Conducting an Efficient Proactive Risk Assessment Prior to CPOE Implementation in an Intensive Care Unit

PubMed Central

Hundt, Ann Schoofs; Adams, Jean A.; Schmid, J. Andrew; Musser, Linda M.; Walker, James M.; Wetterneck, Tosha B; Douglas, Stephen V.; Paris, Bonnie L.; Carayon, Pascale

2012-01-01

Purpose To develop, conduct, and evaluate a proactive risk assessment (PRA) of the design and implementation of CPOE in an ICU. Methods We developed a PRA method based on issues identified from documented experience with conventional PRA methods and the constraints of an organization about to implement CPOE in an intensive care unit. The PRA method consists of three phases: planning (three months), team (one five-hour meeting), and evaluation (short- and long-term). Results Sixteen unique relevant vulnerabilities were identified as a result of the PRA team’s efforts. Negative consequences resulting from the vulnerabilities included potential patient safety and quality of care issues, non-compliance with regulatory requirements, increases in cognitive burden on CPOE users, and/or worker inconvenience or distress. Actions taken to address the vulnerabilities included redesign of the technology, process (workflow) redesign, user training, and/or ongoing monitoring. Verbal and written evaluation by the team members indicated that the PRA method was useful and that participants were willing to participate in future PRAs. Long-term evaluation was accomplished by monitoring an ongoing “issues list” of CPOE problems identified by or reported to IT staff. Vulnerabilities identified by the team were either resolved prior to CPOE implementation (n = 7) or shortly thereafter (n = 9). No other issues were identified beside those identified by the team. Conclusions Generally positive results from the various evaluations including a long-term evaluation demonstrate the value of developing an efficient PRA method that meets organizational and contextual requirements and constraints. PMID:22608242

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

PubMed

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

2014-08-01

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

Safety Issues at the DOE Test and Research Reactors. A Report to the U.S. Department of Energy.

ERIC Educational Resources Information Center

National Academy of Sciences - National Research Council, Washington, DC. Commission on Physical Sciences, Mathematics, and Resources.

This report provides an assessment of safety issues at the Department of Energy (DOE) test and research reactors. Part A identifies six safety issues of the reactors. These issues include the safety design philosophy, the conduct of safety reviews, the performance of probabilistic risk assessments, the reliance on reactor operators, the fragmented…

In-situ medical simulation for pre-implementation testing of clinical service in a regional hospital in Hong Kong.

PubMed

Chen, P P; Tsui, N Tk; Fung, A Sw; Chiu, A Hf; Wong, W Cw; Leong, H T; Lee, P Sf; Lau, J Yw

2017-08-01

The implementation of a new clinical service is associated with anxiety and challenges that may prevent smooth and safe execution of the service. Unexpected issues may not be apparent until the actual clinical service commences. We present a novel approach to test the new clinical setting before actual implementation of our endovascular aortic repair service. In-situ simulation at the new clinical location would enable identification of potential process and system issues prior to implementation of the service. After preliminary planning, a simulation test utilising a case scenario with actual simulation of the entire care process was carried out to identify any logistic, equipment, settings or clinical workflow issues, and to trial a contingency plan for a surgical complication. All patient care including anaesthetic, surgical, and nursing procedures and processes were simulated and tested. Overall, 17 vital process and system issues were identified during the simulation as potential clinical concerns. They included difficult patient positioning, draping pattern, unsatisfactory equipment setup, inadequate critical surgical instruments, blood products logistics, and inadequate nursing support during crisis. In-situ simulation provides an innovative method to identify critical deficiencies and unexpected issues before implementation of a new clinical service. Life-threatening and serious practical issues can be identified and corrected before formal service commences. This article describes our experience with the use of simulation in pre-implementation testing of a clinical process or service. We found the method useful and would recommend it to others.

Preparing students for the ethical challenges on international health electives: A systematic review of the literature on educational interventions.

PubMed

Rahim, Anika; Knights Née Jones, Felicity; Fyfe, Molly; Alagarajah, Janagan; Baraitser, Paula

2016-09-01

International health electives pose specific ethical challenges for students travelling from to low and middle income countries. We undertook a systematic review of the literature on interventions to prepare students to identify ethical issues addressed, educational approaches and to collate evidence on the effectiveness of different strategies. We searched nine electronic databases of peer-reviewed literature and identified grey literature through key word searches; supplemented through citation mapping and expert consultation. Articles that described ethical training conducted by universities or professional bodies were included for review. We reviewed forty-four full text articles. Ten sources of published literature and seven sources of grey literature met our inclusion criteria. We identified thirteen ethical situations that students should be prepared to manage and eight generic skills to support this process. Most interventions were delivered before the elective, used case studies or guidelines. Some suggested ethical principles or a framework for analysis of ethical issues. Only two papers evaluated the intervention described. Our paper collates a small but growing body of work on education to prepare students to manage ethical issues. Ethical training should have elements that are delivered before, during and after the elective. Interventions should include case studies covering thirteen ethical issues identified here, linked to ethical principles and a process for responding to ethical issues. We suggest that evaluations of interventions are an important area for future research.

Checklists of Methodological Issues for Review Authors to Consider When Including Non-Randomized Studies in Systematic Reviews

ERIC Educational Resources Information Center

Wells, George A.; Shea, Beverley; Higgins, Julian P. T.; Sterne, Jonathan; Tugwell, Peter; Reeves, Barnaby C.

2013-01-01

Background: There is increasing interest from review authors about including non-randomized studies (NRS) in their systematic reviews of health care interventions. This series from the Ottawa Non-Randomized Studies Workshop consists of six papers identifying methodological issues when doing this. Aim: To format the guidance from the preceding…

Invasion Science: A Horizon Scan of Emerging Challenges and Opportunities

Treesearch

Anthony Ricciardi; Tim M. Blackburn; James T. Carlton; Jaimie T.A. Dick; Philip E. Hulme; Josephine C. Iacarella; Jonathan M. Jeschke; Andrew M. Liebhold; Julie L. Lockwood; Hugh J. MacIsaac; Petr Pyšek; David M. Richardson; Gregory M. Ruiz; Daniel Simberloff; William J. Sutherland; David A. Wardle; David C. Aldridge

2017-01-01

We identified emerging scientific, technological, and sociopolitical issues likely to affect how biological invasions are studied and managed over the next two decades. Issues were ranked according to their probability of emergence, pervasiveness, potential impact, and novelty. Top-ranked issues include the application of genomic modification tools to control invasions...

Ethical issues in medical research in the developing world: a report on a meeting organised by Fondation Mérieux.

PubMed

Perrey, Christophe; Wassenaar, Douglas; Gilchrist, Shawn; Ivanoff, Bernard

2009-08-01

This paper reports on a multidisciplinary meeting held to discuss ethical issues in medical research in the developing world. Many studies, including clinical trials, are conducted in developing countries with a high burden of disease. Conditions under which this research is conducted vary because of differences in culture, public health, political, legal and social contexts specific to these countries. Research practices, including standards of care for participants, may vary as a result. It is therefore not surprising that ethical issues emerge. This meeting sought to identify and discuss these issues from the perspectives of the many actors in such research, including community representatives, with a view to finding ethical and pragmatic solutions to these issues. Dialogue between these actors was also promoted, with a view to identifying the need to develop such dialogue in future. Drawing from the experiences of the speakers, the colloquium attempted to outline some answers to several key questions characterising the field today. Experiences related to epidemiologic research, vaccine trials, drug trials, diagnostic tests and to some fundamental ethical issues in health research. Speakers were from different countries, disciplines and professions. The meeting provided a forum for consultation and debate between different ethics actors. Both encouraging findings and challenges emerged.

Supervisory needs of research doctoral students in a university teaching hospital setting.

PubMed

Caldwell, Patrina Hy; Oldmeadow, Wendy; Jones, Cheryl A

2012-10-01

Teaching hospitals affiliated with universities are now common sites for research higher degree supervision. We hypothesised that the hospital environment poses unique challenges to supervision compared with the traditional university research institute setting. This study aimed to identify and rank important supervision issues in a clinical setting from the students' perspective. Using the Delphi method to explore issues and facilitate consensus, small group discussions were conducted with 10 research doctoral students from a tertiary teaching hospital. We identified supervision issues that are unique to the hospital-based context. These include the demands placed on supervisors combining clinical and supervisory roles, the challenges of academic medical/scientific writing and career issues for students who are already established in their professions. Other issues identified, common to all doctoral students, include differing expectations between students and supervisors (with students wanting support for their career plans, training in research skills and increasing autonomy and responsibility), supervisor access, quality and frequency of meetings, lack of training in writing and dealing with conflicts. Our research identified that postgraduate students of supervisors who combine clinical and supervisory roles report significant issues with supervision, some of which are unique to the clinical setting. Clinician researchers who supervise postgraduate students need to balance clinical and supervisory responsibilities, identify and negotiate student expectations early in candidature and provide career counselling to students who are already highly experienced. Furthermore, clinician supervisors should undertake postgraduate supervisor training programme tailored to the hospital setting to better support their students. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

42 CFR 422.503 - General provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... activities, the furnishing of services, the quality improvement program, and the administrative and... program, including but not limited to reporting potential issues, investigating issues, conducting self... raised, investigating potential compliance problems as identified in the course of self-evaluations and...

Ethical issues with colorectal cancer screening-a systematic review.

PubMed

Hofmann, Bjørn

2017-06-01

Colorectal cancer (CRC) screening is widely recommended and implemented. However, sometimes CRC screening is not implemented despite good evidence, and some types of CRC screening are implemented despite lack of evidence. The objective of this article is to expose and elucidate relevant ethical issues in the literature on CRC screening that are important for open and transparent deliberation on CRC screening. An axiological question-based method is used for exposing and elucidating ethical issues relevant in HTA. A literature search in MEDLINE, Embase, PsycINFO, PubMed Bioethics subset, ISI Web of Knowledge, Bioethics Literature Database (BELIT), Ethics in Medicine (ETHMED), SIBIL Base dati di bioetica, LEWI Bibliographic Database on Ethics in the Sciences and Humanities, and EUROETHICS identified 870 references of which 114 were found relevant according to title and abstract. The content of the included papers were subject to ethical analysis to highlight the ethical issues, concerns, and arguments. A wide range of important ethical issues were identified. The main benefits are reduced relative CRC mortality rate, and potentially incidence rate, but there is no evidence of reduced absolute mortality rate. Potential harms are bleeding, perforation, false test results, overdetection, overdiagnosis, overtreatment (including unnecessary removal of polyps), and (rarely) death. Other important issues are related to autonomy and informed choice equity, justice, medicalization, and expanding disease. A series of important ethical issues have been identified and need to be addressed in open and transparent deliberation on CRC screening. © 2016 John Wiley & Sons, Ltd.

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

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.

Current Issues for Higher Education Information Resources Management.

ERIC Educational Resources Information Center

CAUSE/EFFECT, 1996

1996-01-01

Issues identified as important to the future of information resources management and use in higher education include information policy in a networked environment, distributed computing, integrating information resources and college planning, benchmarking information technology, integrated digital libraries, technology integration in teaching,…

CACD Journal, 2001.

ERIC Educational Resources Information Center

Wickwire, Pat Nellor, Ed.

2001-01-01

This journal of the California Association for Counseling and Development attempts to identify the current issues of concern in the counseling field and share research to help improve the professional learning community. The articles in this issue include: "The Editor's Message" (Pat Nellor Wickwire); "The CACD President's…

CACD Journal, 2000.

ERIC Educational Resources Information Center

Wickwire, Pat Nellor, Ed.

2000-01-01

This journal of the California Association for Counseling and Development attempts to identify the current issues of concern in the counseling field and share research to help improve the professional learning community. The articles in this issue include: "The Editor's Message" (Pat Nellor Wickwire); "The CACD President's…

A Re-Examination of Educational Issues.

ERIC Educational Resources Information Center

Kitano, Margie

This paper suggests how an anthropological perspective can help educators rethink important educational issues, including multicultural education, leadership training, and educational processes. Opening sections of the paper define anthropology (the study of human beings and their ways of life), and identify anthropological concepts and principles…

Gifted and Talented Students. IDRA Focus.

ERIC Educational Resources Information Center

IDRA Newsletter, 1998

1998-01-01

This theme issue includes five articles that focus on issues surrounding gifted and talented students, especially as they relate to poor, minority, or limited-English-proficient children. "Traditional Methods of Identifying Gifted Students Overlooks Many" (Linda Cantu) presents findings from the National Educational Longitudinal Study…

Electrical and chemical interactions at Mars Workshop, part 1

NASA Technical Reports Server (NTRS)

1992-01-01

The Electrical and Chemical Interactions at Mars Workshop, hosted by NASA Lewis Research Center on November 19 and 20, 1991, was held with the following objectives in mind: (1) to identify issues related to electrical and chemical interactions between systems and their local environments on Mars, and (2) to recommend means of addressing those issues, including the dispatch of robotic spacecraft to Mars to acquire necessary information. The workshop began with presentations about Mars' surface and orbital environments, Space Exploration Initiative (SEI) systems, environmental interactions, modeling and analysis, and plans for exploration. Participants were then divided into two working groups: one to examine the surface of Mars; and the other, the orbit of Mars. The working groups were to identify issues relating to environmental interactions; to state for each issue what is known and what new knowledge is needed; and to recommend ways to fulfill the need. Issues were prioritized within each working group using the relative severity of effects as a criterion. Described here are the two working groups' contributions. A bibliography of materials used during the workshop and suggested reference materials is included.

A horizon scan of global conservation issues for 2013.

PubMed

Sutherland, William J; Bardsley, Sarah; Clout, Mick; Depledge, Michael H; Dicks, Lynn V; Fellman, Liz; Fleishman, Erica; Gibbons, David W; Keim, Brandon; Lickorish, Fiona; Margerison, Ceri; Monk, Kathryn A; Norris, Kenneth; Peck, Lloyd S; Prior, Stephanie V; Scharlemann, Jörn P W; Spalding, Mark D; Watkinson, Andrew R

2013-01-01

This paper presents the findings of our fourth annual horizon-scanning exercise, which aims to identify topics that increasingly may affect conservation of biological diversity. The 15 issues were identified via an iterative, transferable process by a team of professional horizon scanners, researchers, practitioners, and a journalist. The 15 topics include the commercial use of antimicrobial peptides, thorium-fuelled nuclear power, and undersea oil production. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Case Study of Professional Boundary Issues Experienced by Undergraduate Psychology Students in a Supervised Field Experience Course

ERIC Educational Resources Information Center

Sharp, Gwen; Yao, Richard; Cresiski, Robin; Hahn, Kate

2013-01-01

There has been little research on the types of boundary issues encountered in undergraduate psychology field experience courses, despite the increased popularity of such courses. This case study identifies the frequency and types of boundary issues faced by undergraduate psychology students enrolled in such a course, including the most common…

Gender-based violence: concepts, methods, and findings.

PubMed

Russo, Nancy Felipe; Pirlott, Angela

2006-11-01

The United Nations has identified gender-based violence against women as a global health and development issue, and a host of policies, public education, and action programs aimed at reducing gender-based violence have been undertaken around the world. This article highlights new conceptualizations, methodological issues, and selected research findings that can inform such activities. In addition to describing recent research findings that document relationships between gender, power, sexuality, and intimate violence cross-nationally, it identifies cultural factors, including linkages between sex and violence through media images that may increase women's risk for violence, and profiles a host of negative physical, mental, and behavioral health outcomes associated with victimization including unwanted pregnancy and abortion. More research is needed to identify the causes, dynamics, and outcomes of gender-based violence, including media effects, and to articulate how different forms of such violence vary in outcomes depending on cultural context.

Public Policy Issues on the Horizon.

ERIC Educational Resources Information Center

Business Officer, 1997

1997-01-01

The National Association of College and University Business Officers (NACUBO) has identified public policy issues of interest to its membership in 1997, including those in budget and appropriations, college costs and pricing, distance learning and technology, environmental health and safety, federal audit and accounting standards, Higher Education…

Issues in the Sphere of Elder Abuse and Neglect: The Role of Education.

ERIC Educational Resources Information Center

Kingston, Paul; Penhale, Bridget

1997-01-01

Issues related to elder abuse and neglect should be systematically addressed in nursing curricula, including ways to identify abuse at the macro, mezzo, and micro levels and the inclusion of the views of elders in the educational process. (SK)

Health Care Needs and Care Utilization Among Lesbian, Gay, Bisexual, and Transgender Populations in New Jersey.

PubMed

Qureshi, Rubab I; Zha, Peijia; Kim, Suzanne; Hindin, Patricia; Naqvi, Zoon; Holly, Cheryl; Dubbs, William; Ritch, Wendy

2018-01-01

The purpose of this study was to explore prevalent health issues, perceived barriers to seeking health care, and utilization of health care among lesbian, gay, bisexual, and transgender (LGBT) populations in New Jersey. A cross-sectional online survey was administered to 438 self-identified LGBT people. Results identified health needs, which included management of chronic diseases, preventive care for risky behaviors, mental health issues, and issues related to interpersonal violence. Barriers to seeking health care included scarceness of health professionals competent in LGBT health, inadequate health insurance coverage and lack of personal finances, and widely dispersed LGBT inclusive practices making transportation difficult. There is a need for better preparation of health care professionals who care for LGBT patients, to strengthen social services to improve access and for better integration of medical and social services.

Stresses and satisfactions of the two-pharmacist relationship.

PubMed

Stanton, A L; Berger, B A

1987-12-01

Potential advantages and disadvantages of dual-career relationships are identified, and strategies for addressing common issues encountered by dual-career couples are presented. With regard to career issues, clarification of expectations and discussion between partners regarding career commitment, job selection and mobility, and maintenance of professional identity is emphasized. Benefits of dual-career relationships include shared occupational interests, financial rewards, and respect for each partner's professional expertise. Strategies for managing domestic responsibilities include modifying standards, setting priorities, and distributing tasks evenly among family members. Pharmacist couples who are parents have chosen several routes in managing child-care issues, including postponing childbearing until each adult's career is established, decreasing one partner's career involvement, and hiring community or in-home caretakers. Sharing equally in child care can help prevent an excessive workload for one parent. Progressive family-oriented employment practices may also aid dual-career couples with children. Striking a balance between career and family is identified as perhaps the most challenging task facing the dual-career couple; time distribution must be adjusted according to the couple's priorities. Identifying realistic priorities, negotiating honestly regarding attainment of mutual and individual goals, and maintaining flexibility are key in achieving success in the professional and private lives of two-pharmacist couples.

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.

Quality Control Review of the Defense Contract Management Agency Internal Review Audit Function

DTIC Science & Technology

2013-04-18

DMI-2011-001, “Audit of DCMA Telework Program,” November 29, 2011, we identified issues with independence. For the Audit of DCMA Telework Program...and Audit of DCMA Telework Program, we identified issues with audit planning. Specifically, we found that both audits did not include documentation...of fraud risks had been performed during audit planning. For the audit of the DCMA Telework Program, steps were added to the audit program to

Can Faculty Afford Honors?

ERIC Educational Resources Information Center

Guzy, Annmarie

2012-01-01

In "Costs and Benefits in the Economy of Honors," Richard Badenhausen identifies several pressing issues regarding the economic status of honors in the current financial climate of higher education, including the role of faculty in addressing those issues. In her response to Badenhausen's essay, Annmarie Guzy, a faculty member at the…

The Teacher/Scientist: From Trainer to Educator.

ERIC Educational Resources Information Center

Ellerbrock, Michael J.

Problems and issues in U.S. undergraduate education are identified, and 10 recommendations for improvement are offered. Specific reference is made to agriculture faculty. Problems and issues include: current emphasis on academic specialization rather than the development of integrated, holistic students; the purpose of a liberal education versus…

Issues Affecting Cross-Cultural Adaptation of International Graduate Students

ERIC Educational Resources Information Center

Hartshorne, Richard; Baucom, Jennifer

2007-01-01

The purpose of this study was to identify and analyze the adjustment problems encountered by international graduate students enrolled in American universities. Issues of interest included motives for attending graduate school, factors involved in facilitating and constraining the graduate school experience, personality traits that contribute to…

Baccalaureate Degrees at Ontario Colleges: Issues and Implications

ERIC Educational Resources Information Center

Panacci, Adam G.

2014-01-01

This paper identifies and examines major issues and implications of the proposal to substantially increase the number of applied baccalaureate degrees offered by Ontario's Colleges of Applied Arts and Technology, including increasing four-year applied degree offerings and introducing three-year applied degrees. Currently, provincial legislation…

A Feminist Multicultural Perspective on Supervision

ERIC Educational Resources Information Center

Nelson, Mary Lee; Gizara, Sharon; Hope, Anna Crombach; Phelps, Rosemary; Steward, Robbie; Weitzman, Lauren

2006-01-01

Sixteen members of the Section for the Advancement of Women conference work group identified themes and issues relevant to a feminist multicultural perspective on supervision. Issues raised included feminist silence and White privilege, the importance of self-examination, the courage to be anxious, personal commitment to uncertainty, and isolation…

Crew Factors in Flight Operations. 11; A Survey of Fatigue Factors in Regional Airline Operations

NASA Technical Reports Server (NTRS)

Co, Elizabeth L.; Gregory, Kevin B.; Johnson, Julie M.; Rosekind, Mark R.

1999-01-01

This report is the eleventh in a series on the physiological effects of flight operations on flight crews. A 119-question survey was completed by 1,424 flight crewmembers from 26 regional carriers to identify factors contributing to fatigue in regional airline operations. Eighty-nine percent of crewmembers identified fatigue as a moderate or serious concern with 88% reporting that it was a common occurrence and 92% reporting that, when it occurs, fatigue represents a moderate or serious safety issue. However, 86% reported they received no company training addressing fatigue issues. Identified fatigue factors included multiple flight segments, scheduling considerations, varying regulations, and others. The two most commonly cited fatigue factors regarded flying multiple (more than four) segments. Scheduling factors accounted for nine of the ten most common recommendations to reduce fatigue in regional operations. Differing requirements among regulations were cited as contributing to fatigue. Other identified factors were the flight deck environment, automation, and diet. The data suggested specific recommendations, including education of industry personnel about fatigue issues and examination of scheduling practices. Education plays a critical role in any effort to address fatigue. Analyzing scheduling practices and identifying potential improvements may result in reduced fatigue as well as other benefits to operations.

Joint federal research and development process to meet state and local needs. Part 1. Science and technology and political decision making

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

Wise, H F; Smith, L K; Einsweiler, R C

This part of the handbook addresses the basic how to do it - how states and local governments can identify complex and cross-cutting issues and develop and manage scientific and technical resources in seeking policy solutions to such issues. The following subjects are discussed: background statement of the issue; the research/decision-making process; defining problems and identifying research components; research and decision-making strategies; how to identify existing knowledge or ongoing research in the area of policy concern; and managing multi-disciplinary research. The fourteen agencies involved in this effort include: US Departments of Energy, Agriculture, Transportation, Housing and Urban Development, Environmental Protectionmore » Agency, and National Science Foundation. (PSB)« less

Issues in Developing the IFSP: A Framework for Establishing Family Outcomes.

ERIC Educational Resources Information Center

Beckman, Paula J.; Bristol, Marie M.

1991-01-01

This paper identifies four key issues in the implementation of Individualized Family Service Plans (IFSPs) to provide services to young handicapped children as required by Public Law 99-457. These include sensitivity to cultural diversity, family assessment, intrusiveness, and establishing family outcomes. A typology of family outcomes which…

Issues Involved in the Evaluation of Gifted Programmes.

ERIC Educational Resources Information Center

Ali, A. Sidiq

2001-01-01

This article discusses the purpose of gifted program evaluation and identifies some of the pertinent issues involved in evaluating gifted programs. The gifted program delivered by the Peel District Board of Education in Ontario, Canada, is used to illustrate key evaluation considerations, including gifted identification procedures and gifted…

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

ERIC Educational Resources Information Center

Simmonds Patience L.; Ingold, Jane L.

2002-01-01

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

Internet Safety Issues for Adolescents and Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Buijs, Petra C. M.; Boot, Erik; Shugar, Andrea; Fung, Wai Lun Alan; Bassett, Anne S.

2017-01-01

Background: Research on Internet safety for adolescents has identified several important issues including unwanted exposure to sexual material and sexual solicitation. Methods: Although individuals with intellectual disabilities often have poor insight and judgment, and may therefore be at risk for Internet dangers, there is surprisingly little…

Sustainable Electronic Roadmap and Forum Summary; Sustainable Electronics Forum, October 15-18, 2012, Racine, WI

EPA Science Inventory

The Roadmap presents critical issues and research questions for each theme. For Theme 1, the issues for limiting the harm from materials and process in electronics industry include identifying the chemicals in products, production process, in the extraction of virgin materials, i...

Community Colleges in the Highway: Major Issues for Technology Planning.

ERIC Educational Resources Information Center

Moquin, Bert; Travis, Jon E.

1999-01-01

Rates the importance of planning topics, as identified by technology personnel at Texas community colleges, related to the information superhighway (ISH). Finds, through a Delphi study, that significant issues that should be considered in strategic technology planning include training, cost, planning, security/legal, uses and innovations,…

The IRS Work Plan: IRS Official Identifies Hot Issues.

ERIC Educational Resources Information Center

Owens, Marcus

1993-01-01

A federal tax official specializing in tax-exempt organizations discusses the relatively new use of coordinated examination audits. Significant issues being raised as the use of such audits expands are examined, including employment tax, contractors, withholding on students, unrelated business income, bond financing, the audit process, corporate…

Considering the Challenges of Counselling Practice in Schools

ERIC Educational Resources Information Center

Low, Poi Kee

2009-01-01

School counselling is developing rapidly in many countries around the World. As with any practice in a secondary setting, challenges and special issues are often identified, discussed, and managed. These can be categorized into four distinct domains: 1) Internal challenges, which include issues related to clientele groups, teachers' attitudes…

Business Speaks: A Study of the Themes in Speeches by America's Corporate Leaders.

ERIC Educational Resources Information Center

Myers, Robert J.; Kessler, Martha Stout

1980-01-01

Identifies the issues concerning the American business community as reflected in speeches by corporate leaders on government regulation, energy, capital investment, inflation, the public image of business, and international business. Strategies for dealing with these issues include increased social responsibility, influencing government policy,…

Trend Shifts Evident on College Campuses.

ERIC Educational Resources Information Center

Blackburn, Richard D.

1987-01-01

Campus issues and trends identified by college union and student activities administrators are considered. The major college issue is alcohol and its impact on the campus. Since all but eight states have adopted the 21 drinking age, there are many administrative concerns, including monitoring campus alcohol service and finding alternatives for pub…

Experimental evaluation of candidate graphical microburst alert displays

NASA Technical Reports Server (NTRS)

Wanke, Craig R.; Hansman, R. John

1992-01-01

A piloted flight simulator experiment was conducted to evaluate issues related to the display of microburst alerts on electronic cockpit instrumentation. Issues addressed include display clarity, usefulness of multilevel microburst intensity information, and whether information from multiple sensors should be presented separately or 'fused' into combined alerts. Nine active airline pilots of 'glass cockpit' aircraft participated in the study. Microburst alerts presented on a moving map display were found to be visually clear and useful to pilots. Also, multilevel intensity information coded by colors or patterns was found to be important for decision making purposes. Pilot opinion was mixed on whether to 'fuse' data from multiple sensors, and some resulting design tradeoffs were identified. The positional information included in the graphical alert presentation was found useful by the pilots for planning lateral missed approach maneuvers, but may result in deviations which could interfere with normal airport operations. A number of flight crew training issues were also identified.

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.

Discussion of Priorities

NASA Technical Reports Server (NTRS)

2003-01-01

The Microgravity Science Division identifies four priority ratings for microgravity research and technology issues: 1) Critical; 2) Severely Limiting; 3) Enhancements; 4) Communication. Reduced gravity instabilities are critical, while severely limiting issues include phase separation, phase change, and flow through components. Enhancements are listed for passive phase separation and phase change. This viewgraph presentation also classifies microgravity issues as spaceflight, ground-based, or other for the time periods 2003-2008, 2009-2015, and beyond.

A web-based tool for the Comprehensive Unit-based Safety Program (CUSP).

PubMed

Pronovost, Peter J; King, Jay; Holzmueller, Christine G; Sawyer, Melinda; Bivens, Shauna; Michael, Michelle; Haig, Kathy; Paine, Lori; Moore, Dana; Miller, Marlene

2006-03-01

An organization's ability to change is driven by its culture, which in turn has a significant impact on safety. The six-step Comprehensive Unit-Based Safety Program (CUSP) is intended to improve local culture and safety. A Web-based project management tool for CUSP was developed and then pilot tested at two hospitals. HOW ECUSP WORKS: Once a patient safety concern is identified (step 3), a unit-level interdisciplinary safety committee determines issue criticality and starts up the projects (step 4), which are managed using project management tools within eCUSP (step 5). On a project's completion, the results are disseminated through a shared story (step 6). OSF St. Joseph's Medical Center-The Medical Birthing Center (Bloomington, Illinois), identified 11 safety issues, implemented 11 projects, and created 9 shared stories--including one for its Armband Project. The Johns Hopkins Hospital (Baltimore) Medical Progressive Care (MPC4) Unit identified 5 safety issues and implemented 4 ongoing projects, including the intravenous (IV) Tubing Compliance Project. The eCUSP tool's success depends on an organizational commitment to creating a culture of safety.

International adoption: a health and developmental prospective.

PubMed

Mason, Patrick; Narad, Christine

2005-02-01

Adoptions from international countries have become an option for many US families, with over 150,000 children adopted in the past 14 years. Typically, internationally adopted children present with a host of medical and developmental concerns. Issues such as growth stunting, abnormal behaviors, and significant delays in motor, speech, and language development are likely directly related to the prenatal and early postnatal environment experienced prior to adoption. The new family and its health-care team must quickly work to identify and address these issues to aid the child's integration into his or her new family. This article will examine potential issues seen in children who are being adopted, including the impact of early environment on subsequent development. We will summarize early and long-term medical issues and review the extent of developmental delays seen in children adopted internationally. Finally, we will discuss possible mechanisms leading to the observed delays, including the impact of stress on subsequent development. By understanding the extent of expected delays and the mechanisms likely causing the issues, the health-care team will be in a good position to quickly identify and develop intervention protocols that will foster the child's assimilation into his or her new family.

Listening for Prescriptions: A National Consultation on Pharmaceutical Policy Issues

PubMed Central

Morgan, Steve; Cunningham, Colleen M.

2010-01-01

Objectives and Methods: Pharmaceutical policy is an increasingly costly, essential and challenging component of health system management. We sought to identify priority pharmaceutical policy issues in Canada and to translate them into research priorities using key informant interviews, stakeholder surveys and a deliberative workshop. Results: We found consensus on overarching policy goals: to provide all Canadians with equitable and sustainable access to necessary medicines. We also found widespread frustration that many key pharmaceutical policy issues in Canada — including improving prescription drug financing and pricing — have been persistent challenges owing to a lack of policy coordination. The coverage of extraordinarily costly medicines for serious conditions was identified as a rapidly emerging policy issue. Conclusion: Targeted research and knowledge translation activities can help address key policy issues and, importantly, challenges of policy coordination in Canada and thereby reduce inequity and inefficiency in policy approaches and outcomes. PMID:22043223

Aging Action: A Course in Senior Advocacy in Kansas.

ERIC Educational Resources Information Center

Kansas State Advisory Council on Aging, Topeka.

Skills useful in advocacy of senior citizens' needs are discussed in this manual. The topics included are: (1) the meaning of advocacy; (2) assertiveness training for aging-action; (3) identifying issues; (4) choosing issues; (5) developing a plan of action; (6) organizing; (7) legislative advocacy; (8) criteria to evaluate potential legislative…

Public Relations State-of-the-Art 2000: A Shift in Perception.

ERIC Educational Resources Information Center

White, Maureen E.

This paper begins by examining various definitions of public relations and reviewing the history of the profession. The paper then identifies critical concerns, issues, and trends that both the public relations practitioner and the public will face in the future. These issues include ethics, community relations, communication theory and research,…

75 FR 47616 - Intent To Prepare an Environmental Impact Statement for the Proposed Fee-to-Trust Conveyance of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... scoping meeting to identify potential issues and content for inclusion in the environmental impact... 1000-room hotel, restaurants, retail establishments, entertainment facilities, a spa and health club... employee parking. Significant issues to be covered during the scoping process may include, but are not...

Faculty Workload Studies: Perspectives, Needs, and Future Directions. ERIC Digest.

ERIC Educational Resources Information Center

Meyer, Katrina A.

This digest reviews the literature and discusses issues concerning college faculty workload. Trends in the United States which have created interest in faculty workload issues are identified including faltering state economies in the late 1980s and rising costs of higher education especially of personnel. Criticism of higher education by the…

Legal Issues in Higher Education.

ERIC Educational Resources Information Center

Branton, Wiley A.

1984-01-01

Legal problems that colleges and universities might avoid are identified. Colleges are being sued over a broad range of legal issues and are expending money for legal and court fees, settlements, and judgments. Legal problems include right of admission to particular colleges, the right to stay in school, questions of faculty promotion and tenure,…

Listing of Issues in American Elementary and Secondary Education, 1979. Interim Report.

ERIC Educational Resources Information Center

McBain, Susan; And Others

This document lists issues in elementary and secondary education which were identified by a review of education journals and newspapers, including: Congressional Quarterly, Education Daily, Education U.S.A., Harvard Educational Review, National Journal, Newsweek, New York Times, Phi Delta Kappan, School Review, Time, Wall Street Journal, and…

Teachers Teaching Teachers (T3)[TM]. Volume 4, Number 6

ERIC Educational Resources Information Center

von Frank, Valerie, Ed.

2009-01-01

"Teachers Teaching Teachers" ("T3") focuses on coaches' roles in the professional development of teachers. Each issue also explores the challenges and rewards that teacher leaders encounter. This issue includes: (1) Values and Clarity Build Classroom Language (Valerie von Frank); (2) Tools: Identifying and Clarifying Beliefs about Learning; (3)…

The Imperative of Solving Nurses' Usability Problems With Health Information Technology.

PubMed

Staggers, Nancy; Elias, Beth L; Makar, Ellen; Alexander, Gregory L

2018-04-01

Health information technology (IT) usability issues are a key concern for nurse executives and nurses. The aims of this study are to understand usability pain points faced by nurses regarding the use of health IT, identify their impact and importance, discuss responsibilities, and develop possible solutions to improve the health IT-user experience for nurses. Twenty-seven experts were interviewed including nursing leaders, informaticists, executives, engineers, researchers, and human factors experts across acute care, long-term care, and vendor settings. Semistructured questions guided the interviews, and content analysis was used to identify themes. Four themes emerged: 1) user experience pain points, 2) importance of the issues, 3) the responsibility gap, and 4) acting on usability issues. Nurses continue to endure significant health IT-usability issues that negatively impact patients, nurses, and healthcare organizations. Solutions include enhancing the voice of nursing at the national and local levels, creating a digital strategy for nursing, providing incentives to improve usability in health IT, and accelerating the understanding of nurses' work intended to inform and translate nurses' work into health IT design.

An introduction to intellectual property licensing for technology companies

NASA Astrophysics Data System (ADS)

Meier, Lawrence H.

2001-05-01

Intellectual property licensing is an important issue facing all technology companies. Before entering into license agreements a number of issues need to be addressed, including invention ownership, obtaining and identifying licensable subject matter, and developing a licensing strategy. There are a number of important provisions that are included in most intellectual property license agreements. These provisions include definitions, the license grant, consideration, audit rights confidentiality, warranties, indemnification, and limitation of liability. Special licensing considerations exist relative to each type of intellectual property, and when the other party is a foreign company or a university.

Fluorescence techniques in agricultural applications

NASA Astrophysics Data System (ADS)

McMurtrey, James E.; Corp, Lawrence A.; Kim, Moon S.; Chappelle, Emmett W.; Daughtry, Craig S. T.; DiBenedetto, J. D.

2001-03-01

Intellectual property licensing is an important issue facing all technology companies. Before entering into license agreements a number of issues need to be addressed, including invention ownership, obtaining and identifying licensable subject matter, and developing a licensing strategy. There are a number of important provisions that are included in most intellectual property license agreements. These provisions include definitions, the license grant, consideration, audit rights, confidentiality, warranties, indemnification, and limitation of liability. Special licensing considerations exist relative to each type of intellectual property, and when the other party is a foreign company or a university.

DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale

PubMed Central

Hasin, Deborah S.; O’Brien, Charles P.; Auriacombe, Marc; Borges, Guilherme; Bucholz, Kathleen; Budney, Alan; Compton, Wilson M.; Crowley, Thomas; Ling, Walter; Petry, Nancy M.; Schuckit, Marc; Grant, Bridget F.

2013-01-01

Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions. This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available. PMID:23903334

DSM-5 criteria for substance use disorders: recommendations and rationale.

PubMed

Hasin, Deborah S; O'Brien, Charles P; Auriacombe, Marc; Borges, Guilherme; Bucholz, Kathleen; Budney, Alan; Compton, Wilson M; Crowley, Thomas; Ling, Walter; Petry, Nancy M; Schuckit, Marc; Grant, Bridget F

2013-08-01

Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions.This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available.

Psychosocial issues and mental health treatment recommendations for patients with hepatitis C.

PubMed

Silberbogen, Amy K; Ulloa, Erin W; Janke, E Amy; Mori, DeAnna L

2009-01-01

Mental health needs of patients with HCV are increasingly being addressed in medical contexts. The authors review the psychosocial issues relevant to patients with hepatitis C and provide mental health treatment recommendations. Patients with HCV are faced with a number of challenges, including adjustment to a chronic medical illness, management of symptoms and treatment side effects, and making and maintaining lifestyle changes. Given these issues, mental health clinicians have the opportunity to make a significant contribution to patient care. After reviewing the relevant research on these psychosocial issues, the authors have identified areas in which clinicians can intervene; these include adjustment to having a chronic medical illness, coping with stigma and relationship changes, management of side effects, and implementing healthy lifestyle changes.

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.

A data-driven approach to quality risk management.

PubMed

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-10-01

An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. ONLY A SUBSET OF THE RISK FACTORS HAD A SIGNIFICANT ASSOCIATION WITH QUALITY ISSUES, AND INCLUDED: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety.

Wildland fire research: Future Search conference notes

Treesearch

Jim Saveland; Dave Thomas

1998-01-01

This conference provided an arena for identifying common key issues that are shaping wildland fire research. Commonly identified desired outcomes include: research, integrated across disciplines, and management form partnerships; communication between management and research is effective and continuous; responsive and proactive research balances long-term scientific...

Preventing Youth Incarceration through Reading Remediation: Issues and Solutions

ERIC Educational Resources Information Center

Christle, Christine A.; Yell, Mitchell L.

2008-01-01

The majority of court-involved youths have experienced academic failure, school exclusion, and dropout. Researchers have identified factors that increase a youth's risk for court involvement and incarceration. The risk factors include individual, family, community, peer, and school factors. Researchers actually have identified specific…

Framework for measuring sustainable development in catchment systems.

PubMed

Walmsley, Jay J

2002-02-01

Integrated catchment management represents an approach to managing the resources of a catchment by integrating environmental, economic, and social issues. It is aimed at deriving sustainable benefits for future generations, while protecting natural resources, particularly water, and minimizing possible adverse social, economic, and environmental consequences. Indicators of sustainable development, which summarize information for use in decision-making, are invaluable when trying to assess the diverse, interacting components of catchment processes and resource management actions. The Driving-Forces--Pressure--State--Impact--Response (DPSIR) indicator framework is useful for identifying and developing indicators of sustainable development for catchment management. Driving forces have been identified as the natural conditions occurring in a catchment and the level of development and economic activity. Pressures include the natural and anthropogenic supply of water, water demand, and water pollution. State indicators can be split into those of quantity and those of quality. Impacts include those that affect the ecosystems directly and those that impact the use value of the resource. It core indicators are identified within each of the categories given in the framework, most major catchment-based management issues can be evaluated. This framework is applied to identify key issues in catchment management in South Africa, and develop a set of indicators for evaluating catchments throughout the country.

Classroom Assessment in Mathematics: Views from a National Science Foundation Working Conference (Greensboro, North Carolina, May 16-18, 1997).

ERIC Educational Resources Information Center

Bright, George W., Ed.; Joyner, Jeane M., Ed.

This document presents papers from a National Science Foundation (NSF) working conference to identify research issues and implementation strategies that support quality classroom assessment. Papers include: (1) "Understanding and Improving Classroom Assessment: Summary of Issues Raised" (George W. Bright and Jeane M. Joyner); (2) "Recommendations…

Social & Economic Issues in Siting a Hazardous Waste Facility: Ideas for Communities and Local Assessment Committees.

ERIC Educational Resources Information Center

Hurley, Mike

This handbook was prepared for communities selected as potential sites for hazardous waste facilities, identifying issues which need to be addressed and suggesting specific and positive steps that communities can take to shape proposals to meet their concerns. Following an introduction, specific areas addressed include: community controls,…

Sexuality Issues for Youth with Disabilities and Chronic Health Conditions. Healthy & Ready To Work (HRTW) Policy Brief.

ERIC Educational Resources Information Center

Shapland, Ceci

This policy paper addresses sexuality issues of youth with disabilities and chronic health conditions. The first section introduces the problem of teen pregnancy and pregnancy prevention. The second section provides definitions of disabilities including both visible and invisible disabilities. Risk factors for teen pregnancy are identified and…

The role of universities in energy and environmental R & D: An extended outline

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

Drucker, H.

1995-12-31

Issues related to university research and development roles in energy and environmental areas are very briefly outlined in the paper. Fundamental issues discussed include basic versus applied science, and applied science versus technology development. Some specific issues appropriate for university research are identified, such as desulfurizing coal and managing mixed wastes in groundwater. The Plant Biotechnology consortium is described as a model that builds on university strengths in basic and applied technology.

Clinical imaging guidelines part 2: Risks, benefits, barriers, and solutions.

PubMed

Malone, James; del Rosario-Perez, Maria; Van Bladel, Lodewijk; Jung, Seung Eun; Holmberg, Ola; Bettmann, Michael A

2015-02-01

A recent international meeting was convened by two United Nations bodies to focus on international collaboration on clinical appropriateness/referral guidelines for use in medical imaging. This paper, the second of 4 from this technical meeting, addresses barriers to the successful development/deployment of clinical imaging guidelines and means of overcoming them. It reflects the discussions of the attendees, and the issues identified are treated under 7 headings: ■ Practical Strategy for Development and Deployment of Guidelines; ■ Governance Arrangements and Concerns with Deployment of Guidelines; ■ Finance, Sustainability, Reimbursement, and Related Issues; ■ Identifying Benefits and Radiation Risks from Radiological Examinations; ■ Information Given to Patients and the Public, and Consent Issues; ■ Special Concerns Related to Pregnancy; and ■ The Research Agenda. Examples of topics identified include the observation that guideline development is a global task and there is no case for continuing it as the project of the few professional organizations that have been brave enough to make the long-term commitment required. Advocacy for guidelines should include the expectations that they will facilitate: (1) better health care delivery; (2) lower cost of that delivery; with (3) reduced radiation dose and associated health risks. Radiation protection issues should not be isolated; rather, they should be integrated with the overall health care picture. The type of dose/radiation risk information to be provided with guidelines should include the uncertainty involved and advice on application of the precautionary principle with patients. This principle may be taken as an extension of the well-established medical principle of "first do no harm." Copyright © 2015. Published by Elsevier Inc.

Corporate Functional Management Evaluation of the LLNL Radiation Safety Organization

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

Sygitowicz, L S

2008-03-20

A Corporate Assess, Improve, and Modernize review was conducted at Lawrence Livermore National Laboratory (LLNL) to evaluate the LLNL Radiation Safety Program and recommend actions to address the conditions identified in the Internal Assessment conducted July 23-25, 2007. This review confirms the findings of the Internal Assessment of the Institutional Radiation Safety Program (RSP) including the noted deficiencies and vulnerabilities to be valid. The actions recommended are a result of interviews with about 35 individuals representing senior management through the technician level. The deficiencies identified in the LLNL Internal Assessment of the Institutional Radiation Safety Program were discussed with Radiationmore » Safety personnel team leads, customers of Radiation Safety Program, DOE Livermore site office, and senior ES&H management. There are significant issues with the RSP. LLNL RSP is not an integrated, cohesive, consistently implemented program with a single authority that has the clear roll and responsibility and authority to assure radiological operations at LLNL are conducted in a safe and compliant manner. There is no institutional commitment to address the deficiencies that are identified in the internal assessment. Some of these deficiencies have been previously identified and corrective actions have not been taken or are ineffective in addressing the issues. Serious funding and staffing issues have prevented addressing previously identified issues in the Radiation Calibration Laboratory, Internal Dosimetry, Bioassay Laboratory, and the Whole Body Counter. There is a lack of technical basis documentation for the Radiation Calibration Laboratory and an inadequate QA plan that does not specify standards of work. The Radiation Safety Program lack rigor and consistency across all supported programs. The implementation of DOE Standard 1098-99 Radiological Control can be used as a tool to establish this consistency across LLNL. The establishment of a site wide ALARA Committee and administrative control levels would focus attention on improved processes. Currently LLNL issues dosimeters to a large number of employees and visitors that do not enter areas requiring dosimetry. This includes 25,000 visitor TLDs per year. Dosimeters should be issued to only those personnel who enter areas where dosimetry is required.« less

Mining Electronic Health Records Data: Domestic Violence and Adverse Health Effects.

PubMed

Karakurt, Gunnur; Patel, Vishal; Whiting, Kathleen; Koyutürk, Mehmet

2017-01-01

Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims. The Domestic abuse population contained 5870 patients, while the Non-Domestic Abuse population contained 14,315,140 patients. Explorys provides National Big Data from the entire USA. Statistical analysis identified 2429 terms as significantly more prevalent among victims of domestic abuse, compared to the general population. These terms were classified into broad categories, including acute injury, chronic conditions, substance abuse, mental health, disorders, gynecological and pregnancy related problems.

Factors influencing community nursing roles and health service provision in rural areas: a review of literature.

PubMed

Barrett, Annette; Terry, Daniel R; Lê, Quynh; Hoang, Ha

2016-02-01

This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role.

Socio-technical issues and challenges in implementing safe patient handovers: insights from ethnographic case studies.

PubMed

Balka, Ellen; Tolar, Marianne; Coates, Shannon; Whitehouse, Sandra

2013-12-01

Ineffective handovers in patient care, including those where information loss occurs between care providers, have been identified as a risk to patient safety. Computerization of health information is often offered as a solution to improve the quality of care handovers and decrease adverse events related to patient safety. The purpose of this paper is to broaden our understanding of clinical handover as a patient safety issue, and to identify socio-technical issues which may come to bear on the success of computer based handover tools. Three in depth ethnographic case studies were undertaken. Field notes were transcribed and analyzed with the aid of qualitative data analysis software. Within case analysis was performed on each case, and subsequently, cross case analyses were performed. We identified five types of socio-technical issues which must be addressed if electronic handover tools are to succeed. The inter-dependencies of these issues are addressed in relation to arenas in which health care work takes place. We suggest that the contextual nature of information, ethical and medico-legal issues arising in relation to information handover, and issues related to data standards and system interoperability must be addressed if computerized health information systems are to achieve improvements in patient safety related to handovers in care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Structured inspection of medications carried and stored by emergency medical services agencies identifies practices that may lead to medication errors.

PubMed

Kupas, Douglas F; Shayhorn, Meghan A; Green, Paul; Payton, Thomas F

2012-01-01

Medications are essential to emergency medical services (EMS) agencies when providing lifesaving care, but the EMS environment has challenges related to safe medication storage when compared with a hospital setting. We developed a structured process, based on common pharmacy practices, to review medications carried by EMS agencies to identify situations that may lead to medication error and to determine some best practices that may reduce potential errors and the risk of patient harm. To provide a descriptive account of EMS practices related to carrying and storing medications that have the potential for causing a medication administration error or patient harm. Using a structured process for inspection, an emergency medicine pharmacist and emergency physician(s) reviewed the medication carrying and storage practices of all nine advanced life support ambulance agencies within a five-county EMS region. Each medication carried and stored by the EMS agency was inspected for predetermined and spontaneously observed issues that could lead to medication error. These issues were documented and photographed. Two EMS medical directors reviewed each potential error for the risk of producing patient harm and assigned each to a category of high, moderate, or low risk. Because issues of temperature on EMS medications have been addressed elsewhere, this study concentrated on potential for EMS medication administration errors exclusive of storage temperatures. When reviewing medications carried by the nine EMS agencies, 38 medication safety issues were identified (range 1 to 8 per EMS agency). Of these, 16 were considered to be high risk, 14 moderate risk, and eight low risk for patient harm. Examples of potential issues included carrying expired medications, container-labeling issues, different medications stored in look-alike vials or prefilled syringes in the same compartment, and carrying crystalloid solutions next to solutions premixed with a medication. When reviewing medications stored at the EMS agency stations, eight safety issues were identified (range from 0 to 4 per station), including five moderate-risk and three low-risk issues. No agency had any high-risk medication issues related to storage of medication stock in the station. We observed potential medication safety issues related to how medications are carried and stored at all nine EMS agencies in a five-county region. Understanding these issues may assist EMS agencies in reducing the potential for a medication error and risk of patient harm. More research is needed to determine whether following these suggested best practices for carrying medications on EMS vehicles actually reduces errors in medication administration by EMS providers or decreases patient harm.

Proceedings of the Hydrokinetic and Wave Energy Technologies Technical and Environmental Issues Workshop

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

None

2006-03-01

Renewable energy technologies offer the promise of non-polluting alternatives to fossil and nuclear-fueled power plants to meet growing demand for electrical energy. Two emerging categories of renewable energy technologies, hydrokinetic and wave energy conversion devices, offer ways to tap the energy of moving water without impoundment (dams) or diversion required by many conventional hydroelectric facilities. These technologies include devices designed for deployment in natural streams, tidal estuaries, ocean currents, and constructed waterways, as well as devices designed to capture the energy of ocean waves. On October 26-28, 2005, 54 representatives from government, non-governmental organizations, and private business met to (1)more » identify the varieties of hydrokinetic energy and wave technology devices, their stages of development, and the projected cost to bring each to market; (2) identify where these technologies can best operate; (3) identify the potential environmental issues associated with these technologies and possible mitigation measures; (4) develop a list of research needs and/or practical solutions to address unresolved environmental issues. These workshop proceedings include detailed summaries of the 24 presentations made and the discussions that followed.« less

An exploration into study design for biomarker identification: issues and recommendations.

PubMed

Hall, Jacqueline A; Brown, Robert; Paul, Jim

2007-01-01

Genomic profiling produces large amounts of data and a challenge remains in identifying relevant biological processes associated with clinical outcome. Many candidate biomarkers have been identified but few have been successfully validated and make an impact clinically. This review focuses on some of the study design issues encountered in data mining for biomarker identification with illustrations of how study design may influence the final results. This includes issues of clinical endpoint use and selection, power, statistical, biological and clinical significance. We give particular attention to study design for the application of supervised clustering methods for identification of gene networks associated with clinical outcome and provide recommendations for future work to increase the success of identification of clinically relevant biomarkers.

Potential SSP Perfluorooctanoic Acid Related Fluoropolymer Materials Obsolescence

NASA Technical Reports Server (NTRS)

Segars, Matt G.

2006-01-01

The Shuttle Environmental Assurance Initiative (SEA) has identified a potential for the Space Shuttle Program (SSP) to incur materials obsolescence issues due to agreements between the fluoro-chemical industry and the United States Environmental Protection Agency (USEPA) to participate in a Global Stewardship Program for perfluorooctanoic acid (PFOA). This presentation will include discussions of the chemistry, regulatory drivers, affected types of fluoropolymer and fluoroelastomer products, timeline for reformulations, and methodology for addressing the issue. It will cover the coordination of assessment efforts with the International Space Station and Head Quarters Air Force Space Command, along with some examples of impacted materials. The presentation is directed at all members of the international aerospace community concerned with identifying potential environmentally driven materials obsolescence issues.

A 2018 Horizon Scan of Emerging Issues for Global Conservation and Biological Diversity.

PubMed

Sutherland, William J; Butchart, Stuart H M; Connor, Ben; Culshaw, Caroline; Dicks, Lynn V; Dinsdale, Jason; Doran, Helen; Entwistle, Abigail C; Fleishman, Erica; Gibbons, David W; Jiang, Zhigang; Keim, Brandon; Roux, Xavier Le; Lickorish, Fiona A; Markillie, Paul; Monk, Kathryn A; Mortimer, Diana; Pearce-Higgins, James W; Peck, Lloyd S; Pretty, Jules; Seymour, Colleen L; Spalding, Mark D; Tonneijck, Femke H; Gleave, Rosalind A

2018-01-01

This is our ninth annual horizon scan to identify emerging issues that we believe could affect global biological diversity, natural capital and ecosystem services, and conservation efforts. Our diverse and international team, with expertise in horizon scanning, science communication, as well as conservation science, practice, and policy, reviewed 117 potential issues. We identified the 15 that may have the greatest positive or negative effects but are not yet well recognised by the global conservation community. Themes among these topics include new mechanisms driving the emergence and geographic expansion of diseases, innovative biotechnologies, reassessments of global change, and the development of strategic infrastructure to facilitate global economic priorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Appendix.

ERIC Educational Resources Information Center

Naturescope, 1987

1987-01-01

Contains a glossary of terms related to endangered species and lists reference books, children's books, audio-visual materials, software, and activity sources on the topics. Also identifies wildlife laws and explains what they mean. An index of issues of "Ranger Rick," which includes articles on endangered species, is included. (ML)

The Academic Library: A Time of Crisis, Change, and Opportunity.

ERIC Educational Resources Information Center

Dougherty, Richard M.; Dougherty, Ann P.

1993-01-01

Discusses concerns for academic libraries identified by a survey of editors and manuscript readers of this journal. Highlights include technology; leadership; library users; management issues, including recruitment, communication, and new services; access versus ownership; funding; copyright; licensing; teaching and research; electronic…

The future of arid grasslands: identifying issues, seeking solutions

Treesearch

Barbara Tallman; Deborah M. Finch; Carl Edminster; Robert Hamre

1998-01-01

This conference was designed to provide a non-confrontational setting for a variety of people from differing viewpoints to discuss the threats facing arid grasslands of the Southwest. Participants included ranchers and other private economists, scientists, and students. The sessions were organized around the major themes of understanding grasslands, identifying...

Legal implications of monitoring workers for carcinogenic and mutagenic risk.

PubMed

Damme, C J

1982-01-01

Many industries have initiated testing programs designed to identify workers who are especially vulnerable to workplace assaults by carcinogenic or mutagenic agents. This paper examines a number of legal issues attendant on such programs, including disclosure and consent, confidentiality, and other potential liability-producing factors. This paper also briefly looks at the legal issues that might arise if the federal government were to mandate similar programs. Finally, the basic rationale of industrial monitoring programs is discussed within the context of the emerging legal issues.

A geospatial approach to identify water quality issues for National Wildlife Refuges in Oregon and Washington

USGS Publications Warehouse

Hinck, Jo Ellen; Chojnacki, Kimberly; Finger, Susan E.; Linder, Greg; Kilbride, Kevin

2011-01-01

Many National Wildlife Refuges (Refuges) have impaired water quality resulting from historic and current land uses, upstream sources, and aerial pollutant deposition. Competing duties limit the time available for Refuge staff to identify and evaluate potential water quality issues. As a result, water quality–related issues may not be resolved until a problem has already arisen. This study developed a geospatial approach for identifying and prioritizing water quality issues affecting natural resources (including migratory birds and federally listed species) within Refuge boundaries. We assessed the location and status of streams pursuant to the Clean Water Act in relation to individual Refuges in Oregon and Washington, United States. Although twelve Refuges in Oregon (60%) and eight Refuges in Washington (40%) were assessed under the Clean Water Act, only 12% and 3% of total Refuge stream lengths were assessed, respectively. Very few assessed Refuge streams were not designated as impaired (0% in Oregon, 1% in Washington). Despite the low proportions of stream lengths assessed, most Refuges in Oregon (70%) and Washington (65%) are located in watersheds with approved total maximum daily loads. We developed summaries of current water quality issues for individual Refuges and identified large gaps for Refuge-specific water quality data and habitat utilization by sensitive species. We conclude that monitoring is warranted on many Refuges to better characterize water quality under the Clean Water Act.

Report number codes

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

Nelson, R.N.

This publication lists all report number codes processed by the Office of Scientific and Technical Information. The report codes are substantially based on the American National Standards Institute, Standard Technical Report Number (STRN)-Format and Creation Z39.23-1983. The Standard Technical Report Number (STRN) provides one of the primary methods of identifying a specific technical report. The STRN consists of two parts: The report code and the sequential number. The report code identifies the issuing organization, a specific program, or a type of document. The sequential number, which is assigned in sequence by each report issuing entity, is not included in thismore » publication. Part I of this compilation is alphabetized by report codes followed by issuing installations. Part II lists the issuing organization followed by the assigned report code(s). In both Parts I and II, the names of issuing organizations appear for the most part in the form used at the time the reports were issued. However, for some of the more prolific installations which have had name changes, all entries have been merged under the current name.« less

"Ethical Positioning" a Strategy in Overcoming Student Resistance and Fostering Engagement in Teaching Aboriginal History as a Compulsory Subject to Pre-Service Primary Education Students

ERIC Educational Resources Information Center

O'Dowd, Mary

2010-01-01

The paper describes and analyses the issues that impacted on pre service Primary Education students' engagement with the subject "Aboriginal culture and history" at a rural university. The paper identifies how issues including pioneer identity and local "conversations" about race related strongly to this particular rural…

A Survey of Self-Advocacy Groups for People with Learning Disabilities in an English Region: Part II.

ERIC Educational Resources Information Center

McNally, Steve

2003-01-01

The second article on a survey of self-advocacy groups for people with learning disabilities in England reports key findings that included the consistency of the issues identified as important and the willingness to engage in research. Key themes were self-advocacy, rights, day service center issues, staffing, personal relationships, complaints,…

Critical Analysis of a Population Mental Health Strategy: Effects on Stigma for People with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Hamdani, Yani; Ary, Ayelet; Lunsky, Yona

2017-01-01

Introduction: Stigma is widely identified as an issue affecting the health and well-being of people with intellectual and developmental disabilities (IDD), and those with mental illnesses. To address this issue, a population mental health strategy, which includes a focus on reducing stigma and discrimination, was developed by the government of…

[White House Conference on Aging, 1981. Research in Aging. Report and Executive Summary of the Technical Committee.

ERIC Educational Resources Information Center

Birren, James E.; And Others

This Technical Committee Report provides an overview and historical sketch of research in aging and proposes a need for new knowledge. An examination of key issues notes the difficulty in assigning priority to research topics, and identifies emerging issues of public concern including: (1) physical health (alcohol and drugs, falls and accidents,…

Space station human productivity study. Volume 5: Management plans

NASA Technical Reports Server (NTRS)

1985-01-01

The 67 Management Plans represent recommended study approaches for resolving 108 of the 305 Issues which were identified. Each study Management Plan is prepared in three formats: Management Plan Overview (lists the subsumed Issues, study background, and related overview information); Study Plan (details the study approach by tasks, lists special needs, and describes expected study products); Schedule-Task Flow (provides a time-lined schedule for the study tasks and resource requirements). The Management Relationships Matrix, included in this volume, shows the data input-output relationships among all recommended studies. A listing is also included which cross-references the unresolved requirements to Issues to management plans. A glossary of all abbreviations utilized is provided.

Unpacking the burden: gender issues in anaesthesia.

PubMed

Strange Khursandi, D C

1998-02-01

A survey carried out by the Australian Society of Anaesthetists explored gender issues in the personal and professional lives of anaesthetists. Issues highlighted include training and career paths, combining anaesthetic training with domestic responsibilities, personal relationships, pregnancy and childrearing, private practice, part-time work, parental leave, the single anaesthetist, doctor spouses, sexual harassment, and negative attitudes in colleagues. Particular problems were identified in the training years, in part-time work, in private practice, and in combining parental and domestic responsibilities with a career in anaesthesia. Strategies to address relevant issues are discussed, with reference to the increasing proportion of women in medicine and anaesthesia.

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand

PubMed Central

2010-01-01

Background Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. Methods A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Results Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. Conclusions The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations. PMID:21138584

Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand.

PubMed

Ameratunga, Shanthi; Abel, Sally; Tin Tin, Sandar; Asiasiga, Lanuola; Milne, Sharon; Crengle, Sue

2010-12-07

Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and patient levels. Of particular relevance are strategies that enable families to have better access to information, including culturally appropriate oral and written sources; improve communication amongst staff and between staff and families; and carefully developed discharge plans that provide care continuity across boundaries between hospital and community settings. Māori and Pacific family support services are important and need better resourcing and support from an organisational culture responsive to the needs of these populations.

Barriers to midwives and nurses addressing mental health issues with women during the perinatal period: The Mind Mothers study.

PubMed

Higgins, Agnes; Downes, Carmel; Monahan, Mark; Gill, Ailish; Lamb, Stephen A; Carroll, Margaret

2018-01-03

To explore barriers to midwives and nurses addressing mental health issues with women during the perinatal period. Perinatal mental health is considered an important public health issue with health policy internationally identifying the importance of psychological support for women in the perinatal period. Midwives and primary care nurses are ideally positioned to detect mental distress early, but evidence suggests that they are reluctant to discuss mental health issues with women during pregnancy or in the postnatal period. The research used a descriptive design. A total of 809 midwives and nurses completed an anonymous, online or hard copy survey. Designed by the research team, the survey listed 26 potential barriers to the provision of perinatal mental health care. Participants identified organisational factors as presenting the greatest barriers. Organisational barriers included lack of perinatal mental health services, absence of care pathways, heavy workload, lack of time, lack of privacy and not seeing women regularly enough to build a relationship. Over 50% of participants identified practitioner-related barriers, such as lack of knowledge on perinatal mental health and cultural issues; lack of skill, in particular, skills to respond to a disclosure of a mental health issue; and fears of causing women offence and distress. Findings also indicated that the context of care and education influenced the degree to which participants perceived certain items as barriers. Midwives and primary care nurses encounter many organisational- and practitioner-related barriers that negatively impact on their ability to incorporate mental health care into their practice. Midwifery and nursing services need to develop strategies to address system- and practitioner-related barriers, including the development of services and care pathways, and the provision of culturally sensitive education on perinatal mental health in order to support practitioners to address issues with confidence and competence. © 2018 John Wiley & Sons Ltd.

A data-driven approach to quality risk management

PubMed Central

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-01-01

Aim: An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Materials and Methods: Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. Results: Only a subset of the risk factors had a significant association with quality issues, and included: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Conclusion: Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety. PMID:24312890

Strategies to use tablet computers for collection of electronic patient-reported outcomes.

PubMed

Schick-Makaroff, Kara; Molzahn, Anita

2015-01-22

Mobile devices are increasingly being used for data collection in research. However, many researchers do not have experience in collecting data electronically. Hence, the purpose of this short report was to identify issues that emerged in a study that incorporated electronic capture of patient-reported outcomes in clinical settings, and strategies used to address the issues. The issues pertaining to electronic patient-reported outcome data collection were captured qualitatively during a study on use of electronic patient-reported outcomes in two home dialysis units. Fifty-six patients completed three surveys on tablet computers, including the Kidney Disease Quality of Life-36, the Edmonton Symptom Assessment Scale, and a satisfaction measure. Issues that arose throughout the research process were recorded during ethics reviews, implementation process, and data collection. Four core issues emerged including logistics of technology, security, institutional and financial support, and electronic design. Although use of mobile devices for data collection has many benefits, it also poses new challenges for researchers. Advance consideration of possible issues that emerge in the process, and strategies that can help address these issues, may prevent disruption and enhance validity of findings.

Pathways to potentially preventable hospitalizations for diabetes and heart failure: a qualitative analysis of patient perspectives.

PubMed

Sentell, Tetine L; Seto, Todd B; Young, Malia M; Vawer, May; Quensell, Michelle L; Braun, Kathryn L; Taira, Deborah A

2016-07-26

Potentially preventable hospitalizations (PPH) for heart failure (HF) and diabetes mellitus (DM) cost the United States over $14 billion annually. Studies about PPH typically lack patient perspectives, especially across diverse racial/ethnic groups with known PPH health disparities. English-speaking individuals with a HF or DM-related PPH (n = 90) at the largest hospital in Hawai'i completed an in-person interview, including open-ended questions on precipitating factors to their PPH. Using the framework approach, two independent coders identified patient-reported factors and pathways to their PPH. Seventy-two percent of respondents were under 65 years, 30 % were female, 90 % had health insurance, and 66 % had previously been hospitalized for the same problem. Patients' stories identified immediate, precipitating, and underlying reasons for the admission. Underlying background factors were critical to understanding why patients had the acute problems necessitating their hospitalizations. Six, non-exclusive, underlying factors included: extreme social vulnerability (e.g., homeless, poverty, no social support, reported by 54 % of respondents); health system interaction issues (e.g., poor communication with providers, 44 %); limited health-related knowledge (42 %); behavioral health issues (e.g., substance abuse, mental illness, 36 %); denial of illness (27 %); and practical problems (e.g., too busy, 6 %). From these findings, we developed a model to understand an individual's pathways to a PPH through immediate, precipitating, and underlying factors, which could help identify potential intervention foci. We demonstrate the model's utility using five examples. In a young, predominately insured population, factors well outside the traditional purview of the hospital, or even clinical medicine, critically influenced many PPH. Patient perspectives were vital to understanding this issue. Innovative partnerships and policies should address these issues, including linkages to social services and behavioral health.

Somerville Charter School: Management Issues and Recommendations.

ERIC Educational Resources Information Center

Massachusetts State Office of the Inspector General, Boston.

Somerville Charter School was among 24 Massachusetts charter schools included in a study undertaken by the Office of the Inspector General in March 1998. The office identified weaknesses in the contracting practices, procurement procedures, and financial management of some schools, including Somerville. These weaknesses could undermine the…

Safe Zones: Creating LGBT Safe Space Ally Programs

ERIC Educational Resources Information Center

Poynter, Kerry John; Tubbs, Nancy Jean

2008-01-01

This article discusses model LGBT Safe Space Ally programs. These programs, often called "Safe Zones," include self selected students, faculty, and employees who publicly show support by displaying stickers, signs, and other identifiable items. Issues covered in the article include history, development, training, membership, assessment, and…

New Frontiers in Analyzing Dynamic Group Interactions: Bridging Social and Computer Science

PubMed Central

Lehmann-Willenbrock, Nale; Hung, Hayley; Keyton, Joann

2017-01-01

This special issue on advancing interdisciplinary collaboration between computer scientists and social scientists documents the joint results of the international Lorentz workshop, “Interdisciplinary Insights into Group and Team Dynamics,” which took place in Leiden, The Netherlands, July 2016. An equal number of scholars from social and computer science participated in the workshop and contributed to the papers included in this special issue. In this introduction, we first identify interaction dynamics as the core of group and team models and review how scholars in social and computer science have typically approached behavioral interactions in groups and teams. Next, we identify key challenges for interdisciplinary collaboration between social and computer scientists, and we provide an overview of the different articles in this special issue aimed at addressing these challenges. PMID:29249891

New Frontiers in Analyzing Dynamic Group Interactions: Bridging Social and Computer Science.

PubMed

Lehmann-Willenbrock, Nale; Hung, Hayley; Keyton, Joann

2017-10-01

This special issue on advancing interdisciplinary collaboration between computer scientists and social scientists documents the joint results of the international Lorentz workshop, "Interdisciplinary Insights into Group and Team Dynamics," which took place in Leiden, The Netherlands, July 2016. An equal number of scholars from social and computer science participated in the workshop and contributed to the papers included in this special issue. In this introduction, we first identify interaction dynamics as the core of group and team models and review how scholars in social and computer science have typically approached behavioral interactions in groups and teams. Next, we identify key challenges for interdisciplinary collaboration between social and computer scientists, and we provide an overview of the different articles in this special issue aimed at addressing these challenges.

The Third National Telemedicine & Telehealth Service Provider Showcase Conference: Advancing Telehealth Partnerships.

PubMed

Alverson, Dale C; Krupinski, Elizabeth A; Erps, Kristine A; Rowe, Nancy S; Weinstein, Ronald S

2018-05-31

As telemedicine and telehealth services are experiencing increasing rates of adoption, industry leaders and healthcare service providers are becoming increasingly focused on human resource issues encountered in the delivery of a broad range of telehealth services. To create a forum for the discussion of many interrelated elements of telehealth service industry, a national conference entitled "Telemedicine & Telehealth Service Provider Showcase" (SPS) Conference was established in 2014, and repeated in 2016 and 2017, in Arizona. These SPS Conferences include thought leaders, telehealth service providers, government administrators, and academicians from leading programs addressing service provider workforce issues. This report summarizes the content of SPS 2017 conference, held in Phoenix, AZ, October 2-3, 2017. The topics covered at SPS 2017 include using telehealth services as a strategic asset; development of appropriate effective partnerships; direct-to-consumer initiatives; important reimbursement, legislative, and regulatory issues (i.e., Centers for Medicare & Medicaid Services [CMS] approaches, financial models, and return on investment [ROI]); marketing; evaluation and applied metrics; remote monitoring and sensors; integration with electronic health records; and overall lessons learned. The content of SPS 2017 is summarized in the body of this report. The SPS 2017 program evaluators included attendees, speakers, and exhibitors. The knowledge attendees gained at SPS 2017 was characterized, by all three groups, as forward-looking and practical. SPS 2017 succeeded in identifying, and focusing on, solutions for issues, challenges, and barriers impacting the rapidly expanding telehealth service segment of the healthcare industry. The growing interest in this annual SPS Conference series apparently reflects, in part, the program committee's successes in identifying practical issues and their potential solutions.

BRCA1 genetic mutation and its link to ovarian cancer: implications for advanced practice nurses.

PubMed

Brunsvold, Amy N; Wung, Shu-Fen; Merkle, Carrie J

2005-12-01

The purpose of this paper is to review (a) the linkage between the BRCA1 gene and ovarian cancer and (b) BRCA1 testing and its related issues. This review is aimed for nurse practitioners (NPs), who may be in positions to identify those at risk for BRCA1-associated ovarian cancer and to assist patients with related issues. Data sources include reviews and original research from scholarly journals and Internet sites. Ovarian cancer is a deadly disease. Identification of those at risk because of BRCA1 mutation is possible through genetic testing. Testing for BRCA1 gene mutations has many implications whether results are positive or negative. Those with positive results will be faced with decisions regarding the best management strategies. Negative results do not completely eliminate ovarian cancer risk. Current management options for carriers of the BRCA1 mutation include taking no action, increasing surveillance for ovarian cancer, and chemoprevention with oral contraceptives or prophylactic oophorectomy for those who have completed childbearing. It is essential that NPs have knowledge underlying the issues and concerns of patients and their families at risk for BRCA1-associated ovarian cancer. NPs are in a unique position to help identify BRCA1 mutation carriers and to assist them and their families with the complex issues involving genetic testing and management options. Understanding these issues will allow NPs to give appropriate care that may include making appropriate referrals to certified genetic counselors and having balanced discussions on treatment options. Such measurements may improve early diagnosis of ovarian cancer and increase survival from this disease.

Recent Reform and Perspectives in Higher Education: Report of the Seminar Including a Range of Countries from Asia-Pacific and Europe.

ERIC Educational Resources Information Center

National Inst. for Educational Research, Tokyo (Japan).

This report describes a 1998 seminar held to review the situation of higher education reform in Asia and the Pacific region, as well as in some Western nations, and to identify common issues and priorities, and then develop a collaborative framework for addressing these issues and setting priorities. Seventeen participants from 16 countries…

University Facilities Respond to the Changing Landscape of Higher Education Including the Top Ten Critical Facilities Issues. APPA Thought Leaders Series

ERIC Educational Resources Information Center

Lunday, Elizabeth

2006-01-01

This report was issued from a 2006 meeting of individuals representing a variety of higher education institutions. The purpose of the meeting was to consider the future of higher education with particular attention to its built environment. The report provides a contextual overview of the changing landscape of higher education by identifying the…

Use of digital media technology for primary prevention of STIs/HIV in youth.

PubMed

Chávez, Noé Rubén; Shearer, Lee S; Rosenthal, Susan L

2014-10-01

The relevant literature was reviewed to identify issues in research evaluating digital media technology (DMT) interventions for the primary prevention of STIs/HIV in adolescents and young adults. A literature search with relevant key terms was conducted in PubMed, for articles with studies that included: (a) participants between 11-29 years; (b) use of one or more of the following forms of DMT: interactive digital video or CD-ROM, computer, text messaging, or Internet; (c) evaluation of an STI/HIV primary prevention intervention; and (d) use of a cognitive, psychosocial, behavioral, or biological outcome. Twenty-nine studies were identified and included in the review. Based on the review of these studies, 7 main issues were discussed and recommendations for improving future research were offered. The 7 main issues were: (a) need for a balance between universal application and specific sub-group focus, (b) lack of a developmental framework, (c) challenge of applying DMT in resource limited contexts, (d) rapidly changing nature of DMT, (e) lack of biological outcomes, (f) lack of comparison/control groups to assess the impact of DMT, and (g) limited temporal follow-up. There is increasing literature evaluating the effectiveness of DMT for preventing STIs/HIV among adolescents and young adults. A careful consideration of 7 main issues identified in the literature can improve the design and evaluation of these interventions and enhance our understanding of their effectiveness. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Physician satisfaction with a critical care clinical information system using a multimethod evaluation of usability.

PubMed

Hudson, Darren; Kushniruk, Andre; Borycki, Elizabeth; Zuege, Danny J

2018-04-01

Physician satisfaction with electronic medical records has often been poor. Usability has frequently been identified as a source for decreased satisfaction. While surveys can identify many issues, and are logistically easier to administer, they may miss issues identified using other methods This study sought to understand the level of physician satisfaction and usability issues associated with a critical care clinical information system (eCritical Alberta) implemented throughout the province of Alberta, Canada. All critical care attending physicians using the system were invited to participate in an online survey. Questions included components of the User Acceptance of Information Technology and Usability Questionnaire as well as free text feedback on system components. Physicians were also invited to participate in a think aloud test using simulated scenarios. The transcribed think aloud text and questionnaire were subjected to textual analysis. 82% of all eligible physicians completed the on-line survey (n = 61). Eight physicians were invited and seven completed the think aloud test. Overall satisfaction with the system was moderate. Usability was identified as a significant factor contributing to satisfaction. The major usability factors identified were system response time and layout. The think aloud component identified additional factors beyond those identified in the on-line survey. This study found a modestly high level of physician satisfaction with a province-wide clinical critical care information system. Usability continues to be a significant factor in physician satisfaction. Using multiple methods of evaluation can capture the benefits of a large sample size and deeper understanding of the issues. Copyright © 2018 Elsevier B.V. All rights reserved.

Patient complaints in healthcare systems: a systematic review and coding taxonomy

PubMed Central

Reader, Tom W; Gillespie, Alex; Roberts, Jane

2014-01-01

Background Patient complaints have been identified as a valuable resource for monitoring and improving patient safety. This article critically reviews the literature on patient complaints, and synthesises the research findings to develop a coding taxonomy for analysing patient complaints. Methods The PubMed, Science Direct and Medline databases were systematically investigated to identify patient complaint research studies. Publications were included if they reported primary quantitative data on the content of patient-initiated complaints. Data were extracted and synthesised on (1) basic study characteristics; (2) methodological details; and (3) the issues patients complained about. Results 59 studies, reporting 88 069 patient complaints, were included. Patient complaint coding methodologies varied considerably (eg, in attributing single or multiple causes to complaints). In total, 113 551 issues were found to underlie the patient complaints. These were analysed using 205 different analytical codes which when combined represented 29 subcategories of complaint issue. The most common issues complained about were ‘treatment’ (15.6%) and ‘communication’ (13.7%). To develop a patient complaint coding taxonomy, the subcategories were thematically grouped into seven categories, and then three conceptually distinct domains. The first domain related to complaints on the safety and quality of clinical care (representing 33.7% of complaint issues), the second to the management of healthcare organisations (35.1%) and the third to problems in healthcare staff–patient relationships (29.1%). Conclusions Rigorous analyses of patient complaints will help to identify problems in patient safety. To achieve this, it is necessary to standardise how patient complaints are analysed and interpreted. Through synthesising data from 59 patient complaint studies, we propose a coding taxonomy for supporting future research and practice in the analysis of patient complaint data. PMID:24876289

Characterizing Sleep Issues Using Twitter.

PubMed

McIver, David J; Hawkins, Jared B; Chunara, Rumi; Chatterjee, Arnaub K; Bhandari, Aman; Fitzgerald, Timothy P; Jain, Sachin H; Brownstein, John S

2015-06-08

Sleep issues such as insomnia affect over 50 million Americans and can lead to serious health problems, including depression and obesity, and can increase risk of injury. Social media platforms such as Twitter offer exciting potential for their use in studying and identifying both diseases and social phenomenon. Our aim was to determine whether social media can be used as a method to conduct research focusing on sleep issues. Twitter posts were collected and curated to determine whether a user exhibited signs of sleep issues based on the presence of several keywords in tweets such as insomnia, "can't sleep", Ambien, and others. Users whose tweets contain any of the keywords were designated as having self-identified sleep issues (sleep group). Users who did not have self-identified sleep issues (non-sleep group) were selected from tweets that did not contain pre-defined words or phrases used as a proxy for sleep issues. User data such as number of tweets, friends, followers, and location were collected, as well as the time and date of tweets. Additionally, the sentiment of each tweet and average sentiment of each user were determined to investigate differences between non-sleep and sleep groups. It was found that sleep group users were significantly less active on Twitter (P=.04), had fewer friends (P<.001), and fewer followers (P<.001) compared to others, after adjusting for the length of time each user's account has been active. Sleep group users were more active during typical sleeping hours than others, which may suggest they were having difficulty sleeping. Sleep group users also had significantly lower sentiment in their tweets (P<.001), indicating a possible relationship between sleep and pyschosocial issues. We have demonstrated a novel method for studying sleep issues that allows for fast, cost-effective, and customizable data to be gathered.

Kansas legislators prioritize obesity but overlook nutrition and physical activity issues.

PubMed

Heinrich, Katie M; Stephen, Mellina O; Vaughan, Katherine B; Kellogg, Melinda

2013-01-01

State-level policymakers play an important role in the fight against obesity because of their ability to create policies that influence opportunities for physical activity and nutrition. In 2011, we investigated how Kansas policymakers regarded obesity, nutrition, and physical activity in comparison to other issues. This study used a cross-sectional design. This study was conducted in Kansas, a predominately rural and Republican Midwestern state. All 181 state-level policymakers in Kansas were mailed a cover letter and survey. Policymakers were asked to identify and rate the importance of issues or problems in need of attention for Kansas. The 2011 state legislative report was content analyzed and coded to match the survey. Comparisons were made by political party. Of the 49 policymakers who completed a survey, 37 were Republicans and 43 were elected to their position. Although obesity-related issues were rated second highest after jobs, physical activity- and nutrition-related issues were not seen as important problems; moreover, little corresponding legislation was introduced. Other key issues identified by policymakers included budget/spending/taxes, education, jobs/economy, and drug abuse, with more legislation reflecting these problems. The Democrats ranked 11 issues as more significant problems than did the Republicans: quality of public education, poverty, access to health care, lack of affordable housing, ethics in government, lack of public health training, access to healthy groceries, lack of pedestrian walkways/crosswalks/sidewalks, pedestrian safety, air pollution, and global warming (P < .05). There is a need to provide more public health education on the relationship between nutrition and physical activity issues and obesity for Kansas policymakers. Issues identified may be similar for other predominately rural and Republican states.

SABIS International Charter School: Management Issues and Recommendations.

ERIC Educational Resources Information Center

Massachusetts State Office of the Inspector General, Boston.

SABIS International Charter School was among 24 Commonwealth charter schools included in a study undertaken by the Office of the Inspector General in March 1998. The Office identified weaknesses in the contracting practices, procurement procedures, and financial management. Findings include: (1) the Board of Trustees did not employ sound business…

Children's Literature & Disability. Resources You Can Use. NICHCY Bibliography 5. Second Edition.

ERIC Educational Resources Information Center

National Information Center for Children and Youth with Disabilities, Washington, DC.

This bibliography of 95 items is intended to help parents and professionals identify books that are written about or include characters with a disability. The list is grouped according to the following disabilities or issues: attention deficit/hyperactivity disorder, autism, Down syndrome, hearing impairment (including deafness, learning…

PRELIMINARY RISK ASSESSMENT FOR VIRUSES IN MUNICIPAL SEWAGE SLUDGE APPLIED TO LAND

EPA Science Inventory

Section 405 of the Clean Water Act requires the U.S. Environmental Protection Agency to develoP and issue regulations that identify; (1) uses for sludge including disposal; (2) specify factors (including costs) to be taken into account in determining the measures and practices ap...

Establishing national priorities for Australian occupational health and safety research.

PubMed

Smith, Derek R

2010-01-01

This study aimed to identify current and emerging issues relevant to Occupational Health & Safety (OHS) research in Australia, and to formulate strategic research directions and strategies for the future. A national research forum was held which included leading OHS academics, employer and employee representative groups, as well as executives from state (New South Wales) and national (Safe Work Australia) representative bodies. A modified Delphi technique was used for collecting data in three phases. When ranked according to group consensus, the top three priorities for future OHS research in Australia were identified as being psychosocial and soft tissue injury hazards, work/life issues, and the impact of multiple, long-term exposures. Strategies to enhance collaboration despite limited research funding included the need to focus on complementary skills, to make the best use of Safe Work Australia's role (particularly to link with strategic and operational plans), and to foster closer engagement with research communities. While certain research priorities appear to be similar to those of other countries, the current study did identify some unique characteristics within an Australian context. High quality investigations of these issues should now be considered, in conjunction with greater cooperation between governments, regulators, employers and employee groups for the more effective facilitation of applied OHS research in the coming years.

Public health and terrorism preparedness: cross-border issues.

PubMed

Olson, Debra; Leitheiser, Aggie; Atchison, Christopher; Larson, Susan; Homzik, Cassandra

2005-01-01

On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the "Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable." The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.

USSR space life sciences digest, issue 27

NASA Technical Reports Server (NTRS)

Stone, Lydia Razran (Editor); Teeter, Ronald (Editor); Garshnek, Victoria (Editor); Rowe, Joseph (Editor)

1990-01-01

This is the twenty-fifth issue of NASA's Space Life Sciences Digest. It contains abstracts of 30 journal papers or book chapters published in Russian and of 2 Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. The abstracts in this issue have been identified as relevant to 18 areas of space biology and medicine. These areas include: adaptation, aviation medicine, biological rhythms, biospherics, botany, cardiovascular and respiratory systems, endocrinology, enzymology, exobiology, habitability and environmental effects, hematology, immunology, metabolism, musculoskeletal system, neurophysiology, radiobiology, and space medicine. A Soviet book review of a British handbook of aviation medicine and a description of the work of the division on aviation and space medicine of the Moscow Physiological Society are also included.

Mining Electronic Health Records Data: Domestic Violence and Adverse Health Effects

PubMed Central

Karakurt, Gunnur; Patel, Vishal; Whiting, Kathleen; Koyutürk, Mehmet

2016-01-01

Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims. The Domestic abuse population contained 5870 patients, while the Non-Domestic Abuse population contained 14,315,140 patients. Explorys provides National Big Data from the entire USA. Statistical analysis identified 2429 terms as significantly more prevalent among victims of domestic abuse, compared to the general population. These terms were classified into broad categories, including acute injury, chronic conditions, substance abuse, mental health, disorders, gynecological and pregnancy related problems. PMID:28435184

USSR Space Life Sciences Digest, issue 32

NASA Technical Reports Server (NTRS)

Stone, Lydia Razran (Editor); Rowe, Joseph (Editor)

1992-01-01

This is the thirty-second issue of NASA's USSR Space Life Sciences Digest. It contains abstracts of 34 journal or conference papers published in Russian and of 4 Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. The abstracts in this issue have been identified as relevant to 18 areas of space biology and medicine. These areas include: adaptation, aviation medicine, biological rhythms, biospherics, cardiovascular and respiratory systems, developmental biology, exobiology, habitability and environmental effects, human performance, hematology, mathematical models, metabolism, microbiology, musculoskeletal system, neurophysiology, operational medicine, and reproductive system.

Ethics of health policy and systems research: a scoping review of the literature.

PubMed

Pratt, Bridget; Paul, Amy; Hyder, Adnan A; Ali, Joseph

2017-07-01

Health policy and systems research (HPSR) is increasingly funded and undertaken as part of health system strengthening efforts worldwide. HPSR ethics is also a relatively new and emerging field, with numerous normative and descriptive questions that have largely not been considered. Normative questions include what ethical principles and values should guide HPSR. Descriptive questions include what ethical concerns arise when conducting HPSR. A small but growing body of scholarly work characterizes the various ethics issues inherent in HPSR. Towards informing the future development of ethics guidance for HPSR, a scoping review was undertaken to: (1) identify the range of ethics issues relevant to the conduct of HPSR-with a deliberate (though not exclusive) focus on low- and middle-income country settings and (2) describe existing guidance on key ethics issues relevant to HPSR. Using the Cochrane methods as a basis, the review identified formal and informal literature on HPSR ethics by searching the following databases: PubMed's Medline, Embase, Global Health, Scopus, WHO Global Health Regional Libraries, LILACs, OpenDOAR and Bielefeld Academic Search Engine. In total, 11 062 documents were identified from the formal (10 519) and informal (543) literature. One hundred and seven of these documents (formal 99 and informal 8) met at least one inclusion criterion and underwent thematic analysis. Ethical issues in four main categories were identified: upholding autonomy, identifying and balancing risks and benefits, justice and determination of ethical review requirements. The review indicated that the ethical values behind HPSR place an emphasis on its contributing to the reduction of health disparities. Unsurprisingly then, numerous ethical concerns relating to justice arise in HPSR. However, the majority of existing guidance focuses on obtaining or waiving informed consent and, thus, appears to be insufficient for HPSR. A list of priority ethics issues in HPSR in need of guidance development is provided. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.

What FDA Learned About Dark Chocolate and Milk Allergies

MedlinePlus

... the issues identified in the study. Further, allergen contamination is included in the preventive and risk-based controls mandated by the FDA Food Safety Modernization Act (FSMA). Under the proposed Preventive ...

78 FR 40084 - Proposed Requirement-Migrant Education Program Consortium Incentive Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... techniques may include ``identifying changing future compliance costs that might result from technological innovation or anticipated behavioral changes.'' We are issuing this proposed requirement only on a reasoned...

78 FR 18933 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Advanced...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... techniques may include ``identifying changing future compliance costs that might result from technological innovation or anticipated behavioral changes.'' We are issuing this proposed priority only upon a reasoned...

Review of ITS/CVO Institutional Issues Studies

DOT National Transportation Integrated Search

1997-03-01

Several regional coalitions are developing multi-year programs for commercial vehicle opera-tions (CVO). This program will include the application of Intelligent Transportation Systems (ITS) technologies and services. This report identifies the insti...

Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India: a qualitative inquiry

PubMed Central

Chamania, Shobha; Potokar, Tom; Ivers, Rebecca

2018-01-01

Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks. PMID:29523568

California Tribal Nations Technical Water Research

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

Ben, C; Coty, J

2005-08-15

This research focused on identifying the key technical water issues of federally recognized California Native American tribes, the context within which these water issues arise for the tribes, and an appropriate format for potentially opening further dialogue on water research issues between the tribes and Lawrence Livermore National Laboratory (LLNL) scientists. At LLNL, a Water Quality and Resource Management Issues Workshop held in January of 2003 resulted in multiple recommendations, one proposing a LLNL dialogue with California tribes to further inform LLNL's prioritization of water issues based on identified needs across national sectors. The focus of this aforementioned Water Qualitymore » and Resource Management Issues Workshop was to identify national and international priority water research issues with which LLNL may align their research efforts and contribute to resolving these needs. LLNL staff researched various sectors to delineate the key water issues associated with each. This preliminary water issue research included diverse entities such as international water agencies, federal and state agencies, industry, non-governmental agencies, and private organizations. The key (identified) water issues across these sectors were presented to workshop attendees and used during workshop debates and sessions. However, the key water issues of federally recognized Native American tribes remained less understood, resulting in a workshop proposal for additional research and LLNL potentially hosting a dialog with representatives of these tribes. Federally recognized Native American tribes have a unique government-to-government relationship with the United States (U.S.) government, in contrast to other sectors researched for the workshop. Within the U.S., the number of federally recognized tribes currently stands at 562 and, in addition to this large number of tribes, much diversity across these tribes exists. For the purposes of this preliminary research and report, it was necessary to confine the analysis to a smaller geographic area, yet still represent the diversity of tribes and context within which tribal water issues arise. The state of California provides this opportunity. California has 106 federally recognized tribes. California is diverse in its geography, environment, demographics, and economic bases; California tribes demonstrate similar diversity. Additionally, no central repository of national or state tribal water issues exists and information must be aggregated, in general, tribe by tribe. This presents research challenges and, for this report, these were overcome by developing a method to essentially ''sub-sample'' the 106 federally recognized tribes in the state, while making every effort to maintain a sub-sample that broadly represents all of the 106 tribes. n an effort to develop an equitable and appropriate method with which to identify this set of representative tribes, multiple entities were contacted for guidance. Consultation with the Bureau of Indian Affairs (BIA), Environmental Protection Agency (EPA), Indian Health Services (IHS), U.S. Department of Agriculture (USDA), Bureau of Reclamation (BOR) and Tribal Environmental Directors, provided key information and recommendations to guide the research process. It is hoped that an appropriate representation of the diversity of tribes across the state has been achieved; this includes an adequate representation of similarities and differences between Californian tribes on key water research issues (and the same between regions). This research occurred over a limited time period (i.e., three months) and given a general concern that this may not be sufficient, any information and conclusions in this report should be viewed with this in mind. Finally, it is hoped that this research allows for an (enhanced) informed capacity to better propose further dialog between tribes and LLNL to continue to exchange water research perspectives and define potential research collaborations.« less

PRA in Design: Increasing Confidence in Pre-Operational Assessments of Risks (Results of a Joint NASA/NRC Workshop)

NASA Technical Reports Server (NTRS)

Youngblood, Robert; Dezfuli, Homayoon; Siu, Nathan

2010-01-01

In late 2009, the National Aeronautics and Space Administration (NASA) and the U.S. Nuclear Regulatory Commission (NRC) jointly organized a workshop to discuss technical issues associated with application of risk assessments to early phases of system design. The workshop, which was coordinated by the Idaho National Laboratory, involved invited presentations from a number of PRA experts in the aerospace and nuclear fields and subsequent discussion to address the following questions: (a) What technical issues limit decision-makers' confidence in PRA results, especially at a pre-operational phase of the system life cycle? (b) What is being done to address these issues'? (c) What more can be done ? The workshop resulted in participant observations and suggestions on several technical issues, including the pursuit of non-traditional approaches to risk assessment and the verification and validation of risk models. The workshop participants also identified several important non-technical issues, including risk communication with decision makers, and the integration of PRA into the overall design process.

User community development for the space transportation system/Skylab

NASA Technical Reports Server (NTRS)

Archer, J. L.; Beauchamp, N. A.

1974-01-01

The New User Function plan for identifying beneficial uses of space is described. Critical issues such as funding, manpower, and protection of user proprietary rights are discussed along with common barriers which impede the development of a user community. Studies for developing methodologies of identifying new users and uses of the space transportation system are included.

A 2017 Horizon Scan of Emerging Issues for Global Conservation and Biological Diversity.

PubMed

Sutherland, William J; Barnard, Phoebe; Broad, Steven; Clout, Mick; Connor, Ben; Côté, Isabelle M; Dicks, Lynn V; Doran, Helen; Entwistle, Abigail C; Fleishman, Erica; Fox, Marie; Gaston, Kevin J; Gibbons, David W; Jiang, Zhigang; Keim, Brandon; Lickorish, Fiona A; Markillie, Paul; Monk, Kathryn A; Pearce-Higgins, James W; Peck, Lloyd S; Pretty, Jules; Spalding, Mark D; Tonneijck, Femke H; Wintle, Bonnie C; Ockendon, Nancy

2017-01-01

We present the results of our eighth annual horizon scan of emerging issues likely to affect global biological diversity, the environment, and conservation efforts in the future. The potential effects of these novel issues might not yet be fully recognized or understood by the global conservation community, and the issues can be regarded as both opportunities and risks. A diverse international team with collective expertise in horizon scanning, science communication, and conservation research, practice, and policy reviewed 100 potential issues and identified 15 that qualified as emerging, with potential substantial global effects. These issues include new developments in energy storage and fuel production, sand extraction, potential solutions to combat coral bleaching and invasive marine species, and blockchain technology. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

A horizon scanning assessment of current and potential future threats to migratory shorebirds

USGS Publications Warehouse

Sutherland, William J.; Alves, José A.; Amano, Tatsuya; Chang, Charlotte H.; Davidson, Nicholas C.; Finlayson, C. Max; Gill, Jennifer A.; Gill, Robert E.; González, Patricia M.; Gunnarsson, Tómas Grétar; Kleijn, David; Spray, Chris J.; Székely, Tamás; Thompson, Des B.A.

2012-01-01

We review the conservation issues facing migratory shorebird populations that breed in temperate regions and use wetlands in the non-breeding season. Shorebirds are excellent model organisms for understanding ecological, behavioural and evolutionary processes and are often used as indicators of wetland health. A global team of experienced shorebird researchers identified 45 issues facing these shorebird populations, and divided them into three categories (natural, current anthropogenic and future issues). The natural issues included megatsunamis, volcanoes and regional climate changes, while current anthropogenic threats encompassed agricultural intensification, conversion of tidal flats and coastal wetlands by human infrastructure developments and eutrophication of coastal systems. Possible future threats to shorebirds include microplastics, new means of recreation and infectious diseases. We suggest that this review process be broadened to other taxa to aid the identification and ranking of current and future conservation actions.

NASA Presentation to TechAmerica G12 Committee

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Sampson, Michael J.

2011-01-01

This slide presentation reviews some of the actions that NASA is taking to address the issue of counterfeit electronic parts. While the emphasis is on electronic parts, the vision is broad enough to include materials and software. The effort includes coordination with other agencies, to identify and with the Government-Industry Data Exchange Program (GIDEP). An interim GIDEP Policy for suspected counterfeits was instituted. NASA's recommendation to the policy was for identification of the supplier and suggests allowing access to that information by government only. The issues with the General MIL specification, the testing requirements for radiation issues, the continuing development of Class Y standards for electronic equipment, status of package case isolation tests needed for 750 and 883,enhancement of 750 Internal Visual Inspection are reviewed. Further issues with consistent ESD control conditions across commodities, test methods, humidity limits, etc are briefly reviewed. The cost benefit analysis of film versus Real time radiography are also reviewed.

Implementation Issues for Departure Planning Systems

NASA Technical Reports Server (NTRS)

Hansman, R. John; Feron, Eric; Clarke, John-Paul; Odoni, Amedeo

1999-01-01

The objective of the proposed effort is to investigate issues associated with the design and implementation of decision aiding tools to assist in improving the departure process at congested airports. This effort follows a preliminary investigation of potential Departure Planning approaches and strategies, which identified potential benefits in departure efficiency, and also in reducing the environmental impact of aircraft in the departure queue. The preliminary study bas based, in large part, on observations and analysis of departure processes at Boston, Logan airport. The objective of this follow-on effort is to address key implementation issues and to expand the observational base to include airports with different constraints and traffic demand. Specifically, the objectives of this research are to: (1) Expand the observational base to include airports with different underlying operational dynamics. (2) Develop prototype decision aiding algorithms/approaches and assess potential benefits. and (3) Investigate Human Machine Integration (HMI) issues associated with decision aids in tower environments.

A review of issues and concerns of family members of adult burn survivors.

PubMed

Sundara, Diana C

2011-01-01

The purpose of this review is to synthesize what is known about the issues and concerns of families of adult burn survivors from research and clinical articles written between 1973 and 2009. Electronic database searching, ancestry searching, and electronic hand searching were performed to identify relevant articles. Seventeen research studies and 14 clinical articles were identified. Families are often in crisis immediately after the injury. This crisis involves strong emotions, some of which may persist over time. Throughout the course of hospitalization, family issues include worries about their loved one's physical appearance, logistical concerns, and the transition to home. For partners, role changes and sexual concerns may be of particular importance. Extended family, friends, the burn team, and other families affected by a burn injury are important sources of support for family members. Few studies have been conducted beyond the time of hospitalization. Clinical articles have identified issues not present in the research literature. Further research is needed that focuses more closely on families and their experiences both in and out of the hospital. Implications for burn care providers based on the findings of this review are discussed.

Working Notes from the 1992 AAAI Workshop on Automating Software Design. Theme: Domain Specific Software Design

NASA Technical Reports Server (NTRS)

Keller, Richard M. (Editor); Barstow, David; Lowry, Michael R.; Tong, Christopher H.

1992-01-01

The goal of this workshop is to identify different architectural approaches to building domain-specific software design systems and to explore issues unique to domain-specific (vs. general-purpose) software design. Some general issues that cut across the particular software design domain include: (1) knowledge representation, acquisition, and maintenance; (2) specialized software design techniques; and (3) user interaction and user interface.

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

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

PubMed

Ali, Syeda Kauser; Baig, Lubna A

2012-05-16

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

Who helps the leaders? Difficulties experienced by cancer support group leaders.

PubMed

Kirsten, Laura; Butow, Phyllis; Price, Melanie; Hobbs, Kim; Sunquist, Kendra

2006-07-01

Cancer support groups are an important source of support for cancer patients, yet little is known about the challenges and training needs of both professionally trained and untrained leaders. The aim of this study was to discover the difficulties experienced and training desired by cancer support group leaders. Twenty-seven leaders of 34 cancer support groups participated in focus groups or individual interviews. Groups were purposively selected as representative of 173 support groups identified in New South Wales which were for adults with cancer and/or their adult carers and were not therapeutic or education-only groups. Difficulties identified included dealing with people's different communication styles and needs; dealing with recurrence, metastases and death; practical issues, including resources, setting the programme and funding security; maintaining personal balance and preventing burn out; establishing group credibility; dealing with group cycles; and leading groups in rural areas. Leaders also identified benefits and rewards from group leadership such as contributing to others' well-being, self-development and insight into others' lives. Non-professionally trained leaders experienced more difficulties, particularly in dealing with group process and practical issues. Difficulties identified were related both to working with a cancer population specifically and to working with groups in general. While some issues were common to both health professionals and non-health professionals, non-health professionals reported greater supportive needs. Clear guidelines, targeted training and development of better methods of support to reduce the stress and burn out experienced by group leaders are needed.

DNAPL SITE EVALUATION - Project Summary

EPA Science Inventory

Dense nonaqueous-phase liquids (DNAPLs), especially chlorinated solvents, are among the most prevalent subsurface contaminants identified in ground-water supplies and at waste disposal sites. There are several site-characterization issues specific to DNAPL sites including (a) the...

Teaching Occupational Health to Physicians

ERIC Educational Resources Information Center

Wegman, David H.; And Others

1978-01-01

A comprehensive training program is described that prepares students to identify and prevent occupational disease, emphasizing public health. Content areas include epidemiology and biostatistics, toxicology, industrial hygiene, safety and ergonomics, policy issues, administration, and clinical aspects. (Author/LBH)

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

Leading trends in environmental regulation that affect energy development. Final report

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

Steele, R V; Attaway, L D; Christerson, J A

1980-01-01

Major environmental issues that are likely to affect the implementation of energy technologies between now and the year 2000 are identified and assessed. The energy technologies specifically addressed are: oil recovery and processing; gas recovery and processing; coal liquefaction; coal gasification (surface); in situ coal gasification; direct coal combustion; advanced power systems; magnetohydrodynamics; surface oil shale retorting; true and modified in situ oil shale retorting; geothermal energy; biomass energy conversion; and nuclear power (fission). Environmental analyses of these technologies included, in addition to the main processing steps, the complete fuel cycle from resource extraction to end use. A comprehensive surveymore » of the environmental community (including environmental groups, researchers, and regulatory agencies) was carried out in parallel with an analysis of the technologies to identify important future environmental issues. Each of the final 20 issues selected by the project staff has the following common attributes: consensus of the environmental community that the issue is important; it is a likely candidate for future regulatory action; it deals with a major environmental aspect of energy development. The analyses of the 20 major issues address their environmental problem areas, current regulatory status, and the impact of future regulations. These analyses are followed by a quantitative assessment of the impact on energy costs and nationwide pollutant emissions of possible future regulations. This is accomplished by employing the Strategic Environmental Assessment System (SEAS) for a subset of the 20 major issues. The report concludes with a more general discussion of the impact of environmental regulatory action on energy development.« less

Health economics of screening for gynaecological cancers.

PubMed

Kulasingam, Shalini; Havrilesky, Laura

2012-04-01

In this chapter, we summarise findings from recent cost-effectiveness analyses of screening for cervical cancer and ovarian cancer. We begin with a brief summary of key issues that affect the cost-effectiveness of screening, including disease burden, and availability and type of screening tests. For cervical cancer, we discuss the potential effect of human papilloma virus vaccines on screening. Outstanding epidemiological and cost-effectiveness issues are included. For cervical cancer, this includes incorporating the long-term effect of treatment (including adverse birth outcomes in treated women who are of reproductive age) into cost-effectiveness models using newly available trial data to identify the best strategy for incorporating human papilloma virus tests. A second issue is the need for additional data on human papilloma virus vaccines, such as effectiveness of reduced cancer incidence and mortality, effectiveness in previously exposed women and coverage. Definitive data on these parameters will allow us to update model-based analyses to include more realistic estimates, and also potentially dramatically alter our approach to screening. For ovarian cancer, outstanding issues include confirming within the context of a trial that screening is effective for reducing mortality and incorporating tests with high specificity into screening into screening algorithms for ovarian cancer. Copyright © 2011 Elsevier Ltd. All rights reserved.

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.

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/.

Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area.

PubMed

Stellenberg, Ethelwynn L; Dorse, Alta J

2014-06-06

Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts, target setting, the shortage of nurses and expertise. The objectives of the study were to identify ethical issues related to patient care, to describe ethical issues related to patient diversity, rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment. A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5%) was drawn from all nurses and caregivers (N = 2990) working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables. RESULTS included (95%) of respondents provided safe and committed care to their patients, (99%) loved to care for their patients and (93%) believed in the Nurses' Pledge of Service. Fifty percent (50%) of the respondents indicated verbal abuse from patients and only (59%) experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse. This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient.

Attentional Requirements for the Selection of Words from Different Grammatical Categories

ERIC Educational Resources Information Center

Ayora, Pauline; Janssen, Niels; Dell'Acqua, Roberto; Alario, F.-Xavier

2009-01-01

Two grammatical classes are commonly distinguished in psycholinguistic research. The open-class includes content words such as nouns, whereas the closed-class includes function words such as determiners. A standing issue is to identify whether these words are retrieved through similar or distinct selection mechanisms. We report a comparative…

The Director's Toolbox for Including Children with Special Needs

ERIC Educational Resources Information Center

Barker, Linda; Goldberg, Roberta

2012-01-01

Directors of early childhood programs are the "frontline" for parents seeking admission for their children with identified special needs. In addition, developmental and behavioral issues that emerge after a child is enrolled in a program quickly come to the director's attention. Determining who can be included at a site, how to prepare the…

PATHOGEN RISK ASSESSMENT FOR LAND APPLICATION OF MUNICIPAL SLUDGE, VOLUME II: USER'S MANUAL

EPA Science Inventory

Section 405 of the Clean Water Act requires the U.S. EPA to develop and issue regulations that identify: 1) uses for sludge including disposal; 2) specific factors (including costs) to be taken into account in determining the measures and practices applicable for each use or disp...

PATHOGEN RISK ASSESSMENT FOR LAND APPLICATION OF MUNICIPAL SLUDGE VOLUME I: METHODOLOGY AND COMPUTER MODEL

EPA Science Inventory

Section 405 of the Clean Water Act requires the U.S. EPA to develop and issue regulations that identify: 1) uses for sludge including disposal; 2) specific factors (including costs) to be taken into account in determining the measures and practices applicable for each use or disp...

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

Berman, M.; Boyack, K.; VanDevender, J.P.

Prosperity Games are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games are unique in that both the game format and the player contributions vary from game to game. This report documents the Environmental Prosperity Game conducted under the sponsorship of the Silicon Valley Environmental Partnership. Playersmore » were drawn from all stakeholders involved in environmental technologies including small and large companies, government, national laboratories, universities, environmentalists, the legal profession, finance, and the media. The primary objectives of this game were to: investigate strategies for developing a multi-agency (national/state/regional), one-step regulatory approval process for certifying and implementing environmental technologies and evaluating the simulated results; identify the regulatory hurdles and requirements, and the best approaches for surmounting them; identify technical problems and potential resources (environmental consultants, labs, universities) for solving them. The deliberations and recommendations of these players provided valuable insights as to the views of this diverse group of decision makers concerning environmental issues, including the development, licensing, and commercialization of new technologies.« less

Ethical issues in public health surveillance: a systematic qualitative review.

PubMed

Klingler, Corinna; Silva, Diego Steven; Schuermann, Christopher; Reis, Andreas Alois; Saxena, Abha; Strech, Daniel

2017-04-04

Public health surveillance is not ethically neutral and yet, ethics guidance and training for surveillance programmes is sparse. Development of ethics guidance should be based on comprehensive and transparently derived overviews of ethical issues and arguments. However, existing overviews on surveillance ethics are limited in scope and in how transparently they derived their results. Our objective was accordingly to provide an overview of ethical issues in public health surveillance; in addition, to list the arguments put forward with regards to arguably the most contested issue in surveillance, that is whether to obtain informed consent. Ethical issues were defined based on principlism. We assumed an ethical issue to arise in surveillance when a relevant normative principle is not adequately considered or two principles come into conflict. We searched Pubmed and Google Books for relevant publications. We analysed and synthesized the data using qualitative content analysis. Our search strategy retrieved 525 references of which 83 were included in the analysis. We identified 86 distinct ethical issues arising in the different phases of the surveillance life-cycle. We further identified 20 distinct conditions that make it more or less justifiable to forego informed consent procedures. This is the first systematic qualitative review of ethical issues in public health surveillance resulting in a comprehensive ethics matrix that can inform guidelines, reports, strategy papers, and educational material and raise awareness among practitioners.

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 .

Facilitating access to pre-processed research evidence in public health

PubMed Central

2010-01-01

Background Evidence-informed decision making is accepted in Canada and worldwide as necessary for the provision of effective health services. This process involves: 1) clearly articulating a practice-based issue; 2) searching for and accessing relevant evidence; 3) appraising methodological rigor and choosing the most synthesized evidence of the highest quality and relevance to the practice issue and setting that is available; and 4) extracting, interpreting, and translating knowledge, in light of the local context and resources, into practice, program and policy decisions. While the public health sector in Canada is working toward evidence-informed decision making, considerable barriers, including efficient access to synthesized resources, exist. Methods In this paper we map to a previously developed 6 level pyramid of pre-processed research evidence, relevant resources that include public health-related effectiveness evidence. The resources were identified through extensive searches of both the published and unpublished domains. Results Many resources with public health-related evidence were identified. While there were very few resources dedicated solely to public health evidence, many clinically focused resources include public health-related evidence, making tools such as the pyramid, that identify these resources, particularly helpful for public health decisions makers. A practical example illustrates the application of this model and highlights its potential to reduce the time and effort that would be required by public health decision makers to address their practice-based issues. Conclusions This paper describes an existing hierarchy of pre-processed evidence and its adaptation to the public health setting. A number of resources with public health-relevant content that are either freely accessible or requiring a subscription are identified. This will facilitate easier and faster access to pre-processed, public health-relevant evidence, with the intent of promoting evidence-informed decision making. Access to such resources addresses several barriers identified by public health decision makers to evidence-informed decision making, most importantly time, as well as lack of knowledge of resources that house public health-relevant evidence. PMID:20181270

On Identifying the Sound Sources in a Turbulent Flow

NASA Technical Reports Server (NTRS)

Goldstein, M. E.

2008-01-01

A space-time filtering approach is used to divide an unbounded turbulent flow into its radiating and non-radiating components. The result is then used to clarify a number of issues including the possibility of identifying the sources of the sound in such flows. It is also used to investigate the efficacy of some of the more recent computational approaches.

Validity, Reliability, and Equity Issues in an Observational Talent Assessment Process in the Performing Arts

ERIC Educational Resources Information Center

Oreck, Barry A.; Owen, Steven V.; Baum, Susan M.

2003-01-01

The lack of valid, research-based methods to identify potential artistic talent hampers the inclusion of the arts in programs for the gifted and talented. The Talent Assessment Process in Dance, Music, and Theater (D/M/T TAP) was designed to identify potential performing arts talent in diverse populations, including bilingual and special education…

Using a communication audit to improve communication on clinical placement in pre-registration nursing.

PubMed

Hogard, Elaine; Ellis, Roger; Ellis, Jackie; Barker, Chris

2005-02-01

This article describes a novel communication audit conducted with those concerned with the practice placements of pre-registration Nursing students. The study, uniquely, addressed all who were involved in communication concerning placement in what is described as an organisational analysis. The aim of the audit was to identify levels of satisfaction and dissatisfaction with present communication processes and to identify points for improvement. The audit used the Hogard-Barker Communication Audit of Practice a customized version of a well established tool, devised to cover issues relevant to practice placements. A key feature of the tool is the opportunity for participants to identify the amount of communication they are receiving on particular topics and issues against the amount they would like to receive. Participants in the audit included students, assessor mentors, ward managers, clinical facilitators and link tutors. Overall there was considerable dissatisfaction with what was perceived to be the insufficient amount of communication received on a number of topics including allocations, the curriculum, students' learning outcomes and commitments in terms of college work. In addition to identifying points for improvement the audit provides a baseline against which progress can be assessed through a future audit.

77 FR 39425 - Approval and Promulgation of Implementation Plans; Louisiana; Regional Haze State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... disapproval because of deficiencies in Louisiana's RH SIP submittal that go beyond the issues addressed in the... submittal includes several deficient provisions. The deficiencies identified in the proposal go beyond those...

Health Informatics.

ERIC Educational Resources Information Center

Russell, Marie; Brittain, J. Michael

2002-01-01

Identifies current trends and issues in health informatics with examples of applications, particularly in English-speaking countries. Topics include health systems, professionals, and patients; consumer health information; electronic medical records; nursing; privacy and confidentiality; finding and using information; the Internet; e-mail;…

Validity of juvenile idiopathic arthritis diagnoses using administrative health data.

PubMed

Stringer, Elizabeth; Bernatsky, Sasha

2015-03-01

Administrative health databases are valuable sources of data for conducting research including disease surveillance, outcomes research, and processes of health care at the population level. There has been limited use of administrative data to conduct studies of pediatric rheumatic conditions and no studies validating case definitions in Canada. We report a validation study of incident cases of juvenile idiopathic arthritis in the Canadian province of Nova Scotia. Cases identified through administrative data algorithms were compared to diagnoses in a clinical database. The sensitivity of algorithms that included pediatric rheumatology specialist claims was 81-86%. However, 35-48% of cases that were identified could not be verified in the clinical database depending on the algorithm used. Our case definitions would likely lead to overestimates of disease burden. Our findings may be related to issues pertaining to the non-fee-for-service remuneration model in Nova Scotia, in particular, systematic issues related to the process of submitting claims.

Electrical and Chemical Interactions at Mars Workshop. Part 2: Appendix

NASA Technical Reports Server (NTRS)

1992-01-01

The objectives of the workshop were the following: (1) to identify issues related to electrical and chemical interactions between systems and their local environments at Mars; and (2) to recommend means of addressing those issues, including the dispatch of robotic spacecraft to Mars to acquire necessary information. Presentations about Mars' surface and orbital environments, Space Exploration Initiative (SEI) systems, environmental interactions, modeling and analysis, and plans for exploration are presented in viewgraph form.

Life from a plantary perspective: Fundamental issues in global ecology

NASA Technical Reports Server (NTRS)

Botkin, D. B.

1980-01-01

Twenty-three scientists from diverse disciplines met for one week at the University of California, Santa Barbara to discuss life from a planetary perspective. The scientists represented the major disciplines concerned with the Earth's biota, oceans, atmosphere and sediments, including geochemistry, atmospheric chemistry, chemical oceanography, limnology, forestry, terrestrial ecology, microbiology, biophysics, geography and remote sensing as well as mathematics. These twenty-three scientists met to discuss whether there was, at this time, a set of scientific issues concerning life and the entire Earth as a single unit, to set down the major tractable issues, and to suggest a set of activities that would promote the study of the issues identified. Their conclusions are summarized.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas.

PubMed

Impoinvil, Daniel E; Ahmad, Sajjad; Troyo, Adriana; Keating, Joseph; Githeko, Andrew K; Mbogo, Charles M; Kibe, Lydiah; Githure, John I; Gad, Adel M; Hassan, Ali N; Orshan, Laor; Warburg, Alon; Calderón-Arguedas, Olger; Sánchez-Loría, Victoria M; Velit-Suarez, Rosanna; Chadee, Dave D; Novak, Robert J; Beier, John C

2007-10-01

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus-group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site's biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying "best practices" for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission.

Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas

PubMed Central

Impoinvil, Daniel E.; Ahmad, Sajjad; Troyo, Adriana; Keating, Joseph; Githeko, Andrew K.; Mbogo, Charles M; Kibe, Lydiah; Githure, John I.; Gad, Adel M.; Hassan, Ali N.; Orshan, Laor; Warburg, Alon; Calderón-Arguedas, Olger; Sánchez-Loría, Victoria M.; Velit-Suarez, Rosanna; Chadee, Dave D.; Novak, Robert J.; Beier, John C.

2007-01-01

Mosquito control programs at seven urban sites in Kenya, Egypt, Israel, Costa Rica, and Trinidad are described and compared. Site-specific urban and disease characteristics, organizational diagrams, and strengths, weaknesses, obstacles and threats (SWOT) analysis tools are used to provide a descriptive assessment of each mosquito control program, and provide a comparison of the factors affecting mosquito abatement. The information for SWOT analysis is collected from surveys, focus group discussions, and personal communication. SWOT analysis identified various issues affecting the efficiency and sustainability of mosquito control operations. The main outcome of our work was the description and comparison of mosquito control operations within the context of each study site’s biological, social, political, management, and economic conditions. The issues identified in this study ranged from lack of inter-sector collaboration to operational issues of mosquito control efforts. A lack of sustainable funding for mosquito control was a common problem for most sites. Many unique problems were also identified, which included lack of mosquito surveillance, lack of law enforcement, and negative consequences of human behavior. Identifying common virtues and shortcomings of mosquito control operations is useful in identifying “best practices” for mosquito control operations, thus leading to better control of mosquito biting and mosquito-borne disease transmission. PMID:17316882

Issues in identifying germ tube positive yeasts by conventional methods.

PubMed

Yazdanpanah, Atta; Khaithir, Tzar Mohd Nizam

2014-01-01

Candida speciation is vital for epidemiology and management of candidiasis. Nonmolecular conventional methods often fail to identify closely related germ tube positive yeasts from clinical specimens. The present study was conducted to identify these yeasts and to highlight issues in conventional versus molecular methods of identification. A total of 98 germ tube positive yeasts from high vaginal swabs were studied over a 12-month period. Isolates were examined with various methods including growth at 42 °C and 45 °C on Sabouraud dextrose agar (SDA), color development on CHROMagar Candida medium, chlamydospore production on corn meal agar at 25 °C, carbohydrate assimilation using ID 32C system, and polymerase chain reaction using a single pair of primers targeting the hyphal wall protein 1 (Hwp1) gene. Of all the isolates studied, 97 were molecularly confirmed as C. albicans and one isolate was identified as C. dubliniensis. No C. africana was detected in this study. The molecular method used in our study was an accurate and useful tool for discriminating C. albicans, C. dubliniensis, and C. africana. The conventional methods, however, were less accurate and riddled with many issues that will be discussed in further details. © 2013 Wiley Periodicals, Inc.

USSR Space Life Sciences Digest, issue 28

NASA Technical Reports Server (NTRS)

Stone, Lydia Razran (Editor); Teeter, Ronald (Editor); Rowe, Joseph (Editor)

1990-01-01

This is the twenty-eighth issue of NASA's Space Life Sciences Digest. It contains abstracts of 60 journal papers or book chapters published in Russian and of 3 Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. The abstracts in this issue have been identified as relevant to 20 areas of space biology and medicine. These areas include: adaptation, aviation medicine, botany, cardiovascular and respiratory systems, developmental biology, endocrinology, enzymology, equipment and instrumentation, hematology, human performance, immunology, life support systems, mathematical modeling, musculoskeletal system, neurophysiology, personnel selection, psychology, radiobiology, reproductive system, and space medicine.

USSR Space Life Sciences Digest, issue 30

NASA Technical Reports Server (NTRS)

Stone, Lydia Razran (Editor); Teeter, Ronald (Editor); Rowe, Joseph (Editor)

1991-01-01

This is the thirtieth issue of NASA's Space Life Sciences Digest. It contains abstracts of 47 journal papers or book chapters published in Russian and of three Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. The abstracts in this issue have been identified as relevant to 20 areas of space biology and medicine. These areas include: adaptation, biospheric research, cardiovascular and respiratory systems, endocrinology, equipment and instrumentation, gastrointestinal system, group dynamics, habitability and environmental effects, hematology, human performance, immunology, life support systems, mathematical modeling, metabolism, musculoskeletal system, neurophysiology, nutrition, psychology, radiobiology, and space biology and medicine.

USSR Space Life Sciences Digest, issue 31

NASA Technical Reports Server (NTRS)

Hooke, Lydia Razran (Editor); Teeter, Ronald (Editor); Garshnek, Victoria (Editor); Rowe, Joseph (Editor)

1990-01-01

This is the thirty first issue of NASA's Space Life Sciences Digest. It contains abstracts of 55 journal papers or book chapters published in Russian and of 5 Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. The abstracts in this issue have been identified as relevant to 18 areas of space biology and medicine. These areas include: adaptation, biological rhythms, cardiovascular and respiratory systems, endocrinology, enzymology, genetics, group dynamics, habitability and environmental effects, hematology, life support systems, metabolism, microbiology, musculoskeletal system, neurophysiology, nutrition, operational medicine, psychology, radiobiology, and space biology and medicine.

Clinically relevant safety issues associated with St. John's wort product labels.

PubMed

Clauson, Kevin A; Santamarina, Marile L; Rutledge, Jennifer C

2008-07-17

St. John's wort (SJW), used to treat depression, is popular in the USA, Canada, and parts of Europe. However, there are documented interactions between SJW and prescription medications including warfarin, cyclosporine, indinavir, and oral contraceptives. One source of information about these safety considerations is the product label. The aim of this study was to evaluate the clinically relevant safety information included on labeling in a nationally representative sample of SJW products from the USA. Eight clinically relevant safety issues were identified: drug interactions (SJW-HIV medications, SJW-immunosupressants, SJW-oral contraceptives, and SJW-warfarin), contraindications (bipolar disorder), therapeutic duplication (antidepressants), and general considerations (phototoxicity and advice to consult a healthcare professional (HCP)). A list of SJW products was identified to assess their labels. Percentages and totals were used to present findings. Of the seventy-four products evaluated, no product label provided information for all 8 evaluation criteria. Three products (4.1%) provided information on 7 of the 8 criteria. Four products provided no safety information whatsoever. Percentage of products with label information was: SJW-HIV (8.1%), SJW-immunosupressants (5.4%), SJW-OCPs (8.1%), SJW-warfarin (5.4%), bipolar (1.4%), antidepressants (23.0%), phototoxicity (51.4%), and consult HCP (87.8%). Other safety-related information on labels included warnings about pregnancy (74.3%), lactation (64.9%), discontinue if adverse reaction (23.0%), and not for use in patients under 18 years old (13.5%). The average number of a priori safety issues included on a product label was 1.91 (range 0-8) for 23.9% completeness. The vast majority of SJW products fail to adequately address clinically relevant safety issues on their labeling. A few products do provide an acceptable amount of information on clinically relevant safety issues which could enhance the quality of counseling by HCPs and health store clerks. HCPs and consumers may benefit if the FDA re-examined labeling requirements for dietary supplements.

Clinically relevant safety issues associated with St. John's wort product labels

PubMed Central

Clauson, Kevin A; Santamarina, Marile L; Rutledge, Jennifer C

2008-01-01

Background St. John's wort (SJW), used to treat depression, is popular in the USA, Canada, and parts of Europe. However, there are documented interactions between SJW and prescription medications including warfarin, cyclosporine, indinavir, and oral contraceptives. One source of information about these safety considerations is the product label. The aim of this study was to evaluate the clinically relevant safety information included on labeling in a nationally representative sample of SJW products from the USA. Methods Eight clinically relevant safety issues were identified: drug interactions (SJW-HIV medications, SJW-immunosupressants, SJW-oral contraceptives, and SJW-warfarin), contraindications (bipolar disorder), therapeutic duplication (antidepressants), and general considerations (phototoxicity and advice to consult a healthcare professional (HCP)). A list of SJW products was identified to assess their labels. Percentages and totals were used to present findings. Results Of the seventy-four products evaluated, no product label provided information for all 8 evaluation criteria. Three products (4.1%) provided information on 7 of the 8 criteria. Four products provided no safety information whatsoever. Percentage of products with label information was: SJW-HIV (8.1%), SJW-immunosupressants (5.4%), SJW-OCPs (8.1%), SJW-warfarin (5.4%), bipolar (1.4%), antidepressants (23.0%), phototoxicity (51.4%), and consult HCP (87.8%). Other safety-related information on labels included warnings about pregnancy (74.3%), lactation (64.9%), discontinue if adverse reaction (23.0%), and not for use in patients under 18 years old (13.5%). The average number of a priori safety issues included on a product label was 1.91 (range 0–8) for 23.9% completeness. Conclusion The vast majority of SJW products fail to adequately address clinically relevant safety issues on their labeling. A few products do provide an acceptable amount of information on clinically relevant safety issues which could enhance the quality of counseling by HCPs and health store clerks. HCPs and consumers may benefit if the FDA re-examined labeling requirements for dietary supplements. PMID:18637192

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.

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.

Prescription opioid abuse, pain and addiction: Clinical issues and implications

PubMed Central

LING, WALTER; MOONEY, LARISSA; HILLHOUSE, MAUREEN

2014-01-01

Issues Prescription opioid misuse in the USA has increased over threefold since 1990 to epidemic proportions, with substantial increases in prescription opioid use also reported in other countries, such as Australia and New Zealand. The broad availability of prescription pain medications, coupled with public misconceptions about their safety and addictive potential, have contributed to the recent surge in non-medical use of prescription opioids and corresponding increases in treatment admissions for problems related to opioid misuse. Given competing pressures faced by physicians to both diagnose and treat pain syndromes and identify individuals at risk for addictive disorders, the use of opioids in the treatment of pain poses a significant clinical challenge. Approach This paper reviews the interaction between pain and opioid addiction with a focus on clinical management issues, including risk factors for opioid dependence in patients with chronic pain and the use of assessment tools to identify and monitor at-risk individuals. Treatment options for opioid dependence and pain are reviewed, including the use of the partial μ agonist buprenorphine in the management of concurrent pain and opioid addiction. Implications Physicians should strive to find a reasonable balance between minimising potential adverse effects of opioid medications without diminishing legitimate access to opioids for analgesia. Conclusions The article discusses the need to identify methods for minimising risks and negative consequences associated with opioid analgesics and poses research directions, including the development of abuse-deterrent opioid formulations, genetic risk factors for opioid dependence and opioid-induced hyperalgesia as a potential target for medication therapy. PMID:21545561

Feasibility and benefits of laminar flow control on supersonic cruise airplanes

NASA Technical Reports Server (NTRS)

Powell, A. G.; Agrawal, S.; Lacey, T. R.

1989-01-01

An evaluation was made of the applicability and benefits of laminar flow control (LFC) technology to supersonic cruise airplanes. Ancillary objectives were to identify the technical issues critical to supersonic LFC application, and to determine how those issues can be addressed through flight and wind-tunnel testing. Vehicle types studied include a Mach 2.2 supersonic transport configuration, a Mach 4.0 transport, and two Mach 2-class fighter concepts. Laminar flow control methodologies developed for subsonic and transonic wing laminarization were extended and applied. No intractible aerodynamic problems were found in applying LFC to airplanes of the Mach 2 class, even ones of large size. Improvements of 12 to 17 percent in lift-drag ratios were found. Several key technical issues, such as contamination avoidance and excresence criteria were identified. Recommendations are made for their resolution. A need for an inverse supersonic wing design methodology is indicated.

Challenges, issues and trends in fall detection systems

PubMed Central

2013-01-01

Since falls are a major public health problem among older people, the number of systems aimed at detecting them has increased dramatically over recent years. This work presents an extensive literature review of fall detection systems, including comparisons among various kinds of studies. It aims to serve as a reference for both clinicians and biomedical engineers planning or conducting field investigations. Challenges, issues and trends in fall detection have been identified after the reviewing work. The number of studies using context-aware techniques is still increasing but there is a new trend towards the integration of fall detection into smartphones as well as the use of machine learning methods in the detection algorithm. We have also identified challenges regarding performance under real-life conditions, usability, and user acceptance as well as issues related to power consumption, real-time operations, sensing limitations, privacy and record of real-life falls. PMID:23829390

Ni{sub 3}Al technology transfer

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

Sikka, V.K.; Viswanathan, S.; Santella, M.L.

1997-04-01

Ductile Ni{sub 3}Al and Ni{sub 3}Al-based alloys have been identified for a range of applications. These applications require the use of material in a variety of product forms such as sheet, plate, bar, wire, tubing, piping, and castings. Although significant progress has been made in the melting, casting, and near-net-shape forming of nickel aluminides, some issues still remain. These include the need for: (1) high-strength castable composition for many applications that have been identified; (2) castability (mold type, fluidity, hot-shortness, porosity, etc.); (3) weld reparability of castings; and (4) workability of cast or powder metallurgy product to sheet, bar, andmore » wire. The four issues listed above can be {open_quotes}show stoppers{close_quotes} for the commercial application of nickel aluminides. This report describes the work completed to address some of these issues during FY 1996.« less

Using Community-Based Participatory Research to Identify Environmental Justice Issues in an Inner-City Community and Inform Urban Planning.

PubMed

Mansyur, Carol Leler; Jeng, Hueiwang Anna; Holloman, Erica; DeBrew, Linwood

2016-01-01

The Southeast CARE Coalition has been using community-based participatory research to examine environmental degradation in the Southeast Community, Newport News, Virginia. A survey was developed to collect assessment data. Up to 66% of respondents were concerned about environmental problems in their community. Those with health conditions were significantly more likely to identify specific environmental problems. The top 5 environmental concerns included coal dust, air quality, crime, water quality, and trash. The community-based participatory research process is building community capacity and participation, providing community input into strategic planning, and empowering community members to take control of environmental justice issues in their community.

The EPA's Human Exposure Research Program for Assessing Cumulative Risk in Communities

EPA Science Inventory

Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available...

Major workforce challenges confronting New York City Transit.

DOT National Transportation Integrated Search

2017-05-01

The purpose of this research was to identify the pressing workforce issues confronted by transit authorities : nationwide and promising ways in which they are being addressed. The study also included a closer : examination of New York City Transit (N...

14 CFR 1216.307 - Scoping.

Code of Federal Regulations, 2012 CFR

2012-01-01

... addressed in environmental impact statements and for identifying the significant issues related to a... process must include considerations of the range of actions, alternatives, and impacts discussed in § 1508...; (i) Historical, archeological, and recreational factors; (j) Wetlands and floodplains; and (k...

14 CFR 1216.307 - Scoping.

Code of Federal Regulations, 2011 CFR

2011-01-01

... addressed in environmental impact statements and for identifying the significant issues related to a... process must include considerations of the range of actions, alternatives, and impacts discussed in § 1508...; (i) Historical, archeological, and recreational factors; (j) Wetlands and floodplains; and (k...

14 CFR 1216.307 - Scoping.

Code of Federal Regulations, 2010 CFR

2010-01-01

... addressed in environmental impact statements and for identifying the significant issues related to a... process must include considerations of the range of actions, alternatives, and impacts discussed in § 1508...; (i) Historical, archeological, and recreational factors; (j) Wetlands and floodplains; and (k...

Education and Work.

ERIC Educational Resources Information Center

Poole, Millicent E., Ed.

This book contains 13 papers that identify major education and work issues related to post-compulsory schooling in Australia. The following papers are included: "Changing Policy Perspectives" (Millicent E. Poole); "A Historical Essay" (Andrew Spaull); "A Philosophical Perspective" (Colin W. Evers); "School to…

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.

Teaching the Ethical Aspects of Environmental Science

NASA Astrophysics Data System (ADS)

Palinkas, C. M.

2014-12-01

Environmental and societal issues are often inherently linked, especially in coastal and estuarine environments, and science and social values must often be balanced in ecosystem management and decision-making. A new seminar course has been developed for the Marine Estuarine and Environmental Science (MEES) graduate program, an inter-institutional program within the University System of Maryland, to examine these issues. This 1-credit course, offered for the first time in Spring 2015, takes a complex systems perspective on major environmental and societal challenges to examine these linked issues in a variety of contexts. After a brief introduction to the emerging field of "geoethics," students develop a list of issues to examine throughout the seminar. Example topics could include fracking, offshore wind technology, dam removal, and iron fertilization, among others. A case-study approach is taken, with each class meeting focusing on one issue. For each case study, students are asked to 1) identify relevant scientific principles and major knowledge gaps, 2) predict potential outcomes, 3) identify stakeholders and likely viewpoints, and 4) construct communication plans to disseminate findings to these stakeholders. At the end of the semester, students give a brief presentation of the ethical aspects of their own research topics.

Report of sampling and analysis results, Addison Army housing units, Addison, Illinois. Final report

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

Not Available

1990-09-01

The objectives of this sampling and analysis effort include further characterization of environmental contamination identified in an enhanced preliminary assessment carried out in 1989. The specific activities performed at this site were identification, evaluation of the condition, and collection of samples from specific suspected asbestos-containing materials, including floor tiles, pipe run and pipe fitting insulation, dust in the ductwork, and exterior siding, where present. These evaluation were necessary to clarify potential environmental issues identified in the earlier report, prior to the sale or realignment of the property.

Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

PubMed

Meadows, Andrew B; Maine, Lucinda L; Keyes, Elizabeth K; Pearson, Kathy; Finstuen, Kenn

2005-01-01

To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. Delphi method for executive decision making. Civilian pharmacy profession. 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

Strategies for Limiting Engineers' Potential Liability for Indoor Air Quality Problems.

PubMed

von Oppenfeld, Rolf R; Freeze, Mark E; Sabo, Sean M

1998-10-01

Engineers face indoor air quality (IAQ) issues at the design phase of building construction as well as during the investigation and mitigation of potential indoor air pollution problems during building operation. IAQ issues that can be identified are "building-related illnesses" that may include problems of volatile organic compounds (VOCs). IAQ issues that cannot be identified are termed "sick building syndrome." Frequently, microorganism-caused illnesses are difficult to confirm. Engineers who provide professional services that directly or indirectly impact IAQ face significant potential liability to clients and third parties when performing these duties. Potential theories supporting liability claims for IAQ problems against engineers include breach of contract and various common law tort theories such as negligence and negligent misrepresentation. Furthermore, an increasing number of federal, state, and local regulations affect IAQ issues and can directly increase the potential liability of engineers. A duty to disclose potential or actual air quality concerns to third parties may apply for engineers in given circumstances. Such a duty may arise from judicial precedent, the Model Guide for Professional Conduct for Engineers, or the Code of Ethics for Engineers. Practical strategies engineers can use to protect themselves from liability include regular training and continuing education in relevant regulatory, scientific, and case law developments; detailed documentation and recordkeeping practices; adequate insurance coverage; contractual indemnity clauses; contractual provisions limiting liability to the scope of work performed; and contractual provisions limiting the extent of liability for engineers' negligence. Furthermore, through the proper use of building materials and construction techniques, an engineer or other design professional can effectively limit the potential for IAQ liability.

Environmental assessment overview

NASA Technical Reports Server (NTRS)

Valentino, A. R.

1980-01-01

The assessment program has as its objectives: to identify the environmental issues associated with the SPS Reference System; to prepare a preliminary assessment based on existing data; to suggest mitigating strategies and provide environmental data and guidance to other components of the program as required; and to plan long-range research to reduce the uncertainty in the preliminary assessment. The key environmental issues associated with the satellite power system are discussed and include human health and safety, ecosystems, climate, and interaction with electromagnetic systems.

The Top 10 Challenges in Extreme-Scale Visual Analytics

PubMed Central

Wong, Pak Chung; Shen, Han-Wei; Johnson, Christopher R.; Chen, Chaomei; Ross, Robert B.

2013-01-01

In this issue of CG&A, researchers share their R&D findings and results on applying visual analytics (VA) to extreme-scale data. Having surveyed these articles and other R&D in this field, we’ve identified what we consider the top challenges of extreme-scale VA. To cater to the magazine’s diverse readership, our discussion evaluates challenges in all areas of the field, including algorithms, hardware, software, engineering, and social issues. PMID:24489426

The health status of young adults in the United States.

PubMed

Park, M Jane; Paul Mulye, Tina; Adams, Sally H; Brindis, Claire D; Irwin, Charles E

2006-09-01

The health issues of young adulthood have received relatively little attention compared with those of adolescence, although the critical issues in young adulthood parallel those of adolescence. Young adults often fare worse than adolescents on health indicators, with many measures of negative outcomes--including rates of injury, homicide, and substance use--peaking during the young adult years. The contextual factors shaping health status and access to care in young adulthood differ significantly from the context of adolescence. This article synthesizes national data to present a health profile of young adults, reviewing social indicators that describe the context of young adulthood and presenting measures of health status. We examine mortality, morbidity, risky behaviors, and health care access and utilization, identifying the most significant gender and racial/ethnic disparities. The article also identifies limitations of existing data and offers suggestions for future research and health monitoring in this area. We conclude with a discussion of current efforts to address the health and well-being of young adults and argue for creating a national health agenda for young adults that includes research, programs and policies to address health issues during this period of the lifespan.

Moral distress in rehabilitation professionals: results from a hospital ethics survey.

PubMed

Mukherjee, Debjani; Brashler, Rebecca; Savage, Teresa A; Kirschner, Kristi L

2009-05-01

Moral distress in the rehabilitation setting was examined in a follow-up survey. The survey had 3 goals: (1) to systematically and anonymously gather data about the ethical issues that employees struggle with in their daily work; (2) to raise the visibility of the hospital-based ethics program and resources available to employees; and (3) to prioritize and focus the direction of the program's educational seminars, quality improvement projects, and ethics consultation. Online survey of employees. Urban rehabilitation system of care. The survey was open to all employees; 207 completed the survey. N/A MAIN OUTCOME MEASUREMENTS: N/A CONCLUSIONS: Three broad categories of moral distress were identified: institutional ethics, professional practice, and clinical decision-making. Institutional ethics issues related to the health care environment, such as health care reimbursement pressures and corporate culture. Professional practice issues involved codes of behavior and concepts of professionalism, including patient confidentiality/privacy. Clinical decision-making included such practical dilemmas as conflicts around goal-setting, discharge planning, and assessment of decision-making capacity. An anonymous survey of staff members allowed the hospital ethics program to identify sources of moral distress and prioritize strategies to address them.

Validating Computational Human Behavior Models: Consistency and Accuracy Issues

DTIC Science & Technology

2004-06-01

includes a discussion of SME demographics, content, and organization of the datasets . This research generalizes data from two pilot studies and two base...meet requirements for validating the varied and complex behavioral models. Through a series of empirical studies , this research identifies subject...meet requirements for validating the varied and complex behavioral models. Through a series of empirical studies , this research identifies subject

The role of the speech-language pathologist in identifying and treating children with auditory processing disorder.

PubMed

Richard, Gail J

2011-07-01

A summary of issues regarding auditory processing disorder (APD) is presented, including some of the remaining questions and challenges raised by the articles included in the clinical forum. Evolution of APD as a diagnostic entity within audiology and speech-language pathology is reviewed. A summary of treatment efficacy results and issues is provided, as well as the continuing dilemma for speech-language pathologists (SLPs) charged with providing treatment for referred APD clients. The role of the SLP in diagnosing and treating APD remains under discussion, despite lack of efficacy data supporting auditory intervention and questions regarding the clinical relevance and validity of APD.

Wireless technologies and accessibility for people with disabilities: findings from a policy research instrument.

PubMed

Baker, Paul M A; Moon, Nathan W

2008-01-01

The near universal deployment in the United States of a wide variety of information and communications technologies, both wired and wireless, creates potential barriers to use for several key populations, including the poor, people with disabilities, and the aging. Equal access to wireless technologies and services can be achieved through a variety of mechanisms, including legislation and regulations, market-based solutions, and awareness and outreach-based approaches. This article discusses the results of policy research conducted by the Rehabilitation Engineering Research Center on Wireless Technologies (Wireless RERC) using policy Delphi polling methodology to probe stakeholders' opinions on key access barrier issues and to explore potential policy responses. Participants included disability advocates, disability/wireless technology policy makers, and product developers/manufacturers. Respondent input informed subsequent development of potential policy initiatives to increase access to these technologies. The findings from the Delphi suggest that awareness issues remain most important, especially manufacturer awareness of user needs and availability of consumer information for selecting the most appropriate wireless devices and services. Other key issues included the ability of people with disabilities to afford technologies and inadequacies in legislation and policy making for ensuring their general accessibility, as well as usefulness in emergencies. Technical issues, including interoperability, speech-to-text conversion, and hearing aid compatibility, were also identified by participating stakeholders as important. To address all these issues, Delphi respondents favored goals and options congruent with voluntary market-driven solutions where possible but also supported federal involvement, where necessary, to aid this process.

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.

USSR Space Life Sciences Digest, issue 14

NASA Technical Reports Server (NTRS)

Hooke, Lydia Razran; Teeter, Ronald; Radtke, Mike; Rowe, Joseph

1988-01-01

This is the fourteenth issue of NASA's USSR Space Life Sciences Digest. It contains abstracts of 32 papers recently published in Russian language periodicals and bound collections and of three new Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. Also included is a review of a recent Soviet conference on Space Biology and Aerospace Medicine. Current Soviet life sciences titles available in English are cited. The materials included in this issue have been identified as relevant to the following areas of aerospace medicine and space biology: adaptation, biological rhythms, body fluids, botany, cardiovascular and respiratory systems, developmental biology, endocrinology, enzymology, equipment and instrumentation, gastrointestinal systems, habitability and environment effects, human performance, immunology, life support systems, mathematical modeling, metabolism, musculoskeletal system, neurophysiology, nutrition, operational medicine, perception, personnel selection, psychology, radiobiology, and space biology and medicine.

USSR Space Life Sciences Digest, issue 29

NASA Technical Reports Server (NTRS)

Stone, Lydia Razran (Editor); Teeter, Ronald (Editor); Rowe, Joseph (Editor)

1991-01-01

This is the twenty-ninth issue of NASA's Space Life Sciences Digest. It is a double issue covering two issues of the Soviet Space Biology and Aerospace Medicine Journal. Issue 29 contains abstracts of 60 journal papers or book chapters published in Russian and of three Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. A review of a book on environmental hygiene and a list of papers presented at a Soviet conference on space biology and medicine are also included. The materials in this issue were identified as relevant to 28 areas of space biology and medicine. The areas are: adaptation, aviation medicine, biological rhythms, body fluids, botany, cardiovascular and respiratory systems, developmental biology, digestive system, endocrinology, equipment and instrumentation, genetics, habitability and environment effects, hematology, human performance, immunology, life support systems, mathematical modeling, metabolism, musculoskeletal system, neurophysiology, nutrition, personnel selection, psychology, radiobiology, reproductive system, space biology and medicine, and the economics of space flight.

Distance Learning.

ERIC Educational Resources Information Center

Orey, Michael; Koenecke, Lynne; Snider, Richard C.; Perkins, Ross A.; Holmes, Glen A.; Lockee, Barbara B.; Moller, Leslie A.; Harvey, Douglas; Downs, Margaret; Godshalk, Veronica M.

2003-01-01

Contains four articles covering trends and issues on distance learning including: the experience of two learners learning via the Internet; a systematic approach to determining the scalability of a distance education program; identifying factors that affect learning community development and performance in asynchronous distance education; and…

Writing of water and recreation

Treesearch

Linda E. Kruger

2017-01-01

The paper presents a personal perspective on water and recreation including challenges for managers and researchers and approaches to contemporary issues. The article explores the relationship between group identify and connection to place, developed through trecreation activities, and engagement in stewardhsip and sustainability activities.

Technology Toolkit.

ERIC Educational Resources Information Center

Brooklyn Public Library, NY.

This reference resource identifies issues concerning technology use in library literacy programs and describes approaches that work at the Brooklyn (New York) Public Library. Section 1 discusses the learning centers at the library, including its mission, philosophy, curriculum, technology, volunteer tutors, and active learning environment. Section…

Diversification and Competition in Higher Education.

ERIC Educational Resources Information Center

Ruegg, Walter

1987-01-01

Understanding the issues involved in the diversifications of missions and functions in higher education requires (1) distinguishing between vertical and horizontal diversification, either between or within institutions and (2) identifying the agents and mechanisms causing diversification within different higher education systems, including both…

Community impact assessment and environmental justice for transit agencies

DOT National Transportation Integrated Search

2002-01-01

The objectives of the re-search included identifying information and materials on issues and resources related to environmental justice, Title VI of the Civil Rights Act of 1964, social equity, and the use of community impact assessment techniques (C...

ISPI's Value Proposition: Two Examples.

ERIC Educational Resources Information Center

Swinney, John

2003-01-01

Describes two experiences that illustrate the value of the International Society for Performance Improvement (ISPI). Highlights include measuring organizational results; identifying opportunities to improve performance; training as part of the solution; the role of ISD (instructional systems design); HPT (human performance technology) issues; and…

Syndromic Surveillance: Adapting Innovations to Developing Settings

DTIC Science & Technology

2008-03-01

outbreak investigation was initiated, including rectal swab sampling of patients with watery diarrhea. Culture tests identified Vibrio cholerae in 44...GF, Kulldorff M, Madigan D, et al. (2007) Issues in applied statistics for public health bioterrorism Technical considerations • Harvesting data

Identifying Health Promotion Needs Among Dominican-American Adolescents.

PubMed

Champion, Jane Dimmitt; Roye, Carol F

Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although adolescent pregnancy and obesity are common concerns among Hispanics, little is known specifically about Dominican adolescent health. This study was undertaken to assess Dominican-American adolescents' health concerns and their perceptions about their health promotion needs. Dominican-American adolescents (N=25) were recruited in a pediatric clinic in New York City which primarily serves a Dominican population. Eligibility criteria included age 13-21years, self-identifying as Dominican ethnicity, and able to speak and read English. They completed a questionnaire, with demographic questions and questions about their risk behaviors including sexual and substance use. After completing the questionnaire, they participated in a semi-structured interview addressing their health education experiences and suggestions for such programs. Quantitative data were analyzed using frequencies to provide a demographic and behavioral profile. Qualitative data were analyzed using thematic analysis. Twenty-five adolescents, ages 13-21years, (female N=19, male N=6) participated in the study. Most were in school (92%) and were sexually experienced (68%). Programmatic preferences included in-person programs rather than online. They spontaneously addressed the importance of cultural issues, and the need to address several issues in addition to sexuality, including obesity and substance use. Programming for this population should address a broad conceptualization of health, and incorporate Dominican cultural issues. Nurses working with adolescents of Dominican origin, should provide health education that incorporates the specific needs of this population, including culturally congruent face-to-face interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Exploring work-related issues on corporate sustainability.

PubMed

Brunoro, C M; Bolis, I; Sznelwar, L I

2015-01-01

In a research project about work-related issues and corporate sustainability conducted in Brazil, the goal was to better understand how work-related issues were addressed in the corporate context. Particularly, there are some specific initiatives that serve as guides to organizational decisions, which make their performance indicators for the context of corporate sustainability. 1) To explore the presence of work-related issues and their origins in corporate sustainability approach, analyzing a) corporate disclosures; b) sustainability guidelines that are identified as relevant in corporate disclosures; c) documents that are related to sustainable development and also identified as key-documents for these guidelines and initiatives. 2) To present the activity-centered ergonomics and psychodynamics of work contributions to work-related issues in a corporate sustainability approach. An exploratory study based on multiple sources of evidence that were performed from 2012 to 2013, including interviews with companies that engaged in corporate sustainability and document analysis using the content analysis approach. Work-related issues have been presented since the earliest sustainable development documents. It is feasible to construct an empirical framework for work-related issues and corporate sustainability approaches. 1) Although some authors argue that corporate sustainability has its roots based only on the environmental dimension, there is strong empirical evidence showing that social dimension aspects such as work-related issues have been present since the beginning. 2) Some indicators should be redesigned to more precisely translate the reality of some workplaces, particularly those indicators related to organizational design and mental health.

Ada (trademark) projects at NASA. Runtime environment issues and recommendations

NASA Technical Reports Server (NTRS)

Roy, Daniel M.; Wilke, Randall W.

1988-01-01

Ada practitioners should use this document to discuss and establish common short term requirements for Ada runtime environments. The major current Ada runtime environment issues are identified through the analysis of some of the Ada efforts at NASA and other research centers. The runtime environment characteristics of major compilers are compared while alternate runtime implementations are reviewed. Modifications and extensions to the Ada Language Reference Manual to address some of these runtime issues are proposed. Three classes of projects focusing on the most critical runtime features of Ada are recommended, including a range of immediately feasible full scale Ada development projects. Also, a list of runtime features and procurement issues is proposed for consideration by the vendors, contractors and the government.

Ethical and scientific issues of nanotechnology in the workplace.

PubMed

Schulte, Paul A; Salamanca-Buentello, Fabio

2007-01-01

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decision making about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers' acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective.

Ethical and scientific issues of nanotechnology in the workplace.

PubMed

Schulte, Paul A; Salamanca-Buentello, Fabio

2007-01-01

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decisionmaking about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers' acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective.

Ethical and Scientific Issues of Nanotechnology in the Workplace

PubMed Central

Schulte, Paul A.; Salamanca-Buentello, Fabio

2007-01-01

In the absence of scientific clarity about the potential health effects of occupational exposure to nanoparticles, a need exists for guidance in decisionmaking about hazards, risks, and controls. An identification of the ethical issues involved may be useful to decision makers, particularly employers, workers, investors, and health authorities. Because the goal of occupational safety and health is the prevention of disease in workers, the situations that have ethical implications that most affect workers have been identified. These situations include the a) identification and communication of hazards and risks by scientists, authorities, and employers; b) workers’ acceptance of risk; c) selection and implementation of controls; d) establishment of medical screening programs; and e) investment in toxicologic and control research. The ethical issues involve the unbiased determination of hazards and risks, nonmaleficence (doing no harm), autonomy, justice, privacy, and promoting respect for persons. As the ethical issues are identified and explored, options for decision makers can be developed. Additionally, societal deliberations about workplace risks of nanotechnologies may be enhanced by special emphasis on small businesses and adoption of a global perspective. PMID:17366812

Biomedical technology prosperity game{trademark}

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

Berman, M.; Boyack, K.W.; Wesenberg, D.L.

1996-07-01

Prosperity Games{trademark} are an outgrowth and adaptation of move/countermove and seminar War Games. Prosperity Games{trademark} are simulations that explore complex issues in a variety of areas including economics, politics, sociology, environment, education and research. These issues can be examined from a variety of perspectives ranging from a global, macroeconomic and geopolitical viewpoint down to the details of customer/supplier/market interactions in specific industries. All Prosperity Games{trademark} are unique in that both the game format and the player contributions vary from game to game. This report documents the Biomedical Technology Prosperity Game{trademark} conducted under the sponsorship of Sandia National Laboratories, the Defensemore » Advanced Research Projects Agency, and the Koop Foundation, Inc. Players were drawn from all stakeholders involved in biomedical technologies including patients, hospitals, doctors, insurance companies, legislators, suppliers/manufacturers, regulators, funding organizations, universities/laboratories, and the legal profession. The primary objectives of this game were to: (1) Identify advanced/critical technology issues that affect the cost and quality of health care. (2) Explore the development, patenting, manufacturing and licensing of needed technologies that would decrease costs while maintaining or improving quality. (3) Identify policy and regulatory changes that would reduce costs and improve quality and timeliness of health care delivery. (4) Identify and apply existing resources and facilities to develop and implement improved technologies and policies. (5) Begin to develop Biomedical Technology Roadmaps for industry and government cooperation. The deliberations and recommendations of these players provided valuable insights as to the views of this diverse group of decision makers concerning biomedical issues. Significant progress was made in the roadmapping of key areas in the biomedical technology field.« less

Indicators of Marine Pollution in the North Pacific Ocean.

PubMed

Brown, Tanya M; Takada, Hideshige

2017-08-01

The complex nature of ocean pollution underscores the utility in identifying and characterizing a limited number of "indicators" that enables scientists and managers to track trends over space and time. This paper introduces a special issue on indicators of marine pollution in the North Pacific Ocean and builds on a scientific session that was held at the North Pacific Marine Science Organization. The special issue highlights studies using a variety of indicators to provide insight into the identification of legacy and emerging contaminants, the ranking of priority pollutants from various sources, and the effects of contaminants on ecosystem health in the North Pacific Ocean. Examples include the use of mussels to illustrate spatial and temporal trends of a number of contaminants following the 2011 tsunami in Japan, the use of molecular marker (linear alkylbenzenes, hopanes, and polycyclic aromatic hydrocarbons) profiles to identify pollution sources, and the use of plastic resin pellets to illustrate spatial trends of petroleum pollution around the world. Stable isotopes were used to strengthen the utility of the Glaucous-winged gull (Larus glaucescens) as an indicator of marine pollution. Examples also demonstrate the development and application of biomarker approaches, including gene transcripts, oxidative stress, estradiol, hatchability, and respiration and swimming behavior abnormalities, as a function of exposure to polychlorinated biphenyls, sulfur-diesel, Pinghu crude oil, galaxolide and antifouling biocides. We provide a brief review of indicators of marine pollution, identify research gaps, and summarize key findings from the articles published within the issue. This special issue represents the first compilation of research pertaining to marine pollution indicators in the North Pacific Ocean and provides guidance to inform mitigation and monitoring efforts of contaminants in the region.

Unleashing the power of human genetic variation knowledge: New Zealand stakeholder perspectives.

PubMed

Gu, Yulong; Warren, James Roy; Day, Karen Jean

2011-01-01

This study aimed to characterize the challenges in using genetic information in health care and to identify opportunities for improvement. Taking a grounded theory approach, semistructured interviews were conducted with 48 participants to collect multiple stakeholder perspectives on genetic services in New Zealand. Three themes emerged from the data: (1) four service delivery models were identified in operation, including both those expected models involving genetic counselors and variations that do not route through the formal genetic service program; (2) multiple barriers to sharing and using genetic information were perceived, including technological, organizational, institutional, legal, ethical, and social issues; and (3) impediments to wider use of genetic testing technology, including variable understanding of genetic test utilities among clinicians and the limited capacity of clinical genetic services. Targeting these problems, information technologies and knowledge management tools have the potential to support key tasks in genetic services delivery, improve knowledge processes, and enhance knowledge networks. Because of the effect of issues in genetic information and knowledge management, the potential of human genetic variation knowledge to enhance health care delivery has been put on a "leash."

Implementation of a Point-of-Care Radiologist-Technologist Communication Tool in a Quality Assurance Program.

PubMed

Ong, Leonard; Elnajjar, Pierre; Nyman, C Gregory; Mair, Thomas; Juluru, Krishna

2017-07-01

We implemented an Image Quality Reporting and Tracking Solution (IQuaRTS), directly linked from the PACS, to improve communication between radiologists and technologists. IQuaRTS launched in May 2015. We compared MRI issues filed in the period before IQuaRTS implementation (May-September 2014) using a manual system with MRI issues filed in the IQuaRTS period (May-September 2015). The unpaired t test was used for analysis. For assessment of overall results in the IQuaRTS period alone, all issues filed across all modalities were included. Summary statistics and charts were generated using Excel and Tableau. For MRI issues, the number of issues filed during the IQuaRTS period was 498 (2.5% of overall MRI examination volume) compared with 78 issues filed during the period before IQuaRTS implementation (0.4% of total examination volume) (p = 0.0001), representing a 625% relative increase. Tickets that documented excellent work were 8%. Other issues included images not pushed to PACS (20%), film library issues (19%), and documentation or labeling (8%). Of the issues filed, 55% were MRI-related and 25% were CT-related. The issues were stratified across six sites within our institution. Staff requiring additional training could be readily identified, and 80% of the issues were resolved within 72 hours. IQuaRTS is a cost-effective online issue reporting tool that enables robust data collection and analytics to be incorporated into quality improvement programs. One limitation of the system is that it must be implemented in an environment where staff are receptive to quality improvement.

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

PubMed

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

2000-08-01

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

Symptom outcomes important to women with anal incontinence: a conceptual framework.

PubMed

Sung, Vivian W; Rogers, Rebecca G; Bann, Carla M; Arya, Lily; Barber, Matthew D; Lowder, Jerry; Lukacz, Emily S; Markland, Alayne; Siddiqui, Nazema; Wilmot, Amanda; Meikle, Susan F

2014-05-01

To develop a framework that describes the most important symptom outcomes for anal incontinence treatment from the patient perspective. A conceptual framework was developed by the Pelvic Floor Disorders Network based on four semistructured focus groups and confirmed in two sets of 10 cognitive interviews including women with anal incontinence. We explored: 1) patient-preferred terminology for describing anal incontinence symptoms; 2) patient definitions of treatment "success"; 3) importance of symptoms and outcomes in the framework; and 4) conceptual gaps (defined as outcomes not previously identified as important). Sessions were conducted according to grounded theory transcribed, coded, and qualitatively and quantitatively analyzed to identify relevant themes. Content and face validity of the framework were further assessed using cognitive interviews. Thirty-four women participated in focus groups and 20 in cognitive interviews. Overall, 29 (54%) were aged 60 years or older, 42 (78%) were white, and 10 (19%) had a high school degree or less. Two overarching outcome themes were identified: "primary bowel leakage symptoms" and "ancillary bowel symptoms." Subdomains important in primary bowel leakage symptoms included leakage characteristics (symptom frequency, amount of leakage, symptom bother) and conditions when bowel leakage occurs (predictability, awareness, urgency). Subdomains important under ancillary bowel symptoms included emptying disorders (constipation, obstructed defecation, and wiping issues) and discomfort (pain, burning). New outcomes identified included predictability, awareness, wiping issues, and discomfort. Women with anal incontinence desire a wide range of symptom outcomes after treatment. These are captured in our conceptual framework, which can aid clinicians and researchers in assessing anal incontinence. LEVEL OF EVIEDENCE: II.

USSR Space Life Sciences Digest, issue 25

NASA Technical Reports Server (NTRS)

Hooke, Lydia Razran (Editor); Teeter, Ronald (Editor); Garshnek, Victoria (Editor); Rowe, Joseph (Editor)

1990-01-01

This is the twenty-fifth issue of NASA's Space Life Sciences Digest. It contains abstracts of 42 journal papers or book chapters published in Russian and of 3 Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. The abstracts in this issue have been identified as relevant to 26 areas of space biology and medicine. These areas include: adaptation, body fluids, botany, cardiovascular and respiratory systems, developmental biology, endocrinology, enzymology, equipment and instrumentation, exobiology, gravitational biology, habitability and environmental effects, human performance, immunology, life support systems, man-machine systems, mathematical modeling, metabolism, microbiology, musculoskeletal system, neurophysiology, nutrition, operational medicine, psychology, radiobiology, reproductive system, and space biology and medicine.

Learning to think strategically.

PubMed

1994-01-01

Strategic thinking focuses on issues that directly affect the ability of a family planning program to attract and retain clients. This issue of "The Family Planning Manager" outlines the five steps of strategic thinking in family planning administration: 1) define the organization's mission and strategic goals; 2) identify opportunities for improving quality, expanding access, and increasing demand; 3) evaluate each option in terms of its compatibility with the organization's goals; 4) select an option; and 5) transform strategies into action. Also included in this issue is a 20-question test designed to permit readers to assess their "strategic thinking quotient" and a list of sample questions to guide a strategic analysis.

Using Cultural Modeling to Inform a NEDSS-Compatible System Functionality Evaluation

PubMed Central

Anderson, Olympia; Torres-Urquidy, Miguel

2013-01-01

Objective The culture by which public health professionals work defines their organizational objectives, expectations, policies, and values. These aspects of culture are often intangible and difficult to qualify. The introduction of an information system could further complicate the culture of a jurisdiction if the intangibles of a culture are not clearly understood. This report describes how cultural modeling can be used to capture intangible elements or factors that may affect NEDSS-compatible (NC) system functionalities within the culture of public health jurisdictions. Introduction The National Notifiable Disease Surveillance System (NNDSS) comprises many activities including collaborations, processes, standards, and systems which support gathering data from US states and territories. As part of NNDSS, the National Electronic Disease Surveillance System (NEDSS) provides the standards, tools, and resources to support reporting public health jurisdictions (jurisdictions). The NEDSS Base System (NBS) is a CDC-developed, software application available to jurisdictions to collect, manage, analyze and report national notifiable disease (NND) data. An evaluation of NEDSS with the objective of identifying the functionalities of NC systems and the impact of these features on the user’s culture is underway. Methods We used cultural models to capture additional NC system functionality gaps within the culture of the user. Cultural modeling is a process of graphically depicting people and organizations referred to as influencers and the intangible factors that affect the user’s operations or work as influences. Influencers are denoted as bubbles while influences are depicted as arrows penetrating the bubbles. In the cultural model, influence can be seen by the size and proximity (or lack of) in the model. We restricted the models to secondary data sources and interviews of CDC programs (data users) and public health jurisdictions (data reporters). Results Three cultural models were developed from the secondary information sources; these models include the NBS vendor, public health jurisdiction (jurisdiction) activities, and NEDSS technical consultants. The vendor cultural model identified channels of communication about functionalities flowing from the vendor and the NBS users with CDC as the approval mechanism. The jurisdiction activities model highlighted perceived issues external to the organization that had some impact in their organization. Key disconnecting issues in the jurisdiction model included situational awareness, data competency, and bureaucracy. This model also identified poor coordination as a major influencer of the jurisdiction’s activities. The NEDSS technical model identified major issues and disconnects among data access, capture and reporting, processing, and ELR functionalities (Figure 1). The data processing functionality resulted in the largest negative influencer with issues that included: loss of data specificity, lengthy submission strategies, and risk of data use. Collectively, the models depict issues with the system functionality but mostly identify other factors that may influence how jurisdictions use the system, moreover determining the functionalities to be included. Conclusions By using the cultural model as a guide, we are able to clarify complex relationships using multiple data sources and improve our understanding of the impacts of the NC system functionalities on user’s operations. Modeling the recipients of the data (e.g. CDC programs) will provide insight on additional factors that may inform the NEDSS evaluation.

Research in Science Education, Volume 19, 1989. Selected Refereed Papers from the Annual Conference of the Australian Science Education Research Association Held at the Frankston Campus of the Chisholm Institute of Technology (20th, Victoria, New South Wales, Australia, July 1989).

ERIC Educational Resources Information Center

Tisher, Richard P., Ed.

Diverse themes from the annual conference of the Australian Science Education Research Association are addressed in this volume. New topic concerns as well as concerns that have been cited in previous issues are identified. Papers focus on issues including: (1) science and technology; (2) classroom practices and processes; (3) international…

Does an employee assistance programme benefit employers and employees alike?

PubMed

MacAlister, E

1999-09-01

EAPs are not a psychological sticking plaster. They are a clinically and corporately balanced service which benefits the employee, via the direct services and the employer, via the feedback in the form of usage statistics derived from the continuous tracking of the account through which organizational and employment issues are identified. Well positioned EAPs offer employees confidential counselling, and information services including legal, financial and child-based issues and are able to offer employers tailored training and consultancy.

Earth Observatory Satellite system definition study. Report no. 3: Design/cost tradeoff studies

NASA Technical Reports Server (NTRS)

1974-01-01

The key issues in the Earth Observatory Satellite (EOS) program which are subject to configuration study and tradeoff are identified. The issue of a combined operational and research and development program is considered. It is stated that cost and spacecraft weight are the key design variables and design options are proposed in terms of these parameters. A cost analysis of the EOS program is provided. Diagrams of the satellite configuration and subsystem components are included.

American Recovery and Reinvestment Act (ARRA) Federal Energy Management Program Technical Assistance Project 279 IMCOM-Southeast Region: Redstone Arsenal

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

Hatley, Darrel D.; Goddard, James K.

2010-09-30

Report describing a building retuning workshop presented to staff at Redstone Arsenal. Document includes issues identified during building audits and recommendations for future activities to reduce energy use at the site.

Approaches to Ethics in International Business Education.

ERIC Educational Resources Information Center

Iyer, Gopalkrishnan R.

1999-01-01

Identifies major issues in international business ethics (such as cultural relativism and ethical imperialism) that should be addressed when incorporating ethics in international business education. Also discusses instructional approaches, including alternative ways of thinking about morality, philosophy versus practice, the ethical agent, and…

End-Users: Dollars but Doubts.

ERIC Educational Resources Information Center

Arnold, Stephen E.

1989-01-01

Identifies existing categories of end users of online information retrieval systems, discusses problems that have been encountered by information providers and customers, and suggests strategies for capturing new end-user markets. Issues discussed include user cordial interfaces, CD-ROM products, ethics involved in information provision, and…

Managing Technology Is Different.

ERIC Educational Resources Information Center

Levinson, Eliot; Grohe, Barbara

2002-01-01

Discusses methods that school superintendents can use to manage technology issues in their schools beyond traditional delegation. Highlights include participation more than delegation to a technology coordinator; identifying the right problems; determining what to make and what to buy; and the need for continual technology funding. (LRW)

Black Women into Higher Education: Recognizing Achievement and Identifying Obstacles.

ERIC Educational Resources Information Center

Lyon, E. Stina

1995-01-01

Issues facing black women in higher education include whether their formal credentials are "relevant"; informal restrictions on access caused by prejudicial notions of suitability for a course or a job; and social and financial limitations emerging from their environment. (SK)

REHABILITATION OF AGING WATER INFRASTRUCTURE SYSTEMS: KEY CHALLENGES AND ISSUES

EPA Science Inventory

Presented in this paper are the results of a state-of-the-practice survey on the rehabilitation of water distribution and wastewater collection systems. The survey identified several needs, including the need for rational and common design approaches for rehabilitation systems, ...

Stakeholder perspectives on ethical challenges in HIV vaccine trials in South Africa.

PubMed

Essack, Zaynab; Koen, Jennifer; Barsdorf, Nicola; Slack, Catherine; Quayle, Michael; Milford, Cedilia; Lindegger, Graham; Ranchod, Chitra; Mukuka, Richard

2010-04-01

There is little published literature on the ethical concerns of stakeholders in HIV vaccine trials. This study explored the ethical challenges identified by various stakeholders, through an open-ended, in-depth approach. While the few previous studies have been largely quantitative, respondents in this study had the opportunity to spontaneously identify the issues that they perceived to be of priority concern in the South African context. Stakeholders spontaneously identified the following as ethical priorities: informed consent, social harms, collaborative relationships between research stakeholders, the participation of children and adolescents, access to treatment for participants who become infected with HIV, physical harms, fair participant and community selection, confidentiality, benefits, and payment. While there is some speculation that research in developing countries poses special ethical challenges, overall no issues were identified that have not been anticipated in international guidance, literature and popular frameworks. However, the South African context affords a distinctive gloss to these expected issues; for example, respondents were concerned that the predominant selection of black participants may perpetuate racist practices of apartheid. Stakeholders should be aware of contextual factors impacting on the implementation of ethical principles. We make a series of recommendations for South African trials, including amendments to the ethical-legal framework and research policies, and, for further research.

Anticipated Ethics and Regulatory Challenges in PCORnet: The National Patient-Centered Clinical Research Network.

PubMed

Ali, Joseph; Califf, Robert; Sugarman, Jeremy

2016-01-01

PCORnet, the National Patient-Centered Clinical Research Network, seeks to establish a robust national health data network for patient-centered comparative effectiveness research. This article reports the results of a PCORnet survey designed to identify the ethics and regulatory challenges anticipated in network implementation. A 12-item online survey was developed by leadership of the PCORnet Ethics and Regulatory Task Force; responses were collected from the 29 PCORnet networks. The most pressing ethics issues identified related to informed consent, patient engagement, privacy and confidentiality, and data sharing. High priority regulatory issues included IRB coordination, privacy and confidentiality, informed consent, and data sharing. Over 150 IRBs and five different approaches to managing multisite IRB review were identified within PCORnet. Further empirical and scholarly work, as well as practical and policy guidance, is essential if important initiatives that rely on comparative effectiveness research are to move forward.

Navigating the currents of seascape genomics: how spatial analyses can augment population genomic studies

PubMed Central

Crandall, Eric D.; Liggins, Libby; Bongaerts, Pim; Treml, Eric A.

2016-01-01

Population genomic approaches are making rapid inroads in the study of non-model organisms, including marine taxa. To date, these marine studies have predominantly focused on rudimentary metrics describing the spatial and environmental context of their study region (e.g., geographical distance, average sea surface temperature, average salinity). We contend that a more nuanced and considered approach to quantifying seascape dynamics and patterns can strengthen population genomic investigations and help identify spatial, temporal, and environmental factors associated with differing selective regimes or demographic histories. Nevertheless, approaches for quantifying marine landscapes are complicated. Characteristic features of the marine environment, including pelagic living in flowing water (experienced by most marine taxa at some point in their life cycle), require a well-designed spatial-temporal sampling strategy and analysis. Many genetic summary statistics used to describe populations may be inappropriate for marine species with large population sizes, large species ranges, stochastic recruitment, and asymmetrical gene flow. Finally, statistical approaches for testing associations between seascapes and population genomic patterns are still maturing with no single approach able to capture all relevant considerations. None of these issues are completely unique to marine systems and therefore similar issues and solutions will be shared for many organisms regardless of habitat. Here, we outline goals and spatial approaches for landscape genomics with an emphasis on marine systems and review the growing empirical literature on seascape genomics. We review established tools and approaches and highlight promising new strategies to overcome select issues including a strategy to spatially optimize sampling. Despite the many challenges, we argue that marine systems may be especially well suited for identifying candidate genomic regions under environmentally mediated selection and that seascape genomic approaches are especially useful for identifying robust locus-by-environment associations. PMID:29491947

Navigating the currents of seascape genomics: how spatial analyses can augment population genomic studies.

PubMed

Riginos, Cynthia; Crandall, Eric D; Liggins, Libby; Bongaerts, Pim; Treml, Eric A

2016-12-01

Population genomic approaches are making rapid inroads in the study of non-model organisms, including marine taxa. To date, these marine studies have predominantly focused on rudimentary metrics describing the spatial and environmental context of their study region (e.g., geographical distance, average sea surface temperature, average salinity). We contend that a more nuanced and considered approach to quantifying seascape dynamics and patterns can strengthen population genomic investigations and help identify spatial, temporal, and environmental factors associated with differing selective regimes or demographic histories. Nevertheless, approaches for quantifying marine landscapes are complicated. Characteristic features of the marine environment, including pelagic living in flowing water (experienced by most marine taxa at some point in their life cycle), require a well-designed spatial-temporal sampling strategy and analysis. Many genetic summary statistics used to describe populations may be inappropriate for marine species with large population sizes, large species ranges, stochastic recruitment, and asymmetrical gene flow. Finally, statistical approaches for testing associations between seascapes and population genomic patterns are still maturing with no single approach able to capture all relevant considerations. None of these issues are completely unique to marine systems and therefore similar issues and solutions will be shared for many organisms regardless of habitat. Here, we outline goals and spatial approaches for landscape genomics with an emphasis on marine systems and review the growing empirical literature on seascape genomics. We review established tools and approaches and highlight promising new strategies to overcome select issues including a strategy to spatially optimize sampling. Despite the many challenges, we argue that marine systems may be especially well suited for identifying candidate genomic regions under environmentally mediated selection and that seascape genomic approaches are especially useful for identifying robust locus-by-environment associations.

Identifying geoscience knowledge likely to affect foreign policy

NASA Astrophysics Data System (ADS)

Kelmelis, J. A.

2006-12-01

The earth sciences play an important role in foreign policy and have done so throughout history. Whether it is access to resources, knowledge of weather or other earth system conditions, planning for or responding to disasters, protecting the environment, facilitating transportation and communication, or any of a number of other important topics, the geosciences continue to inform our decision making. The importance of science, technology, and health (STH) is being increasingly recognized in the foreign policy community. The National Research Council (NRC) recommended that the Department of State (State) expand its scientific base to address the importance of STH issues. In part, this consists of increasing the number of scientists within State. Another important aspect is not only identifying the STH issues that are of current concern, but also the issues that will be of importance in the future. A number of studies funded by the U.S. Government have identified some important STH areas of concern at a high level. These provide a basis for more in-depth investigations. However, there are additional phenomena, beyond those identified in the studies, which have foreign policy implications. The scientific findings may be well known to scientists but their foreign policy importance is not always obvious. The scientific and foreign policy communities could improve their dialog to better develop strategies for foreign policy and future scientific research. One way to help facilitate that is to ease identification of scientific issues with potential significance to foreign policy and to clarify uncertainties around those issues. A qualitative method relating the likelihood that the scientific finding has foreign policy importance to the potential level of foreign policy importance has been used to clarify the significance of a variety of scientific findings including Arctic warming, methane hydrates, atmospheric dust, disease, and natural hazards. From a foreign policy perspective, the significance of some scientific findings can cascade through emerging international issues and manifest themselves in ways that have both strategic and tactical concern.

USSR Space Life Sciences Digest, issue 11

NASA Technical Reports Server (NTRS)

Hooke, Lydia Razran (Editor); Radtke, Mike (Editor); Radtke, Mike (Editor); Radtke, Mike (Editor); Radtke, Mike (Editor); Radtke, Mike (Editor)

1987-01-01

This is the eleventh issue of NASA's USSR Space Life Sciences Digest. It contains abstracts of 54 papers recently published in Russian language periodicals and bound collections and of four new Soviet monographs. Selected abstracts are illustrated. Additional features include the translation of a paper presented in Russian to the United Nations, a review of a book on space ecology, and report of a conference on evaluating human functional capacities and predicting health. Current Soviet Life Sciences titles available in English are cited. The materials included in this issue have been identified as relevant to 30 areas of aerospace medicine and space biology. These areas are: adaptation, aviation physiology, biological rhythms, biospherics, body fluids, botany, cardiovascular and respiratory systems, cosmonaut training, developmental biology, endocrinology, enzymology, equipment and instrumentation, gastrointestinal systems, group dynamics, genetics, hematology, human performance, immunology, life support systems, mathematical modeling, metabolism, microbiology, musculoskeletal system, neurophysiology, nutrition, operational medicine, perception, personnel selection, psychology, and radiobiology.

USSR Space Life Sciences Digest, issue 13

NASA Technical Reports Server (NTRS)

Hooke, Lydia Razran (Editor); Teeter, Ronald (Editor); Teeter, Ronald (Editor); Teeter, Ronald (Editor); Teeter, Ronald (Editor)

1987-01-01

This is the thirteenth issue of NASA's USSR Space Life Sciences Digest. It contains abstracts of 39 papers recently published in Russian-language periodicals and bound collections, two papers delivered at an international life sciences symposium, and three new Soviet monographs. Selected abstracts are illustrated with figures and tables from the original. Also included is a review of a recent Soviet-French symposium on Space Cytology. Current Soviet Life Sciences titles available in English are cited. The materials included in this issue have been identified as relevant to 31 areas of aerospace medicine and space biology. These areas are: adaptation, biological rhythms, body fluids, botany, cardiovascular and respiratory systems, cosmonaut training, cytology, developmental biology, endocrinology, enzymology, equipment and instrumentation, gastrointestinal systems, genetics, habitability and environment effects, hematology, human performance, immunology, life support systems, mathematical modeling, metabolism, microbiology, musculoskeletal system, neurophysiology, nutrition, operational medicine, perception, personnel selection, psychology, radiobiology, space biology, and space medicine.

Faculty Salary Equity: Issues and Options.

ERIC Educational Resources Information Center

Snyder, Julie K.; And Others

1994-01-01

An approach to identifying and correcting college faculty salary inequities based on gender is presented. Steps include determining whether a problem exists using an objective, legally sound procedure; developing feasible adjustment strategies; and implementing correction and a monitoring process consistent with institutional culture and values.…

49 CFR 1150.1 - Introduction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Energy and Environmental Regulations at 49 CFR parts 1106 and 1105 (including consulting with the Board's Section of Environmental Analysis at least 6 months prior to filing an application, to begin the scoping process to identify environmental issues and outline procedures for analysis of this aspect of the...

Processing Problems and Language Impairment in Children.

ERIC Educational Resources Information Center

Watkins, Ruth V.

1990-01-01

The article reviews studies on the assessment of rapid auditory processing abilities. Issues in auditory processing research are identified including a link between otitis media with effusion and language learning problems. A theory that linguistically impaired children experience difficulty in perceiving and processing low phonetic substance…

Designing Training for Global Environments: Knowing What Questions To Ask.

ERIC Educational Resources Information Center

Gayeski, Diane M.; Sanchirico, Christine; Anderson, Janet

2002-01-01

Presents a framework for identifying important issues for instructional design and delivery in global settings. Highlights include cultural factors in global training; an instructional design model; corporate globalization strategy; communication and training norms; language barriers; implicit value differences; and technical and legal…

Effects of jackhammer weight on bridge deck preparation prior to overlay.

DOT National Transportation Integrated Search

2011-02-18

We found one citation for a research project directly related to the issue of jackhammer weight: a 2002 Missouri DOT study. : Because we were unable to identify any other published research on this topic, we have included excerpts from 14 : state spe...

Land Use, Environmental Stressors, and Water Resources: Degradation to Restoration

EPA Science Inventory

Land use and climate change can accelerate the depletion of freshwater resources that support humans and ecosystem services on a global scale. Here, we briefly review studies from around the world, including those in this special issue. We identify stages, which characterize i...

Developing Competitive Excellence in the Talented Female Athlete.

ERIC Educational Resources Information Center

Wildenhaus, Kevin J.

1995-01-01

This article reviews the historical development of female participation in sports, then identifies the unique issues associated with women's struggles for athletic acceptance and competitive excellence. Topics discussed include talent recognition and development, sex roles and socialization, physiology and maturation, coaching the female athlete,…

Impact. Volume 18, Number 2, Spring 2005

ERIC Educational Resources Information Center

Gaylord, Vicki, Ed.

2005-01-01

This issue of the quarterly publication focuses on Fostering Success in School and Beyond for Students with Emotional/Behavioral Disorders. Editorial introduction notes that today's K-12 educators must effectively work with increasingly diverse populations in their classrooms, including educating students identified as having emotional/behavioral…

EFFECTIVENESS AND SAFETY OF STRATEGIES FOR OIL SPILL BIOREMEDIATION: POTENTIAL AND LIMITATION, LABORATORY TO FIELD (RESEARCH BRIEF)

EPA Science Inventory

Several important additional research efforts were identified during the development of test systems and protocols for assessing the effectiveness and environmental safety of oil spill commercial bioremediation agents (CBAs). Research that examined CBA efficacy issues included: (...

"Library Quarterly" Management Literature, 1931-2004

ERIC Educational Resources Information Center

Young, Arthur P.

2006-01-01

Management literature appearing in "Library Quarterly," 1931-2004, is examined in this essay. A total of 145 articles are identified that focus on administrative and managerial issues related to libraries during this period. Management literature is construed expansively and includes accounting, administration, assessment, budgets, facilities,…

Post-approval safety issues with innovative drugs: a European cohort study.

PubMed

Mol, Peter G M; Arnardottir, Arna H; Motola, Domenico; Vrijlandt, Patrick J; Duijnhoven, Ruben G; Haaijer-Ruskamp, Flora M; de Graeff, Pieter A; Denig, Petra; Straus, Sabine M J M

2013-11-01

At time of approval, knowledge of the full benefit risk of any drug is limited, in particular with regards to safety. Post-approval surveillance of potential drug safety concerns is recognized as an important task of regulatory agencies. For innovative, often first-in-class drugs, safety knowledge at time of approval is often even less extensive and these may require tighter scrutiny post approval. We evaluated whether more post-approval serious safety issues were identified for drugs with a higher level of innovation. A cohort study was performed that included all new active substances approved under the European Centralized Procedure and for which serious safety issues were identified post-approval from 1 January 1999 to 1 January 2012. Serious safety issues were defined as issues requiring a Direct Healthcare Professional Communication to alert individual healthcare professionals of a new serious safety issue, or a safety-related drug withdrawal. Data were retrieved from publicly available websites of the Dutch Medicines Evaluation Board and the European Medicines Agency. The level of innovation was scored using a validated algorithm, grading drugs as important (A), moderate (B) or modest (C) innovations or as pharmacological or technological (pharm/tech) innovations. The data were analyzed using appropriate descriptive statistics and Kaplan-Meier analysis, with a Mantel-Cox log-rank test, and Cox-regression models correcting for follow-up duration, to identify a possible trend in serious safety issues with an increasing level of innovation. In Europe, 279 new drugs were approved between 1999 and 2011. Fifty-nine (21 %) were graded as important, 63 (23 %) moderate, or 34 (12 %) modest innovations and 123 (44 %) as non-innovative (pharm/tech), while 15 (25 %), 13 (21 %), 8 (24 %) and 17 (14 %) had post-approval safety issues, respectively (p = 0.06, linear-by-linear test). Five drugs were withdrawn from the market. The Kaplan-Meier-derived probability for having a first serious safety issue was statistically significant, log-rank (Mantel-Cox) p = 0.036. In the final adjusted Cox proportional hazard model there was no statistically significant difference in occurrence of a first serious safety issue for important, moderate and modest innovations versus non-innovative drugs; hazard ratios 1.76 (95 % CI 0.82-3.77), 1.61 (95 % CI 0.76-3.41)], and 1.25 (95 % CI 0.51-3.06), respectively. A higher level of innovation was not clearly related to an increased risk of serious safety issues identified after approval.

Inroads into Equestrian Safety: Rider-Reported Factors Contributing to Horse-Related Accidents and Near Misses on Australian Roads

PubMed Central

Thompson, Kirrilly; Matthews, Chelsea

2015-01-01

Simple Summary Riding horses on roads can be dangerous, but little is known about accidents and near misses. To explore road safety issues amongst Australian equestrians, we conducted an online survey. More than half of all riders (52%) reported having experienced at least one accident or near miss in the 12 months prior to the survey, mostly attributed to speed. Whilst our findings confirmed factors identified overseas, we also identified issues around road rules, hand signals and road rage. This paper suggests strategies for improving the safety of horses, riders and other road users. Abstract Horse riding and horse-related interactions are inherently dangerous. When they occur on public roads, the risk profile of equestrian activities is complicated by interactions with other road users. Research has identified speed, proximity, visibility, conspicuity and mutual misunderstanding as factors contributing to accidents and near misses. However, little is known about their significance or incidence in Australia. To explore road safety issues amongst Australian equestrians, we conducted an online survey. More than half of all riders (52%) reported having experienced at least one accident or near miss in the 12 months prior to the survey. Whilst our findings confirm the factors identified overseas, we also identified issues around rider misunderstanding of road rules and driver misunderstanding of rider hand signals. Of particular concern, we also found reports of potentially dangerous rider-directed road rage. We identify several areas for potential safety intervention including (1) identifying equestrians as vulnerable road users and horses as sentient decision-making vehicles; (2) harmonising laws regarding passing horses; (3) mandating personal protective equipment; (4) improving road signage; (5) comprehensive data collection; (6) developing mutual understanding amongst road-users; (7) safer road design and alternative riding spaces; and (8) increasing investment in horse-related safety initiatives. PMID:26479376

Bibliography of Lewis Research Center technical contributions announced in 1976

NASA Technical Reports Server (NTRS)

1977-01-01

Abstracts of Lewis authored publications and publications resulting from Lewis managed contracts which were announced in the 1976 issues of STAR (Scientific and Technical Aerospace Reports) and IAA (International Aerospace Abstracts) are presented. Research reports, journal articles, conference presentations, patents and patent applications, and these are included. The arrangement is by NASA subject category. Citations indicate report literature (identified by their N-numbers) and the journal and conference presentations (identified by their A-numbers). A grouping of indexes helps locate specific publications by author (including contractor authors), contractor organization, contract number, and report number.

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.

Alcohol & drug abuse: Revisiting employee assistance programs and substance use problems in the workplace: key issues and a research agenda.

PubMed

Merrick, Elizabeth S Levy; Volpe-Vartanian, Joanna; Horgan, Constance M; McCann, Bernard

2007-10-01

This column describes employee assistance program (EAPs) and identifies key issues for contemporary EAPs. These programs began as occupational alcohol programs and have evolved into more comprehensive resources. To better understand contemporary EAPs, the authors suggest a research agenda that includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs' effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures.

Revisiting Employee Assistance Programs and Substance Use Problems in the Workplace: Key Issues and a Research Agenda

PubMed Central

Levy Merrick, Elizabeth S.; Volpe-Vartanian, Joanna; Horgan, Constance M.; McCann, Bernard

2012-01-01

This column describes employee assistance program (EAPs) and identifies key issues for contemporary EAPs. These programs began as occupational alcohol programs and have evolved into more comprehensive resources. To better understand contemporary EAPs, the authors suggest a research agenda at includes descriptive studies to provide an up-to-date picture of services; investigations of how contemporary EAPs address substance use problems, including management consultation for early identification; further study of EAPs’ effects on outcomes, such as productivity and work group outcomes; examination of the relationship between EAPs and other workplace resources; further examination of influences on EAP utilization; and development and testing of EAP performance measures. PMID:17914000

How do we Remain Us in a Time of Change: Culture and Knowledge Management at NASA

NASA Technical Reports Server (NTRS)

Linde, Charlotte

2003-01-01

This viewgraph representation presents an overview of findings of a NASA agency-wide Knowledge Management Team considering culture and knowledge management issues at the agency. Specific issues identified by the team include: (1) NASA must move from being a knowledge hoarding culture to a knowledge sharing culture; (2) NASA must move from being center focused to being Agency focused; (3) NASA must capture the knowledge of a departing workforce. Topics considered include: what must NASA know to remain NASA, what were previous forms of knowledge reproduction and how has technological innovations changed these systems, and what changes in funding and relationships between contractors and NASA affected knowledge reproduction.

Priority Questions and Horizon Scanning for Conservation: A Comparative Study

PubMed Central

Kark, Salit; Sutherland, William J.; Shanas, Uri; Klass, Keren; Achisar, Hila; Dayan, Tamar; Gavrieli, Yael; Justo-Hanani, Ronit; Mandelik, Yael; Orion, Nir; Pargament, David; Portman, Michelle; Reisman-Berman, Orna; Safriel, Uriel N.; Schaffer, Gad; Steiner, Noa; Tauber, Israel; Levin, Noam

2016-01-01

Several projects aimed at identifying priority issues for conservation with high relevance to policy have recently been completed in several countries. Two major types of projects have been undertaken, aimed at identifying (i) policy-relevant questions most imperative to conservation and (ii) horizon scanning topics, defined as emerging issues that are expected to have substantial implications for biodiversity conservation and policy in the future. Here, we provide the first overview of the outcomes of biodiversity and conservation-oriented projects recently completed around the world using this framework. We also include the results of the first questions and horizon scanning project completed for a Mediterranean country. Overall, the outcomes of the different projects undertaken (at the global scale, in the UK, US, Canada, Switzerland and in Israel) were strongly correlated in terms of the proportion of questions and/or horizon scanning topics selected when comparing different topic areas. However, some major differences were found across regions. There was large variation among regions in the percentage of proactive (i.e. action and response oriented) versus descriptive (non-response oriented) priority questions and in the emphasis given to socio-political issues. Substantial differences were also found when comparing outcomes of priority questions versus horizon scanning projects undertaken for the same region. For example, issues related to climate change, human demography and marine ecosystems received higher priority as horizon scanning topics, while ecosystem services were more emphasized as current priority questions. We suggest that future initiatives aimed at identifying priority conservation questions and horizon scanning topics should allow simultaneous identification of both current and future priority issues, as presented here for the first time. We propose that further emphasis on social-political issues should be explicitly integrated into future related projects. PMID:26815653

Development of Reliable Life Support Systems

NASA Technical Reports Server (NTRS)

Carter, Layne

2017-01-01

The life support systems on the International Space Station (ISS) are the culmination of an extensive effort encompassing development, design, and test to provide the highest possible confidence in their operation on ISS. Many years of development testing are initially performed to identify the optimum technology and the optimum operational approach. The success of this development program depends on the accuracy of the system interfaces. The critical interfaces include the specific operational environment, the composition of the waste stream to be processed and the quality of the product. Once the development program is complete, a detailed system schematic is built based on the specific design requirements, followed by component procurement, assembly, and acceptance testing. A successful acceptance test again depends on accurately simulating the anticipated environment on ISS. The ISS Water Recovery System (WRS) provides an excellent example of where this process worked, as well as lessons learned that can be applied to the success of future missions. More importantly, ISS has provided a test bed to identify these design issues. Mechanical design issues have included an unreliable harmonic drive train in the Urine Processor's fluids pump, and seals in the Water Processor's Catalytic Reactor with insufficient life at the operational temperature. Systems issues have included elevated calcium in crew urine (due to microgravity effect) that resulted in precipitation at the desired water recovery rate, and the presence of an organosilicon compound (dimethylsilanediol) in the condensate that is not well removed by the water treatment process. Modifications to the WRS to address these issues are either complete (and now being evaluated on ISS) or are currently in work to insure the WRS has the required reliability before embarking on a mission to Mars.

Space station Simulation Computer System (SCS) study for NASA/MSFC. Volume 6: Study issues report

NASA Technical Reports Server (NTRS)

1989-01-01

The Simulation Computer System (SCS) is the computer hardware, software, and workstations that will support the Payload Training Complex (PTC) at the Marshall Space Flight Center (MSFC). The PTC will train the space station payload specialists and mission specialists to operate the wide variety of experiments that will be on-board the Freedom Space Station. This simulation Computer System (SCS) study issues report summarizes the analysis and study done as task 1-identify and analyze the CSC study issues- of the SCS study contract.This work was performed over the first three months of the SCS study which began in August of 1988. First issues were identified from all sources. These included the NASA SOW, the TRW proposal, and working groups which focused the experience of NASA and the contractor team performing the study-TRW, Essex, and Grumman. The final list is organized into training related issues, and SCS associated development issues. To begin the analysis of the issues, a list of all the functions for which the SCS could be used was created, i.e., when the computer is turned on, what will it be doing. Analysis was continued by creating an operational functions matrix of SCS users vs. SCS functions to insure all the functions considered were valid, and to aid in identification of users as the analysis progressed. The functions will form the basis for the requirements, which are currently being developed under task 3 of the SCS study.

Effective Connectivity Modeling for fMRI: Six Issues and Possible Solutions Using Linear Dynamic Systems

PubMed Central

Smith, Jason F.; Pillai, Ajay; Chen, Kewei; Horwitz, Barry

2012-01-01

Analysis of directionally specific or causal interactions between regions in functional magnetic resonance imaging (fMRI) data has proliferated. Here we identify six issues with existing effective connectivity methods that need to be addressed. The issues are discussed within the framework of linear dynamic systems for fMRI (LDSf). The first concerns the use of deterministic models to identify inter-regional effective connectivity. We show that deterministic dynamics are incapable of identifying the trial-to-trial variability typically investigated as the marker of connectivity while stochastic models can capture this variability. The second concerns the simplistic (constant) connectivity modeled by most methods. Connectivity parameters of the LDSf model can vary at the same timescale as the input data. Further, extending LDSf to mixtures of multiple models provides more robust connectivity variation. The third concerns the correct identification of the network itself including the number and anatomical origin of the network nodes. Augmentation of the LDSf state space can identify additional nodes of a network. The fourth concerns the locus of the signal used as a “node” in a network. A novel extension LDSf incorporating sparse canonical correlations can select most relevant voxels from an anatomically defined region based on connectivity. The fifth concerns connection interpretation. Individual parameter differences have received most attention. We present alternative network descriptors of connectivity changes which consider the whole network. The sixth concerns the temporal resolution of fMRI data relative to the timescale of the inter-regional interactions in the brain. LDSf includes an “instantaneous” connection term to capture connectivity occurring at timescales faster than the data resolution. The LDS framework can also be extended to statistically combine fMRI and EEG data. The LDSf framework is a promising foundation for effective connectivity analysis. PMID:22279430

Geological, hydrological, and biological issues related to the proposed development of a park at the confluence of the Los Angeles River and the Arroyo Seco, Los Angeles County, California

USGS Publications Warehouse

Land, Michael; Trenham, Peter C.; Ponti, Daniel J.; Reichard, Eric G.; Tinsley, John C.; Warrick, Jonathan A.; Meyer, Robert W.

2005-01-01

A new park is being considered for the confluence of the Los Angeles River and the Arroyo Seco in Los Angeles County, California. Components of the park development may include creation of a temporary lake on the Los Angeles River, removal of channel lining along part of the Arroyo Seco, restoration of native plants, creation of walking paths, and building of facilities such as a boat ramp and a visitor center. This report, prepared in cooperation with the Mountains Recreation and Conservancy Authority, delineates the geological, hydrological, and biological issues that may have an impact on the park development or result from development at the confluence, and identifies a set a tasks to help address these science issues. Geologic issues of concern relate to surface faulting, earthquake ground motions, liquefaction, landsliding, and induced seismicity. Hydrologic issues of concern relate to the hydraulics and water quality of both surface water and ground water. Biological issues of concern include colonization-extinction dynamics, wildlife corridors, wildlife reintroduction, non-native species, ecotoxicology, and restoration of local habitat and ecology. Potential tasks include (1) basic data collection and follow-up monitoring, and (2) statistical and probabilistic analyses and simulation modeling of the seismic, hydraulic, and ecological processes that may have the greatest impact on the park. The science issues and associated tasks delineated for the proposed confluence park will also have transfer value for river restoration in other urban settings.

[Materiality Analysis of Health Plans Based on Stakeholder Engagement and the Issues Included at ISO 26000:2010].

PubMed

Moyano Santiago, Miguel Angel; Rivera Lirio, Juana María

2017-01-18

Health plans of the Spanish autonomous communities can incorporate sustainable development criteria in its development. There have been no analysis or proposals about development and indicators. The goal is to add a contribution to help build better health plans aimed at sustainable development and help to manage economic, social and environmental impacts of health systems criteria. We used a variation of the RAND/UCLA or modified Delphi technique method. The process consisted of a bibliographical and context matters and issues related to health and social responsibility analysis based on ISO 26000: 2010. A survey by deliberately to a selection of 70 expert members of the identified stakeholders was carried out and a discussion group was held to determine the consensus on the issues addressed in the survey sample. The research was conducted in 2015. From the literature review 33 health issues included in ISO 26000:2010 were obtained. 7 survey proved relevant high consensus, 8 relevance and average consensus and 18 with less relevance and high level of dissent. The expert group excluded 4 of the 18 subjects with less consensus. 29 issues included 33 at work, divided into 7 subjects contained in the guide ISO 26000 of social responsibility, were relevant stakeholders regarding possible inclusion in health plans. Considering the direct relationship published by ISO (International Organization for Standardization) among the issues ISO 26000 and the economic, social and environmental indicators in GRI (Global Reporting Initiative) in its G4 version, a panel with monitoring indicators related to relevant issues were elaborated.

From Systematic Review to Call for Action.

PubMed

Sawin, Erika Metzler; Sobel, Linda L; Annan, Sandra L; Schminkey, Donna L

2017-06-01

Intimate partner violence (IPV) is a global public health and criminal justice concern with significant impacts; especially high rates are seen among rural Hispanic American (HA) communities, the fastest growing population in the United States. They experience additional barriers to care including extreme poverty, lesser education, gender norms, and language and immigration issues. A systematic literature review was conducted using Cooper's framework to identify evidence supporting associations between interventions and prevention, reduction, and elimination of IPV among rural HA women. Searches conducted on databases including CINAHL, PubMed, Medline, Women's Studies International, MedicLatina, and JSTOR used the MeSH terms Hispanic Americans (Latino/a and Hispanic), domestic violence, and intimate partner violence. Selected studies were published between January 1, 2000, and January 1, 2014. Of the 617 yielded articles, only 6 met the inclusion criteria. Of these, none closely examined rurality or provided valid and reliable measures of outcomes, instead reporting program descriptions and suggested interventions. We identify key findings to guide program, screening, and tool development. Our study identifies a gap in knowledge, research, and effective practices and issues a call for action to create evidence-based tools to prevent, reduce, and eliminate IPV in these underserved populations.

An Independent Scientific Assessment of Well Stimulation in California Volume I

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

Jane C.S. Long; Laura C. Feinstein; Birkholzer, Jens

In 2013, the California Legislature passed Senate Bill 4 (SB 4), setting the framework for regulation of well stimulation technologies in California, including hydraulic fracturing. SB 4 also requires the California Natural Resources Agency to conduct an independent scientific study of well stimulation technologies in California to assess current and potential future practices, including the likelihood that well stimulation technologies could enable extensive new petroleum production in the state, evaluate the impacts of well stimulation technologies and the gaps in data that preclude this understanding, identify risks associated with current practices, and identify alternative practices which might limit these risks.more » The study is issued in three volumes. This document, Volume I, provides the factual basis describing well stimulation technologies, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II discusses how well stimulation affects water, the atmosphere, seismic activity, wildlife and vegetation, traffic, light and noise levels; it will also explore human health hazards, and identify data gaps and alternative practices. Volume III presents case studies to assess environmental issues and qualitative« less

Radiation safety issues related to radiolabeled antibodies. [Contains glossary

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

Barber, D.E.; Baum, J.W.; Meinhold, C. B.

1991-03-01

Techniques related to the use of radiolabeled antibodies in humans are reviewed and evaluated in this report. It is intended as an informational resource for the US Nuclear Regulatory Commission (NRC) and NRC licensees. Descriptions of techniques and health and safety issues are provided. Principal methods for labeling antibodies are summarized to help identify related radiation safety problems in the preparation of dosages for administration to patients. The descriptions are derived from an extensive literature review and consultations with experts in the field. A glossary of terms and acronyms is also included. An assessment was made of the extent ofmore » the involvement of organizations (other than the NRC) with safety issues related to radiolabeled antibodies, in order to identify regulatory issues which require attention. Federal regulations and guides were also reviewed for their relevance. A few (but significant) differences between the use of common radiopharmaceuticals and radiolabeled antibodies were observed. The clearance rate of whole, radiolabeled immunoglobulin is somewhat slower than common radiopharmaceuticals, and new methods of administration are being used. New nuclides are being used or considered (e.g., Re-186 and At-211) for labeling antibodies. Some of these nuclides present new dosimetry, instrument calibration, and patient management problems. Subjects related to radiation safety that require additional research are identified. 149 refs., 3 figs., 20 tabs.« less

How can we not 'lose it' if we still don't understand how to 'use it'? Unanswered questions about the influence of activity participation on cognitive performance in older age--a mini-review.

PubMed

Bielak, Allison A M

2010-01-01

The 'use it or lose it' hypothesis of cognitive aging predicts that engagement in intellectual, social, and physical activities offers protective benefits from age-related cognitive decline and lowers dementia risk. Although this hypothesis has not yet been supported conclusively, there is some empirical evidence in favor of the proposal. However, a number of questions surrounding the relationship between activity participation and cognitive ability in older adulthood are not yet well answered. This mini-review identifies seven key methodological and theoretical issues that are critical to our understanding and eventual possible promotion of activity participation as a way to maintain cognitive well-being. These include the mechanisms involved, the optimal ways of assessing activity engagement, which cognitive domains receive the most benefit from activity engagement, the temporal nature and the directionality of the relationship, the influence of demographic variables such as age, gender, or education, and whether one activity domain offers the most benefit to cognition. The current knowledge on each of these issues is critically evaluated, including describing what we already know about the issue, and identifying potential difficulties and opportunities that may exist in finding an answer. More studies need to take on the challenge of specifically targeting these issues, as each is essential to moving the field forward. Copyright (c) 2009 S. Karger AG, Basel.

Stakeholders' perspective on issues and challenges associated with care and treatment of aging-related cognitive impairment disorders in Singapore.

PubMed

Setia, Monika; Islam, Amina M; Thompson, James P; Matchar, David B

2011-11-01

An expanding elderly population poses challenges for the provision of care and treatment for age-related physical and mental disorders. Cognitive impairment (CI)/dementia is one such mental disorder that is on the rise in Singapore and has concomitant implications for social and health systems. The objective of this study is to understand the perspectives of prominent stakeholders about current and future issues and challenges associated with CI/dementia among the elderly in Singapore. Using indepth interviews, this qualitative study obtained the views of multiple stakeholders on issues and challenges associated with CI/dementia in Singapore. The 30 individuals interviewed as part of the study included clinicians, policy-makers, researchers, community workers, administrators, and caregivers. Using a framework approach, interview texts were indexed into domains and issues by utilizing NVivo 9.0 software. The stakeholders expressed concerns related to multiple domains of the CI/dementia care system: attitude and awareness, economics, education, family caregiving, inputs to care system, living arrangements, prevention, screening and diagnosis, and treatment and management of care. Within each domain, multiple issues and challenges were identified by respondents. The study identifies a complex set of inter-related issues and challenges that are associated with the care and treatment of people with CI/dementia. The results suggest that CI and dementia profoundly affect patients, families, and communities and that the issues related to the two disorders are truly system-wide. These findings lay the foundation for utilization of a systems approach to studying CI/dementia and provide an analytic framework for future research on complex health care issues.

The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

PubMed

Allott, Kelly; Lloyd, Susan

2009-07-01

Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

Time to get serious about assessing - and managing - psychosocial issues associated with chronic wounds.

PubMed

Alexander, Susan J

2013-03-01

This article comprises a review of the literature published during the period January 2011 to June 2012 on the topic of the psychosocial impact of wounds and strategies to manage them. There is a growing discussion of the reciprocal link between psychological influences and wound healing. Although the mechanisms underlying these influences are not well understood, evidence from the reviewed literature adds to the existing body of evidence demonstrating that negative psychological states can impair immune function and wound healing. Despite this recognition, there are still few studies that provide strategies to address the identified psychosocial issues associated with wounds, particularly those of chronic duration. A wide range of psychosocial factors likely to be associated with a wound have been identified. The importance of understanding the nature and extent of their impact is illustrated by the patients' experiences of living with a chronic wound which they rate as serious as cancer or myocardial infarction. Although there is currently limited evidence on which to base management strategies, it is recommended that interventions should commence with a comprehensive individualized assessment which can then inform the development of an appropriate management plan that includes the identified psychosocial issues.

Strengthening Community Capacity for Environmental Health Promotion through Photovoice.

PubMed

Postma, Julie; Ramon, Cristian

2016-07-01

The study aims were to: (1) Identify health promoters'; perceptions of housing issues faced by farmworker families in an agricultural community, and (2) Strengthen community capacity to promote healthy and affordable housing. Photovoice was used to identify participants'; perceptions about farmworker housing. Thematic analysis was used to analyze participant interviews. Freudenberg's "Community Capacity for Environmental Health Promotion" framework was used to organize activities that contributed to strengthening community capacity. Purposive sampling was used to recruit six bilingual health promoters into the study. A demographic questionnaire was administered to characterize participants. An interview guide was used to inquire about housing conditions and the research process. A tracking tool was used to document capacity-building activities 2 years post data collection. Housing issues faced by farmworker families included housing availability, poor conditions, and invisibility. All dimensions of community capacity were represented. Most occurred on an individual level. Health promoters identified housing issues and built community capacity to support farmworker housing. Nurses can support housing initiatives by assessing housing status, using data to support healthy housing, supporting health promoter programs in new service delivery models, and leading coalitions to address housing as a social determinant of health. © 2015 Wiley Periodicals, Inc.

The balancing act: key issues in the lives of women general practitioners in Australia.

PubMed

Kilmartin, Margaret R; Newell, Christopher J; Line, Martin A

2002-07-15

To identify key issues affecting women general practitioners in their professional and non-professional lives. A qualitative study using the Delphi technique, with three rounds of data provision circulated to each participant. Coding was used to ensure anonymity. The participants were a purposive sample of 40 women GPs drawn from all Australian States and Territories. The study was conducted between October 1996 and January 1997. Key issues affecting the professional and non-professional lives of women GPs. Some of the key professional issues for women GPs were job satisfaction, balancing work and personal life, autonomy, availability of flexible and part-time work and training, affordability of professional expenses, fair remuneration, and having a voice in decision-making. Key non-professional issues included self-care; time for relationships with a partner, children, family and friends; and time management to allow pursuit of non-medical interests. The conflicting demands made on women GPs diminish their job satisfaction and lead to stress and imbalance in their lives. Recommendations to ameliorate the problems for women GPs include appropriate training, policy formation, financial and other support, and a change in cultural expectations of women GPs by the community, the profession and governments.

Conceptual design of the MHD Engineering Test Facility

NASA Technical Reports Server (NTRS)

Bents, D. J.; Bercaw, R. W.; Burkhart, J. A.; Mroz, T. S.; Rigo, H. S.; Pearson, C. V.; Warinner, D. K.; Hatch, A. M.; Borden, M.; Giza, D. A.

1981-01-01

The reference conceptual design of the MHD engineering test facility, a prototype 200 MWe coal-fired electric generating plant designed to demonstrate the commerical feasibility of open cycle MHD is summarized. Main elements of the design are identified and explained, and the rationale behind them is reviewed. Major systems and plant facilities are listed and discussed. Construction cost and schedule estimates are included and the engineering issues that should be reexamined are identified.

Work participation and arthritis: a systematic overview of challenges, adaptations and opportunities for interventions.

PubMed

Hoving, Jan L; van Zwieten, Myra C B; van der Meer, Marrit; Sluiter, Judith K; Frings-Dresen, Monique H W

2013-07-01

Understanding the factors that play a role in maintaining people with inflammatory arthritis in the workforce may aid the design of interventions to support work participation. The objective of this systematic overview is to summarize qualitative studies that explore experiences of patients with inflammatory arthritis to remain employed or return to work. Bibliographic databases including MEDLINE, EMBASE and PsycInfo were searched until December 2011 to identify any qualitative studies that focused on experiences, challenges or adaptations of patients with inflammatory arthritis to remain employed. Thematic analyses were used to identify any first or higher order themes for which all data were entered into MAXQDA software. In addition, methodological quality was assessed using an eight-item checklist. Of 6338 citations, 10 studies were included. RA was the condition in eight studies. Individual interviews (six studies) were used more frequently than group interviews (four studies). Methodological quality varied from 2 to 8 points and had no effect on the number of themes identified. Thematic analyses showed seven key concepts important to patients, including disease symptoms, management of the disease, socioeconomic issues, work conditions and adaptations, emotional challenges, interpersonal issues affecting work and family life and meaning of work. By including studies from different countries and settings, we show a comprehensive overview of themes considered important by patients and strengthen our belief that these factors should be considered in interventions that aim to improve work participation for patients with inflammatory arthritis.

Whistleblowing: An integrative literature review of data-based studies involving nurses.

PubMed

Jackson, Debra; Hickman, Louise D; Hutchinson, Marie; Andrew, Sharon; Smith, James; Potgieter, Ingrid; Cleary, Michelle; Peters, Kath

2014-10-27

Abstract Aim To summarise and critique the research literature about whistleblowing and nurses. Background Whistleblowing is identified as a crucial issue in maintenance of healthcare standards and nurses are frequently involved in whistleblowing events. Despite the importance of this issue, to our knowledge an evaluation of this body of the data-based literature has not been undertaken. Method An integrative literature review approach was used to summarise and critique the research literature. A comprehensive search of five databases including Medline, CINAHL, PubMed and Health Science: Nursing/Academic Edition, and Google, were searched using terms including: 'whistleblow*', 'nurs*'. In addition, relevant journals were examined, as well as reference lists of retrieved papers. Papers published during the years 2007-2013 were selected for inclusion. Findings Fifteen papers were identified, capturing data from nurses in seven countries. The findings in this review demonstrate a growing body of research for the nursing profession at large to engage and respond appropriately to issues involving suboptimal patient care or organisational wrongdoing. Conclusions Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

Whistleblowing: An integrative literature review of data-based studies involving nurses.

PubMed

Jackson, Debra; Hickman, Louise D; Hutchinson, Marie; Andrew, Sharon; Smith, James; Potgieter, Ingrid; Cleary, Michelle; Peters, Kath

2014-01-01

Abstract Aim: To summarise and critique the research literature about whistleblowing and nurses. Whistleblowing is identified as a crucial issue in maintenance of healthcare standards and nurses are frequently involved in whistleblowing events. Despite the importance of this issue, to our knowledge an evaluation of this body of the data-based literature has not been undertaken. An integrative literature review approach was used to summarise and critique the research literature. A comprehensive search of five databases including Medline, CINAHL, PubMed and Health Science: Nursing/Academic Edition, and Google, were searched using terms including: 'Whistleblow*,' 'nurs*.' In addition, relevant journals were examined, as well as reference lists of retrieved papers. Papers published during the years 2007-2013 were selected for inclusion. Fifteen papers were identified, capturing data from nurses in seven countries. The findings in this review demonstrate a growing body of research for the nursing profession at large to engage and respond appropriately to issues involving suboptimal patient care or organisational wrongdoing. Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

Evaluation of physical activity interventions in youth via the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: A systematic review of randomised and non-randomised trials.

PubMed

McGoey, Tara; Root, Zach; Bruner, Mark W; Law, Barbi

2015-07-01

An identified limitation of existing reviews of physical activity interventions in school-aged youth is the lack of reporting on issues related to the translatability of the research into health promotion practice. This review used the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance framework to determine the extent to which intervention studies promoting physical activity in youth report on factors that inform generalizability across settings and populations. A systematic search for controlled interventions conducted within the last ten years identified 50 studies that met the selection criteria. Based on Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance criteria, most of these studies focused on statistically significant findings and internal validity rather than on issues of external validity. Due to this lack of information, it is difficult to determine whether or not reportedly successful interventions are feasible and sustainable in an uncontrolled, real-world setting. Areas requiring further research include costs associated with recruitment and implementation, adoption rate, and representativeness of participants and settings. This review adds data to support recommendations that interventions promoting physical activity in youth should include assessment of adoption and implementation issues. Copyright © 2015 Elsevier Inc. All rights reserved.

The challenges for scientific publishing, 60 years on.

PubMed

Hausmann, Laura; Murphy, Sean P

2016-10-01

The most obvious difference in science publishing between 'then' and 'now' is the dramatic change in the communication of data and in their interpretation. The democratization of science via the Internet has brought not only benefits but also challenges to publishing including fraudulent behavior and plagiarism, data and statistics reporting standards, authorship confirmation and other issues which affect authors, readers, and publishers in different ways. The wide accessibility of data on a global scale permits acquisition and meta-analysis to mine for novel synergies, and has created a highly commercialized environment. As we illustrate here, identifying unacceptable practices leads to changes in the standards for data reporting. In the past decades, science publishing underwent dramatic changes in the communication of data and in their interpretation, in the increasing pressure and commercialization, and the democratization of science on a global scale via the Internet. This article reviews the benefits and challenges to publishing including fraudulent behavior and plagiarism, data and statistics reporting standards, authorship confirmation and other issues, with the aim to provide readers with practical examples and hands-on guidelines. As we illustrate here, identifying unacceptable practices leads to changes in the standards for data reporting. This article is part of the 60th Anniversary special issue. © 2016 International Society for Neurochemistry.

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.

Editorial Perspective: Pathological social withdrawal during in adolescence: a culture-specific or a global phenomenon?

PubMed

Li, Tim M H; Wong, Paul W C

2015-10-01

Impairing patterns of long-term adolescent social withdrawal and self-exclusion, including nonattendance at school or work, and minimal social contact, have been identified as a significant clinical and social problem in Japan since the late 1990s, where it is termed hikikomori. As well clinical impairment for the withdrawn youths and burden for the families, hikikomori has brought societal and health service costs in Japan. Since its first identification, similar cases have been reported in other countries. Socially withdrawn youths, unfortunately, are difficult to identify and their risks can be 'invisible' because of their withdrawn nature and the traditional perspective of what is perceived as at-risk youth. Understanding of the issue including its causes, risks, and outcomes is very limited. In this editorial perspective, we highlight how youth social withdrawal is becoming a clinical and social concern in some parts of the world and respond to the lack of research on this issue by synthesizing some of the basic research findings, and suggesting future directions for research and practice relating to this emerging youth phenomenon in middle-and-high-income countries in the hope of bringing more attention to this issue. © 2015 Association for Child and Adolescent Mental Health.

Challenges in Piaget's legacy.

PubMed

Bibace, Roger

2013-03-01

The publication of After Piaget (Martí and Rodríguez 2012) hopefully triggers a new effort to understand the richness of the efforts of that major psychologist of the 20th century. Piaget was consistently concerned with part/whole relationships throughout his life. He addressed this issue philosophically, epistemologically, and psychologically. Conceptually Piaget struggled with the issue of continuity/discontinuity in development and changed his mind about how to reconcile the discontinuities of stages with his concept of development. I also attribute his variability to the implications of his important work on perception, and to his willingness to get involved in widespread concrete applications of his approach to education including the education of children with special needs; his center for genetic epistemology, and his interest in psychoanalysis. Benefiting from all the authors of After Piaget, I want to point out that Piaget has identified many major issues that will continue to constitute challenges to psychology in this century. These include specifying terms such as 'development;' methodological issues such as sampling both quantitatively in one culture and across cultures; comprehensive inclusion of the psychological processes covered by introductory textbooks in psychology; and conceptual issues such as the relationships among all these parts within a whole. I make a distinction between an 'issue' and a 'problem'--problems have solutions; while issues refer to controversies in science generally as well as in psychology that have persisted for centuries.

A horizon scan of global conservation issues for 2014

PubMed Central

Sutherland, William J.; Aveling, Rosalind; Brooks, Thomas M.; Clout, Mick; Dicks, Lynn V.; Fellman, Liz; Fleishman, Erica; Gibbons, David W.; Keim, Brandon; Lickorish, Fiona; Monk, Kathryn A.; Mortimer, Diana; Peck, Lloyd S.; Pretty, Jules; Rockström, Johan; Rodríguez, Jon Paul; Smith, Rebecca K.; Spalding, Mark D.; Tonneijck, Femke H.; Watkinson, Andrew R.

2014-01-01

This paper presents the output of our fifth annual horizon-scanning exercise, which aims to identify topics that increasingly may affect conservation of biological diversity, but have yet to be widely considered. A team of professional horizon scanners, researchers, practitioners, and a journalist identified 15 topics which were identified via an iterative, Delphi-like process. The 15 topics include a carbon market induced financial crash, rapid geographic expansion of macroalgal cultivation, genetic control of invasive species, probiotic therapy for amphibians, and an emerging snake fungal disease. PMID:24332318

A Shared Vision? Stakeholders' Perspectives on the Internationalization of Higher Education in Canada.

ERIC Educational Resources Information Center

Knight, Jane

1997-01-01

Reports on a Canadian survey concerning differences and similarities in views and expectations among higher education's stakeholders (government, academia, industry) with a central interest is internationalization of education. Emerging issues identified included preparation of knowledgeable and interculturally competent graduates; recruiting and…

Development of a Value Inquiry Model in Biology Education.

ERIC Educational Resources Information Center

Jeong, Eun-Young; Kim, Young-Soo

2000-01-01

Points out the rapid advances in biology, increasing bioethical issues, and how students need to make rational decisions. Introduces a value inquiry model development that includes identifying and clarifying value problems; understanding biological knowledge related to conflict situations; considering, selecting, and evaluating each alternative;…

Land use, climate, and water resources – global stages of interaction

EPA Science Inventory

Land use and climate change can accelerate the depletion of freshwater resources that support humans and ecosystem services on a global scale. Here, we briefly review studies from around the world, including those in this special issue. We identify stages, which characterize i...

Legal Issues Confronting Department Chairs.

ERIC Educational Resources Information Center

Colm, Maxine

2002-01-01

Identifies broad areas affecting department chairs when they deal with academic personnel matters, including sexual harassment and sexual discrimination. Notes that the hiring and reappointment process is at the core of building and maintaining the highest quality faculty members, and that most federal and state courts defer to academic judgment…

How State and Local Interagency Partnerships Work.

ERIC Educational Resources Information Center

Rachal, Patricia, Ed.

1996-01-01

This newsletter theme issue describes a state-local team partnership model for interagency transition efforts for young adults with deaf-blindness. Excepts from a presentation by Jane M. Everson identify key aspects and characteristics of effective state and local interagency partnerships. These include: (1) strategies for initiating and…

Treatment Compliance in Group Therapy: Issues and Interventions

ERIC Educational Resources Information Center

Hunnicutt Hollenbaugh, Karen Michelle

2011-01-01

In this manuscript, research on treatment compliance and dropout in group therapy is reviewed. A number of variables found to be related to the compliance and dropout are identified including client characteristics, treatment characteristics, and therapist perceptions and behavior. Implications of these results for increasing treatment compliance…

Individuals with knee impairments identify items in need of clarification in the Patient Reported Outcomes Measurement Information System (PROMIS®) pain interference and physical function item banks - a qualitative study.

PubMed

Lynch, Andrew D; Dodds, Nathan E; Yu, Lan; Pilkonis, Paul A; Irrgang, James J

2016-05-11

The content and wording of the Patient Reported Outcome Measurement Information System (PROMIS) Physical Function and Pain Interference item banks have not been qualitatively assessed by individuals with knee joint impairments. The purpose of this investigation was to identify items in the PROMIS Physical Function and Pain Interference Item Banks that are irrelevant, unclear, or otherwise difficult to respond to for individuals with impairment of the knee and to suggest modifications based on cognitive interviews. Twenty-nine individuals with knee joint impairments qualitatively assessed items in the Pain Interference and Physical Function Item Banks in a mixed-methods cognitive interview. Field notes were analyzed to identify themes and frequency counts were calculated to identify items not relevant to individuals with knee joint impairments. Issues with clarity were identified in 23 items in the Physical Function Item Bank, resulting in the creation of 43 new or modified items, typically changing words within the item to be clearer. Interpretation issues included whether or not the knee joint played a significant role in overall health and age/gender differences in items. One quarter of the original items (31 of 124) in the Physical Function Item Bank were identified as irrelevant to the knee joint. All 41 items in the Pain Interference Item Bank were identified as clear, although individuals without significant pain substituted other symptoms which interfered with their life. The Physical Function Item Bank would benefit from additional items that are relevant to individuals with knee joint impairments and, by extension, to other lower extremity impairments. Several issues in clarity were identified that are likely to be present in other patient cohorts as well.

HTA and its legal issues: a framework for identifying legal issues in health technology assessment.

PubMed

Widrig, Daniel; Tag, Brigitte

2014-12-01

Legal analysis can highlight important issues that are relevant when deciding whether a medical technology should be implemented or reimbursed. Literature and studies show that even though the law is an acknowledged part of health technology assessment (HTA), legal issues are rarely considered in practice. One reason for this may be the lack of knowledge about the diversity of legal issues that are relevant for HTA. Therefore, this contribution aims primarily to identify and then explain the relevant legal issues in HTA. This study offers a framework for identifying the legal issues in HTAs in different jurisdictions and provides a basis for further research. After extensive literature search, the authors review Swiss health law to identify legal issues that are relevant to HTA. The authors then categorize these legal issues using a framework with an inside and outside perspective. Finally, they explain a selection of these legal issues with several examples. This study reveals numerous legal issues that are relevant for HTA and underlines the necessity of incorporating legal analysis in HTAs. The suggested perspectival framework in this study provides a basis to structure the legal analysis. The identified legal issues are relevant in other countries and the perspectival framework is transferable to other jurisdictions. The article underlines the importance of in-depth discussion about the role of law in HTA. It provides a structured overview of the legal issues in HTA and suggests a development of more concrete instruments toward a standardized legal technology assessment.

Verification Challenges at Low Numbers

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

Benz, Jacob M.; Booker, Paul M.; McDonald, Benjamin S.

2013-06-01

Many papers have dealt with the political difficulties and ramifications of deep nuclear arms reductions, and the issues of “Going to Zero”. Political issues include extended deterrence, conventional weapons, ballistic missile defense, and regional and geo-political security issues. At each step on the road to low numbers, the verification required to ensure compliance of all parties will increase significantly. Looking post New START, the next step will likely include warhead limits in the neighborhood of 1000 . Further reductions will include stepping stones at1000 warheads, 100’s of warheads, and then 10’s of warheads before final elimination could be considered ofmore » the last few remaining warheads and weapons. This paper will focus on these three threshold reduction levels, 1000, 100’s, 10’s. For each, the issues and challenges will be discussed, potential solutions will be identified, and the verification technologies and chain of custody measures that address these solutions will be surveyed. It is important to note that many of the issues that need to be addressed have no current solution. In these cases, the paper will explore new or novel technologies that could be applied. These technologies will draw from the research and development that is ongoing throughout the national laboratory complex, and will look at technologies utilized in other areas of industry for their application to arms control verification.« less

The inclusion of LGBT+ health issues within undergraduate healthcare education and professional training programmes: A systematic review.

PubMed

McCann, Edward; Brown, Michael

2018-05-01

An inclusive health curriculum within undergraduate and continuing professional development programmes (CPD) should include issues related to people whom identify as LGBT+. The aim of this systematic review was to examine the education and training requirements of undergraduate students and health professionals regarding the inclusion of LGBT+ health issues. A systematic review of the available published empirical studies. A systematic literature search was undertaken of the following databases: CINAHL, PubMed, PsycINFO, Embase and Sociological Abstracts. All papers reviewed were from the years 2007 to 2017 and written in English. Three research questions informing the literature review were: (i) What are the education and training requirements of undergraduate students and health professionals regarding the health needs of LGBT+ people? (ii) What are the approaches utilized in the education and training of undergraduate students and health professionals regarding the health needs of LGBT+ people? (iii) What are the best practice examples of the education and training of undergraduate students and health professionals? Following the application of definitive criteria, 22 papers were included in the review. Quality appraisal and data extraction was undertaken by the two authors. The 22 papers were reviewed in detail in the final data analysis and synthesis where four main themes were identified: (1) Cultural competence and inclusivity. (2) Existing knowledge of LGBT+ health-related issues. (3) Curriculum developments and outcomes. (4) Evidence of best practice in education delivery. The review highlights the importance of the inclusion of LGBT+ health-related issues within the health curriculum and continuing professional development programmes and the implications for education and training, clinical practice and research. Copyright © 2018 Elsevier 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.

Added value of involving patients in the first step of multidisciplinary guideline development: a qualitative interview study among infertile patients.

PubMed

den Breejen, Elvira M E; Hermens, Rosella P M G; Galama, Wienke H; Willemsen, Wim N P; Kremer, Jan A M; Nelen, Willianne L D M

2016-06-01

Patient involvement in scoping the guideline is emphasized, but published initiatives actively involving patients are generally limited to the writing and reviewing phase. To assess patients' added value to the scoping phase of a multidisciplinary guideline on infertility. Qualitative interview study. We conducted interviews among 12 infertile couples and 17 professionals. We listed and compared the couples' and professionals' key clinical issues (=care aspects that need improvement) to be addressed in the guideline according to four domains: current guidelines, professionals, patients and organization of care. Main key clinical issues suggested by more than three quarters of the infertile couples and/or at least two professionals were identified and compared. Overall, we identified 32 key clinical issues among infertile couples and 23 among professionals. Of the defined main key clinical issues, infertile couples mentioned eight issues that were not mentioned by the professionals. These main key clinical issues mainly concerned patient-centred (e.g. poor information provision and poor alignment of care) aspects of care on the professional and organizational domain. Both groups mentioned two main key clinical issues collectively that were interpreted differently: the lack of emotional support and respect for patients' values. Including patients from the first phase of the guideline development process leads to valuable additional main key clinical issues for the next step of a multidisciplinary guideline development process and broadens the scope of the guideline, particularly regarding patient-centredness and organizational issues from a patients' perspective. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Using Eight Key Questions as an Inquiry-Based Framework for Ethical Reasoning Issues in a General Education Earth Systems and Climate Change Course

NASA Astrophysics Data System (ADS)

Johnson, E. A.; Ball, T. C.

2014-12-01

An important objective in general education geoscience courses is to help students evaluate social and ethical issues based upon scientific knowledge. It can be difficult for instructors trained in the physical sciences to design effective ways of including ethical issues in large lecture courses where whole-class discussions are not practical. The Quality Enhancement Plan for James Madison University, "The Madison Collaborative: Ethical Reasoning in Action," (http://www.jmu.edu/mc/index.shtml) has identified eight key questions to be used as a framework for developing ethical reasoning exercises and evaluating student learning. These eight questions are represented by the acronym FOR CLEAR and are represented by the concepts of Fairness, Outcomes, Responsibilities, Character, Liberty, Empathy, Authority, and Rights. In this study, we use the eight key questions as an inquiry-based framework for addressing ethical issues in a 100-student general education Earth systems and climate change course. Ethical reasoning exercises are presented throughout the course and range from questions of personal behavior to issues regarding potential future generations and global natural resources. In the first few exercises, key questions are identified for the students and calibrated responses are provided as examples. By the end of the semester, students are expected to identify key questions themselves and justify their own ethical and scientific reasoning. Evaluation rubrics are customized to this scaffolding approach to the exercises. Student feedback and course data will be presented to encourage discussion of this and other approaches to explicitly incorporating ethical reasoning in general education geoscience courses.

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

PubMed

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

2017-02-01

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

SU-E-CAMPUS-J-04: Image Guided Radiation Therapy (IGRT): Review of Technical Standards and Credentialing in Radiotherapy Clinical Trials

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

Giaddui, T; Chen, W; Yu, J

2014-06-15

Purpose: To review IGRT credentialing experience and unexpected technical issues encountered in connection with advanced radiotherapy technologies as implemented in RTOG clinical trials. To update IGRT credentialing procedures with the aim of improving the quality of the process, and to increase the proportion of IGRT credentialing compliance. To develop a living disease site-specific IGRT encyclopedia. Methods: Numerous technical issues were encountered during the IGRT credentialing process. The criteria used for credentialing review were based on: image quality; anatomy included in fused data sets and shift results. Credentialing requirements have been updated according to the AAPM task group reports for IGRTmore » to ensure that all required technical items are included in the quality review process. Implementation instructions have been updated and expanded for recent protocols. Results: Technical issues observed during the credentialing review process include, but are not limited to: poor quality images; inadequate image acquisition region; poor data quality; shifts larger than acceptable; no soft tissue surrogate. The updated IGRT credentialing process will address these issues and will also include the technical items required from AAPM: TG 104; TG 142 and TG 179 reports. An instruction manual has been developed describing a remote credentialing method for reviewers. Submission requirements are updated, including images/documents as well as facility questionnaire. The review report now includes summary of the review process and the parameters that reviewers check. We have reached consensus on the minimum IGRT technical requirement for a number of disease sites. RTOG 1311(NRG-BR002A Phase 1 Study of Stereotactic Body Radiotherapy (SBRT) for the Treatment of Multiple Metastases) is an example, here; the protocol specified the minimum requirement for each anatomical sites (with/without fiducials). Conclusion: Technical issues are identified and reported. IGRT guidelines are updated, with the corresponding credentialing requirements. An IGRT encyclopedia describing site-specific implementation issues is currently in development.« less

Issues in solid-organ transplantation in children: translational research from bench to bedside

PubMed Central

Lipshultz, Steven E.; Chandar, Jayanthi J.; Rusconi, Paolo G.; Fornoni, Alessia; Abitbol, Carolyn L.; Burke III, George W.; Zilleruelo, Gaston E.; Pham, Si M.; Perez, Elena E.; Karnik, Ruchika; Hunter, Juanita A.; Dauphin, Danielle D.; Wilkinson, James D.

2014-01-01

In this review, we identify important challenges facing physicians responsible for renal and cardiac transplantation in children based on a review of the contemporary medical literature. Regarding pediatric renal transplantation, we discuss the challenge of antibody-mediated rejection, focusing on both acute and chronic antibody-mediated rejection. We review new diagnostic approaches to antibody-mediated rejection, such as panel-reactive antibodies, donor-specific cross-matching, antibody assays, risk assessment and diagnosis of antibody-mediated rejection, the pathology of antibody-mediated rejection, the issue of ABO incompatibility in renal transplantation, new therapies for antibody-mediated rejection, inhibiting of residual antibodies, the suppression or depletion of B-cells, genetic approaches to treating acute antibody-mediated rejection, and identifying future translational research directions in kidney transplantation in children. Regarding pediatric cardiac transplantation, we discuss the mechanisms of cardiac transplant rejection, including the role of endomyocardial biopsy in detecting graft rejection and the role of biomarkers in detecting cardiac graft rejection, including biomarkers of inflammation, cardiomyocyte injury, or stress. We review cardiac allograft vasculopathy. We also address the role of genetic analyses, including genome-wide association studies, gene expression profiling using entities such as AlloMap®, and adenosine triphosphate release as a measure of immune function using the Cylex® ImmuKnow™ cell function assay. Finally, we identify future translational research directions in heart transplantation in children. PMID:24860861

Factors Influencing Professional Help-Seeking for Suicidality.

PubMed

Han, Jin; Batterham, Philip J; Calear, Alison L; Randall, Rebecca

2018-05-01

Evidence suggests that the majority of people with suicidality do not seek help. Little systematic evaluation of factors influencing professional help-seeking has been done. To systematically evaluate the factors that influence professional help-seeking for suicidality. Published quantitative and qualitative studies in Medline and PsycInfo databases were reviewed following PRISMA. In all, 55 relevant studies were identified. Of these, 15 studies examined professional help-seeking intentions for perceived suicidal ideation, among people with or without suicidality; 21 studies examined professional help-seeking behavior among people with suicidality; and 19 studies examined suicidal decedents' health services use. Several potential important barriers were identified including high self-reliance, lack of perceived need for treatment, and stigmatizing attitudes toward suicide, toward mental health issues, and toward seeking professional treatment. The presence of suicidality and mental health issues was found to generally decrease help-seeking intentions for perceived suicidal ideation while facilitating actual service use. Social support and informal support from family and friends also played an important role in professional help-seeking. Although the majority of the included studies were of sound quality, some of the factors identified in the review were assessed in relatively few studies, and most of the included studies were conducted in industrialized countries. Further quantitative and qualitative studies examining the potential important factors in broader community samples, especially in developing countries, are needed.

Using rapid assessment and response to operationalise physical activity strategic health communication campaigns in Tonga.

PubMed

Turk, Tahir; Latu, Netina; Cocker-Palu, Elizabeth; Liavaa, Villiami; Vivili, Paul; Gloede, Sara; Simons, Allison

2013-04-01

The aim of the present study was to identify stakeholder and program beneficiary needs and wants in relation to a netball communication strategy in Tonga. In addition, the study aimed to more clearly identify audience segments for targeting of communication campaigns and to identify any barriers or benefits to engaging in the physical activity program. A rapid assessment and response (RAR) methodology was used. The elicitation research encompassed qualitative fieldwork approaches, including semistructured interviews with key informants and focus group discussions with program beneficiaries. Desk research of secondary data sources supported in-field findings. A number of potential barriers to behavioural compliance existed, including cultural factors, gender discrimination, socioeconomic factors, stigmatising attitudes, the threat of domestic violence, infrastructure and training issues. Factors contributing to participation in physical activity included the fun and social aspects of the sport, incentives (including career opportunities, highlighting the health benefits of the activity and the provision of religious and cultural sanctions by local leaders towards the increased physical activity of women. The consultative approach of RAR provided a more in-depth understanding of the need for greater levels of physical activity and opportunities for engagement by all stakeholders. The approach facilitated opportunities for the proposed health behaviours to be realised through the communication strategy. Essential insights for the strategy design were identified from key informants, as well as ensuring future engagement of these stakeholders into the strategy. So what? The expanded use of RAR to inform the design of social marketing interventions is a practical approach to data collection for non-communicable diseases and other health issues in developing countries. The approach allows for the rapid mobilisation of scarce resources for the implementation of more strategic, targeted communication campaigns to support behavioural changes.

Food Supply and Food Safety Issues in China

PubMed Central

Lam, Hon-Ming; Remais, Justin; Fung, Ming-Chiu; Xu, Liqing; Sun, Samuel Sai-Ming

2013-01-01

Food supply and food safety are major global public health issues, and are particularly important in heavily populated countries such as China. Rapid industrialisation and modernisation in China are having profound effects on food supply and food safety. In this Review, we identified important factors limiting agricultural production in China, including conversion of agricultural land to other uses, freshwater deficits, and soil quality issues. Additionally, increased demand for some agricultural products is examined, particularly those needed to satisfy the increased consumption of animal products in the Chinese diet, which threatens to drive production towards crops used as animal feed. Major sources of food poisoning in China include pathogenic microorganisms, toxic animals and plants entering the food supply, and chemical contamination. Meanwhile, two growing food safety issues are illegal additives and contamination of the food supply by toxic industrial waste. China’s connections to global agricultural markets are also having important effects on food supply and food safety within the country. Although the Chinese Government has shown determination to reform laws, establish monitoring systems, and strengthen food safety regulation, weak links in implementation remain. PMID:23746904

Methods for assessment of keel bone damage in poultry.

PubMed

Casey-Trott, T; Heerkens, J L T; Petrik, M; Regmi, P; Schrader, L; Toscano, M J; Widowski, T

2015-10-01

Keel bone damage (KBD) is a critical issue facing the laying hen industry today as a result of the likely pain leading to compromised welfare and the potential for reduced productivity. Recent reports suggest that damage, while highly variable and likely dependent on a host of factors, extends to all systems (including battery cages, furnished cages, and non-cage systems), genetic lines, and management styles. Despite the extent of the problem, the research community remains uncertain as to the causes and influencing factors of KBD. Although progress has been made investigating these factors, the overall effort is hindered by several issues related to the assessment of KBD, including quality and variation in the methods used between research groups. These issues prevent effective comparison of studies, as well as difficulties in identifying the presence of damage leading to poor accuracy and reliability. The current manuscript seeks to resolve these issues by offering precise definitions for types of KBD, reviewing methods for assessment, and providing recommendations that can improve the accuracy and reliability of those assessments. © 2015 Poultry Science Association Inc.

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.

FRAMEWORK FOR DEVELOPING AMBIENT WATER ...

EPA Pesticide Factsheets

Currently, Ambient Water Quality Criteria (AWQC) for aquatic life protection are derived according to the Guidelines for Derivation of Ambient Water Quality Criteria for the Protection of Aquatic Life and Their Uses, published in 1985. To ensure that AWQC are derived from the best available science, Office of Water assessed the need to update the Guidelines and identified issues that should be addressed in the revisions. In December 2002, EPA's Science Advisory Board concurred with EPA's assessment of the need to update the Guidelines as well as with the issues EPA identified to address. Updating the Guidelines is a Priority Strategic Action included in OST's Strategy for Water Quality Standards and Criteria (Next Priority Strategic Action #1). To revise existing methodology for deriving ambient water quality criteria for the protection of aquatic life.

Complaints from emergency department patients largely result from treatment and communication problems.

PubMed

Taylor, David McD; Wolfe, Rory; Cameron, Peter A

2002-03-01

Emergency department patient complaints are often justified and may lead to apology, remedial action or compensation. The aim of the present study was to analyse emergency department patient complaints in order to identify procedures or practices that require change and to make recommendations for intervention strategies aimed at decreasing complaint rates. We undertook a retrospective analysis of patient complaints from 36 Victorian emergency departments during a 61 month period. Data were obtained from the Health Complaint Information Program (Health Services Commissioner). In all, 2,419 emergency department patients complained about a total of 3,418 separate issues (15.4% of all issues from all hospital departments). Of these, 1,157 complaints (47.80%) were received by telephone and 829 (34.3%) were received by letter; 1,526 (63.1 %) complaints were made by a person other than the patient. Highest complaint rates were received from patients who were female, born in non-English-speaking countries and very young or very old. One thousand one hundred and forty-one issues (33.4%) related to patient treatment, including inadequate treatment (329 issues) and inadequate diagnosis (249 issues); 1079 (31.6%) issues related to communication, including poor staff attitude, discourtesy and rudeness (444 issues); 407 (11.9%) issues related to delay in treatment. Overall, 2516 issues (73.6%) were resolved satisfactorily, usually by explanation or apology. Only 59 issues (1.7%) resulted in a procedure or policy change. Remedial action was taken in 109 issues (3.2%) and compensation was paid to eight patients. Communication remains a significant factor in emergency department patient dissatisfaction. While patient complaints have resulted in major changes to policy and procedure, research and intervention strategies into communication problems are indicated. In the short term, focused staff training is recommended.

Orbital Debris: Quarterly News, Volume 14, Issue 2

NASA Technical Reports Server (NTRS)

Liou, J. C. (Editor); Shoots, Debi (Editor)

2010-01-01

This bulletin contains articles from the Orbital Debris Program office. This issue's articles are: "Orbital Debris Success Story --A Decade in the Making", "Old and New Satellite Breakups Identified," "Update on Three Major Debris Clouds," and "MMOD Inspection of the HST Bay 5 Multi-Layer Insulation Panel" about micrometeoroid and orbital debris (MMOD) inspection of the Hubble Space Telescope (HST) insulation panel. A project review is also included (i.e., "Small Debris Observations from the Iridium 33/Cosmos 2251 Collision.") There are also abstra cts of conference papers from the staff of the program office.

Perspectives on contemporary lesbian relationships.

PubMed

Holley, Sarah R

2017-01-02

This article introduces the special issue on contemporary lesbian relationships. The beginning notes some of the prominent changes that have occurred in the past 15 years in the visibility and positive representation of lesbian couples in our popular U.S. culture. The remainder focuses on identifying and summarizing the primary themes of the special issue, including the implications of changes in marriage rights, the acknowledgment and exploration of the effects of sexual minority stress, and a shift in the framing of research to better reflect the diversity of lesbian relationship experiences.

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.

Life Sciences Centrifuge Facility assessment

NASA Technical Reports Server (NTRS)

Benson, Robert H.

1994-01-01

This report provides an assessment of the status of the Centrifuge Facility being developed by ARC for flight on the International Space Station Alpha. The assessment includes technical status, schedules, budgets, project management, performance of facility relative to science requirements, and identifies risks and issues that need to be considered in future development activities.

Studying Individual Differences in Predictability with Gamma Regression and Nonlinear Multilevel Models

ERIC Educational Resources Information Center

Culpepper, Steven Andrew

2010-01-01

Statistical prediction remains an important tool for decisions in a variety of disciplines. An equally important issue is identifying factors that contribute to more or less accurate predictions. The time series literature includes well developed methods for studying predictability and volatility over time. This article develops…

Tax Exemption Issues Facing Academic Health Centers in the Managed Care Environment.

ERIC Educational Resources Information Center

Jones, Darryll K.

1997-01-01

Traditional characteristics of academic health centers are outlined, and conflicts with managed care are identified. Operating strategies designed to resolve the conflicts are discussed in light of tax statutes and regulations, Internal Revenue Service interpretations, and case law. Detailed references are included to provide a complete resource…

Consumer Protection in Postsecondary Education: A National Invitational Conference. Program Handbook.

ERIC Educational Resources Information Center

Albanese, Frank N.; And Others

Twelve preconference papers and background articles that identify issues in consumer protection in postsecondary education are presented. The papers and articles include "Recruitment Practices of Postsecondary Schools" (Frank N. Albanese); "The Role of a State Agency in Consumer Protection" (Philip F. Ashler); "The Three R's of Postsecondary…

METHANOL: THE CURRENT STATUS OF ENVIRONMENTAL HEALTH ISSUES

EPA Science Inventory

Methanol has been a topic of interest both as an environmental pollutant and as a fuel. The Clean Air Act (CAA) includes methanol in a list of 189 toxic air pollutants that the U.S. Congress identified for special consideration in the 1990 CAA Amendments. In addition, growing i...

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…

Concluding Comments about Student Transition to Higher Education

ERIC Educational Resources Information Center

Cole, James S.

2017-01-01

This special issue of Transition to Higher Education contained studies from nine countries across the globe. The following provides a brief review of all nine studies, identifying common themes. These common themes include the importance of student expectations regarding their first-year experiences, as well as the importance of student academic…

25 CFR 559.4 - What must a tribe submit to the Chair with the copy of each facility license that has been issued...

Code of Federal Regulations, 2013 CFR

2013-04-01

... environment and the public health and safety. This means that a tribe has identified and enforces laws... that protect the environment and the public health and safety, including standards under a tribal-state...

Understanding the Implications of HIV Disease in Women.

ERIC Educational Resources Information Center

Carney, Jamie S.

2003-01-01

In this article, counselors are urged to become knowledgeable about the many issues and stressors that women with HIV disease face. This article provides an overview of such concerns, including disease characteristics, progression, and symptoms. In addition, psychological, social, and relationship concerns are identified in relation to parenting,…

Theme Issue: Organizational Communication.

ERIC Educational Resources Information Center

Anapol, Malthon M., Ed.

1978-01-01

The articles in this publication discuss the identity problem of those educated in organizational communication when they face a job market that does not identify specific roles and positions for their specialty. The publication includes an outline for a course in organizational communication and a list of guidelines for the selection of client…

Confidentiality Revisited: A Response to Manhal-Baugus (1996).

ERIC Educational Resources Information Center

Doyle, Kevin

1998-01-01

Reviews the issues relating to confidentiality raised by Manhal-Baugus (1996), identifies problem areas from the 1996 article, and offers additional information about confidentiality not included in the article. Chemical dependency counselors are urged to consider the federal law covering confidentiality of alcohol- and drug-abuse patient records…

Modeling human-environmental systems

Treesearch

Morgan Grove; Charlie Schweik; Tom Evans; Glen Green

2002-01-01

This chapter focuses on the integration and development of environmental models that include human decision making. While many methodological and technical issues are common to all types of environmental models, our goal is to highlight the unique characteristics that need to be considered when modeling human-environmental dynamics and to identify future directions for...

77 FR 48108 - Energy Conservation Standards for Commercial Clothes Washers: Public Meeting and Availability of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-13

... written comments on potential amended standards, including comments on the issues identified in the... Legal Authority II. Test Procedures III. Energy Conservation Standards I. Introduction and Legal... the date of publication of the final standards. II. Test Procedures EPCA requires that CCWs use the...

The Tides of Talent.

ERIC Educational Resources Information Center

Taylor, Craig R.

2003-01-01

Results of recent studies on why people leave or stay with an employer identified organizational, job, and leadership issues. Factors included job satisfaction, organizational climate, salary and benefits, loyalty, and anxiety about the economy and job market. Research showed three periods of highest risk of turnover: after the initial 30-60 days,…

Identification of the Gifted Redefined with Ethics and Equity in Mind

ERIC Educational Resources Information Center

McCluskey, Ken W.

2017-01-01

Throughout his focus article, Robert Sternberg discusses the theoretical underpinnings and rationale behind his emerging Active Concerned Citizenship and Ethical Leadership (ACCEL) model. In the process, he raises several critically important issues, including the misuse of IQ testing as the major method for identifying gifted students, the need…

Children and Youth: Interdisciplinary Perspectives. Issues in Children's and Families' Lives. Volume 7.

ERIC Educational Resources Information Center

Walberg, Herbert J., Ed.; Reyes, Olga, Ed.; Weissberg, Roger P., Ed.

This volume exemplifies the overall interdisciplinary, multiprofessional view of the problems and potential of urban children and youth. The contributors were encouraged to identify current problems and better solutions. Contributions are grouped into sections on families, schools, and health. The following chapters are included: (1) "Introduction…

Related Services for School-Aged Children with Disabilities.

ERIC Educational Resources Information Center

Smith-Davis, Judy; Littlejohn, William R.

1991-01-01

This theme issue provides an overview of related services for school aged children with disabilities as required by federal law, especially the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act of 1973. It identifies the personnel associated with delivering various services including audiology, occupational…

Trends in Career and Technical Education Research

ERIC Educational Resources Information Center

Rojewski, Jay W.; Asunda, Paul; Kim, Soo Jung

2008-01-01

The purpose of this literature review was to identify current trends and issues in research focusing on career and technical education (CTE). The primary sources of literature for this review included all research articles published in three refereed scholarly journals--"Career and Technical Education Research," "Journal of Career and Technical…

Meditation, Social Change, and Undergraduate Education

ERIC Educational Resources Information Center

Rockefeller, Steven C.

2006-01-01

This article argues that meditation guided by a competent teacher can be a positive influence in contemporary American society and even a force for progressive social change. A number of critical issues requiring further study are identified, including the need for a better understanding of meditation from the perspective of developmental…

Decision Making/The Chesapeake Bay. An Interdisciplinary Environmental Education Curriculum Unit.

ERIC Educational Resources Information Center

Maryland Univ., College Park. Science Teaching Center.

This multidisciplinary, self-contained curriculum unit focuses on the management of the Chesapeake Bay, a threatened and complex environmental system. Major unit goals include identifying and analyzing conflicting interests, issues, and public policies concerning the Bay, and determining their effects on people and the environment. The unit…

Creating Opportunities: Good Practice in Small Business Training for Australian Rural Women.

ERIC Educational Resources Information Center

Simpson, Lyn; Daws, Leonie; Wood, Leanne

2002-01-01

To overcome barriers to participation in small business training faced by rural Australian women, training needs and delivery issues were identified and a good practice matrix was developed with the following components: marketing, content, delivery, support, impact, and innovation. Underlying principles included unique needs, diversity, use of…

7 CFR 1291.10 - Reporting and oversight requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., identify and share the lessons learned to help expedite problem-solving. (6) Contact Person. List the... period to meet measurable outcomes for each project. (2) Problems and Delays. Note unexpected delays or... include the following: (1) Project Summary. An outline of the issue, problem, interest, or need for each...

Evidence-Based Practices in Special Education: Current Assumptions and Future Considerations

ERIC Educational Resources Information Center

Russo-Campisi, Jacqueline

2017-01-01

Background: The research on evidence-based practices (EBP) in special education has shifted over the last decade from identifying efficacious interventions to exploring issues that impede implementation in the classroom. Common barriers to implementation include absence of training and resources, limited collaboration between researchers and…

An Introduction to Cost Sharing: Why Good Deeds Do Not Go Unpunished.

ERIC Educational Resources Information Center

Seligman, Richard P.

2000-01-01

Examines the concept of cost sharing between grantor agencies and grantee institutions and identifies problems encountered, including use of cost sharing to leverage funds by both funding agencies and grantee institutions; and various grantee institution costing, accounting, and auditing issues, such as effort reporting, the Cost Accounting…

Health Educators in the Workplace: Helping Companies Respond to the AIDS Crisis.

ERIC Educational Resources Information Center

Bauman, Laurie J.; Aberth, John

1986-01-01

This article identifies various dimensions of the AIDS (Acquired Immune Deficiency Syndrome)-related issues emerging in corporations nationwide, including confidentiality, the right of patients to work, benefits and insurance, HTLV-III (Human T-Lymphotropic Type III) screening, fears of contagion among workers, needs of companies to avoid…

University Students Leaving Relationships (USLR): Scale Development and Gender Differences in Decisions to Leave Romantic Relationships

ERIC Educational Resources Information Center

Hendy, Helen M.; Can, S. Hakan; Joseph, Lauren J.; Scherer, Cory R.

2013-01-01

The University Students Leaving Relationships scale was developed to identify student concerns when contemplating dissolution of romantic relationships. Participants included 1,106 students who rated the importance of issues when deciding to leave relationships. Factor analysis produced three dimensions: Missing the Relationship, Social…

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...

48 CFR 9904.405-60 - Illustrations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... administrative (G&A) expense. In the contractor's proposals for final Segment G&A rates (including corporate home... responsibilities on which his salary was based, no part of the official's salary would be required to be identified... the contract. The contracting officer issues a written decision which supports the auditor's position...

48 CFR 9904.405-60 - Illustrations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... administrative (G&A) expense. In the contractor's proposals for final Segment G&A rates (including corporate home... responsibilities on which his salary was based, no part of the official's salary would be required to be identified... the contract. The contracting officer issues a written decision which supports the auditor's position...

48 CFR 9904.405-60 - Illustrations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... administrative (G&A) expense. In the contractor's proposals for final Segment G&A rates (including corporate home... responsibilities on which his salary was based, no part of the official's salary would be required to be identified... the contract. The contracting officer issues a written decision which supports the auditor's position...

Correspondence Urging Bombing of Auschwitz during World War II. Teaching with Documents.

ERIC Educational Resources Information Center

Blondo, Richard A.; Schmael, Wynell Burroughs

1993-01-01

Presents a classroom lesson that utilizes primary sources about Auschwitz, the World War II Nazi concentration camp. Two letters confronting the issue of whether or not U.S. planes should bomb the camps are included. Recommends seven teaching strategies for the lesson and identifies additional resources. (CFR)

Lifelong Learning and the Absence of Gender

ERIC Educational Resources Information Center

Rogers, Alan

2006-01-01

This paper identifies that (with very few exceptions) in most of current literature on lifelong learning, gender issues are ignored or overlooked. An extensive review of the literature demonstrates this neglect. Some reasons are given for this, including the fact that most analyses of lifelong learning tend to stress the individual learning…

Tips for Dealing with Behavior Management Issues

ERIC Educational Resources Information Center

Bechtel, Pamela A.; Stevens, Lisa A.; Brett, Christine E. W.

2012-01-01

The increased diversity of today's students included in P-12 physical education classes creates new challenges in behavior management for physical education teachers. Currently more students with identified at-risk behaviors, as well as more students with physical or mental disabilities, are placed in general physical education classes. This…

Examining the Impediments to Indigenous Strategy and Approaches in Mainstream Secondary Schools

ERIC Educational Resources Information Center

Hynds, Anne; Averill, Robin; Penetito, Wally; Meyer, Luanna; Hindle, Rawiri; Faircloth, Susan

2016-01-01

Noted Maori scholar Russell Bishop identified three impediments to developing Indigenous principles and practices in schools within colonized countries. These include confusion about the culture of Indigenous children, uneven programme implementation and issues with measuring student achievement. In this article, we present results from a mixed…

Use of simulation to assess electronic health record safety in the intensive care unit: a pilot study

PubMed Central

March, Christopher A; Steiger, David; Scholl, Gretchen; Mohan, Vishnu; Hersh, William R; Gold, Jeffrey A

2013-01-01

Objective To establish the role of high-fidelity simulation training to test the efficacy and safety of the electronic health record (EHR)–user interface within the intensive care unit (ICU) environment. Design Prospective pilot study. Setting Medical ICU in an academic medical centre. Participants Postgraduate medical trainees. Interventions A 5-day-simulated ICU patient was developed in the EHR including labs, hourly vitals, medication administration, ventilator settings, nursing and notes. Fourteen medical issues requiring recognition and subsequent changes in management were included. Issues were chosen based on their frequency of occurrence within the ICU and their ability to test different aspects of the EHR–user interface. ICU residents, blinded to the presence of medical errors within the case, were provided a sign-out and given 10 min to review the case in the EHR. They then presented the case with their management suggestions to an attending physician. Participants were graded on the number of issues identified. All participants were provided with immediate feedback upon completion of the simulation. Primary and secondary outcomes To determine the frequency of error recognition in an EHR simulation. To determine factors associated with improved performance in the simulation. Results 38 participants including 9 interns, 10 residents and 19 fellows were tested. The average error recognition rate was 41% (range 6–73%), which increased slightly with the level of training (35%, 41% and 50% for interns, residents, and fellows, respectively). Over-sedation was the least-recognised error (16%); poor glycemic control was most often recognised (68%). Only 32% of the participants recognised inappropriate antibiotic dosing. Performance correlated with the total number of screens used (p=0.03). Conclusions Despite development of comprehensive EHRs, there remain significant gaps in identifying dangerous medical management issues. This gap remains despite high levels of medical training, suggesting that EHR-specific training may be beneficial. Simulation provides a novel tool in order to both identify these gaps as well as foster EHR-specific training. PMID:23578685

Barriers to treatment for older adults seeking psychological therapy.

PubMed

Wuthrich, Viviana M; Frei, Jacqueline

2015-07-01

Older adults with mental health disorders underutilize mental health services more than other adults. While there are well known general barriers to help seeking across the population, specific barriers for older adults include difficulties with transportation, beliefs that it is normal to be anxious and depressed in old age, and beliefs by referrers that psychological therapy is less likely to be effective. This study examined barriers related to identifying the need for help, seeking help and participating in therapy in a clinical population of older adults. Sixty older adults (aged 60-79 years) with comorbid anxiety and unipolar mood disorders completed barriers to treatment questionnaires before and after psychological group treatment, as well as measures of cognitive ability, anxiety, depression, and quality of life at baseline. The greatest barriers to help seeking related to difficulties identifying the need for help, with 50% of the sample reporting their belief that their symptoms were normal as a major barrier. Other major barriers identified were related to: self-reliance, cost of treatment, and fear of medication replicating previous findings. The main barriers reported for difficulties in continuing therapy included not finding therapy helpful, cost of treatment, and thinking that the therapist did not understand their issues. The main barriers identified related to issues with identifying the need to seek help. More attention is needed to educate older adults and professionals about the need for, and effectiveness of, psychological therapies for older adults with anxiety and depression to reduce this barrier to help seeking.

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.

An overview of depression-prone personality traits and the role of interpersonal sensitivity.

PubMed

Boyce, P; Mason, C

1996-02-01

A number of personality styles have been proposed as vulnerability traits to depression. In this paper methodological problems associated with identifying such traits are discussed. These include state effects contaminating personality scales and the issue of depressive heterogeneity. Potential depression-prone personality traits are then discussed, including obsessionality, neuroticism, dependency and cognitive dysfunction. High interpersonal sensitivity as a risk factor to depression is then discussed.

Analysis of small crack behavior for airframe applications

NASA Technical Reports Server (NTRS)

Mcclung, R. C.; Chan, K. S.; Hudak, S. J., Jr.; Davidson, D. L.

1994-01-01

The small fatigue crack problem is critically reviewed from the perspective of airframe applications. Different types of small cracks-microstructural, mechanical, and chemical-are carefully defined and relevant mechanisms identified. Appropriate analysis techniques, including both rigorous scientific and practical engineering treatments, are briefly described. Important materials data issues are addressed, including increased scatter in small crack data and recommended small crack test methods. Key problems requiring further study are highlighted.

Diabetes and end of life: ethical and methodological issues in gathering evidence to guide care.

PubMed

Dunning, Trisha; Duggan, Nicole; Savage, Sally; Martin, Peter

2013-03-01

Providing palliative care for people with diabetes at the end of life is part of the chronic disease care trajectory, but end of life care is complex and the presence of diabetes further complicates management. The aim of the paper is to discuss the ethical and methodological issues encountered when undertaking research to develop guidelines for managing diabetes at the end of life and the strategies used to address the issues. The issues emerged as we developed guidelines for managing diabetes at the end of life, which included conducting individual interviews with 14 people with diabetes requiring palliative care and 10 family members. A reflexive researcher journal was maintained throughout the guideline development process. The interview transcripts and researcher's journal were analysed to determine key methodological, ethical and researcher-related issues. Key themes were vulnerability of the sampling population, methodological issues included recruiting participants and ensuring rigor, ethical issues concerned benefit and risk, justice, autonomy, privacy, professional boundaries and informed consent. Researcher-related issues were identified such as managing participant distress and their own emotional distress. People were willing to discuss end of life diabetes management preferences. Undertaking research with people at the end of life is complex because of their vulnerability and the ethical issues involved. However, the ethical principles of autonomy and justice apply and people should be given the relevant information and opportunity to decide whether to participate or not. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

ADA members weigh in on critical issues.

PubMed

Burgess, Karen; Ruesch, Jon D; Mikkelsen, Matthew C; Wagner, Karen Schaid

2003-01-01

Science, new technology, patient care, dental reimbursement and government regulations all affect today's dental practitioners. To find out more about how such challenges may affect current private practitioners, the American Dental Association conducted the 2000 Membership Needs and Opinions Survey. A questionnaire was sent to 6,310 ADA members in January 2000 with follow-up mailings in February, March and April 2000. Data collection was completed in July 2000. The survey included questions on critical professional issues, and on perceptions of the ADA and ADA priorities. A total of 3,558 completed surveys were received for an adjusted response rate of 59.5 percent. Members rated the identified issues' level of importance to them. The top three issues included "maintaining my ability to recommend the treatment option I feel is most appropriate for my patients," "receiving fair reimbursement for the dental services I provide," and "protecting myself, my staff and my patients from communicable diseases." New dentists found other items to be more significant to them compared with members overall. Although ADA members as a whole had similar views on critical issues facing dentistry and ADA priorities, there were significant differences regarding some issues. New dentists were far more concerned about securing funds for their practice and paying off debt than were all ADA members. Minority dentists expressed greater levels of concern about certain issues than did all ADA members. When planning and implementing ADA activities, the Association should continue to take into account members' relative rankings of professional issues and note issues of special interest to selected membership subgroups.

Affordable housing and health: a health impact assessment on physical inspection frequency.

PubMed

Klein, Elizabeth G; Keller, Brittney; Hood, Nancy; Holtzen, Holly

2015-01-01

To characterize the prevalence of health-related housing quality exposure for the vulnerable populations that live in affordable housing. Retrospective cross-sectional study. Affordable housing properties in Ohio inspected between 2007 and 2011. Stratified random sample of physical inspection reports (n = 370), including a case study of properties receiving multiple inspections (n = 35). Health-related housing factors, including mold, fire hazard, and others. The majority of affordable housing property inspections (85.1%) included at least 1 health-related housing quality issue. The prevalence of specific health-related violations was varied, with appliance and plumbing issues being the most common, followed by fire, mold, and pest violations. Across funding agencies, the actual implementation of inspection protocols differed. The majority of physical inspections identified housing quality issues that have the potential to impact human health. If the frequency of physical inspections is reduced as a result of inspection alignment, the most health protective inspection protocol should be selected for funding agency inspections; a standardized physical inspection tool is recommended to improve the consistency of inspection findings between mandatory physical inspections in order to promote optimum tenant health.

Mainstreaming in the Philippines programme.

PubMed

Smith, S

1998-07-01

In the Philippines, where the Oxfam team has worked on gender issues since 1990, the group recently conducted an in-house workshop to identify achievements and areas for improvement in gender mainstreaming. Gender activities began with a needs assessment of the fisheries in 1990 and have included gender-sensitivity training for Oxfam partner groups, support of women's issues, and gender research into such areas as disaster management. Successes include the appointment of women to key positions in the community, which was a direct result of advocacy work. Major challenges include 1) determining the best models to develop sectoral networking and advocacy on gender and 2) overcoming gender-resistance in some partners. The team concluded that it is still learning how to mainstream gender issues and is still searching for a framework to integrate gender into other approaches to planning, monitoring, and evaluation. In the future, Oxfam will 1) undertake small-scale and simple gender reviews with selected partners and then pilot gender-mainstreaming contracts with them, 2) build gender-learning teams within sectoral programs, 3) continue supporting networking and capability-building in feminist organizations, and 4) focus on gender at the next partners' meeting.

Custody and access issues with children whose parents are separated or divorced.

PubMed

Palmer, Sally E

2002-01-01

This article discusses the effects of family breakdown--and the resulting issues of custody and access--on children. It explores trends in child custody and access and issues surrounding those trends, particularly in terms of the benefits and limitations of joint custody. It then identifies the contextual problems of family breakups (including the relative poverty experienced by mother-led families, the unreliability of financial support from fathers, the complications for children which result from step-parent figures, including serial partners of their parents, the implications of interparental conflict, the need to fully address suspicions and/or allegations of abuse by one parent against another, and the problem of Parental Alienation Syndrome). Typical responses of children to family breakup are then considered, including feelings of loss, guilt, and responsibility, and a sense of divided loyalties--particularly in light of intense or violent parental conflict. And finally, recommendations are made to minimize the detrimental effects of family breakup on children: (a) allowing children choice and flexibility, (b) exploring the benefits of mediation for families, (c) promoting parental co-operation, and (d) encouraging an ongoing relationship with the nonresidential parent.

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

Representations of women and drug use in policy: A critical policy analysis.

PubMed

Thomas, Natalie; Bull, Melissa

2018-06-01

Contemporary research in the drugs field has demonstrated a number of gender differences in patterns and experiences of substance use, and the design and provision of gender-responsive interventions has been identified as an important policy issue. Consequently, whether and how domestic drug policies attend to women and gender issues is an important question for investigation. This article presents a policy audit and critical analysis of Australian national and state and territory policy documents. It identifies and discusses two key styles of problematisation of women's drug use in policy: 1) drug use and its effect on women's reproductive role (including a focus on pregnant women and women who are mothers), and 2) drug use and its relationship to women's vulnerability to harm (including violent and sexual victimisation, trauma, and mental health issues). Whilst these are important areas for policy to address, we argue that such representations of women who use drugs tend to reinforce particular understandings of women and drug use, while at the same time contributing to areas of 'policy silence' or neglect. In particular, the policy documents analysed are largely silent about the harm reduction needs of all women, as well as the needs of women who are not mothers, young women, older women, transwomen or other women deemed to be outside of dominant normative reproductive discourse. This analysis is important because understanding how women's drug use is problematised and identifying areas of policy silence provides a foundation for redressing gaps in policy, and for assessing the likely effectiveness of current and future policy approaches. Copyright © 2018 Elsevier B.V. All rights reserved.

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.

Barriers to Leisure-Time Physical Activities in Individuals with Spinal Cord Injury.

PubMed

Hwang, Eric J; Groves, Mary D; Sanchez, Jacqueline N; Hudson, Cassandra E; Jao, Rachel G; Kroll, Meghan E

2016-07-01

This study investigated the personal, environmental, and activity barriers to leisure-time physical activities (LTPAs) among individuals with spinal cord injury (SCI). A survey instrument was administered to 85 participants with SCI. Personal barriers to LTPAs included issues involving motivation, pain, scheduling, and financial resources. Environmental barriers marked the issues regarding availability and accessibility to specialized programs, activities, and professional services. Activity barriers included limitations in equipment, training, and personal skills required by the selected activities. Significant negative correlations were found between these barriers and the levels of physical activity and satisfaction with physical activity. While working with clients with SCI, occupational therapists should identify those LTPA barriers and possible solutions in order to establish individualized action plans for enhancing participation in LTPAs.

Gap analysis of cultural and religious needs of hospitalized patients.

PubMed

Davidson, Judy E; Boyer, Merri Lynn; Casey, Debra; Matzel, Stephen Chavez; Walden, Chaplain David

2008-01-01

Identify patient and family needs specifically related to an in-hospital birth or death. This study aimed to perform a gap analysis between identified needs and current hospital practice, services, and resources. With the IRB approval, and purposive sampling using the demographics of a community hospital plus subgroups from problematic cases. Twenty-two semistructured interviews were audiotaped, and 6 lectures and 2 panel discussions were videotaped. Transcriptions were distributed to the research team and manually coded for gaps between current practices versus stated needs. Group process was used to form consensus regarding findings. The following subgroups were targeted: Muslim, Baha'i, Catholic, Protestant, Jewish, Buddhist, Mormon, Jehovah's Witness, Latino, Filipino, Chinese, African American. Gaps in available resources, such as prayer books, rugs, and compasses, were identified. Knowledge gaps included many issues such as the Muslim preference for decreasing sedatives at end of life to be able to recite the sacred prayer while dying. Practice issues such as respecting plain-clothed clergy, the impact of "rule-orientation" on family needs, and the universal need to call clergy early were identified.

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.

The Teen Photovoice Project: A Pilot Study to Promote Health Through Advocacy

PubMed Central

Necheles, Jonathan W.; Chung, Emily Q.; Hawes-Dawson, Jennifer; Ryan, Gery W.; Williams, La’Shield B.; Holmes, Heidi N.; Wells, Kenneth B.; Vaiana, Mary E.; Schuster, Mark A.

2009-01-01

Background Clinicians, public health practitioners, and policymakers would like to understand how youth perceive health issues and how they can become advocates for health promotion in their communities. 1,2 Traditional research methods can be used to capture these perceptions, but are limited in their ability to activate (excite and engage) youth to participate in health promotion activities. Objectives To pilot the use of an adapted version of photovoice as a starting point to engage youth in identifying influences on their health behaviors in a process that encourages the development of health advocacy projects. Methods Application of qualitative and quantitative methods to a participatory research project that teaches youth the photovoice method to identify and address health promotion issues relevant to their lives. Participants included 13 students serving on a Youth Advisory Board (YAB) of the UCLA/RAND Center for Adolescent Health Promotion working in four small groups of two to five participants. Students were from the Los Angeles, California, metropolitan area. Results Results were derived from photograph sorting activities, analysis of photograph narratives, and development of advocacy projects. Youth frequently discussed a variety of topics reflected in their pictures that included unhealthy food choices, inducers of stress, friends, emotions, environment, health, and positive aspects of family. The advocacy projects used social marketing strategies, focusing on unhealthy dietary practices and inducers of stress. The youths’ focus on obesity-related issues have contributed to the center’s success in partnering with the Los Angeles Unified School District on a new community-based participatory research (CBPR) project. Conclusion Youth can engage in a process of identifying community-level health influences, leading to health promotion through advocacy. Participants focused their advocacy work on selected issues addressing the types of unhealthy food available in their communities and stress. This process appears to provide meaningful insight into the youths’ perspective on what influences their health behaviors. PMID:20208284

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

PubMed

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

2016-09-30

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

The philosophy of scientific experimentation: a review

PubMed Central

2009-01-01

Practicing and studying automated experimentation may benefit from philosophical reflection on experimental science in general. This paper reviews the relevant literature and discusses central issues in the philosophy of scientific experimentation. The first two sections present brief accounts of the rise of experimental science and of its philosophical study. The next sections discuss three central issues of scientific experimentation: the scientific and philosophical significance of intervention and production, the relationship between experimental science and technology, and the interactions between experimental and theoretical work. The concluding section identifies three issues for further research: the role of computing and, more specifically, automating, in experimental research, the nature of experimentation in the social and human sciences, and the significance of normative, including ethical, problems in experimental science. PMID:20098589

Index of NACA Technical Publications, 1949 - May, 1951

NASA Technical Reports Server (NTRS)

1952-01-01

The Preface to the Index of NACA Technical Publications, 1915-1949, mentioned that regular supplements would be issued in the future. This is the first such Supplement and covers those documents issued through May of 1951. Similar arrangement is used in both Indexes. First, there is a classified listing of the subject categories; second, a chronological listing of NACA publications under each subject category; third, an alphabetical index to the subject categories; and finally, an author index. The latter feature was not included in the basic 1915-1949 Index but has been issued separately and is available upon request. Immediately following this Preface is an Explanatory Chart of NACA Publications Series Designations which may be of use in identifying references to NACA documents encountered in the literature.

Use of a web-based image reporting and tracking system for assessing abdominal imaging examination quality issues in a single practice.

PubMed

Rosenkrantz, Andrew B; Johnson, Evan; Sanger, Joseph J

2015-10-01

This article presents our local experience in the implementation of a real-time web-based system for reporting and tracking quality issues relating to abdominal imaging examinations. This system allows radiologists to electronically submit examination quality issues during clinical readouts. The submitted information is e-mailed to a designate for the given modality for further follow-up; the designate may subsequently enter text describing their response or action taken, which is e-mailed back to the radiologist. Review of 558 entries over a 6-year period demonstrated documentation of a broad range of examination quality issues, including specific issues relating to protocol deviation, post-processing errors, positioning errors, artifacts, and IT concerns. The most common issues varied among US, CT, MRI, radiography, and fluoroscopy. In addition, the most common issues resulting in a patient recall for repeat imaging (generally related to protocol deviation in MRI and US) were identified. In addition to submitting quality problems, radiologists also commonly used the tool to provide recognition of a well-performed examination. An electronic log of actions taken in response to radiologists' submissions indicated that both positive and negative feedback were commonly communicated to the performing technologist. Information generated using the tool can be used to guide subsequent quality improvement initiatives within a practice, including continued protocol standardization as well as education of technologists in the optimization of abdominal imaging examinations.

Accounting for Scale Heterogeneity in Healthcare-Related Discrete Choice Experiments when Comparing Stated Preferences: A Systematic Review.

PubMed

Wright, Stuart J; Vass, Caroline M; Sim, Gene; Burton, Michael; Fiebig, Denzil G; Payne, Katherine

2018-02-28

Scale heterogeneity, or differences in the error variance of choices, may account for a significant amount of the observed variation in the results of discrete choice experiments (DCEs) when comparing preferences between different groups of respondents. The aim of this study was to identify if, and how, scale heterogeneity has been addressed in healthcare DCEs that compare the preferences of different groups. A systematic review identified all healthcare DCEs published between 1990 and February 2016. The full-text of each DCE was then screened to identify studies that compared preferences using data generated from multiple groups. Data were extracted and tabulated on year of publication, samples compared, tests for scale heterogeneity, and analytical methods to account for scale heterogeneity. Narrative analysis was used to describe if, and how, scale heterogeneity was accounted for when preferences were compared. A total of 626 healthcare DCEs were identified. Of these 199 (32%) aimed to compare the preferences of different groups specified at the design stage, while 79 (13%) compared the preferences of groups identified at the analysis stage. Of the 278 included papers, 49 (18%) discussed potential scale issues, 18 (7%) used a formal method of analysis to account for scale between groups, and 2 (1%) accounted for scale differences between preference groups at the analysis stage. Scale heterogeneity was present in 65% (n = 13) of studies that tested for it. Analytical methods to test for scale heterogeneity included coefficient plots (n = 5, 2%), heteroscedastic conditional logit models (n = 6, 2%), Swait and Louviere tests (n = 4, 1%), generalised multinomial logit models (n = 5, 2%), and scale-adjusted latent class analysis (n = 2, 1%). Scale heterogeneity is a prevalent issue in healthcare DCEs. Despite this, few published DCEs have discussed such issues, and fewer still have used formal methods to identify and account for the impact of scale heterogeneity. The use of formal methods to test for scale heterogeneity should be used, otherwise the results of DCEs potentially risk producing biased and potentially misleading conclusions regarding preferences for aspects of healthcare.

Examining the Role of Mental Health and Clinical Issues within Talent Development

PubMed Central

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2016-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches identified as well placed to detect general “warning signs” such as behavioral change. Short of integrating trained clinicians into talent development environments, as part of a triangulation process, ecologically validated assessment tools—coupled with appropriate training and signposting—could offer a practical way of flagging potential issues in developing athletes. The need for the development of such an instrument is therefore apparent. Finally, education around the influential role of family is also recommended in order to promote the protective elements and mitigate risk factors. PMID:26793153

Examining the Role of Mental Health and Clinical Issues within Talent Development.

PubMed

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2015-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches identified as well placed to detect general "warning signs" such as behavioral change. Short of integrating trained clinicians into talent development environments, as part of a triangulation process, ecologically validated assessment tools-coupled with appropriate training and signposting-could offer a practical way of flagging potential issues in developing athletes. The need for the development of such an instrument is therefore apparent. Finally, education around the influential role of family is also recommended in order to promote the protective elements and mitigate risk factors.

Contributing factors of elective surgical case cancellation: a retrospective cross-sectional study at a single-site hospital.

PubMed

Yu, Kaiye; Xie, Xiaolei; Luo, Li; Gong, Renrong

2017-09-11

Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH), we identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention. We conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014. CC reasons were grouped into six categories. The methods of descriptive statistics and hypothesis test were used to identify the effect of factors. CC reasons (746) were divided into six broad categories: workup related (preoperative diagnostic assessment issues or sudden medical condition changes) (25.8%), non-specified reasons (25.8%), coordination issues (15.1%), patient related (13.0%), support system issues (11.8%), and doctor related (8.5%). The types of the most frequently performed operations are identified, as well as their CRs. The cancellation rate (CR) of males was lower than that of females (16.7% to 18.3%). A large difference in the CRs existed among doctors. The CR on Monday was significantly higher than the other four weekdays. Workup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced CRs among doctors, and tendency of cancellation on Monday are the major identified factors, which account for a significant amount of preventable cancellations. It is suggested that corresponding hospital interventions can reduce CR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed preoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex, paying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top eight doctors, and improving surgery scheduling on Monday.

Spiritual Considerations.

PubMed

Puchalski, Christina M; King, Stephen D W; Ferrell, Betty R

2018-06-01

Spiritual issues play a prominent role for patients with cancer. Studies have demonstrated a positive connection between a patient's spirituality and health outcomes, including quality of life, depression and anxiety, hopefulness, and the ability to cope with illness. Spiritual or existential distress is prominent in patients with cancer. Models are described that identify ways for clinicians to identify or diagnose spiritual or existential distress, and to attend to that distress. It is critical that all clinicians assess for spiritual distress as part of a routine distress assessment, identify appropriate treatment strategies, and work closely with trained spiritual care professionals. Copyright © 2018 Elsevier Inc. All rights reserved.

Getting a handle on DNFB strategies for boosting performance.

PubMed

2015-03-01

Keeping tabs on DNFB requires a commitment from multiple departments, including clinical documentation, health information management, utilization management, and patient financial services. Monitoring DNFB performance daily, weekly, and monthly can help an organization quickly resolve short-term problems and also identify and respond to more systemic issues. By leveraging historical and comparison data, including performance information from peer organizations, hospitals and health systems can set more realistic targets and further highlight improvement opportunities.

Identifying priority medicines policy issues for New Zealand: a general inductive study

PubMed Central

Babar, Zaheer-Ud-Din; Francis, Susan

2014-01-01

Objectives To identify priority medicines policy issues for New Zealand. Setting Stakeholders from a broad range of healthcare and policy institutions including primary, secondary and tertiary care. Participants Exploratory, semistructured interviews were conducted with 20 stakeholders throughout New Zealand. Primary and secondary outcome measures The interviews were digitally recorded, transcribed and coded into INVIVO 10, then compared and grouped for similarity of theme. Perceptions, experiences and opinions regarding New Zealand's medicines policy issues were recorded. Results A large proportion of stakeholders appeared to be unaware of New Zealand's (NZ) medicines policy. In general, the policy was considered to offer consistency to guide decision-making. In the context of Pharmaceutical Management Agency's (PHARMAC's) fixed budget for procuring and subsidising medicines, there was reasonable satisfaction with the range of medicines available—rare disorder medicines being the clear exception. Concerns raised were by whom and how decisions are made and whether desired health outcomes are being measured. Other concerns included inconsistencies in evidence and across health technologies. Despite attempts to improve the situation, lower socioeconomic groups (including rural residents) Māori and Pacific ethnicities and people with rare disorders face challenges with regards to accessing medicines. Other barriers include, convenience to and affordability of prescribers and the increase of prescription fees from NZ$3 to NZ$5. Concerns related to the PHARMAC of New Zealand included: a constraining budget; non-transparency of in-house analysis; lack of consistency in recommendations between the Pharmacology and Therapeutics Advisory Committee. Constraints and inefficiencies also exist in the submission process to access high-cost medicines. Conclusions The results suggest reasonable satisfaction with the availability of subsidised medicines. However, some of the major challenges include access to medicines in vulnerable groups, increasing costs and demand for new medicines, access to prescribers, budgetary constraints, cultural and health literacy, patient affordability and evidence requirement for gaining subsidy for medicines. PMID:24871535

The stress of food allergy issues in daily life.

PubMed

Peniamina, Rana L; Mirosa, Miranda; Bremer, Philip; Conner, Tamlin S

2016-06-01

Food allergies are a growing health concern, but their implications for daily psychological functioning are unknown. This micro-longitudinal study investigated the daily frequency of food allergy issues and how this related to experiences of stress, mood and physical energy. One hundred and eight adults with physician-diagnosed food allergies completed an initial Internet survey followed by a 2-week Internet daily diary survey. The initial survey collected socio-demographic and food allergy information. The daily survey collected information about the participants' experiences of stress, mood, physical energy and food allergy issues during that day. Commonly experienced allergy issues included negative physical symptoms, higher food prices, anxiety about safety of food, trouble maintaining a healthy diet and anxiety/stress at social occasions. Furthermore, multilevel modelling analyses showed that stress and negative mood were significantly higher on days with more allergy issues. Older adults experienced lower positive mood and physical energy on days with more issues. This is the first study to incorporate near to real-time tracking to examine the frequency of food allergy issues and the implications for daily psychological functioning. Targeting the issues we identified could reduce stress in patients with food allergies and improve their overall quality of life.

Workshop on detectors for third-generation synchrotron sources: Proceedings

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

NONE

1994-12-01

The aims of the workshop were (1) to acquaint APS users with current R and D being carried out on detectors, (2) to identify new detector systems possible during the next five years, (3) to identify new detectors theoretically possible in the future, (4) to stimulate interactions between user groups and detector developers, and (5) to obtain recommendations from expert panels on technical issues needing resolution. Development of detectors at ESRF, Spring-8, BNL, CERN and LBL are included.

Retractions in cancer research: a systematic survey.

PubMed

Bozzo, Anthony; Bali, Kamal; Evaniew, Nathan; Ghert, Michelle

2017-01-01

The annual number of retracted publications in the scientific literature is rapidly increasing. The objective of this study was to determine the frequency and reason for retraction of cancer publications and to determine how journals in the cancer field handle retracted articles. We searched three online databases (MEDLINE, Embase, The Cochrane Library) from database inception until 2015 for retracted journal publications related to cancer research. For each article, the reason for retraction was categorized as plagiarism, duplicate publication, fraud, error, authorship issues, or ethical issues. Accessibility of the retracted article was defined as intact, removed, or available but with a watermark over each page. Descriptive data was collected on each retracted article including number of citations, journal name and impact factor, study design, and time between publication and retraction. The publications were screened in duplicated and two reviewers extracted and categorized data. Following database search and article screening, we identified 571 retracted cancer publications. The majority (76.4%) of cancer retractions were issued in the most recent decade, with 16.6 and 6.7% of the retractions in the prior two decades respectively. Retractions were issued by journals with impact factors ranging from 0 (discontinued) to 55.8. The average impact factor was 5.4 (median 3.54, IQR 1.8-5.5). On average, a retracted article was cited 45 times (median 18, IQR 6-51), with a range of 0-742. Reasons for retraction include plagiarism (14.4%), fraud (28.4%), duplicate publication (18.2%), error (24.2%), authorship issues (3.9%), and ethical issues (2.1%). The reason for retraction was not stated in 9.8% of cases. Twenty-nine percent of retracted articles remain available online in their original form. Retractions in cancer research are increasing in frequency at a similar rate to all biomedical research retractions. Cancer retractions are largely due to academic misconduct. Consequences to cancer patients, the public at large, and the research community can be substantial and should be addressed with future research. Despite the implications of this important issue, some cancer journals currently fall short of the current guidelines for clearly stating the reason for retraction and identifying the publication as retracted.

Using fault tree analysis to identify causes of non-compliance: enhancing violation outcome data for the purposes of education and prevention.

PubMed

Emery, R J; Charlton, M A; Orders, A B; Hernandez, M

2001-02-01

An enhanced coding system for the characterization of notices of violation (NOV's) issued to radiation permit holders in the State of Texas was developed based on a series of fault tree analyses serving to identify a set of common causes. The coding system enhancement was retroactively applied to a representative sample (n = 185) of NOV's issued to specific licensees of radioactive materials in Texas during calendar year 1999. The results obtained were then compared to the currently available summary NOV information for the same year. In addition to identifying the most common NOV's, the enhanced coding system revealed that approximately 70% of the sampled NOV's were issued for non-compliance with a specific regulation as opposed to a permit condition. Furthermore, an underlying cause of 94% of the NOV's was the failure on the part of the licensee to execute a specific task. The findings suggest that opportunities exist to improve permit holder compliance through various means, including the creation of summaries which detail specific tasks to be completed, and revising training programs with more focus on the identification and scheduling of permit-related requirements. Broad application of these results is cautioned due to the bias associated with the restricted scope of the project.

Functional perspectives on emotion, behavior, and cognition.

PubMed

Lench, Heather C; Darbor, Kathleen E; Berg, Logan A

2013-12-01

This Editorial reviews the challenges and advantages posed by a functional perspective on the relationships among emotion, behavior, and cognition. We identify the core themes among the articles published as part of this Special Issue. The articles generally address two important questions: (1) are emotions functional and what is their impact on behavioral and cognitive processes, and (2) how do the interactions among emotion, cognition, and behavior play out in particular situations that present adaptive challenges? We also identify two core questions raised by the articles included in this Special Issue. Future research must address the extent to which emotions are best represented as discrete emotional constructs (e.g., anger, sadness, fear) versus emotions that vary along dimensions, such as valence and arousal. Functional perspectives would also be facilitated by identification of situations or environments that are likely to elicit particular emotions and reactions.

Minor's rights versus parental rights: review of legal issues in adolescent health care.

PubMed

Maradiegue, Ann

2003-01-01

The right of adolescents to access confidential health care is sensitive and controversial. Recent challenges in the court system to adolescents' right to access abortion and contraception are eroding current law, including the Roe v Wade decision. The prospect of more than a million pregnancies in individuals under the age of 20 years in the United States with increasingly fewer alternatives to pregnancy is concerning. New regulations under the Health Insurance Portability and Accountability Act are adding yet another layer of complexity to the care of adolescents. Understanding legal issues surrounding adolescent rights to care can help the health care provider make appropriate care available to this age group. Keywords previously identified in CINAHL and MEDLINE were used to perform the literature search. LexisNexis was the search engine used to identify the laws and statutes.

HIV infection risk factors among male-to-female transgender persons: a review of the literature.

PubMed

De Santis, Joseph P

2009-01-01

Male-to-female (MTF) transgender women experience a host of psychosocial issues such as discrimination, stigmatization, and marginalization. These challenges often limit economic opportunities, affect mental health, and may place members of this population at an increased risk for HIV infection. This report presents a review of the literature that focuses on risk factors for HIV infection specific to the MTF population. Factors including needle sharing and substance abuse, high-risk sexual behaviors, commercial sex work, health care access, lack of knowledge regarding HIV transmission, violence, stigma and discrimination, and mental health issues have been identified in the literature as risk factors for the acquisition of HIV infection by members of this population. Implications for care provided to MTF transgender persons are presented, and suggestions for future research are identified.

Engaging Women in Computer Science and Engineering: Promising Practices for Promoting Gender Equity in Undergraduate Research Experiences

ERIC Educational Resources Information Center

Kim, Karen A.; Fann, Amy J.; Misa-Escalante, Kimberly O.

2011-01-01

Building on research that identifies and addresses issues of women's underrepresentation in computing, this article describes promising practices in undergraduate research experiences that promote women's long-term interest in computer science and engineering. Specifically, this article explores whether and how REU programs include programmatic…

Leisure Counseling. Searchlight Plus: Relevant Resources in High Interest Areas. No 48+.

ERIC Educational Resources Information Center

Loesch, Larry

This information analysis paper reviews the literature on leisure counseling, identified by a computer search of the ERIC data base from November 1966 through December 1979. The introduction highlights specific issues and trends, including the changing views and importance of leisure, changes in the nature and functions of leisure, and the…

Shifting Academic Careers: Implications for Enhancing Professionalism in Teaching and Supporting Learning

ERIC Educational Resources Information Center

Locke, William

2014-01-01

This Higher Education Academy (HEA) commissioned report provides a brief review of literature focusing on the changing nature of academic careers in the higher education sector, including any shift towards "teaching only" contracts. It also identifies key issues in terms of teaching and learning, continuing professional development and…

Information Brokers/Free-Lance Librarians: An Alternative Reference Service.

ERIC Educational Resources Information Center

Hogan, Matthew

This paper examines the profession of information brokerage through a look at types of services provided, and through a discussion of major issues, including that of fee for service. The types of information broker and free-lance librarian services are identified: (1) non-profit reference and research services administered by public libraries and…

Supervising Family Therapy Trainees in Primary Care Medical Settings: Context Matters

ERIC Educational Resources Information Center

Edwards, Todd M.; Patterson, Jo Ellen

2006-01-01

The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be…

Trends in Special Education Case Law: Frequency and Outcomes of Published Court Decisions 1998-2012

ERIC Educational Resources Information Center

Karanxha, Zorka; Zirkel, Perry A.

2014-01-01

The Individuals with Disabilities Education Act (IDEA) obligates school districts to identify students with disabilities and provide them with a free and appropriate public education (FAPE), which includes specially designed instruction. Identification, FAPE, least restrictive environment (LRE), and various other issues under the IDEA sometimes…

Teaching and Program Variations in International Business: Past, Present and Future.

ERIC Educational Resources Information Center

Kaynak, Erdener; Schermerhorn, John R., Jr.

1999-01-01

This introductory article in a theme issue identifies common themes in the included papers, such as the need for more "active learning" and "project-based learning," the use of computer technology to facilitate "virtual teamwork," the importance of support services for these initiatives, and reliance on need-oriented programs and courses in…

RESEARCH VISIBILITY. VOCATIONAL EDUCATION IS PEOPLE--YOUTH WITH SPECIAL NEEDS.

ERIC Educational Resources Information Center

LAW, GORDON F., ED.

TWELVE RESEARCH REVIEWS IN THIS ISSUE PERTAIN TO YOUTH WITH SPECIAL NEEDS, ONE OF THE NINE MAJOR AREAS OF CONCERN IDENTIFIED BY THE PANEL OF CONSULTANTS ON VOCATIONAL EDUCATION. THEY ARE ORGANIZED UNDER THE TOPICS--(1) OCCUPATIONALLY ORIENTED PROGRAMS WHICH INCLUDES IDENTIFICATION OF WORK CONCEPTS, (2) COOPERATIVE SCHOOL AND WORK PROGRAMS, WHICH…

Restructuring Higher Education: Cost Containment and Productivity Enhancement Efforts of North American Colleges and Universities.

ERIC Educational Resources Information Center

Primary Research Group, Inc., New York, NY.

This report addresses issues in the efforts of colleges and universities to reduce costs. First, some key findings are identified, including the rapid increase in tuition since 1981; decreases in academic library expenditures; increases in cooperative arrangements; use of more adjunct faculty; and increased privatization of services. Individual…

Teaching Mathematics Effectively and Equitably to Females. Trends and Issues No. 17.

ERIC Educational Resources Information Center

Hanson, Katherine

This monograph looks at mathematics education today in the United States, particularly at how girls are treated in mathematics education in order to identify ways to increase female interest and achievement in mathematics. The first section of the review describes the current status of females in mathematics education including achievement history…

Climate change vulnerability and adaptation in the Blue Mountains

Treesearch

Jessica E. Halofsky; David L. Peterson

2017-01-01

The Blue Mountains Adaptation Partnership was developed to identify climate change issues relevant to resource management in the Blue Mountains region, to find solutions that can minimize negative effects of climate change, and to facilitate transition of diverse ecosystems to a warmer climate. Partnering organizations included three national forests (Malheur, Umatilla...

Educators and Programs Reaching Out to At-Risk Youth.

ERIC Educational Resources Information Center

Lee, M. Linda

1990-01-01

Presents examples of how using technology can help raise self-esteem and improve academic performance for students who are identified as being at-risk. Topics discussed include the use of computer labs, filmstrips, and videos to strengthen academic skills, and to deal with such social issues as drop-outs, alcoholism, pregnancy, and suicide. Two…

How to Reverse a Legacy of Exclusion? Identifying High-Impact Educational Responses

ERIC Educational Resources Information Center

Cummins, Jim

2015-01-01

The authors of papers in this special issue are in agreement that if schools are to reverse underachievement among rural and township students in the South African context the instructional space must be expanded to include students' and teachers' multilingual repertoires together with a focus on explicitly demystifying how academic language…

32 CFR 728.33 - Nonavailability statement (DD 1251).

Code of Federal Regulations, 2014 CFR

2014-07-01

... patient in his or her own right (the episode of care for the infant after discharge of the mother is not... USTF serving the beneficiary's residence inpatient catchment area. (D) Review, with the patient or... include for each individual to whom a DD 1251 is issued: (1) Patient's name and identifying data. (2) The...

32 CFR 728.33 - Nonavailability statement (DD 1251).

Code of Federal Regulations, 2013 CFR

2013-07-01

... patient in his or her own right (the episode of care for the infant after discharge of the mother is not... USTF serving the beneficiary's residence inpatient catchment area. (D) Review, with the patient or... include for each individual to whom a DD 1251 is issued: (1) Patient's name and identifying data. (2) The...

Rules of Thumb for Up-and-Down Economics.

ERIC Educational Resources Information Center

Kennedy, Peter

1994-01-01

Reports that economist Paul Krugman identifies three types of economic writing. Asserts that the major principles of macroeconomics can be synthesized into "Five Rules of Thumb" which can help to interpret economic news. Presents and discusses these five rules and includes a survey summary of journalists and economists on this issue.…

Nurses' Perceived Training Needs in Child Protection Issues

ERIC Educational Resources Information Center

Crisp, Beth R.; Lister, Pam Green

2006-01-01

Purpose: The purpose of this research is to explore nurses' perceptions of their current skills and knowledge and training needs to identify cases of child abuse and their understanding of their roles and responsibilities in relation to child abuse. Nurses, including health visitors and midwives, have been recognised as having a key role in the…

77 FR 72858 - Toxicological Review of Inorganic Arsenic (Cancer and Noncancer Effects): In Support of Summary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... public stakeholder workshop to inform the development of a state of the science toxicological review of... database. Workshop participants will be asked to highlight significant new and emerging research, discuss methods for evaluating literature, identify critical research issues (including mode of action) that may...

[Operation/Maintenance of Fiber Placement Machine

NASA Technical Reports Server (NTRS)

Pelham, L.; Dillard, T.

2000-01-01

NASA contract NAS8-39749 was completed in January 2000. The contract period of performance covered six (6) years and included basic program technical support as required by NASA with up to thirty (30) different technical directives identified and issued by NASA for specific Advanced Composite Technology tasks during the course of the contract.

20 CFR 656.17 - Basic labor certification process.

Code of Federal Regulations, 2010 CFR

2010-04-01

... participant in the job fair. (B) Employer's Web site. The use of the employer's Web site as a recruitment... involved in the application. (C) Job search Web site other than the employer's. The use of a job search Web...) The Department of Labor may issue or require the use of certain identifying information, including...

Citation Patterns to Traditional and Electronic Preprints in the Published Literature.

ERIC Educational Resources Information Center

Youngen, Gregory K.

1998-01-01

Identifies the growing importance of electronic preprints in the published literature of physics and astronomy and address several areas of concern regarding the future role of electronic preprints in scientific communication. Topics include a history of preprints in astronomy and physics; inaccuracies in preprint citations; and archival issues.…

Needs Assessment of Female Street Kids: Children in Danger.

ERIC Educational Resources Information Center

Ivers, Kathryn J.; Carlson, Helena M.

This report presents an assessment of the situation of homeless girls, paying particular attention to the issue of juvenile prostitution. A review of research on prostitutes was conducted, and common elements that seem to present themselves in these studies are identified, including sexual and/or physical abuse, runaway/throwaway status,…

Investing in the Future: Addressing Work/Life Issues of Employees.

ERIC Educational Resources Information Center

Kutilek, Linda M.; Conklin, Nikki L.; Gunderson, Gail

2002-01-01

A national survey of Extension employees identified the most critical work/life challenges as a heavy workload, evening and weekend commitments, and lack of control or job autonomy. Only 40% were aware of benefits and programs offered concerning work/life balance. Recommendations included reducing the workload and time requirements of county-based…

Combating slavery in the 21st century: the role of emergency medicine.

PubMed

Chisolm-Straker, Makini; Richardson, Lynne D; Cossio, Tania

2012-08-01

Human trafficking (HT) victims may present to emergency departments (ED) as patients, but are infrequently identified. To address this issue, we developed and piloted a training intervention for emergency providers on HT and how to identify and treat these patients. Included in the intervention participants were emergency medicine residents, ED attendings, ED nurses, and hospital social workers. Prior to the intervention, 4.8% felt some degree of confidence in their ability to identify and 7.7% to treat a trafficked patient. After the 20-minute intervention, 53.8% felt some degree of confidence in their ability to identify and 56.7% care for this patient population. Because this problem is global, we created a Website that includes an instructive toolkit and an interactive course for self-learning and/or assessment. This intervention will give ED providers the tools they need to assess and treat a patient who might be a victim of human trafficking.

Effect of culture on acceptance of telemedicine in Middle Eastern countries: case study of Jordan and Syria.

PubMed

Alajlani, Mohannad; Clarke, Malcolm

2013-04-01

We investigated issues that affect the use and adoption of telemedicine in Middle Eastern countries, taking the Hashemite Kingdom of Jordan and the Syrian Arab Republic as case studies. Our study is based on interviews with key stakeholders (including doctors, technicians, engineers, and decision makers) and questionnaires administered to key stakeholders (including patients), ensuring opinion was gained from people from a full range of backgrounds and roles in the healthcare system. We found doctor and patient resistance was a major issue preventing the adoption of telemedicine in both countries, followed by poor infrastructure, lack of funding, and lack of information technology training. Our research identifies that culture is a greater issue than technical matters for the adoption of telemedicine in Middle Eastern countries. Based on our preliminary results we developed a guideline framework for each country that might be applied to telemedicine projects at the pre-implementation phase. The proposed guideline framework was validated through a return visit to the stakeholders and seeking further opinion.

USSR Space Life Sciences Digest, issue 9

NASA Technical Reports Server (NTRS)

Hooke, Lydia Razran; Radtke, Mike; Teeter, Ronald; Rowe, Joseph E.

1987-01-01

This is the ninth issue of NASA's USSR Space Lifes Sciences Digest. It contains abstracts of 46 papers recently published in Russian language periodicals and bound collections and of a new Soviet monograph. Selected abstracts are illustrated with figures and tables from the original. Additional features include reviews of a Russian book on biological rhythms and a description of the papers presented at a conference on space biology and medicine. A special feature describes two paradigms frequently cited in Soviet space life sciences literature. Information about English translations of Soviet materials available to readers is provided. The abstracts included in this issue have been identified as relevant to 28 areas of aerospace medicine and space biology. These areas are: adaptation, biological rhythms, body fluids, botany, cardiovascular and respiratory systems, developmental biology, endocrinology, enzymology, equipment and instrumentation, gastrointestinal system, genetics, habitability and environment effects, hematology, human performance, immunology, life support systems, mathematical modeling, metabolism, microbiology, morphology and cytology, musculoskeletal system, nutrition, neurophysiology, operational medicine, perception, personnel selection, psychology, radiobiology, and space biology and medicine.

Is there an "abortion trauma syndrome"? Critiquing the evidence.

PubMed

Robinson, Gail Erlick; Stotland, Nada L; Russo, Nancy Felipe; Lang, Joan A; Occhiogrosso, Mallay

2009-01-01

The objective of this review is to identify and illustrate methodological issues in studies used to support claims that induced abortion results in an "abortion trauma syndrome" or a psychiatric disorder. After identifying key methodological issues to consider when evaluating such research, we illustrate these issues by critically examining recent empirical studies that are widely cited in legislative and judicial testimony in support of the existence of adverse psychiatric sequelae of induced abortion. Recent studies that have been used to assert a causal connection between abortion and subsequent mental disorders are marked by methodological problems that include, but not limited to: poor sample and comparison group selection; inadequate conceptualization and control of relevant variables; poor quality and lack of clinical significance of outcome measures; inappropriateness of statistical analyses; and errors of interpretation, including misattribution of causal effects. By way of contrast, we review some recent major studies that avoid these methodological errors. The most consistent predictor of mental disorders after abortion remains preexisting disorders, which, in turn, are strongly associated with exposure to sexual abuse and intimate violence. Educating researchers, clinicians, and policymakers how to appropriately assess the methodological quality of research about abortion outcomes is crucial. Further, methodologically sound research is needed to evaluate not only psychological outcomes of abortion, but also the impact of existing legislation and the effects of social attitudes and behaviors on women who have abortions.

Effects of efforts to optimise morbidity and mortality rounds to serve contemporary quality improvement and educational goals: a systematic review.

PubMed

Smaggus, Andrew; Mrkobrada, Marko; Marson, Alanna; Appleton, Andrew

2018-01-01

The quality and safety movement has reinvigorated interest in optimising morbidity and mortality (M&M) rounds. We performed a systematic review to identify effective means of updating M&M rounds to (1) identify and address quality and safety issues, and (2) address contemporary educational goals. Relevant databases (Medline, Embase, PubMed, Education Resource Information Centre, Cumulative Index to Nursing and Allied Health Literature, Healthstar, and Global Health) were searched to identify primary sources. Studies were included if they (1) investigated an intervention applied to M&M rounds, (2) reported outcomes relevant to the identification of quality and safety issues, or educational outcomes relevant to quality improvement (QI), patient safety or general medical education and (3) included a control group. Study quality was assessed using the Medical Education Research Study Quality Instrument and Newcastle-Ottawa Scale-Education instruments. Given the heterogeneity of interventions and outcome measures, results were analysed thematically. The final analysis included 19 studies. We identified multiple effective strategies (updating objectives, standardising elements of rounds and attaching rounds to a formal quality committee) to optimise M&M rounds for a QI/safety purpose. These efforts were associated with successful integration of quality and safety content into rounds, and increased implementation of QI interventions. Consistent effects on educational outcomes were difficult to identify, likely due to the use of methodologies ill-fitted for educational research. These results are encouraging for those seeking to optimise the quality and safety mission of M&M rounds. However, the inability to identify consistent educational effects suggests the investigation of M&M rounds could benefit from additional methodologies (qualitative, mixed methods) in order to understand the complex mechanisms driving learning at M&M rounds. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Evaluation of speech errors in Putonghua speakers with cleft palate: a critical review of methodology issues.

PubMed

Jiang, Chenghui; Whitehill, Tara L

2014-04-01

Speech errors associated with cleft palate are well established for English and several other Indo-European languages. Few articles describing the speech of Putonghua (standard Mandarin Chinese) speakers with cleft palate have been published in English language journals. Although methodological guidelines have been published for the perceptual speech evaluation of individuals with cleft palate, there has been no critical review of methodological issues in studies of Putonghua speakers with cleft palate. A literature search was conducted to identify relevant studies published over the past 30 years in Chinese language journals. Only studies incorporating perceptual analysis of speech were included. Thirty-seven articles which met inclusion criteria were analyzed and coded on a number of methodological variables. Reliability was established by having all variables recoded for all studies. This critical review identified many methodological issues. These design flaws make it difficult to draw reliable conclusions about characteristic speech errors in this group of speakers. Specific recommendations are made to improve the reliability and validity of future studies, as well to facilitate cross-center comparisons.

Consensus Development from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014)

PubMed Central

Hsu, Chiun; Chen, Bang-Bin; Chen, Chien-Hung; Ho, Ming-Chih; Cheng, Jason Chia-Hsien; Kokudo, Norihiro; Murakami, Takamichi; Yeo, Winnie; Seong, Jinsil; Jia, Ji-Dong; Han, Kwan-Hyub; Cheng, Ann-Lii

2015-01-01

A key mission of the Asia-Pacific Primary Liver Cancer Expert (APPLE) Association is to ensure a coherent view for management of hepatocellular carcinoma (HCC) and to advance new treatment for this difficult disease. At the 5th APPLE meeting, held in July 2014 in Taipei, Taiwan, an APPLE consensus development program was established to facilitate discussion among experts in the Asia-Pacific region on pertinent issues for HCC management, including (1) surgery for intermediate/advanced-stage disease, (2) prevention of HCC recurrence after curative treatment, (3) optimizing imaging diagnosis, (4) radiotherapy: current practice and future clinical trials, and (5) the role of cytotoxic chemotherapy. A pre-congress questionnaire was undertaken with the consensus development committee members to help understand the current practice patterns for HCC in the Asia-Pacific region and to identify issues relating to optimal patient care and further clinical trials for which consensus needs to be developed. In this report, the results of the questionnaire are presented, and the pertinent issues identified by each consensus group for further discussion and consensus development are summarized. PMID:26020032

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.

An Exploration of Managers’ Discourses of Workplace Bullying

PubMed Central

Johnson, Susan L.; Boutain, Doris M.; Tsai, Jenny Hsin-Chun; Beaton, Randal; de Castro, Arnold B.

2017-01-01

AIM To identify discourses used by hospital nursing unit managers to characterize workplace bullying, and their roles and responsibilities in workplace bullying management. BACKGROUND Nurses around the world have reported being the targets of bullying. These nurses often report that their managers do not effectively help them resolve the issue. There is scant research that examines this topic from the perspective of managers. METHODS This was a descriptive, qualitative study. Interviews were conducted with hospital nursing unit managers who were recruited via purposive and snowball sampling. Data were analyzed using Willig’s Foucauldian discourse analysis. RESULTS Managers characterized bullying as an interpersonal issue involving the target and the perpetrator, as an intrapersonal issue attributable to characteristics of the perpetrator, or as an ambiguous situation. For interpersonal bullying, managers described supporting target’s efforts to end bullying; for intrapersonal bullying, they described taking primary responsibility; and for ambiguous situations, they described several actions, including doing nothing. CONCLUSION Managers have different responses to different categories of bullying. Efforts need to be made to make sure they are correctly identifying and appropriately responding to incidents of workplace bullying. PMID:25597260

Ethical issues in autologous stem cell transplantation (ASCT) in advanced breast cancer: a systematic literature review.

PubMed

Droste, Sigrid; Herrmann-Frank, Annegret; Scheibler, Fueloep; Krones, Tanja

2011-04-15

An effectiveness assessment on ASCT in locally advanced and metastatic breast cancer identified serious ethical issues associated with this intervention. Our objective was to systematically review these aspects by means of a literature analysis. We chose the reflexive Socratic approach as the review method using Hofmann's question list, conducted a comprehensive literature search in biomedical, psychological and ethics bibliographic databases and screened the resulting hits in a 2-step selection process. Relevant arguments were assembled from the included articles, and were assessed and assigned to the question list. Hofmann's questions were addressed by synthesizing these arguments. Of the identified 879 documents 102 included arguments related to one or more questions from Hofmann's question list. The most important ethical issues were the implementation of ASCT in clinical practice on the basis of phase-II trials in the 1990s and the publication of falsified data in the first randomized controlled trials (Bezwoda fraud), which caused significant negative effects on recruiting patients for further clinical trials and the doctor-patient relationship. Recent meta-analyses report a marginal effect in prolonging disease-free survival, accompanied by severe harms, including death. ASCT in breast cancer remains a stigmatized technology. Reported health-related-quality-of-life data are often at high risk of bias in favor of the survivors. Furthermore little attention has been paid to those patients who were dying. The questions were addressed in different degrees of completeness. All arguments were assignable to the questions. The central ethical dimensions of ASCT could be discussed by reviewing the published literature.

Ethical issues in autologous stem cell transplantation (ASCT) in advanced breast cancer: A systematic literature review

PubMed Central

2011-01-01

Background An effectiveness assessment on ASCT in locally advanced and metastatic breast cancer identified serious ethical issues associated with this intervention. Our objective was to systematically review these aspects by means of a literature analysis. Methods We chose the reflexive Socratic approach as the review method using Hofmann's question list, conducted a comprehensive literature search in biomedical, psychological and ethics bibliographic databases and screened the resulting hits in a 2-step selection process. Relevant arguments were assembled from the included articles, and were assessed and assigned to the question list. Hofmann's questions were addressed by synthesizing these arguments. Results Of the identified 879 documents 102 included arguments related to one or more questions from Hofmann's question list. The most important ethical issues were the implementation of ASCT in clinical practice on the basis of phase-II trials in the 1990s and the publication of falsified data in the first randomized controlled trials (Bezwoda fraud), which caused significant negative effects on recruiting patients for further clinical trials and the doctor-patient relationship. Recent meta-analyses report a marginal effect in prolonging disease-free survival, accompanied by severe harms, including death. ASCT in breast cancer remains a stigmatized technology. Reported health-related-quality-of-life data are often at high risk of bias in favor of the survivors. Furthermore little attention has been paid to those patients who were dying. Conclusions The questions were addressed in different degrees of completeness. All arguments were assignable to the questions. The central ethical dimensions of ASCT could be discussed by reviewing the published literature. PMID:21496244

Systematic review of the methodological and reporting quality of case series in surgery.

PubMed

Agha, R A; Fowler, A J; Lee, S-Y; Gundogan, B; Whitehurst, K; Sagoo, H K; Jeong, K J L; Altman, D G; Orgill, D P

2016-09-01

Case series are an important and common study type. No guideline exists for reporting case series and there is evidence of key data being missed from such reports. The first step in the process of developing a methodologically sound reporting guideline is a systematic review of literature relevant to the reporting deficiencies of case series. A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, Embase, Cochrane Methods Register, Science Citation Index and Conference Proceedings Citation index, from the start of indexing to 5 November 2014. Independent screening, eligibility assessments and data extraction were performed. Included articles were then analysed for five areas of deficiency: failure to use standardized definitions, missing or selective data (including the omission of whole cases or important variables), transparency or incomplete reporting, whether alternative study designs were considered, and other issues. Database searching identified 2205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequencies of methodological and reporting issues identified were: failure to use standardized definitions (57 per cent), missing or selective data (66 per cent), transparency or incomplete reporting (70 per cent), whether alternative study designs were considered (11 per cent) and other issues (52 per cent). The methodological and reporting quality of surgical case series needs improvement. The data indicate that evidence-based guidelines for the conduct and reporting of case series may be useful. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

A workout for virtual bodybuilders (design issues for embodiment in multi-actor virtual environments)

NASA Technical Reports Server (NTRS)

Benford, Steve; Bowers, John; Fahlen, Lennart E.; Greenhalgh, Chris; Snowdon, Dave

1994-01-01

This paper explores the issue of user embodiment within collaborative virtual environments. By user embodiment we mean the provision of users with appropriate body images so as to represent them to others and also to themselves. By collaborative virtual environments we mean multi-user virtual reality systems which support cooperative work (although we argue that the results of our exploration may also be applied to other kinds of collaborative systems). The main part of the paper identifies a list of embodiment design issues including: presence, location, identity, activity, availability, history of activity, viewpoint, action point, gesture, facial expression, voluntary versus involuntary expression, degree of presence, reflecting capabilities, manipulating the user's view of others, representation across multiple media, autonomous and distributed body parts, truthfulness and efficiency. Following this, we show how these issues are reflected in our own DIVE and MASSIVE prototype collaborative virtual environments.

Issues of organizational cybernetics and viability beyond Beer's viable systems model

NASA Astrophysics Data System (ADS)

Nechansky, Helmut

2013-11-01

The paper starts summarizing the claims of Beer's viable systems model to identify five issues any viable organizations has to deal with in an unequivocal hierarchical structure of five interrelated systems. Then the evidence is introduced for additional issues and related viable structures of organizations, which deviate from Beer's model. These issues are: (1) the establishment and (2) evolution of an organization; (3) systems for independent top-down control (like "Six Sigma"); (4) systems for independent bottom-up correction of performance problems (like "Kaizen"), both working outside a hierarchical structure; (5) pull production systems ("Just in Time") and (6) systems for checks and balances of top-level power (like boards and shareholder meetings). Based on that an evolutionary approach to organizational cybernetics is outlined, addressing the establishment of organizations and possible courses of developments, including recent developments in quality and production engineering, as well as problems of setting and changing goal values determining organizational policies.

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

Identifying the Effects of Environmental and Policy Change Interventions on Healthy Eating

PubMed Central

Bowen, Deborah J.; Barrington, Wendy E.; Beresford, Shirley A.A.

2015-01-01

Obesity has been characterized as a disease. Strategies to change the incidence and prevalence of this disease include a focus on changing physical and social environments, over and above individual-level strategies, using a multilevel or systems approach. We focus our attention on evidence published between 2008 and 2013 on the effectiveness of interventions in nutrition environments, i.e., environmental interventions designed to influence the intake of healthful foods and amount of energy consumed. An overarching socioecological framework that has guided much of this research was used to characterize different types of environmental strategies. Intervention examples in each area of the framework are provided with a discussion of key findings and related conceptual and methodological issues. The emphasis in this review is on adults, but clearly this literature is only one part of the picture. Much research has been focused on child-specific interventions, including environmental interventions. Some evidence suggests effectiveness of policy-based or other types of interventions that aim to regulate or restructure environments to promote healthy dietary choices, and these strategies would apply to both children and adults. Opportunities to evaluate these policy changes in adults’ social and physical environments are rare. Much of the existing research has been with children. As conceptual and methodological issues continue to be identified and resolved, we hope that future research in this domain will identify environmental strategies that can be included in intervention toolboxes to build healthy nutrition environments for both adults and children. PMID:25785891

Identifying the effects of environmental and policy change interventions on healthy eating.

PubMed

Bowen, Deborah J; Barrington, Wendy E; Beresford, Shirley A A

2015-03-18

Obesity has been characterized as a disease. Strategies to change the incidence and prevalence of this disease include a focus on changing physical and social environments, over and above individual-level strategies, using a multilevel or systems approach. We focus our attention on evidence published between 2008 and 2013 on the effectiveness of interventions in nutrition environments, i.e., environmental interventions designed to influence the intake of healthful foods and amount of energy consumed. An overarching socioecological framework that has guided much of this research was used to characterize different types of environmental strategies. Intervention examples in each area of the framework are provided with a discussion of key findings and related conceptual and methodological issues. The emphasis in this review is on adults, but clearly this literature is only one part of the picture. Much research has been focused on child-specific interventions, including environmental interventions. Some evidence suggests effectiveness of policy-based or other types of interventions that aim to regulate or restructure environments to promote healthy dietary choices, and these strategies would apply to both children and adults. Opportunities to evaluate these policy changes in adults' social and physical environments are rare. Much of the existing research has been with children. As conceptual and methodological issues continue to be identified and resolved, we hope that future research in this domain will identify environmental strategies that can be included in intervention toolboxes to build healthy nutrition environments for both adults and children.

Critical issues in the history, philosophy, and sociology of astrobiology.

PubMed

Dick, Steven J

2012-10-01

Fifty years after serious scientific research began in the field of exobiology, and forty years after serious historical research began on the subject of extraterrestrial life, this paper identifies and examines some of the most important issues in the history, philosophy, and sociology of what is today known as astrobiology. As in the philosophy of science in general, and in the philosophies of particular sciences, critical issues in the philosophy and sociology of astrobiology are both stimulated and illuminated by history. Among those issues are (1) epistemological issues such as the status of astrobiology as a science, the problematic nature of evidence and inference, and the limits of science; (2) metaphysical/scientific issues, including the question of defining the fundamental concepts of life, mind, intelligence, and culture in a universal context; the role of contingency and necessity in the origin of these fundamental phenomena; and whether or not the universe is in some sense fine-tuned for life and perhaps biocentric; (3) societal issues such as the theological, ethical, and worldview impacts of the discovery of microbial or intelligent life; and the question of whether the search for extraterrestrial life should be pursued at all, and with what precautions; and (4) issues related to the sociology of scientific knowledge, including the diverse attitudes and assumptions of different scientific communities and different cultures to the problem of life beyond Earth, the public "will to believe," and the formation of the discipline of astrobiology. All these overlapping issues are framed by the concept of cosmic evolution-the 13.7 billion year Master Narrative of the Universe-which may result in a physical, biological, or postbiological universe and determine the long-term destiny of humanity.

Perspectives in understanding open access to research data - infrastructure and technology challenges

NASA Astrophysics Data System (ADS)

Bigagli, Lorenzo; Sondervan, Jeroen

2014-05-01

The Policy RECommendations for Open Access to Research Data in Europe (RECODE) project, started in February 2013 with a duration of two years, has the objective to identify a series of targeted and over-arching policy recommendations for Open Access to European research data, based on existing good practice and addressing such hindering factors as stakeholder fragmentation, technical and infrastructural issues, ethical and legal issues, and financial and institutional policies. In this work we focus on the technical and infrastructural aspect, where by "infrastructure" we mean the technological assets (hardware and software), the human resources, and all the policies, processes, procedures and training for managing and supporting its continuous operation and evolution. The context targeted by RECODE includes heterogeneous networks, initiatives, projects and communities that are fragmented by discipline, geography, stakeholder category (publishers, academics, repositories, etc.) as well as other boundaries. Many of these organizations are already addressing key technical and infrastructural barriers to Open Access to research data. Such barriers may include: lack of automatic mechanisms for policy enforcement, lack of metadata and data models supporting open access, obsolescence of infrastructures, scarce awareness about new technological solutions, lack of training and/or expertise on IT and semantics aspects. However, these organizations are often heterogeneous and fragmented by discipline, geography, stakeholder category (publishers, academics, repositories, etc.) as well as other boundaries, and often work in isolation, or with limited contact with one another. RECODE has addressed these challenges, and the possible solutions to mitigate them, engaging all the identified stakeholders in a number of ways, including an online questionnaire, case studies interviews, literature review, a workshop. The conclusions have been validated by the RECODE Advisory Board and will contribute to shape the RECODE policy guidelines for Open Access to Research Data. In the work, we report on the identified technological and infrastructural issues, classified according to the barriers of heterogeneity, sustainability, volume, quality, and security.

Silicon-sheet and thin-film cell and module technology potential: Issue study

NASA Technical Reports Server (NTRS)

Shimada, K.; Costogue, E. N.; Ferber, R. R.

1984-01-01

The development of high-efficiency low-cost crystalline silicon ribbon and thih-film solar cells for the energy national photovoltaics program was examined. The findings of an issue study conducted are presented. The collected data identified the status of the technology, future research needs, and problems experienced. The potentials of present research activities to meet the Federal/industry long-term technical goal of achieving 15 cents per kilowatt-hour levelized PV energy cost are assessed. Recommendations for future research needs related to crystalline silicon ribbon and thin-film technologies for flat-plate collectors are also included.

Childhood experiences of female family-violence perpetrators.

PubMed

Keiski, Pia; Flinck, Aune; Kaunonen, Marja; Paavilainen, Eija

2018-04-01

To explore the childhood experiences of women who have perpetrated family-violence and voluntarily sought help. The qualitative design includes in-depth, unstructured individual interviews with 19 women who have perpetrated family-violence. The categories of maltreatment exposure, parental capability, and a role of the sensitive, good girl are identified and described in this article. The findings provide guidance for nurses who encounter families at risk of female family-violence perpetration and for those developing preventive interventions for female family-violence perpetrators whose family-of-origin issues are essential in processing issues of self. © 2017 Wiley Periodicals, Inc.

Usage of noncontact human body measurements for development of Army Work Wear Trousers

NASA Astrophysics Data System (ADS)

Dabolina, Inga; Lapkovska, Eva; Vilumsone, Ausma

2017-10-01

The paper is based on issues related to imperfections of clothing fit, garment construction solutions and control measurement systems of finished products, which were identified in the research process analysing army soldier work wear trousers. The aim is to obtain target group body measurements using noncontact anthropometrical data acquisition method (3D scanning) for selection and analysis of scanned data suitable for trouser design. Tasks include comparison of scanned data with manually taken body measurements and different corresponding human body measurement standard data for establishing potential advantages of noncontact method usage in solving different trouser design issues.

History of the Medical Library Association's credentialing program.

PubMed Central

Bell, J A

1996-01-01

Since the Medical Library Association (MLA) adopted the Code for the Training and Certification of Medical Librarians in 1949, MLA members have reviewed and revised the program regularly. This paper traces the history of MLA's professional recognition program to illustrate how the program has changed over time and to identify the issues that have surrounded it. These issues include the value of the program to individual members, cost to MLA, appropriate entry requirements, certification examinations, and recertification requirements. The development and operation of MLA's current credentialing program, the Academy of Health Information Professionals, is described in detail. PMID:8883980

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

Raffray, A.R.; Meier, W.; Abdel-Khalik, S.

For thick liquid wall concepts, it is important to understand the different mechanisms affecting the chamber dynamics and the state of the chamber prior to each shot a compared with requirements from the driver and target. These include ablation mechanisms, vapor transport and control, possible aerosol formation, as well as protective jet behavior. This paper was motivated by a town meeting on this subject which helped identify the major issues, assess the latest results, review the capabilities of existing modeling and experimental facilities with respect to addressing remaining issues, and helping guide future analysis and R&D efforts; the paper coversmore » these exact points.« less

Influence Map Methodology for Evaluating Systemic Safety Issues

NASA Technical Reports Server (NTRS)

2008-01-01

"Raising the bar" in safety performance is a critical challenge for many organizations, including Kennedy Space Center. Contributing-factor taxonomies organize information about the reasons accidents occur and therefore are essential elements of accident investigations and safety reporting systems. Organizations must balance efforts to identify causes of specific accidents with efforts to evaluate systemic safety issues in order to become more proactive about improving safety. This project successfully addressed the following two problems: (1) methods and metrics to support the design of effective taxonomies are limited and (2) influence relationships among contributing factors are not explicitly modeled within a taxonomy.

Engineering ethics in Puerto Rico: issues and narratives.

PubMed

Frey, William J; O'Neill-Carrillo, Efraín

2008-09-01

This essay discusses engineering ethics in Puerto Rico by examining the impact of the Colegio de Ingenieros y Agrimensores de Puerto Rico (CIAPR) and by outlining the constellation of problems and issues identified in workshops and retreats held with Puerto Rican engineers. Three cases developed and discussed in these workshops will help outline movements in engineering ethics beyond the compliance perspective of the CIAPR. These include the Town Z case, Copper Mining in Puerto Rico, and a hypothetical case researched by UPRM students on laptop disposal. The last section outlines four future challenges in engineering ethics pertinent to the Puerto Rican situation.

Can the EVIDEM Framework Tackle Issues Raised by Evaluating Treatments for Rare Diseases: Analysis of Issues and Policies, and Context-Specific Adaptation.

PubMed

Wagner, Monika; Khoury, Hanane; Willet, Jacob; Rindress, Donna; Goetghebeur, Mireille

2016-03-01

The multiplicity of issues, including uncertainty and ethical dilemmas, and policies involved in appraising interventions for rare diseases suggests that multicriteria decision analysis (MCDA) based on a holistic definition of value is uniquely suited for this purpose. The objective of this study was to analyze and further develop a comprehensive MCDA framework (EVIDEM) to address rare disease issues and policies, while maintaining its applicability across disease areas. Specific issues and policies for rare diseases were identified through literature review. Ethical and methodological foundations of the EVIDEM framework v3.0 were systematically analyzed from the perspective of these issues, and policies and modifications of the framework were performed accordingly to ensure their integration. Analysis showed that the framework integrates ethical dilemmas and issues inherent to appraising interventions for rare diseases but required further integration of specific aspects. Modification thus included the addition of subcriteria to further differentiate disease severity, disease-specific treatment outcomes, and economic consequences of interventions for rare diseases. Scoring scales were further developed to include negative scales for all comparative criteria. A methodology was established to incorporate context-specific population priorities and policies, such as those for rare diseases, into the quantitative part of the framework. This design allows making more explicit trade-offs between competing ethical positions of fairness (prioritization of those who are worst off), the goal of benefiting as many people as possible, the imperative to help, and wise use of knowledge and resources. It also allows addressing variability in institutional policies regarding prioritization of specific disease areas, in addition to existing uncertainty analysis available from EVIDEM. The adapted framework measures value in its widest sense, while being responsive to rare disease issues and policies. It provides an operationalizable platform to integrate values, competing ethical dilemmas, and uncertainty in appraising healthcare interventions.

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.

Analysis of the Issues and Needs of Parents of Children With Developmental Disabilities in Japan Using Focus Group Interviews.

PubMed

Wakimizu, Rie; Fujioka, Hiroshi

2016-03-01

The number of Japanese children with developmental disabilities (DDs) has seen a steady increase in recent years. The parents and families of children with DD experience distress both at the time of DD diagnosis and afterward. This study aimed to elucidate the issues and needs of the parents of children with DD to facilitate the development of effective support strategies necessary to help the family handle the special needs of their child with DD. Japanese-speaking parents with children who were aged 3-14 years and currently being treated in a hospital for DDs were invited to participate in one of three focus groups. A trained moderator led each 90-minute audio-recorded group using a semistructured interview guide. All transcripts were coded using thematic content analysis. Six categories of parents' significant issues were identified, with three of the categories classified as critical needs. The issues and needs identified in this study are useful for developing an effective family support program and a related performance framework. Key concerns include providing relevant information support, providing counseling and consultation support for parents and siblings, and providing resources to children with DD that are necessary to help them deal effectively with their disabilities.

Adapting the coping in deliberation (CODE) framework: a multi-method approach in the context of familial ovarian cancer risk management.

PubMed

Witt, Jana; Elwyn, Glyn; Wood, Fiona; Rogers, Mark T; Menon, Usha; Brain, Kate

2014-11-01

To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. We performed a systematic literature search to identify issues important to women during deliberations about RRSO. Three focus groups with patients (most were pre-menopausal and untested for genetic mutations) and 11 interviews with health professionals were conducted to determine which issues mattered in the UK context. Data were used to adapt the generic CODE framework. The literature search yielded 49 relevant studies, which highlighted various issues and coping options important during deliberations, including mutation status, risks of surgery, family obligations, physician recommendation, peer support and reliable information sources. Consultations with UK stakeholders confirmed most of these factors as pertinent influences on deliberations. Questions in the generic framework were adapted to reflect the issues and coping options identified. The generic CODE framework was readily adapted to a specific preference-sensitive medical decision, showing that deliberations and coping are linked during deliberations about RRSO. Adapted versions of the CODE framework may be used to develop tailored decision support methods and materials in order to improve patient-centred care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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.

Innovation and Integrity in Intervention Research: Conceptual Issues, Methodology, and Knowledge Translation.

PubMed

Malti, Tina; Beelmann, Andreas; Noam, Gil G; Sommer, Simon

2018-04-01

In this article, we introduce the special issue entitled Innovation and Integrity in Intervention Science. Its focus is on essential problems and prospects for intervention research examining two related topics, i.e., methodological issues and research integrity, and challenges in the transfer of research knowledge into practice and policy. The main aims are to identify how to advance methodology in order to improve research quality, examine scientific integrity in the field of intervention science, and discuss future steps to enhance the transfer of knowledge about evidence-based intervention principles into sustained practice, routine activities, and policy decisions. Themes of the special issue are twofold. The first includes questions about research methodology in intervention science, both in terms of research design and methods, as well as data analyses and the reporting of findings. Second, the issue tackles questions surrounding the types of knowledge translation frameworks that might be beneficial to mobilize the transfer of research-based knowledge into practice and public policies. The issue argues that innovations in methodology and thoughtful approaches to knowledge translation can enable transparency, quality, and sustainability of intervention research.

Ethical questions must be considered for electronic health records.

PubMed

Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

2012-09-01

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

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.

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.

Relocating alcohol advertising research: examining socially mediated relationships with alcohol.

PubMed

Cherrington, Jane; Chamberlain, Kerry; Grixti, Joe

2006-03-01

This article reviews, critiques and politicises the positivist approaches that presently dominate alcohol advertising health research, and considers the benefits of a culturalist alternative. Positivist research in this area is identified as: (1) atheoretical and methods-driven; (2) restricted in focus, leaving critical issues unconsidered; and (3) inappropriately conceptualizing the 'normal' drinking person as rational and safe. The culturist alternative proposed is argued to present a more adequate framework, which can include and address problematic issues that are presently excluded, including: the pleasures associated with alcohol use, the involvements of 'normal' people in problem drinking, the inadequacy of present risk categories and the complexities of wider mediatory processes about alcohol in society. We argue for the adoption of more informed, culturalist approaches to alcohol advertising research.

Daily Readiness Huddles in Radiology-Improving Communication, Coordination, and Problem-Solving Reliability.

PubMed

Donnelly, Lane F

Deploying an intentional daily management process is a key part to create high-reliability culture. Key components described in the literature for a successfully daily management process include leadership standard work, visual controls, daily accountability processes, and the discipline to stick to the process over the long term. We believe that the institution of a daily readiness huddle has helped us better coordinate and communicate as a department and improved our ability to deliver imaging services on a daily basis. The daily readiness huddle has enabled us to more rapidly identify issues and has brought accountability to seeing solutions to those issues brought to fruition. In addition, it has helped with team building, including between the radiologists and the nonphysician staff. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Arsenic in the environment: Biology and chemistry

USGS Publications Warehouse

Bhattacharya, Prosun; Welch, Alan H.; Stollenwerk, Kenneth G.; McLaughlin , Mike J.; Bundschuh, Jochen; Panaullah, G.

2007-01-01

Arsenic (As) distribution and toxicology in the environment is a serious issue, with millions of individuals worldwide being affected by As toxicosis. Sources of As contamination are both natural and anthropogenic and the scale of contamination ranges from local to regional. There are many areas of research that are being actively pursued to address the As contamination problem. These include new methods of screening for As in the field, determining the epidemiology of As in humans, and identifying the risk of As uptake in agriculture. Remediation of As-affected water supplies is important and research includes assessing natural remediation potential as well as phytoremediation. Another area of active research is on the microbially mediated biogeochemical interactions of As in the environment.In 2005, a conference was convened to bring together scientists involved in many of the different areas of As research. In this paper, we present a synthesis of the As issues in the light of long-standing research and with regards to the new findings presented at this conference. This contribution provides a backdrop to the issues raised at the conference together with an overview of contemporary and historical issues of As contamination and health impacts.

Choosing Pre-conception Planning for Women/Families: Counselling and Informed Consent (Part 2) - Pre-conception Reproductive Planning, Lifestyle, Immunization, and Psychosocial Issues.

PubMed

Wilson, R Douglas

2017-12-06

To inform reproductive and other health care providers about pre-conception evaluation, including considerations for reproductive planning, lifestyle modification, immunization status and attitudes, and psychosocial issues. This counselling information can be used for patient education and planning and possible pre-conception and/or prenatal testing. This information may allow for improved risk assessment when pre-conception counselling for individual patients and their families is used. CONSIDERATIONS FOR PRE-CONCEPTION CARE (PART 2) REGARDING PRE-CONCEPTION REPRODUCTIVE PLANNING, LIFESTYLE, IMMUNIZATIONS, AND PSYCHOSOCIAL ISSUES: CONSIDERATION FOR CARE STATEMENTS: For this review article, the Consideration for Care Statements use the Grading of Recommendations, Assessment, Development and Evaluations strength and quality principles because they are comparable for the clinician and the patient/public user. For example, "Strong" for clinicians is defined as "the recommendation would apply to most individuals. Formal discussion aids are not likely to be needed to help individuals make decisions consistent with their values and preferences." For patients/the public, "Strong" is defined as, "we believe most people in this situation would want the recommended course of actions and only a small number would not." Quality of evidence (High, Moderate, Low) is based on the confidence that the true effect lies close to that of the estimate of the effect. In addition, the Canadian Task Force on Preventive Health Care key to evidence statements and grading of recommendations are included. PubMed, Medline, and the Cochrane Database were searched until May 2017, using appropriate key words (i.e., preconception, reproductive planning, lifestyle modification, immunization risks and benefits, psychosocial pregnancy factors/issues). Grey (unpublished) literature was identified through searching websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The benefits for the patient and her family from receiving this pre-conception counseling would include an increased understanding of the relevant issues for both pre-conception and in early pregnancy as well as better pregnancy outcomes. Harm includes potential increased anxiety or psychological stress associated with the possibility of identifying maternal pregnancy risks. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

Lesbian, gay, bisexual, and transgender youth: Limited representation in school support personnel journals.

PubMed

Graybill, Emily C; Proctor, Sherrie L

2016-02-01

Many lesbian, gay, bisexual, and transgender (LGBT) youth experience harassment and discrimination in schools and these experiences lead to increased negative social-emotional outcomes. Youth who can identify at least one supportive adult at school report better outcomes than youth who cannot identify a safe adult. Yet, many educators report feeling uncomfortable or unprepared to support LGBT youth. One reason for educators' discomfort may be that content related to issues unique to LGBT youth is sometimes missing or covered minimally in university training programs. We hypothesized that LGBT content may be covered minimally in school support personnel journals, as well. This study analyzed eight school support personnel journals across the disciplines of school counseling, school nursing, school psychology, and school social work for LGBT content published between 2000 and 2014 to gain a better understanding of the visibility of LGBT issues in the research. Results suggested that there has been a lack of presence of LGBT issues in journals across disciplines. These results also suggest a need for an intentional focus on issues relevant to LGBT youth in school support personnel journals. Thus, the article concludes with an introduction to two articles in this special topic section, including Russell, Day, Ioverno, and Toomey's (in this issue) study on teacher perceptions of bullying in the context of enumerated school policies and other supportive sexual orientation and gender identity related practices and Poteat and Vecho's (in this issue) study on characteristics of bystanders in homophobic bullying situations. The broad goal of these three studies is to increase visibility of critical LGBT issues in school support personnel journals. Copyright © 2015 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Prison health service directors' views on research priorities and organizational issues in conducting research in prison: outcomes of a national deliberative roundtable.

PubMed

Simpson, Paul Leslie; Guthrie, Jill; Butler, Tony

2017-06-12

Purpose Given that prisoners have significant health needs across most areas, the paucity of prisoner health research, and the difficulties involved in the conduct of research in this setting, there is a need to develop research priorities that align with key stakeholder groups. One such group are those responsible for health service provision in prisons - prison health service directors. The paper aims to discuss these issues. Design/methodology/approach Prison health service directors in each Australian state and territory were invited to participate in a national (deliberative) roundtable where the consensus building nominal group technique was utilized. This involved the identification of research priorities and organizational issues in conducting research with prisoners, and ranking research priorities. A thematic analysis was conducted on organizational issues. Findings In total, 13 participants attended the roundtable. Participants identified 28 research priorities and 12 organizational issues. Top ranked research priorities were mental health, cognitive and intellectual disability, post-release health maintenance, ageing prisoners, chronic health conditions and Aboriginal and Torres Strait Islander health. Themes identified from the organizational issues included prisoner access to research participation, health and research literacy of custodial staff, and institutional protectionism in response to research that may discover negative information about the custodial setting. Research limitations/implications These findings should inform future efforts to improve research infrastructures to undertake research to improve the health of people in Australian prisons, and help to align researchers' efforts with those of a key organizational stakeholder. Originality/value This is the first paper to determine the research priorities and organizational issues in conducting research in prisons of prison health service directors.

Multimodality imaging of placental masses: a pictorial review.

PubMed

Jha, Priyanka; Paroder, Viktoriya; Mar, Winnie; Horowtiz, Jeanne M; Poder, Liina

2016-12-01

Placental masses are uncommonly identified at the time of obstetric ultrasound evaluation. Understanding the pathologies presenting as placental masses is key for providing a differential diagnosis and guiding subsequent management, which may include additional imaging with magnetic resonance (MR) imaging. Potential benign entities include chorioangiomas and teratomas. Larger chorioangiomas can cause fetal cardiovascular issues from volume overload. Placental mesenchymal dysplasia has an association with fetal anomalies and detailed fetal evaluation should be performed when it is suspected. Identifying other cystic masses such as partial and complete moles is crucial to prevent erroneous pregnancy termination. This review addresses normal imaging appearance of the placenta on ultrasound and MR imaging and describes various trophoblastic and nontrophoblastic placental masses. Potential placental mass mimics including uterine contractions and thrombo-hematomas are also presented.

Medical device procurement in low- and middle-income settings: protocol for a systematic review.

PubMed

Diaconu, Karin; Chen, Yen-Fu; Manaseki-Holland, Semira; Cummins, Carole; Lilford, Richard

2014-10-21

Medical device procurement processes for low- and middle-income countries (LMICs) are a poorly understood and researched topic. To support LMIC policy formulation in this area, international public health organizations and research institutions issue a large body of predominantly grey literature including guidelines, manuals and recommendations. We propose to undertake a systematic review to identify and explore the medical device procurement methodologies suggested within this and further literature. Procurement facilitators and barriers will be identified, and methodologies for medical device prioritization under resource constraints will be discussed. Searches of both bibliographic and grey literature will be conducted to identify documents relating to the procurement of medical devices in LMICs. Data will be extracted according to protocol on a number of pre-specified issues and variables. First, data relating to the specific settings described within the literature will be noted. Second, information relating to medical device procurement methodologies will be extracted, including prioritization of procurement under resource constraints, the use of evidence (e.g. cost-effectiveness evaluations, burden of disease data) as well as stakeholders participating in procurement processes. Information relating to prioritization methodologies will be extracted in the form of quotes or keywords, and analysis will include qualitative meta-summary. Narrative synthesis will be employed to analyse data otherwise extracted. The PRISMA guidelines for reporting will be followed. The current review will identify recommended medical device procurement methodologies for LMICs. Prioritization methods for medical device acquisition will be explored. Relevant stakeholders, facilitators and barriers will be discussed. The review is aimed at both LMIC decision makers and the international research community and hopes to offer a first holistic conceptualization of this topic.

Medical device procurement in low- and middle-income settings: protocol for a systematic review

PubMed Central

2014-01-01

Background Medical device procurement processes for low- and middle-income countries (LMICs) are a poorly understood and researched topic. To support LMIC policy formulation in this area, international public health organizations and research institutions issue a large body of predominantly grey literature including guidelines, manuals and recommendations. We propose to undertake a systematic review to identify and explore the medical device procurement methodologies suggested within this and further literature. Procurement facilitators and barriers will be identified, and methodologies for medical device prioritization under resource constraints will be discussed. Methods/design Searches of both bibliographic and grey literature will be conducted to identify documents relating to the procurement of medical devices in LMICs. Data will be extracted according to protocol on a number of pre-specified issues and variables. First, data relating to the specific settings described within the literature will be noted. Second, information relating to medical device procurement methodologies will be extracted, including prioritization of procurement under resource constraints, the use of evidence (e.g. cost-effectiveness evaluations, burden of disease data) as well as stakeholders participating in procurement processes. Information relating to prioritization methodologies will be extracted in the form of quotes or keywords, and analysis will include qualitative meta-summary. Narrative synthesis will be employed to analyse data otherwise extracted. The PRISMA guidelines for reporting will be followed. Discussion The current review will identify recommended medical device procurement methodologies for LMICs. Prioritization methods for medical device acquisition will be explored. Relevant stakeholders, facilitators and barriers will be discussed. The review is aimed at both LMIC decision makers and the international research community and hopes to offer a first holistic conceptualization of this topic. PMID:25336161

Use of stakeholder analysis to inform risk communication and extension strategies for improved biosecurity amongst small-scale pig producers.

PubMed

Hernández-Jover, M; Gilmour, J; Schembri, N; Sysak, T; Holyoake, P K; Beilin, R; Toribio, J-A L M L

2012-05-01

Extension and communication needs amongst small-scale pig producers, described as pig producers with less than 100 sows, have been previously identified. These producers, who are believed to pose a biosecurity risk to commercial livestock industries, are characterized by a lack of formal networks, mistrust of authorities, poor disease reporting behaviour and motivational diversity, and reliance on other producers, veterinarians and family for pig health and production advice. This paper applies stakeholder identification and analysis tools to determine stakeholders' influence and interest on pig producers' practices. Findings can inform a risk communication process and the development of an extension framework to increase producers' engagement with industry and their compliance with biosecurity standards and legislation in Australia. The process included identification of stakeholders, their issues of concerns regarding small-scale pig producers and biosecurity and their influence and interest in each of these issues. This exercise identified the capacity of different stakeholders to influence the outcomes for each issue and assessed their success or failure to do so. The disconnection identified between the level of interest and influence suggests that government and industry need to work with the small-scale pig producers and with those who have the capacity to influence them. Successful biosecurity risk management will depend on shared responsibility and building trust amongst stakeholders. Flow-on effects may include legitimating the importance of reporting and compliance systems and the co-management of risk. Compliance of small-scale pig producers with biosecurity industry standards and legislation will reduce the risks of entry and spread of exotic diseases in Australia. Copyright © 2011 Elsevier B.V. All rights reserved.

Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis

PubMed Central

Ren, Jun; Li, Xun; Sun, Jin; Han, Mei; Yang, Guo-Yan; Li, Wen-Yuan; Robinson, Nicola; Lewith, George; Liu, Jian-Ping

2015-01-01

Background Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs. Objective To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence. Methods All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors’ Association. TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations. Results A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation). Conclusions Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise. PMID:26041487

Is traditional Chinese medicine recommended in Western medicine clinical practice guidelines in China? A systematic analysis.

PubMed

Ren, Jun; Li, Xun; Sun, Jin; Han, Mei; Yang, Guo-Yan; Li, Wen-Yuan; Robinson, Nicola; Lewith, George; Liu, Jian-Ping

2015-06-03

Evidence-based medicine promotes and relies on the use of evidence in developing clinical practice guidelines (CPGs). The Chinese healthcare system includes both traditional Chinese medicine (TCM) and Western medicine, which are expected to be equally reflected in Chinese CPGs. To evaluate the inclusion of TCM-related information in Western medicine CPGs developed in China and the adoption of high level evidence. All CPGs were identified from the China Guideline Clearinghouse (CGC), which is the main Chinese organisation maintaining the guidelines issued by the Ministry of Health of China, the Chinese Medical Association and the Chinese Medical Doctors' Association.TCM-related contents were extracted from all the CPGs identified. Extracted information comprised the institution issuing the guideline, date of issue, disease, recommendations relating to TCM, evidence level of the recommended content and references supporting the recommendations. A total of 604 CPGs were identified, only a small number of which (74/604; 12%) recommended TCM therapy and only five guidelines (7%) had applied evidence grading. The 74 CPGs involved 13 disease systems according to the International Classification of Diseases 10th edition. TCM was mainly recommended in the treatment part of the guidelines (73/74, 99%), and more than half of the recommendations (43/74, 58%) were related to Chinese herbal medicine (single herbs or herbal treatment based on syndrome differentiation). Few Chinese Western medicine CPGs recommend TCM therapies and very few provide evidence grading for the TCM recommendation. We suggest that future guideline development should be based on systematic searches for evidence to support CPG recommendations and involve a multidisciplinary approach including TCM expertise. 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.

'A band of brothers'-an exploration of the range of medical ethical issues faced by British senior military clinicians on deployment to Afghanistan: a qualitative study.

PubMed

Bernthal, Elizabeth M; Draper, H J A; Henning, J; Kelly, J C

2017-06-01

To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Anthropology and addiction: an historical review.

PubMed

Singer, Merrill

2012-10-01

This paper reviews the world anthropology of drugs and alcohol use literature, identifying key issues addressed by anthropologists, methods and theoretical models in use, trends in focus over time and future directions. Papers and books that comprise the literature were identified through computer search using the keywords: ethnography of drug use (and variants, e.g. drug ethnography, qualitative approaches in drug research), ethnography of drinking, anthropology and drug use, and anthropology and drinking. Search engines included Google Scholar, EBSCOHost, AnthroSource and PubMed. Identified sources were read and integrated into the review. The literature search identified a rich and growing literature on the anthropology of drinking and drug use. The research and published literature on the anthropology of drug use has grown and diversified since the 1970s, found acceptance in the wider multi-disciplinary domain of alcohol and drug studies and developed beyond the socio-cultural model to include life-style, critical medical anthropology and experiential explanatory models. Anthropological research has helped to shape the field of addiction science, e.g. ethnographic studies show that the lived worlds and self-identities of drug users have cultural order and socially constructed purpose and meaning, and experiential research shows that some addictions or aspects of addictions can be affirmative, creative and sustainable, at least at the individual level. The human immunodeficiency virus/acquired immune deficiency syndrome pandemic has significantly increased anthropological research on drug-related issues world-wide. © 2012 The Author, Addiction © 2012 Society for the Study of Addiction.

Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases.

PubMed

Meyer, Diane; Kirk Sell, Tara; Schoch-Spana, Monica; Shearer, Matthew P; Chandler, Hannah; Thomas, Erin; Rose, Dale A; Carbone, Eric G; Toner, Eric

2018-05-01

The domestic response to the West Africa Ebola virus disease (EVD) epidemic from 2014-2016 provides a unique opportunity to distill lessons learned about health sector planning and operations from those individuals directly involved. This research project aimed to identify and integrate these lessons into an actionable checklist that can improve health sector resilience to future high-consequence infectious disease (HCID) events. Interviews (N = 73) were completed with individuals involved in the domestic EVD response in 4 cities (Atlanta, Dallas, New York, and Omaha), and included individuals who worked in academia, emergency management, government, health care, law, media, and public health during the response. Interviews were transcribed and analyzed qualitatively. Two focus groups were then conducted to expand on themes identified in the interviews. Using these themes, an evidence-informed checklist was developed and vetted for completeness and feasibility by an expert advisory group. Salient themes identified included health care facility issues-specifically identifying assessment and treatment hospitals, isolation and treatment unit layout, waste management, community relations, patient identification, patient isolation, limitations on treatment, laboratories, and research considerations-and health care workforce issues-specifically psychosocial impact, unit staffing, staff training, and proper personal protective equipment. The experiences of those involved in the domestic Ebola response provide critical lessons that can help strengthen resilience of health care systems and improve future responses to HCID events. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Translation of lifestyle modification programs focused on physical activity and dietary habits delivered in community settings.

PubMed

Stoutenberg, Mark; Stanzilis, Katie; Falcon, Ashley

2015-06-01

Lifestyle modification programs (LMPs) can provide individuals with behavioral skills to sustain long-term changes to their physical activity (PA) levels and dietary habits. Yet, there is much work to be done in the translation of these programs to community settings. This review identified LMPs that focused on changing both PA and dietary behaviors and examined common features and barriers faced in their translation to community settings. A search of multiple online databases was conducted to identify LMPs that included participants over the age of 18 who enrolled in LMPs, offered in community settings, and had the goal of improving both PA and dietary behaviors. Data were extracted on participant demographics, study design characteristics, and study outcome variables including changes in PA, dietary habits, body weight, and clinical outcomes. We identified 27 studies that met inclusion criteria. Despite high levels of retention and adherence to the interventions, varying levels of success were observed in increasing PA levels, improving dietary habits, reducing body weight, and improving clinic outcomes. LMPs addressing issues of PA and dietary habits can be successfully implemented in a community setting. However, inconsistent reporting of key components in the translation of these studies (participant recruitment, utilization of behavioral strategies) may limit their replication and advancement of future programs. Future efforts should better address issues such as identifying barriers to participation and program implementation, utilization of community resources, and evaluating changes across multiple health behaviors.

Developing consensus measures for global programs: lessons from the Global Alliance for Chronic Diseases Hypertension research program.

PubMed

Riddell, Michaela A; Edwards, Nancy; Thompson, Simon R; Bernabe-Ortiz, Antonio; Praveen, Devarsetty; Johnson, Claire; Kengne, Andre P; Liu, Peter; McCready, Tara; Ng, Eleanor; Nieuwlaat, Robby; Ovbiagele, Bruce; Owolabi, Mayowa; Peiris, David; Thrift, Amanda G; Tobe, Sheldon; Yusoff, Khalid

2017-03-15

The imperative to improve global health has prompted transnational research partnerships to investigate common health issues on a larger scale. The Global Alliance for Chronic Diseases (GACD) is an alliance of national research funding agencies. To enhance research funded by GACD members, this study aimed to standardise data collection methods across the 15 GACD hypertension research teams and evaluate the uptake of these standardised measurements. Furthermore we describe concerns and difficulties associated with the data harmonisation process highlighted and debated during annual meetings of the GACD funded investigators. With these concerns and issues in mind, a working group comprising representatives from the 15 studies iteratively identified and proposed a set of common measures for inclusion in each of the teams' data collection plans. One year later all teams were asked which consensus measures had been implemented. Important issues were identified during the data harmonisation process relating to data ownership, sharing methodologies and ethical concerns. Measures were assessed across eight domains; demographic; dietary; clinical and anthropometric; medical history; hypertension knowledge; physical activity; behavioural (smoking and alcohol); and biochemical domains. Identifying validated measures relevant across a variety of settings presented some difficulties. The resulting GACD hypertension data dictionary comprises 67 consensus measures. Of the 14 responding teams, only two teams were including more than 50 consensus variables, five teams were including between 25 and 50 consensus variables and four teams were including between 6 and 24 consensus variables, one team did not provide details of the variables collected and two teams did not include any of the consensus variables as the project had already commenced or the measures were not relevant to their study. Deriving consensus measures across diverse research projects and contexts was challenging. The major barrier to their implementation was related to the time taken to develop and present these measures. Inclusion of consensus measures into future funding announcements would facilitate researchers integrating these measures within application protocols. We suggest that adoption of consensus measures developed here, across the field of hypertension, would help advance the science in this area, allowing for more comparable data sets and generalizable inferences.

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.

Is There An Academic Audit in Your Future? Reforming Quality Assurance in U.S. Higher Education.

ERIC Educational Resources Information Center

Dill, David D.

2000-01-01

Describes a new form of academic quality assurance, the academic audit. Reviews use of academic audits abroad and experimental use of such audits in the United States. Identifies issues in academic audits, including focus of audits, auditor selection and training, institutional preparation for an audit, interaction between institutional policies…

Using Group-Based Learning in Higher Education. Teaching and Learning in Higher Education Series.

ERIC Educational Resources Information Center

Thorley, Lin, Ed.; Gregory, Roy, Ed.

The 26 papers in this collection from a British conference first provide an overview of group-based learning in higher education, offer a range of examples, and identify issues and trends. Chapters include: (1) "Introduction" (Roy Gregory and Lin Thorley); (2) "An Overview from Higher Education" (Diana M. R. Tribe); (3)…

Standards for the Global Information Infrastructure (GII): A Review of Recent Developments, Ongoing Efforts, Future Directions and Issues.

ERIC Educational Resources Information Center

Needleman, Mark H.

1996-01-01

Reviews developments related to standards in electronic and networked information. Discusses traditional library and Internet communities, and notes the importance of having a supporting infrastructure in place. Topics include: Z39.50; Z39.56 Serial Item/Contribution Identifier (SICI); Interlibrary Loan (ILL) Protocol; character set standards;…

Reasoning about Informal Statistical Inference: One Statistician's View

ERIC Educational Resources Information Center

Rossman, Allan J.

2008-01-01

This paper identifies key concepts and issues associated with the reasoning of informal statistical inference. I focus on key ideas of inference that I think all students should learn, including at secondary level as well as tertiary. I argue that a fundamental component of inference is to go beyond the data at hand, and I propose that statistical…

The Use of Digital Storytelling to Improve the Effectiveness of Social and Conflict Resolution Skill Training for Elementary Students

ERIC Educational Resources Information Center

Lipschutz, Betsy D.

2010-01-01

School safety is one of the most important issues facing administrators, teachers, and parents. Several risk factors have been identified as antecedents to aggression including poor social skills, difficulty dealing with anger and frustration, and inadequate problem solving abilities. "No Child Left Behind" requires all schools receiving…

Infectious Disease Border Issues Conference: Meeting Synopsis

DTIC Science & Technology

2012-04-03

methicillin - resistant Staphylococcus aureus (MRSA). Operation MECACAR 1998 was highlighted as a successful example of cross-border coordination...training courses, no joint public health investigation teams) and illegal animal transportation across borders were identified as some of the existing...Work (2007), including fostering global partnerships; strengthening public health security in travel and transport ; improving the WHO global alert

Ethical Considerations in Conducting Research on Autism Spectrum Disorders in Low and Middle Income Countries

ERIC Educational Resources Information Center

Daley, Tamara C.; Singhal, Nidhi; Krishnamurthy, Vibha

2013-01-01

Autism spectrum disorder (ASD) is being identified in an ever-increasing number of countries, including many that are low or middle income (LMIC). Research conducted in these countries requires awareness of unique ethical issues. Drawing on the experience of two organizations that have been involved in conducting and collaborating in ASD research…

Citizenship and Citizenship Education in a Global Age: Politics, Policies, and Practices in China. Global Studies in Education. Volume 2

ERIC Educational Resources Information Center

Law, Wing-Wah

2011-01-01

This book examines issues of citizenship, citizenship education, and social change in China, exploring the complexity of interactions among global forces, the nation-state, local governments, schools, and individuals--including students--in selecting and identifying with elements of citizenship and citizenship education in a multileveled polity.…

"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…

Incorporating English Learner Progress into State Accountability Systems

ERIC Educational Resources Information Center

Goldschmidt, Pete; Hakuta, Kenji

2017-01-01

The Every Student Succeeds Act (ESSA) proposes changes in how states include the nation's growing population of English Learners (ELs) into the accountability system. The purpose of this paper is to identify key issues and questions that might be considered and explored by state decision makers in this area. Our primary audience is anyone in a…

Administration and Scoring Errors of Graduate Students Learning the WISC-IV: Issues and Controversies

ERIC Educational Resources Information Center

Mrazik, Martin; Janzen, Troy M.; Dombrowski, Stefan C.; Barford, Sean W.; Krawchuk, Lindsey L.

2012-01-01

A total of 19 graduate students enrolled in a graduate course conducted 6 consecutive administrations of the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV, Canadian version). Test protocols were examined to obtain data describing the frequency of examiner errors, including administration and scoring errors. Results identified 511…

Caring for Young Children: An Analysis of Educational and Social Services.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Centre for Educational Research and Innovation.

The purpose of this report is to identify the issues that policy makers and practitioners ought to consider when formulating and establishing social policies and services for young children. The six chapters included are grouped according to three parts. Part 1 describes the context of social and family environments for children living in the…

NASA Langley WINN System Operational Assessment

NASA Technical Reports Server (NTRS)

Jonsson, Jon

2003-01-01

An operational assessment of the NASA Langley Weather Information Network (WINN) System is presented. The objectives of this program include: 1) Determine if near real-time weather information presented on the flight deck improves pilot situational awareness of weather; and 2) Identify pilot interface issues related to the use of WINN system during test flights. This paper is in viewgraph form.

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…

From Metaphorically Speaking to Acting Boldly: A Commentary on the Special Issue

ERIC Educational Resources Information Center

Rock, Marcia L.; Billingsley, Bonnie

2014-01-01

Casting special education teacher development as an avatar living in a virtual and changing landscape is a creative way to consider the current state of the field and project possible futures. In this commentary, the authors consider areas that may help strengthen the Avatar, including conceptualizing and identifying the outcomes of teacher…

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…

Stop Eulogizing, Complicating or Straitjacketing the Concept of Organizational Unlearning, Please

ERIC Educational Resources Information Center

Tsang, Eric W. K.

2017-01-01

Purpose: This paper aims to provide some comments on the four papers, other than the author's own, that were included in a recent special issue on organizational unlearning. Design/methodology/approach: The author carefully reads these papers and identify problems that may hinder unlearning research. Findings: While each paper has its own merits,…

Shifting Challenges in Teacher-Education Research and Accreditation: Lessons Learned from Limitations on Studying Program Impact

ERIC Educational Resources Information Center

Contopidis, Ellen; DaBoll-Lavoie, Kathleen; Dunn, Kerry; Darling, Deana; Wieczorek, Kim

2017-01-01

A critical issue in educator preparation is how to ascertain if program graduates are sufficiently prepared to be effective through the acquisition of meaningful evidence of graduates' impact on their students. Challenges to proving specific impact of educator-preparation programs on student learning include identifying and following program…

Blessings, Banes, and Possibilities in the Study of Childhood Personality

ERIC Educational Resources Information Center

Roberts, Brent W.

2005-01-01

In this commentary I make three points. First, the four articles presented in this special issue are critical examples of the viability and importance of the idea of childhood personality. Second, I identify several concerns, including the narrow scope of the study of childhood personality, the lack of focus on environmental factors that might…

High Variability Phonetic Training as a Bridge from Research to Practice

ERIC Educational Resources Information Center

Barriuso, Taylor Anne; Hayes-Harb, Rachel

2018-01-01

This review of high variability phonetic training (HVPT) research begins by situating HVPT in its historical context and as a methodology for studying second language (L2) pronunciation. Next we identify and discuss issues in HVPT that are of particular relevance to real-world L2 learning and teaching settings, including the generalizability of…

Differential invasion success of salmonids in southern Chile: patterns and hypotheses

Treesearch

Ivan Arismendi; Brooke E. Penaluna; Jason B. Dunham; Carlos Garcia de Leaniz; Doris Soto; Ian A. Fleming; Daniel Gomez-Uchida; Gonzalo Gajardo; Pamela V. Varga; Jorge León-Muñoz

2014-01-01

Biological invasions create complex ecological and societal issues worldwide. Most of the knowledge about invasions comes only from successful invaders, but less is known about which processes determine the differential success of invasions. In this review, we develop a framework to identify the main dimensions driving the success and failure of invaders, including...