Issues engulfed Saudi Arabia construction workers

NASA Astrophysics Data System (ADS)

Al-Emad, N. H.; Rahman, I. A.

2018-04-01

This paper presents an exploratory study conducted in Makkah city to uncover issues faced by construction workers from the construction leaders’ perspective. Eleven construction leaders/experts were interviewed to unleash their experiences on handling the foreign workers working in Makkah construction projects. Most of the experts are senior management staffs with more than 10 years’ working experience in Saudi Arabia construction industry. The interviews were carried out in semi structured mode where all the information was captured manually and also electronically. The identified issues were sorted based on its commonality into 10 clusters. Hence in each cluster, the numbers of issue considered by the experts are reflecting the importance of that particular cluster. The result of the clusters according to the number of issues mentioned by the experts are safety issues, restricted government regulation, demotivated issues, lack of quality workers, poor living quality, communication barriers, adaption issues, poor attitudes, lack of logistical arrangements and lack of education. With these identified issues it will assist the construction players in the construction industry of Saudi Arabia in dealing with their workers.

Advanced Technology Composite Fuselage-Structural Performance

NASA Technical Reports Server (NTRS)

Walker, T. H.; Minguet, P. J.; Flynn, B. W.; Carbery, D. J.; Swanson, G. D.; Ilcewicz, L. B.

1997-01-01

Boeing is studying the technologies associated with the application of composite materials to commercial transport fuselage structure under the NASA-sponsored contracts for Advanced Technology Composite Aircraft Structures (ATCAS) and Materials Development Omnibus Contract (MDOC). This report addresses the program activities related to structural performance of the selected concepts, including both the design development and subsequent detailed evaluation. Design criteria were developed to ensure compliance with regulatory requirements and typical company objectives. Accurate analysis methods were selected and/or developed where practical, and conservative approaches were used where significant approximations were necessary. Design sizing activities supported subsequent development by providing representative design configurations for structural evaluation and by identifying the critical performance issues. Significant program efforts were directed towards assessing structural performance predictive capability. The structural database collected to perform this assessment was intimately linked to the manufacturing scale-up activities to ensure inclusion of manufacturing-induced performance traits. Mechanical tests were conducted to support the development and critical evaluation of analysis methods addressing internal loads, stability, ultimate strength, attachment and splice strength, and damage tolerance. Unresolved aspects of these performance issues were identified as part of the assessments, providing direction for future development.

Identifying influential nodes in complex networks: A node information dimension approach

NASA Astrophysics Data System (ADS)

Bian, Tian; Deng, Yong

2018-04-01

In the field of complex networks, how to identify influential nodes is a significant issue in analyzing the structure of a network. In the existing method proposed to identify influential nodes based on the local dimension, the global structure information in complex networks is not taken into consideration. In this paper, a node information dimension is proposed by synthesizing the local dimensions at different topological distance scales. A case study of the Netscience network is used to illustrate the efficiency and practicability of the proposed method.

Grid related issues for static and dynamic geometry problems using systems of overset structured grids

NASA Technical Reports Server (NTRS)

Meakin, Robert L.

1995-01-01

Grid related issues of the Chimera overset grid method are discussed in the context of a method of solution and analysis of unsteady three-dimensional viscous flows. The state of maturity of the various pieces of support software required to use the approach is considered. Current limitations of the approach are identified.

Business Department Chairperson: An Administrator or a Teacher?

ERIC Educational Resources Information Center

O'Neil, Bryan L.

The responsibilities of the business department chairperson at Castleton State College were assessed. A literature review included the area of organizational structures of academic institutions, and key faculty members and administrators at the college were interviewed to identify the key issues and problems of organizational structures and job…

Structured Ethical Reflection in Practitioner Inquiry: Theory, Pedagogy, and Practice

ERIC Educational Resources Information Center

Stevens, Douglas M.; Brydon-Miller, Mary; Raider-Roth, Miriam

2016-01-01

Practitioner inquiry provides a powerful tool for improving practice and addressing critical issues in classrooms, schools, and broader communities. However, it also raises unique ethical challenges that often go unrecognized and unresolved. Structured Ethical Reflection (SER) provides teacher researchers with a process for identifying core values…

Report: Studies Addressing EPA’s Organizational Structure

EPA Pesticide Factsheets

Report #2006-P-00029, August 16, 2006. The 13 studies, articles, publications, and reports we reviewed identified issues with cross-media management, regional offices, reliable information, and reliable science.

Study on utilization of advanced composites in fuselage structures of large transports

NASA Technical Reports Server (NTRS)

Johnson, R. W.; Thomson, L. W.; Wilson, R. D.

1985-01-01

The potential for utilizing advanced composites in fuselage structures of large transports was assessed. Six fuselage design concepts were selected and evaluated in terms of structural performance, weight, and manufacturing development and costs. Two concepts were selected that merit further consideration for composite fuselage application. These concepts are: (1) a full depth honeycomb design with no stringers, and (2) an I section stringer stiffened laminate skin design. Weight reductions due to applying composites to the fuselages of commercial and military transports were calculated. The benefits of applying composites to a fleet of military transports were determined. Significant technology issues pertinent to composite fuselage structures were identified and evaluated. Program plans for resolving the technology issues were developed.

The use of fault reporting of medical equipment to identify latent design flaws.

PubMed

Flewwelling, C J; Easty, A C; Vicente, K J; Cafazzo, J A

2014-10-01

Poor device design that fails to adequately account for user needs, cognition, and behavior is often responsible for use errors resulting in adverse events. This poor device design is also often latent, and could be responsible for "No Fault Found" (NFF) reporting, in which medical devices sent for repair by clinical users are found to be operating as intended. Unresolved NFF reports may contribute to incident under reporting, clinical user frustration, and biomedical engineering technologist inefficacy. This study uses human factors engineering methods to investigate the relationship between NFF reporting frequency and device usability. An analysis of medical equipment maintenance data was conducted to identify devices with a high NFF reporting frequency. Subsequently, semi-structured interviews and heuristic evaluations were performed in order to identify potential usability issues. Finally, usability testing was conducted in order to validate that latent usability related design faults result in a higher frequency of NFF reporting. The analysis of medical equipment maintenance data identified six devices with a high NFF reporting frequency. Semi-structured interviews, heuristic evaluations and usability testing revealed that usability issues caused a significant portion of the NFF reports. Other factors suspected to contribute to increased NFF reporting include accessory issues, intermittent faults and environmental issues. Usability testing conducted on three of the devices revealed 23 latent usability related design faults. These findings demonstrate that latent usability related design faults manifest themselves as an increase in NFF reporting and that devices containing usability related design faults can be identified through an analysis of medical equipment maintenance data. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

A spectral method to detect community structure based on distance modularity matrix

NASA Astrophysics Data System (ADS)

Yang, Jin-Xuan; Zhang, Xiao-Dong

2017-08-01

There are many community organizations in social and biological networks. How to identify these community structure in complex networks has become a hot issue. In this paper, an algorithm to detect community structure of networks is proposed by using spectra of distance modularity matrix. The proposed algorithm focuses on the distance of vertices within communities, rather than the most weakly connected vertex pairs or number of edges between communities. The experimental results show that our method achieves better effectiveness to identify community structure for a variety of real-world networks and computer generated networks with a little more time-consumption.

Investigating the Relationship between Dialogue Structure and Tutoring Effectiveness: A Hidden Markov Modeling Approach

ERIC Educational Resources Information Center

Boyer, Kristy Elizabeth; Phillips, Robert; Ingram, Amy; Ha, Eun Young; Wallis, Michael; Vouk, Mladen; Lester, James

2011-01-01

Identifying effective tutorial dialogue strategies is a key issue for intelligent tutoring systems research. Human-human tutoring offers a valuable model for identifying effective tutorial strategies, but extracting them is a challenge because of the richness of human dialogue. This article addresses that challenge through a machine learning…

Effective Practices and Structures for Middle Grades Education. Policy Issues.

ERIC Educational Resources Information Center

Mac Iver, Douglas

This document draws upon theory and research about early adolescence and about the effects of middle grades structures and practices on student outcomes. The purpose is to identify specific problem areas and promising innovations that should be considered by policymakers as they establish guidelines for the restructuring of education in the middle…

Study of utilization of advanced composites in fuselage structures of large transports

NASA Technical Reports Server (NTRS)

Jackson, A. C.; Campion, M. C.; Pei, G.

1984-01-01

The effort required by the transport aircraft manufacturers to support the introduction of advanced composite materials into the fuselage structure of future commercial and military transport aircraft is investigated. Technology issues, potential benefits to military life cycle costs and commercial operating costs, and development plans are examined. The most urgent technology issues defined are impact dynamics, acoustic transmission, pressure containment and damage tolerance, post-buckling, cutouts, and joints and splices. A technology demonstration program is defined and a rough cost and schedule identified. The fabrication and test of a full-scale fuselage barrel section is presented. Commercial and military benefits are identified. Fuselage structure weight savings from use of advanced composites are 16.4 percent for the commercial and 21.8 percent for the military. For the all-composite airplanes the savings are 26 percent and 29 percent, respectively. Commercial/operating costs are reduced by 5 percent for the all-composite airplane and military life cycle costs by 10 percent.

Organization in memory and behavior1

PubMed Central

Shimp, Charles P.

1976-01-01

Some common reinforcement contingencies make the delivery of a reinforcer depend on the occurrence of behavior lacking significant temporal structure: a reinforcer may be contingent on nearly instantaneous responses such as a pigeon's key peck, a rat's lever press, a human's button press or brief verbal utterance, and so on. Such a reinforcement contingency conforms much more closely to the functionalist tradition in experimental psychology than to the structuralist tradition. Until recently, the functionalist tradition, in the form of a kind of associationism, typified most research on human learning and memory. Recently, however, research on human memory has focused more on structural issues: now the basic unit of analysis often involves an organized temporal pattern of behavior. A focus on the interrelations between the function and structure of behavior identifies a set of independent and dependent variables different from those identified by certain common kinds of “molar” behavioral analyses. In so doing, such a focus redefines some of the significant issues in the experimental analysis of behavior. PMID:16811925

Green buildings need good ergonomics.

PubMed

Hedge, A; Dorsey, J A

2013-01-01

A retrospective post-occupancy evaluation survey of 44 occupants in two Leadership in Energy and Environmental Design (LEED) Platinum buildings on a US college campus is reported. The Internet survey covered a range of indoor environment and ergonomics issues. Results show that working in these buildings were a generally positive experience for their health, performance and satisfaction. However, in one building there were persistent issues of variability in air temperature, air freshness, air quality and noise that affected the perceived health and performance of the occupants. Although the buildings were energy-efficient and sustainable structures, ergonomics design issues were identified. Implications for the role of ergonomics in green buildings and in the US LEED rating system are discussed. This survey identified a number of ergonomics design issues present in the LEED Platinum energy-efficient and sustainable buildings that were studied. These results highlight the importance of integrating ergonomics design into green buildings as a component in the US LEED rating system.

Matthew Jones House: Recommendations for Treatment

DTIC Science & Technology

2016-04-01

strongly recommend that a structural engineer be contracted to provide in depth analysis and monitoring. The decay of the historic timber top plates...of the structure . This report summarizes the research and findings by the NCPTT. It also includes an engineer’s report and other supplemental in...NEEDED. DO NOT RETURN IT TO THE ORIGINATOR. ERDC/CERL CR-16-1 iii Foreword After identifying a variety of structural issues with the Matthew Jones

Identification of Communication and Coordination Issues in the US Air Traffic Control System

NASA Technical Reports Server (NTRS)

Davison, Hayley J.; Hansman, R. John

2001-01-01

Today's air traffic control system is approaching the point of saturation, as evidenced by increasing delays across the National Airspace System (NAS). There exists an opportunity to enhance NAS efficiency and reduce delays by improving strategic communication throughout the ATC system. Although several measures have been taken to improve communication (e.g., Collaborative Decision Making tools), communication issues between ATC facilities remain. It is hypothesized that by identifying the key issues plaguing inter-facility strategic communication, steps can be taken to enhance these communications, and therefore ATC system efficiency. In this report, a series of site visits were performed at Boston and New York ATC facilities as well as at the Air Traffic Control System Command Center. The results from these site visits were used to determine the current communication and coordination structure of Traffic Management Coordinators, who hold a pivotal role in inter-facility communications. Several themes emerged from the study, including: ambiguity of organizational structure in the current ATC system, awkward coordination between ATC facilities, information flow issues, organizational culture issues, and negotiation behaviors used to cope with organizational culture issues.

Hospital board structure: changing form and changing issues.

PubMed

Tregoning, S

2000-01-01

Economic and social pressures are compelling many hospitals to consider their current board structure in an effort to position their hospital to meet changing demands. A national profile of the structures of hospital boards has been compiled from a questionnaire completed by hospital board representatives from both government and non-government sectors. Results show that hospital board structures are a hybrid of both philanthropic and corporate models. New structures may be required to meet future challenges. In developing new structures, consideration should be given to identifying the skills and processes required to undertake board business.

Demonstration Tokamak Hybrid Reactor (DTHR) blanket design study, December 1978

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

Not Available

1978-01-01

This work represents only the second iteration of the conceptual design of a DTHR blanket; consequently, a number of issues important to a detailed blanket design have not yet been evaluated. The most critical issues identified are those of two-phase flow maldistribution, flow instabilities, flow stratification for horizontal radial inflow of boiling water, fuel rod vibrations, corrosion of clad and structural materials by high quality steam, fretting and cyclic loads. Approaches to minimizing these problems are discussed and experimental testing with flow mock-ups is recommended. These implications on a commercial blanket design are discussed and critical data needs are identified.

Teamwork in high-risk environments analogous to space

NASA Technical Reports Server (NTRS)

Kanki, Barbara G.

1990-01-01

Mountaineering expeditions combine a number of factors which make them potentially good analogs to the planetary exploration facet of long-duration space missions. A study of mountain climbing teams was conducted in order to evaluate the usefulness of the environment as a space analog and to specifically identify the factors and issues surrounding teamwork and 'successful' team performance in two mountaineering environments. This paper focuses on social/organizational factors, including team size and structure, leadership styles and authority structure which were found in the sample of 22 climb teams (122 individuals). The second major issue discussed is the construction of a valid performance measure in this high-risk environment.

Comparing Religious Education in Canadian and Australian Catholic High Schools: Identifying Some Key Structural Issues

ERIC Educational Resources Information Center

Rymarz, Richard

2013-01-01

Religious education (RE) in Catholic high schools in Australia and Canada is compared by examining some of the underlying structural factors that shape the delivery of RE. It is argued that in Canadian Catholic schools RE is diminished by three factors that distinguish it from the Australian experience. These are: the level and history of…

Social Structure and Individual Agency in Second Language Learning: Evidence from Three Life Histories

ERIC Educational Resources Information Center

Flowerdew, John; Miller, Lindsay

2008-01-01

This paper examines the issue of social structure and individual agency in language learning through the life histories of three young engineering graduates in Hong Kong. English is identified as an important form of cultural capital, which to a considerable extent determines the development of the three individuals, each of whom comes from a…

Problem-Based Learning: Using Ill-Structured Problems in Biology Project Work

ERIC Educational Resources Information Center

Chin, Christine; Chia, Li-Gek

2006-01-01

This case study involved year 9 students carrying out project work in biology via problem-based learning. The purpose of the study was to (a) find out how students approach and work through ill-structured problems, (b) identify some issues and challenges related to the use of such problems, and (c) offer some practical suggestions on the…

Bridging the gap between individual-level risk for HIV and structural determinants: using root cause analysis in strategic planning.

PubMed

Willard, Nancy; Chutuape, Kate; Stines, Stephanie; Ellen, Jonathan M

2012-01-01

HIV prevention efforts have expanded beyond individual-level interventions to address structural determinants of risk. Coalitions have been an important vehicle for addressing similar intractable and deeply rooted health-related issues. A root cause analysis process may aid coalitions in identifying fundamental, structural-level contributors to risk and in identifying appropriate solutions. For this article, strategic plans for 13 coalitions were analyzed both before and after a root cause analysis approach was applied to determine the coalitions' strategic plans potential impact and comprehensiveness. After root cause analysis, strategic plans trended toward targeting policies and practices rather than on single agency programmatic changes. Plans expanded to target multiple sectors and several changes within sectors to penetrate deeply into a sector or system. Findings suggest that root cause analysis may be a viable tool to assist coalitions in identifying structural determinants and possible solutions for HIV risk.

Advanced technology commercial fuselage structure

NASA Technical Reports Server (NTRS)

Ilcewicz, L. B.; Smith, P. J.; Walker, T. H.; Johnson, R. W.

1991-01-01

Boeing's program for Advanced Technology Composite Aircraft Structure (ATCAS) has focused on the manufacturing and performance issues associated with a wide body commercial transport fuselage. The primary goal of ATCAS is to demonstrate cost and weight savings over a 1995 aluminum benchmark. A 31 foot section of fuselage directly behind the wing to body intersection was selected for study purposes. This paper summarizes ATCAS contract plans and review progress to date. The six year ATCAS program will study technical issues for crown, side, and keel areas of the fuselage. All structural details in these areas will be included in design studies that incorporate a design build team (DBT) approach. Manufacturing technologies will be developed for concepts deemed by the DBT to have the greatest potential for cost and weight savings. Assembly issues for large, stiff, quadrant panels will receive special attention. Supporting technologies and mechanical tests will concentrate on the major issues identified for fuselage. These include damage tolerance, pressure containment, splices, load redistribution, post-buckled structure, and durability/life. Progress to date includes DBT selection of baseline fuselage concepts; cost and weight comparisons for crown panel designs; initial panel fabrication for manufacturing and structural mechanics research; and toughened material studies related to keel panels. Initial ATCAS studies have shown that NASA's Advanced Composite Technology program goals for cost and weight savings are attainable for composite fuselage.

Ethical learning on international medical electives: a case-based analysis of medical student learning experiences.

PubMed

Bowsher, Gemma; Parry-Billings, Laura; Georgeson, Anna; Baraitser, Paula

2018-04-11

Students on international medical electives face complex ethical issues when undertaking clinical work. The variety of elective destinations and the culturally specific nature of clinical ethical issues suggest that pre-elective preparation could be supplemented by in-elective support. An online, asynchronous, case-based discussion was piloted to support ethical learning on medical student electives. We developed six scenarios from elective diaries to stimulate peer-facilitated discussions during electives. We evaluated the transcripts to assess whether transformative, experiential learning took place, assessing specifically for indications that 1) critical reflection, 2) reflective action and 3) reflective learning were taking place. We also completed a qualitative thematic content analysis of the discussions. Of forty-one extended comments, nine responses showed evidence of transformative learning (Mezirow stage three). The thematic analysis identified five themes: adopting a position on ethical issues without overt analysis; presenting issues in terms of their effects on students' ability to complete tasks; describing local contexts and colleagues as "other"; difficulty navigating between individual and structural issues, and overestimation of the impact of individual action on structures and processes. Results suggest a need to: frame ethical learning on elective so that it builds on earlier ethical programmes in the curriculum, and encourages students to adopt structured approaches to complex ethical issues including cross-cultural negotiation and to enhance global health training within the curriculum.

Training Community Clergy in Serious Illness: Balancing Faith and Medicine.

PubMed

Koss, Sarah E; Weissman, Ross; Chow, Vinca; Smith, Patrick T; Slack, Bethany; Voytenko, Vitaliy; Balboni, Tracy A; Balboni, Michael J

2018-06-06

Community-based clergy are highly engaged in helping seriously ill patients address spiritual concerns at the end of life (EOL). While they desire EOL training, no data exist in guiding how to conceptualize a clergy-training program. The objective of this study was used to identify best practices in an EOL training program for community clergy. As part of the National Clergy Project on End-of-Life Care, the project conducted key informant interviews and focus groups with active clergy in five US states (California, Illinois, Massachusetts, New York, and Texas). A diverse purposive sample of 35 active clergy representing pre-identified racial, educational, theological, and denominational categories hypothesized to be associated with more intensive utilization of medical care at the EOL. We assessed suggested curriculum structure and content for clergy EOL training through interviews and focus groups for the purpose of qualitative analysis. Thematic analysis identified key themes around curriculum structure, curriculum content, and issues of tension. Curriculum structure included ideas for targeting clergy as well as lay congregational leaders and found that clergy were open to combining resources from both religious and health-based institutions. Curriculum content included clergy desires for educational topics such as increasing their medical literacy and reviewing pastoral counseling approaches. Finally, clergy identified challenging barriers to EOL training needing to be openly discussed, including difficulties in collaborating with medical teams, surrounding issues of trust, the role of miracles, and caution of prognostication. Future EOL training is desired and needed for community-based clergy. In partnering together, religious-medical training programs should consider curricula sensitive toward structure, desired content, and perceived clergy tensions.

Stigma of People with Epilepsy in China: Views of health professionals, teachers, employers and community leaders

PubMed Central

Yang, Rongrong; Wang, Wenzhi; Snape, Dee; Chen, Gong; Zhang, Lei; Wu, Jianzhong; Baker, Gus A; Zheng, Xiaoying; Jacoby, Ann

2011-01-01

To identify the possible sources of stigma of epilepsy in key informant groups, “mini-ethnographic” studies were conducted in rural and urban locations in China. Data from 45 semi-structured interviews and 8 focus group discussions (6 persons each) were analysed to investigate the world experienced by people with epilepsy. Underpinned by a social constructionist approach to data analysis, emerging themes were identified with the use of computer-assisted data analysis (NVivo 8). A hierarchical model was then constructed, to include: Practical Level issues: attitudes to risk, attitudes towards costs of epilepsy; and Cultural Level issues: the contrast between rurality and tradition and urbanization and modernity in the Chinese context. The analysis enriches current research on factors and sources of stigma of epilepsy and highlights issues for future practice. PMID:21606005

Design and performance verification of UHPC piles for deep foundations.

DOT National Transportation Integrated Search

2008-11-01

The strategic plan for bridge engineering issued by AASHTO in 2005 identified extending the service life and optimizing structural : systems of bridges in the United States as two grand challenges in bridge engineering, with the objective of producin...

On structural identifiability analysis of the cascaded linear dynamic systems in isotopically non-stationary 13C labelling experiments.

PubMed

Lin, Weilu; Wang, Zejian; Huang, Mingzhi; Zhuang, Yingping; Zhang, Siliang

2018-06-01

The isotopically non-stationary 13C labelling experiments, as an emerging experimental technique, can estimate the intracellular fluxes of the cell culture under an isotopic transient period. However, to the best of our knowledge, the issue of the structural identifiability analysis of non-stationary isotope experiments is not well addressed in the literature. In this work, the local structural identifiability analysis for non-stationary cumomer balance equations is conducted based on the Taylor series approach. The numerical rank of the Jacobian matrices of the finite extended time derivatives of the measured fractions with respect to the free parameters is taken as the criterion. It turns out that only one single time point is necessary to achieve the structural identifiability analysis of the cascaded linear dynamic system of non-stationary isotope experiments. The equivalence between the local structural identifiability of the cascaded linear dynamic systems and the local optimum condition of the nonlinear least squares problem is elucidated in the work. Optimal measurements sets can then be determined for the metabolic network. Two simulated metabolic networks are adopted to demonstrate the utility of the proposed method. Copyright © 2018 Elsevier Inc. All rights reserved.

NASA Composite Materials Development: Lessons Learned and Future Challenges

NASA Technical Reports Server (NTRS)

Tenney, Darrel R.; Davis, John G., Jr.; Pipes, R. Byron; Johnston, Norman

2009-01-01

Composite materials have emerged as the materials of choice for increasing the performance and reducing the weight and cost of military, general aviation, and transport aircraft and space launch vehicles. Major advancements have been made in the ability to design, fabricate, and analyze large complex aerospace structures. The recent efforts by Boeing and Airbus to incorporate composite into primary load carrying structures of large commercial transports and to certify the airworthiness of these structures is evidence of the significant advancements made in understanding and use of these materials in real world aircraft. NASA has been engaged in research on composites since the late 1960 s and has worked to address many development issues with these materials in an effort to ensure safety, improve performance, and improve affordability of air travel for the public good. This research has ranged from synthesis of advanced resin chemistries to development of mathematical analyses tools to reliably predict the response of built-up structures under combined load conditions. The lessons learned from this research are highlighted with specific examples to illustrate the problems encountered and solutions to these problems. Examples include specific technologies related to environmental effects, processing science, fabrication technologies, nondestructive inspection, damage tolerance, micromechanics, structural mechanics, and residual life prediction. The current state of the technology is reviewed and key issues requiring additional research identified. Also, grand challenges to be solved for expanded use of composites in aero structures are identified.

Exact reconstruction analysis/synthesis filter banks with time-varying filters

NASA Technical Reports Server (NTRS)

Arrowood, J. L., Jr.; Smith, M. J. T.

1993-01-01

This paper examines some of the analysis/synthesis issues associated with FIR time-varying filter banks where the filter bank coefficients are allowed to change in response to the input signal. Several issues are identified as being important in order to realize performance gains from time-varying filter banks in image coding applications. These issues relate to the behavior of the filters as transition from one set of filter banks to another occurs. Lattice structure formulations for the time varying filter bank problem are introduced and discussed in terms of their properties and transition characteristics.

Get it together: Issues that facilitate collaboration in teams of learners in intensive care.

PubMed

Conte, Helen; Jirwe, Maria; Scheja, Max; Hjelmqvist, Hans

2016-05-01

The study describes issues that facilitate collaboration in teams of learners in an interprofessional education unit in intensive care. A descriptive qualitative study design was applied using semi-structured interviews based on the critical incident technique and qualitative content analysis. Nineteen participants, eight learners in their specialist training, nine supervisors and two head supervisors in Sweden identified 47 incidents. Teams of learners having control was the core issue. Motivation, time, experiences and reflection were central issues for facilitating collaboration. Efficiently training teams how to collaborate requires learners having control while acting on their common understanding and supervisors taking a facilitating role supporting teams to take control of their critical analysis.

Quality of working life issues of employees with a chronic physical disease: a systematic review.

PubMed

de Jong, Merel; de Boer, Angela G E M; Tamminga, Sietske J; Frings-Dresen, Monique H W

2015-03-01

To assess issues that contribute to the Quality of Working Life (QWL) of employees with a chronic physical disease. A systematic literature search was conducted using the databases PubMed, PsycINFO and EMBASE. Experiences and perceptions during the working life of employees with a chronic physical disease were extracted and synthesized into issues that contributed to their QWL. We organized these synthesized QWL issues into higher order themes and categories with qualitative data analysis software. From a total of 4,044 articles identified by the search, 61 articles were included. Data extraction and data synthesis resulted in an overview of 73 QWL issues that were classified into 30 themes. The following five categories of themes were identified: (1) job characteristics with issues such as job flexibility and work-site access; (2) the social structure and environment containing issues about disclosure, discrimination, misunderstanding, and awareness by employers or colleagues; (3) organizational characteristics with issues such as requesting work accommodations; (4) individual work perceptions including issues about enjoyment and evaluating work or life priorities; and (5) effect of the disease and treatment including issues about cognitive and physical health and work ability. This systematic review offers an extensive overview of issues that might contribute to the QWL of employees with a chronic physical disease. This overview may function as a starting point for occupational support, such as monitoring and evaluating the QWL of employees with a chronic physical disease during return-to-work and work continuation processes.

Workshop report: US-China workshop on smart structures and smart systems

NASA Astrophysics Data System (ADS)

Tomizuka, Masayoshi

2006-03-01

A Joint U.S.-China workshop on the topic of Integrated Sensing Systems, Mechatronics and Smart Structures Technologies was held in Jinan, China in October 2005 to evaluate the current status of research and education in the topic areas in the United States and China, to identify critical and strategic research and educational issues of mutual interest, and to identify joint research projects and potential research teams for collaborative research activities. The workshop included a series of presentations by leading researchers and educators from the United States and China and group discussions on the workshop objectives.

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

McMillan, J.D.

This paper reviews existing and proposed pretreatment processes for biomass. The focus is on the mechanisms by which the various pretreatments act and the influence of biomass structure and composition on the efficacy of particular pretreatment techniques. This analysis is used to identify pretreatment technologies and issues that warrant further research.

Modelling structural and plasma facing materials for fusion power plants: Recent advances and outstanding issues in the EURATOM fusion materials programme

NASA Astrophysics Data System (ADS)

Boutard, Jean-Louis; Dudarev, Sergei; Rieth, Michael

2011-10-01

EFDA Fusion Materials Topical Group was established at the end of 2007 to coordinate the EU effort on the development of structural and protection materials able to withstand the very demanding operating conditions of a future DEMO power plant. Focusing on a selection of well identified materials issues, including the behaviour of Reduced Activation Ferritic-Martensitic steels, and W-alloys under the foreseen operation conditions in a future DEMO, this paper describes recent advances in physical modelling and experimental validation, contributing to the definition of chemical composition and microstructure of materials with improved in-service stability at high temperature, high neutron flux and intense ion bombardment.

Technological Frame Incongruence, Diffusion, and Noncompliance

NASA Astrophysics Data System (ADS)

Sobreperez, Polly

The technological frames of reference strand of social shaping of technology theory is used to overlay the issues arising from a case study looking at noncompliance with information systems. A recent review of the theory suggests that although frame content is often addressed, frame structure, the process of framing, and the characteristics and outcomes of frames are largely overlooked. This paper attempts to address this shortfall by applying the indicators identified by case study research to the frames of different groups and using them to highlight differing perceptions and attitudes. In this way, the author suggests that issues surrounding noncompliance should not be dismissed as resistance but instead should be further studied by managers and developers, leading to accommodation of differing views. Further examination of frame incongruence reveals dependence on inefficient or ineffective organizational situations and thus these indicators can be useful in future studies to identify and address procedural, acceptance and cultural issues leading to acts of noncompliance.

Ethics issues for HIV/AIDS researchers in international settings - perspectives from the Canadian experience.

PubMed

Gahagan, Jacqueline; Sweeney, Ellen; Worthington, Catherine; Perry, Darryl; Satzinger, Franziska; Rogers, Erin

2008-11-01

In recognition of the level of international HIV/AIDS research being conducted by Canadians, the Canadian Association for HIV Research (CAHR), along with its partners, has developed a resource document to assist researchers in identifying and preparing for the unique ethics issues and challenges that may arise during international HIV/AIDS research. Between 2004 and 2007, face-to-face consultations were undertaken with community and government stakeholders, and interviews were conducted with eight prominent HIV/AIDS researchers with international experience to identify key research ethics challenges and structural, cultural, political, social, and economic factors that may impact HIV/AIDS research ethics in resource-limited settings. These challenges and factors served as the basis for the hypothetical ethics issues case scenarios developed for each of the four research tracks. Ethics issues were identified at every stage of the research process. Key contextual issues included: (1) stigma and culturally-embedded conceptualizations of HIV; (2) local and global politics and economics; (3) gender inequities, power dynamics, and sexual roles; and (4) allocation and availability of resources for research and health services. The final document resulting from the consultation process provides a framework for open dialogue on the complex and interconnected ethics issues researchers may experience in the field of international HIV/AIDS research, and contributes to the HIV/AIDS research field by reinforcing the need for high quality and ethically sound research. This document can be found at http://ethics.cahr-acrv.ca/.

Using expert opinion to quantify accuracy and reliability of nondestructive evaluation on bridges.

DOT National Transportation Integrated Search

2015-08-01

Bridge inspection is an important phase in bridge management. In 2009, a joint American Society of Civil : Engineers Structural Engineering Institute and AASHTO Ad-Hoc group was created to identify the issues : in bridge safety and to study current b...

Multicultural Counseling Competencies: Lessons from Assessment

ERIC Educational Resources Information Center

Kitaoka, Sean Kia i

2005-01-01

This article addresses multicultural counseling competencies from the perspective of quantitative assessment. A conceptual review of the current measures identifies 4 relevant issues: (a) diverse factor structures, (b) the working definition of multicultural awareness, (c) test takers' frame of reference, and (d) the implications of an inclusive…

Are Married Parents Really Better for Children? What Research Says about the Effects of Family Structure on Child Well-Being.

ERIC Educational Resources Information Center

Parke, Mary

This annotated brief summarizes research on the effects of family structure on child wellbeing, identifying issues that remain to be explored. On average, children who grow up in families with both their biological parents in a low-conflict marriage are better off in several ways than children who grow up in single-, step-, or cohabiting-parent…

Challenges of CPD for physiotherapists working as lone practitioners in amputee rehabilitation.

PubMed

Cole, Mary Jane; Morris, Jane; Scammell, Amy

2008-09-01

The aim of this study was to explore the issues around continuing professional development (CPD) for physiotherapists working as lone practitioners in amputee rehabilitation in the United Kingdom (UK). Qualitative method using a phenomenological approach via one to one semi-structured interviews and thematic data analysis. Ten physiotherapists with responsibility for amputee rehabilitation working as lone practitioners in hospitals or specialist centres in the UK. CPD is valued and there is commitment towards the process. Current solutions are identified but there are frustrations around more structured CPD and organizational issues. These include inadequate access to learning opportunities, lack of professional feedback, insufficient time and limited learning skills. There are opportunities for improving CPD through organizational structures but specialist input is recommended to support lone practitioners and managers with the process, e.g., consultant or peripatetic therapists.

An Investigation of Joint Service Acquisition Logistics Issues/Problems and Automated Joint Program Support.

DTIC Science & Technology

1984-09-01

Management Information System (ALMIS) to address them. Literature was surveyed and problems were summarized and developed into a questionnaire. Structured interviews were then conducted with over 100 different Air Force and civilian upper and middle JSAP managers. Many general and specific problems and issues were identified and validated using statistical and qualitative methods. General use of ALMIS to address certain joint service problem areas was confirmed. Potential use and desirable capabilities for ALMIS were also determined. Recommendations for ALMIS

Process and assembly plans for low cost commercial fuselage structure

NASA Technical Reports Server (NTRS)

Willden, Kurtis; Metschan, Stephen; Starkey, Val

1991-01-01

Cost and weight reduction for a composite structure is a result of selecting design concepts that can be built using efficient low cost manufacturing and assembly processes. Since design and manufacturing are inherently cost dependent, concurrent engineering in the form of a Design-Build Team (DBT) is essential for low cost designs. Detailed cost analysis from DBT designs and hardware verification must be performed to identify the cost drivers and relationships between design and manufacturing processes. Results from the global evaluation are used to quantitatively rank design, identify cost centers for higher ranking design concepts, define and prioritize a list of technical/economic issues and barriers, and identify parameters that control concept response. These results are then used for final design optimization.

Financial Structure of Mining Sector Companies During an Economic Slowdown /Struktura Finansowania Przedsiębiorstw W Sektorze Górniczym I Wydobywczym W Okresie Spowolnienia Gospodarczego

NASA Astrophysics Data System (ADS)

Sierpińska, Maria; Bąk, Patrycja

2012-12-01

The global economic crisis that started in 2007 in the area of finance, expanded over the subsequent years to the business sphere, and resulted in a drop of demand and production almost in any field of business activity. Access to foreign sources of finance, especially to loans, has become more difficult and expensive. In such circumstances, enterprises have had to resort more often to their own capital generated by the issue of shares, and to retained profit. Banks have limited their loans for business entities, reduced credit periods, and raised credit margins as well as their levels of collaterals. The McKinsey research into the changes that occur in the structures of sources of finance confirms that the share of equity capital in the structure of financing of non-financial enterprises has visibly grown, and their crediting scopes have been limited all over the European Union as well as in the euro zone. The global tendencies as regards directions of changes in the structure of the sources of corporate financing have also been reflected in Poland. The economic slowdown has resulted in changes in the structures of corporate financing. Mining companies have risen the shares of their equity capital in their general sources of financing. This tendency corresponds to the changes of structure of corporate financing in Poland and Europe. Enterprises have resorted to bank loans to a lesser degree than in times of better market situation. In mining, public companies have increased their crediting, while in private sector the tendency has been reverse. Enterprises tend to use more flexible debiting forms as compared to credits by way of issue of long-term corporate bonds. Mining companies have developed issue programs that are to be implemented over three-year periods. Before, only Katowicki Holding Węglowy [Katowice Mining Holding] had issued bonds. The present publication is an attempt at assessing the changes in the structure of corporate financing within the mining sector in the circumstances of economic slowdown. The changes have been assessed against the background of changes in the structure of financing of other business entities. Three problems have been identified and subjected to research. The first concerns the increasing share of equity capital in the structure of corporate financing in mining enterprises. The second issue concerns the scope of corporate crediting. And the third issue relates to the time structure of corporate debt. The said issues have been analysed in the conditions of economic slowdown

Timetabling: A Shared Services Model

ERIC Educational Resources Information Center

O'Regan, Carmel

2012-01-01

This paper identifies common timetabling issues and options as experienced in Australian universities, and develops a rationale to inform management decisions on a suitable system and the associated policies, procedures, management structure and resources at the University of Newcastle, to enable more effective timetabling in line with the needs…

INFLUENCE OF DIET ON THE PERFORMANCE OF BOVINE FECAL POLLUTION DETECTION METHODS AND MICROBIAL POPULATION STRUCTURE

EPA Science Inventory

ABSTRACT Background and Aims. Waterborne diseases originating from bovine fecal material are a significant public health issue. Ensuring water quality requires the use of methods that can consistently identify pollution across a broad range of management practices. One practi...

Clinical ethics issues in HIV care in Canada: an institutional ethnographic study.

PubMed

Kaposy, Chris; Greenspan, Nicole R; Marshall, Zack; Allison, Jill; Marshall, Shelley; Kitson, Cynthia

2017-02-06

This is a study involving three HIV clinics in the Canadian provinces of Newfoundland and Labrador, and Manitoba. We sought to identify ethical issues involving health care providers and clinic clients in these settings, and to gain an understanding of how different ethical issues are managed by these groups. We used an institutional ethnographic method to investigate ethical issues in HIV clinics. Our researcher conducted in-depth semi-structured interviews, compiled participant observation notes, and studied health records in order to document ethical issues in the clinics, and to understand how health care providers and clinic clients manage and resolve these issues. We found that health care providers and clinic clients have developed work processes for managing ethical issues of various types: conflicts between client-autonomy and public health priorities ("treatment as prevention"), difficulties associated with the criminalization of nondisclosure of HIV positive status, challenges with non-adherence to HIV treatment, the protection of confidentiality, barriers to treatment access, and negative social determinants of health and well-being. Some ethical issues resulted from structural disadvantages experienced by clinic clients. The most striking findings in our study were the negative social determinants of health and well-being experienced by some clinic clients - such as experiences of violence and trauma, poverty, racism, colonization, homelessness, and other factors affecting well-being such as problematic substance use. These negative determinants were at the root of other ethical issues, and are themselves of ethical concern.

Blended near-optimal tools for flexible water resources decision making

NASA Astrophysics Data System (ADS)

Rosenberg, David

2015-04-01

State-of-the-art systems analysis techniques focus on efficiently finding optimal solutions. Yet an optimal solution is optimal only for the static modelled issues and managers often seek near-optimal alternatives that address un-modelled or changing objectives, preferences, limits, uncertainties, and other issues. Early on, Modelling to Generate Alternatives (MGA) formalized near-optimal as performance within a tolerable deviation from the optimal objective function value and identified a few maximally-different alternatives that addressed select un-modelled issues. This paper presents new stratified, Monte Carlo Markov Chain sampling and parallel coordinate plotting tools that generate and communicate the structure and full extent of the near-optimal region to an optimization problem. Plot controls allow users to interactively explore region features of most interest. Controls also streamline the process to elicit un-modelled issues and update the model formulation in response to elicited issues. Use for a single-objective water quality management problem at Echo Reservoir, Utah identifies numerous and flexible practices to reduce the phosphorus load to the reservoir and maintain close-to-optimal performance. Compared to MGA, the new blended tools generate more numerous alternatives faster, more fully show the near-optimal region, help elicit a larger set of un-modelled issues, and offer managers greater flexibility to cope in a changing world.

Health Care Financing In Iran; Is Privatization A Good Solution?

PubMed Central

Davari, M; Haycox, A; Walley, T

2012-01-01

Background: This paper considers a range of issues related to the financing of health care system and relevant government policies in Iran. Methods: This study used mixed methods. A systematic literature review was undertaken to identify relevant publications. This was supplemented by hand searching in books and journals, including government publications. The issues and uncertainties identified in the literature were explored in detail through semi-structured interviews with key informants. These were triangulated with empirical evidence in the form of the literature, government statistics and independent expert opinions to validate the views expressed in the interviews. Results: The systematic review of published literature showed that no previous publication has addressed issues relating to the financing of healthcare services in Iran. However, a range of opinion pieces outlined issues to be explored further in the interviews. Such issues summarised into four main categories. Conclusion: The health care market in Iran has faced a period in which financial issues have enhanced managerial complexity. Privatization of health care services would appear to be a step too far in assisting the system to confront its challenges at the current time. The most important step toward solving such challenges is to focus on a feasible, relevant and comprehensive policy, which optimises the use of health care resources in Iran. PMID:23113205

Health care financing in iran; is privatization a good solution?

PubMed

Davari, M; Haycox, A; Walley, T

2012-01-01

This paper considers a range of issues related to the financing of health care system and relevant government policies in Iran. This study used mixed methods. A systematic literature review was undertaken to identify relevant publications. This was supplemented by hand searching in books and journals, including government publications. The issues and uncertainties identified in the literature were explored in detail through semi-structured interviews with key informants. These were triangulated with empirical evidence in the form of the literature, government statistics and independent expert opinions to validate the views expressed in the interviews. The systematic review of published literature showed that no previous publication has addressed issues relating to the financing of healthcare services in Iran. However, a range of opinion pieces outlined issues to be explored further in the interviews. Such issues summarised into four main categories. The health care market in Iran has faced a period in which financial issues have enhanced managerial complexity. Privatization of health care services would appear to be a step too far in assisting the system to confront its challenges at the current time. The most important step toward solving such challenges is to focus on a feasible, relevant and comprehensive policy, which optimises the use of health care resources in Iran.

The expanding universe of thiolated gold nanoclusters and beyond.

PubMed

Jiang, De-en

2013-08-21

Thiolated gold nanoclusters form a universe of their own. Researchers in this field are constantly pushing the boundary of this universe by identifying new compositions and in a few "lucky" cases, solving their structures. Such solved structures, even if there are only few, provide important hints for predicting the many identified compositions that are yet to be crystallized or structure determined. Structure prediction is the most pressing issue for a computational chemist in this field. The success of the density functional theory method in gauging the energetic ordering of isomers for thiolated gold clusters has been truly remarkable, but to predict the most stable structure for a given composition remains a great challenge. In this feature article from a computational chemist's point of view, the author shows how one understands and predicts structures for thiolated gold nanoclusters based on his old and new results. To further entertain the reader, the author also offers several "imaginative" structures, claims, and challenges for this field.

A network model of the interbank market

NASA Astrophysics Data System (ADS)

Li, Shouwei; He, Jianmin; Zhuang, Yaming

2010-12-01

This work introduces a network model of an interbank market based on interbank credit lending relationships. It generates some network features identified through empirical analysis. The critical issue to construct an interbank network is to decide the edges among banks, which is realized in this paper based on the interbank’s degree of trust. Through simulation analysis of the interbank network model, some typical structural features are identified in our interbank network, which are also proved to exist in real interbank networks. They are namely, a low clustering coefficient and a relatively short average path length, community structures, and a two-power-law distribution of out-degree and in-degree.

Surface Modeling, Grid Generation, and Related Issues in Computational Fluid Dynamic (CFD) Solutions

NASA Technical Reports Server (NTRS)

Choo, Yung K. (Compiler)

1995-01-01

The NASA Steering Committee for Surface Modeling and Grid Generation (SMAGG) sponsored a workshop on surface modeling, grid generation, and related issues in Computational Fluid Dynamics (CFD) solutions at Lewis Research Center, Cleveland, Ohio, May 9-11, 1995. The workshop provided a forum to identify industry needs, strengths, and weaknesses of the five grid technologies (patched structured, overset structured, Cartesian, unstructured, and hybrid), and to exchange thoughts about where each technology will be in 2 to 5 years. The workshop also provided opportunities for engineers and scientists to present new methods, approaches, and applications in SMAGG for CFD. This Conference Publication (CP) consists of papers on industry overview, NASA overview, five grid technologies, new methods/ approaches/applications, and software systems.

Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study.

PubMed

McLennan, Stuart; Schwappach, David; Harder, Yves; Staender, Sven; Elger, Bernice

2017-08-01

To identify the spectrum of patient safety issues in office-based surgery and anaesthesia in Switzerland. Purposive sample of 23 experts in surgery and anaesthesia and quality and regulation in Switzerland. Data were collected via individual qualitative interviews using a researcher-developed semi-structured interview guide between March 2016 and September 2016. Interviews were transcribed and analysed using conventional content analysis. Issues were categorised under the headings "structure", "process", and "outcome". Experts identified two key overarching patient safety and regulatory issues in relation to office-based surgery and anaesthesia in Switzerland. First, experts repeatedly raised the current lack of data and transparency of the setting. It is unknown how many surgeons are operating in offices, how many and what types of operations are being done, and what the outcomes are. Secondly, experts also noted the limited oversight and regulation of the setting. While some standards exists, most experts felt that more minimal safety standards are needed regarding the requirements that must be met to do office-based surgery and what can and cannot be done in the office-based setting are needed, but they advocated a self-regulatory approach. There is a lack of empirical data regarding the quantity and quality office-based surgery and anaesthesia in Switzerland. Further research is needed to address these research gaps and inform health policy in relation to patient safety in office-based surgery and anaesthesia in Switzerland. Copyright © 2017. Published by Elsevier GmbH.

A scoping review identifying contemporary issues in rural nursing leadership.

PubMed

Bish, Melanie; Kenny, Amanda; Nay, Rhonda

2012-12-01

Rural nurse leaders on a global scale are being challenged to create structures and processes to enable excellence in nursing care. The purpose of this scoping review is to offer an indication of the available literature relating to contemporary issues in rural nursing leadership. A review of contemporary issues facing rural nurse leaders is timely to assist strategy development that will achieve the goal of excellence in nursing. An interpretative scoping literature review methodological framework has been used with an emphasis on thematic construction. Literature published between 2008 and 2012 was reviewed from five electronic databases using the key words rural, nursing, and leadership. Four themes have been identified: expectations of rural nursing leadership, a highly educated workforce, competing interests, and partnering within rural healthcare systems. The content may resonate with rural nurse leaders and encourage a greater awareness of their relevance to leadership practices. The findings provide a greater awareness and understanding of contemporary issues facing rural nurse leaders and may assist with the development of context-sensitive leadership strategies to facilitate excellence in nursing care. © 2012 Sigma Theta Tau International.

Agricultural conservation planning framework: 3. Land use and field boundary database development and structure

USDA-ARS?s Scientific Manuscript database

Conservation planning information is important in identifying options for watershed water quality improvement, and can be developed for use at field, farm, and watershed scales. Translation across scales is a key issue impeding progress at watershed scales because watershed improvement goals must be...

Integrated inventory and monitoring

Treesearch

George Lightner; Hans T. Schreuder; Barry Bollenbacher; Kerry McMenus

2001-01-01

Understanding and inventorying our ecological systems is key to addressing how issues, questions, and management actions will affect the composition, structure, and function of these systems. Taking an ecological systems approach to the inventory and monitoring framework, is one which we feel will allow answers to currently identified management questions and new ones...

The Sociocultural Context of English Language Teaching in the Gulf.

ERIC Educational Resources Information Center

Syed, Zafar

2003-01-01

Discusses the challenges faced by English-as-a-Foreign-Language teachers in the Arabian Gulf. Seeks to identify structural and contextual issues that have contributed to the present state of language education there. Focuses on four central contributing aspects; contextual framework, human resource development, systems and standards, and research…

Politics, Planning and Regionalism.

ERIC Educational Resources Information Center

Zukosky, Jerome

The concept of regionalism identifies the issues in public affairs pertaining to a region and develops structures through which citizens can participate in the decisionmaking process. This speech describes educational decisions in the State of New York as affected by local decentralization and by concentration of power at the State level. Relevant…

Perceptions of Physical Activity by Older Adults: A Qualitative Study

ERIC Educational Resources Information Center

Jancey, Jonine M.; Clarke, Ann; Howat, Peter; Maycock, Bruce; Lee, Andy H.

2009-01-01

Objective: To identify issues and perceptions concerning physical activity in older adults. Design: Qualitative study. Setting: Perth, Western Australia. Methods: Sixteen adults aged 65 to 74 years were interviewed in their own homes using a semi-structured interview schedule. Data were analysed using a descriptive qualitative methodology.…

Teaching in Middle School Technology Education: A Review of Recent Practices

ERIC Educational Resources Information Center

Sherman, Thomas M.; Sanders, Mark; Kwon, Hyuksoo

2010-01-01

We review articles published between 1995 and 2008 in four journals that are the primary scholarly resources for Technology Education middle school teaching. This descriptive study identified four main issues that scholars addressed: what should be taught in middle school, the structure and content of curriculum transformation, integrating…

Health Care Providers and Dying Patients: Critical Issues in Terminal Care.

ERIC Educational Resources Information Center

Benoliel, Jeanne Quint

1988-01-01

Identifies three major areas of concern in relationship between health care providers and dying patients: (1) nature of difficulties and stresses associated with terminal care; (2) education of providers for work; and (3) influence of organizational structure and institutionalized values on services for dying patients and families. Reviews…

Controversial Issues: Identifying the Concerns and Priorities of Student Teachers

ERIC Educational Resources Information Center

Woolley, Richard

2011-01-01

The theoretical framework of this article considers the significant place of education in the socialisation and enculturation of children. This requires that student teachers develop critical pedagogies as a means of promoting equity, pupil voice and democratic structures in schools. Key to this is Cole's concept of "isms" and…

Conversational Coherency. Technical Report No. 95.

ERIC Educational Resources Information Center

Reichman, Rachel

To analyze the process involved in maintaining conversational coherency, the study described in this paper used a construct called a "context space" that grouped utterances referring to a single issue or episode. The paper defines the types of context spaces, parses individual conversations to identify the underlying model or structure,…

77 FR 46935 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

...-0414; Directorate Identifier 2011-NM-210-AD; Amendment 39-17138; AD 2012-15-09] RIN 2120-AA64... calculated fatigue lives. This AD replaces certain slat extension eccentric bolts with new bolts. We are issuing this AD to prevent fatigue cracking, which could result in the loss of structural integrity of the...

Pathways to Knowledge Work.

ERIC Educational Resources Information Center

Cully, Mark

A study examined how the occupational structure of the Australian labor market evolved and how individuals fared in the process. It identified issues in defining skill and knowledge and followed Elias and McKnight (2001) in stating that sufficient evidence showed a very high correlation between job-required cognitive ability and ordinal skill…

Institutionalizing Environmental Scanning in the ED QUEST Process.

ERIC Educational Resources Information Center

Morrison, James L.

An environmental scanning system is structured to identify and evaluate trends, events, and emerging issues. QUEST represents the quick environmental scanning technique, and an ED QUEST process enables an educational organization to clarify its future and define its options. This paper describes how an educational organization can establish an…

Secondary Schools in Canada: The National Report of the Exemplary Schools Project.

ERIC Educational Resources Information Center

Gaskell, Jane

The Exemplary Schools Project was a national cooperative project that identified successful Canadian secondary schools and analyzed their practices to suggest policy implications. Five issues were examined: the meaning and recognition of success; interactions between the school and its context; the influence of school structures, processes, and…

Relationship Enhancement Therapy: A Case Study for Treating Vaginismus.

ERIC Educational Resources Information Center

Harman, Marsha J.; And Others

1994-01-01

A case study of Relationship Enhancement (RE) therapy with a couple, in which the woman was identified as having vaginismus, is presented including excerpts of transcripts from the therapy sessions. RE's effectiveness at improving communication skills and providing structure in which the couple could discuss the intimate issues affecting the…

17 CFR 229.1103 - (Item 1103) Transaction summary and risk factors.

Code of Federal Regulations, 2012 CFR

2012-04-01

... if doing so will aid understanding. Consider using diagrams to illustrate the relationships among the parties, the structure of the securities offered (including, for example, the flow of funds or any... securities may be issued. (v) Identify the distribution frequency on the securities. (vi) Summarize the flow...

17 CFR 229.1103 - (Item 1103) Transaction summary and risk factors.

Code of Federal Regulations, 2013 CFR

2013-04-01

... if doing so will aid understanding. Consider using diagrams to illustrate the relationships among the parties, the structure of the securities offered (including, for example, the flow of funds or any... securities may be issued. (v) Identify the distribution frequency on the securities. (vi) Summarize the flow...

17 CFR 229.1103 - (Item 1103) Transaction summary and risk factors.

Code of Federal Regulations, 2014 CFR

2014-04-01

... if doing so will aid understanding. Consider using diagrams to illustrate the relationships among the parties, the structure of the securities offered (including, for example, the flow of funds or any... securities may be issued. (v) Identify the distribution frequency on the securities. (vi) Summarize the flow...

Kim Davis: A Mother's Dilemma.

ERIC Educational Resources Information Center

Hudecki, Michael S.

2000-01-01

Presents a discussion case in which parents must decide whether or not to enroll their sons in an experimental treatment program for muscular dystrophy. Identifies teaching objectives and discusses the key issues of the case--muscle structure and function, muscular dystrophy, scientists and money, scientific method and the FDA, and family health…

Contemporary Issues in Cognitive Psychology: The Loyola Symposium.

ERIC Educational Resources Information Center

Solso, Robert L. , Ed.

Contributions in the first section of this volume are: "Learning to Identify Toy Block Structures" by Patrick Winston; "Beyond the Yellow-Volkswagen Detector and the Grandmother Cell: A General Strategy for the Exploration of Operations in Human Pattern Recognition" by Naomi Weisstein; "Visual Recognition in a Theory of Information Processing" by…

Contracts to devolve health services in fragile states and developing countries: do ethics matter?

PubMed

Jayasinghe, S

2009-09-01

Fragile states and developing countries increasingly contract out health services to non-state providers (NSPs) (such as non-governmental organisations, voluntary sector and private sector). The paper identifies ethical issues when contracts involve devolution of health services to NSPs and proposes procedures to prevent or resolve these ethical dilemmas. Ethical issues were identified by examining processes of contracting out. Health needs could be used to select areas to be contracted out and to identify service needs. Health needs comprise "disease-burden-related needs", "health-service needs", and "urgency of health-service needs". The mix of services should include an analysis of cost-effectiveness. NSPs should be selected fairly, without bias, and conflicts of interest during their work must be avoided. The population's views must be respected and accountability structures established. Devolved health services should ensure equity of access to healthcare. The services ought to be sustainable and evaluated objectively. Of these issues, conflicts of interest among NSPs and sustainability of health services have not attracted attention in the literature on ethics of health policy. Fair procedures could address these ethical issues-for example, public consultation on issues; decisions based on the public consultation and made on evidence; principles of decisions stated and reasonable; decisions given adequate publicity; a mechanism established to challenge decisions; assurance that mechanisms meet the above conditions; and regular review of the policies. These procedures are complemented by improving self-governance of NSPs, countries' development of guidelines for devolving health services, and measures to educate the public of the client countries on these issues.

Ethical and methodological issues in research with Sami experiencing disability.

PubMed

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.

Information Issues and Contexts that Impair Team Based Communication Workflow: A Palliative Sedation Case Study.

PubMed

Cornett, Alex; Kuziemsky, Craig

2015-01-01

Implementing team based workflows can be complex because of the scope of providers involved and the extent of information exchange and communication that needs to occur. While a workflow may represent the ideal structure of communication that needs to occur, information issues and contextual factors may impact how the workflow is implemented in practice. Understanding these issues will help us better design systems to support team based workflows. In this paper we use a case study of palliative sedation therapy (PST) to model a PST workflow and then use it to identify purposes of communication, information issues and contextual factors that impact them. We then suggest how our findings could inform health information technology (HIT) design to support team based communication workflows.

Understanding new media. Trends and issues in electronic distribution of information

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

Compaine, B.M.

The authors provide an indepth look at the changes facing information businesses, which have expanded from the traditional publishing and broadcasting companies to include financial service businesses, retailers, and telecommunications carriers. Offering a unique conceptual framework - the information business map - this book stresses the political and regulatory forces that are reshaping the information industry's structure, identifies the issues that face strategic planners and policymakers, and suggests policy options and their potential consequences for the future. Each article provides a selected bibliography. 37 figures, 10 tables.

Microwave power transmission system studies. Volume 3, section 8: Mechanical systems and flight operations

NASA Technical Reports Server (NTRS)

Maynard, O. E.; Brown, W. C.; Edwards, A.; Haley, J. T.; Meltz, G.; Howell, J. M.; Nathan, A.

1975-01-01

The efforts and recommendations associated with preliminary design and concept definition for mechanical systems and flight operations are presented. Technical discussion in the areas of mission analysis, antenna structural concept, configuration analysis, assembly and packaging with associated costs are presented. Technology issues for the control system, structural system, thermal system and assembly including cost and man's role in assembly and maintenance are identified. Background and desired outputs for future efforts are discussed.

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

PubMed

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

2017-12-01

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

Feasibility Study of a Satellite Solar Power Station

NASA Technical Reports Server (NTRS)

Glaser, P. E.; Maynard, O. E.; Mackovciak, J. J. R.; Ralph, E. I.

1974-01-01

A feasibility study of a satellite solar power station (SSPS) was conducted to: (1) explore how an SSPS could be flown and controlled in orbit; (2) determine the techniques needed to avoid radio frequency interference (RFI); and (3) determine the key environmental, technological, and economic issues involved. Structural and dynamic analyses of the SSPS structure were performed, and deflections and internal member loads were determined. Desirable material characteristics were assessed and technology developments identified. Flight control performance of the SSPS baseline design was evaluated and parametric sizing studies were performed. The study of RFI avoidance techniques covered (1) optimization of the microwave transmission system; (2) device design and expected RFI; and (3) SSPS RFI effects. The identification of key issues involved (1) microwave generation, transmissions, and rectification and solar energy conversion; (2) environmental-ecological impact and biological effects; and (3) economic issues, i.e., costs and benefits associated with the SSPS. The feasibility of the SSPS based on the parameters of the study was established.

Structuring policy problems for plastics, the environment and human health: reflections from the UK

PubMed Central

Shaxson, Louise

2009-01-01

How can we strengthen the science–policy interface for plastics, the environment and human health? In a complex policy area with multiple stakeholders, it is important to clarify the nature of the particular plastics-related issue before trying to understand how to reconcile the supply and demand for evidence in policy. This article proposes a simple problem typology to assess the fundamental characteristics of a policy issue and thus identify appropriate processes for science–policy interactions. This is illustrated with two case studies from one UK Government Department, showing how policy and science meet over the environmental problems of plastics waste in the marine environment and on land. A problem-structuring methodology helps us understand why some policy issues can be addressed through relatively linear flows of science from experts to policymakers but why others demand a more reflexive approach to brokering the knowledge between science and policy. Suggestions are given at the end of the article for practical actions that can be taken on both sides. PMID:19528061

Structuring policy problems for plastics, the environment and human health: reflections from the UK.

PubMed

Shaxson, Louise

2009-07-27

How can we strengthen the science-policy interface for plastics, the environment and human health? In a complex policy area with multiple stakeholders, it is important to clarify the nature of the particular plastics-related issue before trying to understand how to reconcile the supply and demand for evidence in policy. This article proposes a simple problem typology to assess the fundamental characteristics of a policy issue and thus identify appropriate processes for science-policy interactions. This is illustrated with two case studies from one UK Government Department, showing how policy and science meet over the environmental problems of plastics waste in the marine environment and on land. A problem-structuring methodology helps us understand why some policy issues can be addressed through relatively linear flows of science from experts to policymakers but why others demand a more reflexive approach to brokering the knowledge between science and policy. Suggestions are given at the end of the article for practical actions that can be taken on both sides.

Appropriate evidence sources for populating decision analytic models within health technology assessment (HTA): a systematic review of HTA manuals and health economic guidelines.

PubMed

Zechmeister-Koss, Ingrid; Schnell-Inderst, Petra; Zauner, Günther

2014-04-01

An increasing number of evidence sources are relevant for populating decision analytic models. What is needed is detailed methodological advice on which type of data is to be used for what type of model parameter. We aim to identify standards in health technology assessment manuals and economic (modeling) guidelines on appropriate evidence sources and on the role different types of data play within a model. Documents were identified via a call among members of the International Network of Agencies for Health Technology Assessment and by hand search. We included documents from Europe, the United States, Canada, Australia, and New Zealand as well as transnational guidelines written in English or German. We systematically summarized in a narrative manner information on appropriate evidence sources for model parameters, their advantages and limitations, data identification methods, and data quality issues. A large variety of evidence sources for populating models are mentioned in the 28 documents included. They comprise research- and non-research-based sources. Valid and less appropriate sources are identified for informing different types of model parameters, such as clinical effect size, natural history of disease, resource use, unit costs, and health state utility values. Guidelines do not provide structured and detailed advice on this issue. The article does not include information from guidelines in languages other than English or German, and the information is not tailored to specific modeling techniques. The usability of guidelines and manuals for modeling could be improved by addressing the issue of evidence sources in a more structured and comprehensive format.

Identification of dynamic load for prosthetic structures.

PubMed

Zhang, Dequan; Han, Xu; Zhang, Zhongpu; Liu, Jie; Jiang, Chao; Yoda, Nobuhiro; Meng, Xianghua; Li, Qing

2017-12-01

Dynamic load exists in numerous biomechanical systems, and its identification signifies a critical issue for characterizing dynamic behaviors and studying biomechanical consequence of the systems. This study aims to identify dynamic load in the dental prosthetic structures, namely, 3-unit implant-supported fixed partial denture (I-FPD) and teeth-supported fixed partial denture. The 3-dimensional finite element models were constructed through specific patient's computerized tomography images. A forward algorithm and regularization technique were developed for identifying dynamic load. To verify the effectiveness of the identification method proposed, the I-FPD and teeth-supported fixed partial denture structures were investigated to determine the dynamic loads. For validating the results of inverse identification, an experimental force-measuring system was developed by using a 3-dimensional piezoelectric transducer to measure the dynamic load in the I-FPD structure in vivo. The computationally identified loads were presented with different noise levels to determine their influence on the identification accuracy. The errors between the measured load and identified counterpart were calculated for evaluating the practical applicability of the proposed procedure in biomechanical engineering. This study is expected to serve as a demonstrative role in identifying dynamic loading in biomedical systems, where a direct in vivo measurement may be rather demanding in some areas of interest clinically. Copyright © 2017 John Wiley & Sons, Ltd.

Socio-Praxis Preferences in Teacher Preparation for Child Sexual Abuse and Its Mandatory Reporting

ERIC Educational Resources Information Center

Goldman, Juliette D. G.; Grimbeek, Peter

2015-01-01

Child abuse and neglect, particularly child sexual abuse, is a pastoral care issue that deeply concerns all education professionals. The literature strongly supports specific training for pre-service teachers about child sexual abuse and its mandatory reporting, although few studies identify how such training should be academically structured.…

Issues and Strategies for Establishing Work-Integrated Learning for Multidisciplinary Teams: A Focus on Degrees in Sustainability

ERIC Educational Resources Information Center

Wilson, Robyn Fay

2015-01-01

This study was conducted to identify challenges and potential strategies to streamline work-integrated learning placements for multidisciplinary teams of students undertaking degrees in sustainability. Face-to-face interviews using a semi-structured questionnaire were conducted with 15 academics and senior university staff, from four universities…

Growth of a Science Center: The Center for Science and Mathematics Education (CESAME) at Stony Brook University

ERIC Educational Resources Information Center

Gafney, Leo; Bynum, R. David; Sheppard, Keith

2015-01-01

This report describes the origin and development of CESAME (The Center for Science and Mathematics Education) at Stony Brook University. The analysis identifies key ingredients in areas of personnel, funding, organizational structures, educational priorities, collaboration, and institutionalization. After a discussion of relevant issues in…

Competence to make treatment decisions in anorexia nervosa: thinking processes and values

PubMed Central

Tan, Dr. Jacinta O. A.; Hope, Professor Tony; Stewart, Dr. Anne; Fitzpatrick, Professor Raymond

2005-01-01

This paper explores the ethical and conceptual implications of the findings from an empirical study of decision-making capacity in anorexia nervosa. In the study, ten female patients aged 13 to 21 years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semi-structured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient participants were also tested using the MacCAT-T test of competence. This is a formalised, structured interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief self-administered questionnaires to assess their levels of psychopathology. The issues identified from the interviews are described under two headings: difficulties with thought processing, and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches or current standardised tests of competence. PMID:18066393

Parenting style and practices in stepfamilies

PubMed Central

Cassoni, Cynthia; Caldana, Regina HL

2012-01-01

There are several studies on the best way to raise a child, ie, what would be the consequences of our actions for our children. We tend to think of how to educate children in a traditional family, but society has undergone many changes and, hence, family structures have undergone changes too. Today, we find a large number of stepfamilies facing the same issues concerning how to educate a child. Stepfamily configuration often entails more than just the addition of a new parent figure. The objective of this study was to shed some light on how these stepfamilies deal with issues of parenting style and practices. We reviewed the Brazilian and international literature concerning parenting styles and practices in stepfamilies. The papers identified were organized and submitted to analysis. We identified very few papers addressing parenting styles and practices, pointing to an important but unaddressed social change as reflected in new family structures. There is a need for longitudinal studies aimed at understanding not only a particular moment in time, but also moments within a context, ie, an analysis with a holistic approach without preconceived ideas. PMID:22977315

Man-machine interface analysis of the flight design system

NASA Technical Reports Server (NTRS)

Ramsey, H. R.; Atwood, M. E.; Willoughby, J. K.

1978-01-01

The objective of the current effort was to perform a broad analysis of the human factors issues involved in the design of the Flight Design System (FDS). The analysis was intended to include characteristics of the system itself, such as: (1) basic structure and functional capabilities of FDS; (2) user backgrounds, capabilities, and possible modes of use; (3) FDS interactive dialogue, problem solving aids; (4) system data management capabilities; and to include, as well, such system related matters as: (1) flight design team structure; (2) roles of technicians; (3) user training; and (4) methods of evaluating system performance. Wherever possible, specific recommendations are made. In other cases, the issues which seem most important are identified. In some cases, additional analyses or experiments which might provide resolution are suggested.

Blended near-optimal alternative generation, visualization, and interaction for water resources decision making

NASA Astrophysics Data System (ADS)

Rosenberg, David E.

2015-04-01

State-of-the-art systems analysis techniques focus on efficiently finding optimal solutions. Yet an optimal solution is optimal only for the modeled issues and managers often seek near-optimal alternatives that address unmodeled objectives, preferences, limits, uncertainties, and other issues. Early on, Modeling to Generate Alternatives (MGA) formalized near-optimal as performance within a tolerable deviation from the optimal objective function value and identified a few maximally different alternatives that addressed some unmodeled issues. This paper presents new stratified, Monte-Carlo Markov Chain sampling and parallel coordinate plotting tools that generate and communicate the structure and extent of the near-optimal region to an optimization problem. Interactive plot controls allow users to explore region features of most interest. Controls also streamline the process to elicit unmodeled issues and update the model formulation in response to elicited issues. Use for an example, single-objective, linear water quality management problem at Echo Reservoir, Utah, identifies numerous and flexible practices to reduce the phosphorus load to the reservoir and maintain close-to-optimal performance. Flexibility is upheld by further interactive alternative generation, transforming the formulation into a multiobjective problem, and relaxing the tolerance parameter to expand the near-optimal region. Compared to MGA, the new blended tools generate more numerous alternatives faster, more fully show the near-optimal region, and help elicit a larger set of unmodeled issues.

Managing crisis: the role of primary care for people with serious mental illness.

PubMed

Lester, Helen; Tritter, Jonathan Q; Sorohan, Helen

2004-01-01

More than 30% of patients with serious mental illness in the United Kingdom now receive all their health care solely from primary care. This study explored the process of managing acute mental health crises from the dual perspective of patients and primary care health professionals. Eighteen focus groups involving 45 patients, 39 general practitioners, and eight practice nurses were held between May and November 2002 in six Primary Care Trusts across the British West Midlands. The topic guide explored perceptions of gold standard care, current issues and critical incidents in receiving/providing care, and ideas on improving services. Themes relevant to the management of acute crisis included issues of process, such as access, advocacy, communication, continuity, and coordination of care; the development of more structured care that might reduce the need for crisis responses; and issues raised by the development of a more structured approach to care. Access to services is a complicated yet crucial feature of managing care in a crisis, with patients identifying barriers at the level of primary care and health professionals at the interface with secondary care. The development of more structured systems as a solution may generate its own ethical and pragmatic challenges.

Control-Structure-Interaction (CSI) technologies and trends to future NASA missions

NASA Technical Reports Server (NTRS)

1990-01-01

Control-structure-interaction (CSI) issues which are relevant for future NASA missions are reviewed. This goal was achieved by: (1) reviewing large space structures (LSS) technologies to provide a background and survey of the current state of the art (SOA); (2) analytically studying a focus mission to identify opportunities where CSI technology may be applied to enhance or enable future NASA spacecraft; and (3) expanding a portion of the focus mission, the large antenna, to provide in-depth trade studies, scaling laws, and methodologies which may be applied to other NASA missions. Several sections are presented. Section 1 defines CSI issues and presents an overview of the relevant modeling and control issues for LLS. Section 2 presents the results of the three phases of the CSI study. Section 2.1 gives the results of a CSI study conducted with the Geostationary Platform (Geoplat) as the focus mission. Section 2.2 contains an overview of the CSI control design methodology available in the technical community. Included is a survey of the CSI ground-based experiments which were conducted to verify theoretical performance predictions. Section 2.3 presents and demonstrates a new CSI scaling law methodology for assessing potential CSI with large antenna systems.

Experiences of Agency for Healthcare Research and Quality-funded projects that implemented practices for safer patient care.

PubMed

Taylor, Stephanie L; Ridgely, M Susan; Greenberg, Michael D; Sorbero, Melony E S; Teleki, Stephanie S; Damberg, Cheryl L; Farley, Donna O

2009-04-01

To synthesize lessons learned from the experiences of Agency for Healthcare Research and Quality-funded patient safety projects in implementing safe practices. Self-reported data from individual and group interviews with Original, Challenge, and Partnerships in Implementing Patient Safety (PIPS) grantees, from 2003 to 2006. Interviews with three grantee groups (n=60 total) implementing safe practice projects, with comparisons on factors influencing project implementation and sustainability. Semi-structured protocols contained open-ended questions on lessons learned and more structured questions on factors associated with project implementation and sustainability. The grantees shared common experiences, frequently identifying lessons learned regarding structural components needing to be in place before implementation, components of the implementation process, components of interventions' results needed for sustainability, changes in timelines or activities, unanticipated issues, and staff acceptance/adoption. Also, fewer Original grants had many of the factors related project to implementation/sustainability than the PIPS or Challenge grantees had. Although much of what was reported seemed like common sense, surprisingly few projects actually planned for or expected many of the barriers or facilitators they experienced during their project implementation. Others implementing practice improvements likely will share the experiences and issues identified by these implementation projects and can learn from their lessons.

Identify High-Quality Protein Structural Models by Enhanced K-Means.

PubMed

Wu, Hongjie; Li, Haiou; Jiang, Min; Chen, Cheng; Lv, Qiang; Wu, Chuang

2017-01-01

Background. One critical issue in protein three-dimensional structure prediction using either ab initio or comparative modeling involves identification of high-quality protein structural models from generated decoys. Currently, clustering algorithms are widely used to identify near-native models; however, their performance is dependent upon different conformational decoys, and, for some algorithms, the accuracy declines when the decoy population increases. Results. Here, we proposed two enhanced K -means clustering algorithms capable of robustly identifying high-quality protein structural models. The first one employs the clustering algorithm SPICKER to determine the initial centroids for basic K -means clustering ( SK -means), whereas the other employs squared distance to optimize the initial centroids ( K -means++). Our results showed that SK -means and K -means++ were more robust as compared with SPICKER alone, detecting 33 (59%) and 42 (75%) of 56 targets, respectively, with template modeling scores better than or equal to those of SPICKER. Conclusions. We observed that the classic K -means algorithm showed a similar performance to that of SPICKER, which is a widely used algorithm for protein-structure identification. Both SK -means and K -means++ demonstrated substantial improvements relative to results from SPICKER and classical K -means.

Identify High-Quality Protein Structural Models by Enhanced K-Means

PubMed Central

Li, Haiou; Chen, Cheng; Lv, Qiang; Wu, Chuang

2017-01-01

Background. One critical issue in protein three-dimensional structure prediction using either ab initio or comparative modeling involves identification of high-quality protein structural models from generated decoys. Currently, clustering algorithms are widely used to identify near-native models; however, their performance is dependent upon different conformational decoys, and, for some algorithms, the accuracy declines when the decoy population increases. Results. Here, we proposed two enhanced K-means clustering algorithms capable of robustly identifying high-quality protein structural models. The first one employs the clustering algorithm SPICKER to determine the initial centroids for basic K-means clustering (SK-means), whereas the other employs squared distance to optimize the initial centroids (K-means++). Our results showed that SK-means and K-means++ were more robust as compared with SPICKER alone, detecting 33 (59%) and 42 (75%) of 56 targets, respectively, with template modeling scores better than or equal to those of SPICKER. Conclusions. We observed that the classic K-means algorithm showed a similar performance to that of SPICKER, which is a widely used algorithm for protein-structure identification. Both SK-means and K-means++ demonstrated substantial improvements relative to results from SPICKER and classical K-means. PMID:28421198

Key barriers to the use of modern contraceptives among women in Albania: a qualitative study.

PubMed

Kragelund Nielsen, Karoline; Nielsen, Siff Malue; Butler, Robb; Lazarus, Jeffrey V

2012-12-01

In spite of a number of communication campaigns since 1999 promoting modern contraceptives in Albania, their use remains low. In this paper we identify and analyse key barriers to the use of modern contraception among women in Albania. Semi-structured interviews with 11 stakeholders from organisations involved in promoting modern contraception, and four focus group discussions with 40 women from Tirana and a rural village in the periphery of Tirana, divided according to age and residence, were also conducted. Content analysis was used to analyse both the interviews and focus group discussions. Barriers identified included socio-cultural issues such as status of the relationship with partners and the importance of virginity, problems talking about sexual issues and contraception being taboo, health care issues--especially cost and availability--and individual issues such as unfavourable social attitudes towards contraceptives and a lack of knowledge about the use and benefits of modern contraception. To promote contraceptive use in the future, campaigns should address these barriers and expand from a focus on women of reproductive age only to target youth, men, health care providers, parents and schoolteachers as well. Copyright © 2012 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Ethical and methodological issues in research with Sami experiencing disability.

PubMed

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.

Ethical and methodological issues in research with Sami experiencing disability

PubMed Central

Melbøe, Line; Hansen, Ketil Lenert; Johnsen, Bjørn-Eirik; Fedreheim, Gunn Elin; Dinesen, Tone; Minde, Gunn-Tove; Rustad, Marit

2016-01-01

Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability. PMID:27396747

Structural considerations for solar installers : an approach for small, simplified solar installations or retrofits.

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

Richards, Elizabeth H.; Schindel, Kay; Bosiljevac, Tom

2011-12-01

Structural Considerations for Solar Installers provides a comprehensive outline of structural considerations associated with simplified solar installations and recommends a set of best practices installers can follow when assessing such considerations. Information in the manual comes from engineering and solar experts as well as case studies. The objectives of the manual are to ensure safety and structural durability for rooftop solar installations and to potentially accelerate the permitting process by identifying and remedying structural issues prior to installation. The purpose of this document is to provide tools and guidelines for installers to help ensure that residential photovoltaic (PV) power systemsmore » are properly specified and installed with respect to the continuing structural integrity of the building.« less

Supporting local planning and budgeting for maternal, neonatal and child health in the Philippines

PubMed Central

2013-01-01

Background Responsibility for planning and delivery of health services in the Philippines is devolved to the local government level. Given the recognised need to strengthen capacity for local planning and budgeting, we implemented Investment Cases (IC) for Maternal, Neonatal and Child Health (MNCH) in three selected sub-national units: two poor, rural provinces and one highly-urbanised city. The IC combines structured problem-solving by local policymakers and planners to identify key health system constraints and strategies to scale-up critical MNCH interventions with a decision-support model to estimate the cost and impact of different scaling-up scenarios. Methods We outline how the initiative was implemented, the aspects that worked well, and the key limitations identified in the sub-national application of this approach. Results Local officials found the structured analysis of health system constraints helpful to identify problems and select locally appropriate strategies. In particular the process was an improvement on standard approaches that focused only on supply-side issues. However, the lack of data available at the local level is a major impediment to planning. While the majority of the strategies recommended by the IC were incorporated into the 2011 plans and budgets in the three study sites, one key strategy in the participating city was subsequently reversed in 2012. Higher level systemic issues are likely to have influenced use of evidence in plans and budgets and implementation of strategies. Conclusions Efforts should be made to improve locally-representative data through routine information systems for planning and monitoring purposes. Even with sound plans and budgets, evidence is only one factor influencing investments in health. Political considerations at a local level and issues related to decentralisation, influence prioritisation and implementation of plans. In addition to the strengthening of capacity at local level, a parallel process at a higher level of government to relieve fund channelling and coordination issues is critical for any evidence-based planning approach to have a significant impact on health service delivery. PMID:23343218

Observations on Student Misconceptions--A Case Study of the Build-Heap Algorithm

ERIC Educational Resources Information Center

Seppala, Otto; Malmi, Lauri; Korhonen, Ari

2006-01-01

Data structures and algorithms are core issues in computer programming. However, learning them is challenging for most students and many of them have various types of misconceptions on how algorithms work. In this study, we discuss the problem of identifying misconceptions on the principles of how algorithms work. Our context is algorithm…

In the Middle of a Chain Interaction.

PubMed

Kinsella, Sinéad; Prehn, Jochen H M

2016-10-20

In this issue of Molecular Cell, Fu et al. (2016) present a detailed structural analysis of death-inducing signaling complex (DISC) assembly and regulation through flexible caspase-8 interactions with cFLIP L , cFLIP S , and the viral inhibitor MC159, thereby identifying novel apoptosis control mechanisms. Copyright © 2016 Elsevier Inc. All rights reserved.

Envisioning Schoolhouse Nostalgia and the Pastoral Retreat: A Rural Landscape Approach to Educational History

ERIC Educational Resources Information Center

Clark, Sara

2014-01-01

The role of nostalgia has been identified by those interested in the unique impact of one-room schoolhouses on historical memory and present-day fascination with the structures. Most notably, educational historian Jonathan Zimmerman explored the issue in "Small Wonder: The Little Red Schoolhouse in History and Memory" (2009). Zimmerman…

Toward Addressing the Issues of Site Selection in District Effectiveness Research: A Two-Level Hierarchical Linear Growth Model

ERIC Educational Resources Information Center

Bowers, Alex J.

2010-01-01

Purpose: District effectiveness research (DER) is an emerging field concerned with identifying the organizational structures, administration, and leadership practices at the school district level that help districts find success with all of their students across the schools within the system. This work has mirrored much of the early school…

Education and Development: The Issues and the Evidence. Education Research. Serial No. 6.

ERIC Educational Resources Information Center

Lewin, Keith M.

This literature review is divided into two main sections. The first part identifies key dimensions of the policy debate that will condition future patterns of investment in education. The themes chosen are the impact of recession, the effects of debt and structural adjustment programs on the resources available for education; the implications of…

"Change is Hard": What Science Teachers Are Telling Us about Reform and Teacher Learning of Innovative Practices.

ERIC Educational Resources Information Center

Davis, Kathleen S.

2003-01-01

Provides a critical analysis of the implementation of an innovative science curriculum at a middle school site. Explores the issues that surround teacher learning of new practices including the structures, policies, and practices that were in place within the reform context that supported or impeded teacher learning. Identifies parallels between…

Access Issues in Adult Vocational Guidance and Counselling for People at Risk of Social Exclusion. Perspectives from Two Qualitative Research Projects.

ERIC Educational Resources Information Center

Clayton, Pamela; McGill, Paul

2000-01-01

Two studies (of 105 Scottish adults returning to study and of social exclusion and lifelong learning) identified structural barriers in adult access to guidance services: rural location, disability, single parenthood, eldercare, homelessness, criminal record, and refugee status. Solutions include publicity, partnerships, outreach, and supportive…

Writing for Business: A Graduate-Level Course in Problem-Solving

ERIC Educational Resources Information Center

Seifert, Christine

2009-01-01

This paper details an assignment sequence that requires graduate students in an applied communication program to identify problems that clients may not be aware of. Good writing and good problem-solving are "inextricably linked to [a student's] ability to frame an issue, gather, and analyze information, and to structure a helpful response" (Musso,…

The Problem-Based Learning Process: Reflections of Pre-Service Elementary School Teachers

ERIC Educational Resources Information Center

Baysal, Zeliha Nurdan

2017-01-01

This study aims to identify the benefits acquired by third-year pre-service elementary school teachers participating in a problem-based learning process in social studies education, the issues they encountered in that process and those they are likely to encounter, and their feelings about the process. Semi-structured interviews were used as one…

State Sales Tax and Assistive Technology: Securing Exemptions for Sensory, Communication, and Mobility Aids.

ERIC Educational Resources Information Center

Mendelsohn, Steven

This paper examines issues involved in identifying and securing sales tax exemptions to curtail the potential negative impact of state sales taxes on assistive technology. Chapter I discusses the nature of sales taxes, including their definition, their impact, their structure and administration, and the sources of exemptions. Chapter II considers…

Use of Digital Repositories by Chemistry Researchers: Results of a Survey

ERIC Educational Resources Information Center

Polydoratou, Panayiota

2007-01-01

Purpose: This paper aims to present findings from a survey that aimed to identify the issues around the use and linkage of source and output repositories and the chemistry researchers' expectations about their use. Design/methodology/approach: This survey was performed by means of an online questionnaire and structured interviews with academic and…

77 FR 20872 - Notice of Intent to Prepare an Environmental Impact Statement: Milwaukee and Ozaukee Counties

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... project study area will be made. A series of public information meetings will be held during the project study. Public notice will be given as to the time and place of all workshops and public information... pavement and structural needs, safety issues and design deficiencies while identifying methods to...

ART/Ada design project, phase 1. Task 2 report: Detailed design

NASA Technical Reports Server (NTRS)

Allen, Bradley P.

1988-01-01

Various issues are studied in the context of the design of an Ada based expert system building tool. Using an existing successful design as a starting point, the impact is analyzed of the Ada language and Ada development methodologies on that design, the Ada system is redesigned, and its performance is analyzed using both complexity-theoretic and empirical techniques. The algorithms specified in the overall design are refined, resolving and documenting any open design issues, identifying each system module, documenting the internal architecture and control logic, and describing the primary data structures involved in the module.

Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

PubMed

Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

2018-02-01

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting ethical principles. © 2017 John Wiley & Sons Ltd.

Identifying the mathematics middle year students use as they address a community issue

NASA Astrophysics Data System (ADS)

Marshman, Margaret

2017-03-01

Middle year students often do not see the mathematics in the real world whereas the Australian Curriculum: Mathematics aims for students to be "confident and creative users and communicators of mathematics" (Australian Curriculum Assessment and Reporting Authority [ACARA] 2012). Using authentic and real mathematics tasks can address this situation. This paper is an account of how, working within a Knowledge Producing Schools' framework, a group of middle year students addressed a real community issue, the problem of the lack of a teenage safe space using mathematics and technology. Data were collected for this case study via journal observations and reflections, semi-structured interviews, samples of the students' work and videos of students working. The data were analysed by identifying the mathematics the students used determining the function and location of the space and focused on problem negotiation, formulation and solving through the statistical investigation cycle. The paper will identify the mathematics and statistics these students used as they addressed a real problem in their local community.

The cognitive nature of action - functional links between cognitive psychology, movement science, and robotics.

PubMed

Schack, Thomas; Ritter, Helge

2009-01-01

This paper examines the cognitive architecture of human action, showing how it is organized over several levels and how it is built up. Basic action concepts (BACs) are identified as major building blocks on a representation level. These BACs are cognitive tools for mastering the functional demands of movement tasks. Results from different lines of research showed that not only the structure formation of mental representations in long-term memory but also chunk formation in working memory are built up on BACs and relate systematically to movement structures. It is concluded that such movement representations might provide the basis for action implementation and action control in skilled voluntary movements in the form of cognitive reference structures. To simulate action implementation we discuss challenges and issues that arise when we try to replicate complex movement abilities in robots. Among the key issues to be addressed is the question how structured representations can arise during skill acquisition and how the underlying processes can be understood sufficiently succinctly to replicate them on robot platforms. Working towards this goal, we translate our findings in studies of motor control in humans into models that can guide the implementation of cognitive robot architectures. Focusing on the issue of manual action control, we illustrate some results in the context of grasping with a five-fingered anthropomorphic robot hand.

Discursive archaeology: constituting knowledge of militant nurses in trade associations.

PubMed

Almeida, Deybson Borba de; Silva, Gilberto Tadeu Reis da; Freitas, Genival Fernandes de; Padilha, Maria Itayra; Almeida, Igor Ferreira Borba de

2018-05-01

To analyze the constituting knowledge of militant nurses in trade associations. Historical research, based on the oral history method, with a qualitative approach carried out with 11 nurses who are/were militants for professional issues since the 1980s in the state of Bahia. The data collected through semi-structured interviews were organized in the software n-vivo 10 and analyzed based on dialectical hermeneutics. We identified pedagogical, administrative, public health, sociological, and trade union background knowledge as constituent of militant individuals. Final considerations: The constituting knowledge of militant nurses are inscribed in the Social Sciences, distanced from biomedical knowledge and power, pointing at ways for structuring nursing curricula. We identified the Brazilian Association of Nursing as a space for political formation.

University Students' Knowledge Structures and Informal Reasoning on the Use of Genetically Modified Foods: Multidimensional Analyses

NASA Astrophysics Data System (ADS)

Wu, Ying-Tien

2013-10-01

This study aims to provide insights into the role of learners' knowledge structures about a socio-scientific issue (SSI) in their informal reasoning on the issue. A total of 42 non-science major university students' knowledge structures and informal reasoning were assessed with multidimensional analyses. With both qualitative and quantitative analyses, this study revealed that those students with more extended and better-organized knowledge structures, as well as those who more frequently used higher-order information processing modes, were more oriented towards achieving a higher-level informal reasoning quality. The regression analyses further showed that the "richness" of the students' knowledge structures explained 25 % of the variation in their rebuttal construction, an important indicator of reasoning quality, indicating the significance of the role of students' sophisticated knowledge structure in SSI reasoning. Besides, this study also provides some initial evidence for the significant role of the "core" concept within one's knowledge structure in one's SSI reasoning. The findings in this study suggest that, in SSI-based instruction, science instructors should try to identify students' core concepts within their prior knowledge regarding the SSI, and then they should try to guide students to construct and structure relevant concepts or ideas regarding the SSI based on their core concepts. Thus, students could obtain extended and well-organized knowledge structures, which would then help them achieve better learning transfer in dealing with SSIs.

Tracking the Remodeling of SNOMED CT's Bacterial Infectious Diseases.

PubMed

Ochs, Christopher; Case, James T; Perl, Yehoshua

2016-01-01

SNOMED CT's content undergoes many changes from one release to the next. Over the last year SNOMED CT's Bacterial infectious disease subhierarchy has undergone significant editing to bring consistent modeling to its concepts. In this paper we analyze the stated and inferred structural modifications that affected the Bacterial infectious disease subhierarchy between the Jan 2015 and Jan 2016 SNOMED CT releases using a two-phased approach. First, we introduce a methodology for creating a human readable list of changes. Next, we utilize partial-area taxonomies, which are compact summaries of SNOMED CT's content and structure, to identify the "big picture" changes that occurred in the subhierarchy. We illustrate how partial-area taxonomies can be used to help identify groups of concepts that were affected by these editing operations and the nature of these changes. Modeling issues identified using our two-phase methodology are discussed.

Identifying States of a Financial Market

NASA Astrophysics Data System (ADS)

Münnix, Michael C.; Shimada, Takashi; Schäfer, Rudi; Leyvraz, Francois; Seligman, Thomas H.; Guhr, Thomas; Stanley, H. Eugene

2012-09-01

The understanding of complex systems has become a central issue because such systems exist in a wide range of scientific disciplines. We here focus on financial markets as an example of a complex system. In particular we analyze financial data from the S&P 500 stocks in the 19-year period 1992-2010. We propose a definition of state for a financial market and use it to identify points of drastic change in the correlation structure. These points are mapped to occurrences of financial crises. We find that a wide variety of characteristic correlation structure patterns exist in the observation time window, and that these characteristic correlation structure patterns can be classified into several typical ``market states''. Using this classification we recognize transitions between different market states. A similarity measure we develop thus affords means of understanding changes in states and of recognizing developments not previously seen.

Identifying states of a financial market.

PubMed

Münnix, Michael C; Shimada, Takashi; Schäfer, Rudi; Leyvraz, Francois; Seligman, Thomas H; Guhr, Thomas; Stanley, H Eugene

2012-01-01

The understanding of complex systems has become a central issue because such systems exist in a wide range of scientific disciplines. We here focus on financial markets as an example of a complex system. In particular we analyze financial data from the S&P 500 stocks in the 19-year period 1992-2010. We propose a definition of state for a financial market and use it to identify points of drastic change in the correlation structure. These points are mapped to occurrences of financial crises. We find that a wide variety of characteristic correlation structure patterns exist in the observation time window, and that these characteristic correlation structure patterns can be classified into several typical "market states". Using this classification we recognize transitions between different market states. A similarity measure we develop thus affords means of understanding changes in states and of recognizing developments not previously seen.

EIT: Solar corona synoptic observations from SOHO with an Extreme-ultraviolet Imaging Telescope

NASA Technical Reports Server (NTRS)

Delaboudiniere, J. P.; Gabriel, A. H.; Artzner, G. E.; Michels, D. J.; Dere, K. P.; Howard, R. A.; Catura, R.; Stern, R.; Lemen, J.; Neupert, W.

1988-01-01

The Extreme-ultraviolet Imaging Telescope (EIT) of SOHO (solar and heliospheric observatory) will provide full disk images in emission lines formed at temperatures that map solar structures ranging from the chromospheric network to the hot magnetically confined plasma in the corona. Images in four narrow bandpasses will be obtained using normal incidence multilayered optics deposited on quadrants of a Ritchey-Chretien telescope. The EIT is capable of providing a uniform one arc second resolution over its entire 50 by 50 arc min field of view. Data from the EIT will be extremely valuable for identifying and interpreting the spatial and temperature fine structures of the solar atmosphere. Temporal analysis will provide information on the stability of these structures and identify dynamical processes. EIT images, issued daily, will provide the global corona context for aid in unifying the investigations and in forming the observing plans for SOHO coronal instruments.

Ergonomics issues in national identity card for homeland security.

PubMed

Yeow, Paul H P; Yuen, Y Y; Loo, W H

2013-09-01

Ever since the 9/11 terrorist attack, many countries are considering the use of smart national identity card (SNIC) which has the ability to identify terrorists due to its biometric verification function. However, there are many ergonomics issues in the use of SNIC, e.g. card credibility. This research presents a case study survey of Malaysian users. Although most citizens (>96%) own MyKad (Malaysia SNIC), many do not carry it around and use its applications. This defeats one of its main purposes, i.e. combating terrorism. Thus, the research investigates ergonomics issues affecting the citizens' Intention to Use (ITU) MyKad for homeland security by using an extended technology acceptance model. Five hundred questionnaires were collected and analysed using structural equation modelling. Results show that perceived credibility and performance expectancy are the key issues. The findings provide many countries with insights into methods of addressing ergonomics issues and increasing adoption of SNIC for homeland security. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Health visiting and refugee families: issues in professional practice.

PubMed

Drennan, Vari M; Joseph, Judy

2005-01-01

This paper reports on the perceptions of experienced health visitors working with refugee families in Inner London. Women who are refugees and asylum seekers in the United Kingdom are more likely to experience depression than either non-refugee women or male asylum seekers. Health visitors provide a universal public health service to all women on the birth of a child, or with children aged under five, and as such are well placed to identify emotional and mental health problems of women who are refugees. Despite successive waves of refugees to the United Kingdom in the 20th century, there are no empirical studies of health visiting practice with this vulnerable group. There is also no body of evidence to inform the practice of health visitors new to working with asylum seekers and refugees. An exploratory study was undertaken in Inner London in 2001. Semi-structured interviews were conducted with a purposive sample of 13 health visitors experienced in working with women and families who are refugees. A range of structural challenges was identified that mediated against the development of a health-promoting relationship between health visitors and refugee women. With refugee families, who were living in temporary accommodation, health visitors were prioritizing basic needs that had to be addressed: in addition, they prioritized the needs of children before those of women. Health visitors were aware of the emotional needs of women and had strategies for addressing these with women in more settled circumstances. Health visitors considered themselves ill-prepared to deal with the complexities of working with women in these situations. This study identifies issues for further exploration, not least from the perspective of refugee women receiving health visiting services. Health visitors in countries receiving refugee women are framing their work with these women in ways that reflect Maslow's theory of a hierarchy of needs. This study suggests ways that public health nursing practice could be improved, and identifies issues for further study.

Identifying emerging issues in forestry as a tool for research planning.

Treesearch

Hans M. Gregersen; Allen L. Lundgren; Pamela J. Jakes; David N. Bengston

1989-01-01

A Delphi exercise is used to identify emerging issues in National Forest management and use, the relative importance of the issues, and barriers to resolving issues. USDA Forest Service managers agree on the importance of the 11 issues identified; however, researchers and National Forest managers do not always agree on the importance of issues or barriers.

Contribution of Patient Interviews as Part of a Comprehensive Approach to the Identification of Drug-Related Problems on Geriatric Wards.

PubMed

Stämpfli, Dominik; Boeni, Fabienne; Gerber, Andy; Bättig, Victor A D; Hersberger, Kurt E; Lampert, Markus L

2018-06-19

Inappropriate prescribing is linked to increased risks for adverse drug reactions and hospitalisation. Combining explicit and implicit criteria of inappropriate prescribing with the information obtained in patient interviews seems beneficial with regard to the identification of drug-related problems (DRPs) in hospitalised patients. We aimed to investigate the inclusion of pharmacist interviews as part of medication reviews (including the use of explicit and implicit criteria of inappropriate prescribing) to identify DRPs in older inpatients. Clinical medication reviews were performed on geriatric and associated physical and neurological rehabilitation wards in a regional secondary care hospital. Data from electronic medical records, laboratory data, and current treatment regimens were complemented with a novel structured patient interview performed by a clinical pharmacist. The structured interview questioned patients on administration issues, prescribed medication, self-medication, and allergies. The reviews included the use of current treatment guidelines, the Medication Appropriateness Index, the Screening Tool of Older People's Prescriptions (STOPP, v2), and the Screening Tool to Alert to Right Treatment (START, v2). The potential relevance of the DRPs was estimated using the German version of the CLEO tool. In 110 patients, 595 DRPs were identified, averaging 5.4 per patient (range 0-17). The structured interviews identified 249 DRPs (41.8%), of which 227 were not identified by any other source of information. The majority of DRPs (213/249, i.e. 85.5%) identified by patient interview were estimated to be of minor clinical relevance (i.e. limited adherence, knowledge, quality of life, or satisfaction). We demonstrated that structured patient interviews identified additional DRPs that other sources did not identify. Embedded within a comprehensive approach, the structured patient interviews were needed as data resource for over one-third of all DRPs.

Key Health Information Technologies and Related Issues for Iran: A Qualitative Study.

PubMed

Hemmat, Morteza; Ayatollahi, Haleh; Maleki, Mohammadreza; Saghafi, Fatemeh

2018-01-01

Planning for the future of Health Information Technology (HIT) requires applying a systematic approach when conducting foresight studies. The aim of this study was to identify key health information technologies and related issues for Iran until 2025. This was a qualitative study and the participants included experts and policy makers in the field of health information technology. In-depth semi-structured interviews were conducted and data were analyzed by using framework analysis and MAXQDA software. The findings revealed that the development of national health information network, electronic health records, patient health records, a cloud-based service center, interoperability standards, patient monitoring technologies, telehealth, mhealth, clinical decision support systems, health information technology and mhealth infrastructure were found to be the key technologies for the future. These technologies could influence the economic, organizational and individual levels. To achieve them, the economic and organizational obstacles need to be overcome. In this study, a number of key technologies and related issues were identified. This approach can help to focus on the most important technologies in the future and to priorities these technologies for better resource allocation and policy making.

Health workers at the core of the health system: framework and research issues.

PubMed

Anand, Sudhir; Bärnighausen, Till

2012-05-01

This paper presents a framework for the health system with health workers at the core. We review existing health-system frameworks and the role they assign to health workers. Earlier frameworks either do not include health workers as a central feature of system functioning or treat them as one among several components of equal importance. As every function of the health system is either undertaken by or mediated through the health worker, we place the health worker at the center of the health system. Our framework is useful for structuring research on the health workforce and for identifying health-worker research issues. We describe six research issues on the health workforce: metrics to measure the capacity of a health system to deliver healthcare; the contribution of public- vs. private-sector health workers in meeting healthcare needs and demands; the appropriate size, composition and distribution of the health workforce; approaches to achieving health-worker requirements; the adoption and adaption of treatments by health workers; and the training of health workers for horizontally vs. vertically structured health systems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Report on Wellesley Conference on Equal Pay and Equal Opportunity Policy in the United States, Canada, and Western Europe.

ERIC Educational Resources Information Center

Ratner, Ronnie Steinberg

After a brief discussion of conference background and structure, these proceedings identify and summarize equal pay and employment policy issues discussed at a four-day working conference of sixty-five people from twelve advanced industrialized countries. Focus is on progress to date and alternative strategies for implementing policies. Strategies…

The Management of Student Affairs Programs in Community Colleges: Revamping Processes and Structures. Horizons Issues Monograph Series.

ERIC Educational Resources Information Center

Deegan, William L.

Based on a review of the management literature in the fields of business and education and on case studies, interviews, and discussions, this monograph identifies the prerequisites for the successful management of student affairs programs. Chapter 1 presents perspectives on the student affairs profession, summarizes the problems facing the field,…

Research challenges for structural use of small-diameter round timbers

Treesearch

Ron Wolfe

2000-01-01

Forest managers have identified forest stands overstocked with small-diameter trees as a critical forest health issue. Overstocked stands are subject to attack by insects and disease and, as a result of the heavy fuel load, risk total destruction by fire. Prescribed burning is an economic tool for suppressing the growth of brush and tree seedlings, but its use is often...

Means to an End: A Guide to Developing Teacher Evaluation Systems That Support Growth and Development. Templates and Worksheets

ERIC Educational Resources Information Center

Aspen Institute, 2012

2012-01-01

"Means to an End" is a practical toolkit for structuring the design process, elevating important issues, and identifying tensions and trade-offs that need to be resolved. The guide was conceived at a 2011 Aspen Institute workshop that brought together leading educators, researchers, and policymakers to share strategies for designing and…

OSFA Goals and Objectives System: Strategies for Improved Program Planning and Management.

ERIC Educational Resources Information Center

Advanced Technology, Inc., Reston, VA.

The purpose and function of the Goals and Objectives System of the U.S. Office of Student Financial Assistance (OSFA) are discussed. Results of a review of the system, policy issues, and a strategy for improving the system in OSFA program planning and management are also addressed. The system identifies a structure for work activities in OSFA and…

Creating and Maintaining a Wellness Environment in Child Care Centers Participating in the Child and Adult Care Food Program

ERIC Educational Resources Information Center

Lofton, Kristi L.; Carr, Deborah H.

2010-01-01

Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess…

Print News Coverage of School-Based HPV Vaccine Mandate

PubMed Central

Casciotti, Dana; Smith, Katherine C.; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C.

2015-01-01

BACKGROUND In 2007, legislation was proposed in 24 states and the District of Columbia for school-based HPV vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. METHODS We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005-2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. RESULTS Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. CONCLUSIONS If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages, and promote informed decision-making by parents and students. PMID:25099421

Identifying clinical learning needs using structured group feedback: first year evaluation of pre-registration nursing and midwifery degree programmes.

PubMed

Frazer, Kate; Connolly, Michael; Naughton, Corina; Kow, Veronica

2014-07-01

Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports. The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme. Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students. The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Data Relationships: Towards a Conceptual Model of Scientific Data Catalogs

NASA Astrophysics Data System (ADS)

Hourcle, J. A.

2008-12-01

As the amount of data, types of processing and storage formats increase, the total number of record permutations increase dramatically. The result is an overwhelming number of records that make identifying the best data object to answer a user's needs more difficult. The issue is further complicated as each archive's data catalog may be designed around different concepts - - anything from individual files to be served, series of similarly generated and processed data, or something entirely different. Catalogs may not only be flat tables, but may be structured as multiple tables with each table being a different data series, or a normalized structure of the individual data files. Merging federated search results from archives with different catalog designs can create situations where the data object of interest is difficult to find due to an overwhelming number of seemingly similar or entirely unwanted records. We present a reference model for discussing data catalogs and the complex relationships between similar data objects. We show how the model can be used to improve scientist's ability to quickly identify the best data object for their purposes and discuss technical issues required to use this model in a federated system.

Health-related quality of life of cranial WHO grade I meningioma patients: are current questionnaires relevant?

PubMed

Zamanipoor Najafabadi, Amir H; Peeters, Marthe C M; Lobatto, Daniel J; Broekman, Marieke L D; Smith, Timothy R; Biermasz, Nienke R; Peerdeman, Saskia M; Peul, Wilco C; Taphoorn, Martin J B; van Furth, Wouter R; Dirven, Linda

2017-11-01

The clinical relevance of Health-Related Quality of Life (HRQoL) in meningioma patients has been increasingly acknowledged in recent years. Various questionnaires have been used. However, almost none of these questionnaires has been particularly developed for and/or validated in this patient group. Therefore, the aim of this study was to assess the relevance and comprehensiveness of existing HRQoL questionnaires used in meningioma research and to assess the agreement between patients and health care professionals (HCPs) on the most relevant and important HRQoL issues. A systematic literature search, following the PRISMA statement, was conducted to identify all HRQoL questionnaires used in meningioma research. Semi-structured interviews were organized with patients and HCPs to (1) assess the relevance of all issues covered by the questionnaires (score 0-3: not relevant-highly relevant), (2) assess the ten most important issues, and (3) identify new relevant HRQoL issues. Fourteen different questionnaires were found in the literature, comprising 140 unique issues. Interviews were conducted with 20 patients (median age 57, 71% female) and 10 HCPs (4 neurosurgeons, 2 neurologists, 2 radiotherapists, 1 rehabilitation specialist, 1 neuropsychologist; median experience 13 years). Meningioma patients rated 17-80% of the issues in each of the questionnaires as relevant, HCPs 90-100%. Patients and HCPs agreed on the relevance of only 49 issues (35%, Cohen's kappa: 0.027). Both patients and HCPs considered lack of energy the most important issue. Patients and HCPs suggested five additional relevant issues not covered by current HRQoL questionnaires. Existing HRQoL questionnaires currently used in meningioma patients do not fully cover all relevant issues to these patients. Agreement between patients and HCPs on the relevance of issues was poor. Both findings support the need to develop and validate a meningioma-specific HRQoL questionnaire.

Market structure and advertising in the U.S. pharmaceutical industry: some implications for public policy.

PubMed

Hornbrook, M C

1978-02-01

Distortions in market processes for pharmaceuticals raise the important policy problem of devising measures to improve industry performance. This paper first reviews the basic issues involved in formulating economic policy regarding the pharmaceutical industry. Methods for reducing structural market power and undesirable promotional expenditures are examined, and the impacts of four oft-suggested policy "reforms"--removal of trade names, removal of patents, relaxation of requirements for certification of new drug products, and increased enforcement of antitrust laws--are then analyzed. Finally, problems requiring additional research are identified.

Major roles for minor bacterial lipids identified by mass spectrometry.

PubMed

Garrett, Teresa A

2017-11-01

Mass spectrometry of lipids, especially those isolated from bacteria, has ballooned over the past two decades, affirming in the process the complexity of the lipidome. With this has come the identification of new and interesting lipid structures. Here is an overview of several novel lipids, from both Gram-negative and Gram-positive bacteria with roles in health and disease, whose structural identification was facilitated using mass spectrometry. This article is part of a Special Issue entitled: Bacterial Lipids edited by Russell E. Bishop. Copyright © 2016 Elsevier B.V. All rights reserved.

The paradox of managing a project-oriented matrix: establishing coherence within chaos.

PubMed

Greiner, L E; Schein, V E

1981-01-01

Projects that require the flexible coordination of multidisciplinary teams have tended to adopt a matrix structure to accomplish complex tasks. Yet these project-oriented matrix structures themselves require careful coordination if they are to realize the objectives set for them. The authors identify the basic organizational questions that project-oriented matrix organizations must face. They examine the relationship between responsibility and authority; the tradeoffs between economic efficiency and the technical quality of the work produced; and the sensitive issues of managing individualistic, highly trained professionals while also maintaining group cohesiveness.

Dental Public Health In Action: Putting Oral Health on the Local Public Health Agenda.

PubMed

Walker, I F; Eapen-Simon, S; Gibson, S

2018-04-18

Oral health is a key public health issue across England. In Wakefield in the north of England, local data suggested the oral health of local children was significantly worse than the national average. This paper describes the work undertaken by Wakefield Council to strategically address this issue. A structured process was adopted. Key lessons include; having senior ownership from the Director of Public Health, partnership working across all key stakeholders, utilising dental public health expertise from Public Health England and the use of extensive engagement with stakeholders. Through this work, oral health is now identified with greater importance in Wakefield as a public health issue. Actions are now strategically co-ordinated across stakeholders to improve oral health in local children. Copyright© 2018 Dennis Barber Ltd.

Failure Mode and Effects Analysis: views of hospital staff in the UK.

PubMed

Shebl, Nada; Franklin, Bryony; Barber, Nick; Burnett, Susan; Parand, Anam

2012-01-01

To explore health care professionals' experiences and perceptions of Failure Mode and Effects Analysis (FMEA), a team-based, prospective risk analysis technique. Semi-structured interviews were conducted with 21 operational leads (20 pharmacists, one nurse) in medicines management teams of hospitals participating in a national quality improvement programme. Interviews were transcribed, coded and emergent themes identified using framework analysis. Themes identified included perceptions and experiences of participants with FMEA, validity and reliability issues, and FMEA's use in practice. FMEA was considered to be a structured but subjective process that helps health care professionals get together to identify high risk areas of care. Both positive and negative opinions were expressed, with the majority of interviewees expressing positive views towards FMEA in relation to its structured nature and the use of a multidisciplinary team. Other participants criticised FMEA for being subjective and lacking validity. Most likely to restrict its widespread use were its time consuming nature and its perceived lack of validity and reliability. FMEA is a subjective but systematic tool that helps identify high risk areas, but its time consuming nature, difficulty with the scores and perceived lack of validity and reliability may limit its widespread use.

Identifiability and estimation of multiple transmission pathways in cholera and waterborne disease.

PubMed

Eisenberg, Marisa C; Robertson, Suzanne L; Tien, Joseph H

2013-05-07

Cholera and many waterborne diseases exhibit multiple characteristic timescales or pathways of infection, which can be modeled as direct and indirect transmission. A major public health issue for waterborne diseases involves understanding the modes of transmission in order to improve control and prevention strategies. An important epidemiological question is: given data for an outbreak, can we determine the role and relative importance of direct vs. environmental/waterborne routes of transmission? We examine whether parameters for a differential equation model of waterborne disease transmission dynamics can be identified, both in the ideal setting of noise-free data (structural identifiability) and in the more realistic setting in the presence of noise (practical identifiability). We used a differential algebra approach together with several numerical approaches, with a particular emphasis on identifiability of the transmission rates. To examine these issues in a practical public health context, we apply the model to a recent cholera outbreak in Angola (2006). Our results show that the model parameters-including both water and person-to-person transmission routes-are globally structurally identifiable, although they become unidentifiable when the environmental transmission timescale is fast. Even for water dynamics within the identifiable range, when noisy data are considered, only a combination of the water transmission parameters can practically be estimated. This makes the waterborne transmission parameters difficult to estimate, leading to inaccurate estimates of important epidemiological parameters such as the basic reproduction number (R0). However, measurements of pathogen persistence time in environmental water sources or measurements of pathogen concentration in the water can improve model identifiability and allow for more accurate estimation of waterborne transmission pathway parameters as well as R0. Parameter estimates for the Angola outbreak suggest that both transmission pathways are needed to explain the observed cholera dynamics. These results highlight the importance of incorporating environmental data when examining waterborne disease. Copyright © 2013 Elsevier Ltd. All rights reserved.

The full spectrum of ethical issues in dementia care: systematic qualitative review.

PubMed

Strech, Daniel; Mertz, Marcel; Knüppel, Hannes; Neitzke, Gerald; Schmidhuber, Martina

2013-06-01

Integrating ethical issues in dementia-specific training material, clinical guidelines and national strategy plans requires an unbiased awareness of all the relevant ethical issues. To determine systematically and transparently the full spectrum of ethical issues in clinical dementia care. We conducted a systematic review in Medline (restricted to English and German literature published between 2000 and 2011) and Google books (with no restrictions). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in clinical dementia care. The literature review retrieved 92 references that together mentioned a spectrum of 56 ethical issues in clinical dementia care. The spectrum was structured into seven major categories that consist of first- and second-order categories for ethical issues. The systematically derived spectrum of ethical issues in clinical dementia care presented in this paper can be used as training material for healthcare professionals, students and the public for raising awareness and understanding of the complexity of ethical issues in dementia care. It can also be used to identify ethical issues that should be addressed in dementia-specific training programmes, national strategy plans and clinical practice guidelines. Further research should evaluate whether this new genre of systematic reviews can be applied to the identification of ethical issues in other cognitive and somatic diseases. Also, the practical challenges in addressing ethical issues in training material, guidelines and policies need to be evaluated.

A Study of the Utilization of Advanced Composites in Fuselage Structures of Commercial Aircraft

NASA Technical Reports Server (NTRS)

Watts, D. J.; Sumida, P. T.; Bunin, B. L.; Janicki, G. S.; Walker, J. V.; Fox, B. R.

1985-01-01

A study was conducted to define the technology and data needed to support the introduction of advanced composites in the future production of fuselage structure in large transport aircraft. Fuselage structures of six candidate airplanes were evaluated for the baseline component. The MD-100 was selected on the basis of its representation of 1990s fuselage structure, an available data base, its impact on the schedule and cost of the development program, and its availability and suitability for flight service evaluation. Acceptance criteria were defined, technology issues were identified, and a composite fuselage technology development plan, including full-scale tests, was identified. The plan was based on composite materials to be available in the mid to late 1980s. Program resources required to develop composite fuselage technology are estimated at a rough order of magnitude to be 877 man-years exclusive of the bird strike and impact dynamic test components. A conceptual composite fuselage was designed, retaining the basic MD-100 structural arrangement for doors, windows, wing, wheel wells, cockpit enclosure, major bulkheads, etc., resulting in a 32 percent weight savings.

Inference of alternative splicing from RNA-Seq data with probabilistic splice graphs

PubMed Central

LeGault, Laura H.; Dewey, Colin N.

2013-01-01

Motivation: Alternative splicing and other processes that allow for different transcripts to be derived from the same gene are significant forces in the eukaryotic cell. RNA-Seq is a promising technology for analyzing alternative transcripts, as it does not require prior knowledge of transcript structures or genome sequences. However, analysis of RNA-Seq data in the presence of genes with large numbers of alternative transcripts is currently challenging due to efficiency, identifiability and representation issues. Results: We present RNA-Seq models and associated inference algorithms based on the concept of probabilistic splice graphs, which alleviate these issues. We prove that our models are often identifiable and demonstrate that our inference methods for quantification and differential processing detection are efficient and accurate. Availability: Software implementing our methods is available at http://deweylab.biostat.wisc.edu/psginfer. Contact: cdewey@biostat.wisc.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:23846746

A Conceptual Framework for the Social Analysis of Reproductive Health

PubMed Central

Hawkins, Kirstan

2007-01-01

The dominant conceptual framework for understanding reproductive behaviour is highly individualistic. In this article, it is demonstrated that such a conceptualization is flawed, as behaviour is shaped by social relations and institutions. Using ethnographic evidence, the value of a social analysis of the local contexts of reproductive health is highlighted. A framework is set out for conducting such a social analysis, which is capable of generating data necessary to allow health programmes to assess the appropriate means of improving the responsiveness of service-delivery structures to the needs of the most vulnerable. Six key issues are identified in the framework for the analysis of social vulnerability to poor reproductive health outcomes. The key issues are: poverty and livelihood strategies, gender, health-seeking behaviour, reproductive behaviour, and access to services. The article concludes by briefly identifying the key interventions and strategies indicated by such an analysis. PMID:17615901

Managing information and knowledge within maternity services: Privacy and consent issues.

PubMed

Baskaran, Vikraman; Davis, Kim; Bali, Rajeev K; Naguib, Raouf N G; Wickramasinghe, Nilmini

2013-09-01

Electronic Patient Records have improved vastly the quality and efficiency of care delivered. However, the formation of single demographic database and the ease of electronic information sharing give rise to many concerns including issues of consent, by whom and how data are accessed and used. This paper examines the organizational and socio-technical issues related to privacy, confidentiality and security when employing electronic records within a maternity service hospital in England. A preliminary questionnaire was administered (n  =  52), in total, 24 responses were received. Sixteen responses were from personnel in the information technology department, 5 from health information department and 3 from midwifery managers. This was followed by a semi-structured interview with representatives from the clinical and technological side. A number of issues related to information governance (IG) have been identified, especially breaches on sharing personal information without consent from the patients have been identified as one immediate challenge that needs to be fixed. There is an immediate need for more robust, realistic, built-in accountability both locally and nationally on data sharing. A culture of ownership and strict adherence to IG principles is paramount. Focused training in the area of data, information and knowledge sharing will bring in a balance of legitimate usage against the individual's rights to confidentiality and privacy.

The organisational stressors encountered by athletes with a disability.

PubMed

Arnold, Rachel; Wagstaff, Christopher R D; Steadman, Lauren; Pratt, Yasmin

2017-06-01

Organisational stressors have been found to be prevalent and problematic for sport performers, with research identifying demographic differences in the stressors encountered. Nevertheless, extant sport psychology research on the topic of stress has generally focused on able-bodied athletes; whilst that which has been conducted on performers with a disability has typically recruited relatively small samples to explore a narrow selection of organisational stressors, or examined other components of the stress process. The purpose of the present study was to explore the various organisational stressors that athletes with a disability encounter. The sample comprised 18 elite athletes with a disability (10 male, 8 female) who had a classified disability and experience of competing at a major championships in their sport (e.g., Paralympic Games, World Championships). Participants took part in a semi-structured interview which was analysed by drawing from grounded theory procedures. A total of 316 organisational stressors were identified, which were abstracted into 31 concepts and four, previously conceptualised, exploratory schemes: leadership and personnel issues, cultural and team issues, logistical and environmental issues, and performance and personal issues. This study not only provides the first illustration of the prevalence of organisational stressors for athletes with a disability, but also significantly points to salient similarities and distinct differences between the stress experiences of performers with and without a disability.

Hunger, ethics and the right to food.

PubMed

Mishra, Srijit

2012-01-01

The management of hunger has to look into the issues of availability, accessibility and adequacy of food supply. From an ethical perspective, this paper argues in favour of the right to food. But, for this to become viable, the state has to come up with an appropriate and effective bill on food and nutrition security, address the issue of inadequate provisioning of storage space by state agencies leading to rotting of food grains--a criminal waste when people are dying of hunger; and rely on local level institutions involving the community, that complement the administrative structure to identify the poor and reduce exclusion and inclusion errors.

Structural and Practical Identifiability Issues of Immuno-Epidemiological Vector-Host Models with Application to Rift Valley Fever.

PubMed

Tuncer, Necibe; Gulbudak, Hayriye; Cannataro, Vincent L; Martcheva, Maia

2016-09-01

In this article, we discuss the structural and practical identifiability of a nested immuno-epidemiological model of arbovirus diseases, where host-vector transmission rate, host recovery, and disease-induced death rates are governed by the within-host immune system. We incorporate the newest ideas and the most up-to-date features of numerical methods to fit multi-scale models to multi-scale data. For an immunological model, we use Rift Valley Fever Virus (RVFV) time-series data obtained from livestock under laboratory experiments, and for an epidemiological model we incorporate a human compartment to the nested model and use the number of human RVFV cases reported by the CDC during the 2006-2007 Kenya outbreak. We show that the immunological model is not structurally identifiable for the measurements of time-series viremia concentrations in the host. Thus, we study the non-dimensionalized and scaled versions of the immunological model and prove that both are structurally globally identifiable. After fixing estimated parameter values for the immunological model derived from the scaled model, we develop a numerical method to fit observable RVFV epidemiological data to the nested model for the remaining parameter values of the multi-scale system. For the given (CDC) data set, Monte Carlo simulations indicate that only three parameters of the epidemiological model are practically identifiable when the immune model parameters are fixed. Alternatively, we fit the multi-scale data to the multi-scale model simultaneously. Monte Carlo simulations for the simultaneous fitting suggest that the parameters of the immunological model and the parameters of the immuno-epidemiological model are practically identifiable. We suggest that analytic approaches for studying the structural identifiability of nested models are a necessity, so that identifiable parameter combinations can be derived to reparameterize the nested model to obtain an identifiable one. This is a crucial step in developing multi-scale models which explain multi-scale data.

Initiatives on early detection and intervention to proactively identify health and social problems in older people: experiences from the Netherlands.

PubMed

Lette, Manon; Baan, Caroline A; van den Berg, Matthijs; de Bruin, Simone R

2015-10-30

Over the last years, several initiatives on early detection and intervention have been put in place to proactively identify health and social problems in (frail) older people. An overview of the initiatives currently available in the Netherlands is lacking, and it is unknown whether they meet the preferences and needs of older people. Therefore, the objectives of this study were threefold: 1. To identify initiatives on early detection and intervention for older people in the Netherlands and compare their characteristics; 2. To explore the experiences of professionals with these initiatives; and 3. To explore to what extent existing initiatives meet the preferences and needs of older people. We performed a qualitative descriptive study in which we conducted semi-structured interviews with seventeen experts in preventive elderly care and three group interviews with volunteer elderly advisors. Data were analysed using the framework analysis method. We identified eight categories of initiatives based on the setting (e.g. general practitioner practice, hospital, municipality) in which they were offered. Initiatives differed in their aims and target groups. The utilization of peers to identify problems and risks, as was done by some initiatives, was seen as a strength. Difficulties were experienced with identifying the target group that would benefit from proactive delivery of care and support most, and with addressing prevalent issues among older people (e.g. psychosocial issues, self-reliance issues). Although there is a broad array of initiatives available, there is a discrepancy between supply and demand. Current initiatives insufficiently address needs of (frail) older people. More insight is needed in "what should be done by whom, for which target group and at what moment", in order to improve current practice in preventive elderly care.

The full spectrum of ethical issues in the care of patients with ALS: a systematic qualitative review.

PubMed

Seitzer, F; Kahrass, H; Neitzke, G; Strech, D

2016-02-01

Dealing systematically with ethical issues in amyotrophic lateral sclerosis (ALS) care requires an unbiased awareness of all the relevant ethical issues. The aim of the study was to determine systematically and transparently the full spectrum of ethical issues in ALS care. We conducted a systematic review in Medline and Google Books (restricted to English and German literature published between 1993 and 2014). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in ALS care. The literature review retrieved 56 references that together mentioned a spectrum of 103 ethical issues in ALS care. The spectrum was structured into six major categories that consist of first and second-order categories of ethical issues. The systematically derived spectrum of ethical issues in ALS care presented in this paper raises awareness and understanding of the complexity of ethical issues in ALS care. It also offers a basis for the systematic development of informational and training materials for health professionals, patients and their relatives, and society as a whole. Finally, it supports a rational and fair selection of all those ethical issues that should be addressed in health policies, position papers and clinical practice guidelines. Further research is needed to identify ways to systematically select the most relevant ethical issues not only in the clinical environment, but also for the development of clinical practice guidelines.

Regulating the chromatin landscape: structural and mechanistic perspectives.

PubMed

Bartholomew, Blaine

2014-01-01

A large family of chromatin remodelers that noncovalently modify chromatin is crucial in cell development and differentiation. They are often the targets of cancer, neurological disorders, and other human diseases. These complexes alter nucleosome positioning, higher-order chromatin structure, and nuclear organization. They also assemble chromatin, exchange out histone variants, and disassemble chromatin at defined locations. We review aspects of the structural organization of these complexes, the functional properties of their protein domains, and variation between complexes. We also address the mechanistic details of these complexes in mobilizing nucleosomes and altering chromatin structure. A better understanding of these issues will be vital for further analyses of subunits of these chromatin remodelers, which are being identified as targets in human diseases by NGS (next-generation sequencing).

Survey of beaver-related restoration practices in rangeland streams of the western USA

USGS Publications Warehouse

Pilliod, David S.; Rohde, Ashley T.; Charnley, Susan; Davee, Rachael R; Dunham, Jason B.; Gosnell, Hannah; Grant, Gordon E.; Hausner, Mark B.; Huntington, Justin L.; Nash, Caroline

2018-01-01

Poor condition of many streams and concerns about future droughts in the arid and semi-arid western USA have motivated novel restoration strategies aimed at accelerating recovery and increasing water resources. Translocation of beavers into formerly occupied habitats, restoration activities encouraging beaver recolonization, and instream structures mimicking the effects of beaver dams are restoration alternatives that have recently gained popularity because of their potential socioeconomic and ecological benefits. However, beaver dams and dam-like structures also harbor a history of social conflict. Hence, we identified a need to assess the use of beaver-related restoration projects in western rangelands to increase awareness and accountability, and identify gaps in scientific knowledge. We inventoried 97 projects implemented by 32 organizations, most in the last 10 years. We found that beaver-related stream restoration projects undertaken mostly involved the relocation of nuisance beavers. The most common goal was to store water, either with beaver dams or artificial structures. Beavers were often moved without regard to genetics, disease, or potential conflicts with nearby landowners. Few projects included post-implementation monitoring or planned for longer term issues, such as what happens when beavers abandon a site or when beaver dams or structures breach. Human dimensions were rarely considered and water rights and other issues were mostly unresolved or addressed through ad-hoc agreements. We conclude that the practice and implementation of beaver-related restoration has outpaced research on its efficacy and best practices. Further scientific research is necessary, especially research that informs the establishment of clear guidelines for best practices.

Survey of Beaver-related Restoration Practices in Rangeland Streams of the Western USA.

PubMed

Pilliod, David S; Rohde, Ashley T; Charnley, Susan; Davee, Rachael R; Dunham, Jason B; Gosnell, Hannah; Grant, Gordon E; Hausner, Mark B; Huntington, Justin L; Nash, Caroline

2018-01-01

Poor condition of many streams and concerns about future droughts in the arid and semi-arid western USA have motivated novel restoration strategies aimed at accelerating recovery and increasing water resources. Translocation of beavers into formerly occupied habitats, restoration activities encouraging beaver recolonization, and instream structures mimicking the effects of beaver dams are restoration alternatives that have recently gained popularity because of their potential socioeconomic and ecological benefits. However, beaver dams and dam-like structures also harbor a history of social conflict. Hence, we identified a need to assess the use of beaver-related restoration projects in western rangelands to increase awareness and accountability, and identify gaps in scientific knowledge. We inventoried 97 projects implemented by 32 organizations, most in the last 10 years. We found that beaver-related stream restoration projects undertaken mostly involved the relocation of nuisance beavers. The most common goal was to store water, either with beaver dams or artificial structures. Beavers were often moved without regard to genetics, disease, or potential conflicts with nearby landowners. Few projects included post-implementation monitoring or planned for longer term issues, such as what happens when beavers abandon a site or when beaver dams or structures breach. Human dimensions were rarely considered and water rights and other issues were mostly unresolved or addressed through ad-hoc agreements. We conclude that the practice and implementation of beaver-related restoration has outpaced research on its efficacy and best practices. Further scientific research is necessary, especially research that informs the establishment of clear guidelines for best practices.

Survey of Beaver-related Restoration Practices in Rangeland Streams of the Western USA

NASA Astrophysics Data System (ADS)

Pilliod, David S.; Rohde, Ashley T.; Charnley, Susan; Davee, Rachael R.; Dunham, Jason B.; Gosnell, Hannah; Grant, Gordon E.; Hausner, Mark B.; Huntington, Justin L.; Nash, Caroline

2018-01-01

Poor condition of many streams and concerns about future droughts in the arid and semi-arid western USA have motivated novel restoration strategies aimed at accelerating recovery and increasing water resources. Translocation of beavers into formerly occupied habitats, restoration activities encouraging beaver recolonization, and instream structures mimicking the effects of beaver dams are restoration alternatives that have recently gained popularity because of their potential socioeconomic and ecological benefits. However, beaver dams and dam-like structures also harbor a history of social conflict. Hence, we identified a need to assess the use of beaver-related restoration projects in western rangelands to increase awareness and accountability, and identify gaps in scientific knowledge. We inventoried 97 projects implemented by 32 organizations, most in the last 10 years. We found that beaver-related stream restoration projects undertaken mostly involved the relocation of nuisance beavers. The most common goal was to store water, either with beaver dams or artificial structures. Beavers were often moved without regard to genetics, disease, or potential conflicts with nearby landowners. Few projects included post-implementation monitoring or planned for longer term issues, such as what happens when beavers abandon a site or when beaver dams or structures breach. Human dimensions were rarely considered and water rights and other issues were mostly unresolved or addressed through ad-hoc agreements. We conclude that the practice and implementation of beaver-related restoration has outpaced research on its efficacy and best practices. Further scientific research is necessary, especially research that informs the establishment of clear guidelines for best practices.

Composite Fuselage Technology

NASA Technical Reports Server (NTRS)

Lagace, Paul A.

1999-01-01

Work was conducted over a ten-year period to address the central issue of damage in primary load-bearing aircraft composite structure, specifically fuselage structure. This included the three facets of damage resistance, damage tolerance, and damage arrest. Experimental, analytical, and numerical work was conducted in order to identify and better understand the mechanisms that control the structural behavior of fuselage structures in their response to the three aspects of damage. Furthermore, work was done to develop straightforward design methodologies that can be employed by structural designers in preliminary design stages to make intelligent choices concerning the material, layup, and structural configurations so that a more efficient structure with structural integrity can be designed and built. Considerable progress was made towards achieving these goals via this work. In regard to damage tolerance considerations, the following were identified as important effects: composite layup and associated orthotropy/structural anisotropy, specifics of initial local damage mechanisms, role of longitudinal versus hoop stress, and large deformation and associated geometric nonlinearity. Means were established to account for effects of radius and for the nonlinear response. In particular, nondimensional parameters were identified to characterize the importance of nonlinearity in the response of pressurized cylinders. This led to the establishment of a iso-nonlinear-error plot for reference in structural design. Finally, in the case of damage tolerance, the general approach of the original methodology to predict the failure pressure involving extending basic plate failure data by accounting for the local stress intensification was accomplished for the general case by accounting for the mechanisms noted by utilizing the capability of the STAGS finite element code and numerically calculating the local stress intensification for the particular configuration to be considered. For the issue of damage arrest, placement of and configuration of stiffeners (including stiffener curvature), and magnitude and orientation of principal strains due to local bending were found to be key considerations. Means were established to account for stiffener effectiveness quantitatively based on radius, slit size, stiffener curvature' and relative bending stifffiesses involved. Geometric nonlinearity was also found to play an - 24 - important role here. Furthermore, it was determined that damage propagation is controlled by different mechanisms (hoop stress versus flapping stress and the associated factors involved in each) depending upon the direction of damage propagation. This latter item results in an inability to scale these phenomena in one test due to the different factors involved. Finally, the importance of shell curvature and associated instability in response to transverse loading including impact were found to be important considerations in damage resistance. A technique, involving asymmetric meshing of a finite element mesh, was developed to predict this behavior and showed excellent correlation with experimental results. Further details of these ten years of work are presented herein with references made to the fourteen documents produced during this work where full details can be found. Implications of this work are discussed and recommendations made. Although it is clear that there is more work to be done to fully understand composite fuselage technology and specifically the overall issue of damage in primary load-bearing composite structures, important understanding and capability has been extended via this work.

Air Mobility Command’s Total Force Integration: A Critical Analysis

DTIC Science & Technology

2012-02-26

variety of techniques available to positively change culture . 9 Changing assumptions of in-group collectivist requires increasing breadth and open...there have been issues. Command structure, cultural differences and vague guidance for implementation have plagued Air Mobility Command’s...through the Governor and not the President of the United States. Cultural Considerations The purpose of this section is to identify and discuss

Stereosat: A proposed private sector/government joint venture in remote sensing from space

NASA Technical Reports Server (NTRS)

Anglin, R. L.

1980-01-01

Stereosat, a free flying Sun synchronous satellite whose purpose is to obtain worldwide cloud-free stereoscopic images of the Earth's land masses, is proposed as a joint private sector/government venture. A number of potential organization models are identified. The legal, economic, and institutional issues which could impact the continuum of potential joint private sector/government institutional structures are examined.

Cleaning by clustering: methodology for addressing data quality issues in biomedical metadata.

PubMed

Hu, Wei; Zaveri, Amrapali; Qiu, Honglei; Dumontier, Michel

2017-09-18

The ability to efficiently search and filter datasets depends on access to high quality metadata. While most biomedical repositories require data submitters to provide a minimal set of metadata, some such as the Gene Expression Omnibus (GEO) allows users to specify additional metadata in the form of textual key-value pairs (e.g. sex: female). However, since there is no structured vocabulary to guide the submitter regarding the metadata terms to use, consequently, the 44,000,000+ key-value pairs in GEO suffer from numerous quality issues including redundancy, heterogeneity, inconsistency, and incompleteness. Such issues hinder the ability of scientists to hone in on datasets that meet their requirements and point to a need for accurate, structured and complete description of the data. In this study, we propose a clustering-based approach to address data quality issues in biomedical, specifically gene expression, metadata. First, we present three different kinds of similarity measures to compare metadata keys. Second, we design a scalable agglomerative clustering algorithm to cluster similar keys together. Our agglomerative cluster algorithm identified metadata keys that were similar, based on (i) name, (ii) core concept and (iii) value similarities, to each other and grouped them together. We evaluated our method using a manually created gold standard in which 359 keys were grouped into 27 clusters based on six types of characteristics: (i) age, (ii) cell line, (iii) disease, (iv) strain, (v) tissue and (vi) treatment. As a result, the algorithm generated 18 clusters containing 355 keys (four clusters with only one key were excluded). In the 18 clusters, there were keys that were identified correctly to be related to that cluster, but there were 13 keys which were not related to that cluster. We compared our approach with four other published methods. Our approach significantly outperformed them for most metadata keys and achieved the best average F-Score (0.63). Our algorithm identified keys that were similar to each other and grouped them together. Our intuition that underpins cleaning by clustering is that, dividing keys into different clusters resolves the scalability issues for data observation and cleaning, and keys in the same cluster with duplicates and errors can easily be found. Our algorithm can also be applied to other biomedical data types.

Clinical Ethics in Gabon: The Spectrum of Clinical Ethical Issues Based on Findings from In-Depth Interviews at Three Public Hospitals.

PubMed

Sippel, Daniel; Marckmann, Georg; Ndzie Atangana, Etienne; Strech, Daniel

2015-01-01

Unlike issues in biomedical research ethics, ethical challenges arising in daily clinical care in Sub-Saharan African countries have not yet been studied in a systematic manner. However this has to be seen as a distinct entity as we argue in this paper. Our aim was to give an overview of the spectrum of clinical ethical issues and to understand what influences clinical ethics in the Sub-Saharan country of Gabon. In-depth interviews with 18 health care professionals were conducted at three hospital sites in Gabon. Interview transcripts were analyzed using a grounded theory approach (open and axial coding), giving a qualitative spectrum of categories for clinical ethical issues. Validity was checked at a meeting with study participants and other health care experts in Gabon after analysis of the data. Twelve main categories (with 28 further-specified subcategories) for clinical ethical issues were identified and grouped under three core categories: A) micro level: "confidentiality and information", "interpersonal, relational and behavioral issues", "psychological strain of individuals", and "scarce resources"; B) meso level: "structural issues of medical institutions", "issues with private clinics", "challenges connected to the family", and "issues of education, training and competence"; and C) macro level: "influence of society, culture, religion and superstition", "applicability of western medicine", "structural issues on the political level", and "legal issues". Interviewees reported a broad spectrum of clinical ethical issues that go beyond challenges related to scarce financial and human resources. Specific socio-cultural, historical and educational backgrounds also played an important role. In fact these influences are central to an understanding of clinical ethics in the studied local context. Further research in the region is necessary to put our study into perspective. As many participants reported a lack of awareness of ethical issues amongst other health care professionals in daily clinical practice, we suggest that international organizations and national medical schools should consider infrastructure and tools to improve context-sensitive capacity building in clinical ethics for Sub-Saharan African countries like Gabon.

An automated curation procedure for addressing chemical errors and inconsistencies in public datasets used in QSAR modelling.

PubMed

Mansouri, K; Grulke, C M; Richard, A M; Judson, R S; Williams, A J

2016-11-01

The increasing availability of large collections of chemical structures and associated experimental data provides an opportunity to build robust QSAR models for applications in different fields. One common concern is the quality of both the chemical structure information and associated experimental data. Here we describe the development of an automated KNIME workflow to curate and correct errors in the structure and identity of chemicals using the publicly available PHYSPROP physicochemical properties and environmental fate datasets. The workflow first assembles structure-identity pairs using up to four provided chemical identifiers, including chemical name, CASRNs, SMILES, and MolBlock. Problems detected included errors and mismatches in chemical structure formats, identifiers and various structure validation issues, including hypervalency and stereochemistry descriptions. Subsequently, a machine learning procedure was applied to evaluate the impact of this curation process. The performance of QSAR models built on only the highest-quality subset of the original dataset was compared with the larger curated and corrected dataset. The latter showed statistically improved predictive performance. The final workflow was used to curate the full list of PHYSPROP datasets, and is being made publicly available for further usage and integration by the scientific community.

Unpacking the ‘structural’ in a structural approach for HIV prevention among female sex workers: A case study from China

PubMed Central

Huang, Yingying; Muessig, Kathryn E.; Zhang, Ning; Maman, Suzanne

2015-01-01

Interventions for HIV prevention among female sex workers (FSWs) in China focus on HIV/sexually transmitted infection (STI) and individual behaviour change. An occupational health framework facilitates intervention across an array of health issues FSWs face including HIV/STI, violence, reproductive health, stigma and substance use. Through a case study of a community-based Jiaozhou (JZ) FSW programme, we developed a conceptual framework incorporating global discussions of structural approaches to HIV prevention with the specific social and structural contexts identified among FSWs in China. Based on ethnographic fieldwork between August 2010 and May 2013, we describe the evolution of this programme to its current occupational health focus and unpack the intervention strategies. We describe the critical features of the programme that have fostered success among FSWs including high-quality clinical services provided within a welcoming setting, responsive outreach work through staff and trained FSW peers, interpersonal and community-level engagement aimed at changing the local social and structural environments of sex work and tailored health education materials. This intervention differs from other projects in China by adopting a more holistic approach to FSW health that incorporates social issues. It also demonstrates the feasibility of structural interventions among FSWs even within an environment that has strong anti-prostitution policies. PMID:25742611

Ethical challenges for accountable care organizations: a structured review.

PubMed

DeCamp, Matthew; Farber, Neil J; Torke, Alexia M; George, Maura; Berger, Zackary; Keirns, Carla C; Kaldjian, Lauris C

2014-10-01

Accountable care organizations (ACOs) are proliferating as a solution to the cost crisis in American health care, and already involve as many as 31 million patients. ACOs hold clinicians, group practices, and in many circumstances hospitals financially accountable for reducing expenditures and improving their patients' health outcomes. The structure of health care affects the ethical issues arising in the practice of medicine; therefore, like all health care organizational structures, ACOs will experience ethical challenges. No framework exists to assist key ACO stakeholders in identifying or managing these challenges. We conducted a structured review of the medical ACO literature using qualitative content analysis to inform identification of ethical challenges for ACOs. Our analysis found infrequent discussion of ethics as an explicit concern for ACOs. Nonetheless, we identified nine critical ethical challenges, often described in other terms, for ACO stakeholders. Leaders could face challenges regarding fair resource allocation (e.g., about fairly using ACOs' shared savings), protection of professionals' ethical obligations (especially related to the design of financial incentives), and development of fair decision processes (e.g., ensuring that beneficiary representatives on the ACO board truly represent the ACO's patients). Clinicians could perceive threats to their professional autonomy (e.g., through cost control measures), a sense of dual or conflicted responsibility to their patients and the ACO, or competition with other clinicians. For patients, critical ethical challenges will include protecting their autonomy, ensuring privacy and confidentiality, and effectively engaging them with the ACO. ACOs are not inherently more or less "ethical" than other health care payment models, such as fee-for-service or pure capitation. ACOs' nascent development and flexibility in design, however, present a time-sensitive opportunity to ensure their ethical operation, promote their success, and refine their design and implementation by identifying, managing, and conducting research into the ethical issues they might face.

Noise elimination algorithm for modal analysis

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

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

2015-07-27

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

Trichomonas vaginalis Metronidazole Resistance Is Associated with Single Nucleotide Polymorphisms in the Nitroreductase Genes ntr4Tv and ntr6Tv

PubMed Central

Paulish-Miller, Teresa E.; Augostini, Peter; Schuyler, Jessica A.; Smith, William L.; Mordechai, Eli; Adelson, Martin E.; Gygax, Scott E.; Secor, William E.

2014-01-01

Metronidazole resistance in the sexually transmitted parasite Trichomonas vaginalis is a problematic public health issue. We have identified single nucleotide polymorphisms (SNPs) in two nitroreductase genes (ntr4Tv and ntr6Tv) associated with resistance. These SNPs were associated with one of two distinct T. vaginalis populations identified by multilocus sequence typing, yet one SNP (ntr6Tv A238T), which results in a premature stop codon, was associated with resistance independent of population structure and may be of diagnostic value. PMID:24550324

E-Beam Processing of Polymer Matrix Composites for Multifunctional Radiation Shielding

NASA Technical Reports Server (NTRS)

Hou, Tan-Hung; Wilson, John W.; Jensen, Brian J.; Thibeault, Sheila A.; Chang, Chie K.; Kiefer, Richard L.

2005-01-01

Aliphatic polymers were identified as optimum radiation shielding polymeric materials for building multifunctional structural elements for in-space habitats. Conceptual damage tolerant configurations of polyolefins have been proposed, but many manufacturing issues relied on methods and materials which have sub-optimal radiation shielding characteristics (for example, epoxy matrix and adhesives). In the present approach, we shall investigate e-beam processing technologies for inclusion of high-strength aliphatic polymer reinforcement structures into a highly cross-linked polyolefin matrix. This paper reports the baseline thermo-mechanical properties of low density polyethylene and highly crystallized polyethylene.

Key issues in application of composites to transport aircraft

NASA Technical Reports Server (NTRS)

Stone, M.

1978-01-01

The application of composite materials to transport aircraft was identified and reviewed including the major contributing disciplines of design, manufacturing, and processing. Factors considered include: crashworthiness considerations (structural integrity, postcrash fires, and structural fusing), electrical/avionics subsystems integration, lightning, and P-static protection design; manufacturing development, evaluation, selection, and refining of tooling and curing procedures; and major joint design considerations. Development of the DC-10 rudder, DC-10 vertical stabilizer, and the DC-9 wing study project was reviewed. The Federal Aviation Administration interface and the effect on component design of compliance with Federal Aviation Regulation 25 Composite Guidelines are discussed.

Phase B - final definition and preliminary design study for the initial Atmospheric Cloud Physics Laboratory (ACPL): A spacelab mission payload. Work breakdown structure for phase C/D DR-MA-06 (preliminary issue)

NASA Technical Reports Server (NTRS)

1976-01-01

The Work Breakdown Structure (WBS) and Dictionary (DR-MA-06) for initial and subsequent flights of the Atmospheric Cloud Physics Laboratory (ACPL) is presented. An attempt is made to identify specific equipment and components in each of the eleven subsystems; they are listed under the appropriate subdivisions of the WBS. The reader is cautioned that some of these components are likely to change substantially during the course of the study, and the list provided should only be considered representative.

Ethical aspects of human biobanks: a systematic review

PubMed Central

Budimir, Danijela; Polašek, Ozren; Marušić, Ana; Kolčić, Ivana; Zemunik, Tatijana; Boraska, Vesna; Jerončić, Ana; Boban, Mladen; Campbell, Harry; Rudan, Igor

2011-01-01

Aim To systematically assess the existing literature on ethical aspects of human biobanks. Method We searched the Web of Science and PubMed databases to find studies addressing ethical problems in biobanks with no limits set (study design, study population, time period, or language of publication). All identified articles published until November 2010 were included. We analyzed the type of published articles, journals publishing them, involvement of countries/institutions, year of publication, and citations received, and qualitatively assessed every article in order to identify ethical issues addressed by the majority of published research on human biobanking. Results Hundred and fifty four studies satisfied our review criteria. The studies mainly came from highly developed countries and were all published in the last two decades, with over half of them published in 2009 or 2010. They most commonly discussed the informed consent, privacy and identifiability, return of results to participants, importance of public trust, involvement of children, commercialization, the role of ethics boards, international data exchange, ownership of samples, and benefit sharing. Conclusions The focus on ethical aspects is strongly present through the whole biobanking research field. Although there is a consensus on the old and most typical ethical issues, with further development of the field and increasingly complex structure of human biobanks, these issues will likely continue to arise and accumulate, hence requiring constant re-appraisal and continuing discussion. PMID:21674823

Implementing the community health worker model within diabetes management: challenges and lessons learned from programs across the United States.

PubMed

Cherrington, Andrea; Ayala, Guadalupe X; Amick, Halle; Allison, Jeroan; Corbie-Smith, Giselle; Scarinci, Isabel

2008-01-01

The purpose of this qualitative study was to examine methods of implementation of the community health worker (CHW) model within diabetes programs, as well as related challenges and lessons learned. Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC's 1998 directory of CHW programs, and Google Search Engine were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Sixteen programs were assessed, all but 3 focused on minority populations. Most CHWs were recruited informally; 6 programs required CHWs to have diabetes. CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate nondiabetes related issues. Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes.

Cities of the future-bionic systems of new urban environment.

PubMed

Krzemińska, Alicja Edyta; Zaręba, Anna Danuta; Dzikowska, Anna; Jarosz, Katarzyna Rozalia

2017-12-07

The concepts of the cities we know nowadays, and which we are accustomed to, change at a very rapid pace. The philosophy of their design is also changing. It will base on new standards, entering a completely different, futuristic dimension. This stage is related to changes in the perception of space, location and lack of belonging to definite, national or cultural structures. Cities of the future are cities primarily intelligent, zero-energetic, zero-waste, environmentally sustainable, self-sufficient in terms of both organic food production and symbiosis between the environment and industry. New cities will be able to have new organisational structures-either city states, or, apolitical, jigsaw-like structures that can change their position-like in the case of the city of Artisanopolis, designed as a floating city, close to the land, reminiscent of the legendary Atlantis. This paper is focused on the main issues connected with problems of the contemporary city planning. The purpose of the research was to identify existing technological solutions, whose aim is to use solar energy and urban greenery. The studies were based on literature related to future city development issues and futuristic projects of the architects and city planners. In the paper, the following issues have been verified: futuristic cities and districts, and original bionic buildings, both residential and industrial. The results of the analysis have been presented in a tabular form.

Group work: Facilitating the learning of international and domestic undergraduate nursing students.

PubMed

Shaw, Julie; Mitchell, Creina; Del Fabbro, Letitia

2015-01-01

Devising innovative strategies to address internationalization is a contemporary challenge for universities. A Participatory Action Research (PAR) project was undertaken to identify issues for international nursing students and their teachers. The findings identified group work as a teaching strategy potentially useful to facilitate international student learning. The educational intervention of structured group work was planned and implemented in one subject of a Nursing degree. Groups of four to five students were formed with one or two international students per group. Structural support was provided by the teacher until the student was learning independently, the traditional view of scaffolding. The group work also encouraged students to learn from one another, a contemporary understanding of scaffolding. Evaluation of the group work teaching strategy occurred via anonymous, self-completed student surveys. The student experience data were analysed using descriptive statistical techniques, and free text comments were analysed using content analysis. Over 85% of respondents positively rated the group work experience. Overwhelmingly, students reported that class discussions and sharing nursing experiences positively influenced their learning and facilitated exchange of knowledge about nursing issues from an international perspective. This evaluation of a structured group work process supports the use of group work in engaging students in learning, adding to our understanding of purposeful scaffolding as a pathway to enhance learning for both international and domestic students. By explicitly using group work within the curriculum, educators can promote student learning, a scholarly approach to teaching and internationalization of the curriculum.

Arctic Freshwater Synthesis: Summary of key emerging issues

NASA Astrophysics Data System (ADS)

Prowse, T.; Bring, A.; Mârd, J.; Carmack, E.; Holland, M.; Instanes, A.; Vihma, T.; Wrona, F. J.

2015-10-01

In response to a joint request from the World Climate Research Program's Climate and Cryosphere Project, the International Arctic Science Committee, and the Arctic Council's Arctic Monitoring and Assessment Program an updated scientific assessment has been conducted of the Arctic Freshwater System (AFS), entitled the Arctic Freshwater Synthesis (AFSΣ). The major reason behind the joint request was an increasing concern that changes to the AFS have produced, and could produce even greater, changes to biogeophysical and socioeconomic systems of special importance to northern residents and also produce extra-Arctic climatic effects that will have global consequences. The AFSΣ was structured around six key thematic areas: atmosphere, oceans, terrestrial hydrology, terrestrial ecology, resources, and modeling, the review of each coauthored by an international group of scientists and published as separate manuscripts in this special issue of Journal of Geophysical Research-Biogeosciences. This AFSΣ summary manuscript reviews key issues that emerged during the conduct of the synthesis, especially those that are cross-thematic in nature, and identifies future research required to address such issues.

Segmentation of 3d Models for Cultural Heritage Structural Analysis - Some Critical Issues

NASA Astrophysics Data System (ADS)

Gonizzi Barsanti, S.; Guidi, G.; De Luca, L.

2017-08-01

Cultural Heritage documentation and preservation has become a fundamental concern in this historical period. 3D modelling offers a perfect aid to record ancient buildings and artefacts and can be used as a valid starting point for restoration, conservation and structural analysis, which can be performed by using Finite Element Methods (FEA). The models derived from reality-based techniques, made up of the exterior surfaces of the objects captured at high resolution, are - for this reason - made of millions of polygons. Such meshes are not directly usable in structural analysis packages and need to be properly pre-processed in order to be transformed in volumetric meshes suitable for FEA. In addition, dealing with ancient objects, a proper segmentation of 3D volumetric models is needed to analyse the behaviour of the structure with the most suitable level of detail for the different sections of the structure under analysis. Segmentation of 3D models is still an open issue, especially when dealing with ancient, complicated and geometrically complex objects that imply the presence of anomalies and gaps, due to environmental agents such as earthquakes, pollution, wind and rain, or human factors. The aims of this paper is to critically analyse some of the different methodologies and algorithms available to segment a 3D point cloud or a mesh, identifying difficulties and problems by showing examples on different structures.

Early career mentoring for translational researchers: mentee perspectives on challenges and issues.

PubMed

Keller, Thomas E; Collier, Peter J; Blakeslee, Jennifer E; Logan, Kay; McCracken, Karen; Morris, Cynthia

2014-01-01

The education and training of early career biomedical translational researchers often involves formal mentoring by more experienced colleagues. This study investigated the nature of these mentoring relationships from the perspective of mentees. The objective was to understand the challenges and issues encountered by mentees in forming and maintaining productive mentoring relationships. Three focus groups (n=14) were conducted with early career researchers who had mentored career development awards. Thematic analysis identified, categorized, and illustrated the challenges and issues reported by mentees. The range of mentee challenges was reflected in five major categories: (a) network--finding appropriate mentors to meet various needs; (b) access--structuring schedules and opportunities to receive mentoring; (c) expectations--negotiating the mechanics of the mentoring relationship and its purpose; (d) alignment--managing mentor-mentee mismatches regarding interests, priorities, and goals; and (e) skills and supports--developing the institutional supports to be successful. Mentoring relationships created for academic training and career development contend with tasks common to many other relationships, namely, recognizing compatibility, finding time, establishing patterns, agreeing to goals, and achieving aims. Identifying challenges faced by mentees can facilitate the development of appropriate trainings and supports to foster mentoring relationships in academic and career settings.

Key Health Information Technologies and Related Issues for Iran: A Qualitative Study

PubMed Central

Hemmat, Morteza; Ayatollahi, Haleh; Maleki, Mohammadreza; Saghafi, Fatemeh

2018-01-01

Background and Objective: Planning for the future of Health Information Technology (HIT) requires applying a systematic approach when conducting foresight studies. The aim of this study was to identify key health information technologies and related issues for Iran until 2025. Methods: This was a qualitative study and the participants included experts and policy makers in the field of health information technology. In-depth semi-structured interviews were conducted and data were analyzed by using framework analysis and MAXQDA software. Results: The findings revealed that the development of national health information network, electronic health records, patient health records, a cloud-based service center, interoperability standards, patient monitoring technologies, telehealth, mhealth, clinical decision support systems, health information technology and mhealth infrastructure were found to be the key technologies for the future. These technologies could influence the economic, organizational and individual levels. To achieve them, the economic and organizational obstacles need to be overcome. Conclusion: In this study, a number of key technologies and related issues were identified. This approach can help to focus on the most important technologies in the future and to priorities these technologies for better resource allocation and policy making. PMID:29854016

Are Australians concerned about nanoparticles? A comparative analysis with established and emerging environmental health issues.

PubMed

Capon, Adam; Rolfe, Margaret; Gillespie, James; Smith, Wayne

2015-02-01

Introducing new technologies into society raises considerable public concern. We determine the public concern about nanoparticles, and compare this concern to other environmental health issues such as wind farms and coal seam gas production. A repeat cross sectional survey examining views on environmental health issues, risk, chemicals and trust was undertaken in more than 1,300 Australian residents in 2000 and 2013. Logistic regression and principal component analysis was used to investigate predictors of nanoparticle concern and identify a component structure for environmental health issues that could explain a trend of future nanoparticle concern. Australians have a relatively low level of concern about the risks of nanoparticles to health when compared to their concerns about other environmental health issues. Items associated with concern included gender, a general wish to avoid chemicals and possibly trust in politicians. Concern over nanoparticles clustered with similar views on technological risks. Current public concern over the risks of nanoparticles is low. However, a reframing of the issue towards 'chemicals' is likely to have a negative effect on risk perceptions. This paper raises questions about appropriate channels for the effective communication of risk. © 2015 Public Health Association of Australia.

Factor Structure of Scores from the Conners’ Rating Scales–Revised Among Nepali Children

PubMed Central

Pendergast, Laura L.; Vandiver, Beverly J.; Schaefer, Barbara A.; Cole, Pamela M.; Murray-Kolb, Laura M.; Christian, Parul

2014-01-01

This study used exploratory and confirmatory factor analyses to examine the structures of scores from the Conners’ Teacher and Parent Rating Scales–Revised (CTRS-R and CPRS-R, respectively; Conners, 1997). The scales were administered to 1,835 parents and 1,387 teachers of children in Nepal's Sarlahi district – a region where no other measures of child psychopathology have been studied. With a Nepali sample, the findings indicate that reduced two factor models for the Conners’ scales are superior to the models identified in the scale development research. The hyperactivity and inattention factors were comparable to what has been identified in prior research, while other factors (e.g., social problems) differed substantially. Implications for use of the Conners’ scales in Nepal and cross cultural issues in the assessment of ADHD symptoms are discussed. PMID:25574454

Improving Olympic health services: what are the common health care planning issues?

PubMed

Kononovas, Kostas; Black, Georgia; Taylor, Jayne; Raine, Rosalind

2014-12-01

Due to their scale, the Olympic and Paralympic Games have the potential to place significant strain on local health services. The Sydney 2000, Athens 2004, Beijing 2008, Vancouver 2010, and London 2012 Olympic host cities shared their experiences by publishing reports describing health care arrangements. Olympic planning reports were compared to highlight best practices, to understand whether and which lessons are transferable, and to identify recurring health care planning issues for future hosts. A structured, critical, qualitative analysis of all available Olympic health care reports was conducted. Recommendations and issues with implications for future Olympic host cities were extracted from each report. The six identified themes were: (1) the importance of early planning and relationship building: clarifying roles early to agree on responsibility and expectations, and engaging external and internal groups in the planning process from the start; (2) the development of appropriate medical provision: most health care needs are addressed inside Olympic venues rather than by hospitals which do not experience significant increases in attendance during the Games; (3) preparing for risks: gastrointestinal and food-borne illnesses are the most common communicable diseases experienced during the Games, but the incidence is still very low; (4) addressing the security risk: security arrangements are one of the most resource-demanding tasks; (5) managing administration and logistical issues: arranging staff permission to work at Games venues ("accreditation") is the most complex administrative task that is likely to encounter delays and errors; and (6) planning and assessing health legacy programs: no previous Games were able to demonstrate that their health legacy initiatives were effective. Although each report identified similar health care planning issues, subsequent Olympic host cities did not appear to have drawn on the transferable experiences of previous host cities. Repeated recommendations and lessons from host cities show that similar health care planning issues occur despite different health systems. To improve health care planning and delivery, host cities should pay heed to the specific planning issues that have been highlighted. It is also advisable to establish good communication with organizers from previous Games to learn first-hand about planning from previous hosts.

Print news coverage of school-based human papillomavirus vaccine mandates.

PubMed

Casciotti, Dana M; Smith, Katherine C; Andon, Lindsay; Vernick, Jon; Tsui, Amy; Klassen, Ann C

2014-02-01

In 2007, legislation was proposed in 24 states and the District of Columbia for school-based human papillomavirus (HPV) vaccine mandates, and mandates were enacted in Texas, Virginia, and the District of Columbia. Media coverage of these events was extensive, and media messages both reflected and contributed to controversy surrounding these legislative activities. Messages communicated through the media are an important influence on adolescent and parent understanding of school-based vaccine mandates. We conducted structured text analysis of newspaper coverage, including quantitative analysis of 169 articles published in mandate jurisdictions from 2005 to 2009, and qualitative analysis of 63 articles from 2007. Our structured analysis identified topics, key stakeholders and sources, tone, and the presence of conflict. Qualitative thematic analysis identified key messages and issues. Media coverage was often incomplete, providing little context about cervical cancer or screening. Skepticism and autonomy concerns were common. Messages reflected conflict and distrust of government activities, which could negatively impact this and other youth-focused public health initiatives. If school health professionals are aware of the potential issues raised in media coverage of school-based health mandates, they will be more able to convey appropriate health education messages and promote informed decision-making by parents and students. © 2014, American School Health Association.

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

Wangel, Josefin, E-mail: josefin.wangel@abe.kth.se; Wallhagen, Marita, E-mail: marita.wallhagen@hig.se; Department of Building, Energy and Environmental Engineering, University of Gävle, SE-801 76 Gävle

Certification systems for sustainable neighbourhoods started to emerge around a decade ago. This study analysed the content, structure, weighting and indicators of two established certification systems for sustainable urban development – BREEAM Communities and LEED for Neighborhood Development. Several limitations of these systems were identified: both have a bias for procedure and feature indicators over indicators that assess actual performance; performance demands are set according to a relative understanding of sustainable development; the focus is on internal sustainability, while upstream and downstream impacts of construction are disregarded; the number and distribution of mandatory issues do not cover essential sustainability aspects;more » and the disproportionately large number of non-mandatory issues makes benchmarking difficult and signals that sustainability aspects are exchangeable. Altogether, this means that an area can be certified without being sustainable. Moreover, the lack of continuous development of certification requirements in the systems means that they risk exerting a conservative effect on urban development, rather than pushing it forward. - Highlights: • BREEAM-C and LEED-ND were analysed in terms of content and structure. • Specific attention was given to the type of indicators used for showing compliance. • In both systems procedure and feature indicators dominate over performance indicators. • Several other limitations of these certification systems were also identified. • Altogether the limitations imply that a certificate does not warrant sustainability.« less

Spectroscopic Studies of the Chan-Lam Amination: A Mechanism-Inspired Solution to Boronic Ester Reactivity.

PubMed

Vantourout, Julien C; Miras, Haralampos N; Isidro-Llobet, Albert; Sproules, Stephen; Watson, Allan J B

2017-04-05

We report an investigation of the Chan-Lam amination reaction. A combination of spectroscopy, computational modeling, and crystallography has identified the structures of key intermediates and allowed a complete mechanistic description to be presented, including off-cycle inhibitory processes, the source of amine and organoboron reactivity issues, and the origin of competing oxidation/protodeboronation side reactions. Identification of key mechanistic events has allowed the development of a simple solution to these issues: manipulating Cu(I) → Cu(II) oxidation and exploiting three synergistic roles of boric acid has allowed the development of a general catalytic Chan-Lam amination, overcoming long-standing and unsolved amine and organoboron limitations of this valuable transformation.

Clinical Ethics in Gabon: The Spectrum of Clinical Ethical Issues Based on Findings from In-Depth Interviews at Three Public Hospitals

PubMed Central

Sippel, Daniel; Marckmann, Georg; Ndzie Atangana, Etienne; Strech, Daniel

2015-01-01

Introduction Unlike issues in biomedical research ethics, ethical challenges arising in daily clinical care in Sub-Saharan African countries have not yet been studied in a systematic manner. However this has to be seen as a distinct entity as we argue in this paper. Our aim was to give an overview of the spectrum of clinical ethical issues and to understand what influences clinical ethics in the Sub-Saharan country of Gabon. Materials and Methods In-depth interviews with 18 health care professionals were conducted at three hospital sites in Gabon. Interview transcripts were analyzed using a grounded theory approach (open and axial coding), giving a qualitative spectrum of categories for clinical ethical issues. Validity was checked at a meeting with study participants and other health care experts in Gabon after analysis of the data. Results Twelve main categories (with 28 further-specified subcategories) for clinical ethical issues were identified and grouped under three core categories: A) micro level: “confidentiality and information”, “interpersonal, relational and behavioral issues”, “psychological strain of individuals”, and “scarce resources”; B) meso level: “structural issues of medical institutions”, “issues with private clinics”, “challenges connected to the family”, and “issues of education, training and competence”; and C) macro level: “influence of society, culture, religion and superstition”, “applicability of western medicine”, “structural issues on the political level”, and “legal issues”. Discussion Interviewees reported a broad spectrum of clinical ethical issues that go beyond challenges related to scarce financial and human resources. Specific socio-cultural, historical and educational backgrounds also played an important role. In fact these influences are central to an understanding of clinical ethics in the studied local context. Further research in the region is necessary to put our study into perspective. As many participants reported a lack of awareness of ethical issues amongst other health care professionals in daily clinical practice, we suggest that international organizations and national medical schools should consider infrastructure and tools to improve context-sensitive capacity building in clinical ethics for Sub-Saharan African countries like Gabon. PMID:26161655

Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking.

PubMed

El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

2015-01-01

Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts' opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can contribute to redefining the role of media in strengthening health systems.

Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

PubMed Central

El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

2015-01-01

Background Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Methods Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Results Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Conclusion Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can contribute to redefining the role of media in strengthening health systems. PMID:26308077

Development of fine-celled bio-fiber composite foams using physical blowing agents and nano-particles

NASA Astrophysics Data System (ADS)

Guo, Gangjian

As one of eco-friendly bio-fibers, wood-fiber has been incorporated in plastics to make wood-fiber/plastic composites (WPC) with an increased stiffness, durability and lowered cost. However, these improvements are usually accompanied by loss in the ductility and impact strength of the composites. These shortcomings can be significantly improved by incorporating a fine-cell foam structure in the composites. This thesis presents the development of the foaming technology for the manufacture of fine-cell WPC foams with environmentally benign physical blowing agents (PBAs), and focuses on the elucidation of the fundamental foaming mechanisms and the related issues involved. One critical issue comes from the volatiles evolved from the wood-fiber during high temperature processing. The volatiles, as a blowing agent, can contribute to the foaming process. However, they lead to gross deterioration of the cell structure of WPC foams. The presence of volatiles makes foaming of WPC "a poorly understood black art". With the use of PBAs, a strategy of lowering processing temperature becomes feasible, to suppress the generation of volatiles. A series of PBA-based experiments were designed using a statistical design of experiments (DOE) technique, and were performed to establish the relationship of processing and material variables with the structure of WPC foams. Fundamental foaming behaviors for two different PBAs and two different polymer systems were identified. WPC foams with a fine-cell morphology and a desired density were successfully obtained at the optimized conditions. Another limitation for the wider application of WPC is their flammability. Innovative use of a small amount of nano-clay in WPC significantly improved the flame-retarding property of WPC, and the key issue was to achieve a high degree of exfoliation of nano-particles in the polymer matrix, to achieve a desired flammability reduction. The synergistic effects of nano-particles in foaming of WPC were identified as well.

Comparison of dissimilarity measures for cluster analysis of X-ray diffraction data from combinatorial libraries

NASA Astrophysics Data System (ADS)

Iwasaki, Yuma; Kusne, A. Gilad; Takeuchi, Ichiro

2017-12-01

Machine learning techniques have proven invaluable to manage the ever growing volume of materials research data produced as developments continue in high-throughput materials simulation, fabrication, and characterization. In particular, machine learning techniques have been demonstrated for their utility in rapidly and automatically identifying potential composition-phase maps from structural data characterization of composition spread libraries, enabling rapid materials fabrication-structure-property analysis and functional materials discovery. A key issue in development of an automated phase-diagram determination method is the choice of dissimilarity measure, or kernel function. The desired measure reduces the impact of confounding structural data issues on analysis performance. The issues include peak height changes and peak shifting due to lattice constant change as a function of composition. In this work, we investigate the choice of dissimilarity measure in X-ray diffraction-based structure analysis and the choice of measure's performance impact on automatic composition-phase map determination. Nine dissimilarity measures are investigated for their impact in analyzing X-ray diffraction patterns for a Fe-Co-Ni ternary alloy composition spread. The cosine, Pearson correlation coefficient, and Jensen-Shannon divergence measures are shown to provide the best performance in the presence of peak height change and peak shifting (due to lattice constant change) when the magnitude of peak shifting is unknown. With prior knowledge of the maximum peak shifting, dynamic time warping in a normalized constrained mode provides the best performance. This work also serves to demonstrate a strategy for rapid analysis of a large number of X-ray diffraction patterns in general beyond data from combinatorial libraries.

Perceptions of work-time and leisure-time among managers and field staff in a UK primary health care trust.

PubMed

Brown, Reva Berman; Adebayo, Shirley A

2004-09-01

The aims of the research were to explore the issues around the perception of District Nurses in an inner London Primary Health Care Trust of their use of work-time and leisure-time, and to reveal how the boundaries between these two aspects can become blurred and impinge on each other. Time use is helpful in considerations of wider issues such as satisfaction at work and work-life balance. The data were collected by a questionnaire to seek the views of managers and field staff on issues such as the impact on the quality of patient care of the nurses' perception of work-time and leisure-time. The research identified the different perception of "work-time" that employees have in relation to their place within the hierarchical structure. The findings answered the question of whether time is perceived differently, dependent on one's occupation within the Trust.

Factors that influence disclosure of hearing loss in the workplace.

PubMed

Southall, Kenneth; Jennings, Mary Beth; Gagné, Jean-Pierre

2011-10-01

The objective of the study was to identify factors that lead individuals to conceal or disclose their hearing loss in the workplace. A qualitative research paradigm called qualitative description was selected to address this issue. Twelve people who had an adult onset hearing loss, and were gainfully employed, participated in audio-recorded semi-structured interviews designed to probe issues related to disclosure of hearing loss. A photo elicitation interview technique was employed during the interviews. Content analyses were used to extract pertinent information from verbatim transcripts. Five recurring themes emerged as important considerations in relation to this topic: (1) perceived importance of the situation; (2) perceived sense of control; (3) community affiliation; (4) burden of communication; and (5) coexisting issues related to hearing loss. The findings are discussed in relation to other concealable stigmatizing traits, stigma-theory, and social-cognitive theory. The clinical implications of these findings are discussed, with particular emphasis placed on worker self-efficacy.

Critical theory as an approach to the ethics of information security.

PubMed

Stahl, Bernd Carsten; Doherty, Neil F; Shaw, Mark; Janicke, Helge

2014-09-01

Information security can be of high moral value. It can equally be used for immoral purposes and have undesirable consequences. In this paper we suggest that critical theory can facilitate a better understanding of possible ethical issues and can provide support when finding ways of addressing them. The paper argues that critical theory has intrinsic links to ethics and that it is possible to identify concepts frequently used in critical theory to pinpoint ethical concerns. Using the example of UK electronic medical records the paper demonstrates that a critical lens can highlight issues that traditional ethical theories tend to overlook. These are often linked to collective issues such as social and organisational structures, which philosophical ethics with its typical focus on the individual does not tend to emphasise. The paper suggests that this insight can help in developing ways of researching and innovating responsibly in the area of information security.

Representing causal knowledge in environmental policy interventions: Advantages and opportunities for qualitative influence diagram applications.

PubMed

Carriger, John F; Dyson, Brian E; Benson, William H

2018-01-15

This article develops and explores a methodology for using qualitative influence diagrams in environmental policy and management to support decision making efforts that minimize risk and increase resiliency. Influence diagrams are representations of the conditional aspects of a problem domain. Their graphical properties are useful for structuring causal knowledge relevant to policy interventions and can be used to enhance inference and inclusivity of multiple viewpoints. Qualitative components of influence diagrams are beneficial tools for identifying and examining the interactions among the critical variables in complex policy development and implementation. Policy interventions on social-environmental systems can be intuitively diagrammed for representing knowledge of critical relationships among economic, environmental, and social attributes. Examples relevant to coastal resiliency issues in the U.S. Gulf Coast region are developed to illustrate model structures for developing qualitative influence diagrams useful for clarifying important policy intervention issues and enhancing transparency in decision making. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

In and across bureaucracy: structural and administrative issues for the tobacco endgame.

PubMed

Isett, Kimberley R

2013-05-01

This article assesses the structural choices for the proposed tobacco endgame strategies. I focus on the issues associated with particular structural choices for the location of the implementation. Specifically, I discuss issues related to implementation of the endgame within a specific single agency, and issues related to a more widespread, broad implementation involving several agencies. Where appropriate, I provide examples of how the dynamics discussed would apply to particular endgame strategies. Issues related to design, administration, authority and finances are raised.

In and across bureaucracy: structural and administrative issues for the tobacco endgame

PubMed Central

Isett, Kimberley R

2013-01-01

This article assesses the structural choices for the proposed tobacco endgame strategies. I focus on the issues associated with particular structural choices for the location of the implementation. Specifically, I discuss issues related to implementation of the endgame within a specific single agency, and issues related to a more widespread, broad implementation involving several agencies. Where appropriate, I provide examples of how the dynamics discussed would apply to particular endgame strategies. Issues related to design, administration, authority and finances are raised. PMID:23591514

Causal discovery and inference: concepts and recent methodological advances.

PubMed

Spirtes, Peter; Zhang, Kun

This paper aims to give a broad coverage of central concepts and principles involved in automated causal inference and emerging approaches to causal discovery from i.i.d data and from time series. After reviewing concepts including manipulations, causal models, sample predictive modeling, causal predictive modeling, and structural equation models, we present the constraint-based approach to causal discovery, which relies on the conditional independence relationships in the data, and discuss the assumptions underlying its validity. We then focus on causal discovery based on structural equations models, in which a key issue is the identifiability of the causal structure implied by appropriately defined structural equation models: in the two-variable case, under what conditions (and why) is the causal direction between the two variables identifiable? We show that the independence between the error term and causes, together with appropriate structural constraints on the structural equation, makes it possible. Next, we report some recent advances in causal discovery from time series. Assuming that the causal relations are linear with nonGaussian noise, we mention two problems which are traditionally difficult to solve, namely causal discovery from subsampled data and that in the presence of confounding time series. Finally, we list a number of open questions in the field of causal discovery and inference.

Propulsion Systems Panel deliberations

NASA Technical Reports Server (NTRS)

Bianca, Carmelo J.; Miner, Robert; Johnston, Lawrence M.; Bruce, R.; Dennies, Daniel P.; Dickenson, W.; Dreshfield, Robert; Karakulko, Walt; Mcgaw, Mike; Munafo, Paul M.

1993-01-01

The Propulsion Systems Panel was established because of the specialized nature of many of the materials and structures technology issues related to propulsion systems. This panel was co-chaired by Carmelo Bianca, MSFC, and Bob Miner, LeRC. Because of the diverse range of missions anticipated for the Space Transportation program, three distinct propulsion system types were identified in the workshop planning process: liquid propulsion systems, solid propulsion systems and nuclear electric/nuclear thermal propulsion systems.

Recent Advances in Agglomerated Multigrid

NASA Technical Reports Server (NTRS)

Nishikawa, Hiroaki; Diskin, Boris; Thomas, James L.; Hammond, Dana P.

2013-01-01

We report recent advancements of the agglomerated multigrid methodology for complex flow simulations on fully unstructured grids. An agglomerated multigrid solver is applied to a wide range of test problems from simple two-dimensional geometries to realistic three- dimensional configurations. The solver is evaluated against a single-grid solver and, in some cases, against a structured-grid multigrid solver. Grid and solver issues are identified and overcome, leading to significant improvements over single-grid solvers.

Propulsion Systems Panel deliberations

NASA Astrophysics Data System (ADS)

Bianca, Carmelo J.; Miner, Robert; Johnston, Lawrence M.; Bruce, R.; Dennies, Daniel P.; Dickenson, W.; Dreshfield, Robert; Karakulko, Walt; McGaw, Mike; Munafo, Paul M.

1993-02-01

The Propulsion Systems Panel was established because of the specialized nature of many of the materials and structures technology issues related to propulsion systems. This panel was co-chaired by Carmelo Bianca, MSFC, and Bob Miner, LeRC. Because of the diverse range of missions anticipated for the Space Transportation program, three distinct propulsion system types were identified in the workshop planning process: liquid propulsion systems, solid propulsion systems and nuclear electric/nuclear thermal propulsion systems.

Algebra of Majorana doubling.

PubMed

Lee, Jaehoon; Wilczek, Frank

2013-11-27

Motivated by the problem of identifying Majorana mode operators at junctions, we analyze a basic algebraic structure leading to a doubled spectrum. For general (nonlinear) interactions the emergent mode creation operator is highly nonlinear in the original effective mode operators, and therefore also in the underlying electron creation and destruction operators. This phenomenon could open up new possibilities for controlled dynamical manipulation of the modes. We briefly compare and contrast related issues in the Pfaffian quantum Hall state.

Emergency management in health: key issues and challenges in the UK.

PubMed

Lee, Andrew C K; Phillips, Wendy; Challen, Kirsty; Goodacre, Steve

2012-10-19

Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Four thematic categories for future research emerged:(i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained.(ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required.(iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus specific planning, and reactive versus proactive approaches to emergencies.(iv) Emergency management system: More study is required of system-wide issues relating to system configuration and operation, public engagement, and how emergency planning is assessed.

Hospital ergonomics: a qualitative study to explore the organizational and cultural factors.

PubMed

Hignett, Sue

2003-07-15

The primary objective was to identify the characteristics of the health care industry with respect to organizational and cultural factors and consider how these might impact on the practice of ergonomics. Qualitative methodology was chosen as a suitable approach. This was supported by a middle ground philosophical position. Twenty-one interviews were carried out with academics and practitioners using a questionnaire proforma which developed iteratively over the 18 months of the project. A progressive four stage sampling strategy was used starting with purposive sampling to spread the net. Suggested contacts were then followed up (snowball sampling), before the third stage of intensity sampling to focus on participants with specific experience in hospital ergonomics. A final strategy of analysis sampling sought extreme and deviant cases to achieve theoretical saturation. The analysis resulted in three categories: organizational, staff and patient issues. The organizational issues included both the size and complexity of the National Health Service. For example, three hierarchical lines were identified in the management structure: an administrative line, a professional line and a patient-focused clinical management line. One of the surprising findings for the staff issues was the perceived lack of ergonomic information about female workers as a population group and traditional female employment sectors. The patient issues incorporated three dimensions associated with the caring role: the type of work; expectations; and possible outcomes. The work tends to be dirty and emotional, with a professional subculture to allow the handling of other peoples' bodies. This subculture was linked to a 'coping' attitude where staff put the patients' needs and well-being before their own. The change in patient expectations (from being apologetic through to demanding their rights) is mirrored in a changing model of care from paternalism to partnership. A lack of ergonomic research was identified for female workers in the health care industry relating to both the type of work and gender issues.

Human Health Risk Assessment of Pharmaceuticals in Water: Issues and Challenges Ahead

PubMed Central

Kumar, Arun; Chang, Biao; Xagoraraki, Irene

2010-01-01

This study identified existing issues related to quantitative pharmaceutical risk assessment (QPhRA, hereafter) for pharmaceuticals in water and proposed possible solutions by analyzing methodologies and findings of different published QPhRA studies. Retrospective site-specific QPhRA studies from different parts of the world (U.S.A., United Kingdom, Europe, India, etc.) were reviewed in a structured manner to understand different assumptions, outcomes obtained and issues, identified/addressed/raised by the different QPhRA studies. Till date, most of the published studies have concluded that there is no appreciable risk to human health during environmental exposures of pharmaceuticals; however, attention is still required to following identified issues: (1) Use of measured versus predicted pharmaceutical concentration, (2) Identification of pharmaceuticals-of-concern and compounds needing special considerations, (3) Use of source water versus finished drinking water-related exposure scenarios, (4) Selection of representative exposure routes, (5) Valuation of uncertainty factors, and (6) Risk assessment for mixture of chemicals. To close the existing data and methodology gaps, this study proposed possible ways to address and/or incorporation these considerations within the QPhRA framework; however, more research work is still required to address issues, such as incorporation of short-term to long-term extrapolation and mixture effects in the QPhRA framework. Specifically, this study proposed a development of a new “mixture effects-related uncertainty factor” for mixture of chemicals (i.e., mixUFcomposite), similar to an uncertainty factor of a single chemical, within the QPhRA framework. In addition to all five traditionally used uncertainty factors, this uncertainty factor is also proposed to include concentration effects due to presence of different range of concentration levels of pharmaceuticals in a mixture. However, further work is required to determine values of all six uncertainty factors and incorporate them to use during estimation of point-of-departure values within the QPhRA framework. PMID:21139869

Structural design considerations for a Personnel Launch System

NASA Technical Reports Server (NTRS)

Bush, Lance B.; Lentz, Christopher A.; Robinson, James C.; Macconochie, Ian O.

1990-01-01

A vehicle capable of performing the transfer of eight people to and from the Space Station Freedom is currently in the conceptual/preliminary design stages at the NASA Langley Research Center. Structural definition of this Personnel Launch System (PLS) and the considerations leading to it are described. Issues such as cost, technology level, human factors, and maintainability are used as guidelines for the structural definition. A synergistic design technique involving aerodynamics, performance, mission, packaging, and weights and sizing analyses is utilized to evaluate the structural design. A closed-loop design is achieved when the mission requirements are met by each previously mentioned analysis for a particular vehicle weight. Although satisfactory, the structural concept presented herein is not to be treated as a final answer, but one promising solution. An examination of alternative designs and more detailed analyses can be undertaken in order to identify design inadequacies and more efficient approaches.

Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH) program

NASA Astrophysics Data System (ADS)

Fayette, Daniel F.; Speicher, Patricia; Stoklosa, Mark J.; Evans, Jillian V.; Evans, John W.; Gentile, Mike; Pagel, Chuck A.; Hakim, Edward

1993-08-01

A joint military-commercial effort to evaluate multichip module (MCM) structures is discussed. The program, Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH), has been designed to identify the failure mechanisms that are possible in MCM structures. The RELTECH test vehicles, technical assessment task, product evaluation plan, reliability modeling task, accelerated and environmental testing, and post-test physical analysis and failure analysis are described. The information obtained through RELTECH can be used to address standardization issues, through development of cost effective qualification and appropriate screening criteria, for inclusion into a commercial specification and the MIL-H-38534 general specification for hybrid microcircuits.

Keeping Hawai’i’s forest birds one step ahead of avian diseases in a warming world: a focus on Hakalau Forest National Wildlife Refuge. A case study from the National Conservation and Training Center Structured Decision Making Workshop

USGS Publications Warehouse

Paxton, Eben H.; Burgett, Jeff; McDonald-Fadden, Eve; Bean, Ellen; Atkinson, Carter T.; Ball, Donna; Cole, Colleen; Crampton, Lisa H.; Kraus, Jim; LaPointe, Dennis A.; Mehrhoff, Loyal; Samuel, Michael D.; Brewer, Donna; Converse, Sarah J.; Morey, Steve

2011-01-01

This report is a product of a one-week workshop on using Structured Decision Making to identify and prioritize conservation actions to address the threat of climate change on Hawaii‟s native forest bird community. Specifically, t his report addresses the issue of global warming ‟s likely role in increasing disease prevalence in upper elevation forests of Hawaii, negatively impacting native bird populations susceptible to the disease but currently disease - free because of the cooler temperatures at high elevations. 

Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH) program

NASA Technical Reports Server (NTRS)

Fayette, Daniel F.; Speicher, Patricia; Stoklosa, Mark J.; Evans, Jillian V.; Evans, John W.; Gentile, Mike; Pagel, Chuck A.; Hakim, Edward

1993-01-01

A joint military-commercial effort to evaluate multichip module (MCM) structures is discussed. The program, Reliability Technology to Achieve Insertion of Advanced Packaging (RELTECH), has been designed to identify the failure mechanisms that are possible in MCM structures. The RELTECH test vehicles, technical assessment task, product evaluation plan, reliability modeling task, accelerated and environmental testing, and post-test physical analysis and failure analysis are described. The information obtained through RELTECH can be used to address standardization issues, through development of cost effective qualification and appropriate screening criteria, for inclusion into a commercial specification and the MIL-H-38534 general specification for hybrid microcircuits.

Work-related barriers, facilitators, and strategies of breast cancer survivors working during curative treatment.

PubMed

Sun, Wenjun; Chen, Karen; Terhaar, Abigail; Wiegmann, Douglas A; Heidrich, Susan M; Tevaarwerk, Amye J; Sesto, Mary E

2016-01-01

Research has identified barriers and facilitators affecting cancer survivors' return to work (RTW) following the end of active treatment (surgery, chemotherapy and/or radiation therapy). However, few studies have focused on barriers and facilitators that cancer survivors experience while working during active treatment. Strategies used by cancer survivors to solve work-related problems during active treatment are underexplored. The aim of this study was to describe factors that impact, either positively or negatively, breast cancer survivors' work activities during active treatment. Semi-structured, recorded interviews were conducted with 35 breast cancer survivors who worked during active treatment. Transcripts of interviews were analyzed using inductive content analysis to identify themes regarding work-related barriers, facilitators and strategies. Barriers identified included symptoms, emotional distress, appearance change, time constraints, work characteristics, unsupportive supervisors and coworkers, family issues and other illness. Facilitators included positive aspects of work, support outside of work, and coworker and supervisor support. Strategies included activities to improve health-related issues and changes to working conditions and tasks. Breast cancer survivors encounter various barriers during active treatment. Several facilitators and strategies can help survivors maintain productive work activities.

Work-related barriers, facilitators, and strategies of breast cancer survivors working during curative treatment

PubMed Central

Sun, Wenjun; Chen, Karen; Terhaar, Abigail; Wiegmann, Douglas A.; Heidrich, Susan M.; Tevaarwerk, Amye J.; Sesto, Mary E.

2017-01-01

BACKGROUND Research has identified barriers and facilitators affecting cancer survivors’ return to work (RTW) following the end of active treatment (surgery, chemotherapy and/or radiation therapy). However, few studies have focused on barriers and facilitators that cancer survivors experience while working during active treatment. Strategies used by cancer survivors to solve work-related problems during active treatment are underexplored. OBJECTIVE The aim of this study was to describe factors that impact, either positively or negatively, breast cancer survivors’ work activities during active treatment. METHODS Semi-structured, recorded interviews were conducted with 35 breast cancer survivors who worked during active treatment. Transcripts of interviews were analyzed using inductive content analysis to identify themes regarding work-related barriers, facilitators and strategies. RESULTS Barriers identified included symptoms, emotional distress, appearance change, time constraints, work characteristics, unsupportive supervisors and coworkers, family issues and other illness. Facilitators included positive aspects of work, support outside of work, and coworker and supervisor support. Strategies included activities to improve health-related issues and changes to working conditions and tasks. CONCLUSIONS Breast cancer survivors encounter various barriers during active treatment. Several facilitators and strategies can help survivors maintain productive work activities. PMID:28059814

Application of a design-build-team approach to low cost and weight composite fuselage structure

NASA Technical Reports Server (NTRS)

Ilcewicz, L. B.; Walker, T. H.; Willden, K. S.; Swanson, G. D.; Truslove, G.; Metschan, S. L.; Pfahl, C. L.

1991-01-01

Relationships between manufacturing costs and design details must be understood to promote the application of advanced composite technologies to transport fuselage structures. A team approach, integrating the disciplines responsible for aircraft structural design and manufacturing, was developed to perform cost and weight trade studies for a twenty-foot diameter aft fuselage section. Baseline composite design and manufacturing concepts were selected for large quadrant panels in crown, side, and keel areas of the fuselage section. The associated technical issues were also identified. Detailed evaluation of crown panels indicated the potential for large weight savings and costs competitive with aluminum technology in the 1995 timeframe. Different processes and material forms were selected for the various elements that comprise the fuselage structure. Additional cost and weight savings potential was estimated for future advancements.

Exploring issues and strengths of cross-cultural marriage among Korean immigrants.

PubMed

Kim, Junhyoung; Park, Se-Hyuk; Kim, May; Kim, Su Yeon

2017-10-01

Cross-cultural marriages have continuously increased in the United States. In spite of this increase, further research is needed to address the paucity of literature on cross-cultural marriage, particularly, between immigrants and their indigenous spouses. In this study, we have focused on the cross-cultural marriages between female Korean immigrants who have married Americans, aiming to identify the positive and/or negative aspects of cross-cultural marriage from the Korean women themselves. For this purpose, semi-structured interviews were conducted on a total of 14 participants. Their ages ranged from 45 to 66 years (M D 52.5 years) and the average length of time since their immigration was 25 years. Each interview lasted between 45 and 120 min and, with participants' permission, were recorded and transcribed. Based on the participants' life experiences and personal statements, we divided our findings into two sections: (a) issues and problems of cross-cultural marriages, and (b) strengths of cross-cultural marriages. With regard to the issues and problems of cross-cultural marriages experienced by participants, three major themes were identified: (a) communication barriers, (b) cultural conflicts and misunderstandings, and (c) unclear cultural identities. The strengths of cross-cultural marriages were identified as: (a) development of coping strategies, and (b) improving cultural understanding. It appears that participants developed their own coping strategies and improved their cultural understanding in order to deal with the various stressors associated with cross-cultural marriage.

Impact of legal regulations and administrative policies on persons with SCI: identifying potential research priorities through expert interviews.

PubMed

Trezzini, Bruno; Phillips, Barbara

2014-01-01

To identify research gaps and potential research priorities regarding the impact that legal regulations and administrative policies might have on people with spinal cord injury (SCI) living in Switzerland. We conducted semi-structured interviews with 14 healthcare professionals working for or being associated with the largest SCI clinic in Switzerland. The transcribed interviews were content analyzed, involving qualitative description, and thematic analysis techniques. Four interrelated clusters of issues were corroborated: (1) social insurance, (2) caregiving, (3) work integration, and (4) aging. In addition, two overarching themes were identified: (1) fairness considerations and (2) unavailability of systematic empirical evidence. Work capacity assessment and family caregiving were deemed to be the most pressing research priority areas. Legal frameworks do play both a direct and an indirect role in the lives of people with SCI in Switzerland. This is particularly true with regard to various issues related to the social insurance system, such as family caregiving and work capacity assessment. The salience of these topics is closely related to major sociodemographic and political driving forces, i.e. aging and social insurance reforms. Research directly involving people with SCI is needed to further substantiate and refine the findings of this study. When dealing with issues related to work reintegration, aging, social insurance, and caregiving, rehabilitation professionals should take existing legal frameworks into account. Eligibility criteria for disability benefits may influence the therapy motivation of rehabilitation clients.

An introduction to structural health monitoring.

PubMed

Farrar, Charles R; Worden, Keith

2007-02-15

The process of implementing a damage identification strategy for aerospace, civil and mechanical engineering infrastructure is referred to as structural health monitoring (SHM). Here, damage is defined as changes to the material and/or geometric properties of these systems, including changes to the boundary conditions and system connectivity, which adversely affect the system's performance. A wide variety of highly effective local non-destructive evaluation tools are available for such monitoring. However, the majority of SHM research conducted over the last 30 years has attempted to identify damage in structures on a more global basis. The past 10 years have seen a rapid increase in the amount of research related to SHM as quantified by the significant escalation in papers published on this subject. The increased interest in SHM and its associated potential for significant life-safety and economic benefits has motivated the need for this theme issue. This introduction begins with a brief history of SHM technology development. Recent research has begun to recognize that the SHM problem is fundamentally one of the statistical pattern recognition (SPR) and a paradigm to address such a problem is described in detail herein as it forms the basis for organization of this theme issue. In the process of providing the historical overview and summarizing the SPR paradigm, the subsequent articles in this theme issue are cited in an effort to show how they fit into this overview of SHM. In conclusion, technical challenges that must be addressed if SHM is to gain wider application are discussed in a general manner.

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

PubMed

Jenkins, Constance L; Elliott, Aaron R; Harris, Janet R

2006-08-01

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

"Any other comments?" Open questions on questionnaires – a bane or a bonus to research?

PubMed Central

O'Cathain, Alicia; Thomas, Kate J

2004-01-01

Background The habitual "any other comments" general open question at the end of structured questionnaires has the potential to increase response rates, elaborate responses to closed questions, and allow respondents to identify new issues not captured in the closed questions. However, we believe that many researchers have collected such data and failed to analyse or present it. Discussion General open questions at the end of structured questionnaires can present a problem because of their uncomfortable status of being strictly neither qualitative nor quantitative data, the consequent lack of clarity around how to analyse and report them, and the time and expertise needed to do so. We suggest that the value of these questions can be optimised if researchers start with a clear understanding of the type of data they wish to generate from such a question, and employ an appropriate strategy when designing the study. The intention can be to generate depth data or 'stories' from purposively defined groups of respondents for qualitative analysis, or to produce quantifiable data, representative of the population sampled, as a 'safety net' to identify issues which might complement the closed questions. Summary We encourage researchers to consider developing a more strategic use of general open questions at the end of structured questionnaires. This may optimise the quality of the data and the analysis, reduce dilemmas regarding whether and how to analyse such data, and result in a more ethical approach to making best use of the data which respondents kindly provide. PMID:15533249

An initial investigation on the challenges of managing construction workforce in Saudi Arabia

NASA Astrophysics Data System (ADS)

Al-Emad, N.; Rahman, I. A.

2017-11-01

Most of the construction workers in Saudi Arabia are foreigners from several countries having different knowledge, skills and cultures. These create challenges to administer the workers in ensuring project success. This paper presents an initial investigation to uncover the challenges faced by construction professionals in managing construction workforce in Saudi Arabia. It describes insight processes of handling the workforce during planning stage, recruitment procedures and construction stage based on interview with senior manager who are well experienced in handling mega construction projects in Saudi Arabia. The interview was carried out in semi structured mode where the interviewee was given ample time to express the experiences encountered in dealing the workforce issue. This preliminary work able to identify among important issues related to construction workers are restrictions to non-Muslim skilled workers, limited visa quota, being away from family, delay in salary payment, cheating of workers skill’s status, safety issues, communication barriers and living conditions. Hence, these issues require quality leadership attributes such as continuous empathy with workers, respectful, trustful, sincere, reliable, good communication skills and problem solving skills. These findings are useful to construction practitioners and also research work related to construction leadership in handling worker’s issues.

Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: a reflective tool to enhance interdisciplinary teamwork using Structured, Facilitated Action Research for Implementation.

PubMed

Nancarrow, Susan A; Smith, Tony; Ariss, Steven; Enderby, Pamela M

2015-07-01

Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool (IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take for reflection, and executive support to be able to broker changes that are beyond the scope of the team. © 2014 John Wiley & Sons Ltd.

An empirical examination of the factor structure of compassion.

PubMed

Gu, Jenny; Cavanagh, Kate; Baer, Ruth; Strauss, Clara

2017-01-01

Compassion has long been regarded as a core part of our humanity by contemplative traditions, and in recent years, it has received growing research interest. Following a recent review of existing conceptualisations, compassion has been defined as consisting of the following five elements: 1) recognising suffering, 2) understanding the universality of suffering in human experience, 3) feeling moved by the person suffering and emotionally connecting with their distress, 4) tolerating uncomfortable feelings aroused (e.g., fear, distress) so that we remain open to and accepting of the person suffering, and 5) acting or being motivated to act to alleviate suffering. As a prerequisite to developing a high quality compassion measure and furthering research in this field, the current study empirically investigated the factor structure of the five-element definition using a combination of existing and newly generated self-report items. This study consisted of three stages: a systematic consultation with experts to review items from existing self-report measures of compassion and generate additional items (Stage 1), exploratory factor analysis of items gathered from Stage 1 to identify the underlying structure of compassion (Stage 2), and confirmatory factor analysis to validate the identified factor structure (Stage 3). Findings showed preliminary empirical support for a five-factor structure of compassion consistent with the five-element definition. However, findings indicated that the 'tolerating' factor may be problematic and not a core aspect of compassion. This possibility requires further empirical testing. Limitations with items from included measures lead us to recommend against using these items collectively to assess compassion. Instead, we call for the development of a new self-report measure of compassion, using the five-element definition to guide item generation. We recommend including newly generated 'tolerating' items in the initial item pool, to determine whether or not factor-level issues are resolved once item-level issues are addressed.

Ethical issues experienced by healthcare workers in nursing homes: Literature review.

PubMed

Preshaw, Deborah Hl; Brazil, Kevin; McLaughlin, Dorry; Frolic, Andrea

2016-08-01

Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress. The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs' experiences of ethical issues. Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home. The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work. The review highlighted a need for improved ethics education for care-providers. © The Author(s) 2015.

Evidence-based ergonomics: a model and conceptual structure proposal.

PubMed

Silveira, Dierci Marcio

2012-01-01

In Human Factors and Ergonomics Science (HFES), it is difficult to identify what is the best approach to tackle the workplace and systems design problems which needs to be solved, and it has been also advocated as transdisciplinary and multidisciplinary the issue of "How to solve the human factors and ergonomics problems that are identified?". The proposition on this study is to combine the theoretical approach for Sustainability Science, the Taxonomy of the Human Factors and Ergonomics (HFE) discipline and the framework for Evidence-Based Medicine in an attempt to be applied in Human Factors and Ergonomics. Applications of ontologies are known in the field of medical research and computer science. By scrutinizing the key requirements for the HFES structuring of knowledge, it was designed a reference model, First, it was identified the important requirements for HFES Concept structuring, as regarded by Meister. Second, it was developed an evidence-based ergonomics framework as a reference model composed of six levels based on these requirements. Third, it was devised a mapping tool using linguistic resources to translate human work, systems environment and the complexities inherent to their hierarchical relationships to support future development at Level 2 of the reference model and for meeting the two major challenges for HFES, namely, identifying what problems should be addressed in HFE as an Autonomous Science itself and proposing solutions by integrating concepts and methods applied in HFES for those problems.

Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis

PubMed Central

Carter, Holly; Amlôt, Richard

2016-01-01

Introduction: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents. The review focuses on five psychosocial aspects of incident management: likely public behaviour; responder management style; communication strategy; privacy/ modesty concerns; and vulnerable groups. Methods: Two structured literature reviews were carried out; one to identify decontamination guidance documents for first responders, and another to identify evidence which is relevant to the understanding of the psychosocial aspects of mass decontamination.  The guidance documents and relevant research were reviewed to identify whether the guidance documents contain information relating to psychosocial issues and where it exists, that the guidance is consistent with the existing evidence-base. Results: Psychosocial aspects of incident management receive limited attention in current decontamination guidance.  In addition, our review has identified a number of gaps and inconsistencies between guidance and research evidence.  For each of the five areas we identify: what is currently presented in guidance documents, to what extent this is consistent with the existing research evidence and where it diverges.  We present a series of evidence-based recommendations for updating decontamination guidance to address the psychosocial aspects of mass decontamination. Conclusions: Effective communication and respect for casualties’ needs are critical in ensuring decontamination is completed quickly and effectively.  We identify a number of areas requiring further research including: identifying effective methods for communicating in an emergency; better understanding of the needs of vulnerable groups during decontamination; effective training for emergency responders on psychosocial issues, and pre-incident public education for incidents involving emergency decontamination.  It is essential that the psychosocial aspects of mass decontamination are not neglected in the pursuit of solely technical solutions. PMID:27790383

Current Situation, Determinants, and Solutions to Drug Shortages in Shaanxi Province, China: A Qualitative Study.

PubMed

Yang, Caijun; Wu, Lina; Cai, Wenfang; Zhu, Wenwen; Shen, Qian; Li, Zongjie; Fang, Yu

2016-01-01

Drug shortages were a complex global problem. The aim of this study was to analyze, characterize, and assess the drug shortages, and identify possible solutions in Shaanxi Province, western China. A qualitative methodological approach was conducted during May-June 2015 and December 2015-January 2016. Semi-structured interviews were performed to gather information from representatives of hospital pharmacists, wholesalers, pharmaceutical producers, and local health authorities. Thirty participants took part in the study. Eight traditional Chinese medicines and 87 types of biologicals and chemicals were reported to be in short supply. Most were essential medicines. Five main determinants of drug shortages were detected: too low prices, too low market demands, Good Manufacturing Practice (GMP) issues, materials issues, and approval issues for imported drugs. Five different solutions were proposed by the participants: 1) let the market decide the drug price; 2) establish an information platform; 3) establish a reserve system; 4) enhance the communication among the three parties in the supply chain; and 5) improve hospital inventory management. Western China was currently experiencing a serious drug shortage. Numerous reasons for the shortage were identified. Most drug shortages in China were currently because of "too low prices." To solve this problem, all of the stakeholders, especially the government, needed to participate in managing the drug shortages.

Early Career Mentoring for Translational Researchers: Mentee Perspectives on Challenges and Issues

PubMed Central

Keller, Thomas E.; Collier, Peter J.; Blakeslee, Jennifer E.; Logan, Kay; McCracken, Karen; Morris, Cynthia

2014-01-01

Background and purposes The education and training of early career biomedical translational researchers often involves formal mentoring by more experienced colleagues. This study investigated the nature of these mentoring relationships from the perspective of mentees. The objective was to understand the challenges and issues encountered by mentees in forming and maintaining productive mentoring relationships. Method Three focus groups (n=14) were conducted with early career researchers who had mentored career development awards. Thematic analysis identified, categorized, and illustrated the challenges and issues reported by mentees. Results The range of mentee challenges was reflected in five major categories: 1) network—finding appropriate mentors to meet various needs; 2) access—structuring schedules and opportunities to receive mentoring; 3) expectations—negotiating the mechanics of the mentoring relationship and its purpose; 4) alignment—managing mentor-mentee mismatches regarding interests, priorities, and goals; and 5) skills and supports—developing the institutional supports to be successful. Conclusions Mentoring relationships created for academic training and career development contend with tasks common to many other relationships, namely recognizing compatibility, finding time, establishing patterns, agreeing to goals, and achieving aims. Identifying challenges faced by mentees can facilitate the development of appropriate trainings and supports to foster mentoring relationships in academic and career settings. PMID:25010230

CIRDAP -- the British Council Regional Workshop. Towards Gender Equity: Poverty, Rights, and Participation.

PubMed

1998-03-01

This article describes a February 1998, regional workshop entitled "Towards Gender Equity: Poverty, Rights, and Participation," which was organized by the Center on Integrated Rural Development for Asia and the Pacific (CIRDAP) and the British Council. Participants included about 60 high-level representatives of governments, nongovernmental organizations, academicians, and activists from CIRDAP, the UK, and Bangladesh. The aim was to identify ways to monitor the implementation of the Beijing Platform of Action (BPOA)in CIRDAP member countries and advocate continual compliance with the BPOA. The agenda included five issue-based working sessions, plenaries, group discussions, adoption of group resolutions, and closure. Participants visited urban schools run by the Bangladesh Rural Advancement Committee and the Gono Shahajjo Sangstha that provided education for low income, disadvantaged children. Press conferences were held pre-post workshop. Each participant at the workshop end identified at least one issue or recommendation that they would follow-up on after the workshop. Subthemes were access to income for women (access to and control of resources, microcredit, and small enterprises); rights (land rights, inheritance of property, and legal rights); political participation (good governance, community participation); economic reforms and sustainable development (structural adjustment, liberalization, and globalization), and BPOA. Under each subtheme are lists of issues or problems and recommendations.

The policy context of patient centered medical homes: perspectives of primary care providers.

PubMed

Alexander, Jeffrey A; Cohen, Genna R; Wise, Christopher G; Green, Lee A

2013-01-01

Interest in the patient centered medical home (PCMH) model has increased significantly in recent years. Despite this attention, information is limited regarding the influence of policy context on implementation of the PCMH model. Using comparative, qualitative data, we identify several key policy impediments to PCMH implementation, and propose practical guidelines for addressing these issues. Qualitative, semi-structured in-person interviews with representatives of physician organizations and primary care practices pursuing PCMH. Practitioners and staff at 16 physician practices in Michigan, as well as key leaders of physician organizations. We identified five primary policy issues cited by physicians and physician organization leaders as most impactful on their efforts to adopt PCMH: misalignment of current reimbursement schemes, administrative burden, conflicting criteria for PCMH designation, workforce policy issues, and uncertainty of health care reform. These policies were largely seen as barriers to their ability to implement PCMH. Providers' motivation to embrace PCMH, and their level of confidence regarding the results of such change, are greatly influenced by their perception of the external environment and the control they believe they have over this environment. Having policies in place that shape the path to PCMH in a manner that makes it as easy as possible for providers to accomplish the desired changes could well make the difference in whether successful transformation is achieved.

Framework development for the assessment of interprofessional teamwork in mental health settings.

PubMed

Tomizawa, Ryoko; Shigeta, Masahiro; Reeves, Scott

2017-01-01

In mental health settings, interprofessional practice is regarded as a comprehensive approach to prevent relapse and manage chronic conditions with practice of various teamwork interventions. To reinforce the potential of interprofessional teamwork, it is recommended that theories or conceptual frameworks be employed. There continues, however, to be a limited use of such approaches that assess the quality of interprofessional teamwork in mental health settings. This article aimed to present a new conceptual framework for the assessment of interprofessional teamwork based on the findings of a scoping review of the literature. This review was undertaken to identify conceptual frameworks utilised in interprofessional teamwork in mental health settings. After reviewing 952 articles, the methodological characteristics extracted from 12 articles were considered. The included studies were synthesised into the Donabedian structure-process-outcome model. The findings revealed that structural issues comprised three elements: professional characteristics, client-care characteristics, and contextual characteristics in organisations. Process issues comprised two elements: team mechanisms and community-oriented services. Finally, outcome issues comprised the following elements: clients' outcomes and professionals' outcomes. The review findings suggested possibilities for further development of how to assess the quality of interprofessional teamwork and provided information about what specific approach is required to improve interprofessional teamwork. Future research should utilise various areas and cultures to clarify the adaptation potential.

Supply Chain Management on IBS Implementation in Klang Valley Construction Industry: Challenges and Issues

NASA Astrophysics Data System (ADS)

Azrizal Fauzi, Mohd; Hasim, Sulaiman; Awang, Anizah; Ridzuan, Ahmad Ruslan Mohd; Nur Yunus, Juzailah

2017-12-01

Industrialized Building System (IBS) is a system where the components of the building are manufactured in a factory and it will be transported to the site to form the structures. The supply chain management (SCM) is a system where the delivery flows of the IBS products from manufacturers to the site. The aim of this research is to identify the major challenges and to analyze the issues on IBS implementation in SCM in Klang Valley from the manufacturers perspective. The methodology used in this paper is based on primary data through questionnaire and interview. Questionnaires were sent to the Manufacturers. It can be concluded that this paper attempts to present more on the challenges and issues that those companies of manufacturers faced during their success journey in finding integration in their supply chain. The main contributions of this paper are integrating all the supply chain integration challenges and issues on IBS. Therefore, these contributions will be helpful for the organization of manufacturers and IBS players that establish the integration in their SCM.

People are failing! Something needs to be done: Canadian students' experience with the NCLEX-RN.

PubMed

McGillis Hall, Linda; Lalonde, Michelle; Kashin, Jordana

2016-11-01

Canada's nurse regulators adopted the NCLEX as the entry-to-practice licensing exam for Canada's registered nurses effective January 2015. It is important to determine whether any issues from this change emerged for nursing students in preparing for and taking this new exam. To explore the experiences of Canadian graduate student nurses who were the first to write the NCLEX examination for entry to practice in Canada, determine whether any issues with implementation were identified and how these could be addressed. A qualitative study. Thematic analysis of semi-structured interview data obtained through interviews with 202 graduate Canadian nursing students was the methodology employed in this study. The predominant theme that emerged from the interview data was policy related issues that students identified with preparing for and taking the NCLEX. Sub-themes included: a) temporary test centre concerns, b) perceptions of American context and content on the exam, c) lack of French language resources and translation issues, d) the limited number of opportunities to write the exam, e) communication and engagement with regulators, f) financial costs incurred and g) reputational costs for the Canadian nursing profession. The experiences of study participants with NCLEX implementation in Canada were less than positive. This is of critical importance given the pass rates for first-time NCLEX writers in Canada were reported as 69.7%, substantially lower than pass rates on the previous Canadian entry-to-practice exam. Copyright © 2016 Elsevier Ltd. All rights reserved.

Problems with provision: barriers to drinking water quality and public health in rural Tasmania, Australia.

PubMed

Whelan, Jessica J; Willis, Karen

2007-01-01

Access to safe drinking water is essential to human life and wellbeing, and is a key public health issue. However, many communities in rural and regional parts of Australia are unable to access drinking water that meets national standards for protecting human health. The aim of this research was to identify the key issues in and barriers to the provision and management of safe drinking water in rural Tasmania, Australia. Semi-structured interviews were conducted with key local government employees and public health officials responsible for management of drinking water in rural Tasmania. Participants were asked about their core public health duties, regulatory responsibilities, perceptions and management of risk, as well as the key barriers that may be affecting the provision of safe drinking water. This research highlights the effect of rural locality on management and safety of fresh water in protecting public health. The key issues contributing to problems with drinking water provision and quality identified by participants included: poor and inadequate water supply infrastructure; lack of resources and staffing; inadequate catchment monitoring; and the effect of competing land uses, such as forestry, on water supply quality. This research raises issues of inequity in the provision of safe drinking water in rural communities. It highlights not only the increasing need for greater funding by state and commonwealth government for basic services such as drinking water, but also the importance of an holistic and integrated approach to managing drinking water resources in rural Tasmania.

Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up.

PubMed

Dutton, Tegan; Stevens, Wendy; Newman, Jamie

2016-01-01

This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

Sales compensation governance: the last frontier of corporate reform.

PubMed

Gundy, Peter R; Gaeta, Elizabeth C

2004-01-01

The area of sales compensation has remained relatively untouched by recent pressures for compensation reform. This article highlights some of the ways that sales organizations stumble in managing their compensation programs, and why it takes more than a simple tactical fix to address these problems effectively. The authors describe a more structured governance framework that not only identifies and resolves key sales compensation issues, but ultimately safeguards the effectiveness and financial integrity of the sales organization itself.

Afghan Ministry of Defense Headquarters: $154.7 Million Building Appears Well Built, but Has Several Construction Issues that Should Be Assessed

DTIC Science & Technology

2016-02-01

complete breaks in the floors, walls, and ceilings that divide the building into discrete sections. The objectives of this inspection were to... ceiling panels, as well as fire suppression pumps, fire alarms, and communications lines. We found other deficiencies not identified by AFCEC that...structural components suspended from the ceiling or floor above, such as heating/cooling equipment, duct work, dropped ceilings , electrical fixtures

CDS Re Mix

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

None

CDS (Change Detection Systems) is a mechanism for rapid visual analysis using complex image alignment algorithms. CDS is controlled with a simple interface that has been designed for use for anyone that can operate a digital camera. A challenge of complex industrial systems like nuclear power plants is to accurately identify changes in systems, structures and components that may critically impact the operation of the facility. CDS can provide a means of early intervention before the issues evolve into safety and production challenges.

A solid-state control system for dynein-based ciliary/flagellar motility

PubMed Central

2013-01-01

Ciliary and flagellar beating requires the coordinated action of multiple dyneins with different enzymatic and motor properties. In this issue, Yamamoto et al. (2013. J. Cell Biol. http://dx.doi.org/10.1083/jcb.201211048) identify the MIA (modifier of inner arms) complex within the Chlamydomonas reinhardtii axoneme that physically links to a known regulatory structure and provides a signaling conduit from the radial spokes to an inner arm dynein essential for waveform determination. PMID:23569213

Attitude Isn't the Only Thing, It's Everything: Humanistic Care of the Bariatric Patient Using Donabedian's Perspective on Quality of Care.

PubMed

Beitz, Janice M

2018-01-01

Comprehensive care of bariatric patients is challenging. Although structural knowledge exists about safe care given correct equipment and supplies, care processes also must be humane. The literature suggests morbidly obese patients may fear the health system because of past negative experiences. The purpose of this literature review was to examine quality issues in the care of bariatric patients in light of Donabedian's structure-process-outcomes model, emphasizing process components. Using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, and PsycINFO; the criteria English language and years 2005 to 2017; and the search terms morbid obesity, obesity, bariatric, attitudes, health professionals, health clinicians, and patient care yielded 150 articles. Of those, 35 were pertinent to the review. A subsequent search using the terms Donabedian, care, and quality in MEDLINE and CINAHL resulted in 68 and 36 citations, respectively; 4 were used. When the searches were combined, no articles were identified. Findings show care providers generally understand structure aspects (knowledge or what to do) but need increased understanding of optimal care interventions (process issues or how to perform an intervention), including physical and psychological aspects. Organizations have a responsibility to ensure appropriate equipment and supportive services are available to achieve desired outcomes. Structure components will not overcome barriers or prevent complications if uncaring attitudes (processes) interfere with interpersonal interactions. Implications for clinical practice include requisite reflection on personal belief systems and empathetic understanding of precursors to morbid obesity development. Research needs to analyze what process issues are hampering quality care delivery and how to eradicate deficiencies. Health professionals can promote optimal bariatric patient outcomes by developing necessary insight and clinical wisdom. Obesity is a worldwide epidemic and those affected deserve improved care now.

Kinetic analyses of vasculogenesis inform mechanistic studies

PubMed Central

Winfree, Seth; Chu, Chenghao; Tu, Wanzhu; Blue, Emily K.; Gohn, Cassandra R.; Dunn, Kenneth W.

2017-01-01

Vasculogenesis is a complex process by which endothelial stem and progenitor cells undergo de novo vessel formation. Quantitative assessment of vasculogenesis is a central readout of endothelial progenitor cell functionality. However, current assays lack kinetic measurements. To address this issue, new approaches were developed to quantitatively assess in vitro endothelial colony-forming cell (ECFC) network formation in real time. Eight parameters of network structure were quantified using novel Kinetic Analysis of Vasculogenesis (KAV) software. KAV assessment of structure complexity identified two phases of network formation. This observation guided the development of additional vasculogenic readouts. A tissue cytometry approach was established to quantify the frequency and localization of dividing ECFCs. Additionally, Fiji TrackMate was used to quantify ECFC displacement and speed at the single-cell level during network formation. These novel approaches were then implemented to identify how intrauterine exposure to maternal diabetes mellitus (DM) impairs fetal ECFC vasculogenesis. Fetal ECFCs exposed to maternal DM form fewer initial network structures, which are not stable over time. Correlation analyses demonstrated that ECFC samples with greater division in branches form fewer closed network structures. Additionally, reductions in average ECFC movement over time decrease structural connectivity. Identification of these novel phenotypes utilizing the newly established methodologies provides evidence for the cellular mechanisms contributing to aberrant ECFC vasculogenesis. PMID:28100488

A Thematic Analysis of Online Discussion Boards for Vasectomy.

PubMed

Samplaski, Mary K

2018-01-01

To examine posts on Internet discussion groups related to vasectomies, and identify common ideas through a structured theme analysis. Internet discussion boards were identified using the search term "vasectomy." Three discussion boards were identified as having the most posts and were chosen for analysis. Using an iterative and structured analysis process, each post was analyzed using thematic analysis in 3 steps (open coding, axial coding, and selective coding) to determine common themes. A total of 129 posts were analyzed. The most common posts related to changes in sexual function after vasectomy. The second most common theme was pain after vasectomy. There were also posts about considerations before vasectomy, planning for postvasectomy care, what to expect after vasectomy, potential issues after vasectomy and how to manage these, and feelings about vasectomy. Some of the information present did not have a factual basis. Posts dedicated to postvasectomy pain and sexual dysfunction were of the highest quantity. There was no medical provider input to these discussion boards. Educational efforts should be targeted to these areas and should include a health-care professional. Copyright © 2017 Elsevier Inc. All rights reserved.

The naphthalene state of the science symposium: objectives, organization, structure, and charge.

PubMed

Belzer, Richard B; Bus, James S; Cavalieri, Ercole L; Lewis, Steven C; North, D Warner; Pleus, Richard C

2008-07-01

This report provides a summary of the objectives, organization, structure and charge for the naphthalene state of the science symposium (NS(3)), Monterey, CA, October 9-12, 2006. A 1-day preliminary conference was held followed by a 3-day state of the science symposium covering four topics judged by the Planning Committee to be crucial for developing valid and reliable scientific estimates of low-dose human cancer risk from naphthalene. The Planning Committee reviewed the relevant scientific literature to identify singularly knowledgeable researchers and a pool of scientists qualified to serve as expert panelists. In two cases, independent scientists were commissioned to develop comprehensive reviews of the relevant science in a specific area for which no leading researcher could be identified. Researchers and expert panelists alike were screened for conflicts of interest. All policy issues related to risk assessment practices and risk management were scrupulously excluded. NS(3) was novel in several ways and provides an innovative model for the effective use of peer review to identify scientific uncertainties and propose research strategies for reducing or eliminating them prior to the conduct of risk assessment.

Social network analysis in identifying influential webloggers: A preliminary study

NASA Astrophysics Data System (ADS)

Hasmuni, Noraini; Sulaiman, Nor Intan Saniah; Zaibidi, Nerda Zura

2014-12-01

In recent years, second generation of internet-based services such as weblog has become an effective communication tool to publish information on the Web. Weblogs have unique characteristics that deserve users' attention. Some of webloggers have seen weblogs as appropriate medium to initiate and expand business. These webloggers or also known as direct profit-oriented webloggers (DPOWs) communicate and share knowledge with each other through social interaction. However, survivability is the main issue among DPOW. Frequent communication with influential webloggers is one of the way to keep survive as DPOW. This paper aims to understand the network structure and identify influential webloggers within the network. Proper understanding of the network structure can assist us in knowing how the information is exchanged among members and enhance survivability among DPOW. 30 DPOW were involved in this study. Degree centrality and betweenness centrality measurement in Social Network Analysis (SNA) were used to examine the strength relation and identify influential webloggers within the network. Thus, webloggers with the highest value of these measurements are considered as the most influential webloggers in the network.

Correlations between brain structure and symptom dimensions of psychosis in schizophrenia, schizoaffective, and psychotic bipolar I disorders.

PubMed

Padmanabhan, Jaya L; Tandon, Neeraj; Haller, Chiara S; Mathew, Ian T; Eack, Shaun M; Clementz, Brett A; Pearlson, Godfrey D; Sweeney, John A; Tamminga, Carol A; Keshavan, Matcheri S

2015-01-01

Structural alterations may correlate with symptom severity in psychotic disorders, but the existing literature on this issue is heterogeneous. In addition, it is not known how cortical thickness and cortical surface area correlate with symptom dimensions of psychosis. Subjects included 455 individuals with schizophrenia, schizoaffective, or bipolar I disorders. Data were obtained as part of the Bipolar Schizophrenia Network for Intermediate Phenotypes study. Diagnosis was made through the Structured Clinical Interview for DSM-IV. Positive and negative symptom subscales were assessed using the Positive and Negative Syndrome Scale. Structural brain measurements were extracted from T1-weight structural MRIs using FreeSurfer v5.1 and were correlated with symptom subscales using partial correlations. Exploratory factor analysis was also used to identify factors among those regions correlating with symptom subscales. The positive symptom subscale correlated inversely with gray matter volume (GMV) and cortical thickness in frontal and temporal regions, whereas the negative symptom subscale correlated inversely with right frontal cortical surface area. Among regions correlating with the positive subscale, factor analysis identified four factors, including a temporal cortical thickness factor and frontal GMV factor. Among regions correlating with the negative subscale, factor analysis identified a frontal GMV-cortical surface area factor. There was no significant diagnosis by structure interactions with symptom severity. Structural measures correlate with positive and negative symptom severity in psychotic disorders. Cortical thickness demonstrated more associations with psychopathology than cortical surface area. © The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Utilization of two web-based continuing education courses evaluated by Markov chain model.

PubMed

Tian, Hao; Lin, Jin-Mann S; Reeves, William C

2012-01-01

To evaluate the web structure of two web-based continuing education courses, identify problems and assess the effects of web site modifications. Markov chain models were built from 2008 web usage data to evaluate the courses' web structure and navigation patterns. The web site was then modified to resolve identified design issues and the improvement in user activity over the subsequent 12 months was quantitatively evaluated. Web navigation paths were collected between 2008 and 2010. The probability of navigating from one web page to another was analyzed. The continuing education courses' sequential structure design was clearly reflected in the resulting actual web usage models, and none of the skip transitions provided was heavily used. The web navigation patterns of the two different continuing education courses were similar. Two possible design flaws were identified and fixed in only one of the two courses. Over the following 12 months, the drop-out rate in the modified course significantly decreased from 41% to 35%, but remained unchanged in the unmodified course. The web improvement effects were further verified via a second-order Markov chain model. The results imply that differences in web content have less impact than web structure design on how learners navigate through continuing education courses. Evaluation of user navigation can help identify web design flaws and guide modifications. This study showed that Markov chain models provide a valuable tool to evaluate web-based education courses. Both the results and techniques in this study would be very useful for public health education and research specialists.

Utilization of two web-based continuing education courses evaluated by Markov chain model

PubMed Central

Lin, Jin-Mann S; Reeves, William C

2011-01-01

Objectives To evaluate the web structure of two web-based continuing education courses, identify problems and assess the effects of web site modifications. Design Markov chain models were built from 2008 web usage data to evaluate the courses' web structure and navigation patterns. The web site was then modified to resolve identified design issues and the improvement in user activity over the subsequent 12 months was quantitatively evaluated. Measurements Web navigation paths were collected between 2008 and 2010. The probability of navigating from one web page to another was analyzed. Results The continuing education courses' sequential structure design was clearly reflected in the resulting actual web usage models, and none of the skip transitions provided was heavily used. The web navigation patterns of the two different continuing education courses were similar. Two possible design flaws were identified and fixed in only one of the two courses. Over the following 12 months, the drop-out rate in the modified course significantly decreased from 41% to 35%, but remained unchanged in the unmodified course. The web improvement effects were further verified via a second-order Markov chain model. Conclusions The results imply that differences in web content have less impact than web structure design on how learners navigate through continuing education courses. Evaluation of user navigation can help identify web design flaws and guide modifications. This study showed that Markov chain models provide a valuable tool to evaluate web-based education courses. Both the results and techniques in this study would be very useful for public health education and research specialists. PMID:21976027

Usability and feasibility of a tablet-based Decision-Support and Integrated Record-keeping (DESIRE) tool in the nurse management of hypertension in rural western Kenya.

PubMed

Vedanthan, Rajesh; Blank, Evan; Tuikong, Nelly; Kamano, Jemima; Misoi, Lawrence; Tulienge, Deborah; Hutchinson, Claire; Ascheim, Deborah D; Kimaiyo, Sylvester; Fuster, Valentin; Were, Martin C

2015-03-01

Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Usability testing consisted of "think aloud" exercises and "mock patient encounters" with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The early development phases of a European Organisation for Research and Treatment of Cancer (EORTC) module to assess patient reported outcomes (PROs) in women undergoing breast reconstruction.

PubMed

Thomson, H J; Winters, Z E; Brandberg, Y; Didier, F; Blazeby, J M; Mills, J

2013-03-01

A comprehensive evaluation of breast reconstruction (BRR) surgery includes measurement of patient reported outcomes (PROs). There is, however, a lack of validated BRR-specific PRO measures (PROMs) that adequately assess relevant issues. This study is developing a European Organisation for Research and Treatment of Cancer (EORTC) questionnaire/module specific for PROs in BRR to supplement the cancer-core and breast cancer EORTC questionnaires, respectively: the QLQ-C30 and QLQ-BR23. Phases I and II of questionnaire development followed EORTC guidelines including a systematic literature review to identify all potential 'issues' (concepts relevant to PROs) and semi-structured interviews with 89 patients and 9 European multi-disciplinary health care professionals (HCPs) (Sweden, Italy and the United Kingdom [UK]). Interviewers asked participants the 'relevance' of outcomes identified in the literature and captured additional 'issues' of importance. The literature search and interviews of patients and HCPs yielded 69 issues relating to BRR operationalised into 31 provisional items (single questions) for the module, which was conceptualised to contain five scales: treatment/surgery related symptoms (affecting the shoulder, arm and reconstructed breast), body image, sexuality, cosmetic outcomes (pertaining to three areas: breast, donor site and nipple) and overall satisfaction. The provisional development of the EORTC BRR module has 31 items addressing issues of importance to patients as well as HCPs. Further international testing is underway as a UK National Cancer Research Network trial to ensure that this PROM will be psychometrically and clinically robust and applicable for use in clinical trials, cohort studies, national audit and clinical practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Usability and Feasibility of a Tablet-Based Decision-Support and Integrated Record-Keeping (DESIRE) Tool in the Nurse Management of Hypertension in Rural Western Kenya

PubMed Central

Vedanthan, Rajesh; Blank, Evan; Tuikong, Nelly; Kamano, Jemima; Misoi, Lawrence; Tulienge, Deborah; Hutchinson, Claire; Ascheim, Deborah D.; Kimaiyo, Sylvester; Fuster, Valentin; Were, Martin C.

2015-01-01

Background Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. Objective To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Methods Usability testing consisted of “think aloud” exercises and “mock patient encounters” with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Results Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. Conclusions This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions. PMID:25612791

Smart-Glasses: Exposing and Elucidating the Ethical Issues.

PubMed

Hofmann, Bjørn; Haustein, Dušan; Landeweerd, Laurens

2017-06-01

The objective of this study is to provide an overview over the ethical issues relevant to the assessment, implementation, and use of smart-glasses. The purpose of the overview is to facilitate deliberation, decision making, and the formation of knowledge and norms for this emerging technology. An axiological question-based method for human cognitive enhancement including an extensive literature search on smart-glasses is used to identify relevant ethical issues. The search is supplemented with relevant ethical issues identified in the literature on human cognitive enhancement (in general) and in the study of the technical aspects of smart-glasses. Identified papers were subject to traditional content analysis: 739 references were identified of which 247 were regarded as relevant for full text examinations, and 155 were included in the study. A wide variety of ethical issues with smart-glasses have been identified, such as issues related to privacy, safety, justice, change in human agency, accountability, responsibility, social interaction, power and ideology. Smart-glasses are envisioned to change individual human identity and behavior as well as social interaction. Taking these issues into account appears to be relevant when developing, deliberating, deciding on, implementing, and using smart-glasses.

Collagens--structure, function, and biosynthesis.

PubMed

Gelse, K; Pöschl, E; Aigner, T

2003-11-28

The extracellular matrix represents a complex alloy of variable members of diverse protein families defining structural integrity and various physiological functions. The most abundant family is the collagens with more than 20 different collagen types identified so far. Collagens are centrally involved in the formation of fibrillar and microfibrillar networks of the extracellular matrix, basement membranes as well as other structures of the extracellular matrix. This review focuses on the distribution and function of various collagen types in different tissues. It introduces their basic structural subunits and points out major steps in the biosynthesis and supramolecular processing of fibrillar collagens as prototypical members of this protein family. A final outlook indicates the importance of different collagen types not only for the understanding of collagen-related diseases, but also as a basis for the therapeutical use of members of this protein family discussed in other chapters of this issue.

Real time software tools and methodologies

NASA Technical Reports Server (NTRS)

Christofferson, M. J.

1981-01-01

Real time systems are characterized by high speed processing and throughput as well as asynchronous event processing requirements. These requirements give rise to particular implementations of parallel or pipeline multitasking structures, of intertask or interprocess communications mechanisms, and finally of message (buffer) routing or switching mechanisms. These mechanisms or structures, along with the data structue, describe the essential character of the system. These common structural elements and mechanisms are identified, their implementation in the form of routines, tasks or macros - in other words, tools are formalized. The tools developed support or make available the following: reentrant task creation, generalized message routing techniques, generalized task structures/task families, standardized intertask communications mechanisms, and pipeline and parallel processing architectures in a multitasking environment. Tools development raise some interesting prospects in the areas of software instrumentation and software portability. These issues are discussed following the description of the tools themselves.

Public Investments in Training: Perspectives on Macro-Level Structural Issues and Micro-Level Delivery Systems. EQW Working Papers WP24.

ERIC Educational Resources Information Center

Cascio, Wayne F.

Training issues can be examined from at least two perspectives: the structural level (macro-level) and the micro-level. Structural issues in the delivery of training include the following: absent or uneven corporate commitment, inadequate expenditures by businesses, degrees awarded by schools that do not guarantee skill mastery, poaching of…

Building an Ontology for Identity Resolution in Healthcare and Public Health.

PubMed

Duncan, Jeffrey; Eilbeck, Karen; Narus, Scott P; Clyde, Stephen; Thornton, Sidney; Staes, Catherine

2015-01-01

Integration of disparate information from electronic health records, clinical data warehouses, birth certificate registries and other public health information systems offers great potential for clinical care, public health practice, and research. Such integration, however, depends on correctly matching patient-specific records using demographic identifiers. Without standards for these identifiers, record linkage is complicated by issues of structural and semantic heterogeneity. Our objectives were to develop and validate an ontology to: 1) identify components of identity and events subsequent to birth that result in creation, change, or sharing of identity information; 2) develop an ontology to facilitate data integration from multiple healthcare and public health sources; and 3) validate the ontology's ability to model identity-changing events over time. We interviewed domain experts in area hospitals and public health programs and developed process models describing the creation and transmission of identity information among various organizations for activities subsequent to a birth event. We searched for existing relevant ontologies. We validated the content of our ontology with simulated identity information conforming to scenarios identified in our process models. We chose the Simple Event Model (SEM) to describe events in early childhood and integrated the Clinical Element Model (CEM) for demographic information. We demonstrated the ability of the combined SEM-CEM ontology to model identity events over time. The use of an ontology can overcome issues of semantic and syntactic heterogeneity to facilitate record linkage.

ASIS healthcare security benchmarking study.

PubMed

2001-01-01

Effective security has aligned itself into the everyday operations of a healthcare organization. This is evident in every regional market segment, regardless of size, location, and provider clinical expertise or organizational growth. This research addresses key security issues from an acute care provider to freestanding facilities, from rural hospitals and community hospitals to large urban teaching hospitals. Security issues and concerns are identified and addressed daily by senior and middle management. As provider campuses become larger and more diverse, the hospitals surveyed have identified critical changes and improvements that are proposed or pending. Mitigating liabilities and improving patient, visitor, and/or employee safety are consequential to the performance and viability of all healthcare providers. Healthcare organizations have identified the requirement to compete for patient volume and revenue. The facility that can deliver high-quality healthcare in a comfortable, safe, secure, and efficient atmosphere will have a significant competitive advantage over a facility where patient or visitor security and safety is deficient. Continuing changes in healthcare organizations' operating structure and healthcare geographic layout mean changes in leadership and direction. These changes have led to higher levels of corporate responsibility. As a result, each organization participating in this benchmark study has added value and will derive value for the overall benefit of the healthcare providers throughout the nation. This study provides a better understanding of how the fundamental security needs of security in healthcare organizations are being addressed and its solutions identified and implemented.

Reconnecting to Spirituality: Christian-Identified Adolescents and Emerging Adult Young Men's Journey from Diagnosis of HIV to Coping.

PubMed

Smith, Sharon T; Blanchard, Jennifer; Kools, Susan; Butler, Derrick

2017-02-01

Spirituality is important to holistic health, yet little is known about its impact on young people with HIV. To address this knowledge deficit, a grounded theory study used semi-structured interviews of 20 Christian-identified adolescent and emerging adult gay males and one perinatally infected male. This study revealed that, to cope with HIV health issues, participants used a process of reconnecting with their spirituality. In order to successfully reconnect with their spirituality, study participants reported a need to re-embrace and re-engage in spiritual practices, hold onto hope, believe they are normal, and commit to beliefs and practices despite rejection from the church.

Barriers to implementation of workplace health interventions: an economic perspective.

PubMed

Cherniack, Martin; Lahiri, Supriya

2010-09-01

To identify insurance related, structural, and workplace cultural barriers to the implementation of effective preventive and upstream clinical interventions in the working age adult population. Analysis of avoided costs from perspective of health economics theory and from empiric observations from large studies; presentation of data from our own cost-plus model on integrating health promotion and ergonomics. We identify key avoided costs issues as a misalignment of interests between employers, insurers, service institutions, and government. Conceptual limitations of neoclassical economics are attributable to work culture and supply-driven nature of health care. Effective valuation of avoided costs is a necessary condition for redirecting allocations and incentives. Key content for valuation models is discussed.

A qualitative study of treatment needs among pregnant and postpartum women with substance use and depression

PubMed Central

Kuo, Caroline; Schonbrun, Yael Chatav; Zlotnick, Caron; Bates, Nicole; RalitsaTodorova; Chien-Wen Kao, Jennifer; Johnson, Jennifer

2013-01-01

Little is known about treatment for pregnant and postpartum women with co-occurring substance use and depression. Funded by the National Institute of Drug Abuse, we conducted three focus groups with 18 pregnant and postpartum women in 2011 at an urban substance use treatment clinic. A semi-structured discussion guide probed for factors impacting treatment outcomes and needs. Data were analyzed using grounded theory. Women identified motivational, family, friend, romantic, and agency characteristics as facilitative or challenging to their recoveries, and desired structure (group treatment, a safe environment, transportation) and content (attention to mental health, family, and gender-specific issues) of treatment. PMID:23819737

Structure, inhibition, and regulation of essential lipid A enzymes.

PubMed

Zhou, Pei; Zhao, Jinshi

2017-11-01

The Raetz pathway of lipid A biosynthesis plays a vital role in the survival and fitness of Gram-negative bacteria. Research efforts in the past three decades have identified individual enzymes of the pathway and have provided a mechanistic understanding of the action and regulation of these enzymes at the molecular level. This article reviews the discovery, biochemical and structural characterization, and regulation of the essential lipid A enzymes, as well as continued efforts to develop novel antibiotics against Gram-negative pathogens by targeting lipid A biosynthesis. This article is part of a Special Issue entitled: Bacterial Lipids edited by Russell E. Bishop. Copyright © 2016 Elsevier B.V. All rights reserved.

A Privacy-Protecting Authentication Scheme for Roaming Services with Smart Cards

NASA Astrophysics Data System (ADS)

Son, Kyungho; Han, Dong-Guk; Won, Dongho

In this work we propose a novel smart card based privacy-protecting authentication scheme for roaming services. Our proposal achieves so-called Class 2 privacy protection, i.e., no information identifying a roaming user and also linking the user's behaviors is not revealed in a visited network. It can be used to overcome the inherent structural flaws of smart card based anonymous authentication schemes issued recently. As shown in our analysis, our scheme is computationally efficient for a mobile user.

E-beam-Cure Fabrication of Polymer Fiber/Matrix Composites for Multifunctional Radiation Shielding

NASA Technical Reports Server (NTRS)

Wilson, John W.; Jensen, Brian J.; Thibeault, Sheila A.; Hou, Tan-Hung; Saether, Erik; Glaessgen, Edward H.; Humes, Donald H.; Chang, Chie K.; Badavi, Francis F.; Kiefer, Rrichard L.;

Proceedings from the Conference on Critical Issues in the Development of High Temperature Structural Materials Held in Kona, Hawaii on March 7-14, 1993,

DTIC Science & Technology

1993-01-14

composite has not been established and may restrict the use temperature; and/or lifetime. Precipitation of second phase particles in a master alloy (XD...intermetallic alloys with both ordered and disordered precipitate phases including precipitates based upon carbide or nitride phases which involve an...to identify likely pathways or to eliminate others i.e., define a transformation hierarchy. The crystallographic symmetries of the precipitate phase

Space Technology Plasma Issues in 2001

NASA Technical Reports Server (NTRS)

Garrett, Henry (Editor); Feynman, Joan (Editor); Gabriel, Stephen (Editor)

1986-01-01

The purpose of the workshop was to identify and discuss plasma issues that need to be resolved during the next 10 to 20 years (circa 2001) to facilitate the development of the advanced space technology that will be required 20 or 30 years into the future. The workshop consisted of 2 days of invited papers and 2 sessions of contributed poster papers. During the third day the meeting broke into 5 working groups, each of which held discussions and then reported back to the conference as a whole. The five panels were: Measurements Technology and Active Experiments Working Group; Advanced High-Voltage, High-Power and Energy-Storage Space Systems Working Group; Large Structures and Tethers Working Group; Plasma Interactions and Surface/Materials Effects Working Group; and Beam Plasmas, Electronic Propulsion and Active Experiments Using Beams Working Group.

Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder.

PubMed

Nicholas, David B; Zwaigenbaum, Lonnie; Muskat, Barbara; Craig, William R; Newton, Amanda S; Kilmer, Christopher; Greenblatt, Andrea; Roberts, Wendy; Cohen-Silver, Justine

2016-07-01

Care for children with autism spectrum disorder (ASD) in the emergency department (ED) is increasingly recognized as difficult. Communication, sensory and behavioral challenges in a high intensity environment pose risks for negative experiences and outcomes. Through semi-structured interviews, parents (n = 31) and their children (n = 4) with ASD shared their perspectives on ED care. Participants identified issues that negatively affected care experiences, including care processes, communication issues, insufficient staff knowledge about ASD, and inadequate partnership with parents. Elements contributing to an improved ED experience were also cited, including staff knowledge about ASD, child- and family-centered care, and clarity of communication. Findings inform an emerging model of ED care. Recommendations for capacity building and practice development are offered.

The RICH detector of the CBM experiment

NASA Astrophysics Data System (ADS)

Adamczewski-Musch, J.; Akishin, P.; Becker, K.-H.; Belogurov, S.; Bendarouach, J.; Boldyreva, N.; Deveaux, C.; Dobyrn, V.; Dürr, M.; Eschke, J.; Förtsch, J.; Heep, J.; Höhne, C.; Kampert, K.-H.; Kochenda, L.; Kopfer, J.; Kravtsov, P.; Kres, I.; Lebedev, S.; Lebedeva, E.; Leonova, E.; Linev, S.; Mahmoud, T.; Michel, J.; Miftakhov, N.; Niebur, W.; Ovcharenko, E.; Patel, V.; Pauly, C.; Pfeifer, D.; Querchfeld, S.; Rautenberg, J.; Reinecke, S.; Riabov, Y.; Roshchin, E.; Samsonov, V.; Schetinin, V.; Tarasenkova, O.; Traxler, M.; Ugur, C.; Vznuzdaev, E.; Vznuzdaev, M.

2017-12-01

The CBM-RICH detector is designed to identify electrons with momenta up to 8 GeV/c and high purity as this is essential for the CBM physics program. The detector consist of a CO2-gaseous radiator, a spherical mirror system, and Multi-Anode PhotoMultiplier Tubes (MAPMT) of type H12700 from Hamamatsu as photon detectors. The detector concept was verified through R&D studies and a laterally scaled prototype. The results were summarized in a TDR, in which open issues were defined concerning the readout electronics, the shielding of the magnetic stray field in the MAPMT region, the radiation hardness of the MAPMT sensors, and the mechanical holding structure of the mirror system. In this article an overview is given on the CBM RICH development with focus on those open issues.

Getting serious about the social determinants of health: new directions for public health workers.

PubMed

Raphael, Dennis

2008-09-01

International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that as compared to other wealthy nations Canada presents a mediocre population health profile and public policy environments increasingly less supportive of health, the Canadian public health gaze is firmly - and narrowly - focused on lifestyle issues of diet, physical activity and tobacco use. Much of this has to do with Canada being identified as being driven by a liberal political economy, a situation shared with a cluster of other developed nations. Reasons for Canada's neglect of structural and public policy issues are explored and ways by which public health workers in Canada and elsewhere can help to shift policymakers and the general public's understandings of the determinants of health are outlined.

Knowledge, perceptions and practices towards medical ethics among physician residents of University of Alexandria Hospitals, Egypt.

PubMed

Mohamed, A M; Ghanem, M A; Kassem, A

2012-09-01

This cross-sectional study was conducted to assess the knowledge, perceptions and practices towards medical ethics of physician residents at university hospitals in Alexandria, Egypt. A self-administered structured questionnaire was used for knowledge and perceptions and a checklist for observations of doctor-patient interactions in the outpatient setting. Only 18.0% ofthe 128 participating residents had obtained their knowledge from their medical education and 29.9% were dissatisfied with the roles played by the ethics committee. Most of the residents had satisfactory knowledge and 60.2% had satisfactory perceptions regarding ethical issues. The lowest perception score was in the domain of disclosing medical errors. Only 48.0% of the residents were compliant with the principles of medical ethics in practice and 52.0% of patients were dissatisfied with their treating physicians. The study identified areas of unsatisfactory knowledge and practices towards ethical issues so as to devise means to sensitize residents to these issues and train them appropriately.

Ultrasonic guided wave interpretation for structural health inspections

NASA Astrophysics Data System (ADS)

Bingham, Jill Paisley

Structural Health Management (SHM) combines the use of onboard sensors with artificial intelligence algorithms to automatically identify and monitor structural health issues. A fully integrated approach to SHM systems demands an understanding of the sensor output relative to the structure, along with sophisticated prognostic systems that automatically draw conclusions about structural integrity issues. Ultrasonic guided wave methods allow us to examine the interaction of multimode signals within key structural components. Since they propagate relatively long distances within plate- and shell-like structures, guided waves allow inspection of greater areas with fewer sensors, making this technique attractive for a variety of applications. This dissertation describes the experimental development of automatic guided wave interpretation for three real world applications. Using the guided wave theories for idealized plates we have systematically developed techniques for identifying the mass loading of underwater limpet mines on US Navy ship hulls, characterizing type and bonding of protective coatings on large diameter pipelines, and detecting the thinning effects of corrosion on aluminum aircraft structural stringers. In each of these circumstances the signals received are too complex for interpretation without knowledge of the guided wave physics. We employ a signal processing technique called the Dynamic Wavelet Fingerprint Technique (DFWT) in order to render the guided wave mode information in two-dimensional binary images. The use of wavelets allows us to keep track of both time and scale features from the original signals. With simple image processing we have developed automatic extraction algorithms for features that correspond to the arrival times of the guided wave modes of interest for each of the applications. Due to the dispersive nature of the guided wave modes, the mode arrival times give details of the structure in the propagation path. For further understanding of how the guided wave modes propagate through the real structures, we have developed parallel processing, 3D elastic wave simulations using the finite integration technique (EFIT). This full field, numeric simulation technique easily examines models too complex for analytical solutions. We have developed the algorithm to handle built up 3D structures as well as layers with different material properties and surface detail. The simulations produce informative visualizations of the guided wave modes in the structures as well as the output from sensors placed in the simulation space to mimic the placement from experiment. Using the previously developed mode extraction algorithms we were then able to compare our 3D EFIT data to their experimental counterparts with consistency.

Recruitment and retention of mental health care providers in rural Nebraska: perceptions of providers and administrators.

PubMed

Watanabe-Galloway, Shinobu; Madison, Lynda; Watkins, Katherine L; Nguyen, Anh T; Chen, Li-Wu

2015-01-01

The nationwide shortage of mental health professionals is especially severe in rural communities in the USA. Consistent with national workforce statistics, Nebraska's mental health workforce is underrepresented in rural and frontier parts of the state, with 88 of Nebraska's 93 counties being designated as federal mental health professional shortage areas. Seventy-eight counties have no practicing psychiatrists. However, supply statistics alone are inadequate in understanding workforce behavior. The objective of this study was to understand mental health recruitment and retention issues from the perspectives of administrators and mental healthcare professionals in order to identify potential solutions for increasing the mental health workforce in rural communities. The study used semi-structured focus groups to obtain input from administrators and mental health providers. Three separate focus groups were conducted in each of four regions in 2012 and 2013: licensed psychiatrists and licensed psychologists, licensed (independent) mental health practitioners, and administrators (including community, hospital, and private practice administrators and directors) who hire mental health practitioners. The transcripts were independently reviewed by two reviewers to identify themes. A total of 21 themes were identified. Participants reported that low insurance reimbursement negatively affects rural healthcare organizations' ability to attract and retain psychiatrists and continue programs. Participants also suggested that enhanced loan repayment programs would provide an incentive for mental health professionals to practice in rural areas. Longer rural residency programs were advocated to encourage psychiatrists to establish roots in a community. Establishment of rural internship programs was identified as a key factor in attracting and retaining psychologists. To increase the number of psychologists willing to provide supervision to provisionally licensed psychologists and mental health practitioners, financial reimbursement for time spent in this activity was identified as important. The present study showed that a comprehensive approach is needed to address workforce shortage issues for different types of professionals. In addition, systemic issues related to reimbursement and other financial aspects must be resolved to strengthen the overall rural mental healthcare delivery system.

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

PubMed

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

2011-07-01

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

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

PubMed Central

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

2011-01-01

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

Exploring the significance of structural hierarchy in material systems-A review

NASA Astrophysics Data System (ADS)

Pan, Ning

2014-06-01

Structural hierarchy and heterogeneity are inherent features in biological materials, but their significance in affecting the system behaviors is yet to be fully understood. In Sec. I, this article first identifies the major characteristics that manifest, or are resulted from, such hierarchy and heterogeneity in materials. Then in Sec. II, it presents several typical natural material systems including wood, bone, and others from animals to illustrate the proposed views. The paper also discusses a man-made smart material, textiles, to demonstrate that textiles are hierarchal, multifunctional, highly complex, and arguably the engineered material closest on a par with biological materials in complexity, and, more importantly, we can still learn quite a few new things from them in development of novel materials. In Sec. III, the paper summarizes several general approaches in developing a hierarchal material system at various scales, including structure thinning and splitting, laminating and layering, spatial and angular orientation, heterogenization and hybridization, and analyzes the advantages associated with them. It also stresses the adverse consequences once the existing structural hierarchy breaks down due to various mutations in biological systems. It discusses, in particular, the influences of moisture and air on material properties, given the near ubiquitousness of both air and water in materials. It next deals with in Sec. IV, some theoretical issues in material research including packing and ordering, the bi-modular mechanics, the behavior non-affinities due to disparity in hierarchal levels, the importance of system dimensionality in a hierarchal material system, and more philosophically, the issues of Nature's wisdom versus Intelligent Design. Section V then offers some concluding remarks, including a recap of the major issues covered in this article, and some general conclusions derived from the analyses and discussions. The main purpose of this paper is to make an effort to explore, identify, derive, or theorize some generic principles based on the existing results, not to offer another comprehensive review of current research activities in the fields for that there already exist some excellent ones. This paper examines the related topics with several approaches to not only reveal the underlying geometrical and physical mechanisms but also to emphasize the ways in which such mechanisms may be applied to developing engineered material systems with novel properties.

Identifying effective factors on consumers' choice behavior toward green products: the case of Tehran, the capital of Iran.

PubMed

Rahnama, Hassan; Rajabpour, Shayan

2017-01-01

The environment is increasingly turning to a vital and very important issue for all people. By increasing environmental concerns as well as legislating and regulating rules on the protection of the environment and the emergence of green consumers, implementing green marketing approach for organizations seems to be more crucial and essential. As a result, the need for ecological products and green business activities compels companies to combine environmental issues with marketing strategies. The first step in the success of companies and organizations is to identify consumers and their consumption behaviors correctly and accurately. So, the purpose of this study is to identify effective factors for the choice of consumers of green products. We used consumption values (functional value, social value, emotional value, conditional value, epistemic value, and environmental value) as the effective factor for choosing green products. The original place of this research was in Tehran, capital city of Iran, which is one of the most polluted cities in the world due to environmental issues. The results from the survey questionnaires are analyzed using confirmatory factor analysis and structural equation modelling. The results indicated that functional value-price, functional value-quality, social value, epistemic value, and environmental value had significantly positive effects on the choice of green products; also, conditional value and emotional value had no influence on it. It was concluded that the main influential factors for consumers' choice behavior regarding green products included environmental value and epistemic value. This study emphasized the proper pricing of green products by producers and sellers.

Implementing the Community Health Worker Model within Diabetes Management: Challenges and Lessons Learned from Programs across the U.S.

PubMed Central

Cherrington, Andrea; Ayala, Guadalupe X.; Amick, Halle; Allison, Jeroan; Corbie-Smith, Giselle; Scarinci, Isabel

2018-01-01

Introduction/objectives The Community Health Worker (CHW) model has gained popularity as a method for reaching vulnerable populations with diabetes mellitus (DM), yet little is known about its actual role in program delivery. The purpose of this qualitative study was to examine methods of implementation as well as related challenges and lessons learned. Methods Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC’s 1998 directory of CHW programs and Google Search Engine and were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Results Sixteen programs were assessed, all but three focused on minority populations. Most CHWs were recruited informally; six programs required CHWs to have diabetes. CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate non-diabetes related issues. Conclusions Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes. PMID:18832287

Exploring performance obstacles of intensive care nurses.

PubMed

Gurses, Ayse P; Carayon, Pascale

2009-05-01

High nursing workload, poor patient safety, and poor nursing quality of working life (QWL) are major issues in intensive care units (ICUs). Characteristics of the ICU and performance obstacles may contribute to these issues. The goal of this study was to comprehensively identify the performance obstacles perceived by ICU nurses. We used a qualitative research design and conducted semi-structured interviews with 15 ICU nurses of a medical-surgical ICU. Based on this qualitative study and a previously reported quantitative study, we identified seven main types of performance obstacles experienced by ICU nurses. Obstacles related to the physical environment (e.g., noise, amount of space), family relations (e.g., distractions caused by family, lack of time to spend with family), and equipment (e.g., unavailability, misplacement) were the most frequently experienced performance obstacles. The qualitative interview data provided rich information regarding the factors contributing to the performance obstacles. Overall, ICU nurses experience a variety of performance obstacles in their work on a daily basis. Future research is needed to understand the impact of performance obstacles on nursing workload, nursing QWL, and quality and safety of care.

Health sector reform in central and eastern Europe: the professional dimension.

PubMed

Healy, J; Mckee, M

1997-12-01

The success or failure of health sector reform in the countries of Central and Eastern Europe depends, to a large extent, on their health care staff. Commentators have focused on the structures to be put in place, such as mechanisms of financing or changes in ownership of facilities, but less attention has been paid to the role and status of the different groups working in health care services. This paper draws on a study of trends in staffing and working conditions throughout the region. It identifies several key issues including the traditionally lower status and pay of health sector workers compared to the West, the credibility crisis of trade unions, and the under-developed roles of professional associations. In order to implement health sector reforms and to address the deteriorating health status of the population, the health sector workforce has to be restructured and training programmes reoriented towards primary care. Finally, the paper identifies emerging issues such as the erosion of 'workplace welfare' and its adverse effects upon a predominantly female health care workforce.

A simple method for identifying parameter correlations in partially observed linear dynamic models.

PubMed

Li, Pu; Vu, Quoc Dong

2015-12-14

Parameter estimation represents one of the most significant challenges in systems biology. This is because biological models commonly contain a large number of parameters among which there may be functional interrelationships, thus leading to the problem of non-identifiability. Although identifiability analysis has been extensively studied by analytical as well as numerical approaches, systematic methods for remedying practically non-identifiable models have rarely been investigated. We propose a simple method for identifying pairwise correlations and higher order interrelationships of parameters in partially observed linear dynamic models. This is made by derivation of the output sensitivity matrix and analysis of the linear dependencies of its columns. Consequently, analytical relations between the identifiability of the model parameters and the initial conditions as well as the input functions can be achieved. In the case of structural non-identifiability, identifiable combinations can be obtained by solving the resulting homogenous linear equations. In the case of practical non-identifiability, experiment conditions (i.e. initial condition and constant control signals) can be provided which are necessary for remedying the non-identifiability and unique parameter estimation. It is noted that the approach does not consider noisy data. In this way, the practical non-identifiability issue, which is popular for linear biological models, can be remedied. Several linear compartment models including an insulin receptor dynamics model are taken to illustrate the application of the proposed approach. Both structural and practical identifiability of partially observed linear dynamic models can be clarified by the proposed method. The result of this method provides important information for experimental design to remedy the practical non-identifiability if applicable. The derivation of the method is straightforward and thus the algorithm can be easily implemented into a software packet.

Protein structure database search and evolutionary classification.

PubMed

Yang, Jinn-Moon; Tung, Chi-Hua

2006-01-01

As more protein structures become available and structural genomics efforts provide structural models in a genome-wide strategy, there is a growing need for fast and accurate methods for discovering homologous proteins and evolutionary classifications of newly determined structures. We have developed 3D-BLAST, in part, to address these issues. 3D-BLAST is as fast as BLAST and calculates the statistical significance (E-value) of an alignment to indicate the reliability of the prediction. Using this method, we first identified 23 states of the structural alphabet that represent pattern profiles of the backbone fragments and then used them to represent protein structure databases as structural alphabet sequence databases (SADB). Our method enhanced BLAST as a search method, using a new structural alphabet substitution matrix (SASM) to find the longest common substructures with high-scoring structured segment pairs from an SADB database. Using personal computers with Intel Pentium4 (2.8 GHz) processors, our method searched more than 10 000 protein structures in 1.3 s and achieved a good agreement with search results from detailed structure alignment methods. [3D-BLAST is available at http://3d-blast.life.nctu.edu.tw].

Introducing an electronic Palliative Care Summary (ePCS) in Scotland: patient, carer and professional perspectives.

PubMed

Hall, Susan; Murchie, Peter; Campbell, Christine; Murray, Scott A

2012-10-01

An electronic Palliative Care Summary (ePCS) is currently being implemented throughout Scotland to provide out-of-hours (OOH) staff with up-to-date summaries of medical history, patient understanding and wishes, medications and decisions regarding treatment of patients requiring palliative care: automatic twice daily updates of information from GP records to a central electronic repository are available to OOH services. To identify key issues related to the introduction of ePCS from primary care and OOH staff, to identify facilitators and barriers to their use, to explore the experiences of patients and carers and to make recommendations for improvements. Twenty-two semi-structured interviews were carried out with a purposive sample of health professionals [practice nurses (3 interviews), GPs (12 interviews), a practice manager (1 interview) from practices using different computing software systems] and patients and/or carers (6 interviews for whom an ePCS had been completed). Interviews were digitally recorded, transcribed and analysed thematically. Patients and carers were reassured that OOH staff were informed about their current circumstances. OOH staff considered the ePCS allowed them to be better informed in decision making and in carrying out home visits. GPs viewed the introduction of ePCSs to have benefits for in-hours structures of care including advance care planning. No interviewee expressed concern about confidentiality. Barriers raised related to the introduction of new technology including unfamiliarity with the process, limited time and information technology skills. The ePCS has clear potential to improve patient care although several implementation issues and technical problems require to be addressed first to enable this. GPs and community nurses should identify more patients with malignant and non-malignant illnesses for completion of the ePCS.

Healthcare professionals' organisational barriers to health information technologies-a literature review.

PubMed

Lluch, Maria

2011-12-01

This literature review identifies and categorises, from an organisational management perspective, barriers to the use of HIT or ICT for health. Based on the review, it offers policy interventions. This systematic literature review was carried out during December 2009 and January 2010. Additional on-going reviews of updates through automated system alerts took place up until this paper was submitted. A total of thirty-one sources were searched including nine software platforms/databases, fifteen specialised websites/targeted databases, Google Scholar, ISI Science Citation Index and five journals hand-searched. The study covers seventy-nine articles on organisational barriers to ICT adoption by healthcare professionals. These are categorised under five main headings - (I) Structure of healthcare organisations; (II) Tasks; (III) People policies; (IV) Incentives; and (V) Information and decision processes. A total of ten subcategories are also identified. By adopting an organisational management approach, some recommendations to remove organisational management barriers are made. Despite their apparent promise, health information technologies (HIT) have proved difficult to implement. This systematic review reveals the implementation barriers associated to organisational management and their interrelations. Several important future directions in the field are also suggested: (1) there is a need for further research providing evidence of HIT cost-effectiveness as well as the development of optimal HIT applications; (2) more information is needed regarding organisational change, incentives, liability issues, end-users HIT competences and skills, structure and work process issues involved in realising the benefits from HIT. Future policy interventions should consider the five dimensions identified when addressing the impact of HIT in healthcare organisational systems, and how the impact of an intervention aimed at a particular dimension would interrelate with others. 2011 Elsevier Ireland Ltd. All rights reserved.

Interface design recommendations for computerised clinical audit and feedback: Hybrid usability evidence from a research-led system.

PubMed

Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

2016-10-01

Audit and Feedback (A&F) is a widely used quality improvement technique that measures clinicians' clinical performance and reports it back to them. Computerised A&F (e-A&F) system interfaces may consist of four key components: (1) Summaries of clinical performance; (2) Patient lists; (3) Patient-level data; (4) Recommended actions. There is a lack of evidence regarding how to best design e-A&F interfaces; establishing such evidence is key to maximising usability, and in turn improving patient safety. To evaluate the usability of a novel theoretically-informed and research-led e-A&F system for primary care (the Performance Improvement plaN GeneratoR: PINGR). (1) Describe PINGR's design, rationale and theoretical basis; (2) Identify usability issues with PINGR; (3) Understand how these issues may interfere with the cognitive goals of end-users; (4) Translate the issues into recommendations for the user-centred design of e-A&F systems. Eight experienced health system evaluators performed a usability inspection using an innovative hybrid approach consisting of five stages: (1) Development of representative user tasks, Goals, and Actions; (2) Combining Heuristic Evaluation and Cognitive Walkthrough methods into a single protocol to identify usability issues; (3) Consolidation of issues; (4) Severity rating of consolidated issues; (5) Analysis of issues according to usability heuristics, interface components, and Goal-Action structure. A final list of 47 issues were categorised into 8 heuristic themes. The most error-prone heuristics were 'Consistency and standards' (13 usability issues; 28% of the total) and 'Match between system and real world' (n=10, 21%). The recommended actions component of the PINGR interface had the most usability issues (n=21, 45%), followed by patient-level data (n=5, 11%), patient lists (n=4, 9%), and summaries of clinical performance (n=4, 9%). The most error-prone Actions across all user Goals were: (1) Patient selection from a list; (2) Data identification from a figure (both population-level and patient-level); (3) Disagreement with a system recommendation. By contextualising our findings within the wider literature on health information system usability, we provide recommendations for the design of e-A&F system interfaces relating to their four key components, in addition to how they may be integrated within a system. Copyright © 2016. Published by Elsevier Ireland Ltd.

Evaluation of structural issues related to isolation of the 100-KE/100-KW discharge chute

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

Winkel, B.V.; Hyde, L.L.

The issue of excessive post-seismic leakage in the discharge chute of the K East and K West fuel storage basins was resolved by designing isolation barriers to maintain basin water levels if the discharge chute should drain. This report addresses the structural issues associated with isolation of the discharge chute. The report demonstrates the structural adequacy of the components associated with chute isolation for normal and seismic loading. Associated issues, such as hardware drop accidents and seismic slosh heights are also addressed.

Multi-Objective Community Detection Based on Memetic Algorithm

PubMed Central

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels. PMID:25932646

Multi-objective community detection based on memetic algorithm.

PubMed

Wu, Peng; Pan, Li

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels.

Facing the dilemma of patient-centred psoriasis care: a qualitative study identifying patient needs in dermatological outpatient clinics.

PubMed

Khoury, L R; Skov, L; Møller, T

2017-08-01

Caregivers must be aware of patients' current needs by providing care responsive to patients' values and preferences and by identifying what approach improves and encourages patients to participate in their treatment and disease management. Patients with psoriasis healthcare needs perhaps change as medical knowledge improves, new drugs emerge and the healthcare system improves its efficiency as a result of constant structural development. To explore the unmet needs and health perceptions of people with psoriasis, regarding interaction with clinicians and the structure inherent to consultations in a hospital outpatient dermatological clinic. A qualitative investigation with data generated from semi-structured interviews. Transcriptions were subsequently analysed using the template analysis method. Sixteen patients with psoriasis were interviewed. Challenges and dilemmas of patient-centred psoriasis care were identified. Patients have a strong need to be met as individuals as the burden of living with psoriasis goes beyond the skin. Patients strive for efficient treatment and ultimately dream of being cured of psoriasis. They prefer individualized health education in order to adjust their knowledge and self-management skills. These central issues are as yet rarely addressed in clinical consultations. Consultations with a standardized structure do not match the individual challenges and healthcare needs of patients with psoriasis. In order to achieve a more patient-centred approach, health professionals should implement minor structural changes to dermatological services to meet patients' current needs and invite dialogue about the patients' emotional well-being and concerns that go beyond biomedical factors, as well as offer individualized health education. © 2016 British Association of Dermatologists.

Identification of priority health conditions for field-based screening in urban slums in Bangalore, India.

PubMed

Abdi, Sarah; Wadugodapitiya, Avanti; Bedaf, Sandra; George, Carolin Elizabeth; Norman, Gift; Hawley, Mark; de Witte, Luc

2018-03-02

Urban slums are characterised by unique challenging living conditions, which increase their inhabitants' vulnerability to specific health conditions. The identification and prioritization of the key health issues occurring in these settings is essential for the development of programmes that aim to enhance the health of local slum communities effectively. As such, the present study sought to identify and prioritise the key health issues occurring in urban slums, with a focus on the perceptions of health professionals and community workers, in the rapidly growing city of Bangalore, India. The study followed a two-phased mixed methods design. During Phase I of the study, a total of 60 health conditions belonging to four major categories: - 1) non-communicable diseases; 2) infectious diseases; 3) maternal and women's reproductive health; and 4) child health - were identified through a systematic literature review and semi-structured interviews conducted with health professionals and other relevant stakeholders with experience working with urban slum communities in Bangalore. In Phase II, the health issues were prioritised based on four criteria through a consensus workshop conducted in Bangalore. The top health issues prioritized during the workshop were: diabetes and hypertension (non-communicable diseases category), dengue fever (infectious diseases category), malnutrition and anaemia (child health, and maternal and women's reproductive health categories). Diarrhoea was also selected as a top priority in children. These health issues were in line with national and international reports that listed them as top causes of mortality and major contributors to the burden of diseases in India. The results of this study will be used to inform the development of technologies and the design of interventions to improve the health outcomes of local communities. Identification of priority health issues in the slums of other regions of India, and in other low and lower middle-income countries, is recommended.

Code qualification of structural materials for AFCI advanced recycling reactors.

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

Natesan, K.; Li, M.; Majumdar, S.

2012-05-31

This report summarizes the further findings from the assessments of current status and future needs in code qualification and licensing of reference structural materials and new advanced alloys for advanced recycling reactors (ARRs) in support of Advanced Fuel Cycle Initiative (AFCI). The work is a combined effort between Argonne National Laboratory (ANL) and Oak Ridge National Laboratory (ORNL) with ANL as the technical lead, as part of Advanced Structural Materials Program for AFCI Reactor Campaign. The report is the second deliverable in FY08 (M505011401) under the work package 'Advanced Materials Code Qualification'. The overall objective of the Advanced Materials Codemore » Qualification project is to evaluate key requirements for the ASME Code qualification and the Nuclear Regulatory Commission (NRC) approval of structural materials in support of the design and licensing of the ARR. Advanced materials are a critical element in the development of sodium reactor technologies. Enhanced materials performance not only improves safety margins and provides design flexibility, but also is essential for the economics of future advanced sodium reactors. Code qualification and licensing of advanced materials are prominent needs for developing and implementing advanced sodium reactor technologies. Nuclear structural component design in the U.S. must comply with the ASME Boiler and Pressure Vessel Code Section III (Rules for Construction of Nuclear Facility Components) and the NRC grants the operational license. As the ARR will operate at higher temperatures than the current light water reactors (LWRs), the design of elevated-temperature components must comply with ASME Subsection NH (Class 1 Components in Elevated Temperature Service). However, the NRC has not approved the use of Subsection NH for reactor components, and this puts additional burdens on materials qualification of the ARR. In the past licensing review for the Clinch River Breeder Reactor Project (CRBRP) and the Power Reactor Innovative Small Module (PRISM), the NRC/Advisory Committee on Reactor Safeguards (ACRS) raised numerous safety-related issues regarding elevated-temperature structural integrity criteria. Most of these issues remained unresolved today. These critical licensing reviews provide a basis for the evaluation of underlying technical issues for future advanced sodium-cooled reactors. Major materials performance issues and high temperature design methodology issues pertinent to the ARR are addressed in the report. The report is organized as follows: the ARR reference design concepts proposed by the Argonne National Laboratory and four industrial consortia were reviewed first, followed by a summary of the major code qualification and licensing issues for the ARR structural materials. The available database is presented for the ASME Code-qualified structural alloys (e.g. 304, 316 stainless steels, 2.25Cr-1Mo, and mod.9Cr-1Mo), including physical properties, tensile properties, impact properties and fracture toughness, creep, fatigue, creep-fatigue interaction, microstructural stability during long-term thermal aging, material degradation in sodium environments and effects of neutron irradiation for both base metals and weld metals. An assessment of modified versions of Type 316 SS, i.e. Type 316LN and its Japanese version, 316FR, was conducted to provide a perspective for codification of 316LN or 316FR in Subsection NH. Current status and data availability of four new advanced alloys, i.e. NF616, NF616+TMT, NF709, and HT-UPS, are also addressed to identify the R&D needs for their code qualification for ARR applications. For both conventional and new alloys, issues related to high temperature design methodology are described to address the needs for improvements for the ARR design and licensing. Assessments have shown that there are significant data gaps for the full qualification and licensing of the ARR structural materials. Development and evaluation of structural materials require a variety of experimental facilities that have been seriously degraded in the past. The availability and additional needs for the key experimental facilities are summarized at the end of the report. Detailed information covered in each Chapter is given.« less

Androgens in health and disease: An overview

PubMed Central

Jordan, Cynthia L.; DonCarlos, Lydia

2009-01-01

This special issue of Hormones and Behavior, “Androgens in health and disease: new insights into roles and mechanisms of action,” is prompted by a number of relatively recent findings that androgens affect brain morphology and function in ways not previously or widely appreciated. Moreover, recent results also make it clear that androgens utilize a variety of signaling molecules to exert their effects on the brain, which may or may not depend on the classic nuclear androgen receptor (AR). The papers in this issue underscore these two points. This overview is not intended as a comprehensive review of androgen action on the nervous system, since the papers in this issue serve that purpose, but rather to frame the basic issues and themes that tie these papers together. The sum effect of the stories told in this issue encourages us to broaden and refocus our view of androgen action on brain and behavior—to recognize that androgens affect many aspects of brain structure and function throughout the lifespan, from shaping its sexual phenotype to influencing its propensity for disease and repair, and that at least some of these actions are exerted via non-classical modes of action that in many cases were first identified in non-neural tissue or cells. PMID:18407273

Methodology for Conducting Analyses of Army Capabilities

DTIC Science & Technology

1992-06-01

31 Determine Sensitivity of Operations to Functions ........................ 34 Generate Capability Issues ...40 Package and Prioritize Issues ..................................... 40 IDENTIFY AND ASSESS CAPABILITY IMPROVEMENTS .................. 43 Generate...identify critical issues , and make force modernization recommendations to Headquarters, Depart- ment of the Army (HQDA). The work described in this report

Current Strategies for Managing Providers Infected with Bloodborne Pathogens

PubMed Central

Turkel, Sarah; Henderson, David K.

2016-01-01

Background In 1991 CDC issued guidelines to reduce risks for provider-to-patient transmission of bloodborne pathogens. These guidelines, unchanged since 1991, recommend management strategies for hepatitis B ‘e’ antigen-positive providers and for providers infected with human immunodeficiency virus (HIV); they do not address hepatitis-C-virus (HCV)-infected providers. Objective We summarize current state practices and surveyed state health departments to determine: 1) if state policies have been modified since 1991; 2), if state laws require prospective notification of patients and/or expert review panels to manage infected providers; 3) the frequency with which infected-providers issues come to the attention of state health departments; and 4) how state health departments intervene. Methods We reviewed all 50 states’ laws and guidelines to determine current practices and conducted a structured telephone survey of all state health departments. Results Whereas only 19 states require infected providers to notify patients of the providers’ bloodborne pathogen infection, these 19 states require notification under highly varied circumstances. Only ten of 50 state health department officials identified these issues as requiring significant departmental effort. No state law or guideline incorporates information about providers’ viral burdens as part of the risk assessment. Only 3/50 States have modified policies or laws since initial passage; and only 1/50 discusses the management of HCV-infected providers.. Conclusions These results identify a need for incorporating contemporary scientific information into guidelines and also suggest that infected-provider issues are not occurring commonly, are not being detected, or that they are being managed at levels below the state health department. PMID:21515972

Summary Report of a Specialized Workshop on Nuclear Structure and Decay Data (NSDD) Evaluations

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

Nichols, Alan L.; Dimitrious, P.; Kondev, F. G.

2015-04-27

A three-day specialised workshop on Nuclear Structure and Decay Data Evaluations was organised and held at the headquarters of the International Atomic Energy Agency in Vienna, Austria, from 27 to 29 April 2015. This workshop covered a wide range of important topics and issues addressed when evaluating and maintaining the Evaluated Nuclear Structure Data File (ENSDF). The primary aim was to improve evaluators’ abilities to identify and understand the most appropriate evaluation processes to adopt in the formulation of individual ENSDF data sets. Participants assessed and reviewed existing policies, procedures and codes, and round-table discussions included the debate and resolutionmore » of specific difficulties experienced by ENSDF evaluators (i.e., all workshop participants). The contents of this report constitute a record of this workshop, based on the presentations and subsequent discussions.« less

Providers' perspectives on inbound medical tourism in Central America and the Caribbean: factors driving and inhibiting sector development and their health equity implications.

PubMed

Johnston, Rory; Crooks, Valorie A; Cerón, Alejandro; Labonté, Ronald; Snyder, Jeremy; Núñez, Emanuel O; Flores, Walter G

2016-01-01

Many governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector. To identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications. In-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade and economic development, health services delivery, training and administration, and civil society. Transcribed interviews were coded using qualitative data management software, and thematic analysis was used to identify cross-cutting issues regarding the drivers and inhibitors of medical tourism development. Four common drivers of medical tourism development were identified: 1) unused capacity in existing private hospitals, 2) international portability of health insurance, vis-a-vis international hospital accreditation, 3) internationally trained physicians as both marketable assets and industry entrepreneurs, and 4) promotion of medical tourism by public export development corporations. Three common inhibitors for the development of the sector were also identified: 1) the high expense of market entry, 2) poor sector-wide planning, and 3) structural socio-economic issues such as insecurity or relatively high business costs and financial risks. There are shared factors shaping the development of medical tourism in Central America and the Caribbean that help explain why it is being pursued by many hospitals and governments in the region. Development of the sector is primarily being driven by public investment promotion agencies and the private health sector seeking economic benefits with limited consideration and planning for the health equity concerns medical tourism raises.

Providers’ perspectives on inbound medical tourism in Central America and the Caribbean: factors driving and inhibiting sector development and their health equity implications

PubMed Central

Johnston, Rory; Crooks, Valorie A.; Cerón, Alejandro; Labonté, Ronald; Snyder, Jeremy; Núñez, Emanuel O.; Flores, Walter G.

2016-01-01

Background Many governments and health care providers worldwide are enthusiastic to develop medical tourism as a service export. Despite the popularity of this policy uptake, there is relatively little known about the specific local factors prospectively motivating and informing development of this sector. Objective To identify common social, economic, and health system factors shaping the development of medical tourism in three Central American and Caribbean countries and their health equity implications. Design In-depth, semi-structured interviews were conducted in Mexico, Guatemala, and Barbados with 150 health system stakeholders. Participants were recruited from private and public sectors working in various fields: trade and economic development, health services delivery, training and administration, and civil society. Transcribed interviews were coded using qualitative data management software, and thematic analysis was used to identify cross-cutting issues regarding the drivers and inhibitors of medical tourism development. Results Four common drivers of medical tourism development were identified: 1) unused capacity in existing private hospitals, 2) international portability of health insurance, vis-a-vis international hospital accreditation, 3) internationally trained physicians as both marketable assets and industry entrepreneurs, and 4) promotion of medical tourism by public export development corporations. Three common inhibitors for the development of the sector were also identified: 1) the high expense of market entry, 2) poor sector-wide planning, and 3) structural socio-economic issues such as insecurity or relatively high business costs and financial risks. Conclusion There are shared factors shaping the development of medical tourism in Central America and the Caribbean that help explain why it is being pursued by many hospitals and governments in the region. Development of the sector is primarily being driven by public investment promotion agencies and the private health sector seeking economic benefits with limited consideration and planning for the health equity concerns medical tourism raises. PMID:27876457

Structural responses of metallic glasses under neutron irradiation.

PubMed

Yang, L; Li, H Y; Wang, P W; Wu, S Y; Guo, G Q; Liao, B; Guo, Q L; Fan, X Q; Huang, P; Lou, H B; Guo, F M; Zeng, Q S; Sun, T; Ren, Y; Chen, L Y

2017-12-01

Seeking nuclear materials that possess a high resistance to particle irradiation damage is a long-standing issue. Permanent defects, induced by irradiation, are primary structural changes, the accumulation of which will lead to structural damage and performance degradation in crystalline materials served in nuclear plants. In this work, structural responses of neutron irradiation in metallic glasses (MGs) have been investigated by making a series of experimental measurements, coupled with simulations in ZrCu amorphous alloys. It is found that, compared with crystalline alloys, MGs have some specific structural responses to neutron irradiation. Although neutron irradiation can induce transient vacancy-like defects in MGs, they are fully annihilated after structural relaxation by rearrangement of free volumes. In addition, the rearrangement of free volumes depends strongly on constituent elements. In particular, the change in free volumes occurs around the Zr atoms, rather than the Cu centers. This implies that there is a feasible strategy for identifying glassy materials with high structural stability against neutron irradiation by tailoring the microstructures, the systems, or the compositions in alloys. This work will shed light on the development of materials with high irradiation resistance.

HIV treatment as prevention in Jamaica and Barbados: magic bullet or sustainable response?

PubMed

Barrow, Geoffrey; Barrow, Christine

2015-01-01

This discursive article introduces HIV treatment as prevention (TasP) and identifies various models for its extrapolation to wider population levels. Drawing on HIV surveillance data for Jamaica and Barbados, the article identifies significant gaps in HIV response programming in relation to testing, antiretroviral treatment coverage, and treatment adherence, thereby highlighting the disparity between assumptions and prerequisites for TasP success. These gaps are attributable, in large part, to sociocultural impediments and structural barriers, severe resource constraints, declining political will, and the redefinition of HIV as a manageable, chronic health issue. Antiretroviral treatment and TasP can realize success only within a combination prevention frame that addresses structural factors, including stigma and discrimination, gender inequality and gender-based violence, social inequality, and poverty. The remedicalization of the response compromises outcomes and undermines the continued potential of HIV programming as an entry point for the promotion of sexual, health, and human rights. © The Author(s) 2013.

A formative evaluation of problem-based learning as an instructional strategy in a medical laboratory technician course

NASA Astrophysics Data System (ADS)

Nelson, Diane Patricia

2002-09-01

This study is a formative evaluation of problem-based learning as an effective course delivery strategy in a second year introductory Medical Laboratory Technician discipline-specific hematology course. This strategy can serve two purposes in this type of course: discipline specific content knowledge and process skills learning. A needs study identified that students required additional workplace skills as they entered the clinical internship. Students tested well on the national registry examinations, discipline-specific content knowledge, but group process skills needed improvement in the areas of collaboration, communication, and critical reasoning. Problem-based learning was identified as an change intervention to help provide these skills. A search of the literature revealed that the Baker College cultural and physical environment would support this intervention. Twelve cases were written, situated in a clinical laboratory environment, addressing learning issues identified in a modified Delphi survey of laboratory personnel e.g. fiscal responsibility, turn-around time, invasiveness of laboratory techniques, and holistic view of healthcare environment. A hematology class of 13 students received the intervention. The cases were structured to proceed from instructor-centered (guided) learning issues to learner-centered learning issues. Observations of the in-group collaboration processes were documented, as well as oral presentations and critical reasoning, with students given periodic feedback on these skills. Student surveys provided data about satisfaction, attitude to PBL process, and self-efficacy. Multiple choice discipline-specific content examinations were given and compared with classes from the previous four years. The study found that students receiving the PBL treatment scored as well as or better than students from previous years on traditional multiple choice exams. Recall questions showed positive significance and application/analysis questions showed no significance from previous years. Clinical correlations end-of-case evaluations addressing the issues of thoroughness of investigation, supporting evidence, accuracy of information, order and clarity of thought showed positive improvement across the intervention, as did the PBL processes of in-group collaboration skills, teamwork skills, and presentation skills. By the end of the intervention, students expressed preference for student-centered learning issues.

Ethical principles and the rationing of health care: a qualitative study in general practice

PubMed Central

Berney, Lee; Kelly, Moira; Doyal, Len; Feder, Gene; Griffiths, Chris; Jones, Ian Rees

2005-01-01

Background Researching sensitive topics, such as the rationing of treatments and denial of care, raises a number of ethical and methodological problems. Aim To describe the methods and findings from a number of focus group discussions that examined how GPs apply ethical principles when allocating scarce resources. Design of study A small-scale qualitative study involving purposive sampling, semi-structured interviews and focus groups. Setting Twenty-four GPs from two contrasting areas of London: one relatively affluent and one relatively deprived. Method Initial interviews asked GPs to identify key resource allocation issues. The interviews were transcribed and themes were identified. A number of case studies, each illustrative of an ethical issue related to rationing, were written up in the form of vignettes. In focus group discussions, GPs were given a number of these vignettes to debate. Results With respect to the ethical basis for decision making, the findings from this part of the study emphasised the role of social and psychological factors, the influence of the quality of the relationship between GPs and patients and confusion among GPs about their role in decision making. Conclusion The use of vignettes developed from prior interviews with GPs creates a non-threatening environment to discuss sensitive or controversial issues. The acceptance by GPs of general moral principles does not entail clarity of coherence of the application of these principles in practice. PMID:16105371

Recommendations for sexual expression management in long-term care: a qualitative needs assessment

PubMed Central

Syme, Maggie L.; Lichtenberg, Peter; Moye, Jennifer

2017-01-01

Aims To conduct a qualitative needs assessment of Directors of Nursing regarding challenges and recommendations for addressing sexual expression and consent. Background Sexual expression management among long-term care residents is a complex issue for nursing home staff. Little guidance is available for those wanting to follow a person-centred approach. Policies and procedures are needed, and must be usable across long-term care settings. Design Qualitative design for in-depth exploration. Methods Semi-structured interviews were conducted with 20 Directors of Nursing in the spring and summer of 2013, representing a range of regions, facility sizes and resident populations. Interview questions prompted them to identify recommendations that address challenges to improving sexual expression management in long-term care settings. Results Comparative thematic analysis resulted in several codes, which were grouped into eight overall categories. Recommendation categories that addressed key challenges included: address the issue, make environmental changes, identify staff expertise, provide education and training, assess sexuality initially and recurrently, establish policies/procedures for sexual expression management, develop assessment tools for sexual expression and consent, and clarify legal issues. The recommendation to develop national guidelines was observed across categories. Discussion Directors of Nursing report several challenges to sexual expression management in their facilities, and perceive their current methods to be ad hoc. A proactive approach to policy and procedure development is needed. PMID:27188413

Blade system design studies volume II : preliminary blade designs and recommended test matrix.

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

Griffin, Dayton A.

2004-06-01

As part of the U.S. Department of Energy's Wind Partnerships for Advanced Component Technologies (WindPACT) program, Global Energy Concepts, LLC is performing a Blade System Design Study (BSDS) concerning innovations in materials, processes and structural configurations for application to wind turbine blades in the multi-megawatt range. The BSDS Volume I project report addresses issues and constraints identified to scaling conventional blade designs to the megawatt size range, and evaluated candidate materials, manufacturing and design innovations for overcoming and improving large blade economics. The current report (Volume II), presents additional discussion of materials and manufacturing issues for large blades, including amore » summary of current trends in commercial blade manufacturing. Specifications are then developed to guide the preliminary design of MW-scale blades. Using preliminary design calculations for a 3.0 MW blade, parametric analyses are performed to quantify the potential benefits in stiffness and decreased gravity loading by replacement of a baseline fiberglass spar with carbon-fiberglass hybrid material. Complete preliminary designs are then presented for 3.0 MW and 5.0 MW blades that incorporate fiberglass-to-carbon transitions at mid-span. Based on analysis of these designs, technical issues are identified and discussed. Finally, recommendations are made for composites testing under Part I1 of the BSDS, and the initial planned test matrix for that program is presented.« less

Neuropsychological issues in military deployments: lessons observed in the DoD Gulf War Illnesses Research Program.

PubMed

Friedl, Karl E; Grate, Stephen J; Proctor, Susan P

2009-04-01

The U.S. Department of Defense invested $150 M to investigate undiagnosed Gulf War Illnesses (GWI) and twice that amount in post hoc clinical management. No new disease syndrome was identified, but the research produced new understanding and awareness of important psychosocial and neurotoxicological interactions that represented a difficult and relatively untapped frontier in biomedical research, especially concerning chronic multisymptom illnesses. Some specific Gulf War issues such as effects of depleted uranium, Leishmania diagnosis and treatment, and pesticide and prophylactic drug interactions have been intensively investigated; remaining priorities for further investigation include: markers of neurologic change (e.g., neuroimaging, neuropsychological testing), interactions between psychological resilience and neurotoxicity, structure-function relationships of neurotoxins with neurodegenerative disease potential, and predictors of individual susceptibility. The primary conclusions from the program are that no specific neurotoxic chemical has been identified that explains the chronic multisymptom illness observed but wellness of service members in future deployments may be better sustained based on continuing research on preexposure health baselining, fitness and health-damaging behaviors, and stress resilience. The many scientific discoveries and accomplishments of the GWI research effort have advanced military medical science, provided a solid basis on which to build future protections against health and performance risks to the warfighter, and improved the ability to respond to future deployment health issues.

Current Situation, Determinants, and Solutions to Drug Shortages in Shaanxi Province, China: A Qualitative Study

PubMed Central

Yang, Caijun; Wu, Lina; Cai, Wenfang; Zhu, Wenwen; Shen, Qian; Li, Zongjie; Fang, Yu

2016-01-01

Objective Drug shortages were a complex global problem. The aim of this study was to analyze, characterize, and assess the drug shortages, and identify possible solutions in Shaanxi Province, western China. Methods A qualitative methodological approach was conducted during May–June 2015 and December 2015–January 2016. Semi-structured interviews were performed to gather information from representatives of hospital pharmacists, wholesalers, pharmaceutical producers, and local health authorities. Results Thirty participants took part in the study. Eight traditional Chinese medicines and 87 types of biologicals and chemicals were reported to be in short supply. Most were essential medicines. Five main determinants of drug shortages were detected: too low prices, too low market demands, Good Manufacturing Practice (GMP) issues, materials issues, and approval issues for imported drugs. Five different solutions were proposed by the participants: 1) let the market decide the drug price; 2) establish an information platform; 3) establish a reserve system; 4) enhance the communication among the three parties in the supply chain; and 5) improve hospital inventory management. Conclusions Western China was currently experiencing a serious drug shortage. Numerous reasons for the shortage were identified. Most drug shortages in China were currently because of “too low prices.” To solve this problem, all of the stakeholders, especially the government, needed to participate in managing the drug shortages. PMID:27780218

Personal support networks, social capital, and risk of relapse among individuals treated for substance use issues.

PubMed

Panebianco, Daria; Gallupe, Owen; Carrington, Peter J; Colozzi, Ivo

2016-01-01

The success of treatment for substance use issues varies with personal and social factors, including the composition and structure of the individual's personal support network. This paper describes the personal support networks and social capital of a sample of Italian adults after long-term residential therapeutic treatment for substance use issues, and analyses network correlates of post-treatment substance use (relapse). Using a social network analysis approach, data were obtained from structured interviews (90-120 min long) with 80 former clients of a large non-governmental therapeutic treatment agency in Italy providing voluntary residential treatments and rehabilitation services for substance use issues. Participants had concluded the program at least six months prior. Data were collected on socio-demographic variables, addiction history, current drug use status (drug-free or relapsed), and the composition and structure of personal support networks. Factors related to risk of relapse were assessed using bivariate and multivariate logistic regression models. A main goal of this study was to identify differences between the support network profiles of drug free and relapsed participants. Drug free participants had larger, less dense, more heterogeneous and reciprocal support networks, and more brokerage social capital than relapsed participants. Additionally, a lower risk of relapse was associated with higher socio-economic status, being married/cohabiting, and having network members with higher socio-economic status, who have greater occupational heterogeneity, and reciprocate support. Post-treatment relapse was found to be negatively associated with the socioeconomic status and occupational heterogeneity of ego's support network, reciprocity in the ties between ego and network members, and a support network in which the members are relatively loosely connected with one another (i.e., ego possesses "brokerage social capital"). These findings suggest the incorporation into therapeutic programming of interventions that address those aspects of clients' personal support networks. Copyright © 2015 Elsevier B.V. All rights reserved.

A network-based method for the identification of putative genes related to infertility.

PubMed

Wang, ShaoPeng; Huang, GuoHua; Hu, Qinghua; Zou, Quan

2016-11-01

Infertility has become one of the major health problems worldwide, with its incidence having risen markedly in recent decades. There is an urgent need to investigate the pathological mechanisms behind infertility and to design effective treatments. However, this is made difficult by the fact that various biological factors have been identified to be related to infertility, including genetic factors. A network-based method was established to identify new genes potentially related to infertility. A network constructed using human protein-protein interactions based on previously validated infertility-related genes enabled the identification of some novel candidate genes. These genes were then filtered by a permutation test and their functional and structural associations with infertility-related genes. Our method identified 23 novel genes, which have strong functional and structural associations with previously validated infertility-related genes. Substantial evidence indicates that the identified genes are strongly related to dysfunction of the four main biological processes of fertility: reproductive development and physiology, gametogenesis, meiosis and recombination, and hormone regulation. The newly discovered genes may provide new directions for investigating infertility. This article is part of a Special Issue entitled "System Genetics" Guest Editor: Dr. Yudong Cai and Dr. Tao Huang. Copyright © 2016 Elsevier B.V. All rights reserved.

Closed-loop transfer recovery with observer-based controllers. I - Analysis. II - Design

NASA Technical Reports Server (NTRS)

Chen, Ben M.; Saberi, Ali; Ly, Uy-Loi

1992-01-01

A detailed study is presented of three fundamental issues related to the problem of closed-loop transfer (CLT) recovery. The first issues concerns what can and cannot be achieved for a given system and for an arbitrary target CLT function (TCLTF). The second issue involves developing necessary and/or sufficient conditions for a TCLTF to be recoverable either exactly or approximately. The third issue involves the necessary and/or sufficient conditions on a given system such that it has at least one recoverable TCLTF. The results of the analysis identify some fundamental limitations of the given system as a consequence of its structural properties which enables designers to appreciate at the outset different design limitations incurred in the synthesis of output-feedback controllers. Then, the actual design of full-order or reduced-order observer-based controllers is addressed which will achieve as close as possibly the desired TCLTF. Three design methods are considered: (1) the ATEA method, (2) a method that minimizes the H2-norm of a recovery matrix, and (3) a method that minimizes the respective H(infinity) norm. The relative merits of the methods are discussed.

Recent global trends in structural materials research

NASA Astrophysics Data System (ADS)

Murakami, Hideyuki; Ohmura, Takahito; Nishimura, Toshiyuki

2013-02-01

Structural materials support the basis of global society, such as infrastructure and transportation facilities, and are therefore essential for everyday life. The optimization of such materials allows people to overcome environmental, energy and resource depletion issues on a global scale. The creation and manufacture of structural materials make a large contribution to economies around the world every year. The use of strong, resistant materials can also have profound social effects, providing a better quality of life at both local and national levels. The Great East Japan Earthquake of 11 March 2011 caused significant structural damage in the Tohoku and Kanto regions of Japan. On a global scale, accidents caused by the ageing and failure of structural materials occur on a daily basis. Therefore, the provision and inspection of structural reliability, safety of nuclear power facilities and construction of a secure and safe society hold primary importance for researchers and engineers across the world. Clearly, structural materials need to evolve further to address both existing problems and prepare for new challenges that may be faced in the future. With this in mind, the National Institute for Materials Science (NIMS) organized the 'NIMS Conference 2012' to host an extensive discussion on a variety of global issues related to the future development of structural materials. Ranging from reconstruction following natural disasters, verification of structural reliability, energy-saving materials to fundamental problems accompanying the development of materials for high safety standards, the conference covered many key issues in the materials industry today. All the above topics are reflected in this focus issue of STAM, which introduces recent global trends in structural materials research with contributions from world-leading researchers in this field. This issue covers the development of novel alloys, current methodologies in the characterization of structural materials and fundamental research on structure-property relationships. We are grateful to the authors who contributed to cover these issues, and sincerely hope that our readers will expand their knowledge of emerging international research within the field of structural materials.

On Some Interesting Trends in Research of Steel and Composite Structures

NASA Astrophysics Data System (ADS)

Marcinowski, Jakub

2017-06-01

This paper is a kind of introduction to the special issue of CEER devoted to metal and composite structures. Papers collected in this issue were ordered from Authors who took part in International Conference on Metal Structures which was held in Zielona Góra in 2016. Selection of Authors and theme of ordered papers were done in cooperation with Metal Structures Section of the Civil Engineering Committee of the Polish Academy of Sciences. Selected papers included in this special issue of CEER were shortly presented in this editorial.

CNA web server: rigidity theory-based thermal unfolding simulations of proteins for linking structure, (thermo-)stability, and function.

PubMed

Krüger, Dennis M; Rathi, Prakash Chandra; Pfleger, Christopher; Gohlke, Holger

2013-07-01

The Constraint Network Analysis (CNA) web server provides a user-friendly interface to the CNA approach developed in our laboratory for linking results from rigidity analyses to biologically relevant characteristics of a biomolecular structure. The CNA web server provides a refined modeling of thermal unfolding simulations that considers the temperature dependence of hydrophobic tethers and computes a set of global and local indices for quantifying biomacromolecular stability. From the global indices, phase transition points are identified where the structure switches from a rigid to a floppy state; these phase transition points can be related to a protein's (thermo-)stability. Structural weak spots (unfolding nuclei) are automatically identified, too; this knowledge can be exploited in data-driven protein engineering. The local indices are useful in linking flexibility and function and to understand the impact of ligand binding on protein flexibility. The CNA web server robustly handles small-molecule ligands in general. To overcome issues of sensitivity with respect to the input structure, the CNA web server allows performing two ensemble-based variants of thermal unfolding simulations. The web server output is provided as raw data, plots and/or Jmol representations. The CNA web server, accessible at http://cpclab.uni-duesseldorf.de/cna or http://www.cnanalysis.de, is free and open to all users with no login requirement.

CNA web server: rigidity theory-based thermal unfolding simulations of proteins for linking structure, (thermo-)stability, and function

PubMed Central

Krüger, Dennis M.; Rathi, Prakash Chandra; Pfleger, Christopher; Gohlke, Holger

2013-01-01

The Constraint Network Analysis (CNA) web server provides a user-friendly interface to the CNA approach developed in our laboratory for linking results from rigidity analyses to biologically relevant characteristics of a biomolecular structure. The CNA web server provides a refined modeling of thermal unfolding simulations that considers the temperature dependence of hydrophobic tethers and computes a set of global and local indices for quantifying biomacromolecular stability. From the global indices, phase transition points are identified where the structure switches from a rigid to a floppy state; these phase transition points can be related to a protein’s (thermo-)stability. Structural weak spots (unfolding nuclei) are automatically identified, too; this knowledge can be exploited in data-driven protein engineering. The local indices are useful in linking flexibility and function and to understand the impact of ligand binding on protein flexibility. The CNA web server robustly handles small-molecule ligands in general. To overcome issues of sensitivity with respect to the input structure, the CNA web server allows performing two ensemble-based variants of thermal unfolding simulations. The web server output is provided as raw data, plots and/or Jmol representations. The CNA web server, accessible at http://cpclab.uni-duesseldorf.de/cna or http://www.cnanalysis.de, is free and open to all users with no login requirement. PMID:23609541

A horizon scan of global conservation issues for 2012.

PubMed

Sutherland, William J; Aveling, Ros; Bennun, Leon; Chapman, Eleanor; Clout, Mick; Côté, Isabelle M; Depledge, Michael H; Dicks, Lynn V; Dobson, Andrew P; Fellman, Liz; Fleishman, Erica; Gibbons, David W; Keim, Brandon; Lickorish, Fiona; Lindenmayer, David B; Monk, Kathryn A; Norris, Kenneth; Peck, Lloyd S; Prior, Stephanie V; Scharlemann, Jörn P W; Spalding, Mark; Watkinson, Andrew R

2012-01-01

Our aim in conducting annual horizon scans is to identify issues that, although currently receiving little attention, may be of increasing importance to the conservation of biological diversity in the future. The 15 issues presented here were identified by a diverse team of 22 experts in horizon scanning, and conservation science and its application. Methods for identifying and refining issues were the same as in two previous annual scans and are widely transferable to other disciplines. The issues highlight potential changes in climate, technology and human behaviour. Examples include warming of the deep sea, increased cultivation of perennial grains, burning of Arctic tundra, and the development of nuclear batteries and hydrokinetic in-stream turbines. Copyright © 2011 Elsevier Ltd. All rights reserved.

Methodology issues in implementation science.

PubMed

Newhouse, Robin; Bobay, Kathleen; Dykes, Patricia C; Stevens, Kathleen R; Titler, Marita

2013-04-01

Putting evidence into practice at the point of care delivery requires an understanding of implementation strategies that work, in what context and how. To identify methodological issues in implementation science using 4 studies as cases and make recommendations for further methods development. Four cases are presented and methodological issues identified. For each issue raised, evidence on the state of the science is described. Issues in implementation science identified include diverse conceptual frameworks, potential weaknesses in pragmatic study designs, and the paucity of standard concepts and measurement. Recommendations to advance methods in implementation include developing a core set of implementation concepts and metrics, generating standards for implementation methods including pragmatic trials, mixed methods designs, complex interventions and measurement, and endorsing reporting standards for implementation studies.

Project financing of district heating/cooling systems

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

Feldman, R.D.

1986-03-01

Two issues are discussed in detail: the project finance joint venture and technology transfers. An increase if the frequency of these issues has been served in project financings. An understanding of these issues is necessary to structure project financings of alternate energy projects in the future. Capitalization needs are outlined, and typical provisions of a joint finance structure are outlined. The issue of exclusivity as it applies to technology transfers is discussed.

Psychosocial experiences of women with vesicovaginal fistula: a qualitative approach.

PubMed

Farid, Farah Naz; Azhar, Maimoona; Samnani, Sunil Sadruddin; Allana, Saleema; Naz, Angeela; Bohar, Farzana; Shamim; Syed, Shershah

2013-11-01

Vesicovaginal fistula (VVF) is a condition associated with a number of physical and psychological consequences. In order to gain a deeper understanding of the issues faced by women diagnosed with VVF, a qualitative exploratory study was carried out to explore the experiences of women suffering from VVF. The study included 8 women hospitalized with the diagnosis of vesicovaginal fistula at Kohi Goth Women's Hospital, Karachi, Pakistan. Semi structured interviews of each participant were conducted, recorded, and transcribed. Five major themes were identified, among which all of the participants experienced physical discomforts, psychological disturbances, issues with social and interpersonal relationships and financial constraints. However, concerns with religious practices were experienced by 87.5% of the participants. Pakistani women who are suffering through VVF face many challenges. Combined efforts should be made to offer supportive services to women suffering from this condition.

Warm dark matter

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

Horiuchi, Shunsaku, E-mail: horiuchi@vt.edu

2016-06-21

The cold dark matter paradigm has been extremely successful in explaining the large-scale structure of the Universe. However, it continues to face issues when confronted by observations on sub-Galactic scales. A major caveat, now being addressed, has been the incomplete treatment of baryon physics. We first summarize the small-scale issues surrounding cold dark matter and discuss the solutions explored by modern state-of-the-art numerical simulations including treatment of baryonic physics. We identify the too big to fail in field galaxies as among the best targets to study modifications to dark matter, and discuss the particular connection with sterile neutrino warm darkmore » matter. We also discuss how the recently detected anomalous 3.55 keV X-ray lines, when interpreted as sterile neutrino dark matter decay, provide a very good description of small-scale observations of the Local Group.« less

The implementation of psychiatric advance directives: experiences from a Dutch crisis card initiative.

PubMed

van der Ham, Alida J; Voskes, Yolande; van Kempen, Nel; Broerse, Jacqueline E W; Widdershoven, Guy A M

2013-06-01

The crisis card is a specific form of psychiatric advance directive, documenting mental clients' treatment preferences in advance of a potential psychiatric crisis. In this paper, we aim to provide insight into implementation issues surrounding the crisis card. A Dutch crisis-card project formed the scope of this study. Data were collected through interviews with 15 participants from six stakeholder groups. Identified implementation issues are: (a) The role of the crisis-card counselor, (b) lack of distribution and familiarity, (c) care professionals' routines, and (d) client readiness. The crisis-card counselor appears to play a key role in fostering benefits of the crisis card by supporting clients' perspectives. More structural integration of the crisis card in care processes may enhance its impact, but should be carefully explored. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Ethical Considerations in HIV/AIDS Biobehavioral Surveys That Use Respondent-Driven Sampling: Illustrations From Lebanon

PubMed Central

DeJong, Jocelyn; Mahfoud, Ziyad; Khoury, Danielle; Barbir, Farah

2009-01-01

Respondent-driven sampling is especially useful for reaching hidden populations and is increasingly used internationally in public health research, particularly on HIV. Respondent-driven sampling involves peer recruitment and has a dual-incentive structure: both recruiters and their peer recruits are paid. Recent literature focusing on the ethical dimensions of this method in the US context has identified integral safeguards that protect against ethical violations. We analyzed a study of 3 groups in Lebanon who are at risk for HIV (injection drug users, men who have sex with men, female sex workers) and the ethical issues that arose. More explicit attention should be given to ethical issues involved in research implementing respondent-driven sampling of at-risk populations in developing countries, where ethical review mechanisms may be weak. PMID:19608961

Applying usability heuristics to radiotherapy systems.

PubMed

Chan, Alvita J; Islam, Mohammad K; Rosewall, Tara; Jaffray, David A; Easty, Anthony C; Cafazzo, Joseph A

2012-01-01

Heuristic evaluations have been used to evaluate safety of medical devices by identifying and assessing usability issues. Since radiotherapy treatment delivery systems often consist of multiple complex user-interfaces, a heuristic evaluation was conducted to assess the potential safety issues of such a system. A heuristic evaluation was conducted to evaluate the treatment delivery system at Princess Margaret Hospital (Toronto, Canada). Two independent evaluators identified usability issues with the user-interfaces and rated the severity of each issue. The evaluators identified 75 usability issues in total. Eighteen of them were rated as high severity, indicating the potential to have a major impact on patient safety. A majority of issues were found on the record and verify system, and many were associated with the patient setup process. While the hospital has processes in place to ensure patient safety, recommendations were developed to further mitigate the risks of potential consequences. Heuristic evaluation is an efficient and inexpensive method that can be successfully applied to radiotherapy delivery systems to identify usability issues and improve patient safety. Although this study was conducted only at one site, the findings may have broad implications for the design of these systems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Correlating low-similarity peptide sequences and allergenic epitopes.

PubMed

Kanduc, D

2008-01-01

Although a high number of allergenic peptide epitopes has been experimentally identified and defined, the molecular basis and the precise mechanisms underlying peptide allergenicity are unknown. This issue was analyzed exploring the relationship between peptide allergenicity and sequence similarity to the human proteome. The structured analysis of the data reported in literature put into evidence that the most part of IgE-binding epitopes are (or harbor) pentapeptide unit(s) with no/low similarity to the human proteome, this way suggesting that no or low sequence similarity to the host proteome might represent a minimum common denominator identifying allergenic peptides. The present literature analysis might be of relevance in devising and designing short amino acid modules to be used for blocking pathogenic IgE.

Advanced Platform Systems Technology study. Volume 3: Supporting data

NASA Technical Reports Server (NTRS)

1983-01-01

The overall study effort proceeded from the identification of 106 technology topics to the selection of 5 for detail trade studies. The technical issues and options were evaluated through the trade process. Finally, individual consideration was given to costs and benefits for the technologies identified for advancement. Eight priority technology items were identified for advancement. Supporting data generated during the trade selection and trade study process were presented. Space platform requirements, trade study and cost benefits analysis, and technology advancement planning are advanced. The structured approach used took advantage of a number of forms developed to ensure that a consistent approach was employed by each of the diverse specialists that participated. These forms were an intrinsic part of the study protocol.

Residential Fuel Cell Demonstration Handbook

NASA Astrophysics Data System (ADS)

Torrero, E.; McClelland, R.

2002-07-01

This report is a guide for rural electric cooperatives engaged in field testing of equipment and in assessing related application and market issues. Dispersed generation and its companion fuel cell technology have attracted increased interest by rural electric cooperatives and their customers. In addition, fuel cells are a particularly interesting source because their power quality, efficiency, and environmental benefits have now been coupled with major manufacturer development efforts. The overall effort is structured to measure the performance, durability, reliability, and maintainability of these systems, to identify promising types of applications and modes of operation, and to assess the related prospect for future use. In addition, technical successes and shortcomings will be identified by demonstration participants and manufacturers using real-world experience garnered under typical operating environments.

XANES: observation of quantum confinement in the conduction band of colloidal PbS quantum dots

NASA Astrophysics Data System (ADS)

Demchenko, I. N.; Chernyshova, M.; He, X.; Minikayev, R.; Syryanyy, Y.; Derkachova, A.; Derkachov, G.; Stolte, W. C.; Piskorska-Hommel, E.; Reszka, A.; Liang, H.

2013-04-01

The presented investigations aimed at development of inexpensive method for synthesized materials suitable for utilization of solar energy. This important issue was addressed by focusing, mainly, on electronic local structure studies with supporting x-ray diffraction (XRD) and transmission electron microscopy (TEM) analysis of colloidal galena nano-particles (NPs) and quantum dots (QDs) synthesized using wet chemistry under microwave irradiation. Performed x-ray absorption near edge structure (XANES) analysis revealed an evidence of quantum confinement for the sample with QDs, where the bottom of the conduction band was shifted to higher energy. The QDs were found to be passivated with oxides at the surface. Existence of sulfate/sulfite and thiosulfate species in pure PbS and QDs, respectively, was identified.

APPLICATION OF THE 3D MODEL OF RAILWAY VIADUCTS TO COST ESTIMATION AND CONSTRUCTION

NASA Astrophysics Data System (ADS)

Fujisawa, Yasuo; Yabuki, Nobuyoshi; Igarashi, Zenichi; Yoshino, Hiroyuki

Three dimensional models of civil engineering structures are only partially used in either design or construction but not both. Research on integration of design, cost estimation and construction by 3Dmodels has not been heard in civil engineering domain yet. Using continuously a 3D product model of a structure from design to construction through estimation should improve the efficiency and decrease the occurrence of mistakes, hence enhancing the quality. In this research, we investigated the current practices of flow from design to construction, particularly focusing on cost estimation. Then, we identified advantages and issues on utilization of 3D design models to estimation and construction by applying 3D models to an actual railway construction project.

Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems.

PubMed

Ji, Hyerim; Yoo, Sooyoung; Heo, Eun-Young; Hwang, Hee; Kim, Jeong-Whun

2017-10-01

This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

Uncovering Offshore Financial Centers: Conduits and Sinks in the Global Corporate Ownership Network.

PubMed

Garcia-Bernardo, Javier; Fichtner, Jan; Takes, Frank W; Heemskerk, Eelke M

2017-07-24

Multinational corporations use highly complex structures of parents and subsidiaries to organize their operations and ownership. Offshore Financial Centers (OFCs) facilitate these structures through low taxation and lenient regulation, but are increasingly under scrutiny, for instance for enabling tax avoidance. Therefore, the identification of OFC jurisdictions has become a politicized and contested issue. We introduce a novel data-driven approach for identifying OFCs based on the global corporate ownership network, in which over 98 million firms (nodes) are connected through 71 million ownership relations. This granular firm-level network data uniquely allows identifying both sink-OFCs and conduit-OFCs. Sink-OFCs attract and retain foreign capital while conduit-OFCs are attractive intermediate destinations in the routing of international investments and enable the transfer of capital without taxation. We identify 24 sink-OFCs. In addition, a small set of five countries - the Netherlands, the United Kingdom, Ireland, Singapore and Switzerland - canalize the majority of corporate offshore investment as conduit-OFCs. Each conduit jurisdiction is specialized in a geographical area and there is significant specialization based on industrial sectors. Against the idea of OFCs as exotic small islands that cannot be regulated, we show that many sink and conduit-OFCs are highly developed countries.

The Survey of Treatment Entry Pressures (STEP): identifying client's reasons for entering substance abuse treatment.

PubMed

Dugosh, Karen Leggett; Festinger, David S; Lynch, Kevin G; Marlowe, Douglas B

2014-10-01

Systematically identifying reasons that clients enter substance abuse treatment may allow clinicians to immediately focus on issues of greatest relevance to the individual and enhance treatment engagement. We developed the Survey of Treatment Entry Pressures (STEP) to identify the specific factors that precipitated an individual's treatment entry. The instrument contains 121 items from 6 psychosocial domains (i.e., family, financial, social, medical, psychiatric, legal). The current study examined the STEP's psychometric properties. A total of 761 participants from various treatment settings and modalities completed the STEP prior to treatment admission and 4-7 days later. Analyses were performed to examine the instrument's psychometric properties including item response rates, test-retest reliability, internal consistency, and factor structure. The items displayed adequate test-retest reliability and internal consistency within each psychosocial domain. Generally, results from exploratory and confirmatory factor analyses support a 2-factor structure reflecting type of reinforcement schedule. The study provides preliminary support for the psychometric properties of the STEP. The STEP may provide a reliable way for clinicians to characterize and capitalize on a client's treatment motivation early on which may serve to improve treatment retention and therapeutic outcomes. © 2014 Wiley Periodicals, Inc.

Jointly creating digital abstracts: dealing with synonymy and polysemy

PubMed Central

2012-01-01

Background Ideally each Life Science article should get a ‘structured digital abstract’. This is a structured summary of the paper’s findings that is both human-verified and machine-readable. But articles can contain a large variety of information types and contextual details that all need to be reconciled with appropriate names, terms and identifiers, which poses a challenge to any curator. Current approaches mostly use tagging or limited entry-forms for semantic encoding. Findings We implemented a ‘controlled language’ as a more expressive representation method. We studied how usable this format was for wet-lab-biologists that volunteered as curators. We assessed some issues that arise with the usability of ontologies and other controlled vocabularies, for the encoding of structured information by ‘untrained’ curators. We take a user-oriented viewpoint, and make recommendations that may prove useful for creating a better curation environment: one that can engage a large community of volunteer curators. Conclusions Entering information in a biocuration environment could improve in expressiveness and user-friendliness, if curators would be enabled to use synonymous and polysemous terms literally, whereby each term stays linked to an identifier. PMID:23110757

A Survey of Emerging Materials for Revolutionary Aerospace Vehicle Structures and Propulsion Systems

NASA Technical Reports Server (NTRS)

Harris, Charles E.; Shuart, Mark J.; Gray, Hugh R.

2002-01-01

The NASA Strategic Plan identifies the long-term goal of providing safe and affordable space access, orbital transfer, and interplanetary transportation capabilities to enable scientific research, human, and robotic exploration, and the commercial development of space. Numerous scientific and engineering breakthroughs will be required to develop the technology required to achieve this goal. Critical technologies include advanced vehicle primary and secondary structure, radiation protection, propulsion and power systems, fuel storage, electronics and devices, sensors and science instruments, and medical diagnostics and treatment. Advanced materials with revolutionary new capabilities are an essential element of each of these technologies. A survey of emerging materials with applications to aerospace vehicle structures and propulsion systems was conducted to assist in long-term Agency mission planning. The comprehensive survey identified materials already under development that could be available in 5 to 10 years and those that are still in the early research phase and may not be available for another 20 to 30 years. The survey includes typical properties, a description of the material and processing methods, the current development status, and the critical issues that must be overcome to achieve commercial viability.

Implementing care programmes for frail older people: a project management perspective.

PubMed

Bindels, Jill; Cox, Karen; Abma, Tineke A; van Schayck, Onno C P; Widdershoven, Guy

2015-01-01

To examine the issues that influenced the implementation of programmes designed to identify and support frail older people in the community in the Netherlands. Qualitative research methods were used to investigate the perspectives of project leaders, project members and members of the steering committee responsible for the implementation of the programmes. Interviews were conducted in 2009 (n = 10) and in 2012 (n = 13) and a focus group was organised in 2012 (n = 5). The interviews revealed that the implementation was influenced by the extent and quality of collaboration between organisations, adaptation to existing structures, future funding for the programmes and project leadership. A good relationship between participating organisations and professionals is required for successful implementation. A lack of clear project leadership and structural funding hampers the implementation of complex programmes in primary care settings. The findings of this study are useful for organisations and professionals who are planning to implement complex programmes. Identifying barriers concerning institutional collaboration, adaptation to existing structures, leadership and continuation of financial support at an early stage of the implementation process can support practitioners in overcoming them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Model-based metrics of human-automation function allocation in complex work environments

NASA Astrophysics Data System (ADS)

Kim, So Young

Function allocation is the design decision which assigns work functions to all agents in a team, both human and automated. Efforts to guide function allocation systematically has been studied in many fields such as engineering, human factors, team and organization design, management science, and cognitive systems engineering. Each field focuses on certain aspects of function allocation, but not all; thus, an independent discussion of each does not address all necessary issues with function allocation. Four distinctive perspectives emerged from a review of these fields: technology-centered, human-centered, team-oriented, and work-oriented. Each perspective focuses on different aspects of function allocation: capabilities and characteristics of agents (automation or human), team structure and processes, and work structure and the work environment. Together, these perspectives identify the following eight issues with function allocation: 1) Workload, 2) Incoherency in function allocations, 3) Mismatches between responsibility and authority, 4) Interruptive automation, 5) Automation boundary conditions, 6) Function allocation preventing human adaptation to context, 7) Function allocation destabilizing the humans' work environment, and 8) Mission Performance. Addressing these issues systematically requires formal models and simulations that include all necessary aspects of human-automation function allocation: the work environment, the dynamics inherent to the work, agents, and relationships among them. Also, addressing these issues requires not only a (static) model, but also a (dynamic) simulation that captures temporal aspects of work such as the timing of actions and their impact on the agent's work. Therefore, with properly modeled work as described by the work environment, the dynamics inherent to the work, agents, and relationships among them, a modeling framework developed by this thesis, which includes static work models and dynamic simulation, can capture the issues with function allocation. Then, based on the eight issues, eight types of metrics are established. The purpose of these metrics is to assess the extent to which each issue exists with a given function allocation. Specifically, the eight types of metrics assess workload, coherency of a function allocation, mismatches between responsibility and authority, interruptive automation, automation boundary conditions, human adaptation to context, stability of the human's work environment, and mission performance. Finally, to validate the modeling framework and the metrics, a case study was conducted modeling four different function allocations between a pilot and flight deck automation during the arrival and approach phases of flight. A range of pilot cognitive control modes and maximum human taskload limits were also included in the model. The metrics were assessed for these four function allocations and analyzed to validate capability of the metrics to identify important issues in given function allocations. In addition, the design insights provided by the metrics are highlighted. This thesis concludes with a discussion of mechanisms for further validating the modeling framework and function allocation metrics developed here, and highlights where these developments can be applied in research and in the design of function allocations in complex work environments such as aviation operations.

Proceedings of National Avian-Wind Power Planning Meeting IV

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

NWCC Avian Subcommittee

2001-05-01

OAK-B135 The purpose of the fourth meeting was to (1) share research and update research conducted on avian wind interactions (2) identify questions and issues related to the research results, (3) develop conclusions about some avian/wind power issues, and (4) identify questions and issues for future avian research.

Critical comment on: A.J. Mory et al. `Woodleigh, Carnarvon Basin, Western Australia: a new 120 km diameter impact structure'

NASA Astrophysics Data System (ADS)

Reimold, Wolf Uwe; Koeberl, Christian

2000-12-01

Mory et al. [1] claim to report 'a newly discovered basement-cored, multi-ring impact structure' and hint 'at a possible Permian-Triassic boundary age for the impact'. They purport that this structure could be as large as 120 km in diameter. This comment emphasizes that these authors indeed identified a potentially interesting structure, but that the evidence presented is inconclusive and not well constrained. It does not prove that Woodleigh is of impact origin. Mory et al.'s [1] claims, especially regarding the alleged size of this structure and correlation with the P/Tr boundary mass extinction, have generated extensive public interest. Presentation of such an alleged discovery must adhere stringently to scientific principles, namely that convincing evidence is obtained before interpretation, which itself should not go beyond the limits set by the data at hand. This comment demonstrates that Mory et al. did not conform to this principle. Issue will be taken with the arguments of Mory et al. in the sequence according to the structure of their paper.

A qualitative study of physician perspectives of cost-related communication and patients' financial burden with managing chronic disease.

PubMed

Patel, Minal R; Shah, Khooshbu S; Shallcross, Meagan L

2015-11-25

Patient financial burden with chronic disease poses significant health risks, yet it remains outside the scope of clinical visits. Little is known about how physicians perceive their patients' health-related financial burden in the context of primary care. The purpose of this study was to describe physician experiences with patients' financial burden while managing chronic disease and the communication of these issues. In November 2013, four focus groups were conducted in an academic medical center. A convenience sample of 29 internal and family medicine resident physicians was used in this study. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding physicians' experiences with identifying, managing, and communicating financial burden with their patients in the context of primary care. Major themes identified were 1) patient financial burden with chronic care is visible to physicians, 2) patient's financial burden with chronic care and discussing these issues is important to physicians, 3) ability to identify patients who perceive financial burden is imperfect, 4) communication of financial burden with patients is complex and difficult to navigate, 5) strategies utilized to address concerns are not always generalizable, and 6) physicians have ideas for widespread change to make these conversations easier for them. Awareness of physician perspectives in identifying and addressing their patients' disease-related financial burden may better equip researchers and medical educators to develop interventions that aid care teams in better understanding these patient concerns to promote compliance with treatment recommendations.

Building an Ontology for Identity Resolution in Healthcare and Public Health

PubMed Central

Duncan, Jeffrey; Eilbeck, Karen; Narus, Scott P.; Clyde, Stephen; Thornton, Sidney; Staes, Catherine

2015-01-01

Integration of disparate information from electronic health records, clinical data warehouses, birth certificate registries and other public health information systems offers great potential for clinical care, public health practice, and research. Such integration, however, depends on correctly matching patient-specific records using demographic identifiers. Without standards for these identifiers, record linkage is complicated by issues of structural and semantic heterogeneity. Objectives: Our objectives were to develop and validate an ontology to: 1) identify components of identity and events subsequent to birth that result in creation, change, or sharing of identity information; 2) develop an ontology to facilitate data integration from multiple healthcare and public health sources; and 3) validate the ontology’s ability to model identity-changing events over time. Methods: We interviewed domain experts in area hospitals and public health programs and developed process models describing the creation and transmission of identity information among various organizations for activities subsequent to a birth event. We searched for existing relevant ontologies. We validated the content of our ontology with simulated identity information conforming to scenarios identified in our process models. Results: We chose the Simple Event Model (SEM) to describe events in early childhood and integrated the Clinical Element Model (CEM) for demographic information. We demonstrated the ability of the combined SEM-CEM ontology to model identity events over time. Conclusion: The use of an ontology can overcome issues of semantic and syntactic heterogeneity to facilitate record linkage. PMID:26392849

State Children's Cabinets and Councils--Elements of Success Issue 1: Structural Options

ERIC Educational Resources Information Center

Gaines, Elizabeth; Faigley, Ian; Pittman, Karen

2008-01-01

Elements of Success 1: Structural Options outlines the range of current children's cabinet and council structures in place and offers tips and warnings for getting the most effective structure in place. This issue brief builds heavily on interviews conducted by the Forum and on the detailed documentation work done by Susan Robison for the National…

Human Systems Integration and Automation Issues in Small Unmanned Aerial Vehicles

NASA Technical Reports Server (NTRS)

McCauley, Michael E.; Matsangas, Panagiotis

2004-01-01

The goal of this report is to identify Human System Integration (HSI) and automation issues that contribute to improved effectiveness and efficiency in the operation of U.S. military Small Unmanned Aerial Vehicles (SUAVs). HSI issues relevant to SUAV operations are reviewed and observations from field trials are summarized. Short-term improvements are suggested research issues are identified and an overview is provided of automation technologies applicable to future SUAV design.

A horizon scan for species conservation by zoos and aquariums.

PubMed

Gusset, Markus; Fa, John E; Sutherland, William J

2014-01-01

We conducted the first horizon scan for zoos and aquariums to identify the 10 most important emerging issues for species conservation. This involved input from more than 100 experts from both the wider conservation community and the world zoo and aquarium community. Some of the issues are globally important: diseases, zoonoses, and biosecurity issues; new (communication) technologies; global water shortage and food insecurity; developing economies and markets for wildlife consumption; changes in wildlife population dynamics; and political instability and conflicts. Other issues are more specific to zoos and aquariums: need for extractive reserves; space shortage in zoos and aquariums; need for metapopulation management; and demand for caring of more species in zoos and aquariums. We also identified some broad approaches to these issues. Addressing the emerging issues identified in our horizon scan will further increase the contribution of the world zoo and aquarium community to global biodiversity conservation. © 2014 Wiley Periodicals, Inc.

Tobacco control: consensus report of the National Medical Association.

PubMed

Marable, Sharon; Crim, Courtney; Dennis, Gary C; Epps, Roselyn Payne; Freeman, Harold; Mills, Sherry; Coolchan, Eric T; Robinson, Lawrence; Robinson, Robert; Cole, Lorraine; Payne, Pamela H

2002-02-01

Tobacco Control remains one of the greatest determinants for reducing the morbidity and mortality of African Americans. To examine the scope and consequences of tobacco use among African Americans and characterize its implications for the National Medical Association physician membership and their patients, and identify policy, education, advocacy and research issues in Tobacco Control for the organization. Literature review using the MEDLINE database from January 1966 to August 1999 Week 1, searching Medical Subject Heading (MeSH) reading combined with text words "Black" or "African American" and "Tobacco" as a search term, identified 130 articles/110 abstracts published between 1988 and February 1999. The panel selected 61 appropriate articles and a paper summarizing the literature review was developed. The summary paper was used as background material for a formal consensus panel discussion on July 16-17, 1999. Consensus among committee members was reached via mail, fax and e-mail using the summary review paper, annotated bibliographies key informant surveys, and previous NMA resolutions on tobacco control. A formal working session was held on July 16-17, 1999 in which four areas of concentration of issues were determined: Policy, Advocacy, Education and Research. All committee members approved the final report. Because tobacco control issues in African Americans are both complex and poorly understood, the panel views the NMA's role as pivotal in the coordination of resources and capacity-building to address all four areas identified. Stronger partner-ships with traditional federal and nonprofit agencies associated with tobacco control/advocacy in African Americans as well as nontraditional organizations (i.e., churches, academia, marketing and media organizations) also must occur to strengthen the infra-structure needed to assess needs, design appropriate interventions and evaluate the appropriateness, effectiveness and efficacy of tobacco control efforts in African American communities.

Addressing overuse of health services in health systems: a critical interpretive synthesis.

PubMed

Ellen, Moriah E; Wilson, Michael G; Vélez, Marcela; Shach, Ruth; Lavis, John N; Grimshaw, Jeremy M; Moat, Kaelan A

2018-06-15

Health systems are increasingly focusing on the issue of 'overuse' of health services and how to address it. We developed a framework focused on (1) the rationale and context for health systems prioritising addressing overuse, (2) elements of a comprehensive process and approach to reduce overuse and (3) implementation considerations for addressing overuse. We conducted a critical interpretive synthesis informed by a stakeholder-engagement process. The synthesis identified relevant empirical and non-empirical articles about system-level overuse. Two reviewers independently screened records, assessed for inclusion and conceptually mapped included articles. From these, we selected a purposive sample, created structured summaries of key findings and thematically synthesised the results. Our search identified 3545 references, from which we included 251. Most articles (76%; n = 192) were published within 5 years of conducting the review and addressed processes for addressing overuse (63%; n = 158) or political and health system context (60%; n = 151). Besides negative outcomes at the patient, system and global level, there were various contextual factors to addressing service overuse that seem to be key issue drivers. Processes for addressing overuse can be grouped into three elements comprising a comprehensive approach, including (1) approaches to identify overused health services, (2) stakeholder- or patient-led approaches and (3) government-led initiatives. Key implementation considerations include the need to develop 'buy in' from stakeholders and citizens. Health systems want to ensure the use of high-value services to keep citizens healthy and avoid harm. Our synthesis can be used by policy-makers, stakeholders and researchers to understand how the issue has been prioritised, what approaches have been used to address it and implementation considerations. PROSPERO CRD42014013204 .

Continuing professional development and the charity paradigm: interrelated individual, collective and organisational issues about continuing professional development.

PubMed

Munro, Kathleen M

2008-11-01

This paper aims to highlight some issues and tensions that currently challenge the profession, individual nurses and their employers when considering the need for continuing professional development. The Nursing and Midwifery Council states the professional requirements for continuing professional development. However the nature and type required seems to be determined by the individual on the one hand and the organisation on the other, rather than an integral part of professional activity within the context of work. This can lead to a mismatch between personal and organisational goals. Views emerged from participants in a previous case study that focused on learning through work, about support available to nurses for professional development. The perceptions of nurses and their managers about learning through work were explored, using semi structured interviews, picture mapping and structured interviews. The 'Charity Paradigm' is presented as an outcome of major issues within an organisation. It underpins negative perceptions of individuals about employer support of continuing professional development. It is suggested that there is a need for collaborative collective approaches to structured development in order to meet both individual and organisational needs. This is also advocated in order to achieve life long learning and transformational learning within an organisation. The tension between individual personal ambitions and employer demands can adversely affect the professional development of the practitioner and the organisation that employs them. The personal perspectives of nurses and managers about learning within their organisation are therefore important to acknowledge in terms of positive and negative influences. It is also necessary to recognise the contribution of the employer as well as the identifiable charitable contribution of individual practitioners and the input from external contributors to the organisation.

European questions related to satelite power systems

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

Kassing, D.

1983-01-01

A number of problems which have been identified in recent European studies related to satellite power systems are addressed. Based on energy demand and supply projections for Europe, developed by the International Institute for Applied Systems Analysis, the potential of power satellites in a future energy mix is discussed. A few major constraints are presented which may restrict power transmission to European receiving sites, e.g., orbital limitations, siting problems of the ground station, and economic and institutional issues. Conceptual designs for the structure of ground receiving stations located offshore near the European coastlines are described.

Evolution of forensic odontology: An overview

PubMed Central

Balachander, N.; Babu, N. Aravindha; Jimson, Sudha; Priyadharsini, C.; Masthan, K. M. K.

2015-01-01

Forensic dentistry or forensic odontology admits dentists’ participation or identification of the victim and assisting legal and criminal issues. It refers to the proper handling, examination, identification and evaluation of dental evidence. This article summarizes the evolution of forensic odontology that started right from Garden of Eden to the modern scenario in identification of the gang rape case which happened in the state capital. Forensic dentistry plays a significant role in identifying the victims of crime, deceased individuals through the examination of anatomical structures, dental appliances and dental restorations. PMID:26015703

Educational websites--Bioinformatics Tools II.

PubMed

Lomberk, Gwen

2009-01-01

In this issue, the highlighted websites are a continuation of a series of educational websites; this one in particular from a couple of years ago, Bioinformatics Tools [Pancreatology 2005;5:314-315]. These include sites that are valuable resources for many research needs in genomics and proteomics. Bioinformatics has become a laboratory tool to map sequences to databases, develop models of molecular interactions, evaluate structural compatibilities, describe differences between normal and disease-associated DNA, identify conserved motifs within proteins, and chart extensive signaling networks, all in silico. Copyright 2008 S. Karger AG, Basel and IAP.

Metrology in health: a pilot study

NASA Astrophysics Data System (ADS)

Ferreira, M.; Matos, A.

2015-02-01

The purpose of this paper is to identify and analyze some relevant issues which arise when the concept of metrological traceability is applied to health care facilities. Discussion is structured around the results that were obtained through a characterization and comparative description of the practices applied in 45 different Portuguese health entities. Following a qualitative exploratory approach, the information collected was the support for the initial research hypotheses and the development of the questionnaire survey. It was also applied a quantitative methodology that included a descriptive and inferential statistical analysis of the experimental data set.

Facilitating Discussion Among Expectant Fathers: Is Anyone Interested?

PubMed Central

Friedewald, Mark

2007-01-01

Within childbirth education circles, catering effectively to the needs of expectant fathers who attend antenatal education programs has become an issue of concern. This article reviews the literature on all-male discussion groups for expectant fathers as a strategy to address identified deficits in relation to the inclusion of men within existing program structures. An exploration of the attributes considered appropriate for those who facilitate such groups is undertaken, and the article concludes with a report on the recruitment of male facilitators at a health service in New South Wales, Australia. PMID:18311334

AHSP: a novel hemoglobin helper

PubMed Central

Bank, Arthur

2007-01-01

Recently, the small protein α hemoglobin–stabilizing protein (AHSP) was identified and found to specifically bind α-globin, stabilize its structure, and limit the toxic effects of excess α-globin, which are manifest in the inherited blood disorder β thalassemia. In this issue of the JCI, Yu, Weiss, and colleagues show that AHSP is also critical to the formation and stabilization of normal amounts of hemoglobin, even when α-globin is deficient, indicating unique and previously unidentified roles for this molecule (see the related article beginning on page 1856). PMID:17607349

Artificial intelligence in cardiology.

PubMed

Bonderman, Diana

2017-12-01

Decision-making is complex in modern medicine and should ideally be based on available data, structured knowledge and proper interpretation in the context of an individual patient. Automated algorithms, also termed artificial intelligence that are able to extract meaningful patterns from data collections and build decisions upon identified patterns may be useful assistants in clinical decision-making processes. In this article, artificial intelligence-based studies in clinical cardiology are reviewed. The text also touches on the ethical issues and speculates on the future roles of automated algorithms versus clinicians in cardiology and medicine in general.

Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study

PubMed Central

Moise, Imelda K.; Mulhall, Peter F.

2016-01-01

Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1) the structural challenges faced in implementing case management for program participants, and 2) possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty); contractual requirements (predefined catchment neighborhoods, caseload); limited support (client incentives, tailored training, and a high staff turnover rate); and logistic difficulties (organizational issues). Their approach to case management tends to be focused on linking clients to adequate services rather than reporting performance. Case managers favored measurable deliverables rather than operational work products. A proposed solution to current challenges emphasizes and encourages the iterative learning process and shared decision making between program targets, funders and providers. Case managers are aware of the challenging environment in which they operate for their clients and for themselves. However, future interventions will require clearly identified performance measures and increased systems support. PMID:27149061

Identifying Critical Issues and Problems in Technology Education Using a Modified-Delphi Technique.

ERIC Educational Resources Information Center

Wicklein, Robert C.

1993-01-01

Critical issues for technology education (TE) identified by a 25-member Delphi panel were identification of the knowledge base, curriculum development approaches, interdisciplinary approaches, and teacher education reform. Problems identified included inadequate marketing/public relations, teacher shortage, lack of content consensus, and…

Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework.

PubMed

Winkelman, Warren J; Leonard, Kevin J

2004-01-01

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes.

Detecting reactive islands using Lagrangian descriptors and the relevance to transition path sampling.

PubMed

Patra, Sarbani; Keshavamurthy, Srihari

2018-02-14

It has been known for sometime now that isomerization reactions, classically, are mediated by phase space structures called reactive islands (RI). RIs provide one possible route to correct for the nonstatistical effects in the reaction dynamics. In this work, we map out the reactive islands for the two dimensional Müller-Brown model potential and show that the reactive islands are intimately linked to the issue of rare event sampling. In particular, we establish the sensitivity of the so called committor probabilities, useful quantities in the transition path sampling technique, to the hierarchical RI structures. Mapping out the RI structure for high dimensional systems, however, is a challenging task. Here, we show that the technique of Lagrangian descriptors is able to effectively identify the RI hierarchy in the model system. Based on our results, we suggest that the Lagrangian descriptors can be useful for detecting RIs in high dimensional systems.

Identifying mental health issues in detained youth: Testing the structure and invariance of the Massachusetts Youth Screening Inventory-Version 2 (MAYSI-2).

PubMed

Russell, Justin D; Marsee, Monica A; Ryals, John S

2017-06-01

This study examined the factor structure of the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2), a brief self-report measure designed to flag clinically significant mental health needs among youth entering the juvenile justice system. Participants were 981 detained youth in the southeastern United States (mean age = 14.58 years; SD = 1.28 years; 67.5% male; 71.5% African American). Confirmatory factor analyses showed that a seven-factor model represented a satisfactory solution for the data, similar to previous research. The factor structure fit well across gender, age group, race (Black/White), and offense type (violent/nonviolent). Given the widespread use of the MAYSI-2 in juvenile justice settings, examining its psychometric properties is of key importance. Implications and limitations of the study are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Model-Based Heterogeneous Data Fusion for Reliable Force Estimation in Dynamic Structures under Uncertainties

PubMed Central

Khodabandeloo, Babak; Melvin, Dyan; Jo, Hongki

2017-01-01

Direct measurements of external forces acting on a structure are infeasible in many cases. The Augmented Kalman Filter (AKF) has several attractive features that can be utilized to solve the inverse problem of identifying applied forces, as it requires the dynamic model and the measured responses of structure at only a few locations. But, the AKF intrinsically suffers from numerical instabilities when accelerations, which are the most common response measurements in structural dynamics, are the only measured responses. Although displacement measurements can be used to overcome the instability issue, the absolute displacement measurements are challenging and expensive for full-scale dynamic structures. In this paper, a reliable model-based data fusion approach to reconstruct dynamic forces applied to structures using heterogeneous structural measurements (i.e., strains and accelerations) in combination with AKF is investigated. The way of incorporating multi-sensor measurements in the AKF is formulated. Then the formulation is implemented and validated through numerical examples considering possible uncertainties in numerical modeling and sensor measurement. A planar truss example was chosen to clearly explain the formulation, while the method and formulation are applicable to other structures as well. PMID:29149088

Cultural adaptation: translatability assessment and linguistic validation of the patient-reported outcome instrument for irritable bowel syndrome with diarrhea.

PubMed

Delgado-Herrera, Leticia; Lasch, Kathryn; Popielnicki, Ana; Nishida, Akito; Arbuckle, Rob; Banderas, Benjamin; Zentner, Susan; Gagainis, Ingrid; Zeiher, Bernhardt

2016-01-01

Following a 2009 US Food and Drug Administration guidance, a new patient-reported outcome (PRO) instrument was developed to support end points in multinational clinical trials assessing irritable bowel syndrome with diarrhea (IBS-D) symptom severity. Our objective was to assess the translatability of the IBS-D PRO instrument into ten languages, and subsequently perform a cultural adaptation/linguistic validation of the questionnaire into Japanese and US Spanish. Translatability assessments of the US English version of the IBS-D PRO were performed by experienced PRO translators who were native speakers of each target language and currently residing in target-language countries. Languages were Chinese (People's Republic of China), Dutch (the Netherlands), French (Belgium), German (Germany), Japanese (Japan), Polish (Poland), Portuguese (Brazil), Russian (Russia), Spanish (Mexico), and Spanish (US). The project team assessed the instrument to identify potential linguistic and/or cultural adaptation issues. After the issues identified were resolved, the instrument was translated into Spanish (US) and Japanese through a process of two forward translations, one reconciled translation, and one backward translation. The project team reviewed the translated versions before the instruments were evaluated by cognitive debriefing interviews with samples of five Spanish (US) and five Japanese IBS-D patients. Linguistic and cultural adaptation concerns identified during the translatability assessment required minor revisions, mainly the presentation of dates/times and word structure. During the cognitive debriefing interviews, two of five Spanish respondents misunderstood the term "bowel movement" to mean only diarrhea in the Spanish version. Consequently, the term was changed from "movimiento intestinal" to "evacuaciones". None of the Japanese respondents identified issues with the Japanese version. The translatability of the IBS-D PRO instrument into ten target languages was confirmed, with only minor changes made to the translations of the instrument. The translation and linguistic validation into Spanish (US) and Japanese provide evidence that this instrument can be used in multinational trials and clinical settings.

Identifying perceptions of academic reform in pharmacy using a four-frame organizational change model.

PubMed

Bajis, Dalia; Chaar, Betty; Basheti, Iman A; Moles, Rebekah

2017-11-10

In an ever-changing environment, pharmacy education is in the race to catch up and excel to produce competent pharmacists. Examining academic institutions, including schools of pharmacy, their internal systems and framework, it seems appropriate to view these institutions using multiple lenses. Bolman and Deal conceptualized a method to examine organizations using four constructs (structural, human resource, political, and symbolic). The Eastern Mediterranean Region (EMR), with deep-rooted pharmacy education and practice was the setting for this research. To explore factors affecting academic reform in undergraduate pharmacy education in the EMR from stakeholders' and students' perspectives; and to apply Bolman and Deal's four-frame organizational change model to explore how these issues might be viewed. A multiple-method approach was employed and involved collecting, analyzing and integrating qualitative semi-structured interview data with open-ended questions in a survey. Cross-sector stakeholder sample from various EMR countries was recruited and interviewed. Final year pharmacy students from one school of pharmacy in Jordan were surveyed. Emergent themes were indicative that academic reform was addressed by all frames of the Bolman and Deal model. Structural and political frames received substantial weighing pointing to the importance of curricular reform, collaboration and leadership. A need for skillful and role-model teaching academic staff was highlighted, and in harmony with the human resource frame. Issues within the symbolic frame were readily apparent in the data and spanned the other three frames in relation to heritage, customs and cultural barriers. Issues pertinent to academic reform in pharmacy were presented. Viewing change in pharmacy schools from multiple perspectives highlighted the need for structural changes to pharmacy programs, human resource management, political will, leadership, and collaboration. The importance of understanding cultural aspects of organizations is critical as it is these that provide identity to any organization and help reformers better manage change. Copyright © 2017 Elsevier Inc. All rights reserved.

Development and validation of in silico models for estimating drug preformulation risk in PEG400/water and Tween80/water systems.

PubMed

Crivori, Patrizia; Morelli, Amedea; Pezzetta, Daniele; Rocchetti, Maurizio; Poggesi, Italo

2007-11-01

Solubility is one of the most important properties of drug candidates for achieving the targeted plasma concentrations following oral dosing. Furthermore, the formulations adopted in the in vivo preclinical studies, for both oral and intravenous administrations, are usually solutions. To formulate compounds sparingly soluble in water, pharmaceutically acceptable cosolvents or surfactants are typically employed to increase solubility. Compounds poorly soluble also in these systems will likely show severe formulation issues. In such cases, relatively high amount of compounds, rarely available in the early preclinical phases, are needed to identify the most appropriate dosing vehicles. Hence, the purpose of this study was to build two computational models which, on the basis of the molecular structure, are able to predict the compound solubility in two vehicle systems (40% PEG400/water and 10% Tween80/water) used in our company as screening tools for anticipating potential formulation issues. The two models were developed using the solubility data obtained from the analysis of approximately 2000 chemically diverse compounds. The structural diversity and the drug-like space covered by these molecules were investigated using the ChemGPS methodology. The compounds were classified (high/low preformulation risk) based on the experimental solubility value range. A combination of descriptors (i.e. logD at two different pH, E-state indices and other 2D structural descriptors) was correlated to these classes using partial least squares discriminant (PLSD) analysis. The overall accuracy of each PLSD model applied to independent sets of compounds was approximately 78%. The accuracy reached when the models were used in combination to identify molecules with low preformulation risk in both systems was 83%. The models appeared a valuable tool for predicting the preformulation risk of drug candidates and consequently for identifying the most appropriate dosing vehicles to be further investigated before the first in vivo preclinical studies. Since only a small number of 2D descriptors is need to evaluate the preformulation risk classes, the models resulted easy to use and characterized by high throughput.

Identifying nurse and health visitor priorities in a PCT using the Delphi technique.

PubMed

Brooks, Nicky; Barrett, Anna

2003-08-01

A three-stage Delphi investigation was undertaken over a 4-month period in a primary care trust to identify the perceived clinical needs of nurses. Practice nurses, district nurses, health visitors and community hospital nurses all participated. In round 1, there were 28 replies from these groups of nurses, in round 2 there were 31, and in round 3 there were 25 replies. In round 1, 77 issues (excluding duplications) were identified. These were separated into three themes according to the most appropriate method for addressing the issue: education (29 issues), research (16 issues) and management (32). In round 2, the issues were redistributed in the three areas and staff were asked to choose the ten most important issues from education, research and management. Finally, in round 3 the ten issues in education, research and management were prioritized in terms of the "most pressing". The most pressing education need was recognizing accountability; the most pressing research need was caseload/dependency scoring--matching staff levels to workload, and the most pressing management need was risk management, e.g. staff safety. The results have identified locally that there is a gap between the modernization agenda and what nursing staff consider to be the issues that need addressing locally. If measures are not put in place to address these local issues, there is a danger that nurses will not take a full and active role in the modernization of the NHS.

Natural snowfall reveals large-scale flow structures in the wake of a 2.5-MW wind turbine.

PubMed

Hong, Jiarong; Toloui, Mostafa; Chamorro, Leonardo P; Guala, Michele; Howard, Kevin; Riley, Sean; Tucker, James; Sotiropoulos, Fotis

2014-06-24

To improve power production and structural reliability of wind turbines, there is a pressing need to understand how turbines interact with the atmospheric boundary layer. However, experimental techniques capable of quantifying or even qualitatively visualizing the large-scale turbulent flow structures around full-scale turbines do not exist today. Here we use snowflakes from a winter snowstorm as flow tracers to obtain velocity fields downwind of a 2.5-MW wind turbine in a sampling area of ~36 × 36 m(2). The spatial and temporal resolutions of the measurements are sufficiently high to quantify the evolution of blade-generated coherent motions, such as the tip and trailing sheet vortices, identify their instability mechanisms and correlate them with turbine operation, control and performance. Our experiment provides an unprecedented in situ characterization of flow structures around utility-scale turbines, and yields significant insights into the Reynolds number similarity issues presented in wind energy applications.

Issues Facing Urban Agriscience Teachers: A Delphi Study

ERIC Educational Resources Information Center

Warner, Wendy J.; Washburn, Shannon G.

2009-01-01

This national study used the Delphi technique to identify the issues facing urban agriscience teachers. The first round of the study used a questionnaire with one open-ended question to generate responses from the expert panel. In the second round, respondents were asked to rate their level of agreement with 72 issues identified in round one using…

Structures and Materials Working Group report

NASA Technical Reports Server (NTRS)

Torczyner, Robert; Hanks, Brantley R.

1986-01-01

The appropriateness of the selection of four issues (advanced materials development, analysis/design methods, tests of large flexible structures, and structural concepts) was evaluated. A cross-check of the issues and their relationship to the technology drivers is presented. Although all of the issues addressed numerous drivers, the advanced materials development issue impacts six out of the seven drivers and is considered to be the most crucial. The advanced materials technology development and the advanced design/analysis methods development were determined to be enabling technologies with the testing issues and development of structural concepts considered to be of great importance, although not enabling technologies. In addition, and of more general interest and criticality, the need for a Government/Industry commitment which does not now exist, was established. This commitment would call for the establishment of the required infrastructure to facilitate the development of the capabilities highlighted through the availability of resources and testbed facilities, including a national testbed in space to be in place in ten years.

Post-deployment usability evaluation of a radiology workstation.

PubMed

Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A; Oudkerk, Matthijs; Van Ooijen, Peter M A

2016-01-01

To determine the number, nature and severity of usability issues radiologists encounter while using a commercially available radiology workstation in clinical practice, and to assess how well the results of a pre-deployment usability evaluation of this workstation generalize to clinical practice. The usability evaluation consisted of semi-structured interviews and observations of twelve users using the workstation during their daily work. Usability issues and positive usability findings were documented. Each issue was given a severity rating and its root cause was determined. Results were compared to the results of a pre-deployment usability evaluation of the same workstation. Ninety-two usability issues were identified, ranging from issues that cause minor frustration or delay, to issues that cause significant delays, prevent users from completing tasks, or even pose a potential threat to patient safety. The results of the pre-deployment usability evaluation had limited generalizability to clinical practice. This study showed that radiologists encountered a large number and a wide variety of usability issues when using a commercially available radiology workstation in clinical practice. This underlines the need for effective usability engineering in radiology. Given the limitations of pre-deployment usability evaluation in radiology, which were confirmed by our finding that the results of a pre-deployment usability evaluation of this workstation had limited generalizability to clinical practice, it is vital that radiology workstation vendors devote significant resources to usability engineering efforts before deployment of their workstation, and to continue these efforts after the workstation is deployed in a hospital. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Card sorting to evaluate the robustness of the information architecture of a protocol website.

PubMed

Wentzel, J; Müller, F; Beerlage-de Jong, N; van Gemert-Pijnen, J

2016-02-01

A website on Methicillin-Resistant Staphylococcus Aureus, MRSA-net, was developed for Health Care Workers (HCWs) and the general public, in German and in Dutch. The website's content was based on existing protocols and its structure was based on a card sort study. A Human Centered Design approach was applied to ensure a match between user and technology. In the current study we assess whether the website's structure still matches user needs, again via a card sort study. An open card sort study was conducted. Randomly drawn samples of 100 on-site search queries as they were entered on the MRSA-net website (during one year of use) were used as card input. In individual sessions, the cards were sorted by each participant (18 German and 10 Dutch HCWs, and 10 German and 10 Dutch members of the general public) into piles that were meaningful to them. Each participant provided a label for every pile of cards they created. Cluster analysis was performed on the resulting sorts, creating an overview of clusters of items placed together in one pile most frequently. In addition, pile labels were qualitatively analyzed to identify the participants' mental models. Cluster analysis confirmed existing categories and revealed new themes emerging from the search query samples, such as financial issues and consequences for the patient. Even though MRSA-net addresses these topics, they are not prominently covered in the menu structure. The label analysis shows that 7 of a total of 44 MRSA-net categories were not reproduced by the participants. Additional themes such as information on other pathogens and categories such as legal issues emerged. This study shows that the card sort performed to create MRSA-net resulted in overall long-lasting structure and categories. New categories were identified, indicating that additional information needs emerged. Therefore, evaluating website structure should be a recurrent activity. Card sorting with ecological data as input for the cards is useful to identify changes in needs and mental models. By combining qualitative and quantitative analysis we gained insight into additional information needed by the target group, including their view on the domain and related themes. The results show differences between the four user groups in their sorts, which can mostly be explained by the groups' background. These findings confirm that HCD is a valuable approach to tailor information to the target group. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Back home: a qualitative study exploring re-entering cross-cultural missionary aid workers' loss and grief.

PubMed

Selby, Susan; Moulding, Nicole; Clark, Sheila; Jones, Alison; Braunack-Mayer, Annette; Beilby, Justin

2009-01-01

Over 200 Australian, American, and British Non-Government Organizations send aid workers overseas including missionaries. On re-entry, they may suffer psychological distress; however, there is little research about their psychosocial issues and management in the family practice setting. Research suggests loss and grief as a suitable paradigm for family practitioners dealing with psychosocial issues. The aim of this study was to explore loss and grief issues for adult Australian missionary cross-cultural aid workers during their re-entry adjustment. Mixed methods were used and this study reports the qualitative method: semi-structured interviews conducted with 15 participants. Results were analyzed using framework analysis. Themes of re-entry loss and grief were identified with sub-themes of multiple varied losses, mechanisms of loss, loss of control, common grief phenomena, disenfranchised grief, and reactivation of past grief. Theoretical and clinical implications are discussed. Findings of this study suggest that loss and grief is an appropriate paradigm for the management of these workers in the family practice setting. Further research is needed to enable appropriate care.

Researchers’ Perceptions of the Ethical Implications of Pharmacogenomics Research with Children

PubMed Central

Avard, D.; Silverstein, T.; Sillon, G.; Joly, Y.

2009-01-01

Background This paper presents the results of an exploratory qualitative study that assesses Canadian pediatric researchers’ perceptions of a pre-selected group of ethical issues raised by pharmacogenomics research with children. Methods As a pilot study, we conducted semi-structured telephone interviews with Canadian pediatric pharmacogenomic researchers. The interviews were guided by the following themes: (1) benefits and risks of inclusion, (2) the consent/assent process, and (3) the return of research results. Results Issues about assent, consent, risks and benefits, as well as the communication of results were addressed by the respondents. Some issues, such as the unique vulnerability of children, the long term privacy concerns associated with biobanking, additional core elements that need to be discussed and included in the consent/assent forms, as well as the challenges of communicating research results in a pediatric research were not explicitly identified by the respondents. Conclusion Further consideration should be given to address the ethical challenges of including children in pharmacogenomics research. This exploratory study indicates that further guidance is needed if children are to be protected and yet benefit from such research. PMID:19204423

Ethical Issues Raised by Private Practice Physiotherapy Are More Diverse than First Meets the Eye: Recommendations from a Literature Review

PubMed Central

Drolet, Marie-Josée; Williams-Jones, Bryn

2015-01-01

ABSTRACT Purpose: Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. Method: After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. Results: A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. Conclusions: The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported—through education, research, and good governance—in providing the best possible care for their patients. PMID:25931663

Multimedia Learning: Beyond Modality. Commentary.

ERIC Educational Resources Information Center

Reimann, P.

2003-01-01

Identifies and summarizes instructional messages in the articles in this theme issue and also identifies central theoretical issues, focusing on: (1) external representations; (2) dual coding theory; and (3) the effects of animations on learning. (SLD)

Space-based solar power conversion and delivery systems study. Volume 5: Economic analysis

NASA Technical Reports Server (NTRS)

1977-01-01

Space-based solar power conversion and delivery systems are studied along with a variety of economic and programmatic issues relevant to their development and deployment. The costs, uncertainties and risks associated with the current photovoltaic Satellite Solar Power System (SSPS) configuration, and issues affecting the development of an economically viable SSPS development program are addressed. In particular, the desirability of low earth orbit (LEO) and geosynchronous (GEO) test satellites is examined and critical technology areas are identified. The development of SSPS unit production (nth item), and operation and maintenance cost models suitable for incorporation into a risk assessment (Monte Carlo) model (RAM) are reported. The RAM was then used to evaluate the current SSPS configuration expected costs and cost-risk associated with this configuration. By examining differential costs and cost-risk as a function of postulated technology developments, the critical technologies, that is, those which drive costs and/or cost-risk, are identified. It is shown that the key technology area deals with productivity in space, that is, the ability to fabricate and assemble large structures in space, not, as might be expected, with some hardware component technology.

Applying the marketing mix (5 ps) to bionanotechnology.

PubMed

Tomczyk, Michael S

2011-01-01

This chapter, based on concepts developed for my book, NanoInnovation (Tomczyk, Nanoinnovation: What Every Manager Needs to Know, 2011), is one of the first attempts to evaluate nanotechnology in the context of the "marketing mix" - a conceptual challenge given that nanotechnology is not one product or even a set of products, but rather a technology that is incorporated in an expanding list exceeding a 1,000 products - encompassing materials, structures, processes, and devices. My purpose is to use this context to identify some of the critical issues and factors that will influence development of "nanotechnology markets" at this very early stage in the evolution of nanotechnology, and more specifically, bionanotechnology. As technological innovations continue to promote the market growth for nanotechnology, especially in the field of medicine and healthcare, sensemaking frameworks are needed to help decision makers keep pace with these evolving markets. One of the best frameworks is the "marketing mix" which has been used for decades to identify the controllable factors that decision makers can influence through marketing strategies. With so many game-changing innovations poised to move from nanotech research to commercialization, marketing issues are becoming increasingly important to decision makers in science/academia, business/venture development, and government/policymaking.

Return-to-work intervention during cancer treatment - The providers' experiences.

PubMed

Petersen, K S; Momsen, A H; Stapelfeldt, C M; Olsen, P R; Nielsen, C V

2018-03-01

To explore in-depth understanding of providers' experiences when involved in a return-to-work (RTW) intervention offered during cancer treatment. Semi-structured individual interviews and participant observations at a hospital department and two municipal job centers were carried out, including ten providers (physicians, nurses and social workers). A phenomenological-hermeneutic approach was applied, involving coding, identification of themes and interpretation of findings. Three major themes were identified: Treatment first, Work as an integrated component in cancer rehabilitation, and Challenges in bringing up work issues. Differences in providers' experiences of the RTW intervention offered to cancer patients were found: in the hospital setting RTW was a second priority, whereas in the municipality job centers it was an integrated component. Further studies are needed to investigate how and when occupational rehabilitation services can be implemented across sectors to support cancer patients' RTW. In the future, work issues ought to be systematically presented by providers across sectors as early as possible to support cancer patients' RTW. Cancer patients' individual needs and thoughts about RTW are to be identified by both health care providers during treatment and social workers at the municipality level and shared across sectors. © 2017 John Wiley & Sons Ltd.

Representing causal knowledge in environmental policy interventions: Advantages and opportunities for qualitative influence diagram applications.

PubMed

Carriger, John F; Dyson, Brian E; Benson, William H

2018-05-01

This article develops and explores a methodology for using qualitative influence diagrams in environmental policy and management to support decision-making efforts that minimize risk and increase resiliency. Influence diagrams are representations of the conditional aspects of a problem domain. Their graphical properties are useful for structuring causal knowledge relevant to policy interventions and can be used to enhance inference and inclusivity of multiple viewpoints. Qualitative components of influence diagrams are beneficial tools for identifying and examining the interactions among the critical variables in complex policy development and implementation. Policy interventions on social-environmental systems can be intuitively diagrammed for representing knowledge of critical relationships among economic, environmental, and social attributes. Examples relevant to coastal resiliency issues in the US Gulf Coast region are developed to illustrate model structures for developing qualitative influence diagrams useful for clarifying important policy intervention issues and enhancing transparency in decision making. Integr Environ Assess Manag 2018;14:381-394. Published 2018. This article is a US Government work and is in the public domain in the USA. Published 2018. This article is a US Government work and is in the public domain in the USA.

Differential global profiling as a new analytical strategy for revealing micropollutant treatment by-products: application to ethinylestradiol and chlorination water treatment.

PubMed

Gervais, Gaël; Bichon, Emmanuelle; Antignac, Jean-Philippe; Monteau, Fabrice; Leroy, Gaëla; Barritaud, Lauriane; Chachignon, Mathilde; Ingrand, Valérie; Roche, Pascal; Le Bizec, Bruno

2011-06-01

The detection and structural elucidation of micropollutants treatment by-products are major issues to estimate efficiencies of the processes employed for drinking water production versus endocrine disruptive compounds contamination. This issue was mainly investigated at the laboratory scale and in high concentration conditions. However, potential by-products generated after chlorination can be influenced by the dilution factor employed in real conditions. The present study proposes a new methodology borrowed to the metabolomic science, using liquid chromatography coupled to high-resolution mass spectrometry, in order to reveal potential chlorination by-products of ethinylestradiol in spiked real water samples at the part-per-billion level (5 μg L(-1)). Conventional targeted measurements first demonstrated that chlorination with sodium hypochlorite (0.8 mg L(-1)) led to removals of ethinylestradiol over 97%. Then, the developed differential global profiling approach permitted to reveal eight chlorination by-products of EE2, six of them being described for the first time. Among these eight halogenated compounds, five have been structurally identified, demonstrating the potential capabilities of this new methodology applied to environmental samples. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Johns Hopkins Hospital: identifying and addressing risks and safety issues.

PubMed

Paine, Lori A; Baker, David R; Rosenstein, Beryl; Pronovost, Peter J

2004-10-01

At The Johns Hopkins Hospital (JHH), a culture of safety refers to the presence of characteristics such as the belief that harm is untenable and the use of a systems approach to analyzing safety issues. The leadership of JHH provides strategic planning guidance for safety and improvement initiatives, involves the patient safety committee in capital investment allocation decisions and in designing and planning new hospital facilities, and ensures that safety and quality head the agenda of board-of-trustees meetings. Although JHH takes a systems approach, structures such as monitoring staff behavior trends are used to hold people accountable for job performance. JHH encountered three major hurdles in implementing and sustaining a culture of safety. First, JHH's decentralized organizational structure contributes to a silo effect that limits the spread of ideas, practices, and culture. JHH intends to create an internal collaborative of departmental safety initiatives to foster opportunities for units to share ideas and results. Second, in response to the challenge of encouraging teams to think and act in an interdisciplinary fashion, communication and teamwork training are being used to enhance the effectiveness of interdisciplinary teams. Further development of valid and meaningful safety-related measurement and data collection methodologies is JHH's largest remaining challenge.

Validation of ligands in macromolecular structures determined by X-ray crystallography

PubMed Central

Horský, Vladimír; Svobodová Vařeková, Radka; Bendová, Veronika

2018-01-01

Crystallographic studies of ligands bound to biological macromolecules (proteins and nucleic acids) play a crucial role in structure-guided drug discovery and design, and also provide atomic level insights into the physical chemistry of complex formation between macromolecules and ligands. The quality with which small-molecule ligands have been modelled in Protein Data Bank (PDB) entries has been, and continues to be, a matter of concern for many investigators. Correctly interpreting whether electron density found in a binding site is compatible with the soaked or co-crystallized ligand or represents water or buffer molecules is often far from trivial. The Worldwide PDB validation report (VR) provides a mechanism to highlight any major issues concerning the quality of the data and the model at the time of deposition and annotation, so the depositors can fix issues, resulting in improved data quality. The ligand-validation methods used in the generation of the current VRs are described in detail, including an examination of the metrics to assess both geometry and electron-density fit. It is found that the LLDF score currently used to identify ligand electron-density fit outliers can give misleading results and that better ligand-validation metrics are required. PMID:29533230

Global Cost and Weight Evaluation of Fuselage Side Panel Design Concepts

NASA Technical Reports Server (NTRS)

Polland, D. R.; Finn, S. R.; Griess, K. H.; Hafenrichter, J. L.; Hanson, C. T.; Ilcewicz, L. B.; Metschan, S. L.; Scholz, D. B.; Smith, P. J.

1997-01-01

This report documents preliminary design trades conducted under NASA contracts NAS1 18889 (Advanced Technology Composite Aircraft Structures, ATCAS) and NAS1-19349 (Task 3, Pathfinder Shell Design) for a subsonic wide body commercial aircraft fuselage side panel section utilizing composite materials. Included in this effort were (1) development of two complete design concepts, (2) generation of cost and weight estimates, (3) identification of technical issues and potential design enhancements, and (4) selection of a single design to be further developed. The first design concept featured an open-section stringer stiffened skin configuration while the second was based on honeycomb core sandwich construction. The trade study cost and weight results were generated from comprehensive assessment of each structural component comprising the fuselage side panel section from detail fabrication through airplane final assembly. Results were obtained in three phases: (1) for the baseline designs, (2) after global optimization of the designs, and (3) the results anticipated after detailed design optimization. A critical assessment of both designs was performed to determine the risk associated with each concept, that is the relative probability of achieving the cost and weight projections. Seven critical technical issues were identified as the first step towards side panel detailed design optimization.

Federally Funded Programs Related to Building Energy Use: Overlaps, Challenges, and Opportunities for Collaboration

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

Cort, Katherine A.; Butner, Ryan S.; Hostick, Donna J.

2010-10-01

As energy efficiency in buildings continues to move from discreet technology development to an integrated systems approach, the need to understand and integrate complementary goals and targets becomes more pronounced. Whether within Department of Energy’s (DOE) Building Technologies Program (BTP), across the Office of Energy Efficiency and Renewable Energy (EERE), or throughout DOE and the Federal government, mutual gains and collaboration synergies exist that are not easily achieved because of organizational and time constraints. There also cases where federal agencies may be addressing similar issues, but with different (and sometimes conflicting) outcomes in mind. This report conducts a comprehensive inventorymore » across all EERE and other relevant Federal agencies of potential activities with synergistic benefits. A taxonomy of activities with potential interdependencies is presented. The report identifies a number of federal program objectives, products, and plans related to building energy efficiency and characterizes the current structure and interactions related to these plans and programs. Areas where overlap occurs are identified as are the challenges of addressing issues related to overlapping goals and programs. Based on the input gathered from various sources, including 20 separate interviews with federal agency staff and contractor staff supporting buildings programs, this study identifies a number of synergistic opportunities and makes recommends a number of areas where further collaboration could be beneficial.« less

Virtual design and construction of plumbing systems

NASA Astrophysics Data System (ADS)

Filho, João Bosco P. Dantas; Angelim, Bruno Maciel; Guedes, Joana Pimentel; de Castro, Marcelo Augusto Farias; Neto, José de Paula Barros

2016-12-01

Traditionally, the design coordination process is carried out by overlaying and comparing 2D drawings made by different project participants. Detecting information errors from a composite drawing is especially challenging and error prone. This procedure usually leaves many design errors undetected until construction begins, and typically lead to rework. Correcting conflict issues, which were not identified during design and coordination phase, reduces the overall productivity for everyone involved in the construction process. The identification of construction issues in the field generate Request for Information (RFIs) that is one of delays causes. The application of Virtual Design and Construction (VDC) tools to the coordination processes can bring significant value to architecture, structure, and mechanical, electrical, and plumbing (MEP) designs in terms of a reduced number of errors undetected and requests for information. This paper is focused on evaluating requests for information (RFI) associated with water/sanitary facilities of a BIM model. Thus, it is expected to add improvements of water/sanitary facility designs, as well as to assist the virtual construction team to notice and identify design problems. This is an exploratory and descriptive research. A qualitative methodology is used. This study adopts RFI's classification in six analyzed categories: correction, omission, validation of information, modification, divergence of information and verification. The results demonstrate VDC's contribution improving the plumbing system designs. Recommendations are suggested to identify and avoid these RFI types in plumbing system design process or during virtual construction.

The Long-Term Conditions Questionnaire: conceptual framework and item development.

PubMed

Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A'Court, Christine; Fitzpatrick, Ray

2016-01-01

To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey.

Priorities and approaches to investigating Asian youth health: perspectives of young Asian New Zealanders.

PubMed

Wong, Agnes; Peiris-John, Roshini; Sobrun-Maharaj, Amritha; Ameratunga, Shanthi

2015-12-01

The proportion of young people in New Zealand identifying with Asian ethnicities has increased considerably. Despite some prevalent health concerns, Asian youth are less likely than non-Asian peers to seek help. As preparatory research towards a more nuanced approach to service delivery and public policy, this qualitative study aimed to identify young Asian New Zealanders' perspectives on best approaches to investigate health issues of priority concern to them. Three semi-structured focus group discussions were conducted with 15 Asian youth leaders aged 18-24 years. Using an inductive approach for thematic analysis, key themes were identified and analysed. Study participants considered ethno-cultural identity, racism and challenges in integration to play significant roles influencing the health of Asian youth (especially mental health) and their access to health services. While emphasising the importance of engaging young Asians in research and service development so that their needs and aspirations are met, participants also highlighted the need for approaches that are cognisant of the cultural, contextual and intergenerational dimensions of issues involved in promoting youth participation. Research that engages Asian youth as key agents using methods that are sensitive to their cultural and sociological contexts can inform more responsive health services and public policy. This is of particular relevance in primary health care where culturally competent services can mitigate risks of unmet health needs and social isolation.

Healthcare workers' knowledge and perceptions of the risks associated with emerging extensively drug-resistant bacteria.

PubMed

Celeste, C; Jolivet, S; Bonneton, M; Brun-Buisson, C; Jansen, C

2017-11-01

Guidelines have been issued in 2010 to prevent the spread of emerging extensively resistant bacteria (eXDR), but their implementation is difficult. We aimed to evaluate healthcare workers' (HCW) knowledge and their risk perception to identify barriers to the implementation of guidelines. Semi-structured interviews were conducted at a University Hospital, where case patients are regularly admitted. The interviews focused on HCW's knowledge, risk perception, and challenges met. The evaluation of HCW's knowledge and contagiousness and perception of severity of eXDR carriage were analyzed statistically. Risk perception and opinion about guidelines were analyzed by qualitative description. One hundred and twenty-one HCWs were interviewed. The category of HCW, having searched for information on resistant bacteria, and having taken care of case patients were associated with better knowledge. The HCW category, age, type of unit, seniority, and having taken care of case patients were associated with risk perceptions. Qualitative analysis identified 61 themes. HCWs were extremely concerned by the spread of bacteria within the hospital. The main challenges identified were organizational and communication issues. HCWs reported a lack of knowledge and a lack of resources to implement guidelines. Strategies to improve guidelines implementation must be based on a better availability of resources, better communication, and new educational methods. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

Wood, Richard Thomas; Ewing, Paul D.

The U.S. Nuclear Regulatory Commission’s (NRC’s) regulations in Part 50, “Domestic Licensing of Production and Utilization Facilities,” of Title 10 of the Code of Federal Regulations (10 CFR Part 50) state that structures, systems, and components important to safety in a nuclear power plant are to be designed to accommodate the effects of environmental conditions (i.e., remain functional under all postulated service conditions) and that design control measures such as testing are to be used to check the adequacy of design. Regulatory Guide (RG) 1.180 was developed to provide guidance to licensees and applicants on methods acceptable to the NRCmore » staff for complying with the NRC’s regulations on design, installation, and testing practices for addressing the effects of electromagnetic and radio-frequency interference (EMI/RFI) and power surges on safety-related instrumentation and control (I&C) systems. The first revision of RG 1.180 was issued in January 2000 and a second revision was issued in October 2003*. The second revision differed from the first revision in endorsing Military Standard (MIL-STD)-461E and the International Electrotechnical Commission (IEC) Standard (Std) 61000 series of EMI/RFI test methods, extending the guidance to cover signal line testing, incorporating frequency ranges where portable communications devices are experiencing increasing use, and relaxing the operating envelopes (test levels) when experience and confirmatory research warranted. It also offered exemptions from specific test criteria based on technical considerations such as plant conditions and the intended location of the safety-related I&C equipment. Since the last revision, new requirements have been identified, associated RGs have been created and updated, and additional industry guidance has been developed. Additionally, the operational environment has changed with the increase in wireless communication technology for both personal (smartphone) and industrial (remote I&C) purposes. Also, specific concerns and issues with testing methods and methodologies have been identified that must be addressed. Further, most of the standards that serve as the basis for the RG have been revised. Therefore, the NRC’s Office of Regulatory Research has contracted with Oak Ridge National Laboratory (ORNL) to incorporate new information and resolve the identified issues under NRC-HQ-60-14-D-0015, “Update to RG 1.180, Revision 2, Guidelines for Evaluating Electromagnetic and Radio-Frequency Interference in Safety-Related Instrumentation and Control Systems.” The ultimate goal of this project is to provide NRC the technical basis for developing and publishing a new revision of the RG. The focus of Task 4 was for ORNL to identify and address any new or additional EMI/RFI issues that could potentially impact the EMC of I&C systems. More specifically, ORNL was to evaluate the impact of any new issue on safety equipment in their local environments and then determine whether the issues should be included and discussed in the revision to RG 1.180 that is currently under way.« less

Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers.

PubMed

Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha

2015-08-12

The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff. 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.

Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers

PubMed Central

Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha

2015-01-01

Objectives The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client’s homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff. PMID:26270947

Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

PubMed

Knüppel, Hannes; Mertz, Marcel; Schmidhuber, Martina; Neitzke, Gerald; Strech, Daniel

2013-08-01

Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary.

Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis

PubMed Central

Knüppel, Hannes; Schmidhuber, Martina; Neitzke, Gerald

2013-01-01

Background Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care. Methods and Findings To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained. Conclusions Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary PMID:23966839

Photovoltaic system criteria documents. Volume 3: Environmental issues and evaluation criteria for photovoltaic applications

NASA Technical Reports Server (NTRS)

Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

1979-01-01

The environmental issues and evaluation criteria relating to the suitability of sites proposed for photovoltaic (PV) system deployment are identified. The important issues are defined, briefly discussed and then developed into evaluation criteria. System designers are provided with information on the environmental sensitivity of PV systems in realistic applications, background material which indicates the applicability of the siting issues identified, and evaluation criteria are defined to facilitate the selection of sites that maximize PV system operation.

Total Dissolved Gas Effects on Fishes of the Lower Columbia River

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

McGrath, Kathy E.; Dawley, Earl; Geist, David R.

2006-03-31

Gas supersaturation problems generated by spill from dams on the Columbia River were first identified in the 1960s. Since that time, considerable research has been conducted on effects of gas supersaturation on aquatic life, primarily juvenile salmonids. Also since that time, modifications to dam structures and operations have reduced supersaturated gas levels produced by the dams. The limit for total dissolved gas saturation (TDGS) as mandated by current Environmental Protection Agency water quality standards is 110%. State management agencies issue limited waivers to water quality, allowing production of levels of up to 120% TDGS to facilitate the downstream migration ofmore » juvenile salmonids. Recently, gas supersaturation as a water quality issue has resurfaced as concerns have grown regarding chronic effects of spill-related total dissolved gas on salmonids, including incubating embryos and larvae, resident fish species, and other aquatic organisms. Because of current concerns, and because the last comprehensive review of research on supersaturation effects on fishes was conducted in 1997, we reviewed recent supersaturation literature to identify new or ongoing issues that may not be adequately addressed by the current 110% TDGS limit and the 120% TDGS water quality waiver. We found that recent work supports older research indicating that short-term exposure to levels up to 120% TDGS does not produce acute effects on migratory juvenile or adult salmonids when compensating depths are available. Monitoring programs at Snake and Columbia river dams from 1995 to the early 2000s documented a low incidence of significant gas bubble disease or mortality in Columbia River salmonids, resident fishes, or other taxa. We did, however, identify five areas of concern in which total dissolved gas levels lower than water quality limits may produce sublethal effects on fishes of the Columbia River. These areas of concern are 1) sensitive and vulnerable species or life stages, 2) long-term chronic or multiple exposure, 3) vulnerable habitats and reaches, 4) effects on incubating fish in hyporheic habitats, and 5) community and ecosystem effects. Although some of these areas of concern may have been identified previously in earlier works, we suggest that consideration of the issues is warranted to avoid detrimental impacts on aquatic resources of the Columbia River system. We discuss these issues and provide recommendations to regulatory and management agencies based on our review of recent literature. In general, we recommend that additional attention be directed toward resolving the uncertainties within these five areas.« less

A study to identify research issues in the area of electromagnetic measurements and signal handling of remotely sensed data

NASA Technical Reports Server (NTRS)

1982-01-01

Research issues in the area of electromagnetic measurements and signal handling of remotely sensed data are identified. The following seven issues are discussed; platform/sensor system position and velocity, platform/sensor attitudes and attitude rates, optics and antennas, detectors and associated electronics, sensor calibration, signal handling, and system design.

Epidemiological Data Management during an Outbreak of Ebola Virus Disease: Key Issues and Observations from Sierra Leone.

PubMed

Owada, Kei; Eckmanns, Tim; Kamara, Kande-Bure O'Bai; Olu, Olushayo Oluseun

2016-01-01

Sierra Leone experienced intense transmission of Ebola virus disease (EVD) from May 2014 to November 2015 during which a total of 8,704 confirmed cases and over 3,589 confirmed deaths were reported. Our field observation showed many issues in the EVD data management system, which may have contributed to the magnitude and long duration of the outbreak. In this perspective article, we explain the key issues with EVD data management in the field, and the resulting obstacles in analyzing key epidemiological indicators during the outbreak response work. Our observation showed that, during the latter part of the EVD outbreak, surveillance and data management improved at all levels in the country as compared to the earlier stage. We identified incomplete filling and late arrival of the case investigation forms at data management centers, difficulties in detecting double entries and merging identified double entries in the database, and lack of clear process of how death of confirmed cases in holding, treatment, and community care centers are reported to the data centers as some of challenges to effective data management. Furthermore, there was no consolidated database that captured and linked all data sources in a structured way. We propose development of a new application tool easily adaptable to new occurrences, regular data harmonization meetings between national and district data management teams, and establishment of a data quality audit system to assure good quality data as ways to improve EVD data management during future outbreaks.

Genetics objective structured clinical exams at the Maimonides Infants & Children's Hospital of Brooklyn, New York.

PubMed

Altshuler, Lisa; Kachur, Elizabeth; Krinshpun, Shifra; Sullivan, Deborah

2008-11-01

In 2003, the Maimonides Infants & Children's Hospital received a Title VII Residency Training in Primary Care grant to integrate genetic-specific competencies into postgraduate pediatrics education. As part of that endeavor, mandatory yearly genetics objective structured clinical exams (OSCEs) were instituted for third-year residents. This article reports on the first three years of experience with this innovative educational tool.After an overview of genetic concepts, dysmorphology, and communication styles, residents complete a five-station OSCE and receive feedback from standardized patients and from the faculty who observe them. After this clinical exercise, the residents participate in a small-group debriefing session to share strategies for effective communication and clinical case management and to discuss the ethical issues that arise with these genetic cases.In three years, 60 residents have completed the genetics OSCE program. Evaluation data demonstrate that the program has been effective in both introducing genetic-specific challenges and assessing residents' clinical skills. It has helped trainees self-identify both strengths and further training needs. Pre- and postsurveys among the trainees show increased comfort levels in performing 5 of 12 genetic-related clinical tasks.We conclude that genetics OSCEs are an enriching educational tool. Merely providing trainees and practicing physicians with the latest scientific information is unlikely to prepare them for counseling patients about complex genetic issues. Developing proficiency requires focused practice and effective feedback.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.

International Space Station (ISS) Accommodation of a Single US Assured Crew Return Vehicle (ACRV)

NASA Technical Reports Server (NTRS)

Mazanek, Daniel D.; Garn, Michelle A.; Troutman, Patrick A.; Wang, Yuan; Kumar, Renjith; Heck, Michael L.

1997-01-01

The following report was generated to give the International Space Station (ISS) Program some additional insight into the operations and issues associated with accommodating a single U.S. developed Assured Crew Return Vehicle (ACRV). During the generation of this report, changes in both the ISS and ACRV programs were factored into the analysis with the realization that most of the work performed will eventually need to be repeated once the two programs become more integrated. No significant issues associated with the ISS accommodating the ACRV were uncovered. Kinematic analysis of ACRV installation showed that there are viable methods of using Shuttle and Station robotic manipulators. Separation analysis demonstrated that the ACRV departure path clears the Station structure for all likely contingency scenarios. The payload bay packaging analysis identified trades that can be made between payload bay location, Shuttle Remote Manipulator System (SRMS) reach and eventual designs of de-orbit stages and docking adapters.

Deep Learning in Medical Image Analysis

PubMed Central

Shen, Dinggang; Wu, Guorong; Suk, Heung-Il

2016-01-01

The computer-assisted analysis for better interpreting images have been longstanding issues in the medical imaging field. On the image-understanding front, recent advances in machine learning, especially, in the way of deep learning, have made a big leap to help identify, classify, and quantify patterns in medical images. Specifically, exploiting hierarchical feature representations learned solely from data, instead of handcrafted features mostly designed based on domain-specific knowledge, lies at the core of the advances. In that way, deep learning is rapidly proving to be the state-of-the-art foundation, achieving enhanced performances in various medical applications. In this article, we introduce the fundamentals of deep learning methods; review their successes to image registration, anatomical/cell structures detection, tissue segmentation, computer-aided disease diagnosis or prognosis, and so on. We conclude by raising research issues and suggesting future directions for further improvements. PMID:28301734

Improving Voluntary Environmental Management Programs: Facilitating Learning and Adaptation

NASA Astrophysics Data System (ADS)

Genskow, Kenneth D.; Wood, Danielle M.

2011-05-01

Environmental planners and managers face unique challenges understanding and documenting the effectiveness of programs that rely on voluntary actions by private landowners. Programs, such as those aimed at reducing nonpoint source pollution or improving habitat, intend to reach those goals by persuading landowners to adopt behaviors and management practices consistent with environmental restoration and protection. Our purpose with this paper is to identify barriers for improving voluntary environmental management programs and ways to overcome them. We first draw upon insights regarding data, learning, and adaptation from the adaptive management and performance management literatures, describing three key issues: overcoming information constraints, structural limitations, and organizational culture. Although these lessons are applicable to a variety of voluntary environmental management programs, we then present the issues in the context of on-going research for nonpoint source water quality pollution. We end the discussion by highlighting important elements for advancing voluntary program efforts.

IGO-NGO relations and HIV / AIDS: innovation or stalemate?

PubMed

Jonsson, C; Soderholm, P

1995-01-01

This paper is concerned with the emergence of transnational cooperative structures in response to AIDS. Of chief concern are efforts to create and maintain links among and between intergovernmental organizations (IGO) in the UN system and the many heterogenous organizations usually included under the nongovernmental organization (NGO) label. After discussing the nature of the AIDS issue, the authors focus upon the various ways of framing the AIDS issue and the effort by the Global Program on AIDS to coordinate IGO and NGO activities. In closing, they identify lessons and insights of broader applicability emanating from the AIDS case. The paper discusses the nature of AIDS, AIDS as a medical problem, AIDS as a human rights problem, AIDS as a socioeconomic problem, forging IGO-NGO links, an international NGO forum, informal networking, NGOs and AIDS-related foreign assistance, representation, formal versus informal coordination, costs of network building, degree of organization, and expertise.

User-programmer dialogue: Guidelines for designing menus and help files for interactive computer systems

NASA Technical Reports Server (NTRS)

Carlson, P. A.

1983-01-01

This document is a set of guidelines to aid a programmer in making the various decisions necessary for a clear user-programmer dialogue. Its goal is to promote an effective and efficient transfer of information between programmer and user. These guidelines are divided into four sections: (1) Format, (2) Sequence, (3) Audience, and (4) Aim. Format, in terms of this study, means the spatial and structural presentation of information. Sequence deals with the procedural aspects of multiple panel displays. This section looks at the issues of timelines of presentation, modularization of information, and patterns of user behavior. Audience looks at the relationship among programmer, user, and message. It covers the issues of analyzing the audience's knowledge, attitudes, and needs, anticipating the audience's inferences, and identifying textual ambiguities. The programmer's aim or intention shows up in everything from tone to format. Aim considers the programmer's purpose.

Examining the Multi-level Fit between Work and Technology in a Secure Messaging Implementation.

PubMed

Ozkaynak, Mustafa; Johnson, Sharon; Shimada, Stephanie; Petrakis, Beth Ann; Tulu, Bengisu; Archambeault, Cliona; Fix, Gemmae; Schwartz, Erin; Woods, Susan

2014-01-01

Secure messaging (SM) allows patients to communicate with their providers for non-urgent health issues. Like other health information technologies, the design and implementation of SM should account for workflow to avoid suboptimal outcomes. SM may present unique workflow challenges because patients add a layer of complexity, as they are also direct users of the system. This study explores SM implementation at two Veterans Health Administration facilities. We interviewed twenty-nine members of eight primary care teams using semi-structured interviews. Questions addressed staff opinions about the integration of SM with daily practice, and team members' attitudes and experiences with SM. We describe the clinical workflow for SM, examining complexity and variability. We identified eight workflow issues directly related to efficiency and patient satisfaction, based on an exploration of the technology fit with multilevel factors. These findings inform organizational interventions that will accommodate SM implementation and lead to more patient-centered care.

Workshop on High Power ICH Antenna Designs for High Density Tokamaks

NASA Astrophysics Data System (ADS)

Aamodt, R. E.

1990-02-01

A workshop in high power ICH antenna designs for high density tokamaks was held to: (1) review the data base relevant to the high power heating of high density tokamaks; (2) identify the important issues which need to be addressed in order to ensure the success of the ICRF programs on CIT and Alcator C-MOD; and (3) recommend approaches for resolving the issues in a timely realistic manner. Some specific performance goals for the antenna system define a successful design effort. Simply stated these goals are: couple the specified power per antenna into the desired ion species; produce no more than an acceptable level of RF auxiliary power induced impurities; and have a mechanical structure which safely survives the thermal, mechanical and radiation stresses in the relevant environment. These goals are intimately coupled and difficult tradeoffs between scientific and engineering constraints have to be made.

Overview and research agenda arising from the 7th World Workshop on Oral Health and Disease in AIDS.

PubMed

Tappuni, A R; Shiboski, C

2016-04-01

The Research Agenda generated by the 7th World Workshop on Oral Health and Disease in AIDS (WW7) is delivered in this paper. Panels of international experts presided over nine workshops that constituted the conference held in November 2014 in Hyderabad, India. The main goal of the Workshop was to bring together clinician and scientists interested in the subject to debate with world-wide perspectives current issues related to the oral manifestations in HIV/AIDS. The workshops were structured around three themes; basic science, clinical/translational science and social science and were attended by 135 participants from 31 countries. The research questions debated at the workshops are presented in nine consensus papers published in this issue and are summarised in this paper along with an outline of the identified research needs in the field. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Technology and Interactive Multimedia. Identifying Emerging Issues and Trends in Technology for Special Education.

ERIC Educational Resources Information Center

Ashton, Ray

As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper addresses the role of interactive multimedia, especially the digital, optical compact disc technologies, in providing instructional services to special education students. An overview identifies technological and economic trends,…

75 FR 3220 - Transcontinental Gas Pipe Line Company, LLC; Notice of Intent To Prepare an Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

..., recreation, and visual resources. Cultural resources. Socioeconomics. Air quality and noise. Reliability and... Participation section. Currently Identified Environmental Issues We have already identified issues that we think...

Communication and Organization in Software Development: An Empirical Study

NASA Technical Reports Server (NTRS)

Seaman, Carolyn B.; Basili, Victor R.

1996-01-01

The empirical study described in this paper addresses the issue of communication among members of a software development organization. The independent variables are various attributes of organizational structure. The dependent variable is the effort spent on sharing information which is required by the software development process in use. The research questions upon which the study is based ask whether or not these attributes of organizational structure have an effect on the amount of communication effort expended. In addition, there are a number of blocking variables which have been identified. These are used to account for factors other than organizational structure which may have an effect on communication effort. The study uses both quantitative and qualitative methods for data collection and analysis. These methods include participant observation, structured interviews, and graphical data presentation. The results of this study indicate that several attributes of organizational structure do affect communication effort, but not in a simple, straightforward way. In particular, the distances between communicators in the reporting structure of the organization, as well as in the physical layout of offices, affects how quickly they can share needed information, especially during meetings. These results provide a better understanding of how organizational structure helps or hinders communication in software development.

Health system decentralisation in Nepal: identifying the issues.

PubMed

Collins, Charles; Omar, Mayeh; Adhikari, Damodar; Dhakal, Ramji; Emmel, Nick; Dhakal, Megha Raj; Chand, Padam; Thapa, Druba; Singh, Arjun B

2007-01-01

The purpose of this paper is to describe and discuss policy analysis in Nepal and review the wide range of choices feasible in decentralisation decision making. In this paper an iterative qualitative method was developed and used in the research, which consisted of focus group interviews, key informant interviews, document analysis, including descriptive statistics, and analysis of the policy context. Participants in the research reflected the urban/rural mix of districts and the geography of Nepal. Analysis combined transcribed interviews with findings from document searches and analysis of the policy context. Coding was pre-determined during the training workshop and further codes were generated during and after the fieldwork. The paper finds that Nepal is in the process of decentralising public services from the central level to the local level, particularly to local bodies: District Development Committees (DDCs), Village Development Committees (VDCs) and Municipalities. Key contextual factors referred to are the overall structure of decentralisation, the social context of poverty and the political instability leading to a fluid political situation characterised by political tension, armed conflict, controversies and agreements while carrying out the research. The key issues identified and discussed in the paper are the policy process leading to decentralisation, the organisational structure and tension in the proposed system, the systems of resource generation, allocation, planning and management and lastly the forms of accountability, participation, public-private relations and collaborative strategies. The paper discusses the challenges faced in conducting such a policy analysis, the broad ranging and unremitting nature of the decentralisation process, and the contextual setting of the process of change.

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

PubMed

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

2015-06-02

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

Nurse managers' experience with ethical issues in six government hospitals in Malaysia: a cross-sectional study.

PubMed

Musa, Maizura binti; Harun-Or-Rashid, M D; Sakamoto, Junichi

2011-11-16

Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning.

Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica.

PubMed

Johnston, Rory; Crooks, Valorie A; Ormond, Meghann

2015-07-04

Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua's previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context. Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua's framework to identify overlapping and divergent issues. Many of the issues identified in Pocock and Phua's policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework. The framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework's design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism's development or how the specific impacts of the practice are likely to unfold.

Homogeneous Nanodiamonds Are Different in Reality

NASA Astrophysics Data System (ADS)

Wu, Chi-Chin; Gottfried, Jennifer; Pesce-Rodriguez, Rose; Advanced Energetic Materials Team

Commercial detonation nanodiamonds (ND) have been investigated for many applications. They consist of carbon nanoparticles with diamond cores surrounded by onion-like graphitic shells. Unfortunately, variations in the purity and carbon structure between commercial ND samples due to variations in synthesis and purification conditions is an ongoing issue, since these differences can affect the resulting application-dependent ND behavior. Via characterization with transmission electron microscopy, this work investigates the structural and chemical differences among nominally homologous commercial detonation ND sold by a single vendor under the same item number. Significant discrepancies in the carbon structure and crystallinity between different batches with similar sizes and shapes were identified. The ND containing more non-carbon entities as impurities and oxygen-containing surface functional groups were found to possess thicker graphitic shells surrounding an unstable diamond core which quickly transforms to graphite under electron beam irradiation. However, the structure of ND with higher purities and thin onion shells remain unchanged over extended exposure to electron beams. This study demonstrates the structural and chemical differences between nominally identical commercial detonation ND samples and reveals their influence on the decomposition behavior of the particles.

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

Candel, Arno; Li, Z.; Ng, C.

The Compact Linear Collider (CLIC) provides a path to a multi-TeV accelerator to explore the energy frontier of High Energy Physics. Its novel two-beam accelerator concept envisions rf power transfer to the accelerating structures from a separate high-current decelerator beam line consisting of power extraction and transfer structures (PETS). It is critical to numerically verify the fundamental and higher-order mode properties in and between the two beam lines with high accuracy and confidence. To solve these large-scale problems, SLAC's parallel finite element electromagnetic code suite ACE3P is employed. Using curvilinear conformal meshes and higher-order finite element vector basis functions, unprecedentedmore » accuracy and computational efficiency are achieved, enabling high-fidelity modeling of complex detuned structures such as the CLIC TD24 accelerating structure. In this paper, time-domain simulations of wakefield coupling effects in the combined system of PETS and the TD24 structures are presented. The results will help to identify potential issues and provide new insights on the design, leading to further improvements on the novel CLIC two-beam accelerator scheme.« less

Structural technology challenges for evolutionary growth of Space Station Freedom

NASA Technical Reports Server (NTRS)

Doiron, Harold H.

1990-01-01

A proposed evolutionary growth scenario for Space Station Freedom was defined recently by a NASA task force created to study requirements for a Human Exploration Initiative. The study was an initial response to President Bush's July 20, 1989 proposal to begin a long range program of human exploration of space including a permanently manned lunar base and a manned mission to Mars. This growth scenario evolves Freedom into a critical transportation node to support lunar and Mars missions. The growth scenario begins with the Assembly Complete configuration and adds structure, power, and facilities to support a Lunar Transfer Vehicle (LTV) verification flight. Evolutionary growth continues to support expendable, then reusable LTV operations, and finally, LTV and Mars Transfer Vehicle (MTV) operations. The significant structural growth and additional operations creating new loading conditions will present new technological and structural design challenges in addition to the considerable technology requirements of the baseline Space Station Freedom program. Several structural design and technology issues of the baseline program are reviewed and related technology development required by the growth scenario is identified.

Reflexive aerostructures: increased vehicle survivability

NASA Astrophysics Data System (ADS)

Margraf, Thomas W.; Hemmelgarn, Christopher D.; Barnell, Thomas J.; Franklin, Mark A.

2007-04-01

Aerospace systems stand to benefit significantly from the advancement of reflexive aerostructure technologies for increased vehicle survivability. Cornerstone Research Group Inc. (CRG) is developing lightweight, healable composite systems for use as primary load-bearing aircraft components. The reflexive system is comprised of piezoelectric structural health monitoring systems, localized thermal activation systems, and lightweight, healable composite structures. The reflexive system is designed to mimic the involuntary human response to damage. Upon impact, the structural health monitoring system will identify the location and magnitude of the damage, sending a signal to a discrete thermal activation control system to resistively heat the shape memory polymer (SMP) matrix composite above activation temperature, resulting in localized shape recovery and healing of the damaged areas. CRG has demonstrated SMP composites that can recover 90 percent of flexural yield stress and modulus after postfailure healing. During the development, CRG has overcome issues of discrete activation, structural health monitoring integration, and healable resin systems. This paper will address the challenges associated with development of a reflexive aerostructure, including integration of structural health monitoring, discrete healing, and healable shape memory resin systems.

40 CFR 35.4190 - How does my group identify a qualified technical advisor?

Code of Federal Regulations, 2011 CFR

2011-07-01

... issues or public health issues as those issues relate to hazardous substance/toxic waste issues, as... public health issues must have received his or her public health or related training at accredited... hazardous or toxic waste problems, relocation, redevelopment or public health issues, and communicating...

Experience of mixed-sex bays in a general hospital.

PubMed

Bryant, Debbie; Adams, John

To explore patients' and nurses' views on their experience of nursing care in mixed-sex bays. Using a descriptive exploratory method, tape-recorded semi-structured interviews were conducted with a purposive sample of patients and nurses drawn from wards where mixed-sex bays were located. The resulting transcripts were analysed to identify shared themes. The key themes identified were: communication from nursing staff, first reactions, relationships in the bay, reactions of others, awareness of organisational issues and nursing in a mixed-sex ward. While some individuals felt that the attitudes and behaviours displayed by their fellow patients were of greater significance than their gender, there was a general view that mixed-sex bays were less than ideal. Nurses also struggled to maintain patient dignity in mixed-sex bays.

Z-Score-Based Modularity for Community Detection in Networks

PubMed Central

Miyauchi, Atsushi; Kawase, Yasushi

2016-01-01

Identifying community structure in networks is an issue of particular interest in network science. The modularity introduced by Newman and Girvan is the most popular quality function for community detection in networks. In this study, we identify a problem in the concept of modularity and suggest a solution to overcome this problem. Specifically, we obtain a new quality function for community detection. We refer to the function as Z-modularity because it measures the Z-score of a given partition with respect to the fraction of the number of edges within communities. Our theoretical analysis shows that Z-modularity mitigates the resolution limit of the original modularity in certain cases. Computational experiments using both artificial networks and well-known real-world networks demonstrate the validity and reliability of the proposed quality function. PMID:26808270

Sensing with Superconducting Point Contacts

PubMed Central

Nurbawono, Argo; Zhang, Chun

2012-01-01

Superconducting point contacts have been used for measuring magnetic polarizations, identifying magnetic impurities, electronic structures, and even the vibrational modes of small molecules. Due to intrinsically small energy scale in the subgap structures of the supercurrent determined by the size of the superconducting energy gap, superconductors provide ultrahigh sensitivities for high resolution spectroscopies. The so-called Andreev reflection process between normal metal and superconductor carries complex and rich information which can be utilized as powerful sensor when fully exploited. In this review, we would discuss recent experimental and theoretical developments in the supercurrent transport through superconducting point contacts and their relevance to sensing applications, and we would highlight their current issues and potentials. A true utilization of the method based on Andreev reflection analysis opens up possibilities for a new class of ultrasensitive sensors. PMID:22778630

Do textbooks address known learning challenges in area measurement? A comparative analysis

NASA Astrophysics Data System (ADS)

Hong, Dae S.; Choi, Kyong Mi; Runnalls, Cristina; Hwang, Jihyun

2018-02-01

This study compared area lessons from Korean textbooks and US standard-based textbooks to understand differences and similarities among these textbooks, as well as how these textbooks address known learning challenges in area measurement. Several well-known challenges have been identified in previous studies, such as covering, array structure, and linking array structure to area formula. We were interested in knowing if textbooks addressed these issues in their treatments of area measurement and, in doing so, provided students with opportunities to overcome or become familiar with known challenges. The results show that both countries' textbooks demonstrated similar limitations; only few area and area-related lessons are covered and three important learning challenges in area measurement are not covered well, which need to be informed to practicing teachers.

The landscape of nonlinear structural dynamics: an introduction

PubMed Central

Butlin, T.; Woodhouse, J.; Champneys, A. R.

2015-01-01

Nonlinear behaviour is ever-present in vibrations and other dynamical motions of engineering structures. Manifestations of nonlinearity include amplitude-dependent natural frequencies, buzz, squeak and rattle, self-excited oscillation and non-repeatability. This article primarily serves as an extended introduction to a theme issue in which such nonlinear phenomena are highlighted through diverse case studies. More ambitiously though, there is another goal. Both the engineering context and the mathematical techniques that can be used to identify, analyse, control or exploit these phenomena in practice are placed in the context of a mind-map, which has been created through expert elicitation. This map, which is available in software through the electronic supplementary material, attempts to provide a practitioner’s guide to what hitherto might seem like a vast and complex research landscape. PMID:26303925

The landscape of nonlinear structural dynamics: an introduction.

PubMed

Butlin, T; Woodhouse, J; Champneys, A R

2015-09-28

Nonlinear behaviour is ever-present in vibrations and other dynamical motions of engineering structures. Manifestations of nonlinearity include amplitude-dependent natural frequencies, buzz, squeak and rattle, self-excited oscillation and non-repeatability. This article primarily serves as an extended introduction to a theme issue in which such nonlinear phenomena are highlighted through diverse case studies. More ambitiously though, there is another goal. Both the engineering context and the mathematical techniques that can be used to identify, analyse, control or exploit these phenomena in practice are placed in the context of a mind-map, which has been created through expert elicitation. This map, which is available in software through the electronic supplementary material, attempts to provide a practitioner's guide to what hitherto might seem like a vast and complex research landscape. © 2015 The Authors.

Evidence for population bottlenecks and subtle genetic structure in the yellow rail

USGS Publications Warehouse

Popper, Kenneth J.; Miller, Leonard F.; Green, Michael; Haig, Susan M.; Mullins, Thomas D.

2012-01-01

The Yellow Rail (Coturnicops noveboracencis) is among the most enigmatic and least studied North American birds. Nesting exclusively in marshes and wetlands, it breeds largely east of the Rocky Mountains in the northern United States and Canada, but there is an isolated population in southern Oregon once believed extirpated. The degree of connectivity of the Oregon population with the main population is unknown. We used mitochondrial DNA sequences (mtDNA) and six microsatellite loci to characterize the Yellow Rail's genetic structure and diversity patterns in six areas. Our mtDNA-based analyses of genetic structure identified significant population differentiation, but pairwise comparison of regions identified no clear geographic trends. In contrast, microsatellites suggested subtle genetic structure differentiating the Oregon population from those in the five regions sampled in the Yellow Rail's main breeding range. The genetic diversity of the Oregon population was also the lowest of the six regions sampled, and Oregon was one of three regions that demonstrated evidence of recent population bottlenecks. Factors that produced population reductions may include loss of wetlands to development and agricultural conversion, drought, and wildfire. At this time, we are unable to determine if the high percentage (50%) of populations having experienced bottlenecks is representative of the Yellow Rail's entire range. Further genetic data from additional breeding populations will be required for this issue to be addressed.

Design and analysis issues of integrated control systems for high-speed civil transports

NASA Technical Reports Server (NTRS)

Mccarty, Craig A.; Feather, John B.; Dykman, John R.; Page, Mark A.; Hodgkinson, John

1992-01-01

A study was conducted to identify, rank, and define development plans for the critical guidance and control design and analysis issues as related to economically viable and environmentally acceptable high-speed civil transport. The issues were identified in a multistep process. First, pertinent literature on supersonic cruise aircraft was reviewed, and experts were consulted to establish the fundamental characteristics and problems inherent to supersonic cruise aircraft. Next, the advanced technologies and strategies being pursued for the high-speed civil transport were considered to determine any additional unique control problems the transport may have. Finally, existing technologies and methods were examined to determine their capabilities for the design and analysis of high-speed civil transport control systems and to identify the shortcomings and issues. Three priority levels - mandatory, highly beneficial, and desirable - were established. Within each of these levels, the issues were further ranked. Technology development plans for each issue were defined. Each plan contains a task breakdown and schedule.

Workshop on Basic Research Opportunities in Photovoltaics

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

Benner, J.; McConnell, R.; Deb, S., Editors

1999-08-25

The Basic Research Opportunities in Photovoltaics Workshop was held on May 3, 1999, in Seattle, Washington, in conjunction with the 195th Meeting of the Electrochemical Society. The workshop was structured into eight topics. Each topic area opened with a presentation in which the participants were asked to address the following: a brief introduction of the area of research; key research issues that were identified in an earlier workshop in 1992; what fundamental research has been done since then or is currently being done to address those issues; what are the research issues that are still relevant in light of advancesmore » made since the first workshop; identification of new fundamental research opportunities that will lead to important advances and innovations; and identification of significant commonalities and common research issues that have a cross-cutting impact, such as logically exist in silicon-based thin films, II-VI, and related materials. The topic areas discussed included amorphous and microcrystalline silicon, crystalline silicon, cadmium telluride, copper indium diselenide; III-V materials; novel materials and energy conversion approaches, semiconducting oxides, and characterization. After the meeting, participants in each working topic continued discussions by electronic means, completing journal articles that are to be published as a separate section in the ECS Proceedings of the ''PV for the 21st Century'' Symposium.« less

A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania.

PubMed

George, Siân; Daniels, Katy; Fioratou, Evridiki

2018-04-03

Minority vulnerable communities, such as the European Roma, often face numerous barriers to accessing healthcare services, resulting in negative health outcomes. Both these barriers and outcomes have been reported extensively in the literature. However, reports on barriers faced by European non-Roma native communities are limited. The "Health Care Access Barriers" (HCAB) model identifies pertinent financial, structural and cognitive barriers that can be measured and potentially modified. The present study thus aims to explore the barriers to accessing healthcare for a vulnerable population of mixed ethnicity from a charity community centre in Romania, as perceived by the centre's family users and staff members, and assess whether these reflect the barriers identified from the HCAB model. Eleven community members whose children attend the centre and seven staff members working at the centre participated in face-to-face semi-structured interviews, exploring personal experiences and views on accessing healthcare. The interviews were transcribed and analysed using an initial deductive and secondary inductive approach to identify HCAB themes and other emerging themes and subthemes. Identified themes from both groups aligned with HCAB's themes of financial, structural and cognitive barriers and emergent subthemes important to the specific population were identified. Specifically, financial barriers related mostly to health insurance and bribery issues, structural barriers related mostly to service availability and accessibility, and cognitive barriers related mostly to healthcare professionals' attitudes and discrimination and the vulnerable population's lack of education and health literacy. A unique theme of psychological barriers emerged from both groups with associated subthemes of mistrust, hopelessness, fear and anxiety of this vulnerable population. The current study highlights healthcare access barriers to a vulnerable non-Roma native population involved with a charity community centre in Romania. The "Healthcare Access Barriers for Vulnerable Populations" (HABVP) model is proposed as an adaption to the existing HCAB model to account for the unique perceived barriers to healthcare for this population. Recommendations for future resolution of these identified barriers are proposed.

Outcomes of an International Workshop on Preconception Expanded Carrier Screening: Some Considerations for Governments.

PubMed

Molster, Caron M; Lister, Karla; Metternick-Jones, Selina; Baynam, Gareth; Clarke, Angus John; Straub, Volker; Dawkins, Hugh J S; Laing, Nigel

2017-01-01

Consideration of expanded carrier screening has become an emerging issue for governments. However, traditional criteria for decision-making regarding screening programs do not incorporate all the issues relevant to expanded carrier screening. Further, there is a lack of consistent guidance in the literature regarding the development of appropriate criteria for government assessment of expanded carrier screening. Given this, a workshop was held to identify key public policy issues related to preconception expanded carrier screening, which governments should consider when deciding whether to publicly fund such programs. In June 2015, a satellite workshop was held at the European Society of Human Genetics Conference. It was structured around two design features: (1) the provision of information from a range of perspectives and (2) small group deliberations on the key issues that governments need to consider and the benefits, risks, and challenges of implementing publicly funded whole-population preconception carrier screening. Forty-one international experts attended the workshop. The deliberations centered primarily on the conditions to be tested and the elements of the screening program itself. Participants expected only severe conditions to be screened but were concerned about the lack of a consensus definition of "severe." Issues raised regarding the screening program included the purpose, benefits, harms, target population, program acceptability, components of a program, and economic evaluation. Participants also made arguments for consideration of the accuracy of screening tests. A wide range of issues require careful consideration by governments that want to assess expanded carrier screening. Traditional criteria for government decision-making regarding screening programs are not a "best fit" for expanded carrier screening and new models of decision-making with appropriate criteria are required. There is a need to define what a "severe" condition is, to build evidence regarding the reliability and accuracy of screening tests, to consider the equitable availability and downstream effects on and costs of follow-up interventions for those identified as carriers, and to explore the ways in which the components of a screening program would be impacted by unique features of expanded carrier screening.

Three essays on price dynamics and causations among energy markets and macroeconomic information

NASA Astrophysics Data System (ADS)

Hong, Sung Wook

This dissertation examines three important issues in energy markets: price dynamics, information flow, and structural change. We discuss each issue in detail, building empirical time series models, analyzing the results, and interpreting the findings. First, we examine the contemporaneous interdependencies and information flows among crude oil, natural gas, and electricity prices in the United States (US) through the multivariate generalized autoregressive conditional heteroscedasticity (MGARCH) model, Directed Acyclic Graph (DAG) for contemporaneous causal structures and Bernanke factorization for price dynamic processes. Test results show that the DAG from residuals of out-of-sample-forecast is consistent with the DAG from residuals of within-sample-fit. The result supports innovation accounting analysis based on DAGs using residuals of out-of-sample-forecast. Second, we look at the effects of the federal fund rate and/or WTI crude oil price shock on US macroeconomic and financial indicators by using a Factor Augmented Vector Autoregression (FAVAR) model and a graphical model without any deductive assumption. The results show that, in contemporaneous time, the federal fund rate shock is exogenous as the identifying assumption in the Vector Autoregression (VAR) framework of the monetary shock transmission mechanism, whereas the WTI crude oil price return is not exogenous. Third, we examine price dynamics and contemporaneous causality among the price returns of WTI crude oil, gasoline, corn, and the S&P 500. We look for structural break points and then build an econometric model to find the consistent sub-periods having stable parameters in a given VAR framework and to explain recent movements and interdependency among returns. We found strong evidence of two structural breaks and contemporaneous causal relationships among the residuals, but also significant differences between contemporaneous causal structures for each sub-period.

Free-Suspension Residual Flexibility Testing of Space Station Pathfinder: Comparison to Fixed-Base Results

NASA Technical Reports Server (NTRS)

Tinker, Michael L.

1998-01-01

Application of the free-suspension residual flexibility modal test method to the International Space Station Pathfinder structure is described. The Pathfinder, a large structure of the general size and weight of Space Station module elements, was also tested in a large fixed-base fixture to simulate Shuttle Orbiter payload constraints. After correlation of the Pathfinder finite element model to residual flexibility test data, the model was coupled to a fixture model, and constrained modes and frequencies were compared to fixed-base test. modes. The residual flexibility model compared very favorably to results of the fixed-base test. This is the first known direct comparison of free-suspension residual flexibility and fixed-base test results for a large structure. The model correlation approach used by the author for residual flexibility data is presented. Frequency response functions (FRF) for the regions of the structure that interface with the environment (a test fixture or another structure) are shown to be the primary tools for model correlation that distinguish or characterize the residual flexibility approach. A number of critical issues related to use of the structure interface FRF for correlating the model are then identified and discussed, including (1) the requirement of prominent stiffness lines, (2) overcoming problems with measurement noise which makes the antiresonances or minima in the functions difficult to identify, and (3) the use of interface stiffness and lumped mass perturbations to bring the analytical responses into agreement with test data. It is shown that good comparison of analytical-to-experimental FRF is the key to obtaining good agreement of the residual flexibility values.

From phase drift to synchronisation - pedestrian stepping behaviour on laterally oscillating structures and consequences for dynamic stability

NASA Astrophysics Data System (ADS)

Bocian, Mateusz; Burn, Jeremy F.; Macdonald, John H. G.; Brownjohn, James M. W.

2017-03-01

The subject of this paper pertains to the contentious issue of synchronisation of walking pedestrians to lateral structural motion, which is the mechanism most commonly purported to cause lateral dynamic instability. Tests have been conducted on a custom-built experimental setup consisting of an instrumented treadmill laterally driven by a hydraulic shaking table. The experimental setup can accommodate adaptive pedestrian behaviour via a bespoke speed feedback control mechanism that allows automatic adjustment of the treadmill belt speed to that of the walker. 15 people participated in a total of 137 walking tests during which the treadmill underwent lateral sinusoidal motion. The amplitude of this motion was set from 5 to 15 mm and the frequency was set from 0.54 to 1.1 Hz. A variety of stepping behaviours are identified in the kinematic data obtained using a motion capture system. The most common behaviour is for the timing of footsteps to be essentially unaffected by the structural motion, but a few instances of synchronisation are found. A plausible mechanism comprising an intermediate state between unsynchronised and synchronised pedestrian and structural motion is observed. This mechanism, characterised by a weak form of modulation of the timing of footsteps, could possibly explain the under-estimation of negative damping coefficients in models and laboratory trials compared with previously reported site measurements. The results from tests conducted on the setup for which synchronisation is identified are evaluated in the context of structural stability and related to the predictions of the inverted pendulum model, providing insight into fundamental relations governing pedestrian behaviour on laterally oscillating structures.

Psychosis in a Case of Dandy-Walker Syndrome: A Case Report.

PubMed

Dawra, Ripu Daman; Karia, Sagar; Shah, Nilesh; Desousa, Avinash

2017-05-01

Dandy Walker Syndrome (DWS) is a congenital malformation with brain abnormalities, intellectual disabilities, epilepsy and visible structural changes in particular brain structures. We present here a case of psychosis in an 18-year-old male with DWS, epilepsy and intellectual disability. The purpose of this paper is to discuss the clinically relevant issues, psychopharmacological issues, neuropsychiatric manifestations and consultation liaison issues involved.

Psychosis in a Case of Dandy-Walker Syndrome: A Case Report

PubMed Central

Dawra, Ripu Daman; Karia, Sagar; Shah, Nilesh

2017-01-01

Dandy Walker Syndrome (DWS) is a congenital malformation with brain abnormalities, intellectual disabilities, epilepsy and visible structural changes in particular brain structures. We present here a case of psychosis in an 18-year-old male with DWS, epilepsy and intellectual disability. The purpose of this paper is to discuss the clinically relevant issues, psychopharmacological issues, neuropsychiatric manifestations and consultation liaison issues involved. PMID:28658885

Fatigue behavior and life prediction of a SiC/Ti-24Al-11Nb composite under isothermal conditions. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Bartolotta, Paul A.

1991-01-01

Metal Matrix Composites (MMC) and Intermetallic Matrix Composites (IMC) were identified as potential material candidates for advanced aerospace applications. They are especially attractive for high temperature applications which require a low density material that maintains its structural integrity at elevated temperatures. High temperature fatigue resistance plays an important role in determining the structural integrity of the material. This study attempts to examine the relevance of test techniques, failure criterion, and life prediction as they pertain to an IMC material, specifically, unidirectional SiC fiber reinforced titanium aluminide. A series of strain and load controlled fatigue tests were conducted on unidirectional SiC/Ti-24Al-11Nb composite at 425 and 815 C. Several damage mechanism regimes were identified by using a strain-based representation of the data, Talreja's fatigue life diagram concept. Results of these tests were then used to address issues of test control modes, definition of failure, and testing techniques. Finally, a strain-based life prediction method was proposed for an IMC under tensile cyclic loadings at elevated temperatures.

Gender equity and sexual and reproductive health in Eastern and Southern Africa: a critical overview of the literature.

PubMed

MacPherson, Eleanor E; Richards, Esther; Namakhoma, Ireen; Theobald, Sally

2014-01-01

Gender inequalities are important social determinants of health. We set out to critically review the literature relating to gender equity and sexual and reproductive health (SRH) in Eastern and Southern Africa with the aim of identifying priorities for action. During November 2011, we identified studies relating to SRH and gender equity through a comprehensive literature search. We found gender inequalities to be common across a range of health issues relating to SRH with women being particularly disadvantaged. Social and biological determinants combined to increase women's vulnerability to maternal mortality, HIV, and gender-based violence. Health systems significantly disadvantaged women in terms of access to care. Men fared worse in relation to HIV testing and care with social norms leading to men presenting later for treatment. Gender inequity in SRH requires multiple complementary approaches to address the structural drivers of unequal health outcomes. These could include interventions that alter the structural environment in which ill-health is created. Interventions are required both within and beyond the health system.

Structure and functioning of the acid-base system in the Baltic Sea

NASA Astrophysics Data System (ADS)

Kuliński, Karol; Schneider, Bernd; Szymczycha, Beata; Stokowski, Marcin

2017-12-01

The marine acid-base system is relatively well understood for oceanic waters. Its structure and functioning is less obvious for the coastal and shelf seas due to a number of regionally specific anomalies. In this review article we collect and integrate existing knowledge of the acid-base system in the Baltic Sea. Hydrographical and biogeochemical characteristics of the Baltic Sea, as manifested in horizontal and vertical salinity gradients, permanent stratification of the water column, eutrophication, high organic-matter concentrations and high anthropogenic pressure, make the acid-base system complex. In this study, we summarize the general knowledge of the marine acid-base system as well as describe the peculiarities identified and reported for the Baltic Sea specifically. In this context we discuss issues such as dissociation constants in brackish water, different chemical alkalinity models including contributions by organic acid-base systems, long-term changes in total alkalinity, anomalies of borate alkalinity, and the acid-base effects of biomass production and mineralization. Finally, we identify research gaps and specify limitations concerning the Baltic Sea acid-base system.

A systematic review of microfinance and women's health literature: Directions for future research.

PubMed

O'Malley, T L; Burke, J G

2017-11-01

While growing evidence suggests that microfinance is an effective approach for improved women's health, a significant gap remains in our understanding. The objective of this review is to synthesise the findings from published literature focused on microfinance and health issues particularly affecting women, including HIV/AIDS, reproductive health, mental health, and violence. Forty-one articles that examine the impact of microfinance participation on women's health were identified through a systematic search of electronic databases, coded using a structured abstraction form, and synthesised. Review results indicate that the impact of microfinance on women's health is an area in great need of research and publication attention. Varied quality and reporting in the identified articles restricted the ability to draw concrete conclusions regarding the relationship between microfinance participation and women's health, but led to the identification of current gaps in existing published research. Future research should work to address the recommendations provided in order to offer additional evidence to better understand the use of microfinance programming as a structural intervention to improve women's health.

Teaching ethics to engineers - a research-based perspective

NASA Astrophysics Data System (ADS)

Bowden, Peter

2010-10-01

This paper describes research underpinning a course, developed in Australia, on ethics for engineers. The methodology used, that of identifying the principal ethical issues facing the discipline and designing the course around these issues, would be applicable to other disciplines and in other countries. The course was based on the assumption that identifying the major ethical issues in the discipline, and subsequently presenting and analysing them in the classroom, would provide the future professional with knowledge of the ethical problems that they were likely to face on graduation. The student has then to be given the skills and knowledge to combat these concerns, should he/she wish to. These findings feed into several components of the course, such as the development of a code of ethics, the role of a professional society or industry association and the role of ethical theory The sources employed to identify the issues were surveys of the literature and about 30 case studies, in Australia and overseas. The issues thus identified were then put before a sample of engineering managers to assess the relevance to the profession.

High School Students' Informal Reasoning Regarding a Socio-Scientific Issue, with Relation to Scientific Epistemological Beliefs and Cognitive Structures

ERIC Educational Resources Information Center

Wu, Ying-Tien; Tsai, Chin-Chung

2011-01-01

This study investigated the relationship among 68 high school students' scientific epistemological beliefs (SEBs), cognitive structures regarding nuclear power usage, and their informal reasoning regarding this issue. Moreover, the ability of students' SEBs as well as their cognitive structures for predicting their informal reasoning regarding…

Assessing community readiness for overweight and obesity prevention in pre-adolescent girls: a case study

PubMed Central

2013-01-01

Background Childhood overweight and obesity is a global public health concern. For girls in particular, being overweight or obese during pre-adolescence (aged 7–11 years) has intergenerational implications for both the mother and her future offspring. In the United Kingdom (UK) there is increasing interest in community targeted interventions but less is known about how to tailor these approaches to the needs of the community. This study applied the Community Readiness Model (CRM), for the first time in the UK, to demonstrate its applicability in designing tailored interventions. Methods Community readiness assessment was conducted using semi-structured key informant interviews. The community’s key informants were identified through focus groups with pre-adolescent girls. The interviews addressed the community’s efforts; community knowledge of the efforts; leadership; community climate; community knowledge of the issue and resources available to support the issue. Interviews were conducted until the point of theoretical saturation and questions were asked separately regarding physical activity (PA) and healthy eating and drinking (HED) behaviours. The interviews were transcribed verbatim and were firstly analysed thematically and then scored using the assessment guidelines produced by the CRM authors. Results Readiness in this community was higher for PA than for HED behaviours. The lowest scores related to the community’s ’resources’ and the ’community knowledge of the issue’; affirming these two issues as the most appropriate initial targets for intervention. In terms of resources, there is also a need for resources to support the development of HED efforts beyond the school. Investment in greater physical education training for primary school teachers was also identified as an intervention priority. To address the community’s knowledge of the issue, raising the awareness of the prevalence of pre-adolescent girls’ health behaviours is a priority at the local community level. Inconsistent school approaches contributed to tensions between schools and parents regarding school food policies. Conclusions This study has identified the readiness level within a UK community to address the behaviours related to overweight and obesity prevention in pre-adolescent girls. The focus of an intervention in this community should initially be resources and raising awareness of the issue within the community. PMID:24359213

Emerging Issues for Bokori Island Development in Konawe Southeast Sulawesi

NASA Astrophysics Data System (ADS)

Maulidy Navastara, Ardy

2017-07-01

This article discusses about emerging issues for small island development especially Bokori Island in Konawe Southeast Sulawesi. Indonesia have been known as a big archipelago has more than ten thousand small islands scattered about 5.8 million km2 of oceanic area Sabang in the West end to Merauke at the end East. It is also known as the largest “megabiodiversity” marine nation. However, the weak national policy that handles the development and management of small islands is suspected because it is not accurate in identifying strategic issues that occur in the development and management of small islands. Therefore, this article aims to identify and classify strategic issues related to the development of small islands in Konawe Southeast Sulawesi. A normative and empirical approach is made to discuss this article. It resulted that typology of issues such as internal and external issues, urgent issues and its supporting issues. Then local governments should pay attention to the urgent issues and its supporting issues - it is policy, investment, institutional and technological issues and the endogenous issues such as entrepreneurship and leadership.

Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

PubMed

Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

2018-06-01

Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

Overview and introduction: The blood–brain barrier in health and disease

PubMed Central

Abbott, N. Joan; Friedman, Alon

2013-01-01

Summary This article introduces the special issue on “Blood–Brain Barrier and Epilepsy.” We review briefly current understanding of the structure and function of the blood–brain barrier (BBB), including its development and normal physiology, and ways in which it can be affected in pathology. The BBB formed by the endothelium of cerebral blood vessels is one of three main barrier sites protecting the central nervous system (CNS). The barrier is not a rigid structure, but a dynamic interface with a range of interrelated functions, resulting from extremely effective tight junctions, transendothelial transport systems, enzymes, and regulation of leukocyte permeation, which thereby generates the physical, transport, enzymatic, and immune regulatory functions of the BBB. The brain endothelial cells are important components of a “modular” structure, the neurovascular unit (NVU), with several associated cell types and extracellular matrix components. Modern methods have helped in identifying a range of proteins involved in barrier structure and function, and recent studies have revealed important stages, cell types, and signaling pathways important in BBB development. There is a growing list of CNS pathologies showing BBB dysfunction, with strong evidence that this can play a major role in certain disease etiologies. The articles that follow in this issue summarize in more detail reports and discussions of the recent international meeting on “BBB in Neurological Dysfunctions,” which took place recently at Ben-Gurion University of the Negev Desert Campus (Beer-Sheva, Israel), focusing on the link between experimental and clinical studies, and the ways in which these lead to improved drug treatments. PMID:23134489

Understanding India, globalisation and health care systems: a mapping of research in the social sciences

PubMed Central

2012-01-01

National and transnational health care systems are rapidly evolving with current processes of globalisation. What is the contribution of the social sciences to an understanding of this field? A structured scoping exercise was conducted to identify relevant literature using the lens of India – a ‘rising power’ with a rapidly expanding healthcare economy. A five step search and analysis method was employed in order to capture as wide a range of material as possible. Documents published in English that met criteria for a social science contribution were included for review. Via electronic bibliographic databases, websites and hand searches conducted in India, 113 relevant articles, books and reports were identified. These were classified according to topic area, publication date, disciplinary perspective, genre, and theoretical and methodological approaches. Topic areas were identified initially through an inductive approach, then rationalised into seven broad themes. Transnational consumption of health services; the transnational healthcare workforce; the production, consumption and trade in specific health-related commodities, and transnational diffusion of ideas and knowledge have all received attention from social scientists in work related to India. Other themes with smaller volumes of work include new global health governance issues and structures; transnational delivery of health services and the transnational movement of capital. Thirteen disciplines were found represented in our review, with social policy being a clear leader, followed by economics and management studies. Overall this survey of India-related work suggests a young and expanding literature, although hampered by inadequacies in global comparative data, and by difficulties in accessing commercially sensitive information. The field would benefit from further cross-fertilisation between disciplines and greater application of explanatory theory. Literatures around stem cell research and health related commodities provide some excellent examples of illuminating social science. Future research agendas on health systems issues need to include innovative empirical work that captures the dynamics of transnational processes and that links macro-level change to fine-grained observations of social life. PMID:22963264

Understanding India, globalisation and health care systems: a mapping of research in the social sciences.

PubMed

Bisht, Ramila; Pitchforth, Emma; Murray, Susan F

2012-09-10

National and transnational health care systems are rapidly evolving with current processes of globalisation. What is the contribution of the social sciences to an understanding of this field? A structured scoping exercise was conducted to identify relevant literature using the lens of India - a 'rising power' with a rapidly expanding healthcare economy. A five step search and analysis method was employed in order to capture as wide a range of material as possible. Documents published in English that met criteria for a social science contribution were included for review. Via electronic bibliographic databases, websites and hand searches conducted in India, 113 relevant articles, books and reports were identified. These were classified according to topic area, publication date, disciplinary perspective, genre, and theoretical and methodological approaches. Topic areas were identified initially through an inductive approach, then rationalised into seven broad themes. Transnational consumption of health services; the transnational healthcare workforce; the production, consumption and trade in specific health-related commodities, and transnational diffusion of ideas and knowledge have all received attention from social scientists in work related to India. Other themes with smaller volumes of work include new global health governance issues and structures; transnational delivery of health services and the transnational movement of capital. Thirteen disciplines were found represented in our review, with social policy being a clear leader, followed by economics and management studies. Overall this survey of India-related work suggests a young and expanding literature, although hampered by inadequacies in global comparative data, and by difficulties in accessing commercially sensitive information. The field would benefit from further cross-fertilisation between disciplines and greater application of explanatory theory. Literatures around stem cell research and health related commodities provide some excellent examples of illuminating social science. Future research agendas on health systems issues need to include innovative empirical work that captures the dynamics of transnational processes and that links macro-level change to fine-grained observations of social life.

Characteristics of an ITS that evolves from tutor to operator's assistant. [intelligent tutoring system

NASA Technical Reports Server (NTRS)

Chu, R. W.; Mitchell, C. M.; Govindaraj, T.

1989-01-01

This paper discusses the motivation and goals of a research project which addresses the problems and issues of operator training in complex engineering sytems. The research proposes a tutor/aid paradigm for the design of an intelligent tutoring system (ITS) that evolves from a tutor to an operator's assistant for supervisory control of complex dynamic systems. Characteristics of an intelligent tutoring/aiding system are identified with respect to the representation of domain knowledge, the tutor's pedagogical structure, and the student knowledge representation. The research represents a first step in the design of an intelligent complex dynamic systems.

Mobile satellite communications technology - A summary of NASA activities

NASA Technical Reports Server (NTRS)

Dutzi, E. J.; Knouse, G. H.

1986-01-01

Studies in recent years indicate that future high-capacity mobile satellite systems are viable only if certain high-risk enabling technologies are developed. Accordingly, NASA has structured an advanced technology development program aimed at efficient utilization of orbit, spectrum, and power. Over the last two years, studies have concentrated on developing concepts and identifying cost drivers and other issues associated with the major technical areas of emphasis: vehicle antennas, speech compression, bandwidth-efficient digital modems, network architecture, mobile satellite channel characterization, and selected space segment technology. The program is now entering the next phase - breadboarding, development, and field experimentation.

System data communication structures for active-control transport aircraft, volume 1

NASA Technical Reports Server (NTRS)

Hopkins, A. L.; Martin, J. H.; Brock, L. D.; Jansson, D. G.; Serben, S.; Smith, T. B.; Hanley, L. D.

1981-01-01

Candidate data communication techniques are identified, including dedicated links, local buses, broadcast buses, multiplex buses, and mesh networks. The design methodology for mesh networks is then discussed, including network topology and node architecture. Several concepts of power distribution are reviewed, including current limiting and mesh networks for power. The technology issues of packaging, transmission media, and lightning are addressed, and, finally, the analysis tools developed to aid in the communication design process are described. There are special tools to analyze the reliability and connectivity of networks and more general reliability analysis tools for all types of systems.

Beyond Lawrence v. Texas: crafting a fundamental right to sexual privacy.

PubMed

Fasullo, Kristin

2009-05-01

After the watershed 2003 U.S. Supreme Court decision Lawrence v.Texas, courts are faced with the daunting task of navigating the bounds of sexual privacy in light of Lawrence's sweeping language and unconventional structure. This Note focuses on the specific issue of state governments regulating sexual device distribution. Evaluating the substantive due process rights of sexual device retailers and users, this Note ultimately argues that the privacy interest identified in Lawrence is sufficiently broad to protect intimate decisions to engage in adult consensual sexual behavior, including the liberty to sell, purchase, and use a sexual device.

Concluding remarks: Faraday Discussion on chemistry in the urban atmosphere.

PubMed

Jimenez, Jose L

2016-07-18

This article summarises the Concluding remarks from the Faraday Discussion on Chemistry in the Urban Atmosphere. The following themes are addressed: (a) new results that inform our understanding of the evolving sources and composition of the urban atmosphere ("News"); (b) results that identify gaps in our understanding that necessitate further work ("Gaps"); (c) the emerging instrumentation revolution and some of the challenges that it brings; (d) the structural issues of insufficient support for the analysis of field campaigns; and (e) some important areas that were missing from this Faraday Discussion and that should receive an increasing focus in the future.

Structure and energetic basis of overrepresented λ light chain in systemic light chain amyloidosis patients.

PubMed

Zhao, Jun; Zhang, Baohong; Zhu, Jianwei; Nussinov, Ruth; Ma, Buyong

2018-06-01

Amyloid formation and deposition of immunoglobulin light-chain proteins in systemic amyloidosis (AL) cause major organ failures. While the κ light-chain is dominant (λ/κ=1:2) in healthy individuals, λ is highly overrepresented (λ/κ=3:1) in AL patients. The structural basis of the amyloid formation and the sequence preference are unknown. We examined the correlation between sequence and structural stability of dimeric variable domains of immunoglobulin light chains using molecular dynamics simulations of 24 representative dimer interfaces, followed by energy evaluation of conformational ensembles for 20 AL patients' light chain sequences. We identified a stable interface with displaced N-terminal residues, provides the structural basis for AL protein fibrils formation. Proline isomerization may cause the N-terminus to adopt amyloid-prone conformations. We found that λ light-chains prefer misfolded dimer conformation, while κ chain structures are stabilized by a natively folded dimer. Our study may facilitate structure-based small molecule and antibody design to inhibit AL. This article is part of a Special Issue entitled: Accelerating Precision Medicine through Genetic and Genomic Big Data Analysis edited by Yudong Cai & Tao Huang. Copyright © 2017 Elsevier B.V. All rights reserved.

Utility interconnection issues for wind power generation

NASA Technical Reports Server (NTRS)

Herrera, J. I.; Lawler, J. S.; Reddoch, T. W.; Sullivan, R. L.

1986-01-01

This document organizes the total range of utility related issues, reviews wind turbine control and dynamic characteristics, identifies the interaction of wind turbines to electric utility systems, and identifies areas for future research. The material is organized at three levels: the wind turbine, its controls and characteristics; connection strategies as dispersed or WPSs; and the composite issue of planning and operating the electric power system with wind generated electricity.

Post discharge issues identified by a call-back program: identifying improvement opportunities.

PubMed

Ojeda, Patricia I; Kara, Areeba

2017-12-01

The period following discharge from the hospital is one of heightened vulnerability. Discharge instructions serve as a guide during this transition. Yet, clinicians receive little feedback on the quality of this document that ties into the patients' experience. We reviewed the issues voiced by discharged patients via a call-back program and compared them to the discharge instructions they had received. At our institution, patients receive an automated call forty-eight hours following discharge inquiring about progress. If indicated by the response to the call, they are directed to a nurse who assists with problem solving. We reviewed the nursing documentation of these encounters for a period of nine months. The issues voiced were grouped into five categories: communication, medications, durable medical equipment/therapies, follow up and new or ongoing symptoms. The discharge instructions given to each patient were reviewed. We retrieved data on the number of discharges from each specialty from the hospital over the same period. A total of 592 patients voiced 685 issues. The numbers of patients discharged from medical or surgical services identified as having issues via the call-back line paralleled the proportions discharged from medical and surgical services from the hospital during the same period. Nearly a quarter of the issues discussed had been addressed in the discharge instructions. The most common category of issues was related to communication deficits including missing or incomplete information which made it difficult for the patient to enact or understand the plan of care. Medication prescription related issues were the next most common. Resource barriers and questions surrounding medications were often unaddressed. Post discharge issues affect patients discharged from all services equally. Data from call back programs may provide actionable targets for improvement, identify the inpatient team's 'blind spots' and be used to provide feedback to clinicians.

The role of parasite-driven selection in shaping landscape genomic structure in red grouse (Lagopus lagopus scotica).

PubMed

Wenzel, Marius A; Douglas, Alex; James, Marianne C; Redpath, Steve M; Piertney, Stuart B

2016-01-01

Landscape genomics promises to provide novel insights into how neutral and adaptive processes shape genome-wide variation within and among populations. However, there has been little emphasis on examining whether individual-based phenotype-genotype relationships derived from approaches such as genome-wide association (GWAS) manifest themselves as a population-level signature of selection in a landscape context. The two may prove irreconcilable as individual-level patterns become diluted by high levels of gene flow and complex phenotypic or environmental heterogeneity. We illustrate this issue with a case study that examines the role of the highly prevalent gastrointestinal nematode Trichostrongylus tenuis in shaping genomic signatures of selection in red grouse (Lagopus lagopus scotica). Individual-level GWAS involving 384 SNPs has previously identified five SNPs that explain variation in T. tenuis burden. Here, we examine whether these same SNPs display population-level relationships between T. tenuis burden and genetic structure across a small-scale landscape of 21 sites with heterogeneous parasite pressure. Moreover, we identify adaptive SNPs showing signatures of directional selection using F(ST) outlier analysis and relate population- and individual-level patterns of multilocus neutral and adaptive genetic structure to T. tenuis burden. The five candidate SNPs for parasite-driven selection were neither associated with T. tenuis burden on a population level, nor under directional selection. Similarly, there was no evidence of parasite-driven selection in SNPs identified as candidates for directional selection. We discuss these results in the context of red grouse ecology and highlight the broader consequences for the utility of landscape genomics approaches for identifying signatures of selection. © 2015 John Wiley & Sons Ltd.

Modal parameter identification based on combining transmissibility functions and blind source separation techniques

NASA Astrophysics Data System (ADS)

Araújo, Iván Gómez; Sánchez, Jesús Antonio García; Andersen, Palle

2018-05-01

Transmissibility-based operational modal analysis is a recent and alternative approach used to identify the modal parameters of structures under operational conditions. This approach is advantageous compared with traditional operational modal analysis because it does not make any assumptions about the excitation spectrum (i.e., white noise with a flat spectrum). However, common methodologies do not include a procedure to extract closely spaced modes with low signal-to-noise ratios. This issue is relevant when considering that engineering structures generally have closely spaced modes and that their measured responses present high levels of noise. Therefore, to overcome these problems, a new combined method for modal parameter identification is proposed in this work. The proposed method combines blind source separation (BSS) techniques and transmissibility-based methods. Here, BSS techniques were used to recover source signals, and transmissibility-based methods were applied to estimate modal information from the recovered source signals. To achieve this combination, a new method to define a transmissibility function was proposed. The suggested transmissibility function is based on the relationship between the power spectral density (PSD) of mixed signals and the PSD of signals from a single source. The numerical responses of a truss structure with high levels of added noise and very closely spaced modes were processed using the proposed combined method to evaluate its ability to identify modal parameters in these conditions. Colored and white noise excitations were used for the numerical example. The proposed combined method was also used to evaluate the modal parameters of an experimental test on a structure containing closely spaced modes. The results showed that the proposed combined method is capable of identifying very closely spaced modes in the presence of noise and, thus, may be potentially applied to improve the identification of damping ratios.

Workforce 2000 and the Mildly Handicapped. Identifying Emerging Issues and Trends in Technology for Special Education.

ERIC Educational Resources Information Center

Woodward, John

As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper explores the changing nature of the workforce in relation to concurrent changes in education services for students with mild disabilities. Current trends are identified and projections for the next decade are offered, which include the…

"Business Ethics Everywhere": An Experiential Exercise to Develop Students' Ability to Identify and Respond to Ethical Issues in Business

ERIC Educational Resources Information Center

Baker, Susan D.; Comer, Debra R.

2012-01-01

This article introduces an experiential exercise that enhances students' ability to identify ethical issues and to respond to them in ways that consider the relationship between organizational factors and ethical action. Students identify a required number of ethical incidents in their workplaces during a specified period. Students submit a…

Current IT Issues, 2004

ERIC Educational Resources Information Center

Spicer, Donald Z.; Deblois, Peter B.

2004-01-01

This article features the EDUCAUSE Current Issues Survey. Administered by the EDUCAUSE Current Issues Committee, whose members review and recommend the set of issues to be presented each year, the survey identifies the issues that leaders in higher education information technology see as their most critical IT challenges. The Top-Ten current IT…

Specific issues, exact locations: case study of a community mapping project to improve safety in a disadvantaged community.

PubMed

Qummouh, Rana; Rose, Vanessa; Hall, Pat

2012-12-01

Safety is a health issue and a significant concern in disadvantaged communities. This paper describes an example of community-initiated action to address perceptions of fear and safety in a suburb in south-west Sydney which led to the development of a local, community-driven research project. As a first step in developing community capacity to take action on issues of safety, a joint resident-agency group implemented a community safety mapping project to identify the extent of safety issues in the community and their exact geographical location. Two aerial maps of the suburb, measuring one metre by two metres, were placed on display at different locations for four months. Residents used coloured stickers to identify specific issues and exact locations where crime and safety were a concern. Residents identified 294 specific safety issues in the suburb, 41.9% (n=123) associated with public infrastructure, such as poor lighting and pathways, and 31.9% (n=94) associated with drug-related issues such as drug activity and discarded syringes. Good health promotion practice reflects community need. In a very practical sense, this project responded to community calls for action by mapping resident knowledge on specific safety issues and exact locations and presenting these maps to local decision makers for further action.

To Guide or Not to Guide: Issues in the Sequencing of Pedagogical Structure in Computational Model-Based Learning

ERIC Educational Resources Information Center

Jacobson, Michael J.; Kim, Beaumie; Pathak, Suneeta; Zhang, BaoHui

2015-01-01

This research explores issues related to the sequencing of structure that is provided as pedagogical guidance. A study was conducted that involved grade 10 students in Singapore as they learned concepts about electricity using four NetLogo Investigations of Electricity agent-based models. It was found that the low-to-high structure learning…

University Students' Knowledge Structures and Informal Reasoning on the Use of Genetically Modified Foods: Multidimensional Analyses

ERIC Educational Resources Information Center

Wu, Ying-Tien

2013-01-01

This study aims to provide insights into the role of learners' knowledge structures about a socio-scientific issue (SSI) in their informal reasoning on the issue. A total of 42 non-science major university students' knowledge structures and informal reasoning were assessed with multidimensional analyses. With both qualitative and…

Top 10 IT Issues, 2007

ERIC Educational Resources Information Center

Camp, John S.; DeBlois, Peter B.

2007-01-01

The EDUCAUSE Current Issues Committee, whose members review and recommend the set of IT issues to be presented each year, conducted a Web-based survey in December 2006 to identify the five of thirty-one IT issues in each of four areas: (1) issues that are critical for strategic success; (2) issues that are expected to increase in significance; (3)…

It Top-10 Issues 2006

ERIC Educational Resources Information Center

Dewey, Barbara I.; DeBlois, Peter B.

2006-01-01

The EDUCAUSE Current Issues Committee, whose members review and recommend the set of IT issues to be presented each year, conducted a Web-based survey in December 2005 to identify the five of thirty-one IT issues in each of four areas: (1) issues that are critical for strategic success; (2) issues that are expected to increase in significance; (3)…

Identification and Characterization of Key Human Performance Issues and Research in the Next Generation Air Transportation System (NextGen)

NASA Technical Reports Server (NTRS)

Lee, Paul U.; Sheridan, Tom; Poage, james L.; Martin, Lynne Hazel; Jobe, Kimberly K.

2010-01-01

This report identifies key human-performance-related issues associated with Next Generation Air Transportation System (NextGen) research in the NASA NextGen-Airspace Project. Four Research Focus Areas (RFAs) in the NextGen-Airspace Project - namely Separation Assurance (SA), Airspace Super Density Operations (ASDO), Traffic Flow Management (TFM), and Dynamic Airspace Configuration (DAC) - were examined closely. In the course of the research, it was determined that the identified human performance issues needed to be analyzed in the context of NextGen operations rather than through basic human factors research. The main gaps in human factors research in NextGen were found in the need for accurate identification of key human-systems related issues within the context of specific NextGen concepts and better design of the operational requirements for those concepts. By focusing on human-system related issues for individual concepts, key human performance issues for the four RFAs were identified and described in this report. In addition, mixed equipage airspace with components of two RFAs were characterized to illustrate potential human performance issues that arise from the integration of multiple concepts.

Ethically-based clinical decision-making in physical therapy: process and issues.

PubMed

Finch, Elspeth; Geddes, E Lynne; Larin, Hélène

2005-01-01

The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

Identifiability of PBPK Models with Applications to ...

EPA Pesticide Factsheets

Any statistical model should be identifiable in order for estimates and tests using it to be meaningful. We consider statistical analysis of physiologically-based pharmacokinetic (PBPK) models in which parameters cannot be estimated precisely from available data, and discuss different types of identifiability that occur in PBPK models and give reasons why they occur. We particularly focus on how the mathematical structure of a PBPK model and lack of appropriate data can lead to statistical models in which it is impossible to estimate at least some parameters precisely. Methods are reviewed which can determine whether a purely linear PBPK model is globally identifiable. We propose a theorem which determines when identifiability at a set of finite and specific values of the mathematical PBPK model (global discrete identifiability) implies identifiability of the statistical model. However, we are unable to establish conditions that imply global discrete identifiability, and conclude that the only safe approach to analysis of PBPK models involves Bayesian analysis with truncated priors. Finally, computational issues regarding posterior simulations of PBPK models are discussed. The methodology is very general and can be applied to numerous PBPK models which can be expressed as linear time-invariant systems. A real data set of a PBPK model for exposure to dimethyl arsinic acid (DMA(V)) is presented to illustrate the proposed methodology. We consider statistical analy

Critical Issues in Evaluating National-Level Health Data Warehouses in LMICs: Kenya Case Study.

PubMed

Gesicho, Milka B; Babic, Ankica; Were, Martin C

2017-01-01

Low-Middle-Income-Countries (LMICs) are beginning to adopt national health data warehousing (NHDWs) for making strategic decisions and for improving health outcomes. Given the numerous challenges likely to be faced in establishment of NHDWs by LMICs, it is prudent that evaluations are done in relation to the data warehouses (DWs), in order to identify and mitigate critical issues that arise. When critic issues are not identified, DWs are prone to suboptimal implementation with compromised outcomes. Despite the fact that several publications exist on evaluating DWs, evaluations specific to health data warehouses are scanty, with almost none evaluating NHDWs more so in LMICs. This paper uses a systematic approach guided by an evaluation framework to identify critical issues to be considered in evaluating Kenya's NHDW.

PoLi: A Virtual Screening Pipeline Based On Template Pocket And Ligand Similarity

PubMed Central

Roy, Ambrish; Srinivasan, Bharath; Skolnick, Jeffrey

2015-01-01

Often in pharmaceutical research, the goal is to identify small molecules that can interact with and appropriately modify the biological behavior of a new protein target. Unfortunately, most proteins lack both known structures and small molecule binders, prerequisites of many virtual screening, VS, approaches. For such proteins, ligand homology modeling, LHM, that copies ligands from homologous and perhaps evolutionarily distant template proteins, has been shown to be a powerful VS approach to identify possible binding ligands. However, if we want to target a specific pocket for which there is no homologous holo template protein structure, then LHM will not work. To address this issue, in a new pocket based approach, PoLi, we generalize LHM by exploiting the fact that the number of distinct small molecule ligand binding pockets in proteins is small. PoLi identifies similar ligand binding pockets in a holo-template protein library, selectively copies relevant parts of template ligands and uses them for VS. In practice, PoLi is a hybrid structure and ligand based VS algorithm that integrates 2D fingerprint-based and 3D shape-based similarity metrics for improved virtual screening performance. On standard DUD and DUD-E benchmark databases, using modeled receptor structures, PoLi achieves an average enrichment factor of 13.4 and 9.6 respectively, in the top 1% of the screened library. In contrast, traditional docking based VS using AutoDock Vina and homology-based VS using FINDSITEfilt have an average enrichment of 1.6 (3.0) and 9.0 (7.9) on the DUD (DUD-E) sets respectively. Experimental validation of PoLi predictions on dihydrofolate reductase, DHFR, using differential scanning fluorimetry, DSF, identifies multiple ligands with diverse molecular scaffolds, thus demonstrating the advantage of PoLi over current state-of-the-art VS methods. PMID:26225536

A case study of the Australian Plague Locust Commission and environmental due diligence: why mere legislative compliance is no longer sufficient for environmentally responsible locust control in Australia.

PubMed

Story, Paul G; Walker, Paul W; McRae, Heath; Hamilton, John G

2005-07-01

The Australian Plague Locust Commission (APLC) manages locust populations across 2 million square kilometers of eastern Australia using the aerial application of chemical and biological control agents to protect agricultural production. This occurs via a preventative control strategy involving ultralow-volume spray equipment to distribute small droplets of control agent over a target area. The economic costs of, and potential gains stemming from, locust control are well documented. The application of insecticides, however, to fragile arid and semiarid ecosystems is a task that brings with it both real and perceived environmental issues. The APLC is proactive in addressing these issues through a combination of targeted environmental operational research, an ISO-14001-aligned Environmental Management System (EMS), and links with environmental regulatory and research institutions. Increasing due diligence components within Australian environmental legislation dictate that mere legislative compliance is no longer sufficient for industries to ensure that they meet their environmental obligations. The development of external research links and the formulation of an EMS for locust control have enabled the APLC to identify environmental issues and trends, quantify objective environmental targets and strategies, and facilitate continuous improvement in its environmental performance, while maintaining stakeholder support. This article outlines the environmental issues faced by the APLC, the research programs in place to address these issues, and the procedures in place to incorporate research findings into the organization's operational structure.

FHWA LTBP Workshop to Identify Bridge Substructure Performance Issues

DOT National Transportation Integrated Search

2013-06-01

This TechBrief provides an overview of the proceedings and findings of the "FHWA Workshop to Identify Bridge Substructure Performance Issues" held in Orlando, Florida, from March 4 to 6, 2010. The purpose of the workshop was to consider overall bridg...

ITS Institutional and Legal Issues Program : Review of the Houston Smart Commuter Operational Test

DOT National Transportation Integrated Search

1997-01-01

The purpose of this study is to identify and evaluate critical issues relating to user acceptance of CVO services by interstate truck and bus drivers and to identify the CVO information needs of other interested parties.

Effective Organizational Structures and Processes: Addressing Issues of Change

ERIC Educational Resources Information Center

Andrade, Maureen Snow

2016-01-01

This chapter describes organizational structures and processes at the institutional and project levels for the development and support of distance learning initiatives. It addresses environmental and stakeholder issues and explores principles and strategies of effective leadership for change creation and management.

Nurse managers' experience with ethical issues in six government hospitals in Malaysia: A cross-sectional study

PubMed Central

2011-01-01

Background Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. Methods A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. Results A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Conclusions Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning. PMID:22085735

Introduction: The challenge of optimum integration of propulsion systems and large space structures

NASA Technical Reports Server (NTRS)

Carlisle, R. F.

1980-01-01

A functional matrix of possible propulsion system characteristics for a spacecraft for deployable and assembled spacecraft structures shows that either electric propulsion or low thrust chemical propulsion systems could provide the propulsion required. The trade-off considerations of a single propulsion engine or multiengines are outlined and it is shown that a single point engine is bounded by some upper limit of thrust for assembled spacecraft. The matrix also shows several additional functions that can be provided to the spacecraft if a propulsion system is an integral part of the spacecraft. A review of all of the functions that can be provided for a spacecraft by an integral propulsion system may result in the inclusion of the propulsion for several functions even if no single function were mandatory. Propulsion interface issues for each combination of engines are identified.

Use Of Infrared Thermography For The Identification Of Design And Construction Faults In Buildings

NASA Astrophysics Data System (ADS)

Seeber, Stephen A.

1984-03-01

Many design and construction details can affect building energy consumption in unex-pected ways. Further, design and construction errors can increase building energy consumption, result in discomfort to building occupants and cause structural damage to the building. Infrared inspections can easily evaluate the energy efficiency of various aspects of a building's design and identify flaws that might otherwise be detected as a result of occupants' complaints or damage to the building's mechanical or structural systems. Infrared thermography can be used by the architect to evaluate his designs and by the contractor to control the quality of construction. This paper discusses a number of issues that can help determine the effectiveness of infrared building surveys. Following this, three case stud-ies will be presented to illustrate design flaws that were detected through infrared build-ing surveys.

A transatlantic perspective on 20 emerging issues in biological engineering.

PubMed

Wintle, Bonnie C; Boehm, Christian R; Rhodes, Catherine; Molloy, Jennifer C; Millett, Piers; Adam, Laura; Breitling, Rainer; Carlson, Rob; Casagrande, Rocco; Dando, Malcolm; Doubleday, Robert; Drexler, Eric; Edwards, Brett; Ellis, Tom; Evans, Nicholas G; Hammond, Richard; Haseloff, Jim; Kahl, Linda; Kuiken, Todd; Lichman, Benjamin R; Matthewman, Colette A; Napier, Johnathan A; ÓhÉigeartaigh, Seán S; Patron, Nicola J; Perello, Edward; Shapira, Philip; Tait, Joyce; Takano, Eriko; Sutherland, William J

2017-11-14

Advances in biological engineering are likely to have substantial impacts on global society. To explore these potential impacts we ran a horizon scanning exercise to capture a range of perspectives on the opportunities and risks presented by biological engineering. We first identified 70 potential issues, and then used an iterative process to prioritise 20 issues that we considered to be emerging, to have potential global impact, and to be relatively unknown outside the field of biological engineering. The issues identified may be of interest to researchers, businesses and policy makers in sectors such as health, energy, agriculture and the environment.

A comparative analysis of policies addressing rural oral health in eight English-speaking OECD countries.

PubMed

Crocombe, Leonard A; Goldberg, Lynette R; Bell, Erica; Seidel, Bastian

2017-01-01

Oral health is fundamental to overall health. Poor oral health is largely preventable but unacceptable inequalities exist, particularly for people in rural areas. The issues are complex. Rural populations are characterised by lower rates of health insurance, higher rates of poverty, less water fluoridation, fewer dentists and oral health specialists, and greater distances to access care. These factors inter-relate with educational, attitudinal, and system-level issues. An important area of enquiry is whether and how national oral health policies address causes and solutions for poor rural oral health. The purpose of this study was to examine a series of government policies on oral health to (i) determine the extent to which such policies addressed rural oral health issues, and (ii) identify enabling assumptions in policy language about problems and solutions regarding rural communities. Eight current oral health policies were identified from Australia, New Zealand, Canada, the USA, England, Scotland, Northern Ireland, and Wales. Validated content and critical discourse analyses were used to document and explore the concepts in these policy documents, with a particular focus on the frequency with which rural oral health was mentioned, and the enabling assumptions in policy language about rural communities. Seventy-three concepts relating to oral health were identified from the textual analysis of the eight policy documents. The rural concept addressing oral health issues occurred in only 2% of all policies and was notably absent from the oral health policies of countries with substantial rural populations. It occurred most frequently in the policy documents from Australia and Scotland, less so in the policy documents from Canada, Wales, and New Zealand, and not at all in the oral health policies from the US, England, and Northern Ireland. Thus, the oral health needs of rural communities were generally not the focus of, nor included in, the oral health policy documents in this study. When the language of concepts related to rural oral health was examined, the qualitative analysis identified four discourse themes related to both causality and solutions. These ranked discourse themes focused on service models, workforce issues, social determinants of health, and prevention. None of the policies addressed the structural economic determinants of unequal rural oral health, nor did they specifically assert the rights of children in rural communities to equitable oral health care. This study documented the limited focus on rural oral health that existed in national oral health policies from eight different English-speaking countries. It supports the need for an increased focus on rural oral health issues in oral health policies, particularly as increased oral health is clearly associated with increased general health. It speaks to the critical importance of periodic analysis of the content of oral health policies to ensure that issues of inequality are addressed. Further, it reinforces the need for research findings about effective oral health care to be translated into practice in the development of practical and financially viable policies to make access to oral health care more equitable, particularly for people living in rural and remote areas.

The use of neuroscientific evidence in the courtroom by those accused of criminal offenses in England and Wales

PubMed Central

Catley, Paul; Claydon, Lisa

2015-01-01

This examination of the extent of the use of neuroscientific evidence in England and Wales identifies 204 reported cases in which such evidence has been used by those accused of criminal offenses during the eight-year period from 2005–12. Based on the number of reported cases found, the use of such evidence appears well established with those accused of criminal offenses utilizing such evidence in approximately 1 per cent of cases in the Court of Appeal (Criminal Division). Neuroscientific evidence is used to quash convictions, to lead to convictions for lesser offenses and to lead to reduced sentences. In addition, cases are identified where neuroscientific evidence is used to avoid extradition, to challenge bail conditions and to resist prosecution appeals against unduly lenient sentences. The range of uses identified is wide: including challenging prosecution evidence as to the cause of death or injury, challenging the credibility of witnesses and arguing that those convicted were unfit to plead, lacked mens rea or were entitled to mental condition defenses. The acceptance of such evidence reflects the willingness of the courts in England and Wales to hear novel scientific argument, where it is valid and directly relevant to the issue(s) to be decided. Indeed, in some of the cases the courts expressed an expectation that structural brain scan evidence should have been presented to support the argument being made. PMID:27774211

The Long-Term Conditions Questionnaire: conceptual framework and item development

PubMed Central

Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A’Court, Christine; Fitzpatrick, Ray

2016-01-01

Purpose To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Materials and methods Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Results Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. Conclusion The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey. PMID:27621678

The Psychiatry OSCE: a 20-year retrospective.

PubMed

Hodges, Brian D; Hollenberg, Elisa; McNaughton, Nancy; Hanson, Mark D; Regehr, Glenn

2014-02-01

Twenty years ago researchers at the University of Toronto launched the Psychiatry Skills Assessment Project (PSAP), a research program exploring Objective Structured Clinical Examinations (OSCEs) in psychiatry. Between 1994 and 2005 PSAP produced publications on the feasibility, reliability, validity, ethics, and practical concerns of OSCEs in psychiatry. The current review has two parts: a review of the state of the art of OSCEs in psychiatry 20 years after they were introduced and documentation of the impact of the PSAP research program. A literature search identified all publications on OSCEs and psychiatry. Articles were coded thematically, and locations of agreement and controversies were identified. Bibliometric analysis identified citations of PSAP research papers, which were analyzed thematically. As of May 2013, there were 250 publications related to OSCEs in psychiatry (not including 10 PSAP papers), published in 29 different countries and ten languages. Prominent topics were the validity and acceptability of OSCEs and SPs, systems issues in adopting OSCEs in psychiatry, and the effects on learning. Eighty-eight percent of all publications cited PSAP work (300 citations). Citations were employed for four purposes: as evidence/justification (54 %); to frame replication research (14 %); to support adaptation of OSCEs in other countries and professions (15 %); and for debate (18 %). Over the past 20 years, use of OSCEs has grown steadily in psychiatry, and several national certification organizations have adopted OSCEs. PSAP work, introduced two decades ago, continues to provide a scholarly foundation for psychometric, practical, and ethical issues of interest to this field.

Issues Management and the Role of Strategic Planning. AIR 1985 Annual Forum Paper.

ERIC Educational Resources Information Center

Lozier, G. Gregory; Chittipeddi, Kumar

The integration of issues management into the institutional strategic planning process at Pennsylvania State University is discussed. The significance of issues management as an organizational process is also considered. Stages of the issues management process are: (1) scanning the external environment to identify strategic issues; (2) analyzing…

Structural Integrity and Aging-Related Issues of Helicopters

DTIC Science & Technology

2000-10-01

inherently damage lolerant , any damage- inspection in critical locations where tests have indicated tolerant features in airframe design only enhances...required, so European Rotorcraft Forum. Marseilles, France, 15- that helicopters are equipped with such features as fly- 17 September 1998 . by-wire and...fatigue Evaluation of structural integrity issues of aging helicopters. The Structure," 29 April, 1998 . extended safe-life approach encompasses the best

Chemically exfoliated Mo S2 layers: Spectroscopic evidence for the semiconducting nature of the dominant trigonal metastable phase

NASA Astrophysics Data System (ADS)

Pal, Banabir; Singh, Anjali; Sharada, G.; Mahale, Pratibha; Kumar, Abhinav; Thirupathaiah, S.; Sezen, H.; Amati, M.; Gregoratti, Luca; Waghmare, Umesh V.; Sarma, D. D.

2017-11-01

A metastable trigonal phase, existing only as small patches on a chemically exfoliated few-layered, thermodynamically stable 1 H phase of Mo S2 , is believed to critically influence the properties of Mo S2 -based devices. The electronic structure of this metastable phase is little understood in the absence of a direct experimental investigation of its electronic properties, complicated further by conflicting claims from theoretical investigations. We address this issue by investigating the electronic structure of this minority phase in chemically exfoliated Mo S2 few-layered systems by enhancing its contributions with the use of highly spatially resolved (≤120 nm resolution) photoemission spectroscopy and Raman spectroscopy in conjunction with state-of-the-art electronic structure calculations. Based on these results, we establish that the ground state of this phase, arrived at by the chemical exfoliation of Mo S2 using the usual Li intercalation technique, is a small gap (˜90 ±40 meV ) semiconductor in contrast to most claims in the literature; we also identify the specific trigonal structure it has among many suggested ones.

A stretch of residues within the protease-resistant core is not necessary for prion structure and infectivity

PubMed Central

Munoz-Montesino, Carola; Sizun, Christina; Moudjou, Mohammed; Herzog, Laetitia; Reine, Fabienne; Igel-Egalon, Angelique; Barbereau, Clément; Chapuis, Jérôme; Ciric, Danica; Laude, Hubert; Béringue, Vincent; Rezaei, Human; Dron, Michel

2017-01-01

ABSTRACT Mapping out regions of PrP influencing prion conversion remains a challenging issue complicated by the lack of prion structure. The portion of PrP associated with infectivity contains the α-helical domain of the correctly folded protein and turns into a β-sheet-rich insoluble core in prions. Deletions performed so far inside this segment essentially prevented the conversion. Recently we found that deletion of the last C-terminal residues of the helix H2 was fully compatible with prion conversion in the RK13-ovPrP cell culture model, using 3 different infecting strains. This was in agreement with preservation of the overall PrPC structure even after removal of up to one-third of this helix. Prions with internal deletion were infectious for cells and mice expressing the wild-type PrP and they retained prion strain-specific characteristics. We thus identified a piece of the prion domain that is neither necessary for the conformational transition of PrPC nor for the formation of a stable prion structure. PMID:28281924

A stretch of residues within the protease-resistant core is not necessary for prion structure and infectivity.

PubMed

Munoz-Montesino, Carola; Sizun, Christina; Moudjou, Mohammed; Herzog, Laetitia; Reine, Fabienne; Igel-Egalon, Angelique; Barbereau, Clément; Chapuis, Jérôme; Ciric, Danica; Laude, Hubert; Béringue, Vincent; Rezaei, Human; Dron, Michel

2017-01-02

Mapping out regions of PrP influencing prion conversion remains a challenging issue complicated by the lack of prion structure. The portion of PrP associated with infectivity contains the α-helical domain of the correctly folded protein and turns into a β-sheet-rich insoluble core in prions. Deletions performed so far inside this segment essentially prevented the conversion. Recently we found that deletion of the last C-terminal residues of the helix H2 was fully compatible with prion conversion in the RK13-ovPrP cell culture model, using 3 different infecting strains. This was in agreement with preservation of the overall PrP C structure even after removal of up to one-third of this helix. Prions with internal deletion were infectious for cells and mice expressing the wild-type PrP and they retained prion strain-specific characteristics. We thus identified a piece of the prion domain that is neither necessary for the conformational transition of PrP C nor for the formation of a stable prion structure.

Statistical Significance for Hierarchical Clustering

PubMed Central

Kimes, Patrick K.; Liu, Yufeng; Hayes, D. Neil; Marron, J. S.

2017-01-01

Summary Cluster analysis has proved to be an invaluable tool for the exploratory and unsupervised analysis of high dimensional datasets. Among methods for clustering, hierarchical approaches have enjoyed substantial popularity in genomics and other fields for their ability to simultaneously uncover multiple layers of clustering structure. A critical and challenging question in cluster analysis is whether the identified clusters represent important underlying structure or are artifacts of natural sampling variation. Few approaches have been proposed for addressing this problem in the context of hierarchical clustering, for which the problem is further complicated by the natural tree structure of the partition, and the multiplicity of tests required to parse the layers of nested clusters. In this paper, we propose a Monte Carlo based approach for testing statistical significance in hierarchical clustering which addresses these issues. The approach is implemented as a sequential testing procedure guaranteeing control of the family-wise error rate. Theoretical justification is provided for our approach, and its power to detect true clustering structure is illustrated through several simulation studies and applications to two cancer gene expression datasets. PMID:28099990

Link Prediction in Evolving Networks Based on Popularity of Nodes.

PubMed

Wang, Tong; He, Xing-Sheng; Zhou, Ming-Yang; Fu, Zhong-Qian

2017-08-02

Link prediction aims to uncover the underlying relationship behind networks, which could be utilized to predict missing edges or identify the spurious edges. The key issue of link prediction is to estimate the likelihood of potential links in networks. Most classical static-structure based methods ignore the temporal aspects of networks, limited by the time-varying features, such approaches perform poorly in evolving networks. In this paper, we propose a hypothesis that the ability of each node to attract links depends not only on its structural importance, but also on its current popularity (activeness), since active nodes have much more probability to attract future links. Then a novel approach named popularity based structural perturbation method (PBSPM) and its fast algorithm are proposed to characterize the likelihood of an edge from both existing connectivity structure and current popularity of its two endpoints. Experiments on six evolving networks show that the proposed methods outperform state-of-the-art methods in accuracy and robustness. Besides, visual results and statistical analysis reveal that the proposed methods are inclined to predict future edges between active nodes, rather than edges between inactive nodes.

Structural barriers at the workplace for employees with vision and locomotor disabilities in New Delhi, India.

PubMed

Saigal, Neha; Narayan, Rajeev

2014-01-01

India, a signatory to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), has 2.21% of people with disabilities to the total population of which 26% are employed (Census 2011 and 2001). Accessibility was introduced for the first time in 1995 under The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act. Article 9 of UNCRPD promotes barrier-free environment on an equal basis with others. Despite the legislation and the UN convention, structural barriers continue to be one of the largest barriers posing concern for PwDs at their workplace. To identify various physicall barriers limiting accessibility of PWDs in the formal sector in Delhi. Quantitative descriptive research design. Random sample was drawn. Structural barriers create difficulty in accessing basic amenities such as canteens, toilets etc. Disability is a human rights issue. An employee with disability is entitled to dignified life. Effective implementation of Article 9 and 27 of UNCRPD will pave a way for removing structural barriers at workplace.

PACS administrators' and radiologists' perspective on the importance of features for PACS selection.

PubMed

Joshi, Vivek; Narra, Vamsi R; Joshi, Kailash; Lee, Kyootai; Melson, David

2014-08-01

Picture archiving and communication systems (PACS) play a critical role in radiology. This paper presents the criteria important to PACS administrators for selecting a PACS. A set of criteria are identified and organized into an integrative hierarchical framework. Survey responses from 48 administrators are used to identify the relative weights of these criteria through an analytical hierarchy process. The five main dimensions for PACS selection in order of importance are system continuity and functionality, system performance and architecture, user interface for workflow management, user interface for image manipulation, and display quality. Among the subdimensions, the highest weights were assessed for security, backup, and continuity; tools for continuous performance monitoring; support for multispecialty images; and voice recognition/transcription. PACS administrators' preferences were generally in line with that of previously reported results for radiologists. Both groups assigned the highest priority to ensuring business continuity and preventing loss of data through features such as security, backup, downtime prevention, and tools for continuous PACS performance monitoring. PACS administrators' next high priorities were support for multispecialty images, image retrieval speeds from short-term and long-term storage, real-time monitoring, and architectural issues of compatibility and integration with other products. Thus, next to ensuring business continuity, administrators' focus was on issues that impact their ability to deliver services and support. On the other hand, radiologists gave high priorities to voice recognition, transcription, and reporting; structured reporting; and convenience and responsiveness in manipulation of images. Thus, radiologists' focus appears to be on issues that may impact their productivity, effort, and accuracy.