAVE as a virtual-reality device.

Integrating Quality Improvement and Continuing Professional Development: A Model From the Mental Health Care System.

PubMed

Sockalingam, Sanjeev; Tehrani, Hedieh; Lin, Elizabeth; Lieff, Susan; Harris, Ilene; Soklaridis, Sophie

2016-04-01

To explore the perspectives of leaders in psychiatry and continuing professional development (CPD) regarding the relationship, opportunities, and challenges in integrating quality improvement (QI) and CPD. In 2013-2014, the authors interviewed 18 participants in Canada: 10 psychiatrists-in-chief, 6 CPD leaders in psychiatry, and 2 individuals with experience integrating these domains in psychiatry who were identified through snowball sampling. Questions were designed to identify participants' perspectives about the definition, relationship, and integration of QI and CPD in psychiatry. Interviews were recorded and transcribed. An iterative, inductive method was used to thematically analyze the transcripts. To ensure the rigor of the analysis, the authors performed member checking and sampling until theoretical saturation was achieved. Participants defined QI as a concept measured at the individual, hospital, and health care system levels and CPD as a concept measured predominantly at the individual and hospital levels. Four themes related to the relationship between QI and CPD were identified: challenges with QI training, adoption of QI into the mental health care system, implementation of QI in CPD, and practice improvement outcomes. Despite participants describing QI and CPD as mutually beneficial, they expressed uncertainty about the appropriateness of aligning these domains within a mental health care context because of the identified challenges. This study identified challenges with aligning QI and CPD in psychiatry and yielded a framework to inform future integration efforts. Further research is needed to determine the generalizability of this framework to other specialties and health care professions.

Modelling regional cropping patterns under scenarios of climate and socio-economic change in Hungary.

PubMed

Li, Sen; Juhász-Horváth, Linda; Pintér, László; Rounsevell, Mark D A; Harrison, Paula A

2018-05-01

Impacts of socio-economic, political and climatic change on agricultural land systems are inherently uncertain. The role of regional and local-level actors is critical in developing effective policy responses that accommodate such uncertainty in a flexible and informed way across governance levels. This study identified potential regional challenges in arable land use systems, which may arise from climate and socio-economic change for two counties in western Hungary: Veszprém and Tolna. An empirically-grounded, agent-based model was developed from an extensive farmer household survey about local land use practices. The model was used to project future patterns of arable land use under four localised, stakeholder-driven scenarios of plausible future socio-economic and climate change. The results show strong differences in farmers' behaviour and current agricultural land use patterns between the two regions, highlighting the need to implement focused policy at the regional level. For instance, policy that encourages local food security may need to support improvements in the capacity of farmers to adapt to physical constraints in Veszprém and farmer access to social capital and environmental awareness in Tolna. It is further suggested that the two regions will experience different challenges to adaptation under possible future conditions (up to 2100). For example, Veszprém was projected to have increased fallow land under a scenario with high inequality, ineffective institutions and higher-end climate change, implying risks of land abandonment. By contrast, Tolna was projected to have a considerable decline in major cereals under a scenario assuming a de-globalising future with moderate climate change, inferring challenges to local food self-sufficiency. The study provides insight into how socio-economic and physical factors influence the selection of crop rotation plans by farmers in western Hungary and how farmer behaviour may affect future risks to agricultural land systems under environmental change. Copyright © 2017 Elsevier B.V. All rights reserved.

Modifying agricultural crops for improved nutrition.

PubMed

McGloughlin, Martina Newell

2010-11-30

The first generation of biotechnology products commercialized were crops focusing largely on input agronomic traits whose value was often opaque to consumers. The coming generations of crop plants can be grouped into four broad areas each presenting what, on the surface, may appear as unique challenges and opportunities. The present and future focus is on continuing improvement of agronomic traits such as yield and abiotic stress resistance in addition to the biotic stress tolerance of the present generation; crop plants as biomass feedstocks for biofuels and "bio-synthetics"; value-added output traits such as improved nutrition and food functionality; and plants as production factories for therapeutics and industrial products. From a consumer perspective, the focus on value-added traits, especially improved nutrition, is undoubtedly one of the areas of greatest interest. From a basic nutrition perspective, there is a clear dichotomy in demonstrated need between different regions and socioeconomic groups, the starkest being inappropriate consumption in the developed world and under-nourishment in Less Developed Countries (LDCs). Dramatic increases in the occurrence of obesity and related ailments in affluent regions are in sharp contrast to chronic malnutrition in many LDCs. Both problems require a modified food supply, and the tools of biotechnology have a part to play. Developing plants with improved traits involves overcoming a variety of technical, regulatory and indeed perception hurdles inherent in perceived and real challenges of complex traits modifications. Continuing improvements in molecular and genomic technologies are contributing to the acceleration of product development to produce plants with the appropriate quality traits for the different regions and needs. Crops with improved traits in the pipeline, the evolving technologies and the opportunities and challenges that lie ahead are covered. Copyright © 2010. Published by Elsevier B.V.

Transmission expansion with smart switching under demand uncertainty and line failures

DOE PAGES

Schumacher, Kathryn M.; Chen, Richard Li-Yang; Cohn, Amy E. M.

2016-06-07

One of the major challenges in deciding where to build new transmission lines is that there is uncertainty regarding future loads, renewal generation output and equipment failures. We propose a robust optimization model whose transmission expansion solutions ensure that demand can be met over a wide range of conditions. Specifically, we require feasible operation for all loads and renewable generation levels within given ranges, and for all single transmission line failures. Furthermore, we consider transmission switching as an allowable recovery action. This relatively inexpensive method of redirecting power flows improves resiliency, but introduces computational challenges. Lastly, we present a novelmore » algorithm to solve this model. Computational results are discussed.« less

From Nonissue to Healthcare Crisis: A Historical Review of Aging and Dying With an Intellectual and Developmental Disability.

PubMed

McGinley, Jacqueline M

2016-04-01

Individuals with intellectual and developmental disabilities are living unprecedentedly longer lives primarily due to the long-term benefits of the deinstitutionalization movement and widespread improvements in health outcomes. However, the consequences of this protracted aging process are significant, complex, and often poor not only for the individuals and their caregivers but for the mainstream healthcare community. This article will explore, utilizing a constructionist perspective, how these challenges evolved from a nonissue to an impending crisis in less than 25 years. Additionally, present-day efforts by researchers, policymakers, and practitioners to address these challenges will be explored and recommendations will be made for future directions.

The Health Services Researcher of 2020: A Summit to Assess the Field's Workforce Needs

PubMed Central

Pittman, Patricia; Holve, Erin

2009-01-01

Objective To summarize the current state of the health services research (HSR) workforce and recommend ways to improve the field's ability to respond to future challenges facing the health system. Data Summaries of workgroup discussions and recommendations at a stakeholder meeting. Study Design In late 2007, 50 educators, students, employers, and funders of HSR participated in a meeting to discuss findings of three commissioned papers on the HSR workforce. The group undertook a consultative process to develop recommendations for the field. Principal Findings Stakeholders developed recommendations in five major areas focused on HSR workforce needs: (1) improving the size and composition of the field; (2) understanding the growth of HSR in the private sector; (3) improving the graduate training of health services researchers, especially at the master's level; (4) expanding postgraduate training and continuing education opportunities; and (5) increasing awareness of the value of HSR. Conclusions Specific recommendations in the five major areas emphasized developing partnerships between HSR organizations and other professional societies or health organizations, as well as ways to improve training for the future workforce. The need to develop a “client orientation” toward research by improving communication and dissemination skills was discussed, as was the importance of improving diversity in the field. PMID:20459583

The Third Nuclear Age: How I Learned to Start Worrying about the Clean Bomb

DTIC Science & Technology

2013-02-14

Fourth generation fusion nuclear weapons (FGNW) represent a significant improvement in nuclear weapons technology and suggest the potential for...future challenges that the United States and its Air Force may face twenty-five years from now. This paper does not answer whether the fusion technology...is possible and assumes it as an inevitable technological advancement. Instead, this study predicts a world in which low yield, clean fusion

Current and Future Challenges for Asian Nonproliferation Export Controls: A Regional Response

DTIC Science & Technology

2004-10-01

degree of financial interdependence was evidenced by the 1997 financial crisis, which resulted in the Chiang Mai + 3 Initiative.ř Intra-company trade...financial crisis, the finance ministers of ASEAN+3 countries (China, Japan, and South Korea) reached agreement on the " Chiang Mai Initiative," which...stability. The Chiang Mai Initiative has contributed to improving exchange rate stability and in doing so may also have contributed to closer regional

Fabrication and Testing of Ceramic Matrix Composite Propulsion Components

NASA Technical Reports Server (NTRS)

Effinger, Michael R.; Clinton, R. G., Jr.; Dennis, Jay; Elam, Sandy; Genge, Gary; Eckel, Andy; Jaskowiak, Martha H.; Kiser, J. Douglas; Lang, Jerry

2000-01-01

A viewgraph presentation outlines NASA's goals for the Second and Third Generation Reusable Launch Vehicles, placing emphasis on improving safety and decreasing the cost of transporting payloads to orbit. The use of ceramic matrix composite (CMC) technology is discussed. The development of CMC components, such as the Simplex CMC Blisk, cooled CMC nozzle ramps, cooled CMC thrust chambers, and CMC gas generators, are described, including challenges, test results, and likely future developments.

Systematic Calibration for Ultra-High Accuracy Inertial Measurement Units.

PubMed

Cai, Qingzhong; Yang, Gongliu; Song, Ningfang; Liu, Yiliang

2016-06-22

An inertial navigation system (INS) has been widely used in challenging GPS environments. With the rapid development of modern physics, an atomic gyroscope will come into use in the near future with a predicted accuracy of 5 × 10(-6)°/h or better. However, existing calibration methods and devices can not satisfy the accuracy requirements of future ultra-high accuracy inertial sensors. In this paper, an improved calibration model is established by introducing gyro g-sensitivity errors, accelerometer cross-coupling errors and lever arm errors. A systematic calibration method is proposed based on a 51-state Kalman filter and smoother. Simulation results show that the proposed calibration method can realize the estimation of all the parameters using a common dual-axis turntable. Laboratory and sailing tests prove that the position accuracy in a five-day inertial navigation can be improved about 8% by the proposed calibration method. The accuracy can be improved at least 20% when the position accuracy of the atomic gyro INS can reach a level of 0.1 nautical miles/5 d. Compared with the existing calibration methods, the proposed method, with more error sources and high order small error parameters calibrated for ultra-high accuracy inertial measurement units (IMUs) using common turntables, has a great application potential in future atomic gyro INSs.

Challenge, Change and Opportunity: Overview, Texts and Agenda.

ERIC Educational Resources Information Center

Runnymede Trust, London (England).

"The Future of Multi-Ethnic Britain: Challenges, Changes, and Opportunities" was a conference organized by the Runnymede Trust in partnership with other organizations to consider changes in multiethnic Britain in recent years, principal challenges and opportunities for the future, and what to do about them. These issues were discussed in…

World Health Organization perspectives on the contribution of the Global Alliance for Vaccines and Immunization on reducing child mortality.

PubMed

Bustreo, F; Okwo-Bele, J-M; Kamara, L

2015-02-01

Child mortality has decreased substantially globally-from 12.6 million in 1990 to 6.3 million in 2013-due, in large part to of governments' and organisations' work, to prevent pneumonia, diarrhoea and malaria, the main causes of death in the postneonatal period. In 2012, the World Health Assembly adopted the Decade of Vaccines Global Vaccine Action Plan 2011-2020 as the current framework aimed at preventing millions of deaths through more equitable access to existing vaccines for people in all communities. The Global Alliance for Vaccines and Immunization (GAVI) plays a critical role in this effort by financing and facilitating delivery platforms for vaccines, with focused support for the achievements of improved vaccination coverage and acceleration of the uptake of WHO-recommended lifesaving new vaccines in 73 low-income countries. The GAVI Alliance has contributed substantially towards the progress of Millennium Development Goal 4 and to improving women's lives. By 2013, the GAVI Alliance had immunised 440 million additional children and averted six million future deaths from vaccine-preventable diseases in the world's poorest countries. The GAVI Alliance is on track to reducing child mortality to 68 per 1000 live births by 2015 in supported countries. This paper discusses the GAVI Alliance achievements related to Millennium Development Goal 4 and its broader contribution to improving women's lives and health systems, as well as challenges and obstacles it has faced. Additionally, it looks at challenges for the future and how it will continue its work related to reducing child mortality and improving women's health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Cholangiocarcinoma—controversies and challenges

PubMed Central

Patel, Tushar

2013-01-01

Cholangiocarcinomas are a diverse group of tumors that are presumed to originate from the biliary tract epithelium either within the liver or the biliary tract. These cancers are often difficult to diagnose, their pathogenesis is poorly understood, and their dismal prognosis has resulted in a nihilistic approach to their management. The two major clinical phenotypes are intrahepatic, mass-forming tumors and large ductal tumors. Among the ductal cancers, lesions at the liver hilum are most prevalent. The risk factors, clinical presentation, natural history and management of these two types of cholangiocarcinoma are distinct. Efforts to improve outcomes for patients with these diseases are affected by several challenges to effective management. For example, designations based on anatomical characteristics have been inconsistently applied, which has confounded analysis of epidemiological trends and assessment of risk factors. The evaluation of therapeutic options, particularly systemic therapies, has been limited by a lack of appreciation of the different phenotypes. Controversies exist regarding the appropriate workup and choice of management approach. However, new and emerging tools for improved diagnosis, expanded indications for surgical approaches, an emerging role for locoregional and intrabiliary therapies and improved systemic therapies provide optimism and hope for improved outcomes in the future. PMID:21460876

Geriatrics in family practice residency education: an unmet challenge.

PubMed

Gazewood, John D; Vanderhoff, Bruce; Ackermann, Richard; Cefalu, Charles

2003-01-01

The aging of the US population poses one of the greatest future challenges for family practice residency graduates. At a time when our discipline should be strengthening geriatric education to address the needs of our aging population, the Group on Geriatric Education of the Society of Teachers of Family Medicine believes that recent guidelines from important family medicine organizations suggest that our discipline's interest in geriatric education may be waning. Barriers to improving geriatric education in family practice residencies include limited geriatric faculty, changes in geriatric fellowship training, competing curricular demands, and limited diversity of geriatric training sites. Improving geriatric education in family practice residencies will require greater emphasis on faculty development and integration of geriatric principles throughout family practice residency education. The Residency Review Committee for Family Practice should review the Program Requirements for Residency Education to ensure that geriatric training requirements are consistent with current educational needs. The leadership of family medicine organizations should collaboratively address the need for continued improvement in training our residents to care for older patients and the chronically ill.

Using Technology to Meet the Challenges of Medical Education

PubMed Central

Guze, Phyllis A.

2015-01-01

Medical education is rapidly changing, influenced by many factors including the changing health care environment, the changing role of the physician, altered societal expectations, rapidly changing medical science, and the diversity of pedagogical techniques. Changes in societal expectations put patient safety in the forefront, and raises the ethical issues of learning interactions and procedures on live patients, with the long-standing teaching method of “see one, do one, teach one” no longer acceptable. The educational goals of using technology in medical education include facilitating basic knowledge acquisition, improving decision making, enhancement of perceptual variation, improving skill coordination, practicing for rare or critical events, learning team training, and improving psychomotor skills. Different technologies can address these goals. Technologies such as podcasts and videos with flipped classrooms, mobile devices with apps, video games, simulations (part-time trainers, integrated simulators, virtual reality), and wearable devices (google glass) are some of the techniques available to address the changing educational environment. This article presents how the use of technologies can provide the infrastructure and basis for addressing many of the challenges in providing medical education for the future. PMID:26330687

Using Technology to Meet the Challenges of Medical Education.

PubMed

Guze, Phyllis A

2015-01-01

Medical education is rapidly changing, influenced by many factors including the changing health care environment, the changing role of the physician, altered societal expectations, rapidly changing medical science, and the diversity of pedagogical techniques. Changes in societal expectations put patient safety in the forefront, and raises the ethical issues of learning interactions and procedures on live patients, with the long-standing teaching method of "see one, do one, teach one" no longer acceptable. The educational goals of using technology in medical education include facilitating basic knowledge acquisition, improving decision making, enhancement of perceptual variation, improving skill coordination, practicing for rare or critical events, learning team training, and improving psychomotor skills. Different technologies can address these goals. Technologies such as podcasts and videos with flipped classrooms, mobile devices with apps, video games, simulations (part-time trainers, integrated simulators, virtual reality), and wearable devices (google glass) are some of the techniques available to address the changing educational environment. This article presents how the use of technologies can provide the infrastructure and basis for addressing many of the challenges in providing medical education for the future.

Advances in U.S. Land Imaging Capabilities

NASA Astrophysics Data System (ADS)

Stryker, T. S.

2017-12-01

Advancements in Earth observations, cloud computing, and data science are improving everyday life. Information from land-imaging satellites, such as the U.S. Landsat system, helps us to better understand the changing landscapes where we live, work, and play. This understanding builds capacity for improved decision-making about our lands, waters, and resources, driving economic growth, protecting lives and property, and safeguarding the environment. The USGS is fostering the use of land remote sensing technology to meet local, national, and global challenges. A key dimension to meeting these challenges is the full, free, and open provision of land remote sensing observations for both public and private sector applications. To achieve maximum impact, these data must also be easily discoverable, accessible, and usable. The presenter will describe the USGS Land Remote Sensing Program's current capabilities and future plans to collect and deliver land remote sensing information for societal benefit. He will discuss these capabilities in the context of national plans and policies, domestic partnerships, and international collaboration. The presenter will conclude with examples of how Landsat data is being used on a daily basis to improve lives and livelihoods.

Microbiome engineering: Current applications and its future.

PubMed

Foo, Jee Loon; Ling, Hua; Lee, Yung Seng; Chang, Matthew Wook

2017-03-01

Microbiomes exist in all ecosystems and are composed of diverse microbial communities. Perturbation to microbiomes brings about undesirable phenotypes in the hosts, resulting in diseases and disorders, and disturbs the balance of the associated ecosystems. Engineering of microbiomes can be used to modify structures of the microbiota and restore ecological balance. Consequently, microbiome engineering has been employed for improving human health and agricultural productivity. The importance and current applications of microbiome engineering, particularly in humans, animals, plants and soil is reviewed. Furthermore, we explore the challenges in engineering microbiome and the future of this field, thus providing perspectives and outlook of microbiome engineering. Copyright © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The development of a diversity mentoring program for faculty and trainees: A program at the Brown Clinical Psychology Training Consortium

PubMed Central

de Dios, Marcel A.; Kuo, Caroline; Hernandez, Lynn; Clark, Uraina S.; Wenze, Susan J.; Boisseau, Christina L.; Hunter, Heather L.; Reddy, Madhavi K.; Tolou-Shams, Marina; Zlotnick, Caron

2013-01-01

There is a critical need for increasing the diversity representation among clinicians and researchers in academic medicine, including departments of psychiatry and psychology. Mentorship of under-represented groups has been identified as an important way to remediate diversity-related barriers in the field. This paper outlines the early development and pilot implementation of a diversity mentorship program at Brown University. In an effort to inform and guide future diversity programs, we discuss the challenges faced in creating the program, the successes experienced during the first year, and the future directions undertaken as a means for improving the program. PMID:25346563

Digital Media for Primary Health Care in Austria.

PubMed

Kriegel, Johannes; Tuttle-Weidinger, Linda; Reckwitz, Luise

2017-01-01

Primary health care (PHC) is currently being improved in all developed industries. The aim is to make healthcare more patient-centered and close to the patient's place of residence. In addition to the organizational and interdisciplinary reorientation, the use of digital media is increasingly being emphasized. Through literature research and an online survey among Austrian doctors and general practitioners, the current and future challenges for the use of digital media in networked and regional primary health care were identified and prioritized. It becomes clear that basic functions like documentation, communication and coordination in the individual medical practice are at the forefront. In the future it will be necessary to support regional and interprofessional networking through digital media.

Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx.

PubMed

Boyle, Todd A; MacKinnon, Neil J; Mahaffey, Thomas; Duggan, Kellie; Dow, Natalie

2012-01-01

Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one. This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff. Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced. Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning. This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change over time. Copyright © 2012 Elsevier Inc. All rights reserved.

Summary of the DREAM8 Parameter Estimation Challenge: Toward Parameter Identification for Whole-Cell Models.

PubMed

Karr, Jonathan R; Williams, Alex H; Zucker, Jeremy D; Raue, Andreas; Steiert, Bernhard; Timmer, Jens; Kreutz, Clemens; Wilkinson, Simon; Allgood, Brandon A; Bot, Brian M; Hoff, Bruce R; Kellen, Michael R; Covert, Markus W; Stolovitzky, Gustavo A; Meyer, Pablo

2015-05-01

Whole-cell models that explicitly represent all cellular components at the molecular level have the potential to predict phenotype from genotype. However, even for simple bacteria, whole-cell models will contain thousands of parameters, many of which are poorly characterized or unknown. New algorithms are needed to estimate these parameters and enable researchers to build increasingly comprehensive models. We organized the Dialogue for Reverse Engineering Assessments and Methods (DREAM) 8 Whole-Cell Parameter Estimation Challenge to develop new parameter estimation algorithms for whole-cell models. We asked participants to identify a subset of parameters of a whole-cell model given the model's structure and in silico "experimental" data. Here we describe the challenge, the best performing methods, and new insights into the identifiability of whole-cell models. We also describe several valuable lessons we learned toward improving future challenges. Going forward, we believe that collaborative efforts supported by inexpensive cloud computing have the potential to solve whole-cell model parameter estimation.

Summary of the DREAM8 Parameter Estimation Challenge: Toward Parameter Identification for Whole-Cell Models

PubMed Central

Karr, Jonathan R.; Williams, Alex H.; Zucker, Jeremy D.; Raue, Andreas; Steiert, Bernhard; Timmer, Jens; Kreutz, Clemens; Wilkinson, Simon; Allgood, Brandon A.; Bot, Brian M.; Hoff, Bruce R.; Kellen, Michael R.; Covert, Markus W.; Stolovitzky, Gustavo A.; Meyer, Pablo

2015-01-01

Whole-cell models that explicitly represent all cellular components at the molecular level have the potential to predict phenotype from genotype. However, even for simple bacteria, whole-cell models will contain thousands of parameters, many of which are poorly characterized or unknown. New algorithms are needed to estimate these parameters and enable researchers to build increasingly comprehensive models. We organized the Dialogue for Reverse Engineering Assessments and Methods (DREAM) 8 Whole-Cell Parameter Estimation Challenge to develop new parameter estimation algorithms for whole-cell models. We asked participants to identify a subset of parameters of a whole-cell model given the model’s structure and in silico “experimental” data. Here we describe the challenge, the best performing methods, and new insights into the identifiability of whole-cell models. We also describe several valuable lessons we learned toward improving future challenges. Going forward, we believe that collaborative efforts supported by inexpensive cloud computing have the potential to solve whole-cell model parameter estimation. PMID:26020786

Material Challenges and Opportunities for Commercial Electric Aircraft

NASA Technical Reports Server (NTRS)

Misra, Ajay

2014-01-01

Significant reduction in carbon dioxide emission for future air transportation system will require adoption of electric propulsion system and more electric architectures. Various options for aircraft electric propulsion include hybrid electric, turboelectric, and full electric system. Realization of electric propulsion system for commercial aircraft applications will require significant increases in power density of electric motors and energy density of energy storage system, such as the batteries and fuel cells. In addition, transmission of MW of power in the aircraft will require high voltage power transmission system to reduce the weight of the power transmission system. Finally, there will be significant thermal management challenges. Significant advances in material technologies will be required to meet these challenges. Technologies of interest include materials with higher electrical conductivity than Cu, high thermal conductivity materials, and lightweight electrically insulating materials with high breakdown voltage, high temperature magnets, advanced battery and fuel cell materials, and multifunctional materials. The presentation will include various challenges for commercial electric aircraft and provide an overview of material improvements that will be required to meet these challenges.

Dental education in Wuhan, China: challenges and changes.

PubMed

Huang, Cui; Bian, Zhuan; Tai, Baojun; Fan, Mingwen; Kwan, Chiu-Yin

2007-02-01

The aim of this article is to describe the innovations in the School of Stomatology at Wuhan University (WHUSS) that are likely to shape the future of dental education in the People's Republic of China. There are forty dental schools in China; the five most well known are located in Beijing, Chengdu, Shanghai, Xi'an, and Wuhan. Although patient-centered, comprehensive care has been recommended as the future of dental education, traditional dental education in China still faces many challenges to accomplish this goal. WHUSS, one of the more progressive dental schools in China, has implemented several educational innovations to traditional dental education by restructuring the curriculum through the introduction of problem-based learning (PBL) and other strategies in clinical training. Although implementation of educational innovations is still at an early stage throughout China, it is reasonable to speculate that many schools will develop similar strategies as those developed at Wuhan to improve dental education during the next several years. However, additional research is necessary to evaluate the efficacy of such educational strategies and to determine the appropriate implementation of a contemporary dental curriculum and pedagogic methodology. The curriculum modifications that have been achieved to date as well as the existing challenges are discussed to provide the reader with an understanding of contemporary dental education in China.

Nano/microvehicles for efficient delivery and (bio)sensing at the cellular level

PubMed Central

Esteban-Fernández de Ávila, B.; Yáñez-Sedeño, P.

2017-01-01

A perspective review of recent strategies involving the use of nano/microvehicles to address the key challenges associated with delivery and (bio)sensing at the cellular level is presented. The main types and characteristics of the different nano/microvehicles used for these cellular applications are discussed, including fabrication pathways, propulsion (catalytic, magnetic, acoustic or biological) and navigation strategies, and relevant parameters affecting their propulsion performance and sensing and delivery capabilities. Thereafter, selected applications are critically discussed. An emphasis is made on enhancing the extra- and intra-cellular biosensing capabilities, fast cell internalization, rapid inter- or intra-cellular movement, efficient payload delivery and targeted on-demand controlled release in order to greatly improve the monitoring and modulation of cellular processes. A critical discussion of selected breakthrough applications illustrates how these smart multifunctional nano/microdevices operate as nano/microcarriers and sensors at the intra- and extra-cellular levels. These advances allow both the real-time biosensing of relevant targets and processes even at a single cell level, and the delivery of different cargoes (drugs, functional proteins, oligonucleotides and cells) for therapeutics, gene silencing/transfection and assisted fertilization, while overcoming challenges faced by current affinity biosensors and delivery vehicles. Key challenges for the future and the envisioned opportunities and future perspectives of this remarkably exciting field are discussed. PMID:29147499

Implementing recommended screening for critical congenital heart disease.

PubMed

Martin, Gerard R; Beekman, Robert H; Mikula, Elizabeth Bradshaw; Fasules, James; Garg, Lorraine F; Kemper, Alex R; Morrow, W Robert; Pearson, Gail D; Mahle, William T

2013-07-01

Critical congenital heart disease (CCHD) is endorsed by the US Secretary of Health and Human Services as part of the recommended uniform screening panel for newborns. Although initial recommendations for implementation exist, as states and hospitals have moved forward with implementation of screening, new challenges and areas for additional focus have been identified. The objective of this study was to develop recommendations to address current challenges and areas of focus surrounding CCHD newborn screening. A workgroup of experts and stakeholders was convened in Washington, District of Columbia, for a 1-day meeting in February 2012. At the beginning of the meeting, the stakeholders held a brainstorming session to identify areas of main priority based on their experience. After this, stakeholders broke into small groups to refine recommendations, which were then finalized by consensus. Recommendations to address selection of screening equipment, standards for reporting of screening outcomes to stakeholders, training of health care providers and educating families, future research priorities, payment for screening, follow-up diagnostic testing, and public health oversight, and advocacy to facilitate effective and comprehensive screening were proposed. Suggestions for future work were developed. Screening for CCHD presents novel challenges and opportunities; however, addressing these will strengthen newborn screening and newborn care networks, and ultimately improve health outcomes.

Where Is Current Research on Blockchain Technology?—A Systematic Review

PubMed Central

Yli-Huumo, Jesse; Ko, Deokyoon; Park, Sooyong; Smolander, Kari

2016-01-01

Blockchain is a decentralized transaction and data management technology developed first for Bitcoin cryptocurrency. The interest in Blockchain technology has been increasing since the idea was coined in 2008. The reason for the interest in Blockchain is its central attributes that provide security, anonymity and data integrity without any third party organization in control of the transactions, and therefore it creates interesting research areas, especially from the perspective of technical challenges and limitations. In this research, we have conducted a systematic mapping study with the goal of collecting all relevant research on Blockchain technology. Our objective is to understand the current research topics, challenges and future directions regarding Blockchain technology from the technical perspective. We have extracted 41 primary papers from scientific databases. The results show that focus in over 80% of the papers is on Bitcoin system and less than 20% deals with other Blockchain applications including e.g. smart contracts and licensing. The majority of research is focusing on revealing and improving limitations of Blockchain from privacy and security perspectives, but many of the proposed solutions lack concrete evaluation on their effectiveness. Many other Blockchain scalability related challenges including throughput and latency have been left unstudied. On the basis of this study, recommendations on future research directions are provided for researchers. PMID:27695049

Where Is Current Research on Blockchain Technology?-A Systematic Review.

PubMed

Yli-Huumo, Jesse; Ko, Deokyoon; Choi, Sujin; Park, Sooyong; Smolander, Kari

2016-01-01

Blockchain is a decentralized transaction and data management technology developed first for Bitcoin cryptocurrency. The interest in Blockchain technology has been increasing since the idea was coined in 2008. The reason for the interest in Blockchain is its central attributes that provide security, anonymity and data integrity without any third party organization in control of the transactions, and therefore it creates interesting research areas, especially from the perspective of technical challenges and limitations. In this research, we have conducted a systematic mapping study with the goal of collecting all relevant research on Blockchain technology. Our objective is to understand the current research topics, challenges and future directions regarding Blockchain technology from the technical perspective. We have extracted 41 primary papers from scientific databases. The results show that focus in over 80% of the papers is on Bitcoin system and less than 20% deals with other Blockchain applications including e.g. smart contracts and licensing. The majority of research is focusing on revealing and improving limitations of Blockchain from privacy and security perspectives, but many of the proposed solutions lack concrete evaluation on their effectiveness. Many other Blockchain scalability related challenges including throughput and latency have been left unstudied. On the basis of this study, recommendations on future research directions are provided for researchers.

Performance and Challenges of Point of Use Devices for Lead ...

EPA Pesticide Factsheets

this presentation summarizes the performance of POU devices for the removal of lead and some other metals, in Flint, Michigan. The mechanism of POU filters for metal removal is described as being a combination of physical filtration with surface sorption and adherence to embedded functional groups in the carbon block, along with the certification process and how to find certified products from the web listings. Finally, there is a discussion of several alternative approaches for possible improvement of the NSF/ANSI 53 and 42 standards to improve the amount of protection afforded by the devices, in the future. this presentation summarizes the performance of POU devices for the removal of lead and some other metals, in Flint, Michigan. The mechanism of POU filters for metal removal is described as being a combination of physical filtration with surface sorption and adherence to embedded functional groups in the carbon block, along with the certification process and how to find certified products from the web listings. Finally, there is a discussion of several alternative approaches for possible improvement of the NSF/ANSI 53 and 42 standards to improve the amount of protection afforded by the devices, in the future.

Strategic planning as a focus for continuous improvement. A case study

NASA Technical Reports Server (NTRS)

Oneill, John W.; Gordon-Winkler, Lyn

1992-01-01

What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

Retinal stimulation strategies to restore vision: Fundamentals and systems.

PubMed

Yue, Lan; Weiland, James D; Roska, Botond; Humayun, Mark S

2016-07-01

Retinal degeneration, a leading cause of blindness worldwide, is primarily characterized by the dysfunctional/degenerated photoreceptors that impair the ability of the retina to detect light. Our group and others have shown that bioelectronic retinal implants restore useful visual input to those who have been blind for decades. This unprecedented approach of restoring sight demonstrates that patients can adapt to new visual input, and thereby opens up opportunities to not only improve this technology but also develop alternative retinal stimulation approaches. These future improvements or new technologies could have the potential of selectively stimulating specific cell classes in the inner retina, leading to improved visual resolution and color vision. In this review we will detail the progress of bioelectronic retinal implants and future devices in this genre as well as discuss other technologies such as optogenetics, chemical photoswitches, and ultrasound stimulation. We will discuss the principles, biological aspects, technology development, current status, clinical outcomes/prospects, and challenges for each approach. The review will cover functional imaging documented cortical responses to retinal stimulation in blind patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Application of dexterous space robotics technology to myoelectric prostheses

NASA Astrophysics Data System (ADS)

Hess, Clifford; Li, Larry C. H.; Farry, Kristin A.; Walker, Ian D.

1994-02-01

Future space missions will require robots equipped with highly dexterous robotic hands to perform a variety of tasks. A major technical challenge in making this possible is an improvement in the way these dexterous robotic hands are remotely controlled or teleoperated. NASA is currently investigating the feasibility of using myoelectric signals to teleoperate a dexterous robotic hand. In theory, myoelectric control of robotic hands will require little or no mechanical parts and will greatly reduce the bulk and weight usually found in dexterous robotic hand control devices. An improvement in myoelectric control of multifinger hands will also benefit prosthetics users. Therefore, as an effort to transfer dexterous space robotics technology to prosthetics applications and to benefit from existing myoelectric technology, NASA is collaborating with the Limbs of Love Foundation, the Institute for Rehabilitation and Research, and Rice University in developing improved myoelectric control multifinger hands and prostheses. In this paper, we will address the objectives and approaches of this collaborative effort and discuss the technical issues associated with myoelectric control of multifinger hands. We will also report our current progress and discuss plans for future work.

Application of dexterous space robotics technology to myoelectric prostheses

NASA Technical Reports Server (NTRS)

Hess, Clifford; Li, Larry C. H.; Farry, Kristin A.; Walker, Ian D.

1994-01-01

Future space missions will require robots equipped with highly dexterous robotic hands to perform a variety of tasks. A major technical challenge in making this possible is an improvement in the way these dexterous robotic hands are remotely controlled or teleoperated. NASA is currently investigating the feasibility of using myoelectric signals to teleoperate a dexterous robotic hand. In theory, myoelectric control of robotic hands will require little or no mechanical parts and will greatly reduce the bulk and weight usually found in dexterous robotic hand control devices. An improvement in myoelectric control of multifinger hands will also benefit prosthetics users. Therefore, as an effort to transfer dexterous space robotics technology to prosthetics applications and to benefit from existing myoelectric technology, NASA is collaborating with the Limbs of Love Foundation, the Institute for Rehabilitation and Research, and Rice University in developing improved myoelectric control multifinger hands and prostheses. In this paper, we will address the objectives and approaches of this collaborative effort and discuss the technical issues associated with myoelectric control of multifinger hands. We will also report our current progress and discuss plans for future work.

Strategic planning as a focus for continuous improvement. A case study

NASA Astrophysics Data System (ADS)

Oneill, John W.; Gordon-Winkler, Lyn

What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

Lessons learned for composite structures

NASA Technical Reports Server (NTRS)

Whitehead, R. S.

1991-01-01

Lessons learned for composite structures are presented in three technology areas: materials, manufacturing, and design. In addition, future challenges for composite structures are presented. Composite materials have long gestation periods from the developmental stage to fully matured production status. Many examples exist of unsuccessful attempts to accelerate this gestation period. Experience has shown that technology transition of a new material system to fully matured production status is time consuming, involves risk, is expensive and should not be undertaken lightly. The future challenges for composite materials require an intensification of the science based approach to material development, extension of the vendor/customer interaction process to include all engineering disciplines of the end user, reduced material costs because they are a significant factor in overall part cost, and improved batch-to-batch pre-preg physical property control. Historical manufacturing lessons learned are presented using current in-service production structure as examples. Most producibility problems for these structures can be traced to their sequential engineering design. This caused an excessive emphasis on design-to-weight and schedule at the expense of design-to-cost. This resulted in expensive performance originated designs, which required costly tooling and led to non-producible parts. Historically these problems have been allowed to persist throughout the production run. The current/future approach for the production of affordable composite structures mandates concurrent engineering design where equal emphasis is placed on product and process design. Design for simplified assembly is also emphasized, since assembly costs account for a major portion of total airframe costs. The future challenge for composite manufacturing is, therefore, to utilize concurrent engineering in conjunction with automated manufacturing techniques to build affordable composite structures. Composite design experience has shown that significant weight savings have been achieved, outstanding fatigue and corrosion resistance have been demonstrated, and in-service performance has been very successful. Currently no structural design show stoppers exist for composite structures. A major lesson learned is that the full scale static test is the key test for composites, since it is the primary structural 'hot spot' indicator. The major durability issue is supportability of thin skinned structure. Impact damage has been identified as the most significant issue for the damage tolerance control of composite structures. However, delaminations induced during assembly operations have demonstrated a significant nuisance value. The future challenges for composite structures are threefold. Firstly, composite airframe weight fraction should increase to 60 percent. At the same time, the cost of composite structures must be reduced by 50 percent to attain the goal of affordability. To support these challenges it is essential to develop lower cost materials and processes.

Role of modern chemistry in sustainable arable crop protection.

PubMed

Smith, Keith; Evans, David A; El-Hiti, Gamal A

2008-02-12

Organic chemistry has been, and for the foreseeable future will remain, vitally important for crop protection. Control of fungal pathogens, insect pests and weeds is crucial to enhanced food provision. As world population continues to grow, it is timely to assess the current situation, anticipate future challenges and consider how new chemistry may help meet those challenges. In future, agriculture will increasingly be expected to provide not only food and feed, but also crops for conversion into renewable fuels and chemical feedstocks. This will further increase the demand for higher crop yields per unit area, requiring chemicals used in crop production to be even more sophisticated. In order to contribute to programmes of integrated crop management, there is a requirement for chemicals to display high specificity, demonstrate benign environmental and toxicological profiles, and be biodegradable. It will also be necessary to improve production of those chemicals, because waste generated by the production process mitigates the overall benefit. Three aspects are considered in this review: advances in the discovery process for new molecules for sustainable crop protection, including tests for environmental and toxicological properties as well as biological activity; advances in synthetic chemistry that may offer efficient and environmentally benign manufacturing processes for modern crop protection chemicals; and issues related to energy use and production through agriculture.

WE-H-BRB-03: Learning Health Systems for Radiation Oncology: Needs and Challenges for Future Success

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

McNutt, T.

Big Data in Radiation Oncology: (1) Overview of the NIH 2015 Big Data Workshop, (2) Where do we stand in the applications of big data in radiation oncology?, and (3) Learning Health Systems for Radiation Oncology: Needs and Challenges for Future Success The overriding goal of this trio panel of presentations is to improve awareness of the wide ranging opportunities for big data impact on patient quality care and enhancing potential for research and collaboration opportunities with NIH and a host of new big data initiatives. This presentation will also summarize the Big Data workshop that was held at themore » NIH Campus on August 13–14, 2015 and sponsored by AAPM, ASTRO, and NIH. The workshop included discussion of current Big Data cancer registry initiatives, safety and incident reporting systems, and other strategies that will have the greatest impact on radiation oncology research, quality assurance, safety, and outcomes analysis. Learning Objectives: To discuss current and future sources of big data for use in radiation oncology research To optimize our current data collection by adopting new strategies from outside radiation oncology To determine what new knowledge big data can provide for clinical decision support for personalized medicine L. Xing, NIH/NCI Google Inc.« less

Intervention studies to foster resilience - A systematic review and proposal for a resilience framework in future intervention studies.

PubMed

Chmitorz, A; Kunzler, A; Helmreich, I; Tüscher, O; Kalisch, R; Kubiak, T; Wessa, M; Lieb, K

2018-02-01

Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major problems are the use of definitions of resilience as trait or a composite of resilience factors, the use of unsuited assessment instruments, and inappropriate study designs. To overcome these challenges, we propose 1) an outcome-oriented definition of resilience, 2) an outcome-oriented assessment of resilience as change in mental health in relation to stressor load, and 3) methodological standards for suitable study designs of future intervention studies. Our proposals may contribute to an improved quality of resilience intervention studies and may stimulate further progress in this growing research field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Future clinical challenges in multiple sclerosis: Relevance to sphingosine 1-phosphate receptor modulator therapy.

PubMed

Hohlfeld, Reinhard; Barkhof, Frederik; Polman, Chris

2011-02-22

The limitations of established therapies for multiple sclerosis (MS) are well-known and include the need for injections, treatment adherence and convenience issues, partial efficacy, and, in some cases, a risk of potentially life-threatening adverse events, such as progressive multifocal leukoencephalopathy. Recently, attention has focused on developing more effective therapies that are administered orally and target neurodegeneration as well as inflammation. In this review, we provide an outlook on the future clinical challenges for MS treatment and management, and focus specifically on the emerging sphingosine 1-phosphate receptor (S1PR) modulators. We highlight the importance of improving our understanding of the neurobiological basis of MS to develop well-tolerated targeted therapies and the need to include advanced MRI assessments that quantify neurodegeneration in interventional studies in MS. As more treatments become available, often with complex pharmacodynamic actions, objective assessment of benefit-to-risk profiles becomes increasingly important to ensure that patients receive appropriate care. Pharmacovigilance and immune monitoring will become important aspects of patient treatment and management in the future. With respect to S1PR modulation, we review the experimental agents that are in clinical development for MS and summarize the steps taken in postmarketing surveillance to ensure that fingolimod (FTY720) has a well-characterized safety profile.

New challenges of public health: bringing the future of personalised healthcare into focus.

PubMed

Ricciardi, Walter; Boccia, Stefania

2017-10-01

The greater personalization of healthcare represents a driver of innovation for research, and for the healthcare systems and industries as a whole. Still policy-makers, healthcare professionals, citizens and private companies need to take some steps to realize the potential for such a radical shift. In this paper, we illustrate the challenges, the benefits and consequences that might accompany the implementation of personalized healthcare, and the steps that policy-makers and practitioners would need to take to realise its potential. Six main prerequisites for radical change in healthcare are presented, that include achieving better genetic literacy for professionals and for the public; engaging citizen in the discourse; improved governance, consent and trust in healthcare; feeding and harnessing the data-knowledge cycle for better health; adopting and adapting the Health Technology Assessment framework for the evaluation of the new technologies; and retaining humanity and community in health and care. Some of these concepts originate from a discussion on the future of health and healthcare, looking at least 15-20 years into the future, that we had at the end of 2016 at Ickworth with an international group of experts, under the aegis of the PHG Foundation. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Fiber-Based Tissue Engineering: Progress, Challenges, and Opportunities

PubMed Central

Tamayol, Ali; Akbari, Mohsen; Annabi, Nasim; Paul, Arghya; Khademhosseini, Ali; Juncker, David

2013-01-01

Tissue engineering aims to improve the function of diseased or damaged organs by creating biological substitutes. To fabricate a functional tissue, the engineered construct should mimic the physiological environment including its structural, topographical, and mechanical properties. Moreover, the construct should facilitate nutrients and oxygen diffusion as well as removal of metabolic waste during tissue regeneration. In the last decade, fiber-based techniques such as weaving, knitting, braiding, as well as electrospinning, and direct writing have emerged as promising platforms for making 3D tissue constructs that can address the above mentioned challenges. Here, we critically review the techniques used to form cell-free and cell-laden fibers and to assemble them into scaffolds. We compare their mechanical properties, morphological features and biological activity. We discuss current challenges and future opportunities of fiber-based tissue engineering (FBTE) for use in research and clinical practice. PMID:23195284

Challenges in Modern Anti-Doping Analytical Science.

PubMed

Ayotte, Christiane; Miller, John; Thevis, Mario

2017-01-01

The challenges facing modern anti-doping analytical science are increasingly complex given the expansion of target drug substances, as the pharmaceutical industry introduces more novel therapeutic compounds and the internet offers designer drugs to improve performance. The technical challenges are manifold, including, for example, the need for advanced instrumentation for greater speed of analyses and increased sensitivity, specific techniques capable of distinguishing between endogenous and exogenous metabolites, or biological assays for the detection of peptide hormones or their markers, all of which require an important investment from the laboratories and recruitment of highly specialized scientific personnel. The consequences of introducing sophisticated and complex analytical procedures may result in the future in a change in the strategy applied by the Word Anti-Doping Agency in relation to the introduction and performance of new techniques by the network of accredited anti-doping laboratories. © 2017 S. Karger AG, Basel.

Multi-Agent Many-Objective Robust Decision Making: Supporting Cooperative Regional Water Portfolio Planning in the Eastern United States

NASA Astrophysics Data System (ADS)

Herman, J. D.; Zeff, H. B.; Reed, P. M.; Characklis, G. W.

2013-12-01

In the Eastern United States, water infrastructure and institutional frameworks have evolved in a historically water-rich environment. However, large regional droughts over the past decade combined with continuing population growth have marked a transition to a state of water scarcity, for which current planning paradigms are ill-suited. Significant opportunities exist to improve the efficiency of water infrastructure via regional coordination, namely, regional 'portfolios' of water-related assets such as reservoirs, conveyance, conservation measures, and transfer agreements. Regional coordination offers the potential to improve reliability, cost, and environmental impact in the expected future state of the world, and, with informed planning, to improve robustness to future uncertainty. In support of this challenge, this study advances a multi-agent many-objective robust decision making (multi-agent MORDM) framework that blends novel computational search and uncertainty analysis tools to discover flexible, robust regional portfolios. Our multi-agent MORDM framework is demonstrated for four water utilities in the Research Triangle region of North Carolina, USA. The utilities supply nearly two million customers and have the ability to interact with one another via transfer agreements and shared infrastructure. We show that strategies for this region which are Pareto-optimal in the expected future state of the world remain vulnerable to performance degradation under alternative scenarios of deeply uncertain hydrologic and economic factors. We then apply the Patient Rule Induction Method (PRIM) to identify which of these uncertain factors drives the individual and collective vulnerabilities for the four cooperating utilities. Our results indicate that clear multi-agent tradeoffs emerge for attaining robustness across the utilities. Furthermore, the key factor identified for improving the robustness of the region's water supply is cooperative demand reduction. This type of approach is critically important given the risks and challenges posed by rising supply development costs, limits on new infrastructure, growing water demands and the underlying uncertainties associated with climate change. The proposed framework serves as a planning template for other historically water-rich regions which must now confront the reality of impending water scarcity.

Remote Sensing of Drought: Progress and Opportunities for Improving Drought Monitoring and Prediction

NASA Astrophysics Data System (ADS)

AghaKouchak, A.; Huning, L. S.; Love, C. A.; Farahmand, A.

2017-12-01

This presentation surveys current and emerging drought monitoring approaches using satellite remote sensing observations from climatological and ecosystem perspectives. Satellite observations that are not currently used for operational drought monitoring, such as near-surface air relative humidity and water vapor, provide opportunities to improve early drought warning. Current and future satellite missions offer opportunities to develop composite and multi-indicator drought models. This presentation describes how different satellite observations can be combined for overall drought development and impact assessment. Finally, we provide an overview of the research gaps and challenges that are facing us ahead in the remote sensing of drought.

Debris Removal: An Opportunity for Cooperative Research?

NASA Technical Reports Server (NTRS)

Johnson, Nicholas L.

2007-01-01

Space debris mitigation practices will be insufficient to prevent the continued growth of the Earth satellite population. Removal of orbital debris can improve the reliability of present and future space systems. The challenges of developing an effective, affordable debris removal capability are considerable. The time is right for a new look at space remediation concepts. In concert with or following the current IAA study An international approach to the remediation of the near-Earth space environment will likely be required.

2014 - 2015 Civil Affairs Issue Papers: The Future of Civil Affairs

DTIC Science & Technology

2015-02-18

companies. Included is a request for a SME on zoonotic diseases to help with a strange virus effecting goat herds in Beledweyne, a call for advice from a...local veterinary officer orders the right medication to treat the goats , the water plant manager or- ders the right pumps to improve agricultural...Since most CIM RFI deal with longer term civil sector challenges such as agri- cultural, farming , and education questions, responses are not

Report on the ''2017 ESO Calibration Workshop: The Second-Generation VLT Instruments and Friends''

NASA Astrophysics Data System (ADS)

Smette, A.; Kerber, F.; Kaufer, A.

2017-03-01

The participants at the 2017 ESO Calibration Workshop shared their experiences and the challenges encountered in calibrating VLT second-generation instruments and the upgraded first-generation instruments, and discussed improvements in the characterisation of the atmosphere and data reduction. A small group of ESO participants held a follow-up retreat and identified possible game changers in the future operations of the La Silla Paranal Observatory: feedback on the proposals is encouraged.

Challenges faced by Arab women who are interested in becoming physicians.

PubMed

Bisharat, Bishara; Bowirrat, Abdalla

2015-01-01

Understanding the underlying reasons for the under-representation of Arab women within the health care system in Israel is crucial for creating future strategies for intervention, in order to minimize the gaps in the health care system and thus improve the medical services and health status. Our commentary tries to shed light on the underrepresentation and the marginalization of the Arab women in society in general and in the medical field in specific.

Sustainable development: challenges and opportunities for the natural sciences (Invited)

NASA Astrophysics Data System (ADS)

Mutter, J. C.; Fishman, R.; Anttila-Hughes, J. K.; Hsiang, S. M.

2009-12-01

The challenges of sustainable development -- equitably improving global human welfare while ensuring that the environment is preserved for future generations - demand research at the nexus of the social and natural sciences. Massive and inevitable changes in climate, ecosystem functions, and human interaction with the environment will perturb societies throughout the world in different ways over the coming century. The changes faced by poor societies and their ability to cope differs markedly from those that face the richest. Yet in all regions the dynamic interaction of social and natural drivers will govern the prospects for human welfare and its improvement. Developing an understanding of these phenomena will require field research together with analytical and modeling capabilities that couple physical and social phenomena, allowing feedback between the two to manifest and permit forecasting over long time scales. Heterogeneous income and population growth further complicate this need through their consequences for food security, migration, resource allocation, and conflict. In this contribution, we identify some key concepts of sustainable development, open research questions and outline how scientific research might engage this emerging discipline. Using recent examples of interaction, we discuss the opportunities and challenges facing the further development of this dialogue.

The Role for Virtual Patients in the Future of Medical Education.

PubMed

Berman, Norman B; Durning, Steven J; Fischer, Martin R; Huwendiek, Soren; Triola, Marc M

2016-09-01

The medical education community is working-across disciplines and across the continuum-to address the current challenges facing the medical education system and to implement strategies to improve educational outcomes. Educational technology offers the promise of addressing these important challenges in ways not previously possible. The authors propose a role for virtual patients (VPs), which they define as multimedia, screen-based interactive patient scenarios. They believe VPs offer capabilities and benefits particularly well suited to addressing the challenges facing medical education. Well-designed, interactive VP-based learning activities can promote the deep learning that is needed to handle the rapid growth in medical knowledge. Clinically oriented learning from VPs can capture intrinsic motivation and promote mastery learning. VPs can also enhance trainees' application of foundational knowledge to promote the development of clinical reasoning, the foundation of medical practice. Although not the entire solution, VPs can support competency-based education. The data created by the use of VPs can serve as the basis for multi-institutional research that will enable the medical education community both to better understand the effectiveness of educational interventions and to measure progress toward an improved system of medical education.

Methods in Enzymology: “Flexible backbone sampling methods to model and design protein alternative conformations”

PubMed Central

Ollikainen, Noah; Smith, Colin A.; Fraser, James S.; Kortemme, Tanja

2013-01-01

Sampling alternative conformations is key to understanding how proteins work and engineering them for new functions. However, accurately characterizing and modeling protein conformational ensembles remains experimentally and computationally challenging. These challenges must be met before protein conformational heterogeneity can be exploited in protein engineering and design. Here, as a stepping stone, we describe methods to detect alternative conformations in proteins and strategies to model these near-native conformational changes based on backrub-type Monte Carlo moves in Rosetta. We illustrate how Rosetta simulations that apply backrub moves improve modeling of point mutant side chain conformations, native side chain conformational heterogeneity, functional conformational changes, tolerated sequence space, protein interaction specificity, and amino acid co-variation across protein-protein interfaces. We include relevant Rosetta command lines and RosettaScripts to encourage the application of these types of simulations to other systems. Our work highlights that critical scoring and sampling improvements will be necessary to approximate conformational landscapes. Challenges for the future development of these methods include modeling conformational changes that propagate away from designed mutation sites and modulating backbone flexibility to predictively design functionally important conformational heterogeneity. PMID:23422426

Neonatal Meningitis: Overcoming Challenges in Diagnosis, Prognosis, and Treatment with Omics

PubMed Central

Gordon, Scott M.; Srinivasan, Lakshmi; Harris, Mary Catherine

2017-01-01

Neonatal meningitis is a devastating condition. Prognosis has not improved in decades, despite the advent of improved antimicrobial therapy and heightened index of suspicion among clinicians caring for affected infants. One in ten infants die from meningitis, and up to half of survivors develop significant lifelong complications, including seizures, impaired hearing and vision, and delayed or arrested development of such basic skills as talking and walking. At present, it is not possible to predict which infants will suffer poor outcomes. Early treatment is critical to promote more favorable outcomes, though diagnosis of meningitis in infants is technically challenging, time-intensive, and invasive. Profound neuronal injury has long been described in the setting of neonatal meningitis, as has elevated levels of many pro- and anti-inflammatory cytokines. Mechanisms of the host immune response that drive clearance of the offending organism and underlie brain injury due to meningitis are not well understood, however. In this review, we will discuss challenges in diagnosis, prognosis, and treatment of neonatal meningitis. We will highlight transcriptomic, proteomic, and metabolomic data that contribute to suggested mechanisms of inflammation and brain injury in this setting with a view toward fruitful areas for future investigation. PMID:28670576

Drug Delivery in Cancer Therapy, Quo Vadis?

PubMed

Lu, Zheng-Rong; Qiao, Peter

2018-03-22

The treatment of malignancies has undergone dramatic changes in the past few decades. Advances in drug delivery techniques and nanotechnology have allowed for new formulations of old drugs, so as to improve the pharmacokinetics, to enhance accumulation in solid tumors, and to reduce the significant toxic effects of these important therapeutic agents. Here, we review the published clinical data in cancer therapy of several major drug delivery systems, including targeted radionuclide therapy, antibody-drug conjugates, liposomes, polymer-drug conjugates, polymer implants, micelles, and nanoparticles. The clinical outcomes of these delivery systems from various phases of clinical trials are summarized. The success and limitations of the drug delivery strategies are discussed based on the clinical observations. In addition, the challenges in applying drug delivery for efficacious cancer therapy, including physical barriers, tumor heterogeneity, drug resistance, and metastasis, are discussed along with future perspectives of drug delivery in cancer therapy. In doing so, we intend to underscore that efficient delivery of cancer therapeutics to solid malignancies remains a major challenge in cancer therapy, and requires a multidisciplinary approach that integrates knowledge from the diverse fields of chemistry, biology, engineering, and medicine. The overall objective of this review is to improve our understanding of the clinical fate of commonly investigated drug delivery strategies, and to identify the limitations that must be addressed in future drug delivery strategies, toward the pursuit of curative therapies for cancer.

Reducing health inequalities among girls and adolescent women living in poverty: the success of Bangladesh.

PubMed

Rousham, Emily K; Khandakar, Ikhtiar Uddin

2016-01-01

Bangladesh has made dramatic improvements in the health of girls and women in the last 20 years. This paper examines whether gender inequalities in health are evident among older children and adolescents among extremely poor households and identifies future health challenges for improving the health of girls and women. Gender inequalities in health were examined using data from a school health survey of school children and adolescents (n = 900, 6.5-13.5 years). Anthropometric status, household possessions and number of siblings were measured. Under-nutrition was assessed as stunting (height-for-age z-score) and thinness (BMI-for-age z-score). The prevalence of under-nutrition was high (35.3% stunting; 42.4% thinness), but there were no significant differences according to gender or socio-economic indicators (via possession score). Girls had more younger siblings (p < 0.05), while boys had more older siblings (p < 0.05). These findings accord with the national picture of successful reductions in gender inequalities in health through low cost, community-based health programmes and education policies targeting the poorest sectors. The prevalence of under-nutrition, however, remains high. Reproductive behaviours may still be influenced by poverty and the gender of existing offspring. Future challenges lie in reducing the adverse health consequences to women and their infants associated with early age at marriage and childbirth.

Challenges and lessons learned in implementing a community-academic partnership for drug prevention in a Native Hawaiian community

PubMed Central

Davis, Kanoelani; Haumana

2017-01-01

Objective The broad purpose of this project is to improve health in Native Hawaiian communities through the prevention of substance use. Our community-academic partnership (CAP) team developed an intervention called Puni Ke Ola for this purpose. This paper provides a brief overview of the intervention, then describes challenges and lessons learned in piloting Puni Ke Ola. Methods A single module of the Puni Ke Ola intervention was implemented, after which the intervention leaders (N=3) convened for a debriefing meeting. The information shared was content analyzed to identify challenges in implementation. Results Five challenges were identified: 1) timeline and schedule, 2) participant recruitment and sample size, 3) place-based intervention intensity and transportation, 4) communication, and 5) staff time and funding. Conclusion Challenges were reframed as lessons learned and organized under the overarching theme of Kapu Aloha. Kapu Aloha refers to the idea that practicing aloha (love and compassion) is sacred and extends to all of our interactions. By honoring this value, our CAP team managed a number of challenges throughout the implementation process, which also has implications for future implementation. PMID:28622407

Artificial Intelligence for the Artificial Kidney: Pointers to the Future of a Personalized Hemodialysis Therapy.

PubMed

Hueso, Miguel; Vellido, Alfredo; Montero, Nuria; Barbieri, Carlo; Ramos, Rosa; Angoso, Manuel; Cruzado, Josep Maria; Jonsson, Anders

2018-02-01

Current dialysis devices are not able to react when unexpected changes occur during dialysis treatment or to learn about experience for therapy personalization. Furthermore, great efforts are dedicated to develop miniaturized artificial kidneys to achieve a continuous and personalized dialysis therapy, in order to improve the patient's quality of life. These innovative dialysis devices will require a real-time monitoring of equipment alarms, dialysis parameters, and patient-related data to ensure patient safety and to allow instantaneous changes of the dialysis prescription for the assessment of their adequacy. The analysis and evaluation of the resulting large-scale data sets enters the realm of "big data" and will require real-time predictive models. These may come from the fields of machine learning and computational intelligence, both included in artificial intelligence, a branch of engineering involved with the creation of devices that simulate intelligent behavior. The incorporation of artificial intelligence should provide a fully new approach to data analysis, enabling future advances in personalized dialysis therapies. With the purpose to learn about the present and potential future impact on medicine from experts in artificial intelligence and machine learning, a scientific meeting was organized in the Hospital Universitari Bellvitge (L'Hospitalet, Barcelona). As an outcome of that meeting, the aim of this review is to investigate artificial intel ligence experiences on dialysis, with a focus on potential barriers, challenges, and prospects for future applications of these technologies. Artificial intelligence research on dialysis is still in an early stage, and the main challenge relies on interpretability and/or comprehensibility of data models when applied to decision making. Artificial neural networks and medical decision support systems have been used to make predictions about anemia, total body water, or intradialysis hypotension and are promising approaches for the prescription and monitoring of hemodialysis therapy. Current dialysis machines are continuously improving due to innovative technological developments, but patient safety is still a key challenge. Real-time monitoring systems, coupled with automatic instantaneous biofeedback, will allow changing dialysis prescriptions continuously. The integration of vital sign monitoring with dialysis parameters will produce large data sets that will require the use of data analysis techniques, possibly from the area of machine learning, in order to make better decisions and increase the safety of patients.

Prospective Longitudinal Studies of Infant Siblings of Children With Autism: Lessons Learned and Future Directions.

PubMed

Szatmari, Peter; Chawarska, Katarzyna; Dawson, Geraldine; Georgiades, Stelios; Landa, Rebecca; Lord, Catherine; Messinger, Daniel S; Thurm, Audrey; Halladay, Alycia

2016-03-01

The objectives of this review are to highlight the impact of the first decade of high-risk (HR) infant sibling work in autism spectrum disorder (ASD) and to identify potential areas of translational focus for the next decade of research. A group of clinicians and researchers in ASD working both inside and outside of the HR design met on a regular basis to review the infant sibling research, and came to an agreement on areas that had changed clinical practice and areas that had the potential to change practice with further research. The group then outlined several methodological and translational challenges that must be addressed in the next decade of research if the field is to reach its potential. The review concluded that the HR design has yielded an understanding that ASD often, but not always, begins to emerge between 6 and 18 months, with early signs affecting social communication. Research using the HR design has also allowed a better understanding of the sibling recurrence risk (between 10% and 20%). Emerging areas of interest include the developmental trajectories of social communications skills in the early years, the expression of a milder phenotype in siblings not affected with ASD, and the possibility that early intervention with infant siblings may improve outcomes for those with ASD. Important challenges for the future include linking screening to intervention, collecting large sample sizes while ensuring cross-site reliability, and building in capacity for replication. Although there are significant methodological and translational challenges for high-risk infant sibling research, the potential of this design to improve long-term outcomes of all children with ASD is substantial. Published by Elsevier Inc.

Prospective Longitudinal Studies of Infant Siblings of Children With Autism: Lessons Learned and Future Directions

PubMed Central

Szatmari, Peter; Chawarska, Katarzyna; Dawson, Geraldine; Georgiades, Stelios; Landa, Rebecca; Lord, Catherine; Messinger, Daniel S.; Thurm, Audrey; Halladay, Alycia

2016-01-01

Objective The objectives of this review are to highlight the impact of the first decade of high-risk (HR) infant sibling work in autism spectrum disorder (ASD) and to identify potential areas of translational focus for the next decade of research. Method A group of clinicians and researchers in ASD working both inside and outside of the HR design met on a regular basis to review the infant sibling research, and came to an agreement on areas that had changed clinical practice and areas that had the potential to change practice with further research. The group then outlined several methodological and translational challenges that must be addressed in the next decade of research if the field is to reach its potential. Results The review concluded that the HR design has yielded an understanding that ASD often, but not always, begins to emerge between 6 and 18 months, with early signs affecting social communication. Research using the HR design has also allowed a better understanding of the sibling recurrence risk (between 10% and 20%). Emerging areas of interest include the developmental trajectories of social communications skills in the early years, the expression of a milder phenotype in siblings not affected with ASD, and the possibility that early intervention with infant siblings may improve outcomes for those with ASD. Important challenges for the future include linking screening to intervention, collecting large sample sizes while ensuring cross-site reliability, and building in capacity for replication. Conclusion Although there are significant methodological and translational challenges for high-risk infant sibling research, the potential of this design to improve long-term outcomes of all children with ASD is substantial. PMID:26903251

Using Information from the Electronic Health Record to Improve Measurement of Unemployment in Service Members and Veterans with mTBI and Post-Deployment Stress

PubMed Central

Dillahunt-Aspillaga, Christina; Finch, Dezon; Massengale, Jill; Kretzmer, Tracy; Luther, Stephen L.; McCart, James A.

2014-01-01

Objective The purpose of this pilot study is 1) to develop an annotation schema and a training set of annotated notes to support the future development of a natural language processing (NLP) system to automatically extract employment information, and 2) to determine if information about employment status, goals and work-related challenges reported by service members and Veterans with mild traumatic brain injury (mTBI) and post-deployment stress can be identified in the Electronic Health Record (EHR). Design Retrospective cohort study using data from selected progress notes stored in the EHR. Setting Post-deployment Rehabilitation and Evaluation Program (PREP), an in-patient rehabilitation program for Veterans with TBI at the James A. Haley Veterans' Hospital in Tampa, Florida. Participants Service members and Veterans with TBI who participated in the PREP program (N = 60). Main Outcome Measures Documentation of employment status, goals, and work-related challenges reported by service members and recorded in the EHR. Results Two hundred notes were examined and unique vocational information was found indicating a variety of self-reported employment challenges. Current employment status and future vocational goals along with information about cognitive, physical, and behavioral symptoms that may affect return-to-work were extracted from the EHR. The annotation schema developed for this study provides an excellent tool upon which NLP studies can be developed. Conclusions Information related to employment status and vocational history is stored in text notes in the EHR system. Information stored in text does not lend itself to easy extraction or summarization for research and rehabilitation planning purposes. Development of NLP systems to automatically extract text-based employment information provides data that may improve the understanding and measurement of employment in this important cohort. PMID:25541956

Surrogate Joint Aerial Layer Network (JALN) Experiment: Applications of Commercial-Off-The-Shelf Technologies for Researching Future JALN Challenges

DTIC Science & Technology

2014-12-01

CHALLENGES DECEMBER 2014 TECHNICAL REPORT APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED STINFO COPY AIR FORCE RESEARCH LABORATORY INFORMATION...JOINT AERIAL LAYER NETWORK (JALN) EXPERIMENT: APPLICATION OF COMMERCIAL-OFF-THE-SHELF TECHNOLOGIES FOR RESEARCHING FUTURE JALN CHALLENGES 5a... challenge JALN developers. The use of low-cost COTS wireless technology is found to be a suitable surrogate for military hardware for investigating

Grade-Level Differences in Future-Oriented Self-Concept During Early Adolescence: Potential Relevance to School Nursing

PubMed Central

2016-01-01

The middle school and early high school years are a time of significant development, including an increasing ability to envision oneself in the future. Little is known about how adolescents’ future-oriented self-concept (i.e., possible selves) differs across grade levels, although this knowledge may aid in establishing rapport with students and building effective health-promotion and risk reduction interventions. Therefore, this study explored grade-level differences in hoped for and feared possible selves in a sample of 6th – 9th grade students (n = 2,498; Mage = 12.72, SD = 1.15; 51.3% female). Findings suggest that adolescents list a variety of possible selves, and the content differs according to grade-level. These findings offer helpful insight for intervention work aimed at improving student outcomes and preventing risk behavior. Understanding what adolescents hope and fear for themselves in the future may be particularly beneficial for school nurses in identifying the unique challenges students experience and tailoring health-promotion efforts. PMID:27222444

Grade-Level Differences in Future-Oriented Self-Concept During Early Adolescence: Potential Relevance to School Nursing.

PubMed

Stoddard, Sarah A; Pierce, Jennifer; Schmidt, Carissa J

2016-12-01

The middle school and early high school years are a time of significant development, including an increasing ability to envision oneself in the future. Little is known about how adolescents' future-oriented self-concept (i.e., possible selves) differs across grade levels, although this knowledge may aid in establishing rapport with students and building effective health promotion and risk reduction interventions. Therefore, this study explored grade-level differences in hoped for and feared possible selves in a sample of sixth- to ninth-grade students (n = 2,498; M age = 12.72, SD = 1.15; 51.3% female). Findings suggest that adolescents list a variety of possible selves, and the content differs according to grade level. These findings offer helpful insight for intervention work aimed at improving student outcomes and preventing risk behavior. Understanding what adolescents hope and fear for themselves in the future may be particularly beneficial for school nurses in identifying the unique challenges students experience and tailoring health promotion efforts. © The Author(s) 2016.

The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

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

Schultz, Courtney A., E-mail: courtney.schultz@colostate.edu

Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is donemore » under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.« less

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

The significance of ethics reflection groups in mental health care: a focus group study among health care professionals.

PubMed

Hem, Marit Helene; Molewijk, Bert; Gjerberg, Elisabeth; Lillemoen, Lillian; Pedersen, Reidar

2018-06-05

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices.

Reference Structures: Stagnation, Progress, and Future Challenges.

ERIC Educational Resources Information Center

Greenberg, Jane

1997-01-01

Assesses the current state of reference structures in online public access catalogs (OPACs) in a framework defined by stagnation, progress, and future challenges. Outlines six areas for reference structure development. Twenty figures provide illustrations. (AEF)

Targeted delivery of miRNA therapeutics for cardiovascular diseases: opportunities and challenges.

PubMed

Kwekkeboom, Rick F J; Lei, Zhiyong; Doevendans, Pieter A; Musters, René J P; Sluijter, Joost P G

2014-09-01

Dysregulation of miRNA expression has been associated with many cardiovascular diseases in animal models, as well as in patients. In the present review, we summarize recent findings on the role of miRNAs in cardiovascular diseases and discuss the opportunities, possibilities and challenges of using miRNAs as future therapeutic targets. Furthermore, we focus on the different approaches that can be used to deliver these newly developed miRNA therapeutics to their sites of action. Since siRNAs are structurally homologous with the miRNA therapeutics, important lessons learned from siRNA delivery strategies are discussed that might be applicable to targeted delivery of miRNA therapeutics, thereby reducing costs and potential side effects, and improving efficacy.

Introduction to Special Section on Oceanic Responses and Feedbacks to Tropical Cyclones

NASA Astrophysics Data System (ADS)

Zhou, Lei; Chen, Dake; Karnauskas, Kristopher B.; Wang, Chunzai; Lei, Xiaotu; Wang, Wei; Wang, Guihua; Han, Guijun

2018-02-01

Tropical cyclones (TCs) are among the most destructive natural hazards on Earth. The ocean can have dramatic responses to TCs and further imposes significant feedbacks to the atmosphere. A comprehensive understanding of the ocean-TC interaction is a challenging hindrance for improving the simulation and prediction of TCs and therefore avoidance of human and economic losses. A special section of JGR-Oceans was thus organized, in order to have a broad summary of latest progress in ocean-TC interactions. This introduction presents a brief overview of the contributions found in this collection. We hope it can also shed light on recent advance and future challenges in the studies on the oceanic responses and feedbacks to TCs.

Big data in biomedicine.

PubMed

Costa, Fabricio F

2014-04-01

The increasing availability and growth rate of biomedical information, also known as 'big data', provides an opportunity for future personalized medicine programs that will significantly improve patient care. Recent advances in information technology (IT) applied to biomedicine are changing the landscape of privacy and personal information, with patients getting more control of their health information. Conceivably, big data analytics is already impacting health decisions and patient care; however, specific challenges need to be addressed to integrate current discoveries into medical practice. In this article, I will discuss the major breakthroughs achieved in combining omics and clinical health data in terms of their application to personalized medicine. I will also review the challenges associated with using big data in biomedicine and translational science. Copyright © 2013 Elsevier Ltd. All rights reserved.

Topical, Biological and Clinical Challenges in the Management of Patients with Acne Vulgaris

PubMed Central

Al-Hammadi, Anwar; Al-Ismaily, Abla; Al-Ali, Sameer; Ramadurai, Rajesh; Jain, Rishi; McKinley-Grant, Lynn; Mughal, Tariq I.

2016-01-01

Acne vulgaris is one of the most common chronic inflammatory skin disorders among adolescents and young adults. It is associated with substantial morbidity and, rarely, with mortality. The exact worldwide incidence and prevalence are currently unknown. Current challenges involve improving understanding of the underlying pathophysiology of acne vulgaris and developing a practical treatment consensus. Expert panel discussions were held in 2013 and 2014 among a group of scientists and clinicians from the Omani and United Arab Emirate Dermatology Societies to ascertain the current optimal management of acne vulgaris, identify clinically relevant end-points and construct suitable methodology for future clinical trial designs. This article reviews the discussions of these sessions and recent literature on this topic. PMID:27226905

Kidney transplantation in the elderly.

PubMed

Singh, Neeraj; Nori, Uday; Pesavento, Todd

2009-08-01

Recent outcome data, ongoing organ shortage and proposed changes in allocation policies are driving the need to review current practices and possible future course of kidney transplantation in the elderly patients. A proposed new kidney allocation system based on matching donor and recipient characteristics to enable 'age-matched' kidney allocation is currently being discussed in the USA. While this system benefits younger recipients, implications for elderly recipients receiving older grafts remain a matter of debate. Despite improved outcomes, there remain significant challenges to kidney transplantation in the elderly, including organ shortage, poor transplant rate, evolving allocation policies, high wait-list mortality and nonstandardized immunosuppression. Prospective studies are needed to evaluate the strategies to meet these challenges and to study the impact of proposed new allocation system.

Key challenges in future Li-battery research.

PubMed

Tarascon, J-M

2010-07-28

Batteries are a major technological challenge in this new century as they are a key method to make more efficient use of energy. Although today's Li-ion technology has conquered the portable electronic markets and is still improving, it falls short of meeting the demands dictated by the powering of both hybrid electric vehicles and electric vehicles or by the storage of renewable energies (wind, solar). There is room for optimism as long as we pursue paradigm shifts while keeping in mind the concept of materials sustainability. Some of these concepts, relying on new ways to prepare electrode materials via eco-efficient processes, on the use of organic rather than inorganic materials or new chemistries will be discussed. Achieving these concepts will require the inputs of multiple disciplines.

Quantifying the economic risks of climate change

NASA Astrophysics Data System (ADS)

Diaz, Delavane; Moore, Frances

2017-11-01

Understanding the value of reducing greenhouse-gas emissions matters for policy decisions and climate risk management, but quantification is challenging because of the complex interactions and uncertainties in the Earth and human systems, as well as normative ethical considerations. Current modelling approaches use damage functions to parameterize a simplified relationship between climate variables, such as temperature change, and economic losses. Here we review and synthesize the limitations of these damage functions and describe how incorporating impacts, adaptation and vulnerability research advances and empirical findings could substantially improve damage modelling and the robustness of social cost of carbon values produced. We discuss the opportunities and challenges associated with integrating these research advances into cost-benefit integrated assessment models, with guidance for future work.

Futures research: A neglected dimension in environmental policy and planning

Treesearch

David N. Bengston

2012-01-01

The need for strategic foresight in an increasingly complex and rapidly changing world poses a formidable challenge to environmental planners and policy makers. Th is paper introduces futures research as an under used but fruitful set of approaches to addressing this challenge. Futures research is a transdisciplinary social science that uses a wide range of methods to...

Early experience of a safety net provider reorganizing into an accountable care organization.

PubMed

Hacker, Karen; Santos, Palmira; Thompson, Douglas; Stout, Somava S; Bearse, Adriana; Mechanic, Robert E

2014-08-01

Although safety net providers will benefit from health insurance expansions under the Affordable Care Act, they also face significant challenges in the postreform environment. Some have embraced the concept of the accountable care organization to help improve quality and efficiency while addressing financial shortfalls. The experience of Cambridge Health Alliance (CHA) in Massachusetts, where health care reform began six years ago, provides insight into the opportunities and challenges of this approach in the safety net. CHA's strategies include care redesign, financial realignment, workforce transformation, and development of external partnerships. Early results show some improvement in access, patient experience, quality, and utilization; however, the potential efficiencies will not eliminate CHA's current operating deficit. The patient population, payer mix, service mix, cost structure, and political requirements reduce the likelihood of financial sustainability without significant changes in these factors, increased public funding, or both. Thus the future of safety net institutions, regardless of payment and care redesign success, remains at risk. Copyright © 2014 by Duke University Press.

Improving Discussion in Astronomy Courses Taught Online

NASA Astrophysics Data System (ADS)

Troischt, Parker

2017-06-01

Astronomy courses that are either hybrid in nature or offered in a completely online format are becoming more common at colleges and universities. In particular, faculty members at small colleges are being encouraged to develop courses that can be taught online in order to give students increased flexibility in scheduling classes and reach a separate population of learners. For instructors accustomed to teaching students in person using plenty of interaction, making the switch to teaching even one online course a year can be challenging. However, some topics are developing so rapidly (exoplanets) that it is difficult to imagine having students rely on a standard textbook at all, and the use of online resources become essential. Here, we describe methods used to promote discussion, evaluate its content and effectively incorporate the use of recently released articles in order to keep students engaged. We present efforts to produce a lively classroom atmosphere centered on recent advances and several debated topics. Lastly, we report on successes, challenges and plans for improving online courses in the future.

Label-free optical imaging technologies for rapid translation and use during intraoperative surgical and tumor margin assessment

NASA Astrophysics Data System (ADS)

Boppart, Stephen A.; Brown, J. Quincy; Farah, Camile S.; Kho, Esther; Marcu, Laura; Saunders, Christobel M.; Sterenborg, Henricus J. C. M.

2018-02-01

The biannual International Conference on Biophotonics was recently held on April 30 to May 1, 2017, in Fremantle, Western Australia. This continuing conference series brought together key opinion leaders in biophotonics to present their latest results and, importantly, to participate in discussions on the future of the field and what opportunities exist when we collectively work together for using biophotonics for biological discovery and medical applications. One session in this conference, entitled "Tumor Margin Identification: Critiquing Technologies," challenged invited speakers and attendees to review and critique representative label-free optical imaging technologies and their application for intraoperative assessment and guidance in surgical oncology. We are pleased to share a summary in this outlook paper, with the intent to motivate more research inquiry and investigations, to challenge these and other optical imaging modalities to evaluate and improve performance, to spur translation and adoption, and ultimately, to improve the care and outcomes of patients.

Meeting the challenge of food and energy security.

PubMed

Karp, Angela; Richter, Goetz M

2011-06-01

Growing crops for bioenergy or biofuels is increasingly viewed as conflicting with food production. However, energy use continues to rise and food production requires fuel inputs, which have increased with intensification. Focussing on the question of food or fuel is thus not helpful. The bigger, more pertinent, challenge is how the increasing demands for food and energy can be met in the future, particularly when water and land availability will be limited. Energy crop production systems differ greatly in environmental impact. The use of high-input food crops for liquid transport fuels (first-generation biofuels) needs to be phased out and replaced by the use of crop residues and low-input perennial crops (second/advanced-generation biofuels) with multiple environmental benefits. More research effort is needed to improve yields of biomass crops grown on lower grade land, and maximum value should be extracted through the exploitation of co-products and integrated biorefinery systems. Policy must continually emphasize the changes needed and tie incentives to improved greenhous gas reduction and environmental performance of biofuels.

The development of urban community health centres for strengthening primary care in China: a systematic literature review.

PubMed

Wang, Harry H X; Wang, Jia Ji; Wong, Samuel Y S; Wong, Martin C S; Mercer, Stewart W; Griffiths, Sian M

2015-01-01

This review outlines the development of China's primary care system, with implications for improving equitable health care. Government documents, official statistics, and recent literature identified through systematic searches performed on NCBI PubMed. Community health centres (CHCs) are being developed as the major primary care provider in urban China, with laudable achievements. The road towards a strong primary care-led system is promising but challenging. The effectiveness in improving equitable care through the expansion of primary care workforce and redesign of the social medical insurance system warrants further exploration. Healthcare disparities exist in the health system wherein universal health coverage and gatekeepers have not yet been established. Future prospective studies should aim to provide solutions for strengthening the leading role of CHCs in providing equitable care in response to population ageing and multimorbidity challenges. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Chimeric Antigen Receptor-Modified T Cells for Solid Tumors: Challenges and Prospects

PubMed Central

Guo, Yelei; Wang, Yao; Han, Weidong

2016-01-01

Recent studies have highlighted the successes of chimeric antigen receptor-modified T- (CART-) cell-based therapy for B-cell malignancies, and early phase clinical trials have been launched in recent years. The few published clinical studies of CART cells in solid tumors have addressed safety and feasibility, but the clinical outcome data are limited. Although antitumor effects were confirmed in vitro and in animal models, CART-cell-based therapy still faces several challenges when directed towards solid tumors, and it has been difficult to achieve the desired outcomes in clinical practice. Many studies have struggled to improve the clinical responses to and benefits of CART-cell treatment of solid tumors. In this review, the status quo of CART cells and their clinical applications for solid tumors will be summarized first. Importantly, we will suggest improvements that could increase the therapeutic effectiveness of CART cells for solid tumors and their future clinical applications. These interventions will make treatment with CART cells an effective and routine therapy for solid tumors. PMID:26998495

Crystal growth and materials research in photovoltaics: progress and challenges

NASA Astrophysics Data System (ADS)

Surek, Thomas

2005-02-01

Photovoltaics (PV) is solar electric power—a semiconductor-based technology that converts sunlight to electricity. Three decades of research has led to the discovery of new materials and devices and new processing techniques for low-cost manufacturing. This has resulted in improved sunlight-to-electricity conversion efficiencies, improved outdoor reliability, and lower module and system costs. The manufacture and sale of PV has grown into a $5 billion industry worldwide, with more than 740 megawatts of PV modules shipped in 2003. This paper reviews the significant progress that has occurred in PV materials and devices research over the past 30 years, focusing on the advances in crystal growth and materials research, and examines the challenges to reaching the ultimate potential of current-generation (crystalline silicon), next-generation (thin films and concentrators), and future-generation PV technologies. The latter includes innovative materials and device concepts that hold the promise of significantly higher conversion efficiencies and/or much lower costs.

Mental health literacy as theory: current challenges and future directions.

PubMed

Spiker, Douglas A; Hammer, Joseph H

2018-02-13

Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include additional constructs, but no consensus has yet been reached on what constructs should be included as part of MHL. The purpose of this paper is to (i) elucidate how the expansion of the MHL construct has impeded the growth of MHL research and (ii) through the lens of construct and theory development, highlight how these challenges might be remedied. An inclusive search of the literature was undertaken to identify MHL studies. The principles of construct and theory development guided a critical analysis of MHL. The review of the literature found that MHL violates many principles of what constitutes an acceptable construct definition. To address these concerns, we proposed conceptualizing MHL as a theory and recommended principles of theory development that should be taken into consideration. A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships. For practitioners, a theory of MHL can help inform how to improve MHL at both the individual and community level.

Challenges and Future in Vaccines, Drug Development, and Immunomodulatory Therapy

PubMed Central

Nau, Gerard J.; Ross, Ted M.; Evans, Thomas G.; Chakraborty, Krishnendu; Empey, Kerry M.; Flynn, JoAnne L.

2014-01-01

Pulmonary diseases and infections are among the top contributors to human morbidity and mortality worldwide, and despite the successful history of vaccines and antimicrobial therapeutics, infectious disease still presents a significant threat to human health. Effective vaccines are frequently unavailable in developing countries, and successful vaccines have yet to be developed for major global maladies, such as tuberculosis. Furthermore, antibiotic resistance poses a growing threat to human health. The “Challenges and Future in Vaccines, Drug Development, and Immunomodulatory Therapy” session of the 2013 Pittsburgh International Lung Conference highlighted several recent and current studies related to treatment and prevention of antibiotic-resistant bacterial infections, highly pathogenic influenza, respiratory syncytial virus, and tuberculosis. Research presented here focused on novel antimicrobial therapies, new vaccines that are either in development or currently in clinical trials, and the potential for immunomodulatory therapies. These studies are making important contributions to the areas of microbiology, virology, and immunology related to pulmonary diseases and infections and are paving the way for improvements in the efficacy of vaccines and antimicrobials. PMID:25148426

Toward Superior Capacitive Energy Storage: Recent Advances in Pore Engineering for Dense Electrodes.

PubMed

Liu, Congcong; Yan, Xiaojun; Hu, Fei; Gao, Guohua; Wu, Guangming; Yang, Xiaowei

2018-04-01

With the rapid development of mobile electronics and electric vehicles, future electrochemical capacitors (ECs) need to store as much energy as possible in a rather limited space. As the core component of ECs, dense electrodes that have a high volumetric energy density and superior rate capability are the key to achieving improved energy storage. Here, the significance of and recent progress in the high volumetric performance of dense electrodes are presented. Furthermore, dense yet porous electrodes, as the critical precondition for realizing superior electrochemical capacitive energy, have become a scientific challenge and an attractive research focus. From a pore-engineering perspective, insight into the guidelines of engineering the pore size, connectivity, and wettability is provided to design dense electrodes with different porous architectures toward high-performance capacitive energy storage. The current challenges and future opportunities toward dense electrodes are discussed and include the construction of an orderly porous structure with an appropriate gradient, the coupling of pore sizes with the solvated cations and anions, and the design of coupled pores with diverse electrolyte ions. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Time-Resolved Diffuse Optical Spectroscopy and Imaging Using Solid-State Detectors: Characteristics, Present Status, and Research Challenges.

PubMed

Alayed, Mrwan; Deen, M Jamal

2017-09-14

Diffuse optical spectroscopy (DOS) and diffuse optical imaging (DOI) are emerging non-invasive imaging modalities that have wide spread potential applications in many fields, particularly for structural and functional imaging in medicine. In this article, we review time-resolved diffuse optical imaging (TR-DOI) systems using solid-state detectors with a special focus on Single-Photon Avalanche Diodes (SPADs) and Silicon Photomultipliers (SiPMs). These TR-DOI systems can be categorized into two types based on the operation mode of the detector (free-running or time-gated). For the TR-DOI prototypes, the physical concepts, main components, figures-of-merit of detectors, and evaluation parameters are described. The performance of TR-DOI prototypes is evaluated according to the parameters used in common protocols to test DOI systems particularly basic instrumental performance (BIP). In addition, the potential features of SPADs and SiPMs to improve TR-DOI systems and expand their applications in the foreseeable future are discussed. Lastly, research challenges and future developments for TR-DOI are discussed for each component in the prototype separately and also for the entire system.

Simulation in surgery: a review.

PubMed

Tan, Shaun Shi Yan; Sarker, Sudip K

2011-05-01

The ability to acquire surgical skills requires consistent practice, and evidence suggests that many of these technical skills can be learnt away from the operating theatre. The aim of this review article is to discuss the importance of surgical simulation today and its various types, exploring the effectiveness of simulation in the clinical setting and its challenges for the future. Surgical simulation offers the opportunity for trainees to practise their surgical skills prior to entering the operating theatre, allowing detailed feedback and objective assessment of their performance. This enables better patient safety and standards of care. Surgical simulators can be divided into organic or inorganic simulators. Organic simulators, consisting of live animal and fresh human cadaver models, are considered to be of high-fidelity. Inorganic simulators comprise virtual reality simulators and synthetic bench models. Current evidence suggests that skills acquired through training with simulators, positively transfers to the clinical setting and improves operative outcome. The major challenge for the future revolves around understanding the value of this new technology and developing an educational curriculum that can incorporate surgical simulators.

The science of teams in the military: Contributions from over 60 years of research.

PubMed

Goodwin, Gerald F; Blacksmith, Nikki; Coats, Meredith R

2018-01-01

Teams are the foundational building blocks of the military, which uses a hierarchical structure built on and around teams to form larger units. Consequently, team effectiveness has been a substantial focus of research within the military for decades to ensure military teams have the human capabilities to complete their missions and address future challenges successfully. This research has contributed greatly to broader team theory and informed the development of evidence-based interventions. Team-focused research supported or executed by the military has yielded major insights into the nature of team performance, advanced the methods for measuring and improving team performance, and broken new ground in understanding the assembly of effective teams. Furthermore, military research has made major contributions to advancing methodological and statistical techniques for studying teams. We highlight the military contributions to the broader team literature and conclude with a discussion of critical areas of future research on teams and enduring challenges for both the military and team science as a whole. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Cochrane Rehabilitation Methodology Committee: an international survey of priorities for future work.

PubMed

Levack, William M; Meyer, Thorsten; Negrini, Stefano; Malmivaara, Antti

2017-10-01

Cochrane Rehabilitation aims to improve the application of evidence-based practice in rehabilitation. It also aims to support Cochrane in the production of reliable, clinically meaningful syntheses of evidence related to the practice of rehabilitation, while accommodating the many methodological challenges facing the field. To this end, Cochrane Rehabilitation established a Methodology Committee to examine, explore and find solutions for the methodological challenges related to evidence synthesis and knowledge translation in rehabilitation. We conducted an international online survey via Cochrane Rehabilitation networks to canvass opinions regarding the future work priorities for this committee and to seek information on people's current capabilities to assist with this work. The survey findings indicated strongest interest in work on how reviewers have interpreted and applied Cochrane methods in reviews on rehabilitation topics in the past, and on gathering a collection of existing publications on review methods for undertaking systematic reviews relevant to rehabilitation. Many people are already interested in contributing to the work of the Methodology Committee and there is a large amount of expertise for this work in the extended Cochrane Rehabilitation network already.

Cancer Trends in Mexico: Essential Data for the Creation and Follow-Up of Public Policies

PubMed Central

Mohar-Betancourt, Alejandro; Armas-Texta, Daniel; Gutiérrez-Delgado, Cristina; Torres-Domínguez, Juan A.

2017-01-01

Purpose Cancer in a country like Mexico is a challenge for the current health system and for public health. However, the statistics about cancer in Mexico are scarce, so epidemiologic surveillance needs to be improved. The objectives of this article were to describe the extent of cancer and to estimate the national burden of cancer through 2020. Materials and Methods To meet this objective, an analysis of secondary official sources was performed. The cancer cases through 2020 were estimated on the basis of trends in mortality and the projection of incident cases reported by GLOBOCAN. Results In 2013, cancer was the cause of 12.84% of all deaths in Mexico. It is projected that the prevalence of cancer will be 904,581 by 2017 and will reach 1,262,861 by early in the next decade (ie, 2020). Conclusion Available data for cancer are incomplete. The development and implementation of population-based cancer registries in Mexico are essential. Assessment of the future outlook of cancer in Mexico will provide awareness of future challenges and can help health systems prepare to face them. PMID:29244991

Optimizing secondary prevention of cervical cancer: Recent advances and future challenges.

PubMed

Ogilvie, Gina; Nakisige, Carolyn; Huh, Warner K; Mehrotra, Ravi; Franco, Eduardo L; Jeronimo, Jose

2017-07-01

Although human papillomavirus (HPV) vaccines offer enormous promise for the ultimate control and possible elimination of cervical cancer, barriers to uptake and coverage of the vaccine both in high- and low/middle-income settings mean that advances in secondary prevention continue to be essential to prevent unnecessary deaths and suffering from cervical cancer for decades to come. While cytology (the Pap smear) has reduced cervical cancer incidence and prevalence in jurisdictions where it has been systematically implemented in population-based programs-mainly in high-income settings-limitations inherent to this method, and to program delivery, leave many women still vulnerable to cervical cancer. Recent evidence has confirmed that screening based on HPV testing prevents more invasive cervical cancer and precancerous lesions, and offers innovative options such as self-collection of specimens to improve screening uptake broadly. In this paper, we review key advances, future opportunities, and ongoing challenges for secondary prevention of cervical cancer using HPV-based testing. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

AMCP Partnership Forum: Improving Quality, Value, and Outcomes with Patient-Reported Outcomes.

PubMed

2018-03-01

Patient-reported outcomes (PROs), which provide a direct measure of a patient's health status or treatment preferences, represent a key component of the shift toward patient-centered health care. PROs can measure the state of a patient's disease-specific and overall health throughout the care continuum, enabling them to have a variety of uses for key health care stakeholders. Currently, PROs are used in drug development, aligning patient and clinician goals in care, quality-of-care measures, and coverage and reimbursement decisions. While there have been significant strides by key health care stakeholders to further the development and use of PROs, there are a number of challenges limiting more widespread use. In light of these current challenges and the potential for PROs to improve health care quality and value, on October 19, 2017, the Academy of Managed Care Pharmacy convened a forum of key stakeholders representing patients, payers, providers, government, and pharmaceutical companies to discuss and identify solutions to the current challenges and barriers to further use of PROs. These discussions informed the development of participants' ideal future state in which PROs maximize the goals of all health care stakeholders and the actionable steps required to make the future state a reality. While stakeholders shared unique perspectives throughout the forum, they had consensus on 2 overarching issues: the importance of PROs in defining value, improving patient care, and implementing value-based payment models and the need for strong organizational and operational systems to achieve optimal adoption and use. Participants identified several key challenges in PRO use and adoption: achieving a representative patient population, inclusion of PRO data in medication labels, the necessity for both standardized and customizable PROs, and operational and organizational barriers to collecting and analyzing PROs. To overcome these challenges, participants recommended that manufacturers should engage key stakeholders early and throughout the drug development process to ensure the most valid and representative PROs and patient populations will be included. To streamline the PRO collection process, participants suggested engaging pharmacists and other providers who may have more frequent interaction with patients. Participants also recommended that PRO collection and analysis should use common technology platforms, streamline components of clinician care to reduce workflow, and be integrated with claims data to provider payers a better understanding of patient health in real time. Finally, additional work should be done to develop patient-reported outcome measures that contain relevant measures for all healthcare stakeholders. While significant challenges remain in PRO development and adoption, participants agreed that greater use can only be achieved through collaboration and patient-centered care. The AMCP Partnership Forum titled "Improving Quality, Value, and Outcomes with Patient-Reported Outcomes" and the development of this proceedings report were supported by Amgen, Boehringer Ingelheim Pharmaceuticals, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals, Novo Nordisk, Precision for Value, Premier, Sanofi, Takeda Pharmaceuticals USA, and Xcenda.

Integration of Mobile Health Technology in the Treatment of Chronic Pain: A Critical Review.

PubMed

Sundararaman, Lalitha V; Edwards, Robert R; Ross, Edgar L; Jamison, Robert N

This article provides a critical overview and best-evidence synthesis of the use of mobile health (mHealth) technology among persons with chronic pain and their health care providers and examines the future benefits and barriers of implementing mHealth technology in clinical care. We critically review articles about electronic pain diaries, pain assessment programs, text messaging, and smartphone pain apps for management of persons with pain. Also presented are findings on the utility of activity trackers and use of telehealth to deliver cognitive behavioral therapy. Finally, barriers, study gaps, and future challenges of incorporating mobile technology for chronic pain are discussed. Although the future of mHealth technology and telemedicine in clinical practice is promising, this critical review highlights the need for rigorous studies to establish an association of the use of mHealth technology with improved quality of life, functional autonomy, and decreased hospital use.

The past, current and future of diagnosis and management of pleural disease

PubMed Central

2015-01-01

Pleural disease is frequently encountered by the chest physician. Pleural effusions arise as the sequelae of underlying disease processes including pressure/volume imbalances, infection and malignancy. In addition to pleural effusions, persistent air leaks after surgery and bronchopleural fistulae remain a challenge. Our understanding of pleural disease including its diagnosis and management, have made tremendous strides. The introduction of the molecular detection of organism specific infection, risk stratification and improvements in the non-surgical treatment of patients with pleural infection are all within reach and may be the standard of care in the very near future. Malignant pleural effusion management continues to evolve with the introduction of tunneled pleural catheters and procedures combining that and chemical pleurodesis. These advances in the diagnostic and therapeutic evaluation of pleural disease as well as what seems to be an increasing multidisciplinary interest in the space foretell a bright future. PMID:26807281

Improving cardiac surgical care: a work systems approach.

PubMed

Wiegmann, Douglas A; Eggman, Ashley A; Elbardissi, Andrew W; Parker, Sarah Henrickson; Sundt, Thoralf M

2010-09-01

Over the past 50 years, significant improvements in cardiac surgical care have been achieved. Nevertheless, surgical errors that significantly impact patient safety continue to occur. In order to further improve surgical outcomes, patient safety programs must focus on rectifying work system factors in the operating room (OR) that negatively impact the delivery of reliable surgical care. The goal of this paper is to provide an integrative review of specific work system factors in the OR that may directly impact surgical care processes, as well as the subsequent recommendations that have been put forth to improve surgical outcomes and patient safety. The important role that surgeons can play in facilitating work system changes in the OR is also discussed. The paper concludes with a discussion of the challenges involved in assessing the impact that interventions have on improving surgical care. Opportunities for future research are also highlighted throughout the paper. 2010 Elsevier Ltd. All rights reserved.

Dementia in Latin America

PubMed Central

Parra, Mario A.; Baez, Sandra; Allegri, Ricardo; Nitrini, Ricardo; Lopera, Francisco; Slachevsky, Andrea; Custodio, Nilton; Lira, David; Piguet, Olivier; Kumfor, Fiona; Huepe, David; Cogram, Patricia; Bak, Thomas; Manes, Facundo

2018-01-01

The demographic structure of Latin American countries (LAC) is fast approaching that of developing countries, and the predicted prevalence of dementia in the former already exceeds the latter. Dementia has been declared a global challenge, yet regions around the world show differences in both the nature and magnitude of such a challenge. This article provides evidence and insights on barriers which, if overcome, would enable the harmonization of strategies to tackle the dementia challenge in LAC. First, we analyze the lack of available epidemiologic data, the need for standardizing clinical practice and improving physician training, and the existing barriers regarding resources, culture, and stigmas. We discuss how these are preventing timely care and research. Regarding specific health actions, most LAC have minimal mental health facilities and do not have specific mental health policies or budgets specific to dementia. In addition, local regulations may need to consider the regional context when developing treatment and prevention strategies. The support needed nationally and internationally to enable a smooth and timely transition of LAC to a position that integrates global strategies is highlighted. We focus on shared issues of poverty, cultural barriers, and socioeconomic vulnerability. We identify avenues for collaboration aimed to study unique populations, improve valid assessment methods, and generate opportunities for translational research, thus establishing a regional network. The issues identified here point to future specific actions aimed at tackling the dementia challenge in LAC. PMID:29305437

Incorporating national priorities into the curriculum.

PubMed

Lewis, Deborah Y

2012-01-01

There are many aspects of care that need an overhaul to function safely, efficiently, and effectively. There needs to be a new culture in health care that focuses on safety and quality, and it will take many shareholders working together to make this possible. The National Priorities Partnership is a group of 28 national organizations from across the health care spectrum collaborating to change the health care delivery system. The Partners acknowledged four challenges individuals face in the current U.S. system: harm, disparity, disease burden, and waste. To meet these challenges and improve performance, the Partners identified six priorities: patient and family engagement, population health, safety, care coordination, palliative and end-of-life care, and overuse (National Priorities Partnership). It is hopeful that when put into practice, these essentials will have a significant impact on improving health care. It comes down to creating a culture of safety and quality. This culture should start during entry-level education for health care providers, such as nursing schools. The priorities and goals provide a framework that can be incorporated into the curriculum so future nurses are aware of the issues and challenges in health care today. Each challenge needs evidence-based strategies for achieving the desired results. It is time to create a culture of safety and quality in health care. Copyright © 2012 Elsevier Inc. All rights reserved.

Rethinking Global Water Governance for the 21st Century

NASA Astrophysics Data System (ADS)

Ajami, N. K.; Cooley, H.

2012-12-01

Growing pressure on the world's water resources is having major impacts on our social and economic well-being. According to the United Nations, today, at least 1.1 billion people do not have access to clean drinking water. Pressures on water resources are likely to continue to worsen in response to decaying and crumbling infrastructure, continued population growth, climate change, degradation of water quality, and other challenges. If these challenges are not addressed, they pose future risks for many countries around the world, making it urgent that efforts are made to understand both the nature of the problems and the possible solutions that can effectively reduce the associated risks. There is growing understanding of the need to rethink governance to meet the 21st century water challenges. More and more water problems extend over traditional national boundaries and to the global community and the types and numbers of organizations addressing water issues are large and growing. Economic globalization and transnational organizations and activities point to the need for improving coordination and integration on addressing water issues, which are increasingly tied to food and energy security, trade, global climate change, and other international policies. We will present some of the key limitations of global water governance institutions and provide recommendations for improving these institutions to address 21st century global water challenges more effectively.

Boosting Quality Registries with Clinical Decision Support Functionality*. User Acceptance of a Prototype Applied to HIV/TB Drug Therapy.

PubMed

Wannheden, Carolina; Hvitfeldt-Forsberg, Helena; Eftimovska, Elena; Westling, Katarina; Ellenius, Johan

2017-08-11

The care of HIV-related tuberculosis (HIV/TB) is complex and challenging. Clinical decision support (CDS) systems can contribute to improve quality of care, but more knowledge is needed on factors determining user acceptance of CDS. To analyze physicians' and nurses' acceptance of a CDS prototype for evidence-based drug therapy recommendations for HIV/TB treatment. Physicians and nurses were involved in designing a CDS prototype intended for future integration with the Swedish national HIV quality registry. Focus group evaluation was performed with ten nurses and four physicians, respectively. The Unified Theory of Acceptance and Use of Technology (UTAUT) was used to analyze acceptance. We identified several potential benefits with the CDS prototype as well as some concerns that could be addressed by redesign. There was also concern about dependence on physician attitudes, as well as technical, organizational, and legal issues. Acceptance evaluation at a prototype stage provided rich data to improve the future design of a CDS prototype. Apart from design and development efforts, substantial organizational efforts are needed to enable the implementation and maintenance of a future CDS system.

Performance improvement and implementation science: infection prevention competencies for current and future role development.

PubMed

Hanchett, Marilyn

2012-05-01

The Association for Professionals in Infection Control and Epidemiology, Inc, developed its first model of infection preventionist (IP) competency in 2011. The model is based on the principles of patient safety, professional and practice standards, and core competencies identified through research conducted by the Certification Board of Infection Control and Epidemiology, Inc. In addition, the model highlights 4 domains that are predicted to be key areas for future competency development. Performance improvement (PI) and implementation represent 1 of the 4 forward-focused domains. Concurrently, the inclusion of implementation science (IS) in the competency model is consistent with the research goals established by the Association for Professionals in Infection Control and Epidemiology, Inc, in its 2020 strategic plan. This article explains the importance of PI and IS and describes their relevance to the current and future IP role development. Significant challenges such as role delineation and compression are discussed. The need for the IP to acquire new competencies at integrating, as well as differentiating, PI and IS are explored in terms of emerging issues and trends. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Maximizing research study effectiveness in malaria elimination settings: a mixed methods study to capture the experiences of field-based staff.

PubMed

Canavati, Sara E; Quintero, Cesia E; Haller, Britt; Lek, Dysoley; Yok, Sovann; Richards, Jack S; Whittaker, Maxine Anne

2017-09-11

In a drug-resistant, malaria elimination setting like Western Cambodia, field research is essential for the development of novel anti-malarial regimens and the public health solutions necessary to monitor the spread of resistance and eliminate infection. Such field studies often face a variety of similar implementation challenges, but these are rarely captured in a systematic way or used to optimize future study designs that might overcome similar challenges. Field-based research staff often have extensive experience and can provide valuable insight regarding these issues, but their perspectives and experiences are rarely documented and seldom integrated into future research protocols. This mixed-methods analysis sought to gain an understanding of the daily challenges encountered by research field staff in the artemisinin-resistant, malaria elimination setting of Western Cambodia. In doing so, this study seeks to understand how the experiences and opinions of field staff can be captured, and used to inform future study designs. Twenty-two reports from six field-based malaria studies conducted in Western Cambodia were reviewed using content analysis to identify challenges to conducting the research. Informal Interviews, Focus Group Discussions and In-depth Interviews were also conducted among field research staff. Thematic analysis of the data was undertaken using Nvivo 9 ® software. Triangulation and critical case analysis was also used. There was a lack of formalized avenues through which field workers could report challenges experienced when conducting the malaria studies. Field research staff faced significant logistical barriers to participant recruitment and data collection, including a lack of available transportation to cover long distances, and the fact that mobile and migrant populations (MMPs) are usually excluded from studies because of challenges in follow-up. Cultural barriers to communication also hindered participant recruitment and created unexpected delays. Field staff often paid a physical, emotional and financial cost, going beyond their duty in order to keep the study running. Formal monthly reports filled out by field study staff could be a key tool for capturing field study staff experiences effectively, but require specific report fields to encourage staff to outline their challenges and to propose potential solutions. Forging strong bonds with communities and their leaders may improve communication, and decrease barriers to participant recruitment. Study designs that make it feasible for MMPs to participate should be pursued; in addition to increasing the potential participant pool, this will ensure that the most malaria-endemic demographic is taken into account in research studies. Overlaps between clinical care and research create ethical dilemmas for study staff, a fact that warrants careful consideration. Lessons learned from study field staff should be used to create a set of locally-relevant recommendations to inform future study designs.

Current challenges and future achievements of blood transfusion service in Afghanistan.

PubMed

Cheraghali, A M; Sanei Moghaddam, E; Masoud, A; Faisal, H

2012-10-01

Afghanistan is a country with population of over 28 million. The long term conflicts have devastated country's qualified resources including human resources. ANBSTS was established by MoPH as the country national blood service. Currently in addition to central and regional blood centers of ANBSTS many other hospitals have their own transfusion services. Blood donation in Afghanistan mainly depends on replacement donors. Donor selection and donor interview are not very efficient. Most of the blood in Afghanistan is administered as fresh whole blood. Although blood transfusion services in Afghanistan require more efforts to be fully efficient, based on recent improvements in working procedures of ANBSTS a promising future for blood transfusion services in Afghanistan is predicted. Copyright © 2012 Elsevier Ltd. All rights reserved.

Building a quality culture in the Office of Space Flight: Approach, lessons learned and implications for the future

NASA Astrophysics Data System (ADS)

Roberts, C. Shannon

The purpose of this paper is to describe the approach and lessons learned by the Office of Space Flight (OSF), National Aeronautics and Space Administration (NASA), in its introduction of quality. In particular, the experience of OSF Headquarters is discussed as an example of an organization within NASA that is considering both the business and human elements of the change and the opportunities the quality focus presents to improve continuously. It is hoped that the insights shared will be of use to those embarking upon similar cultural changes. The paper is presented in the following parts: the leadership challenge; background; context of the approach to quality; initial steps; current initiatives; lessons learned; and implications for the future.

Building a quality culture in the Office of Space Flight: Approach, lessons learned and implications for the future

NASA Technical Reports Server (NTRS)

Roberts, C. Shannon

1992-01-01

The purpose of this paper is to describe the approach and lessons learned by the Office of Space Flight (OSF), National Aeronautics and Space Administration (NASA), in its introduction of quality. In particular, the experience of OSF Headquarters is discussed as an example of an organization within NASA that is considering both the business and human elements of the change and the opportunities the quality focus presents to improve continuously. It is hoped that the insights shared will be of use to those embarking upon similar cultural changes. The paper is presented in the following parts: the leadership challenge; background; context of the approach to quality; initial steps; current initiatives; lessons learned; and implications for the future.

Cellular and Molecular Bioengineering: A Tipping Point

PubMed Central

Brown, Genevieve; Butler, Peter J.; Chang, David W.; Chien, Shu; Clegg, Robert M.; Dewey, C. Forbes; Dong, Cheng; Guo, X. Edward; Helmke, Brian P.; Hess, Henry; Jacobs, Christopher R.; Kaunas, Roland R.; Kumar, Sanjay; Lu, Helen H.; Mathur, Anshu B.; Mow, Van C.; Schmid-Schönbein, Geert W.; Skoracki, Roman; Wang, Ning; Wang, Yingxiao; Zhu, Cheng

2012-01-01

In January of 2011, the Biomedical Engineering Society (BMES) and the Society for Physical Regulation in Biology and Medicine (SPRBM) held its inaugural Cellular and Molecular Bioengineering (CMBE) conference. The CMBE conference assembled worldwide leaders in the field of CMBE and held a very successful Round Table discussion among leaders. One of the action items was to collectively construct a white paper regarding the future of CMBE. Thus, the goal of this report is to emphasize the impact of CMBE as an emerging field, identify critical gaps in research that may be answered by the expertise of CMBE, and provide perspectives on enabling CMBE to address challenges in improving human health. Our goal is to provide constructive guidelines in shaping the future of CMBE. PMID:23264805

Knowledge Exchange between Poland and Vietnam in Mining and Geology - the Status Quo and Future Development

NASA Astrophysics Data System (ADS)

Nguyen, Nga; Pham, Nguyet

2018-03-01

From the beginning of the 21st century, knowledge exchange between Poland and Vietnam in mining and geology has been focusing in technology, education and training. Since years, Polish academic and commercial partners have been developing a close collaboration with Vietnam National Coal - Mineral Industries Holding Corporation Limited. Major outcomes of the collaboration are installations and operation of mining equipments and machines in Vietnamese mining companies, and excellent training programs for graduate and post graduate students and mining staff for both countries, etc. From aspects of knowledge management in globalization, the article highlights the outstanding outcomes of knowledge exchanges between the two countries, outlines cultural and economic challenges for the exchange and proposes some improvement in the future.

What will my child's future hold? phenotypes of intellectual development in 2-8-year-olds with autism spectrum disorder.

PubMed

Solomon, Marjorie; Iosif, Ana-Maria; Reinhardt, Vanessa P; Libero, Lauren E; Nordahl, Christine W; Ozonoff, Sally; Rogers, Sally J; Amaral, David G

2018-01-01

We examined phenotypes of autism spectrum disorder (ASD) based on trajectories of intellectual development from early (ages 2-3 ½) to middle (ages 5-8) childhood in a recent clinically ascertained cohort. Participants included 102 children (82 males) initially diagnosed with ASD from the Autism Phenome Project longitudinal sample. Latent class growth analysis was used to identify distinct IQ trajectories. Baseline and developmental course differences among groups were assessed using univariate techniques and repeated measures regression models, respectively. A four class model best represented the data. Using the highest posterior probability, participants were assigned to High Challenges (25.5%), Stable Low (17.6%), Changers (35.3%), and Lesser Challenges (21.6%) groups. The High Challenges and Stable Low groups exhibited persistently low IQ, although, the High Challenges group experienced declines while the Stable Low group's scores remained more constant. Changers showed IQ improvement of > 2 standard deviations. The Lesser Challenges group had IQs in the average range at both times that were about 1 standard deviation higher at T2. In summation, 75% of the participants experienced some relative improvements in intellectual and/or other areas of functioning between ages 2 and 8 years. The Changers group demonstrated the most significant IQ change that was accompanied by adaptive communication improvement and declining externalizing symptoms. Only the Lesser Challenges group showed a significant reduction in ASD symptom severity, such that by age 8, 14% of them no longer met ADOS-2 criteria for ASD. All groups showed reductions in internalizing symptoms. Intervention history was not associated with group status. Autism Res 2018, 11: 121-132. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. We examined how the IQs of children with autism spectrum disorder change between ages 2 and 8, and identified four patterns. Two groups exhibited persistently lower IQs. One group showed IQ increases of greater than 30 points with improved communicate abilities and declining disruptive behaviors. The final group had IQs in the average or better range at both time points, and 14% of them lost their diagnoses. Over half of the children experienced improved intellectual functioning between ages 2 and 8, whereas about 25% showed declines. Findings were not associated with intervention history. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Improving care and wellness in bipolar disorder: origins, evolution and future directions of a collaborative knowledge exchange network

PubMed Central

2012-01-01

The Collaborative RESearch team to study psychosocial factors in bipolar disorder (CREST.BD) is a multidisciplinary, cross-sectoral network dedicated to both fundamental research and knowledge exchange on bipolar disorder (BD). The core mission of the network is to advance the science and understanding of psychological and social issues associated with BD, improve the care and wellness of people living with BD, and strengthen services and supports for these individuals. CREST.BD bridges traditional and newer research approaches, particularly embracing community-based participatory research (CBPR) methods. Membership of CREST is broad, including academic researchers, people with BD, their family members and supports, and a variety of health care providers. Here, we describe the origins, evolution, approach to planning and evaluation and future vision for our network within the landscape of CBPR and integrated knowledge translation (KT), and explore the keys and challenges to success we have encountered working within this framework. PMID:22963889

Integrating Environmental Management of Asthma into Pediatric Health Care: What Worked and What Still Needs Improvement?

PubMed

Roberts, James R; Newman, Nicholas; McCurdy, Leyla E; Chang, Jane S; Salas, Mauro A; Eskridge, Bernard; De Ybarrondo, Lisa; Sandel, Megan; Mazur, Lynnette; Karr, Catherine J

2016-12-01

The National Environmental Education Foundation (NEEF) launched an initiative in 2005 to integrate environmental management of asthma into pediatric health care. This study, a follow-up to a 2013 study, evaluated the program's impact and assessed training results by 5 new faculty champions. We surveyed attendees at training sessions to measure knowledge and the likelihood of asking about and managing environmental triggers of asthma. To conduct the program evaluation, a workshop was held with the faculty champions and NEEF staff in which we identified major program benefits, as well as challenges and suggestions for the future. Trainee baseline knowledge of environmental triggers was low, but they reported robust improvement in environmental triggers knowledge and intention to recommend environmental management. The program has a broad, national scope, reaching more than 12 000 physicians, health care providers, and students, and some faculty champions successfully integrated materials into health record. Program barriers and future endeavors were identified.

Evidence for Management of Carotid Artery Stenosis

PubMed Central

YOSHIDA, Kazumichi; MIYAMOTO, Susumu

2015-01-01

In this review, we presented the evidence concerning carotid artery stenosis treatment in symptomatic stenosis and asymptomatic stenosis separately, and discussed the future challenges. The validity of carotid endarterectomy (CEA) to treat moderate or greater degree of symptomatic carotid artery stenosis appears to be established. Due to the additional option of carotid artery stenting (CAS), it is necessary to comprehensively determine whether CEA or CAS is more appropriate for each individual patient. Moreover, since there are rapid advancements in devices for CAS and improvements in treatment outcomes, continual learning of the latest treatment method is essential. For asymptomatic stenosis, due to improvements in the outcomes with best medical treatment (BMT), it is essential to re-evaluate the use of invasive CEA/CAS. Continual verification of the latest randomized clinical trial that compares CEA, CAS, and BMT, and establishment of a diagnostic method that can accurately extract the group of patients who have the highest future risk of developing ischemia, are desired. PMID:25739437

Exposure Assessment at 30 000 Feet: Challenges and Future Directions

PubMed Central

Grajewski, Barbara; Pinkerton, Lynne E.

2015-01-01

Few studies of cancer mortality and incidence among flight crew have included a detailed assessment of both occupational exposures and lifestyle factors that may influence the risk of cancer. In this issue, Kojo et al. (Risk factors for skin cancer among Finnish airline cabin crew. Ann. Occup. Hyg 2013; 57: 695–704) evaluated the relative contributions of ultraviolet and cosmic radiation to the incidence of skin cancer in Finnish flight attendants. This is a useful contribution, yet the reason flight crew members have an increased risk of skin cancer compared with the general population remains unclear. Good policy decisions for flight crew will depend on continued and emerging effective collaborations to increase study power and improve exposure assessment in future flight crew health studies. Improving the assessment of occupational exposures and non-occupational factors will cost additional time and effort, which are well spent if the role of exposures can be clarified in larger studies. PMID:23818455

Parallel compression/decompression-based datapath architecture for multibeam mask writers

NASA Astrophysics Data System (ADS)

Chaudhary, Narendra; Savari, Serap A.

2017-06-01

Multibeam electron beam systems will be used in the future for mask writing and for complimentary lithography. The major challenges of the multibeam systems are in meeting throughput requirements and in handling the large data volumes associated with writing grayscale data on the wafer. In terms of future communications and computational requirements Amdahl's Law suggests that a simple increase of computation power and parallelism may not be a sustainable solution. We propose a parallel data compression algorithm to exploit the sparsity of mask data and a grayscale video-like representation of data. To improve the communication and computational efficiency of these systems at the write time we propose an alternate datapath architecture partly motivated by multibeam direct write lithography and partly motivated by the circuit testing literature, where parallel decompression reduces clock cycles. We explain a deflection plate architecture inspired by NuFlare Technology's multibeam mask writing system and how our datapath architecture can be easily added to it to improve performance.

Parallel compression/decompression-based datapath architecture for multibeam mask writers

NASA Astrophysics Data System (ADS)

Chaudhary, Narendra; Savari, Serap A.

2017-10-01

Multibeam electron beam systems will be used in the future for mask writing and for complementary lithography. The major challenges of the multibeam systems are in meeting throughput requirements and in handling the large data volumes associated with writing grayscale data on the wafer. In terms of future communications and computational requirements, Amdahl's law suggests that a simple increase of computation power and parallelism may not be a sustainable solution. We propose a parallel data compression algorithm to exploit the sparsity of mask data and a grayscale video-like representation of data. To improve the communication and computational efficiency of these systems at the write time, we propose an alternate datapath architecture partly motivated by multibeam direct-write lithography and partly motivated by the circuit testing literature, where parallel decompression reduces clock cycles. We explain a deflection plate architecture inspired by NuFlare Technology's multibeam mask writing system and how our datapath architecture can be easily added to it to improve performance.

Infectious Diseases, Urbanization and Climate Change: Challenges in Future China.

PubMed

Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

2015-09-07

China is one of the largest countries in the world with nearly 20% of the world's population. There have been significant improvements in economy, education and technology over the last three decades. Due to substantial investments from all levels of government, the public health system in China has been improved since the 2003 severe acute respiratory syndrome (SARS) outbreak. However, infectious diseases still remain a major population health issue and this may be exacerbated by rapid urbanization and unprecedented impacts of climate change. This commentary aims to explore China's current capacity to manage infectious diseases which impair population health. It discusses the existing disease surveillance system and underscores the critical importance of strengthening the system. It also explores how the growing migrant population, dramatic changes in the natural landscape following rapid urbanization, and changing climatic conditions can contribute to the emergence and re-emergence of infectious disease. Continuing research on infectious diseases, urbanization and climate change may inform the country's capacity to deal with emerging and re-emerging infectious diseases in the future.

Subjective response as a consideration in the pharmacogenetics of alcoholism treatment.

PubMed

Roche, Daniel Jo; Ray, Lara A

2015-01-01

Currently available pharmacological treatments for alcoholism have modest efficacy and high individual variability in treatment outcomes, both of which have been partially attributed to genetic factors. One path to reducing the variability and improving the efficacy associated with these pharmacotherapies may be to identify overlapping genetic contributions to individual differences in both subjective responses to alcohol and alcoholism pharmacotherapy outcomes. As acute subjective response to alcohol is highly predictive of future alcohol related problems, identifying such shared genetic mechanisms may inform the development of personalized treatments that can effectively target converging pathophysiological mechanisms that convey risk for alcoholism. The focus of this review is to revisit the association between subjective response to alcohol and the etiology of alcoholism while also describing genetic contributions to this relationship, discuss potential pharmacogenetic approaches to target subjective response to alcohol in order to improve the treatment of alcoholism and examine conceptual and methodological issues associated with these topics, and outline future approaches to overcome these challenges.

Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

PubMed

Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

2018-06-01

Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

On the Reconstruction of Palaeo-Ice Sheets: Recent Advances and Future Challenges

NASA Technical Reports Server (NTRS)

Stokes, Chris R.; Tarasov, Lev; Blomdin, Robin; Cronin, Thomas M.; Fisher, Timothy G.; Gyllencreutz, Richard; Hattestrand, Clas; Heyman, Jacob; Hindmarsh, Richard C. A.; Hughes, Anna L. C.;

On the reconstruction of palaeo-ice sheets: Recent advances and future challenges

USGS Publications Warehouse

Stokes, Chris R.; Tarasov, Lev; Blomdin, Robin; Cronin, Thomas M.; Fisher, Timothy G.; Gyllencreutz, Richard; Hattestrand, Clas; Heyman, Jakob; Hindmarsh, Richard C. A.; Hughes, Anna L. C.; Jakobsson, Martin; Kirchner, Nina; Livingstone, Stephen J.; Margold, Martin; Murton, Julian B.; Noormets, Riko; Peltier, W. Richard; Peteet, Dorothy M.; Piper, David J. W.; Preusser, Frank; Renssen, Hans; Roberts, David H.; Roche, Didier M.; Saint-Ange, Francky; Stroeven, Arjen P.; Teller, James T.

2015-01-01

Reconstructing the growth and decay of palaeo-ice sheets is critical to understanding mechanisms of global climate change and associated sea-level fluctuations in the past, present and future. The significance of palaeo-ice sheets is further underlined by the broad range of disciplines concerned with reconstructing their behaviour, many of which have undergone a rapid expansion since the 1980s. In particular, there has been a major increase in the size and qualitative diversity of empirical data used to reconstruct and date ice sheets, and major improvements in our ability to simulate their dynamics in numerical ice sheet models. These developments have made it increasingly necessary to forge interdisciplinary links between sub-disciplines and to link numerical modelling with observations and dating of proxy records. The aim of this paper is to evaluate recent developments in the methods used to reconstruct ice sheets and outline some key challenges that remain, with an emphasis on how future work might integrate terrestrial and marine evidence together with numerical modelling. Our focus is on pan-ice sheet reconstructions of the last deglaciation, but regional case studies are used to illustrate methodological achievements, challenges and opportunities. Whilst various disciplines have made important progress in our understanding of ice-sheet dynamics, it is clear that data-model integration remains under-used, and that uncertainties remain poorly quantified in both empirically-based and numerical ice-sheet reconstructions. The representation of past climate will continue to be the largest source of uncertainty for numerical modelling. As such, palaeo-observations are critical to constrain and validate modelling. State-of-the-art numerical models will continue to improve both in model resolution and in the breadth of inclusion of relevant processes, thereby enabling more accurate and more direct comparison with the increasing range of palaeo-observations. Thus, the capability is developing to use all relevant palaeo-records to more strongly constrain deglacial (and to a lesser extent pre-LGM) ice sheet evolution. In working towards that goal, the accurate representation of uncertainties is required for both constraint data and model outputs. Close cooperation between modelling and data-gathering communities is essential to ensure this capability is realised and continues to progress.

Polar ice-sheet contributions to sea level during past warm periods

NASA Astrophysics Data System (ADS)

Dutton, A.

2015-12-01

Recent sea-level rise has been dominated by thermal expansion and glacier loss, but the contribution from mass loss from the Greenland and Antarctic ice sheets is expected to exceed other contributions under future sustained warming. Due to limitations of existing ice sheet models and the lack of relevant analogues in the historical record, projecting the timing and magnitude of polar ice sheet mass loss in the future remains challenging. One approach to improving our understanding of how polar ice-sheet retreat will unfold is to integrate observations and models of sea level, ice sheets, and climate during past intervals of warmth when the polar ice sheets contributed to higher sea levels. A recent review evaluated the evidence of polar ice sheet mass loss during several warm periods, including interglacials during the mid-Pliocene warm period, Marine Isotope Stage (MIS) 11, 5e (Last Interglacial), and 1 (Holocene). Sea-level benchmarks of ice-sheet retreat during the first of these three periods, when global mean climate was ~1 to 3 deg. C warmer than preindustrial, are useful for understanding the long-term potential for future sea-level rise. Despite existing uncertainties in these reconstructions, it is clear that our present climate is warming to a level associated with significant polar ice-sheet loss in the past, resulting in a conservative estimate for a global mean sea-level rise of 6 meters above present (or more). This presentation will focus on identifying the approaches that have yielded significant advances in terms of past sea level and ice sheet reconstruction as well as outstanding challenges. A key element of recent advances in sea-level reconstructions is the ability to recognize and quantify the imprint of geophysical processes, such as glacial isostatic adjustment (GIA) and dynamic topography, that lead to significant spatial variability in sea level reconstructions. Identifying specific ice-sheet sources that contributed to higher sea levels is a challenge that is currently hindered by limited field evidence at high latitudes. Finally, I will explore the concept of how increasing the quantity and quality of paleo sea level and ice sheet reconstructions can lead to improved quantification of contemporary changes in ice sheets and sea level.

Meeting the challenge of interacting threats in freshwater ecosystems: A call to scientists and managers

USGS Publications Warehouse

Craig, Laura S.; Olden, Julian D.; Arthington, Angela; Entrekin, Sally; Hawkins, Charles P.; Kelly, John J.; Kennedy, Theodore A.; Maitland, Bryan M.; Rosi, Emma J.; Roy, Allison; Strayer, David L.; Tank, Jennifer L.; West, Amie O.; Wooten, Matthew S.

2017-01-01

Human activities create threats that have consequences for freshwater ecosystems and, in most watersheds, observed ecological responses are the result of complex interactions among multiple threats and their associated ecological alterations. Here we discuss the value of considering multiple threats in research and management, offer suggestions for filling knowledge gaps, and provide guidance for addressing the urgent management challenges posed by multiple threats in freshwater ecosystems. There is a growing literature assessing responses to multiple alterations, and we build off this background to identify three areas that require greater attention: linking observed alterations to threats, understanding when and where threats overlap, and choosing metrics that best quantify the effects of multiple threats. Advancing science in these areas will help us understand existing ecosystem conditions and predict future risk from multiple threats. Because addressing the complex issues and novel ecosystems that arise from the interaction of multiple threats in freshwater ecosystems represents a significant management challenge, and the risks of management failure include loss of biodiversity, ecological goods, and ecosystem services, we also identify actions that could improve decision-making and management outcomes. These actions include drawing insights from management of individual threats, using threat attributes (e.g., causes and spatio-temporal dynamics) to identify suitable management approaches, testing management strategies that are likely to be successful despite uncertainties about the nature of interactions among threats, avoiding unintended consequences, and maximizing conservation benefits. We also acknowledge the broadly applicable challenges of decision-making within a socio-political and economic framework, and suggest that multidisciplinary teams will be needed to innovate solutions to meet the current and future challenge of interacting threats in freshwater ecosystems. 

Deep Space Control Challenges of the New Millennium

NASA Technical Reports Server (NTRS)

Bayard, David S.; Burdick, Garry M.

1999-01-01

The exploration of deep space presents a variety of significant control challenges. Long communication delays coupled with challenging new science objectives require high levels of system autonomy and increasingly demanding pointing and control capabilities. Historically, missions based on the use of a large single spacecraft have been successful and popular since the early days of NASA. However, these large spacecraft missions are currently being displaced by more frequent and more focused missions based on the use of smaller and less expensive spacecraft designs. This trend drives the need to design smart software and good algorithms which together with the miniaturization of control components will improve performance while replacing the heavier and more expensive hardware used in the past. NASA's future space exploration will also include mission types that have never been attempted before, posing significant challenges to the underlying control system. This includes controlled landing on small bodies (e.g., asteroids and comets), sample return missions (where samples are brought back from other planets), robotic exploration of planetary surfaces (e.g., intelligent rovers), high precision formation flying, and deep space optical interferometry, While the control of planetary spacecraft for traditional flyby and orbiter missions are based on well-understood methodologies, control approaches for many future missions will be fundamentally different. This paradigm shift will require completely new control system development approaches, system architectures, and much greater levels of system autonomy to meet expected performance in the presence of significant environmental disturbances, and plant uncertainties. This paper will trace the motivation for these changes and will layout the approach taken to meet the new challenges. Emerging missions will be used to explain and illustrate the need for these changes.

The use of transcranial magnetic stimulation to evaluate cortical excitability of lower limb musculature: Challenges and opportunities.

PubMed

Kesar, Trisha M; Stinear, James W; Wolf, Steven L

2018-05-05

Neuroplasticity is a fundamental yet relatively unexplored process that can impact rehabilitation of lower extremity (LE) movements. Transcranial magnetic stimulation (TMS) has gained widespread application as a non-invasive brain stimulation technique for evaluating neuroplasticity of the corticospinal pathway. However, a majority of TMS studies have been performed on hand muscles, with a paucity of TMS investigations focused on LE muscles. This perspective review paper proposes that there are unique methodological challenges associated with using TMS to evaluate corticospinal excitability of lower limb muscles. The challenges include: (1) the deeper location of the LE motor homunculus; (2) difficulty with targeting individual LE muscles during TMS; and (3) differences in corticospinal circuity controlling upper and lower limb muscles. We encourage future investigations that modify traditional methodological approaches to help address these challenges. Systematic TMS investigations are needed to determine the extent of overlap in corticomotor maps for different LE muscles. A simple, yet informative methodological solution involves simultaneous recordings from multiple LE muscles, which will provide the added benefit of observing how other relevant muscles co-vary in their responses during targeted TMS assessment directed toward a specific muscle. Furthermore, conventionally used TMS methods (e.g., determination of hot spot location and motor threshold) may need to be modified for TMS studies involving LE muscles. Additional investigations are necessary to determine the influence of testing posture as well as activation state of adjacent and distant LE muscles on TMS-elicited responses. An understanding of these challenges and solutions specific to LE TMS will improve the ability of neurorehabilitation clinicians to interpret TMS literature, and forge novel future directions for neuroscience research focused on elucidating neuroplasticity processes underlying locomotion and gait training.

Refugee resettlement to the United States: recommendations for a new approach.

PubMed

Westermeyer, Joseph John

2011-08-01

Hmong acculturation to the United States has involved high prevalence of several psychosocial challenges: acculturation failure, welfare dependency, psychiatric disorder, mistrust, malignant youth gangs, and violence. Conversely, resettlement of the Thai Dam-a tribal group, also from Laos-has gone remarkably well in comparison. Strategies used for resettlement of these two groups differed greatly. Based on these differences, the author recommends a refugee resettlement strategy aimed at improved mental health and optimal acculturation for future refugee groups.

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

Peterson, John Russell

This grant funded the development and dissemination of the Photon Simulator (PhoSim) for the purpose of studying dark energy at high precision with the upcoming Large Synoptic Survey Telescope (LSST) astronomical survey. The work was in collaboration with the LSST Dark Energy Science Collaboration (DESC). Several detailed physics improvements were made in the optics, atmosphere, and sensor, a number of validation studies were performed, and a significant number of usability features were implemented. Future work in DESC will use PhoSim as the image simulation tool for data challenges used by the analysis groups.

Nanonization strategies for poorly water-soluble drugs.

PubMed

Chen, Huabing; Khemtong, Chalermchai; Yang, Xiangliang; Chang, Xueling; Gao, Jinming

2011-04-01

Poor water solubility for many drugs and drug candidates remains a major obstacle to their development and clinical application. Conventional formulations to improve solubility suffer from low bioavailability and poor pharmacokinetics, with some carriers rendering systemic toxicities (e.g. Cremophor(®) EL). In this review, several major nanonization techniques that seek to overcome these limitations for drug solubilization are presented. Strategies including drug nanocrystals, nanoemulsions and polymeric micelles are reviewed. Finally, perspectives on existing challenges and future opportunities are highlighted. Published by Elsevier Ltd.

Future Directions and Challenges in Shell Stability Analysis

NASA Technical Reports Server (NTRS)

Arbocz, Johann

1998-01-01

An answer is sought to the question of today, in 1997, after so many years of concentrated research effort in designing buckling critical thin walled shells, why one cannot do any better than using the rather conservative Lower Bound Design Philosophy of the sixties. It will be shown that with the establishment of Initial Imperfection Data Banks and the introduction of Probabilistic Design Procedures one has a viable alternative, that when used judiciously, may lead to improved shell design recommendations.

Out of the healthcare crisis.

PubMed

Siriwardena, A Niroshan

2011-01-01

W Edwards Deming's Out of the Crisis, was first published almost three decades ago.(1) It was a bestseller and remains a classic text written by one of the foremost quality improvement experts of the 20th century. It is a book which certainly warrants re-examination in light of today's challenges for health care. This discussion paper reviews what Deming can teach us about causes of failure in management, including health care, what can be done to remedy them and how to avert problems in future.

Cardiac rehabilitation: a comprehensive review

PubMed Central

Lear, Scott A; Ignaszewski, Andrew

2001-01-01

Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these studies. The safety, relevance to special populations, challenges, and future directions of CR will also be reviewed. PMID:11806801

Public goods and procreation.

PubMed

Anomaly, Jonathan

2014-01-01

Procreation is the ultimate public goods problem. Each new child affects the welfare of many other people, and some (but not all) children produce uncompensated value that future people will enjoy. This essay addresses challenges that arise if we think of procreation and parenting as public goods. These include whether individual choices are likely to lead to a socially desirable outcome, and whether changes in laws, social norms, or access to genetic engineering and embryo selection might improve the aggregate outcome of our reproductive choices.

Controls structures interaction, an interdisciplinary challenge for large spacecraft

NASA Technical Reports Server (NTRS)

Hanks, Brantley R.

1990-01-01

Controls structures interaction (CSI), a phenomenon which occurs when control forces interact with the flexible motion of a structure, can, if improperly treated in design and development, cause reduced performance or control instabilities. Properly applied, it can improve flexible spacecraft performance. In this paper, the NASA CSI technology program for future spacecraft applications is described. The program objectives and organization are outlined, and the nature of individual program tasks is described. The interdisciplinary aspects of CSI are also addressed.

Otolaryngology in Low-Resource Settings: Practical and Ethical Considerations.

PubMed

Cordes, Susan R; Robbins, Kevin Thomas; Woodson, Gayle

2018-06-01

Providing otolaryngology care in low-resource settings requires careful preparation to ensure good outcomes. The level of care that can be provided is dictated by available resources and the supplementary equipment, supplies, and personnel brought in. Other challenges include personal health and safety risks as well as cultural and language differences. Studying outcomes will inform future missions. Educating and developing ongoing partnerships with local physicians can lead to sustained improvements in the local health care system. Copyright © 2018 Elsevier Inc. All rights reserved.

How the Army Should Use Lean Six Sigma as a Transformation Strategy for Logistics in the 21st Century

DTIC Science & Technology

2006-02-13

business transformation is cautiously mechanistic or not much different than earlier versions of process improvement systems. This strategic research...tool for business transformation meet future needs of the Army and what changes to current systems are required. The Army should not present L6s as a...continually adapt how we approach and confront challenges, conduct business , and work with others.”3 The Secretary’s purpose for continuous transformation is

Moving NASA Beyond Low Earth Orbit: Future Human-Automation-Robotic Integration Challenges

NASA Technical Reports Server (NTRS)

Marquez, Jessica

2016-01-01

This presentation will provide an overview of current human spaceflight operations. It will also describe how future exploration missions will have to adapt and evolve in order to deal with more complex missions and communication latencies. Additionally, there are many implications regarding advanced automation and robotics, and this presentation will outline future human-automation-robotic integration challenges.

Another 25 Years of AIED? Challenges and Opportunities for Intelligent Educational Technologies of the Future

ERIC Educational Resources Information Center

Pinkwart, Niels

2016-01-01

This paper attempts an analysis of some current trends and future developments in computer science, education, and educational technology. Based on these trends, two possible future predictions of AIED are presented in the form of a utopian vision and a dystopian vision. A comparison of these two visions leads to seven challenges that AIED might…

Ocean waves from tropical cyclones in the Gulf of Mexico and the effect of climate change

NASA Astrophysics Data System (ADS)

Appendini, C. M.; Pedrozo-Acuña, A.; Meza-Padilla, R.; Torres-Freyermuth, A.; Cerezo-Mota, R.; López-González, J.

2016-12-01

To generate projections of wave climate associated to tropical cyclones is a challenge due to their short historical record of events, their low occurrence, and the poor wind field resolution in General Circulation Models. Synthetic tropical cyclones provide an alternative to overcome such limitations, improving robust statistics under present and future climates. We use synthetic events to characterize present and future wave climate associated with tropical cyclones in the Gulf of Mexico. The NCEP/NCAR atmospheric reanalysis and the Coupled Model Intercomparison Project Phase 5 models NOAA/GFDL CM3 and UK Met Office HADGEM2-ES, were used to derive present and future wave climate under RCPs 4.5 and 8.5. The results suggest an increase in wave activity for the future climate, particularly for the GFDL model that shows less bias in the present climate, although some areas are expected to decrease the wave energy. The practical implications of determining the future wave climate is exemplified by means of the 100-year design wave, where the use of the present climate may result in under/over design of structures, since the lifespan of a structure includes the future wave climate period.

Envisioning the Future of Aquatic Animal Tracking: Technology, Science, and Application

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

Lennox, Robert J.; Aarestrup, Kim; Cooke, Steven J.

Electronic tags have proven to be extremely useful for broadening our understanding of aquatic animals by answering diverse questions about their behaviours, physiologies, and life histories fundamental to ecology. Simultaneously, many applied conservation and management efforts are informed by animals tagged with electronic tags. In spite of the many advances in tracking software and hardware, an uncertain future in the world’s aquatic ecosystems portends great challenges for science. Aquatic animal tracking with electronic tags represents both the present and future of integrative biology and ecology in aquatic ecosystems. Here we identify what we regard as the future of aquatic animalmore » tracking in a horizon scanning exercise. We submit that the future of aquatic animal tracking will include opportunities for multi-platform tracking systems for simultaneously monitoring position, activity, physiology, and microhabitat of animals, improved data collection and accessibility with new infrastructure (e.g. tags, receivers) and cyberinfrastructure, and integrated tagging information with animal traits derived from biopsy during tagging. We discuss parallel needs and opportunities in areas related to the application of animal tracking in the future such as knowledge mobilization and governance.« less

Future Wildfire and Managed Fire Interactions in the Lake Tahoe Basin

NASA Astrophysics Data System (ADS)

Scheller, R.; Kretchun, A.

2017-12-01

Managing large forested landscape in the context of a changing climate and altered disturbance regimes presents new challenges and require integrated assessments of forest disturbance, management, succession, and the carbon cycle. Successful management under these circumstances will require information about trade-offs among multiple objectives and opportunities for spatially optimized landscape-scale management. Improved information about the effects of climate on forest communities, disturbance feedbacks, and the effectiveness of mitigation strategies enables actionable options for landscape managers. We evaluated the effects of fire suppression, wildfires, and forest fuel (thinning) treatments on the long-term carbon storage potential for Lake Tahoe Basin (LTB) forests under various climate futures. We simulated management scenarios that encompass fuel treatments across the larger landscape, beyond the Wildland Urban Interface. We improved upon current fire modeling under climate change via an integrated fire modeling module that, a) explicitly captures the influence of climate, fuels, topography, active fire management (e.g., fire suppression), and fuel treatments, and b) can be parameterized from available data, e.g., remote sensing, field reporting, fire databases, expert opinion. These improvements increase geographic flexibility and decrease reliance on broad historical fire regime statistics - imperfect targets for a no analog future and require minimal parameterization and calibration. We assessed the interactions among fuel treatments, prescribe fire, fire suppression, and stochastically recurring wildfires. Predicted changes in climate and ignition patterns in response to future climatic conditions, vegetation dynamics, and fuel treatments indicate larger potential long-term effects on C emissions, forest structure, and forest composition than prior studies.

Parenthood in transition - Somali-born parents' experiences of and needs for parenting support programmes.

PubMed

Osman, Fatumo; Klingberg-Allvin, Marie; Flacking, Renée; Schön, Ulla-Karin

2016-02-16

Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

Measuring Tropospheric Winds from Space Using a Coherent Doppler Lidar Technique

NASA Technical Reports Server (NTRS)

Miller, Timothy L.; Kavaya, Michael J.; Emmitt, G. David

1999-01-01

The global measurement of tropospheric wind profiles has been cited by the operational meteorological community as the most important missing element in the present and planned observing system. The most practical and economical method for obtaining this measurement is from low earth orbit, utilizing a Doppler lidar (laser radar) technique. Specifically, this paper will describe the coherent Doppler wind lidar (CDWL) technique, the design and progress of a current space flight project to fly such a system on the Space Shuttle, and plans for future flights of similar instruments. The SPARCLE (SPAce Readiness Coherent Lidar Experiment) is a Shuttle-based instrument whose flight is targeted for March, 2001. The objectives of SPARCLE are three-fold: Confirm that the coherent Doppler lidar technique can measure line-of-sight winds to within 1-2 m/s accuracy; Collect data to permit validation and improvement of instrument performance models to enable better design of future missions; and Collect wind and backscatter data for future mission optimization and for atmospheric studies. These objectives reflect the nature of the experiment and its program sponsor, NASA's New Millennium Program. The experiment is a technology validation mission whose primary purpose is to provide a space flight validation of this particular technology. (It should be noted that the CDWL technique has successfully been implemented from ground-based and aircraft-based platforms for a number of years.) Since the conduct of the SPARCLE mission is tied to future decisions on the choice of technology for free-flying, operational missions, the collection of data is intrinsically tied to the validation and improvement of instrument performance models that predict the sensitivity and accuracy of any particular present or future instrument system. The challenges unique to space flight for an instrument such as SPARCLE and follow-ons include: Obtaining the required lidar sensitivity from the long distance of orbit height to the lower atmosphere; Maintaining optical alignments after launch to orbit, and during operations in "microgravity"; Obtaining pointing knowledge of sufficient accuracy to remove the speed of the spacecraft (and the rotating Earth) from the measurements; Providing sufficient power (not a problem on the Shuttle) and cooling to the instrument. The paper will describe the status and challenges of the SPARCLE project, the value of obtaining wind data from orbit, and will present a roadmap to future instruments for scientific research and operational meteorology.

The potential for geostationary remote sensing of NO2 to improve weather prediction

NASA Astrophysics Data System (ADS)

Liu, X.; Mizzi, A. P.; Anderson, J. L.; Fung, I. Y.; Cohen, R. C.

2017-12-01

Observations of surface winds remain sparse making it challenging to simulate and predict the weather in circumstances of light winds that are most important for poor air quality. Direct measurements of short-lived chemicals from space might be a solution to this challenge. Here we investigate the application of data assimilation of NO­2 columns as will be observed from geostationary orbit to improve predictions and retrospective analysis of surface wind fields. Specifically, synthetic NO2 observations are sampled from a "nature run (NR)" regarded as the true atmosphere. Then NO2 observations are assimilated using EAKF methods into a "control run (CR)" which differs from the NR in the wind field. Wind errors are generated by introducing (1) errors in the initial conditions, (2) creating a model error by using two different formulations for the planetary boundary layer, (3) and by combining both of these effects. Assimilation of NO2 column observations succeeds in reducing wind errors, indicating the prospects for future geostationary atmospheric composition measurements to improve weather forecasting are substantial. We find that due to the temporal heterogeneity of wind errors, the success of this application favors chemical observations of high frequency, such as those from geostationary platform. We also show the potential to improve soil moisture field by assimilating NO­2 columns.

Using Rapid Improvement Events for Disaster After-Action Reviews: Experience in a Hospital Information Technology Outage and Response.

PubMed

Little, Charles M; McStay, Christopher; Oeth, Justin; Koehler, April; Bookman, Kelly

2018-02-01

The use of after-action reviews (AARs) following major emergency events, such as a disaster, is common and mandated for hospitals and similar organizations. There is a recurrent challenge of identified problems not being resolved and repeated in subsequent events. A process improvement technique called a rapid improvement event (RIE) was used to conduct an AAR following a complete information technology (IT) outage at a large urban hospital. Using RIE methodology to conduct the AAR allowed for the rapid development and implementation of major process improvements to prepare for future IT downtime events. Thus, process improvement methodology, particularly the RIE, is suited for conducting AARs following disasters and holds promise for improving outcomes in emergency management. Little CM , McStay C , Oeth J , Koehler A , Bookman K . Using rapid improvement events for disaster after-action reviews: experience in a hospital information technology outage and response. Prehosp Disaster Med. 2018;33(1):98-100.

Health Provider Views on Improving Antiretroviral Therapy Adherence Among Men Who Have Sex with Men in Coastal Kenya

PubMed Central

Micheni, Murugi; Kombo, Bernadette K.; Secor, Andrew; Simoni, Jane M.; Operario, Don; van der Elst, Elise M.; Mugo, Peter; Kanungi, Jennifer; Sanders, Eduard J.

2017-01-01

Abstract HIV-positive Kenyan men who have sex with men (MSM) are a highly stigmatized group facing barriers to care engagement and antiretroviral therapy (ART) adherence. Because care providers' views are important in improving outcomes, we sought the perspective of those serving MSM patients on how to optimize ART adherence in a setting where same-sex behavior is criminalized. We conducted 4 focus group discussions with a total of 29 healthcare workers (HCWs) experienced in providing HIV care to MSM. The semistructured, open-ended topic guide used was based on an access-information-motivation-proximal cues model of adherence, with added focus on trust in providers, stigma, and discrimination. Detailed facilitator notes and transcripts were translated into English and reviewed for common themes. The HCW identified adherence challenges of MSM patients that are similar to those of the general population, including HIV-related stigma and lack of disclosure. In addition, HCWs noted challenges specific to MSM, such as lack of access to MSM-friendly health services, economic and social challenges due to stigma, difficult relationships with care providers, and discrimination at the clinic and in the community. HCWs recommended clinic staff sensitivity training, use of trained MSM peer navigators, and stigma reduction in the community as interventions that might improve adherence and health outcomes for MSM. Despite noting MSM-specific barriers, HCWs recommended strategies for improving HIV care for MSM in rights-constrained settings that merit future research attention. Most likely, multilevel interventions incorporating both individual and structural factors will be necessary. PMID:28282249

Health Provider Views on Improving Antiretroviral Therapy Adherence Among Men Who Have Sex with Men in Coastal Kenya.

PubMed

Micheni, Murugi; Kombo, Bernadette K; Secor, Andrew; Simoni, Jane M; Operario, Don; van der Elst, Elise M; Mugo, Peter; Kanungi, Jennifer; Sanders, Eduard J; Graham, Susan M

2017-03-01

HIV-positive Kenyan men who have sex with men (MSM) are a highly stigmatized group facing barriers to care engagement and antiretroviral therapy (ART) adherence. Because care providers' views are important in improving outcomes, we sought the perspective of those serving MSM patients on how to optimize ART adherence in a setting where same-sex behavior is criminalized. We conducted 4 focus group discussions with a total of 29 healthcare workers (HCWs) experienced in providing HIV care to MSM. The semistructured, open-ended topic guide used was based on an access-information-motivation-proximal cues model of adherence, with added focus on trust in providers, stigma, and discrimination. Detailed facilitator notes and transcripts were translated into English and reviewed for common themes. The HCW identified adherence challenges of MSM patients that are similar to those of the general population, including HIV-related stigma and lack of disclosure. In addition, HCWs noted challenges specific to MSM, such as lack of access to MSM-friendly health services, economic and social challenges due to stigma, difficult relationships with care providers, and discrimination at the clinic and in the community. HCWs recommended clinic staff sensitivity training, use of trained MSM peer navigators, and stigma reduction in the community as interventions that might improve adherence and health outcomes for MSM. Despite noting MSM-specific barriers, HCWs recommended strategies for improving HIV care for MSM in rights-constrained settings that merit future research attention. Most likely, multilevel interventions incorporating both individual and structural factors will be necessary.

Surgical treatment and management of the severely burn patient: Review and update.

PubMed

Gacto-Sanchez, P

Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult. Research into stem cells, grafting, biomarkers, inflammation control, and rehabilitation will continue to improve individualized care and create new treatment options for these patients. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Special Education Students Improve Academic Performance through Problem-Based Learning and Technology

NASA Astrophysics Data System (ADS)

Freeman, S.; Kintsch, A.

2003-12-01

Boulder High School Special Education students work in teams on donated wireless computers to solve problems created by global climate change. Their text is Richard Somerville's The Forgiving Air. They utilize Wheeling Jesuit University's remote sensing web site and private computer bulletin board. Their central source for problem-based learning (PBL) is www.cotf.edu, NASA's Classroom of the Future Global Change web site. As a result, students not only improve their abilities to write, read, do math and research, speak, and work as team members, they also improve self-esteem, resilience, and willingness to take more challenging classes. Two special education students passed AP exams, Calculus and U.S. Government, last spring and Jay Matthews of Newsweek rates Boulder High as 201st of the nation's top 1000 high schools.

Design control system of telescope force actuators based on WLAN

NASA Astrophysics Data System (ADS)

Shuai, Xiaoying; Zhang, Zhenchao

2010-05-01

With the development of the technology of autocontrol, telescope, computer, network and communication, the control system of the modern large and extra lager telescope become more and more complicated, especially application of active optics. Large telescope based on active optics maybe contain enormous force actuators. This is a challenge to traditional control system based on wired networks, which result in difficult-to-manage, occupy signification space and lack of system flexibility. Wireless network can resolve these disadvantages of wired network. Presented control system of telescope force actuators based on WLAN (WFCS), designed the control system framework of WFCS. To improve the performance of real-time, we developed software of force actuators control system in Linux. Finally, this paper discussed improvement of WFCS real-time, conceived maybe improvement in the future.

Shared Socio-Economic Pathways of the Energy Sector – Quantifying the Narratives

DOE PAGES

Bauer, Nico; Calvin, Katherine; Emmerling, Johannes; ...

2016-08-23

Energy is crucial for supporting basic human needs, development and well-being. The future evolution of the scale and character of the energy system will be fundamentally shaped by socioeconomic conditions and drivers, available energy resources, technologies of energy supply and transformation, and end-use energy demand. However, because energy-related activities are significant sources of greenhouse gas (GHG) emissions and other environmental and social externalities, energy system development will also be influenced by social acceptance and strategic policy choices. All of these uncertainties have important implications for many aspects of economic and environmental sustainability, and climate change in particular. In the Shared-Socioeconomicmore » Pathway (SSP) framework these uncertainties are structured into five narratives, arranged according to the challenges to climate change mitigation and adaptation. In this study we explore future energy sector developments across the five SSPs using Integrated Assessment Models (IAMs), and we also provide summary output and analysis for selected scenarios of global emissions mitigation policies. The mitigation challenge strongly corresponds with global baseline energy sector growth over the 21st century, which varies between 40% and 230% depending on final energy consumer behavior, technological improvements, resource availability and policies. The future baseline CO 2-emission range is even larger, as the most energy-intensive SSP also incorporates a comparatively high share of carbon-intensive fossil fuels, and vice versa. Inter-regional disparities in the SSPs are consistent with the underlying socioeconomic assumptions; these differences are particularly strong in the SSPs with large adaptation challenges, which have little inter-regional convergence in long-term income and final energy demand levels. The scenarios presented do not include feedbacks of climate change on energy sector development. The energy sector SSPs with and without emissions mitigation policies are introduced and analyzed here in order to contribute to future research in climate sciences, mitigation analysis, and studies on impacts, adaptation and vulnerability.« less

Lubrication of space systems: Challenges and potential solutions

NASA Technical Reports Server (NTRS)

Fusaro, Robert L.

1992-01-01

Future space missions will all require advanced mechanical moving components which will require wear protection and lubrication. The tribology practices used today are primarily based upon a technology base that is more than 20 years old. This paper will discuss NASA's future space missions and some of the mechanism tribology challenges that will be encountered. Potential solutions to these challenges using coatings technology will be assessed.

The architecture challenge: Future artificial-intelligence systems will require sophisticated architectures, and knowledge of the brain might guide their construction.

PubMed

Baldassarre, Gianluca; Santucci, Vieri Giuliano; Cartoni, Emilio; Caligiore, Daniele

2017-01-01

In this commentary, we highlight a crucial challenge posed by the proposal of Lake et al. to introduce key elements of human cognition into deep neural networks and future artificial-intelligence systems: the need to design effective sophisticated architectures. We propose that looking at the brain is an important means of facing this great challenge.

Child neurology: past, present, and future: part 3: the future.

PubMed

Ridel, Keith R; Gilbert, Donald L

2010-10-12

This is the last of a 3-part series exploring the past, present, and future of the field of child neurology. This article addresses the 2 fundamental challenges facing child neurology. The most important challenge is our inadequate workforce; based on current numbers, recruitment patterns, and projected retirement, the child neurology clinical and research workforce shortage will likely worsen. The second challenge involves adapting our training to prepare child neurologists for changes ahead. We propose that these 2 issues are related, and that solutions need to include consideration of career options in research, education, and patient care.

A reflective teaching challenge to motivate educational innovation.

PubMed

Edwards, Roger A; Kirwin, Jennifer; Gonyeau, Michael; Matthews, S James; Lancaster, Jason; DiVall, Margarita

2014-06-17

To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

Making Debris Avoidance Decisions for ESMO's EOS Mission Set

NASA Technical Reports Server (NTRS)

Mantziaras, Dimitrios

2016-01-01

The presentation will cover the aspects of making debris risk decisions from the NASA Mission Director's perspective, specifically for NASA Earth Science Mission Operations (ESMO) Earth Observing System (EOS) mission set. ESMO has been involved in analyzing potential debris risk conjunctions with secondary objects since the inception of this discipline. Through the cumulated years of experience and continued exposure to various debris scenarios, ESMO's understanding of the problem and process to deal with this issue has evolved. The presentation will describe the evolution of the ESMO process, specifically as it relates to the maneuver execution and spacecraft risk management decision process. It will briefly cover the original Drag Make-Up Maneuver, several day, methodical manually intensive, ramp up waive off approach, to the present day more automated, pre-canned onboard command, tools based approach. The presentation will also cover the key information needed to make debris decisions and challenges in doing so while still trying to meet science goals, constellation constraints and manage resources. A slide or two at the end of the presentation, will be devoted to discussing what further improvements could be helpful to improve decision making and future process improvement plans challenges.