Key Challenges in the Reform of Governance, Quality Assurance, and Finance in Vietnamese Higher Education--A Case Study

ERIC Educational Resources Information Center

Dao, Khanh Van

2015-01-01

Vietnam's higher education is highly centralized in terms of its governance and management. A couple of higher education reform plans have been introduced over the past decade but they seem to result in poor outcomes. This paper addresses the challenges faced in the areas of governance, quality assurance and finance by a "key" university…

From Assistant Teacher to Teacher: Challenges and Pathways in Situated Pre-Service Teacher Education

ERIC Educational Resources Information Center

Strangeways, Al

2017-01-01

Vocational pathways to Higher Education have a key role in opening teacher education to under-represented groups but bring with them particular challenges. Teacher educators need to address the challenges faced by these learners, of not only connecting their learning but also challenging their knowledge, and doing so in an invested work…

The Inter-Life Project: Researching the Potential of Art, Design and Virtual Worlds as a Vehicle for Assisting Young People with Key Life Changes and Transitions

ERIC Educational Resources Information Center

Lally, Victor; Sclater, Madeleine

2013-01-01

Careers work in the twenty-first century faces a key challenge in terms of digital technologies: to evaluate their potential for careers work in challenging settings. Given the rapidity of developments, technologies require evaluation in research innovations and naturalistic settings. Virtual worlds offer potential for careers and guidance work,…

Reflections on Deaf Education: Perspectives of Deaf Senior Citizens

ERIC Educational Resources Information Center

Roberson, Len; Shaw, Sherry

2015-01-01

Parents with deaf children face many challenges in making educational choices, developing language and a sense of belonging. Other key aspects of life including concept development and social competency are also critical decision points faced by parents. Developing language, whether it is through spoken or signed modalities, is of utmost…

Collaboration Is Key to Leadership

ERIC Educational Resources Information Center

Thomas, Nancy

2007-01-01

Leadership in schools matters today more than ever, since school leaders are faced with leading schools through an era of profound social change that has required fundamental rethinking of what schools do and how they do it. The challenges facing educational leadership have grown tremendously in recent years because of increased public…

Online Learning: Cross-Cultural Development in Time Poor Environments

ERIC Educational Resources Information Center

Cameron, Heather; Limberger, Jacqui

2004-01-01

Faced with a unique problem of providing cross-cultural awareness training on a continuing basis, Griffith University, located in Brisbane, Queensland developed an innovative program to meet the challenges it faced. A key strategy in the University's Indigenous Recruitment Strategy was to establish a cross-cultural awareness program sensitising…

Challenges, Realities, Strategies: The Master Plan for Florida Postsecondary Education for the 21st Century.

ERIC Educational Resources Information Center

Florida State Postsecondary Education Planning Commission, Tallahassee.

A new master plan for higher education in Florida is presented which focuses on the central challenges facing the state and its higher education institutions. The following sections address three key challenges and suggest strategies to help policymakers and governing boards promote positive change. The section on the challenge of improved use of…

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

PubMed

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

2016-02-29

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

Challenges and Opportunities in the Provision of Surgical Care in Vanuatu: A Mixed Methods Analysis.

PubMed

Young, S; Perry, W R G; Leodoro, B; Nosa, V; Bissett, I; Windsor, J A; Dare, A J

2016-08-01

The Pacific island nation of Vanuatu faces a number of challenges in delivering surgical care to its population. We aimed to understand and document the barriers, opportunities and required actions to improve surgical care in the country using a mixed methods analysis which incorporated the perspectives of local health stakeholders. A baseline quantitative assessment of surgical capacity in Vanuatu was carried out using the WHO situational analysis tool. Twenty semi-structured interviews were then conducted on the two main islands (Efate and Espiritu Santo) with surgeons, allied health staff, health managers, policy-makers and other key stakeholders, using a grounded theory qualitative case study methodology. Initial informants were identified by purposive sampling followed by snowball sampling until theoretical saturation was reached. Interviews were open and axially coded with subsequent thematic analysis. Vanuatu faces deficits in surgical infrastructure, equipment and human resources, especially in the rural provinces. Geographic isolation, poverty and culture-including the use of traditional medicine and low health literacy-all act as barriers to patients accessing timely surgical care. Issues with governance, human resourcing and perioperative care were commonly identified by stakeholders as key challenges facing surgical services. Increasing outreach clinics, developing efficient referral systems, building provincial surgical capacity and undertaking locally led research were identified as key actions that can improve surgical care. Documenting locally identified challenges and opportunities for surgical care in Vanuatu is an important first step towards developing formal strategies for improving surgical services at the country level.

Discovery of innovative therapeutics: today's realities and tomorrow's vision. 1. Criticisms faced by the pharmaceutical industry.

PubMed

Abou-Gharbia, Magid; Childers, Wayne E

2013-07-25

The pharmaceutical industry is facing enormous challenges, including reduced efficiency, declining innovation, key patent expirations, fierce price competition from generics, high regulatory hurdles, and a tarnished image. There is a clear need for change in the paradigms designed to address these challenges. Pharma has responded by embarking on a range of initiatives. However, along the way the industry has accrued critics whose accusations have tainted its reputation. The first part of this two-part series will discuss the criticisms that have been leveled at the pharmaceutical industry and summarize the supporting data for and against these criticisms. The second installment will focus on the current challenges facing the pharmaceutical industry and Pharma's responses to address these challenges. It will describe the industry's changing perspective and new business models for coping with the recent loss of talent and declining clinical pipelines as well as present some examples of recent drug discovery successes.

Clinical Research Informatics: Challenges, Opportunities and Definition for an Emerging Domain

PubMed Central

Embi, Peter J.; Payne, Philip R.O.

2009-01-01

Objectives Clinical Research Informatics, an emerging sub-domain of Biomedical Informatics, is currently not well defined. A formal description of CRI including major challenges and opportunities is needed to direct progress in the field. Design Given the early stage of CRI knowledge and activity, we engaged in a series of qualitative studies with key stakeholders and opinion leaders to determine the range of challenges and opportunities facing CRI. These phases employed complimentary methods to triangulate upon our findings. Measurements Study phases included: 1) a group interview with key stakeholders, 2) an email follow-up survey with a larger group of self-identified CRI professionals, and 3) validation of our results via electronic peer-debriefing and member-checking with a group of CRI-related opinion leaders. Data were collected, transcribed, and organized for formal, independent content analyses by experienced qualitative investigators, followed by an iterative process to identify emergent categorizations and thematic descriptions of the data. Results We identified a range of challenges and opportunities facing the CRI domain. These included 13 distinct themes spanning academic, practical, and organizational aspects of CRI. These findings also informed the development of a formal definition of CRI and supported further representations that illustrate areas of emphasis critical to advancing the domain. Conclusions CRI has emerged as a distinct discipline that faces multiple challenges and opportunities. The findings presented summarize those challenges and opportunities and provide a framework that should help inform next steps to advance this important new discipline. PMID:19261934

Success in challenging time: Important lessons learned from the US beekeeping industry

USDA-ARS?s Scientific Manuscript database

The United States plays a leadership role in the global beekeeping and honey industries. This article summarizes the roles of honey bees in agriculture and the key challenges facing the US beekeeping industry as well as innovative solutions to existing problems. The article also provides a review ...

Educational Leadership at 2050: Conjectures, Challenges, and Promises

ERIC Educational Resources Information Center

Papa, Rosemary; Mullen, Carol A.; English, Fenwick W.; Creighton, Theodore

2012-01-01

This is a practical, bold, no-holds barred look at challenges facing educational leaders and the university programs that prepare them through mid-century. It examines key continuities and discontinuities of current times for school, education, and society. Both practice and preparation occur in contested social space, the implications of which…

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

PubMed

Said, Maya; Zerhouni, Elias

2014-11-01

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

Internationalizing Business Education in Latin America: Issues and Challenges

ERIC Educational Resources Information Center

Elahee, Mohammad; Norbis, Mario

2009-01-01

This article examines the extent of internationalization of business education in Latin America and identifies the key challenges facing the Latin American business schools. Based on a survey of the business schools that are members of CLADEA (Consejo Latinoamericano de Escuelas de Administracion--Latin American Council of Management Schools), and…

Challenges Students' Face in Their Transition from Primary to Secondary School and the Interventions Schools Take to Ease the Transition

ERIC Educational Resources Information Center

Tarekegne, Wudu Melese

2015-01-01

This study explores the major challenges that affect students' enrollment and participation and the key measures schools take to mitigate the challenge and help students continue their education. The data were collected from 23 secondary school grade nine students in Amahara Regional State in Ethiopia using the structured questionnaires from…

International and cross-cultural issues: six key challenges for our professions.

PubMed

Marshall, Julie

2003-01-01

This paper discusses a number of key challenges facing professionals who work with people who have communication disabilities. The challenges are related to working internationally and in a cross-culturally competent way. Each challenge is discussed, drawing on material from a range of sources, including the papers in the final 2003 edition of FOLIA PHONIATRICA ET LOGOPAEDICA ('International and Cross-Cultural Issues'). The challenges discussed cover how experiences from majority world countries can be used to benefit services elsewhere, 'mainstreaming' commitment to cross-cultural competence, learning from relationships with other professionals, influencing research practice, responding to requests to work internationally and finally, dealing with cultural differences that challenge working practices. Some solutions are suggested and additional questions posed. Copyright 2003 S. Karger AG, Basel

Parents' Role in the Academic Motivation of Students with Gifts and Talents

ERIC Educational Resources Information Center

Garn, Alex C.; Matthews, Michael S.; Jolly, Jennifer L.

2012-01-01

Parents play a key role in developing their children's academic motivation, and parents of children with gifts and talents also may face additional parenting challenges that are less commonly faced by parents of average-ability learners whose needs are more readily met in the school setting. School psychologists may be charged with addressing…

Critical Thinking of Young Citizens towards News Headlines in Chile

ERIC Educational Resources Information Center

Vernier, Matthieu; Cárcamo, Luis; Scheihing, Eliana

2018-01-01

Strengthening critical thinking abilities of citizens in the face of news published on the web represents a key challenge for education. Young citizens appear to be vulnerable in the face of poor quality news or those containing non-explicit ideologies. In the field of data science, computational and statistical techniques have been developed to…

Reforming a Breadwinner Welfare State: Gender, Race, Class, and Social Security Reform

ERIC Educational Resources Information Center

Herd, Pamela

2005-01-01

A key challenge facing western welfare states is that they offset income risks faced by those in breadwinner families. Social Security is an excellent example. It best protects individuals with lengthy work histories or individuals who get married, stay married, and are never employed. Most women fit neither model. Thus, I analyze…

Joining forces for genetic conservation

Treesearch

Gary Man; Emily Boes; Rhoda Maurer; Michael Dosmann; Matt Lobdell; Kevin Conrad; Mike Kintgen; Rebecca Sucher; Martin Nicholson; David Stevenson; Brianna McTeague; Evan Heck; Richard A. Sniezko

2017-01-01

Facing a Challenge Non-native diseases and insects as well as a changing climate pose serious threats to native trees in North America. Genetic variation in a species is key to its enduring persistence in the face of these abiotic and biotic threats. Efforts to conserve genetic diversity of North American tree at-risk species will ensure the genetic...

The architecture challenge: Future artificial-intelligence systems will require sophisticated architectures, and knowledge of the brain might guide their construction.

PubMed

Baldassarre, Gianluca; Santucci, Vieri Giuliano; Cartoni, Emilio; Caligiore, Daniele

2017-01-01

In this commentary, we highlight a crucial challenge posed by the proposal of Lake et al. to introduce key elements of human cognition into deep neural networks and future artificial-intelligence systems: the need to design effective sophisticated architectures. We propose that looking at the brain is an important means of facing this great challenge.

The Challenge of Violence. [Student Text and] Teacher's Guide.

ERIC Educational Resources Information Center

Croddy, Marshall; Degelman, Charles; Hayes, Bill

This document addresses violence as one of the key challenges facing the democratic and pluralistic republic under the framework of the Constitution and its Bill of Rights. Primary focus is on criminal violence and the factors and behaviors that contribute to violent crime. The text is organized into three chapters: (1) "The Problem of…

Issues and Challenges in Higher Education Leadership: Engaging for Change

ERIC Educational Resources Information Center

Drew, Glenys

2010-01-01

It is proposed from this study that engaging productively with others to achieve change has never been more critical in educational environments, such as universities. Via semi-structured interviews with a cohort of senior leaders from one Australian university, this paper explores their perceptions of the key issues and challenges facing them in…

Open Educational Resources (OER): Opportunities and Challenges for Indian Higher Education

ERIC Educational Resources Information Center

Dutta, Indrajeet

2016-01-01

Creation of knowledge workers holds key for success of a country. Unfortunately, many of the countries though having chain of human resources yet are unable to transform human resources to their advantage as they face multiple challenges like poverty, poor economy, poor infrastructure, limited access to education and inadequate technological…

Responding to Our Critics : From Crisis to Opportunity in Research on Teacher Education

ERIC Educational Resources Information Center

Grossman, Pam

2008-01-01

This article uses Andrew Abbott's concept of jurisdictional challenge to analyze the current challenges facing university-based teacher educators. The author suggests that teacher educators are dangerously close to losing jurisdiction over two key professional tasks--the preparation of new professionals and the production of academic knowledge for…

Creating Safe Schools: Roles and Challenges, a Federal Perspective.

ERIC Educational Resources Information Center

Modzeleski, William

1996-01-01

Presents an overview of the Safe and Drug-Free Schools and Communities Act, a key federal program that provides funding directly to states and local educational agencies to facilitate drug and violence prevention programs. The Gun-Free Schools Act is also examined, and the major challenges communities face in correcting school safety problems are…

Planning Lessons for Refugee-Background Students: Challenges and Strategies

ERIC Educational Resources Information Center

Miller, Jennifer; Windle, Joel Austin; Yazdanpanah, Lilly K.

2014-01-01

This article examines the ways teachers plan lessons for English as an Additional Language (EAL) students from refugee backgrounds in secondary school transition programs. Based on a study of teachers working with students in three Victorian schools, we identify the key challenges teachers face in planning and the strategies they adopt to confront…

Challenges Faced by Key Stakeholders Using Educational Online Technologies in Blended Tertiary Environments

ERIC Educational Resources Information Center

Tuapawa, Kimberley

2016-01-01

Traditional learning spaces have evolved into dynamic blended tertiary environments (BTEs), providing a modern means through which tertiary education institutes (TEIs) can augment delivery to meet stakeholder needs. Despite the significant demand for web-enabled learning, there are obstacles concerning the use of EOTs, which challenge the…

Recovering from 30 Years of War: Refugee Women and Children in Angola.

ERIC Educational Resources Information Center

Women's Commission for Refugee Women and Children, New York, NY.

After 30 years of war, Angola faces the challenge of creating a civil society. This report presents key findings of a visit to Angola, December 1-13, 1996, by the Women's Commission for Refugee Women and Children. The report describes conditions facing women and children affected by war in Angola, addresses the return process of refugees from…

Development of Cryogenic Engine for GSLV MkIII: Technological Challenges

NASA Astrophysics Data System (ADS)

Praveen, RS; Jayan, N.; Bijukumar, KS; Jayaprakash, J.; Narayanan, V.; Ayyappan, G.

2017-02-01

Cryogenic engine capable of delivering 200 kN thrust is being developed for the first time in the country by ISRO for powering the upper stage of GSLV Mk-III, the next generation launch vehicle of ISRO capable of launching four tonne class satellites to Geo-synchronous Transfer Orbit(GTO). Development of this engine started a decade ago when various sub-systems development and testing were taken up. Starting with injector element development, the design, realization and testing of the major sub-systems viz the gas generator, turbopumps, start-up system and thrust chamber have been successfully done in a phased manner before conducting a series of developmental tests in the integrated engine mode. Apart from the major sub-systems, many critical components like the igniter, control components etc were independently developed and qualified. During the development program many challenges were faced in almost all areas of propulsion engineering. Systems engineering of the engine was another key challenge in the realization. This paper gives an outlook on various technological challenges faced in the key areas related to the engine development, insight to the solutions and measures taken to overcome the challenges.

Threats to family planning services in Michigan: organizational responses to economic and political challenges.

PubMed

Dalton, Vanessa K; Jacobson, Peter D; Berson-Grand, Julie; Weisman, Carol S

2005-01-01

Title X is the only federal funding specifically for contraception and family planning services. This study identifies the threats and challenges Title X family planning organizations face in Michigan, and examines organizational responses to these challenges. We hypothesized that organizational responses to current challenges, including recent legislation, would differ between organizational types. We used a multiple case study design to examine safety net providers that received Title X funding in 2001. Cases were selected to represent economic and geographic diversity and included a mix of population densities. Key informants at each organization participated in face-to-face, semistructured interviews. Interviews collected data on current challenges, organizational planning processes, and organizational responses. All Title X organizations reported significant challenges, including rising costs, increasing need, and inadequate funding. Private organizations were more concerned about political challenges, especially recent Michigan legislation, than health departments. Organizational type was associated with the type of response. Health departments tended to close clinics or cut services, whereas private organizations recruited insured populations and increased patient fees. Based on these findings, the family planning safety net in Michigan appears to be undergoing significant change. These changes may decrease the availability of affordable family planning services in Michigan.

Closing the Gap: Supporting Patients’ Transition to Self-Management after Hospitalization

PubMed Central

Pollack, Ari H; Backonja, Uba; Miller, Andrew D.; Mishra, Sonali R.; Khelifi, Maher; Kendall, Logan; Pratt, Wanda

2016-01-01

Patients going home after a hospitalization face many challenges. This transition period exposes patients to unnecessary risks related to inadequate preparation prior to leaving the hospital, potentially leading to errors and patient harm. Although patients engaging in self-management have better health outcomes and increased self-efficacy, little is known about the processes in place to support and develop these skills for patients leaving the hospital. Through qualitative interviews and observations of 28 patients during and after their hospitalizations, we explore the challenges they face transitioning from hospital care to self-management. We identify three key elements in this process: knowledge, resources, and self-efficacy. We describe how both system and individual factors contribute to breakdowns leading to ineffective patient management. This work expands our understanding of the unique challenges faced by patients during this difficult transition and uncovers important design opportunities for supporting crucial yet unmet patient needs. PMID:27500285

Doing qualitative research on suicide in a developing country: practical and ethical challenges.

PubMed

Mugisha, James; Knizek, Birthe Loa; Kinyanda, Eugene; Hjelmeland, Heidi

2011-01-01

This article describes and discusses the challenges faced by researchers who conducted a qualitative interview study on attitudes toward suicide among the Baganda, Uganda. Many of the challenges addressed in this article have not been described earlier in suicide research conducted in the developing world. The aim of this study was to explore attitudes and cultural responses toward suicide among the Baganda, Uganda. Data were collected and analyzed using grounded theory. A total of 28 focus group discussions and 30 key informant interviews were conducted. The findings of this study are organized under two broad categories: community access challenges and expectation challenges. Community access challenges entailed cultural, legal, rapport, informed consent, language, and other research process related issues that could hinder effective access to the study respondents. Expectation challenges concerned how to deal with the immediate and strategic needs of the study communities. This study demonstrates that culturally sensitive approaches to data collection can reduce ethical challenges and, through innovative approaches, practical challenges faced during data collection can be minimized.

Fostering Creative Engineers: A Key to Face the Complexity of Engineering Practice

ERIC Educational Resources Information Center

Zhou, Chunfang

2012-01-01

Recent studies have argued a shift of thinking about engineering practice from a linear conception to a system understanding. The complexity of engineering practice has been thought of as the root of challenges for engineers. Moreover, creativity has been emphasised as one key capability that engineering students should master. This paper aims to…

Facing Up to the Learning Organisation Challenge: Key Issues from a European Perspective. Volume I. CEDEFOP Reference Series.

ERIC Educational Resources Information Center

Nyhan, Barry; Cressey, Peter; Tomassini, Massimo; Kelleher, Michael; Poell, Rob

This first volume of a two-volume publication provides an analytical overview of main questions emerging from recent European research and development projects related to the learning organization. Chapter 1 provides context for the European learning organization challenge and presents four main messages arising from the learning organization…

What Would Terri Want? On the Psychological Challenges of Surrogate Decision Making

ERIC Educational Resources Information Center

Ditto, Peter H

2006-01-01

The Terri Schiavo case was unique in the media attention it garnered, but the decision making challenges faced by Terri's family are common ones encountered by all families who must make choices about the use of life-sustaining medical treatment for an incapacitated loved one. This article highlights three key issues that were particularly…

The Lisbon Strategy Challenges to the Czech Republic Human Resources

ERIC Educational Resources Information Center

Kaderabkova, Anna

2005-01-01

When achieving long-term sustainable growth, the key role is assigned to knowledge-based competitiveness. The new EU Member States therefore face a double challenge on the Lisbon road. On the one hand, higher expenditure is required to improve the quality of research and education input and infrastructure, and on the other, innovation system…

Connecting Thought and Action: The Challenge for Liberal Arts Presidents

ERIC Educational Resources Information Center

Coleman, Elizabeth

2004-01-01

In this article, the author describes a key challenge facing liberal arts presidents: to accommodate a reciprocal relationship between thinking and doing. Achieving a continuum between thought and action has never been easy--on the academic side is the fear of diluting intellectual rigor matched on the practical side by the fear of paralysis.…

Creative and Functional Education: The Challenges and Prospects in a Comatose Economy

ERIC Educational Resources Information Center

Agbowuro, Christine; Saidu, Shuaibu; Jimwan, Christiana S.

2017-01-01

Creativity is a key driver in the global economy. However, in the majority of national curricula creativity is perceived as secondary in many subjects. Unfortunately this means that students leave school without knowing how to create and innovate, consequently they will be under prepared for challenges that our society and economies are facing. In…

Challenges and Opportunities for School Improvement: Recommendations for Urban School Principals

ERIC Educational Resources Information Center

Dolph, David

2017-01-01

Insofar as urban school systems that are often identified as ineffective include such a large segment of U.S. P-12 students, it is vital to improve academic success. To provide context, the article first discusses key challenges facing urban schools. Second, the article identifies and briefly reviews a variety of approaches to reform models often…

The Challenges of Planning Individualized Programmes for Gifted Students

ERIC Educational Resources Information Center

Senicar, Maruška Željeznov

2016-01-01

Individualized programmes for gifted students are one of the ways in which curricula can be adapted to take account of the identified educational needs of gifted students. Planning is a key phase in ensuring that these programmes are carried out in a high-quality manner. This article explores the challenges faced in the planning of individualized…

Collaborating on Global Priorities: Science Education for Everyone--Any Time and Everywhere

ERIC Educational Resources Information Center

Tobin, Kenneth

2016-01-01

Building on the key ideas from Dana Zeidler's paper I expand the conversation from the standpoint that the challenges facing humanity and the capacity of Earth to support life suggest that changes in human lifestyles are a priority. Accordingly, there is an urgent need to educate all humans about some of the science-related grand challenges, such…

Adult Learners in Higher Education: Barriers to Success and Strategies to Improve Results. Employment and Training Administration. Occasional Paper 2007-03

ERIC Educational Resources Information Center

Kazis, Richard; Callahan, Abigail; Davidson, Chris; McLeod, Annie; Bosworth, Brian; Choitz, Vickie; Hoops, John

2007-01-01

This reports synthesizes the research literature on the challenges facing adult learners in higher education today and emerging strategies for increasing the number of adults over 24 who earn college credentials and degrees. This synthesis is meant to provide perspectives on key issues facing adults as more and more of them see the need for higher…

Hydrogen applications for Lambert-St. Louis International Airport

DOT National Transportation Integrated Search

2009-01-01

Today, major airports are facing challenges related to pollution, energy efficiency, and safety and security. Hydrogen and fuel cell technologies, regarded as one of the key energy solutions of the 21st century are more energy efficient and reliable ...

Speak Softly & Carry Your Own Gym Key: A Female High School Principal's Guide to Survival.

ERIC Educational Resources Information Center

Hicks, Anna T.

This book is a series of personal accounts of the challenges faced by one female high school principal. The text recites a lengthy list of difficulties many women confront in their role as educational leaders. The book provides advice on day-to-day experiences, from carrying a walkie-talkie to obtaining a key to the gymnasium. The importance of a…

Finland could become the world leader in horizontal and vertical integration—reason for enthusiasm or worry? …

PubMed Central

Kokko, Simo

2010-01-01

This keynote paper examines how the development of integrated care in Finland has become a key aspect of health and welfare reforms in recent years. However, it poses questions as to whether future reforms to the Finnish system will continue to support care integration and outlines many of the key challenges faced in supporting such an agenda.

Simplified web-based decision support method for traffic management and work zone analysis.

DOT National Transportation Integrated Search

2017-01-01

Traffic congestion mitigation is one of the key challenges that transportation planners and operations engineers face when planning for construction and maintenance activities. There is a wide variety of approaches and methods that address work zone ...

Simplified web-based decision support method for traffic management and work zone analysis.

DOT National Transportation Integrated Search

2015-06-01

Traffic congestion mitigation is one of the key challenges that transportation planners and operations engineers face when : planning for construction and maintenance activities. There is a wide variety of approaches and methods that address work : z...

The Impact of a School-Based Enterprise Program on the Achievement and Behavior of Special Education Students Attending High Schools in South Carolina

ERIC Educational Resources Information Center

Pilot, Grover Cleve

2011-01-01

Our nation's K-12 schools are faced with numerous critical challenges that affect student achievement and consequently impact society. Key challenges, such as elevating academic achievement, meeting state and No Child Left Behind (NCLB) standards, high dropout rates, at-risk students, parental involvement, and the recruitment and retention of…

Service-Learning Might Be the Key: Learning from the Challenges and Implementation Strategies in EFL Teacher Education in Oman

ERIC Educational Resources Information Center

Al Barwani, Thuwayba; Al-Mekhlafi, Abdo; Nagaratnam, Ramani Perur

2013-01-01

Service-learning, a major reform in higher education, is considered essential for developing citizenship for the 21st century. This paper reports a study aimed at investigating the problems and challenges faced when implementing service-learning in pre-service education of teachers of English as a Foreign Language (EFL) and carried out in the…

Community Connectedness, Challenges, and Resilience Among Gay Latino Immigrants

PubMed Central

Gray, Nicole N.; Mendelsohn, David M.; Omoto, Allen M.

2016-01-01

To date, relatively little psychological research has focused on the experiences of lesbian, gay, bisexual, and transgender (LGBT) Latino/a immigrants to the United States. This qualitative study used face-to-face semi-structured interviews to explore the unique sources of stress, challenges, as well as opportunities and factors related to resilience among 13 gay Latino first- and second-generation immigrants. Iterative coding of interview transcripts revealed four key themes, each of which is illustrated with verbatim quotes: 1) feelings of connectedness to the LGBT community, 2) feelings of connectedness to the Latino/a community, 3) intersectional challenges and strategies, and 4) well-being, strength, and resilience. As suggested by these themes, gay Latino immigrants have distinct sources of stress and conflict, many of them associated with community memberships, but also draw on unique sources of support and adaptive thoughts and behaviors in facing stressors. Implications for studying risk and resilience factors among stigmatized populations, including LGBT individuals and immigrants, are discussed. PMID:25576015

Globalization of S&T: Key Challenges Facing DOD

DTIC Science & Technology

2012-02-01

expertise at a very early stage in areas where new concepts are being proposed. Trusted agents should not have vested interests ( pro or con ) regarding...Scanning 14. Scenario Workshops 15. Science Fictioning 16. Simulation Gaming 17. Surveys 18. SWOT Analysis 19. Weak Signals

Beyond Affirmative Action: Leadership Diversity That Works.

ERIC Educational Resources Information Center

Gilliland, J. Richard

1990-01-01

Contends that community colleges need to make full use of leadership talents and capabilities of women and persons of color. Identifies key challenge facing community colleges in 1990s is to develop leadership teams that represent diversity of their students and community constituents. (NB)

Managing the pursuit of health and wealth: the key challenges.

PubMed

Fidler, David P; Drager, Nick; Lee, Kelley

2009-01-24

This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.

Managing the pursuit of health and wealth: the key challenges

PubMed Central

Fidler, David P; Drager, Nick; Lee, Kelley

2009-01-01

This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series. PMID:19167061

Perspectives on the role of stakeholders in knowledge translation in health policy development in Uganda.

PubMed

Nabyonga Orem, Juliet; Marchal, Bruno; Mafigiri, DavidKaawa; Ssengooba, Freddie; Macq, Jean; Da Silveira, Valeria Campos; Criel, Bart

2013-08-19

Stakeholder roles in the application of evidence are influenced by context, the nature of the evidence, the policy development process, and stakeholder interactions. Past research has highlighted the role of stakeholders in knowledge translation (KT) without paying adequate attention to the peculiarities of low-income countries. Here we identify the roles, relations, and interactions among the key stakeholders involved in KT in Uganda and the challenges that they face. This study employed qualitative approaches to examine the roles of and links among various stakeholders in KT. In-depth interviews were conducted with 21 key informants and focused on the key actors in KT, their perceived roles, and challenges. Major stakeholders included civil society organizations with perceived roles of advocacy, community mobilization, and implementation. These stakeholders may ignore unconvincing evidence. The community's role was perceived as advocacy and participation in setting research priorities. The key role of the media was perceived as knowledge dissemination, but respondents noted that the media may misrepresent evidence if it is received in a poorly packaged form. The perceived roles of policy makers were evidence uptake, establishing platforms for KT and stewardship; negative roles included ignoring or even misrepresenting evidence that is not in their favor. The roles of parliamentarians were perceived as advocacy and community mobilization, but they were noted to pursue objectives that may not be supported by the evidence. The researchers' main role was defined as evidence generation, but focusing disproportionately on academic interests was cited as a concern. The donors' main role was defined as funding research and KT, but respondents were concerned about the local relevance of donor-supported research. Respondents reported that links among stakeholders were weak due to the absence of institutionalized, inclusive platforms. Challenges facing the stakeholders in the process of KT were identified. Our investigation revealed the need to consider the roles that various stakeholders are best placed to play. Links and necessary platforms must be put in place to achieve synergy in KT. Relevant capacities need to be built to overcome the challenges faced by the various stakeholders.

Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?

PubMed

Rabbani, Fauziah; Shipton, Leah; White, Franklin; Nuwayhid, Iman; London, Leslie; Ghaffar, Abdul; Ha, Bui Thi Thu; Tomson, Göran; Rimal, Rajiv; Islam, Anwar; Takian, Amirhossein; Wong, Samuel; Zaidi, Shehla; Khan, Kausar; Karmaliani, Rozina; Abbasi, Imran Naeem; Abbas, Farhat

2016-09-07

Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries.

Policies for managing urban growth and landscape change: a key to conservation in the 21st century

Treesearch

David N., tech. ed. Bengston

2005-01-01

Protecting natural areas in the face of urbanization is one of the most important challenges for conservation in the 21st century. The papers in this collection examine key issues related to growth management and selected approaches to managing urban growth and minimizing its social and environmental costs. They were presented at the 2004 annual meeting of the Society...

Toward Impactful Collaborations on Computing and Mental Health

PubMed Central

Dinakar, Karthik; Picard, Rosalind; Christensen, Helen; Torous, John

2018-01-01

We describe an initiative to bring mental health researchers, computer scientists, human-computer interaction researchers, and other communities together to address the challenges of the global mental ill health epidemic. Two face-to-face events and one special issue of the Journal of Medical Internet Research were organized. The works presented in these events and publication reflect key state-of-the-art research in this interdisciplinary collaboration. We summarize the special issue articles and contextualize them to present a picture of the most recent research. In addition, we describe a series of collaborative activities held during the second symposium and where the community identified 5 challenges and their possible solutions. PMID:29426812

Water and fire safety issues addressed.

PubMed

Arrowsmith, Mike

2014-11-01

One of the four conference streams at last month's Healthcare Estates 2014 event focused on some of the key engineering challenges and opportunities facing healthcare estates managers and healthcare engineers. Mike Arrowsmith, HEJ's technical editor, provides an overview of the engineering sessions at this year's IHEEM conference.

Progress in Cytogenetics: Implications for Child Psychopathology

ERIC Educational Resources Information Center

Hoffman, Ellen J.; State, Matthew W.

2010-01-01

Objective: This review considers the impact of chromosomal studies on the understanding of childhood neuropsychiatric syndromes, highlighting key discoveries, advances in technology, and new challenges faced by clinicians trying to interpret recent findings. Method: We review the literature on the genetics of child psychiatric disorders, including…

Improved guidance for users of the 1993 AASHTO flexible pavement design procedures : LTPP TechBrief

DOT National Transportation Integrated Search

1997-08-01

A key design challenge faced by engineers using the 1993 AASHTO Guide for Design of Pavement Structures (AASHTO Guide) is the determination of appropriate design parameters for the subgrade and pavement materials. The Long-Term Pavement Performance (...

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

PubMed

Trafford, Anne; Jane, Danielle

2017-01-01

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

Optimizing Cognitive Rehabilitation: Effective Instructional Methods

ERIC Educational Resources Information Center

Sohlberg, McKay Moore; Turkstra, Lyn S.

2011-01-01

Rehabilitation professionals face a key challenge when working with clients with acquired cognitive impairments: how to teach new skills to individuals who have difficulty learning. Unique in its focus, this book presents evidence-based instructional methods specifically designed to help this population learn more efficiently. The expert authors…

Concepts for Telephone-Based Health Education

ERIC Educational Resources Information Center

Brouse, Corey H.; Basch, Charles E.

2004-01-01

A key challenge facing cancer educators is the extent to which effective programmes can be widely disseminated and implemented. Differences between target populations with respect to social, psychological, and educational characteristics, as well as the social and economic context make it difficult to replicate "cookbook" approaches. Tailoring of…

Preparing Mathematics Teachers for Technology-Rich Environments

ERIC Educational Resources Information Center

Sturdivant, Rodney X.; Dunham, Penelope; Jardine, Richard

2009-01-01

This article describes key elements for faculty development programs to prepare mathematics teachers for technology-rich environments. We offer practical examples from our experiences in teaching mathematics with technology and in teaching others to incorporate technology-based pedagogies. We address challenges faced by faculty using technology,…

Transportation, Equity, and Communities at Risk : Refugee Population and Transportation Accessibility in Vermont.

DOT National Transportation Integrated Search

2011-03-01

This study suggests that transportation is one of the key issues and challenges facing newcomers to Vermont. For refugees and immigrants as for other members of the general population, being able to get to work, school, and medical appointments on ti...

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

PubMed Central

Maphosa, France

2017-01-01

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

Dealing with innovation and costs in orthopedics: a conversation with Dane Miller. Interview by Lawton R Burns.

PubMed

Miller, Dane

2006-01-01

Rob Burns talks with Dane Miller, former CEO of Biomet, about challenges posed by new technology in the orthopedic devices area. One key challenge is the rising cost and use of orthopedic devices at a time when providers are facing decreased profitability and reimbursement for orthopedic services. Another challenge is the long-term time horizon needed to gauge product success that contrasts with payers' and providers' short-term horizon. A third challenge is heightened governmental scrutiny of device makers' relationships with orthopedic surgeons. This interview was conducted before Miller left Biomet in March 2006.

Introducing IT Strategy in an Introductory Course

ERIC Educational Resources Information Center

Woods, David M.

2016-01-01

Professionals working in technology fields face continuing challenges to be involved in the decision-making process about how technology is used by organizations rather than just implementing these decisions. Developing skills for thinking and acting strategically are key skills for our students. This has been recognized by the addition of an IS…

Higher Expectations: Essays on the Future of Postsecondary Education.

ERIC Educational Resources Information Center

National Governors' Association, Washington, DC. Center for Best Practices.

The essays in this collection were commissioned to launch an initiative focusing on state policies to respond to the challenges facing higher education in the new century. The initiative will engage governors and their key advisors in three priorities: increasing student access, learning, and degree attainment; building and sustaining seamless…

Preparing STEM Teachers: The Key to Global Competitiveness

ERIC Educational Resources Information Center

American Association of Colleges for Teacher Education (NJ1), 2007

2007-01-01

Like many sectors in society, the teacher preparation community is working to address challenges the nation faces in relation to global competitiveness. This document highlights institutions around the country that are preparing tomorrow's teachers in the fields of science, technology, engineering, and mathematics (STEM). Well-known shortages of…

Raise the Bar on Problem Solving

ERIC Educational Resources Information Center

Englard, Lisa

2010-01-01

In a 1981 diagnostic test, the Ministry of Education in Singapore found its country facing a challenge: Only 46 percent of students in grades 2-4 could solve word problems that were presented without such key words as "altogether" or "left." Yet today, according to results from the Trends in International Mathematics and…

Pentecostal Theology of Mission in the Making

ERIC Educational Resources Information Center

Karkkainen, Veli-Matti

2004-01-01

While Pentecostals are known for productive and widespread mission work, theological reflection has not kept up with praxis. In recent years, however, a number of leading Pentecostal theologians have started to reflect on key issues such as what are the underlying motifs and distinguishing features as well as urgent challenges facing Pentecostal…

Mystery Fractions

ERIC Educational Resources Information Center

Bhattacharyya, Sonalee; Namakshi, Nama; Zunker, Christina; Warshauer, Hiroko K.; Warshauer, Max

2016-01-01

Making math more engaging for students is a challenge that every teacher faces on a daily basis. These authors write that they are constantly searching for rich problem-solving tasks that cover the necessary content, develop critical-thinking skills, and engage student interest. The Mystery Fraction activity provided here focuses on a key number…

Helping Year 7 Put Some Flesh on Roman Bones

ERIC Educational Resources Information Center

Podesta, Ed

2012-01-01

Like many other history departments nationally, Ed Podesta and his colleagues face a daunting practical challenge: redesigning three years' historical learning so that it can fit into a compressed two-year Key Stage 3, whilst enhancing, rather than compromising, the quality of students' historical learning. Podesta's article reports the beginning…

Teacher Training in Afghanistan: Intersections of Need and Reality

ERIC Educational Resources Information Center

Husting, Sheila; Intili, Jo Ann; Kissam, Edward

2008-01-01

As post-Taliban Afghanistan moves toward the establishment of a viable educational system, key stakeholders and donors are faced with the formidable challenge of how to most rapidly implement teacher training within an environment of diverse, changing, and largely unassessed training needs. The current article explores the dilemmas inherent in…

Operating School Meal Programs in Rural Districts: Challenges and Solutions

ERIC Educational Resources Information Center

Hoffman, Vanessa; Srinivasan, Mithuna; Levin, Madeleine; Scarmo, Stephanie

2018-01-01

Purpose/Objectives: The goal of this study was to explore unique issues that rural school nutrition professionals face in operating successful school meal programs, and their strategies for overcoming those barriers. Methods: This study was conducted through 10 key informant interviews and three focus groups with rural school nutrition…

Professional Development: Teachers Use of GIS to Enhance Student Learning

ERIC Educational Resources Information Center

McClurg, Patricia A.; Buss, Alan

2007-01-01

This article explains a professional development experience of fifth to twelfth grade teachers in using geographic information systems (GIS) and global positioning systems (GPS) technologies to enhance classroom teaching and learning environments. A key challenge faced by the developers was whether teachers would value the technology tools enough…

Keys to success for data-driven decision making: Lessons from participatory monitoring and collaborative adaptive management

USDA-ARS?s Scientific Manuscript database

Recent years have witnessed a call for evidence-based decisions in conservation and natural resource management, including data-driven decision-making. Adaptive management (AM) is one prevalent model for integrating scientific data into decision-making, yet AM has faced numerous challenges and limit...

A Needs Assessment of International Students' Wives

ERIC Educational Resources Information Center

Martens, Vonda Plett; Grant, Peter R.

2008-01-01

Despite the unique adjustment challenges facing international students' spouses, little research has focused on their adjustment experiences or their programming needs. Understanding the adjustment of these individuals is important both in itself and because spouses play a key role in the adjustment and academic success of international students.…

Identifying and Addressing Themes of Job Dissatisfaction for Secondary Principals

ERIC Educational Resources Information Center

De Jong, David; Grundmeyer, Trent; Yankey, Julie

2017-01-01

Secondary principals serve in important roles that are complex, high-stress, and include demanding job responsibilities. Key stakeholders such as superintendents, school board members, and legislators must understand the challenges facing secondary principals in order to address the current themes of job dissatisfaction. Using new survey data…

Current Issues Survey Report, 2007

ERIC Educational Resources Information Center

Camp, John S.; DeBlois, Peter B.

2007-01-01

The Eighth Annual EDUCAUSE Current Issues Survey asked campus information technology leaders to rate the most critical IT challenges facing them, their campuses, and/or their systems. Four findings associated with all respondents to this year's survey merit special mention. First, for the 2007 survey, the CIC decided to split a key issue choice…

Coping with Economic Uncertainty: Focus on Key Risks Essential

ERIC Educational Resources Information Center

Sander, Laura

2009-01-01

During this period of continued economic uncertainty, higher-education institutions are facing a variety of challenges that by now are very familiar to governing boards and institutional leaders, including poor investment returns, reduced liquidity, limited choices in how they structure debt issues, and threats to flexibility in tuition pricing.…

TALIS 2013 Technical Report: Teaching and Learning International Survey

ERIC Educational Resources Information Center

OECD Publishing, 2013

2013-01-01

Effective teaching and teachers are key to producing high-performing students worldwide. So how can countries prepare teachers to face the diverse challenges in today's schools? The Teaching and Learning International Survey (TALIS) helps answer this question. TALIS asks teachers and schools about their working conditions and the learning…

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

PubMed

Raab, G Gregory; Parr, David H

2006-10-01

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

Adaptive Management: From More Talk to Real Action

NASA Astrophysics Data System (ADS)

Williams, Byron K.; Brown, Eleanor D.

2014-02-01

The challenges currently facing resource managers are large-scale and complex, and demand new approaches to balance development and conservation goals. One approach that shows considerable promise for addressing these challenges is adaptive management, which by now is broadly seen as a natural, intuitive, and potentially effective way to address decision-making in the face of uncertainties. Yet the concept of adaptive management continues to evolve, and its record of success remains limited. In this article, we present an operational framework for adaptive decision-making, and describe the challenges and opportunities in applying it to real-world problems. We discuss the key elements required for adaptive decision-making, and their integration into an iterative process that highlights and distinguishes technical and social learning. We illustrate the elements and processes of the framework with some successful on-the-ground examples of natural resource management. Finally, we address some of the difficulties in applying learning-based management, and finish with a discussion of future directions and strategic challenges.

Challenges confronting female surgical leaders: overcoming the barriers.

PubMed

Kass, Rena B; Souba, Wiley W; Thorndyke, Luanne E

2006-05-15

The number of women reaching top ranks in academic surgery is remarkably low. The purpose of this study was to identify: 1) barriers to becoming a female surgical leader; 2) key attributes that enable advancement and success; and 3) current leadership challenges faced as senior leaders. Semi-structured interviews of ten female surgical leaders queried the following dimensions: attributes for success, lessons learned, mistakes, key career steps, the role of mentoring, gender advantages/disadvantages, and challenges. Perseverance (60%) and drive (50%) were identified as critical success factors, as were good communication skills, a passion for scholarship, a stable home life and a positive outlook. Eighty percent identified discrimination or gender prejudice as a major obstacle in their careers. While 90% percent had mentors, 50% acknowledged that they had not been effectively mentored. Career advice included: develop broad career goals (50%); select a conducive environment (30%); find a mentor (60%); take personal responsibility (40%); organize time and achieve balance (40%); network (30%); create a niche (30%); pursue research (30%); publish (50%); speak in public (30%); and enjoy the process (30%). Being in a minority, being highly visible and being collaborative were identified as advantages. Obtaining buy-in and achieving consensus was the greatest leadership challenge reported. Female academic surgeons face challenges to career advancement. While these barriers are real, they can be overcome by resolve, commitment, and developing strong communication skills. These elements should be taken into consideration in designing career development programs for junior female surgical faculty.

Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda

PubMed Central

2014-01-01

Introduction Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. Methods This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs’ representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. Results The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. Conclusion People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities. PMID:25086444

Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda.

PubMed

Ahumuza, Sharon Eva; Matovu, Joseph K B; Ddamulira, John Bosco; Muhanguzi, Florence Kyoheirwe

2014-08-02

Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs' representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities.

A call to action.

PubMed

Thompson, Tommy G

2006-01-01

To summarize the challenges facing the U.S. health care system between now and 2013. Between now and 2013, the American health care system will need to make major changes to successfully address Medicare's funding challenges. Making the patient a partner in care, developing systems that promote and reward prevention efforts, and ensuring that health care purchasers understand and pursue value will be key. The growing prevalence of diabetes and cardiometabolic conditions is one area in which concerted efforts are needed.

Stakeholders' views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs.

PubMed

Kalkman, Shona; van Thiel, Ghislaine J M W; Grobbee, Diederick E; Meinecke, Anna-Katharina; Zuidgeest, Mira G P; van Delden, Johannes J M

2016-08-22

We explored the views of key stakeholders to identify the ethical challenges of pragmatic trials investigating pharmaceutical drugs. A secondary aim was to capture stakeholders' attitudes towards the implementation of pragmatic trials in the drug development process. We conducted semistructured, in-depth interviews among individuals from different key stakeholder groups (academia and independent research institutions, the pharmaceutical industry, regulators, Health Technology Assessment (HTA) agencies and patients' organizations) through telephone or face-to-face sessions. Interviews were structured around the question "what challenges were experienced or perceived during the design, conduct and/or review of pragmatic trials." Respondents were additionally asked about their views on implementation of pragmatic trials in the drug development process. Thematic analysis was used to identify the ethically relevant features across data sets. We interviewed 34 stakeholders in 25 individual sessions and four group sessions. The four perceived challenges of ethical relevance were: (1) less controlled conditions creating safety concerns, (2) comparison with usual care potentially compromising clinical equipoise, (3) tailored or waivers of informed consent affecting patient autonomy, and (4) minimal interference with "real-world" practice reducing the knowledge value of trial results. We identified stakeholder concerns regarding risk assessment, use of suboptimal usual care as a comparator, tailoring of informed consent procedures and ensuring the social value of pragmatic trials. These concerns increased when respondents were asked about pragmatic trials conducted before market authorization.

Physician leaders of medical groups face increasing challenges.

PubMed

Gerbarg, Zack

2002-10-01

Physician leadership has emerged as one of the biggest challenges and opportunities for medical group success. The environment for medical groups has become increasingly complex as the result of five major factors: 1) varying reimbursement methods, 2) growth in the size of groups, 3) technology investments, 4) sale and merger of groups, and 5) regulatory and legal issues. Striking the right balance between too little or too much physician involvement in leading medical groups is a key business decision. Most large, successful businesses view investment in their leaders as critical for success. Medical groups can learn from other businesses that investment in education, coaching, and succession planning for leaders is a key to long-term success.

Shared Electronic Health Record Systems: Key Legal and Security Challenges.

PubMed

Christiansen, Ellen K; Skipenes, Eva; Hausken, Marie F; Skeie, Svein; Østbye, Truls; Iversen, Marjolein M

2017-11-01

Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

Smart textiles: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Cherenack, Kunigunde; van Pieterson, Liesbeth

2012-11-01

Smart textiles research represents a new model for generating creative and novel solutions for integrating electronics into unusual environments and will result in new discoveries that push the boundaries of science forward. A key driver for smart textiles research is the fact that both textile and electronics fabrication processes are capable of functionalizing large-area surfaces at very high speeds. In this article we review the history of smart textiles development, introducing the main trends and technological challenges faced in this field. Then, we identify key challenges that are the focus of ongoing research. We then proceed to discuss fundamentals of smart textiles: textile fabrication methods and textile interconnect lines, textile sensor, and output device components and integration of commercial components into textile architectures. Next we discuss representative smart textile systems and finally provide our outlook over the field and a prediction for the future.

Professional Development. The Evaluation Exchange. Volume 11, Number 4, Winter 2005-2006

ERIC Educational Resources Information Center

DeDeo, Carrie-Anne, Ed.

2006-01-01

This issue hones in on professional development in four key sectors affecting children, youth, and families--K-12 education, early childhood education, child welfare, and youth development. Though these sectors face many of the same professional development challenges, each has its own unique issues, strengths, and goals. The staffing shortage in…

Higher Education in Ethiopia: Expansion, Quality Assurance and Institutional Autonomy

ERIC Educational Resources Information Center

Akalu, Girmaw Abebe

2014-01-01

This article chronicles the key challenges facing Ethiopia as it embarks on an ambitious, ideologically-driven and aggressive expansion of its higher education system in an effort to address its national goals of economic growth and poverty reduction. It is argued that the urge for higher education expansion has placed undue pressures particularly…

Teacher Education and Development Policies: Critical Discourse Analysis from a Comparative Perspective

ERIC Educational Resources Information Center

Pini, Monica E.; Gorostiaga, Jorge M.

2008-01-01

The purpose of this study is to explore teacher education policies in different countries of Latin America and North America through the comparison of policy documents. The training of teachers, a key component of education, faces educational challenges as a result of various reform policies in different countries. Critical discourse analysis…

Essays on the Economics of Education in Developing Countries

ERIC Educational Resources Information Center

Sharma, Uttam

2012-01-01

This dissertation focuses on a key challenge facing developing countries intent on enhancing their human capital base--namely, the issue of quality. One of the chapters evaluates the effectiveness of the One Laptop per Child (OLPC) initiative in Nepal's primary and lower-secondary schools. Although the OLPC program is being heavily promoted in…

Supporting the Transition of Sophomores, Transfers, and Seniors: Opportunities for Residence Life Professionals

ERIC Educational Resources Information Center

Kranzow, Jeannine; Foote, Stephanie M.; Hinkle, Sara E.

2015-01-01

College students transitioning to their sophomore year, those transferring to a new institution, and seniors transitioning out of higher education face various challenges and struggles. The literature on the transitions associated with these student populations indicates that they need sustained support in a few key areas that include student and…

Entrepreneurial Learning in Vocational Education and Training in Albania

ERIC Educational Resources Information Center

Oldroyd, David; Nikolovska, Margareta; Xhillari, Lindita

2011-01-01

This report follows an exploratory investigation of the situation and policies relating to entrepreneurial learning in Albania, as part of ETF 2009 country activities. A research project on entrepreneurial learning has been set up in Albania, aiming to help the key country stakeholders to comprehend the challenges that the country is facing,…

A Conceptual Model for School-Based Management Operation and Quality Assurance in Nigerian Secondary Schools

ERIC Educational Resources Information Center

Ayeni, Adeolu Joshua; Ibukun, Williams Olusola

2013-01-01

This paper examined the School-Based Management Committee's (SBMC) involvement and effectiveness in school governance, curriculum implementation and students' learning outcomes in Nigerian secondary schools; the major challenges facing effective operation of SBMCs were identified as low capacity of key members of the SBMCs; poor attendance of…

Student and Tutor Perspectives of On-Line Moderation

ERIC Educational Resources Information Center

Packham, Gary; Jones, Paul; Thomas, Brychan; Miller, Christopher

2006-01-01

Purpose: The on-line tutor or e-moderator faces a diversity of new challenges, including instructional design, organisation, direct instruction and facilitating discourse. This study aims to contrast the views of students and tutors regarding what factors constitute effective e-moderation in order to identify key attributes of an on-line tutor.…

How Can Organizational and Sociocultural Learning Theories Shed Light on District Instructional Reform?

ERIC Educational Resources Information Center

Knapp, Michael S.

2008-01-01

This article explores how organizational and sociocultural learning theories can help us to understand the problem of system-wide instructional reform in school districts. After briefly summarizing the central challenges facing leaders in such districts, the article reviews key ideas associated with each theoretical lens and considers how each…

Public Policy in Gifted Education

ERIC Educational Resources Information Center

Gallagher, James J., Ed; Reis, Sally M., Ed.

2004-01-01

Raising some of the most challenging questions in the field, this call-to-arms focuses on the important services gifted programs provide, the potential crisis gifted educators face, and what must be done to keep the gifted child movement alive and well. Key features include: (1) James J. Gallagher's unflinching account of the issues that continue…

A Balancing Act: School Budgeting and Resource Allocation on a New Dual Language Campus

ERIC Educational Resources Information Center

Knight, David S.; Izquierdo, Elena; DeMatthews, David E.

2016-01-01

Dual language instructional models have great potential to create inclusive learning environments for traditional under-served students and boost student outcomes. However, principals face many barriers to implementation. One of the key challenges is aligning resources to ensure that the school has (a) an appropriate number of certificated…

A Study of Factors Affecting University Professors' Research Output: Perspectives of Taiwanese Professors

ERIC Educational Resources Information Center

Yang, Jason Cheng-Cheng

2017-01-01

Higher education in Taiwan is facing competition and challenges from the macro environment of globalization. Taiwan's key policy direction is enhancing university quality in order to respond to these future trends. Universities' international competitiveness relies on not only faculty members' teaching quality, but also their research performance.…

Relationship Building One Step at a Time: Case Studies of Successful Faculty-Librarian Partnerships

ERIC Educational Resources Information Center

Díaz, José O.; Mandernach, Meris A.

2017-01-01

Building strong relationships between academic librarians and teaching faculty is paramount for promoting services and resources. While librarians face challenges ranging from new technologies to heightened expectations and fiscal difficulties, the key work remains in solid relationship building. Drawing on the experience of a group of subject…

Decision Points and Considerations for Identifying Rural Districts That Have Closed Student Achievement Gaps. REL 2016-130

ERIC Educational Resources Information Center

Culbertson, Michael J.; Billig, Shelley H.

2016-01-01

Rural districts have long faced challenges in closing achievement gaps between subgroups of students. This brief report describes key decision points and considerations for decision-makers interested in identifying rural districts that have closed academic achievement gaps. Examining practices in these districts may suggest activities associated…

Those Were the Days: Learning about History through Literature

ERIC Educational Resources Information Center

Crawford, Patricia A.; Zygouris-Coe, Vicky

2008-01-01

At a recent professional development program, the authors asked teachers to recall the ways in which they learned about history in the course of their own schooling. The teachers at this professional development gathering not only identified some of the key challenges facing elementary teachers charged with teaching social studies curricula, they…

Developing Sustainable Farmer-Led Extension Groups: Lessons from a Bangladeshi Case Study

ERIC Educational Resources Information Center

Islam, Md. Mofakkarul; Gray, David; Reid, Janet; Kemp, Peter

2011-01-01

The limited effectiveness and fiscal unsustainability of professional-led public sector extension systems in developing countries have aroused considerable interest in Farmer-led Extension (FLE) approaches in the recent decades. A key challenge facing these initiatives is a lack of sustainability of the farmer groups developed through project or…

Beliefs and Values about Intra-Operative Teaching and Learning: A Case Study of Surgical Teachers and Trainees

ERIC Educational Resources Information Center

Ong, Caroline C.; Dodds, Agnes; Nestel, Debra

2016-01-01

Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient…

Leadership and the Force of Love: Six Keys to Motivating with Love.

ERIC Educational Resources Information Center

Hoyle, John R.

Although educators are frequently faced with the challenges of politics, hostility, selfishness, and violence, this book demonstrates that these obstacles can be overcome through vision, teamwork, motivation, empowerment, and communication. By using love as a guiding force in the daily interactions with others, the way one conducts business is…

Designing Educational Social Machines for Effective Feedback

ERIC Educational Resources Information Center

Yee-King, Matthew; Krivenski, Maria; Brenton, Harry; Grimalt-Reynes, Andreu; d'Inverno, Mark

2014-01-01

We report on our development of an educational social machine based on the concept that feedback in communities is an effective means to support the development of communities of learning and practice. Key challenges faced by this work are how best to support educational and social interactions, how to deliver personalised tuition, and how to…

Making Physics Fun: Key Concepts, Classroom Activities, and Everyday Examples, Grades K-8

ERIC Educational Resources Information Center

Prigo, Robert

2007-01-01

Teaching physical science in the elementary and middle grades can be challenging for busy teachers faced with growing science demands and limited classroom resources. Robert Prigo provides fun and engaging activities using safe, available materials that educators can easily incorporate into lesson plans. Extensive examples, sample inquiry…

Taking Teacher Learning to Scale: Sharing Knowledge and Spreading Ideas across Geographies

ERIC Educational Resources Information Center

Klein, Emily J.; Jaffe-Walter, Reva; Riordan, Megan

2016-01-01

This research reports data from case studies of three intermediary organizations facing the challenge of scaling up teacher learning. The turn of the century launched scaling-up efforts of all three intermediaries, growing from intimate groups, where founding teachers and staff were key supports for teacher learning, to large multistate…

Teaching the At-Risk Teenage Brain

ERIC Educational Resources Information Center

Feinstein, Sheryl

2007-01-01

While all teenage behavior and character traits can be challenging, the issues facing the at-risk teenager are particularly thorny. Anger, aggression, and a lack of good decision-making may happen on a minute-to-minute basis, as teachers try to guide these young adults. Unlocking the key to keeping them in school and facilitating proficiency in…

Enhanced Critical Thinking Skills through Problem-Solving Games in Secondary Schools

ERIC Educational Resources Information Center

McDonald, Scott Douglas

2017-01-01

Aim/Purpose: Students face many challenges improving their soft skills such as critical thinking. This paper offers one possible solution to this problem. Background: This paper considers one method of enhancing critical thinking through a problem-solving game called the Coffee Shop. Problem-solving is a key component to critical thinking, and…

Military Cultural Competency: Understanding How to Serve Those Who Serve

ERIC Educational Resources Information Center

Bonura, Kimberlee Bethany; Lovald, Nicole

2015-01-01

The aim of this essay is to define and describe the different constituents of the military population, and present the challenges this demographic faces when pursuing higher education. The essay also discusses key aspects higher education professionals must understand in order to better serve military populations, such as federal regulations and…

Collection Development "Universal Design": Design for Everyone

ERIC Educational Resources Information Center

Felix, Lisa

2008-01-01

As the first wave of baby boomers hit their "golden years," there is a growing demand for housing that meets their changing physical needs. The older and disabled population face a lot of physical challenges in a traditional home. Before homeowners can modify their houses, they must first understand the key design terminology involved.…

Living with Anxiety Disorders--Unemployment as a Barrier to Social Inclusion

ERIC Educational Resources Information Center

Anczweski, Julian; Anczewska, Marta

2015-01-01

Individuals living with anxiety disorders often face significant obstacles in their day to day lives. While trying to manage the physical and emotional symptoms associated with these disorders can be a challenge, sufferers also encounter barriers by way of social exclusion from key life domains: family life, relationships, education, employment…

Reconfiguring Urban Leadership: Taking a Perspective on Community

ERIC Educational Resources Information Center

Riley, Kathryn A.

2009-01-01

This article maps the key features of the community contexts in which a range of challenging urban schools are located, highlighting the community-related issues facing school leaders. Whilst recognising the growing demands on school leaders and the need to reconfigure leadership, the author also identifies steps which they can take to strengthen…

Teaching Students to Visualize: Nine Key Questions for Success

ERIC Educational Resources Information Center

Rader, Laura A.

2009-01-01

The seemingly simple task associated with formal reading instruction may be problematic for many students with speech and language delays who often enter school with meager literacy experiences (B. K. Gunn, D. C. Simmons, & E. J. Kame'enui, 1999). However, the challenges that students face may be reduced when reading instruction includes…

Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa

PubMed Central

2017-01-01

Background Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. Aim This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. Setting The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. Methods The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Results Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. Conclusion South Africa’s HRH strategy for the Health Sector 2012/13–2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised. PMID:28828878

Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa.

PubMed

Mburu, Grace; George, Gavin

2017-07-31

Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. South Africa's HRH strategy for the Health Sector 2012/13-2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

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

PubMed

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

2012-01-01

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

Behavioral medicine: a voyage to the future.

PubMed

Keefe, Francis J

2011-04-01

This paper discusses trends and future directions in behavioral medicine. It is divided into three sections. The first briefly reviews key developments in the history of behavioral medicine. The second section highlights trends and future directions in pain research and practice as a way of illustrating future directions for behavioral medicine. Consistent with the biopsychosocial model of pain, this section focuses on trends and future directions in three key areas: biological, psychological, and social. The third section describes recent Society of Behavioral Medicine initiatives designed to address some of the key challenges facing our field as we prepare for the future.

Linking challenges in wound healing: key highlights from the Hartmann congress.

PubMed

2017-11-02

With a special focus on advanced wound healing (wound bed preparation, epithelialisation and hydration) and negative pressure wound therapy, the Hartmann LINK for Wound Healing Congress took place in Belfast, Northern Ireland, on 19 September. The event aimed to promote the latest advances in wound care and highlight the main challenges that clinicians face when treating different types of wounds. Annabel De Coster, editor of the British Journal of Community Nursing, gives an overview of selected talks from the congress.

From Theory to Practice: One Agency's Experience with Implementing an Evidence-Based Model.

PubMed

Murray, Maureen; Culver, Tom; Farmer, Betsy; Jackson, Leslie Ann; Rixon, Brian

2014-07-01

As evidence-based practice is becoming integrated into children's mental health services as a means of improving outcomes for children and youth with severe behavioral and emotional problems, therapeutic foster care (TFC) which is a specialized treatment program for such youth, is one of few community-based programs considered to be evidence-based. "Together Facing the Challenge" (TFTC) which was developed as a component of a randomized trial of TFC has been identified as an evidence-based model. We describe the experiences reported by one of the agencies that participated in our study and how they have incorporated TFTC into their on-going practice. They highlight key implementation strategies, challenges faced, and lessons learned as they moved forward towards full implementation of TFTC throughout their agency.

Can we match ultraviolet face images against their visible counterparts?

NASA Astrophysics Data System (ADS)

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

2015-05-01

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

Sustainable development: challenges and opportunities for the natural sciences (Invited)

NASA Astrophysics Data System (ADS)

Mutter, J. C.; Fishman, R.; Anttila-Hughes, J. K.; Hsiang, S. M.

2009-12-01

The challenges of sustainable development -- equitably improving global human welfare while ensuring that the environment is preserved for future generations - demand research at the nexus of the social and natural sciences. Massive and inevitable changes in climate, ecosystem functions, and human interaction with the environment will perturb societies throughout the world in different ways over the coming century. The changes faced by poor societies and their ability to cope differs markedly from those that face the richest. Yet in all regions the dynamic interaction of social and natural drivers will govern the prospects for human welfare and its improvement. Developing an understanding of these phenomena will require field research together with analytical and modeling capabilities that couple physical and social phenomena, allowing feedback between the two to manifest and permit forecasting over long time scales. Heterogeneous income and population growth further complicate this need through their consequences for food security, migration, resource allocation, and conflict. In this contribution, we identify some key concepts of sustainable development, open research questions and outline how scientific research might engage this emerging discipline. Using recent examples of interaction, we discuss the opportunities and challenges facing the further development of this dialogue.

Virtualization of the Y.E.S. Congress 2009 Roundtable Symposia (Invited)

NASA Astrophysics Data System (ADS)

Gonzales, L. M.; Gaines, S. M.

2009-12-01

The Y.E.S. Congress 2009 was the first international conference organized by the Y.E.S. Network, an association of early-career geoscientists who represent professional societies, geoscience companies, geoscience departments, and interested policy makers from across the world, in collaboration with the International Year of Planet Earth (IYPE). The conference, hosted by the China University of Geosciences in Beijing, focused on scientific and career challenges faced by early-career geoscientists, with a particular emphasis on how the Y.E.S. Network can work collaboratively and internationally towards solving these challenges and furthering the IYPE motto of “Earth Sciences for Society”. A key features of the Y.E.S. Congress was the implementation of “virtualized” roundtable symposia which engaged senior and early-career geoscientists via presentations, panel discussions, and working group sessions in which strategies related to scientific challenges (i.e. climate change in the polar regions, natural hazards, natural resource sustainability) and academic and career pathway challenges (i.e. academic-industry linkages, gender parity in the geosciences, geoscience education sustainability, and international licensure issues) were developed. These strategies were then tasked to the Y.E.S. Network for further development and implementation. The virtualization of the roundtable symposia facilitated active discussion between those participants and speakers who were physically located at the conference facilities in Beijing with a wider international audience of virtual participants and speakers. This talk will address the key features of the roundtable virtualization, the successes and challenges faced during the pre-conference set-up as well as during the roundtable sessions, and potential future applications.

NASA EOSDIS Evolution in the BigData Era

NASA Technical Reports Server (NTRS)

Lynnes, Christopher

2015-01-01

NASA's EOSDIS system faces several challenges in the Big Data Era. Although volumes are large (but not unmanageably so), the variety of different data collections is daunting. That variety also brings with it a large and diverse user community. One key evolution EOSDIS is working toward is to enable more science analysis to be performed close to the data.

Institutional Culture and OER Policy: How Structure, Culture, and Agency Mediate OER Policy Potential in South African Universities

ERIC Educational Resources Information Center

Cox, Glenda; Trotter, Henry

2016-01-01

Several scholars and organizations suggest that institutional policy is a key enabling factor for academics to contribute their teaching materials as open educational resources (OER). But given the diversity of institutions comprising the higher education sector--and the administrative and financial challenges facing many institutions in the…

Group Projects Using Clients versus Not Using Clients: Do Students Perceive Any Differences?

ERIC Educational Resources Information Center

Parsons, Amy L.; Lepkowska-White, Elzbieta

2009-01-01

Today's educators are faced with the challenge of preparing undergraduate students to be productive employees who can communicate effectively, work well in teams, and solve problems, as well as demonstrate content knowledge. Group projects are one tool that educators can use to help students develop these key skills. Educators may be tempted to…

The Triad Research University or a Post 20th Century Research University Model

ERIC Educational Resources Information Center

Tadmor, Zehev

2006-01-01

In this paper, a model for the future research university is proposed, which answers some of the key challenges facing universities. It consists of three independent yet closely knitted entities: a research institute, a university teaching college and a business unit creating a "triad" structure. The possible inevitability, the advantages and…

Panning for Gold: A Clinician's Guide to Using Research

ERIC Educational Resources Information Center

Williams, Lee M.; Patterson, Jo Ellen; Miller, Richard B.

2006-01-01

The gap between research and clinical practice is one of the key challenges facing family therapy. Clinicians often fail to incorporate research findings into their practice because they do not know how to search, evaluate, or apply research to their clinical work. The purpose of this article is to help clinicians become better consumers of…

Perspectives of UK Vice-Chancellors on Leading Universities in a Knowledge-Based Economy

ERIC Educational Resources Information Center

Bosetti, Lynn; Walker, Keith

2010-01-01

This paper draws upon the experiences and perceptions of ten university vice-chancellors in the United Kingdom on the challenges they face in providing leadership and strategic direction for their institutions into the twenty-first century. The paper reveals the perceptions and spoken words of these leaders as they identify the key challenges…

America's Young Adults: Special Issue, 2014

ERIC Educational Resources Information Center

Cook, Traci; Kappeler, Evelyn; Ellis, Renee; Kominski, Robert; Cooper, Alexia; Smith, Erica; Donoghue, Brecht; Whitestone, Yuko; Snyder, Tom; Aud, Susan; Williamson, Lisa; Henderson, Steve; Steffen, Barry; Madans, Jennifer; Lukacs, Susan; Pastor, Patricia; Goldstrom, Ingrid; Han, Beth; Bures, Regina; Chamberlain, Seth; Despain, Jason; Chadwick, Laura; Park, Jennifer

2014-01-01

The well-being of young adults in the United States today remains an area of key interest to the public and policy-makers alike. This age group faces the well-known challenges of achieving financial and social independence while forming their own households at a time of greater economic uncertainty than in the past. Better understanding of the…

Assessing Capacity to Promote Science-Based Programs: A Key Informant Study of State Teen Pregnancy Prevention Organizations

ERIC Educational Resources Information Center

Saunders, Edward; Sabri, Bushra; Huberman, Barbara; Klaus, T. W.; Davis, Laura

2011-01-01

The purpose of this qualitative study was to identify significant external and internal challenges that state organization leaders face in promoting science-based teen pregnancy prevention programs within their states. The state organization administrators were chosen because their organizations were funded by the U.S. Centers for Disease Control…

Relating Practice to Theory in Indigenous Entrepreneurship: A Pilot Investigation of the Kitsaki Partnership Portfolio

ERIC Educational Resources Information Center

Hindle, Kevin; Anderson, Robert B.; Giberson, Robert J.; Kayseas, Bob

2005-01-01

In Canada and elsewhere around the world, Indigenous Peoples are struggling to rebuild their "nations" and improve the socioeconomic circumstances of their people. Many see economic development as the key to success. Recognizing the challenges they face in attempting to compete in the global economy on their own terms, Indigenous people…

How Successful Superintendents Build Trusting Relationships with Their School Boards during Their Entry Period

ERIC Educational Resources Information Center

Smith, Morgan Wilder

2012-01-01

This study focuses on how superintendents who have experienced success, as measured by having a school district achieve and consistently achieve in the face of many challenges today. Several key strategies and leadership frameworks that superintendents use are examined through a review of current research and are validated by reviewing the results…

An Exercise to Demonstrate Soil Microbial Diversity in Introductory Environmental Science Classrooms

ERIC Educational Resources Information Center

Yarwood, Stephanie A.; Sulzman, Elizabeth W.

2008-01-01

High diversity of microorganisms in the soil matrix has been the focus of extensive research in the fields of soil biology and microbial ecology, and is a key concept that students in the environmental or biological sciences should understand. Two activities to demonstrate diversity and highlight the challenges faced in studying soil microbial…

What Is Next for Functional Requirements for Bibliographic Records? A Delphi Study

ERIC Educational Resources Information Center

Zhang, Yin; Salaba, Athena

2009-01-01

This article reports on a Delphi study conducted to determine key issues and challenges facing Functional Requirements for Bibliographic Records (FRBR) research and practice. The Delphi panel consisted of thirty-three experts in the field who participated in a three-round issue-raising and consensus-building process via a Web-based survey…

State Arts Policy: Trends and Future Prospects

ERIC Educational Resources Information Center

Lowell, Julia F.

2008-01-01

State arts agencies (SAAs)--key players within the U.S. system of public support for the arts--face growing economic, political, and demographic challenges to the roles and missions they adopted when founded in the mid-1960s. This report, the fourth and final in a multiyear study, looks at state arts agencies' efforts to rethink their roles and…

Developing a Course on the Law of Peace Operations: Method and Practice--Making Ends Meet

ERIC Educational Resources Information Center

Oswald, Bruce M.

2007-01-01

This paper reflects on my personal experience conceptualising and teaching the law of peace operations course at The Melbourne Law School. More specifically, the paper examines some of the key challenges I have faced in developing the most appropriate conceptual framework and teaching methodologies to assist graduate students to better understand…

Psychosocial Support for Children Orphaned by HIV/AIDS in Zimbabwe

ERIC Educational Resources Information Center

Chitiyo, Jonathan; Chitiyo, Argnue; Chitiyo, Morgan

2016-01-01

Healthy psychosocial development during childhood is a key determinant to the future well-being of all individuals. In many areas of Africa, demand for psychosocial support continues to grow in response to the increasing number of children left orphaned as a result of the HIV/AIDS pandemic. These orphans face various challenges and yet, in most…

U.S. Offshore Wind Manufacturing and Supply Chain Development

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

Hamilton, Bruce

2013-02-22

This report seeks to provide an organized, analytical approach to identifying and bounding uncertainties around offshore wind manufacturing and supply chain capabilities; projecting potential component-level supply chain needs under three demand scenarios; and identifying key supply chain challenges and opportunities facing the future U.S. market and current suppliers of the nation’s landbased wind market.

The Challenges Facing the Integration of ICT in Teaching in Saudi Secondary Schools

ERIC Educational Resources Information Center

Alkahtani, Aishah

2017-01-01

A study was conducted the information and communications technology component (ICT) of the King Abdullah Public Education Development project (the Project)--part of sweeping educational reforms in Saudi Arabia at four schools in two cities. This study presents two significant shortcomings key players encountered: A lack of training and a lack of…

Exploring the Development of Classroom Group Identities in an Urban High School Chemistry Class

ERIC Educational Resources Information Center

Macaluso, Stefania

2014-01-01

A key to achieving academic success in science is providing students with meaningful experiences and skills to negotiate how these experiences affect them and the society in which they live. Although students strive for academic success, a challenge that faces many urban science students and their teachers is finding ways to promote student…

Facing the Challenges of Educational Reform in the Arab World

ERIC Educational Resources Information Center

Karami Akkary, Rima

2014-01-01

This paper pinpoints and discusses key aspects of the current approaches to school reform in the Arab world against the backdrop of what is accepted as the best practice in the international literature on effective school reform and educational change. The main goal of the paper is to highlight deeply ingrained assumptions and practices that are…

Embedding Social Enterprise Approaches in the Operations of Public Higher Education Institutions: An Exploratory Case Study

ERIC Educational Resources Information Center

Mohammad, Esam Sohail

2017-01-01

In the second decade of the new century, America's public higher education institutions (PHEIs) face several key challenges: rising demands of accountability, a steady drop in public funding, and competition from virtual and for-profit entities. Limited research had been conducted on the applicability of social enterprise theory to these…

The E-Portfolio Continuum: Discovering Variables for E-Portfolio Adoption within Music Education

ERIC Educational Resources Information Center

Taylor, John; Dunbar-Hall, Peter; Rowley, Jennifer

2012-01-01

This article presents the results of audit data compiled from a case study introducing e-portfolios into a Music Education degree program, and highlights the key challenges faced from the initial stages of student use to curricular embedding and student adoption. This article discusses the technological, social and educational impacts inherent in…

Parental Practices and Developmental Challenges of Boys of Color: Opportunities for Early Intervention

ERIC Educational Resources Information Center

Barbarin, Oscar A.

2015-01-01

The "My Brother's Keeper" Initiative (Obama, 2014) has helped to attract public attention to the vulnerabilities faced by many boys of color (BOC). In this article, I review what is known about the developmental status of BOC, identify key family practices that are critical to their development, and consider the implications of both for…

Collaborative Writing: Bridging the Gap between the Textbook and the Workplace

ERIC Educational Resources Information Center

Bremner, Stephen

2010-01-01

A key challenge facing professional communication teachers is the need to bridge the gap between the culture of the classroom and the reality of the workplace. One area of difference between the two contexts is the way in which collaborative activities surrounding the construction of written text are enacted. Differences in collaborative practices…

Challenges in tackling tuberculosis on the Thai-Myanmar border: findings from a qualitative study with health professionals.

PubMed

Kaji, Aiko; Thi, Sein Sein; Smith, Terrence; Charunwatthana, Prakaykaew; Nosten, Francois H

2015-10-09

Myanmar and Thailand belong to the top 22 high burden countries for tuberculosis (TB). Health care organizations play an essential role in addressing TB control in the two bridging border jurisdictions, Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. However, health professionals face difficulties in TB control effort due to the nature of fluid population movements, resource constraints and ambiguous mechanisms to implement collaboration along the border. The purpose of this study is to identify the challenges to TB control among Myanmar migrants faced by stakeholders, focusing on the area of collaboration and interaction along the border. The study conducted in-depth interviews with health policy makers and health care providers responsible for developing and implementing policies and TB programs in Tak province, Thailand and Myawaddy district, Kayin state, Myanmar. The participants included members of government organizations, United Nations agencies, community based organizations, and international NGO. One or two key stakeholders from each organization were approached to participate in the study. We gathered baseline information to identify TB policies and programs available on websites, brochures, and publications. Observations including field notes were made on site. The data transcriptions were coded for qualitative data analysis. Coding also developed categories that led to key themes. A total of 31 respondents (18 in Thailand and 13 in Myanmar) participated in the study. The main theme reported by participants was challenges in limited corroboration and coordination among stakeholders. Unstructured information sharing and lack of communication hindered the stakeholders from engaging in TB control. The respondents stressed that referral mechanisms across the border need to be strengthened. Other challenges were associated with increasing loss to follow up and subsequent MDR cases, constraints of service delivery, shortage of human resources, limited staff capacities within organizations and poor socioeconomic status of patients. Health professionals face many challenges in effectively addressing TB control. Addressing the insufficient coordination and collaboration by strengthening bi-national collaborative mechanisms among health care organizations is an essential step in reducing the burden of disease. Additional support and resources from governmental and non-governmental agencies will be required to address the challenges.

Obtaining Reimbursement in France and Italy for New Diabetes Products

PubMed Central

Schaefer, Elmar; Sonsalla, Jessica

2015-01-01

Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. PMID:25550411

Obtaining reimbursement in France and Italy for new diabetes products.

PubMed

Schaefer, Elmar; Schnell, Gerald; Sonsalla, Jessica

2015-01-01

Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. © 2015 Diabetes Technology Society.

The Intergenerational Legacy of Genocidal Rape: The Realities and Perspectives of Children Born of the Rwandan Genocide.

PubMed

Denov, Myriam; Woolner, Leah; Bahati, Jules Pacifique; Nsuki, Paulin; Shyaka, Obed

2017-05-01

Brutal acts of sexual violence were documented on a mass scale during the 1994 Rwandan genocide. While existing scholarship on sexual violence has significantly increased our understanding of the challenges confronting survivors, gaps in knowledge remain regarding the lived experiences of children born of genocidal rape. This study sought to explore the realities and perspectives of children born of genocidal rape, and the existing opportunities and challenges they experienced in postgenocide Rwanda. Interviews and focus groups were conducted with 60 participants born of genocidal rape in Rwanda. Findings highlight the key challenges that these youth face in the postgenocide context, including struggles with identity and belonging, ambivalence in the mother-child relationship, and a desire to learn of their biological origins and heritage. The findings suggest that children born of conflict-related sexual violence face a distinct set of challenges and needs that have yet to be formally addressed. Our findings highlight the need for the development of programs, policies, and services specific for this important, yet overlooked group of young people affected by armed conflict.

Implementing an interprofessional first-year teamwork project: some key reflections.

PubMed

McNaughton, Susan Maree

2013-09-01

Implementing an interprofessional teamwork project for first-year students presents pedagogical and practical challenges. While transferable skills and attributes are important, engagement of students with limited professional experience in teamwork depends on relevance to current learning needs. This report outlines principles learned from planning and implementing a teamwork project for an interprofessional health administration and service development course. Practising interprofessional teamwork as leaders and teachers, aligning with previous, current and future teamwork content and processes and responding to student feedback and achievement have been the key factors in shaping the project over three semesters. Face-to-face and online interprofessional teamwork learning has necessitated developing resources that support self-direction, using familiar technology and providing enabling physical environments. Implications for first-year interprofessional teamwork are that structured well-resourced processes, responsiveness and alignment of learning all improve student outcomes.

Discovery of innovative therapeutics: today's realities and tomorrow's vision. 2. Pharma's challenges and their commitment to innovation.

PubMed

Abou-Gharbia, Magid; Childers, Wayne E

2014-07-10

The pharmaceutical industry is facing enormous challenges, including reduced efficiency, stagnant success rate, patent expirations for key drugs, fierce price competition from generics, high regulatory hurdles, and the industry's perceived tarnished image. Pharma has responded by embarking on a range of initiatives. Other sectors, including NIH, have also responded. Academic drug discovery groups have appeared to support the transition of innovative academic discoveries and ideas into attractive drug discovery opportunities. Part 1 of this two-part series discussed the criticisms that have been leveled at the pharmaceutical industry over the past 3 decades and summarized the supporting data for and against these criticisms. This second installment will focus on the current challenges facing the pharmaceutical industry and Pharma's responses, focusing on the industry's changing perspective and new business models for coping with the loss of talent and declining clinical pipelines as well as presenting some examples of recent drug discovery successes.

Toward Impactful Collaborations on Computing and Mental Health.

PubMed

Calvo, Rafael Alejandro; Dinakar, Karthik; Picard, Rosalind; Christensen, Helen; Torous, John

2018-02-09

We describe an initiative to bring mental health researchers, computer scientists, human-computer interaction researchers, and other communities together to address the challenges of the global mental ill health epidemic. Two face-to-face events and one special issue of the Journal of Medical Internet Research were organized. The works presented in these events and publication reflect key state-of-the-art research in this interdisciplinary collaboration. We summarize the special issue articles and contextualize them to present a picture of the most recent research. In addition, we describe a series of collaborative activities held during the second symposium and where the community identified 5 challenges and their possible solutions. ©Rafael Alejandro Calvo, Karthik Dinakar, Rosalind Picard, Helen Christensen, John Torous. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.02.2018.

Performance Evaluation of High Speed Multicarrier System for Optical Wireless Communication

NASA Astrophysics Data System (ADS)

Mathur, Harshita; Deepa, T.; Bartalwar, Sophiya

2018-04-01

Optical wireless communication (OWC) in the infrared and visible range is quite impressive solution, especially where radio communication face challenges. Visible light communication (VLC) uses visible light over a range of 400 and 800 THz and is a subdivision of OWC technologies. With an increasing demand for use of wireless communications, wireless access via Wi-Fi is facing many challenges especially in terms of capacity, availability, security and efficiency. VLC uses intensity modulation and direct detection (IM/DD) techniques and hence they require the signals to certainly be real valued positive sequences. These constraints pose limitation on digital modulation techniques. These limitations result in spectrum-efficiency or power-efficiency losses. In this paper, we investigate an amplitude shift keying (ASK) based orthogonal frequency division multiplexing (OFDM) signal transmission scheme using LabVIEW for VLC technology.

Stroke rehabilitation in ontario: an opportunity for health care transformation.

PubMed

Meyer, Matthew J; Meyer, John P; Foley, Norine; Salter, Katherine; McClure, J Andrew; Teasell, Robert

2011-11-01

In this article, Ontario's stroke rehabilitation system is used to exemplify the challenges faced by rehabilitation and healthcare systems across Canada who are attempting to provide quality care to patients in the face of increasing demands. Currently, Ontario's rehabilitation system struggles in its efforts to provide accessible and comprehensive care to patients recovering from stroke. We begin our exploration by identifying both the primary stakeholders and the underlying factors that have contributed to the current challenges. The framework put forward in the Canadian Medical Association's recommendations for transformation is then used to suggest a vision for a more patient-focused system incorporating three key principles: a broader perspective, a patient-first approach, and greater unity. The use of health information technology, proper incentives, and greater accountability are discussed as mechanisms to improve the quality and efficiency of care.

Manifold decoding for neural representations of face viewpoint and gaze direction using magnetoencephalographic data.

PubMed

Kuo, Po-Chih; Chen, Yong-Sheng; Chen, Li-Fen

2018-05-01

The main challenge in decoding neural representations lies in linking neural activity to representational content or abstract concepts. The transformation from a neural-based to a low-dimensional representation may hold the key to encoding perceptual processes in the human brain. In this study, we developed a novel model by which to represent two changeable features of faces: face viewpoint and gaze direction. These features are embedded in spatiotemporal brain activity derived from magnetoencephalographic data. Our decoding results demonstrate that face viewpoint and gaze direction can be represented by manifold structures constructed from brain responses in the bilateral occipital face area and right superior temporal sulcus, respectively. Our results also show that the superposition of brain activity in the manifold space reveals the viewpoints of faces as well as directions of gazes as perceived by the subject. The proposed manifold representation model provides a novel opportunity to gain further insight into the processing of information in the human brain. © 2018 Wiley Periodicals, Inc.

A qualitative exploration of supports and unmet needs of diverse young women with breast cancer.

PubMed

Ruddy, Kathryn J; Greaney, Mary L; Sprunck-Harrild, Kim; Meyer, Meghan E; Emmons, Karen M; Partridge, Ann H

2015-09-01

Young women with breast cancer face different challenges than those faced by older women because of their age and life stage, yet few studies have focused on the different challenges faced by women from diverse populations. To explore existing supports that are important during diagnosis and treatment and the unmet needs for information and support in young women with breast cancer. We conducted 20 semistructured interviews in English with women aged 42 or younger who had been diagnosed with stage I-III invasive breast cancer within the previous 4 years. We recorded and transcribed the interviews and used collaborative group immersion/ crystallization to analyze data, identify emergent themes, and determine if there were differences by race/ethnicity. 20 participants, recruited from 9 US states and Canada, were interviewed, of whom 25% were Hispanic, 15% were black, 50% were white and non-Hispanic, and 10% were another race/ethnicity. Faith and/or spirituality and family were reported as important sources of support by many of the participants. Most of them lamented the inadequacy of their connections with other young survivors and also of supports for their family. Some recommended that young patients be provided with more information about: treatment-related physical and emotional changes; fertility and menopause; relationships after cancer; navigating work challenges; and transitioning into survivorship. None of these supports or recommendations was limited to a specific race/ethnicity or geographic region. Small sample size, exclusion of non-English speakers. Conclusions Key informant interviews of young breast cancer survivors identified similar needs for education and support across various races/ethnicities and geographies. Key informant interviews of young breast cancer survivors identified similar needs for education and support across various races/ethnicities and geographies. ©2015 Frontline Medical Communications.

Keys to successful organ procurement: An experience-based review of clinical practices at a high-performing health-care organization

PubMed Central

Wojda, Thomas R.; Stawicki, Stanislaw P.; Yandle, Kathy P.; Bleil, Maria; Axelband, Jennifer; Wilde-Onia, Rebecca; Thomas, Peter G.; Cipolla, James; Hoff, William S.; Shultz, Jill

2017-01-01

Organ procurement (OP) from donors after brain death and circulatory death represents the primary source of transplanted organs. Despite favorable laws and regulations, OP continues to face challenges for a number of reasons, including institutional, personal, and societal barriers. This focused review presents some of the key components of a successful OP program at a large, high-performing regional health network. This review focuses on effective team approaches, aggressive resuscitative strategies, optimal communication, family support, and community outreach efforts. PMID:28660162

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

PubMed Central

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

2013-01-01

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

Facing the Challenges--Using Information and Communications Technology To Support Teaching and Learning.

ERIC Educational Resources Information Center

Heaney, Liam

2003-01-01

This article explores some of the key issues associated with the use of information and communications technology (ICT) in the classroom. To illustrate ICT integration, a teaching project on dinosaurs, which has been developed with students ages 10-11, is presented. A detailed scheme of work and lesson plans is included. (Contains 4 references.)…

Novel, Effective, Whole: Toward a NEW Framework for Evaluations of Creative Products

ERIC Educational Resources Information Center

Henriksen, Danah; Mishra, Punya; Mehta, Rohit

2015-01-01

Creativity is increasingly viewed as an important 21st century skill that needs to be taught in schools. This emphasis on creativity is often reflected by having students engage in open-ended, project based activities and assignments. A key challenge faced by educators is how such assignments are to be evaluated. An in-depth review of existing…

Beginning Your Journey: A Guide for New Professionals in Student Affairs. Expanded and Revised.

ERIC Educational Resources Information Center

Amey, Marilyn J., Ed.; Reesor, Lori M., Ed.

This book examines key issues facing new professionals and suggests ways of thinking about the challenges and opportunities offered by a career in student affairs. The purpose of this monograph is to ease the transition from graduate student to full-time professional and to increase the retention of new professionals in the field. Chapters…

Computer Based Testing Using "Digital Ink": Participatory Design of a Tablet PC Based Assessment Application for Secondary Education

ERIC Educational Resources Information Center

Siozos, Panagiotis; Palaigeorgiou, George; Triantafyllakos, George; Despotakis, Theofanis

2009-01-01

In this paper, we identify key challenges faced by computer-based assessment (CBA) in secondary education and we put forward a framework of design considerations: design with the students and teachers, select the most appropriate media platform and plan an evolution rather than a revolution of prior practices. We present the CBA application…

Competency-Based Degree Programs in the U.S.: Postsecondary Credentials for Measurable Student Learning and Performance

ERIC Educational Resources Information Center

Klein-Collins, Rebecca

2012-01-01

Today the U.S. higher education system is facing a crisis regarding its perceived quality. One model for improving quality is competency-based education, in which an institution clearly defines the specific competencies expected of its graduates. A key challenge is how to help more people, particularly adults, succeed at the post¬secondary level…

Examining Ratings on the VAL-ED Evaluation Instrument of Principals to Improve Instructional Leadership Practices

ERIC Educational Resources Information Center

Babin, Erin Pevey

2017-01-01

The biggest challenge facing American public schools today is increasing student achievement, and this depends on the educational system's ability to improve the quality of instruction. Principals play a key role in improving the quality of instruction on their campus through the instructional leadership practices they engage in on a daily basis.…

Social Support and Success in Higher Education: The Influence of On-Campus Support on African American and Latino College Students

ERIC Educational Resources Information Center

Baker, Christina N.

2013-01-01

This study focuses on how personal support from the college environment influences the academic performance of African American and Latino college students attending selective colleges. Under-represented students at selective colleges continue to face challenges to their academic success, and support from the college environment is a key factor in…

Public Service Broadcasting: The Challenges of the Twenty-first Century. Reports and Papers on Mass Communication No. 111.

ERIC Educational Resources Information Center

Atkinson, Dave; Raboy, Marc, Ed.

This report presents a review of key research on public broadcasting and a synthesis of the actuality of public service broadcasting today in the face of increasing globalization, with case studies from 16 countries. Following the General Introduction (Pierre Juneau), the report is divided into two parts. Part 1--"Public Service Television in…

Enjoyment Fosters Engagement: The Key to Involving Middle School Students in Physical Education and Physical Activity

ERIC Educational Resources Information Center

Pharez, Emily S.

2016-01-01

This article describes the challenges faced by a middle school teacher who inherited a recreation-based physical education program in which students had been accustomed to choosing what they wanted to do. Stressing the importance of implementing a standards-based program in which students of all skill levels and activity preferences were able to…

Using Speech Recognition Software to Improve Writing Skills

ERIC Educational Resources Information Center

Diaz, Felix

2014-01-01

Orthopedically impaired (OI) students face a formidable challenge during the writing process due to their limited or non-existing ability to use their hands to hold a pen or pencil or even to press the keys on a keyboard. While they may have a clear mental picture of what they want to write, the biggest hurdle comes well before having to tackle…

Availability of Diagnostic and Treatment Services for Acute Stroke in Frontier Counties in Montana and Northern Wyoming

ERIC Educational Resources Information Center

Okon, Nicholas J.; Rodriguez, Daniel V.; Dietrich, Dennis W.; Oser, Carrie S.; Blades, Lynda L.; Burnett, Anne M.; Russell, Joseph A.; Allen, Martha J.; Chasson, Linda; Helgerson, Steven D.; Gohdes, Dorothy; Harwell, Todd S.

2006-01-01

Context: Rapid diagnosis and treatment of ischemic stroke can lead to improved patient outcomes. Hospitals in rural and frontier counties, however, face unique challenges in providing diagnostic and treatment services for acute stroke. Purpose: The aim of this study was to assess the availability of key diagnostic technology and programs for acute…

A Financial Condition Indicator System for School Districts: A Case Study of New York

ERIC Educational Resources Information Center

Ammar, Salwa; Duncombe, William; Jump, Bernard; Wright, Ronald

2005-01-01

State governments are in the midst of one of the most severe fiscal crises of the last half century. The magnitude of the fiscal challenges facing state and local governments highlights the importance of sound fiscal planning and access to key financial indicators. The objective of this article is to develop a financial condition indicator system…

Keys to Success with Autistic Children: Structure, Predictability, and Consistency Are Essential for Students on the Autism Spectrum

ERIC Educational Resources Information Center

Iseminger, Scott H.

2009-01-01

Early childhood and elementary music teachers face particular challenges when including children with special needs in the music classroom. Children with autism act out and misbehave not because they are autistic, but because their fears and anxieties are so great. Knowing that children with autism and other neurological disorders have distinct…

On "Stepping Back and Letting Go": The Role of Control in the Success or Failure of Social Studies Simulations

ERIC Educational Resources Information Center

Wright-Maley, Cory

2015-01-01

This comparative case study presents one key challenge that 2 experienced teachers faced when using simulations: control. Simulations are activities that place high demands on teachers, including the ability to anticipate pitfalls in advance, act in multiple capacities, shape the direction of the activity without unduly interfering, and to be…

The Methodological Illumination of a Blind Spot: Information and Communication Technology and International Research Team Dynamics in a Higher Education Research Program

ERIC Educational Resources Information Center

Hoffman, David M.; Blasi, Brigida; Culum, Bojana; Dragšic, Žarko; Ewen, Amy; Horta, Hugo; Nokkala, Terhi; Rios-Aguilar, Cecilia

2014-01-01

This "self-ethnography" complements the other articles in this special issue by spotlighting a set of key challenges facing international research teams. The study is focused on the relationship between information and communication technology (ICT)-based collaboration and research team dynamics. Our diverse team, drawn from researchers…

Suggestions and Procedures for Choosing a Chinese Institution of Higher Education as a Partner

ERIC Educational Resources Information Center

Willis, Mike

2007-01-01

China has one of the largest and most complex higher education systems in the world, and a key challenge facing any foreign education institution is how to select an appropriate potential partner. This paper considers how a number of foreign university managers selected a university in China. Issues of location, ranking, status, programs, mutual…

Investing in People: Building Social Capital. Profiles of Excellence in Business and Education Leadership.

ERIC Educational Resources Information Center

Larsen, Ralph S.

One of the challenges that faces business and education leaders today is creating an environment in their workplaces and classrooms that is conducive to the "New Realities of Learning." Social capital is a third asset that should be added to the list of key competitive advantages that includes knowledge and human capital. Social capital…

Teaching French to a Non-Sighted Undergraduate: Adjusting Practices to Deliver Inclusive Education

ERIC Educational Resources Information Center

Enjelvin, Geraldine Daniele

2009-01-01

This article sets out to illustrate the needs of a registered blind undergraduate student embarking upon a post-A-level French course at the University of Northampton. It also reflects upon (1) some of the challenges faced by the higher education (HE) tutors concerned and (2) the key adjustments put into place with a view to adopting…

Student Levels of Engagement in Learning: A Case Study of Cape Peninsula University of Technology (CPUT)

ERIC Educational Resources Information Center

Ivala, Eunice; Kioko, Joseph

2013-01-01

South Africa is currently faced with the challenge of undesirably low through put rates in higher education. The need to keep students interested and motivated to succeed are key objectives of many lecturers and institutions. Empirical studies have shown that one of the factors influencing student success at university is student engagement. This…

What Counts When It Comes to School Enjoyment and Aspiration in the Middle Grades

ERIC Educational Resources Information Center

Smith, Megan L.; Mann, Michael J.; Georgieva, Zornitsa; Curtis, Reagan; Schimmel, Christine J.

2016-01-01

Young adolescents, and the middle level educators who work with them, face many exciting but demanding challenges during this key period of development. According to stage-environment fit theory, the degree to which middle grades students perceive a good fit between their school environment and their needs impacts their academic and life outcomes.…

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

Shiltsev, Vladimir

The 2014 P5 report indicated the accelerator-based neutrino and rare decay physics research as a centerpiece of the US domestic HEP program. Operation, upgrade and development of the accelerators for the near-term and longer-term particle physics program at the Intensity Frontier face formidable challenges. Here we discuss key elements of the accelerator physics and technology R&D program toward future multi-MW proton accelerators.

Keeping Students on Course: An Impact Study of a Student Success Course at Guilford Technical Community College. Executive Summary

ERIC Educational Resources Information Center

Rutschow, Elizabeth Zachry; Cullinan, Dan; Welbeck, Rashida

2012-01-01

Improving the success of academically underprepared students who are in need of developmental (or remedial) education is a key challenge facing community colleges today. Many of these students enter college with little awareness of these institutions' expectations or a clear model for how to make effective decisions about their academic careers.…

Keeping Students on Course: An Impact Study of a Student Success Course at Guilford Technical Community College

ERIC Educational Resources Information Center

Rutschow, Elizabeth Zachry; Cullinan, Dan; Welbeck, Rashida

2012-01-01

Improving the success of academically underprepared students who are in need of developmental (or remedial) education is a key challenge facing community colleges today. Many of these students enter college with little awareness of these institutions' expectations or a clear model for how to make effective decisions about their academic careers.…

Mentoring health researchers globally: Diverse experiences, programmes, challenges and responses.

PubMed

Cole, Donald C; Johnson, Nancy; Mejia, Raul; McCullough, Hazel; Turcotte-Tremblay, Anne-Marie; Barnoya, Joaquin; Falabella Luco, María Soledad

2016-10-01

Mentoring experiences and programmes are becoming increasingly recognised as important by those engaged in capacity strengthening in global health research. Using a primarily qualitative study design, we studied three experiences of mentorship and eight mentorship programmes for early career global health researchers based in high-income and low- and middle-income countries. For the latter, we drew upon programme materials, existing unpublished data and more formal mixed-method evaluations, supplemented by individual email questionnaire responses. Research team members wrote stories, and the team assembled and analysed them for key themes. Across the diverse experiences and programmes, key emergent themes included: great mentors inspire others in an inter-generational cascade, mentorship is transformative in personal and professional development and involves reciprocity, and finding the right balance in mentoring relationships and programmes includes responding creatively to failure. Among the challenges encountered were: struggling for more level playing fields for new health researchers globally, changing mindsets in institutions that do not have a culture of mentorship and building collaboration not competition. Mentoring networks spanning institutions and countries using multiple virtual and face-to-face methods are a potential avenue for fostering organisational cultures supporting quality mentorship in global health research.

Mentoring health researchers globally: Diverse experiences, programmes, challenges and responses

PubMed Central

Cole, Donald C.; Johnson, Nancy; Mejia, Raul; McCullough, Hazel; Turcotte-Tremblay, Anne-Marie; Barnoya, Joaquin; Falabella Luco, (María) Soledad

2016-01-01

ABSTRACT Mentoring experiences and programmes are becoming increasingly recognised as important by those engaged in capacity strengthening in global health research. Using a primarily qualitative study design, we studied three experiences of mentorship and eight mentorship programmes for early career global health researchers based in high-income and low- and middle-income countries. For the latter, we drew upon programme materials, existing unpublished data and more formal mixed-method evaluations, supplemented by individual email questionnaire responses. Research team members wrote stories, and the team assembled and analysed them for key themes. Across the diverse experiences and programmes, key emergent themes included: great mentors inspire others in an inter-generational cascade, mentorship is transformative in personal and professional development and involves reciprocity, and finding the right balance in mentoring relationships and programmes includes responding creatively to failure. Among the challenges encountered were: struggling for more level playing fields for new health researchers globally, changing mindsets in institutions that do not have a culture of mentorship and building collaboration not competition. Mentoring networks spanning institutions and countries using multiple virtual and face-to-face methods are a potential avenue for fostering organisational cultures supporting quality mentorship in global health research. PMID:26234691

Cooperative Vehicular Networking: A Survey

PubMed Central

Ahmed, Ejaz

2018-01-01

With the remarkable progress of cooperative communication technology in recent years, its transformation to vehicular networking is gaining momentum. Such a transformation has brought a new research challenge in facing the realization of cooperative vehicular networking (CVN). This paper presents a comprehensive survey of recent advances in the field of CVN. We cover important aspects of CVN research, including physical, medium access control, and routing protocols, as well as link scheduling and security. We also classify these research efforts in a taxonomy of cooperative vehicular networks. A set of key requirements for realizing the vision of cooperative vehicular networks is then identified and discussed. We also discuss open research challenges in enabling CVN. Lastly, the paper concludes by highlighting key points of research and future directions in the domain of CVN. PMID:29881331

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

PubMed

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

2018-05-02

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

Challenges for health care development in Croatia.

PubMed

Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

2012-09-01

The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services.

The clinical academic workforce in Australia and New Zealand: report on the second binational summit to implement a sustainable training pathway.

PubMed

Windsor, John; Garrod, Tamsin; Talley, Nicholas J; Tebbutt, Carmel; Churchill, James; Farmer, Elizabeth; Baur, Louise; Smith, Julian A

2017-04-01

There has been a decline in the proportion of clinical academics compared with full-time clinicians, since 2004. A Working Party was established to help develop and implement a model for the training of clinical academics. After a highly successful first summit in 2014 that summarised the challenges faced by clinical academics in Australia and New Zealand, a second summit was convened late in 2015 to report on progress and to identify key areas for further action. The second summit provided survey results that identified the varied training pathways currently offered to clinical academics and the institutions willing to be involved in developing improved pathways. A literature review also described the contributions that clinical academics make to the health sector and the challenges faced by this workforce sector. Current training pathways created for clinical academics by Australasian institutions were presented as examples of what can be done. The perspectives of government and research organisations presented at the summit helped define how key stakeholders can contribute. Following the summit, there was a strong commitment to continue to work towards developing a sustainable and defined training pathway for clinical academics. The need for a coordinated and integrated approach was highlighted. Some key objectives were agreed upon for the next phase, including identifying and engaging key advocates within government and leading institutions; publishing and profiling the contributions of successful clinical academics to healthcare outcomes; defining the stages of a clinical academic training pathway; and establishing a mentoring programme for training clinical academics. © 2017 Royal Australasian College of Physicians.

Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field.

PubMed

Neville, Stephen; Adams, Jeffery; Cook, Catherine

2016-12-01

Undertaking qualitative research with vulnerable populations is a complex and challenging process for researchers. Traditional and common modes of collecting qualitative data with these groups have been via face-to-face recorded interviews. This article reports on three internet-based data collection methods; email and synchronous online interviews, as well as online qualitative survey. The key characteristics of using email, sychronous online interviews and an online qualitative survey including the strengths and limitations of each are presented. Reflections and insights on the use of these internet-based data collection methods are provided to encourage researchers to embrace technology and move away from using traditional face-to-face interviews when researching with vulnerable populations. Using the internet to collect qualitative data offers additional ways to gather qualitative data over traditional data collection methods. The use of alternative interview methods may encourage participation of vulnerable participants.

Difficulties facing physician mothers in Japan.

PubMed

Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

2011-11-01

Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. © 2011 Tohoku University Medical Press

Influence of novel oral anticoagulants on anticoagulation care management.

PubMed

Janzic, Andrej; Kos, Mitja

2017-09-01

Anticoagulation treatment was recently improved by the introduction of novel oral anticoagulants (NOACs). Using a combination of qualitative and quantitative methods, this study explores the effects of the introduction of NOACs on anticoagulation care in Slovenia. Face-to-face interviews with key stakeholders revealed evolvement and challenges of anticoagulation care from different perspectives. Obtained information was further explored through the analysis of nationwide data of drug prescriptions and realization of health care services. Simplified management of anticoagulation treatment with NOACs and their high penetration expanded the capacity of anticoagulation clinics, and consequentially the treated population increased by more than 50 % in the last 5 years. The main challenge concerned the expenditures for medicines, which increased approximately 10 times in just a few years. At the same time, the anticoagulation clinics and their core organisation were not affected, which is not expected to change, since they are vital in delivering high-quality care.

Nursing care of AIDS patients in Uganda.

PubMed

Fournier, Bonnie; Kipp, Walter; Mill, Judy; Walusimbi, Mariam

2007-07-01

This article reports the findings from a participatory action research study concerning the experience of Ugandan nurses caring for individuals with HIV illness. Six key informants from government and non-governmental organizations were interviewed using a semistructured format. Six nurses from a large national referral hospital in Kampala, Uganda, participated in 10 focus group meetings during a period of 11 months. In-depth interviews, focus groups, and photovoice were used to collect the data. Findings indicate that nurses faced many challenges in their daily care, including poverty, insufficient resources, fear of contagion, and lack of ongoing education. Nurses experienced moral distress due to the many challenges they faced during the care of their patients. Moral distress may lead nurses to quit their jobs, which would exacerbate the acute shortage of nurses in Uganda. This study provides important knowledge for guiding clinical practice and nursing education in resource-constrained countries like Uganda.

Families of returned defence force personnel: a changing landscape of challenges.

PubMed

Berle, David; Steel, Zachary

2015-08-01

This paper aims to identify the key challenges experienced by the families of defence force personnel following deployment. We undertook a selective review of four post-deployment challenges to the families of defence force personnel: (1) changes to relationships; (2) changes to family member roles and responsibilities; (3) adjustment of children and parenting challenges; and (4) anger, family conflict and violence. Emerging issues in the area of post-deployment adjustment are also discussed. Empirical studies of post-deployment family adjustment are lacking. Each of the reviewed challenges can contribute to psychological difficulties and precipitate contact with mental health services. The challenges faced by defence force personnel when returning from deployment arise within a family context. Clinicians should thoroughly assess these factors in families following deployment, but also recognise family strengths and resilience to these challenges. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Professional Wisdom and Writing for Publication: Qualitative Interviews with Editors and Authors in Early Childhood Education

ERIC Educational Resources Information Center

Jalongo, Mary Renck

2013-01-01

College and university faculty members specializing in early childhood education face some unique challenges in scholarly writing. The purpose of this research was to use open-ended interviews as a way to gather the collective wisdom of a group of key informants about academic writing and publishing in the field. Twenty-two editors and/or authors,…

Rwanda's Women and Children: The Long Road to Reconciliation. A Field Report Assessing the Protection and Assistance Needs of Rwandan Women and Children.

ERIC Educational Resources Information Center

Women's Commission for Refugee Women and Children, New York, NY.

Rwanda faces tremendous challenges as it tries to fight off insurgents, rebuild its infrastructure, reintegrate refugees, and assist genocide survivors. This report details an investigation which assessed the protection and assistance needs of Rwandan women and children. Part 1 of the report contains the executive summary, key findings, and the…

Managing e-Learning: What Are the Real Implications for Schools?

ERIC Educational Resources Information Center

Boulton, Helen

2008-01-01

This paper is concerned with the use of e-learning in secondary education. It is based on research that has taken place over a period of two years with students aged 14-16 (Key Stage 4). The paper considers the current research in e-learning and identifies the challenges faced by students, the changing role of the learner, and the impact elearning…

The New Forgotten Half and Research Directions to Support Them. Summary and Key Findings. A William T. Grant Foundation Inequality Paper

ERIC Educational Resources Information Center

Rosenbaum, James; Ahearn, Caitlin; Becker, Kelly; Rosenbaum, Janet

2015-01-01

In 1988, the William T. Grant Foundation issued "The Forgotten Half," the final report of the Foundation's Commission on Youth and America's Future. Focusing on inequality in American society, specifically among non-college-bound 16-24 year olds, the report explored the challenges facing young people and the institutions that serve them.…

Promoting Rural Education: The Role of the Society of the Provision of Education in Rural Australia (SPERA)

ERIC Educational Resources Information Center

Boylan, Colin

2012-01-01

The paper explores the role of the Society for the Provision of Education in Rural Australia (SPERA) and the challenges it has faced as the primary voice for Australian rural educators. The paper charts the origins of SPERA, and the contributions of key people involved in its foundation. The paper then examines the advocacy and impact of SPERA…

SPACE PHYSICS: Developing resources for astrophysics at A-level: the TRUMP Astrophysics project

NASA Astrophysics Data System (ADS)

Swinbank, Elizabeth

1997-01-01

After outlining the astrophysical options now available in A-level physics syllabuses, this paper notes some of the particular challenges facing A-level teachers and students who chose these options and describes a project designed to support them. The paper highlights some key features of the project that could readily be incorporated into other areas of physics curriculum development.

Whose Side Are We on and for Whom Do We Write? Notes on Issues and Challenges Facing Those Researching and Evaluating Public Policy

ERIC Educational Resources Information Center

Warren, Jon; Garthwaite, Kayleigh

2015-01-01

Becker (1967) poses the question "Whose side are we on?," a question which has become an enduring part of discussions within social scientific methodology. This paper explores the key issues in Becker's argument and considers its relevance to researchers today, locating this within a consideration of evaluation-based research and policy.…

Gathering Strength: Canada's Aboriginal Action Plan. A Progress Report = Rassembler nos forces: Le plan d'action du Canada pour les questions autochtones. Rapport d'etape.

ERIC Educational Resources Information Center

Department of Indian Affairs and Northern Development, Ottawa (Ontario).

Gathering Strength is an integrated government-wide plan to address the key challenges facing Canada's Aboriginal people. Following an initial section on reconciliation of historic grievances, this report describes initiatives in the four areas addressed by the action plan: (1) partnerships (all schools received public awareness materials;…

Photonic integrated circuits: new challenges for lithography

NASA Astrophysics Data System (ADS)

Bolten, Jens; Wahlbrink, Thorsten; Prinzen, Andreas; Porschatis, Caroline; Lerch, Holger; Giesecke, Anna Lena

2016-10-01

In this work routes towards the fabrication of photonic integrated circuits (PICs) and the challenges their fabrication poses on lithography, such as large differences in feature dimension of adjacent device features, non-Manhattan-type features, high aspect ratios and significant topographic steps as well as tight lithographic requirements with respect to critical dimension control, line edge roughness and other key figures of merit not only for very small but also for relatively large features, are highlighted. Several ways those challenges are faced in today's low-volume fabrication of PICs, including the concept multi project wafer runs and mix and match approaches, are presented and possible paths towards a real market uptake of PICs are discussed.

Leadership survey. An evaluation of health care executives' challenges.

PubMed

Thrall, T H; Hoppszallern, S

2001-01-01

Locating and keeping employees represents one of the greatest challenges facing health care leaders today. This is a key finding of the third Leadership Survey of executives in physician practices, managed care organizations and hospitals. The survey is sponsored by the Medical Group Management Association and Hospitals & Health Networks magazine. Other significant results: Practices put the most emphasis on teamwork, training and staff development as methods to combat labor shortages; practice executives count adequacy of reimbursements and physician productivity as top leadership challenges, along with the availability of qualified workers; practices choose print advertising and the addition of new products and services as the best ways for them to build market share.

Implementing quality initiatives in healthcare organizations: drivers and challenges.

PubMed

Abdallah, Abdallah

2014-01-01

Various quality initiatives seem to have successful implementation in some healthcare organizations yet fail in others. This paper sets out to study the literature trying to understand drivers and challenges facing quality initiatives implementation in healthcare organizations then compare findings from literature with those of a structured questionnaire answered by 60 representatives from 18 hospitals. Finally it proposes a framework that mitigates challenges and utilizes drivers to ensure best implementation results. Literature regarding implementing various quality initiatives in the healthcare sector was reviewed. Representatives from several healthcare organizations were surveyed. Results from both approaches are compared to highlight the key challenges and drivers facing implementers. This research reveals that internal factors related to leadership and employees greatly affect quality initiative success or failure. Design and relevance play a major role in successful implementation. PRACTICAL IMPLICATIONs: This research offers healthcare professionals greater success when implementing certain quality initiatives by taking success/failure factors into consideration. A general framework for successful implementation in the healthcare sector is provided. This article uncovers reasons behind success or failure in a comprehensive and practical way. It also explores how most popular quality initiatives are applied in hospitals.

Developing IT Infrastructure for Rural Hospitals: A Case Study of Benefits and Challenges of Hospital-to-Hospital Partnerships.

PubMed

Reddy, Madhu C; Purao, Sandeep; Kelly, Mary

2008-01-01

This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful.

Developing IT Infrastructure for Rural Hospitals: A Case Study of Benefits and Challenges of Hospital-to-Hospital Partnerships

PubMed Central

Reddy, Madhu C.; Purao, Sandeep; Kelly, Mary

2008-01-01

This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful. PMID:18436901

A fast key generation method based on dynamic biometrics to secure wireless body sensor networks for p-health.

PubMed

Zhang, G H; Poon, Carmen C Y; Zhang, Y T

2010-01-01

Body sensor networks (BSNs) have emerged as a new technology for healthcare applications, but the security of communication in BSNs remains a formidable challenge yet to be resolved. The paper discusses the typical attacks faced by BSNs and proposes a fast biometric based approach to generate keys for ensuing confidentiality and authentication in BSN communications. The approach was tested on 900 segments of electrocardiogram. Each segment was 4 seconds long and used to generate a 128-bit key. The results of the study found that entropy of 96% of the keys were above 0.95 and 99% of the hamming distances calculated from any two keys were above 50 bits. Based on the randomness and distinctiveness of these keys, it is concluded that the fast biometric based approach has great potential to be used to secure communication in BSNs for health applications.

Groundwater and human development: challenges and opportunities in livelihoods and environment.

PubMed

Shah, T

2005-01-01

At less than 1000 km3/year, the world's annual use of groundwater is 1.5% of renewable water resource but contributes a lion's share of water-induced human welfare. Global groundwater use however has increased manifold in the past 50 years; and the human race has never had to manage groundwater use on such a large scale. Sustaining the massive welfare gains groundwater development has created without ruining the resource is a key water challenge facing the world today. In exploring this challenge, we have focused a good deal on conditions of resource occurrence but less so on resource use. I offer a typology of five groundwater demand systems as Groundwater Socio-ecologies (GwSE), each embodying a unique pattern of interactions between socio-economic and ecological variables, and each facing a distinct groundwater governance challenge. During the past century, a growing corpus of experiential knowledge has accumulated in the industrialized world on managing groundwater in various uses and contexts. A daunting global groundwater issue today is to apply this knowledge intelligently to by far the more formidable challenge that has arisen in developing regions of Asia and Africa, where groundwater irrigation has evolved into a colossal anarchy supporting billions of livelihoods but threatening the resource itself.

Health information, what happens when there isn't any? Information literacy and the challenges for rare and orphan diseases.

PubMed

Spring, Hannah

2014-09-01

This feature looks at the challenges for information literacy in rare and orphan diseases. In particular, it focuses on the information difficulties faced by those living with a rare condition or awaiting a diagnosis, and also those of the health professionals in charge of their care. The feature also highlights some of the key issues that library and information professionals need to be aware of when providing information support in such circumstances. © 2014 The author. Health Information and Libraries Journal © 2014 Health Libraries Group.

Land use politics and law in the 1970's

NASA Technical Reports Server (NTRS)

Lamb, C. M.

1975-01-01

Political facets of the general land use challenge faced in the United States, and the legal authority for governmental action by state and federal officials under given conditions are discussed. Some current and future implications of these political and legal developments are presented. An overview of local versus state versus federal powers is presented along with practices for solving the nation's land use challenge. An analysis is provided of land use law and politics in five states playing active roles in land control. Land use politics and law at the federal level is addressed, with emphasis on three key legislative measures.

Tackling drug and alcohol misuse in Brazil: priorities and challenges for nurses.

PubMed

Rassool, G H; Villar-Luis, M

2004-12-01

To provide an overview of the extent of drug and alcohol misuse in Brazil and the policies and approaches in tackling substance misuse. An examination of the challenges facing the nursing profession in working with substance misusers is presented. Alcohol, cocaine, and cannabis are the most commonly misused psychoactive substances in Brazil. One of the biggest public health problems is the interface between the misuse of psychoactive substances and HIV prevalence and other sexually transmitted diseases. Findings from a recent study suggest that undergraduate nurses in Brazil are not adequately prepared in the care and management of substance misuse problems. The nursing profession in Brazil faces numerous challenges in the development of professional competence of nurses in this field. A strategy proposed is the creation of regional centres in Brazil to study the integration of substance use and misuse in the nursing undergraduate curriculum and the giving of specific support in teaching and research to nurse teachers. Nurses have a key role to play in the early recognition, assessment, prevention, and treatment of substance misuse.

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/.

STAKEHOLDER INVOLVEMENT THROUGHOUT HEALTH TECHNOLOGY ASSESSMENT: AN EXAMPLE FROM PALLIATIVE CARE.

PubMed

Brereton, Louise; Wahlster, Philip; Mozygemba, Kati; Lysdahl, Kristin Bakke; Burns, Jake; Polus, Stephanie; Tummers, Marcia; Refolo, Pietro; Sacchini, Dario; Leppert, Wojciech; Chilcott, James; Ingleton, Christine; Gardiner, Clare; Goyder, Elizabeth

2017-01-01

Internationally, funders require stakeholder involvement throughout health technology assessment (HTA). We report successes, challenges, and lessons learned from extensive stakeholder involvement throughout a palliative care case study that demonstrates new concepts and methods for HTA. A 5-step "INTEGRATE-HTA Model" developed within the INTEGRATE-HTA project guided the case study. Using convenience or purposive sampling or directly / indirectly identifying and approaching individuals / groups, stakeholders participated in qualitative research or consultation meetings. During scoping, 132 stakeholders, aged ≥ 18 years in seven countries (England, Italy, Germany, The Netherlands, Norway, Lithuania, and Poland), highlighted key issues in palliative care that assisted identification of the intervention and comparator. Subsequently stakeholders in four countries participated in face-face, telephone and / or video Skype meetings to inform evidence collection and / or review assessment results. An applicability assessment to identify contextual and implementation barriers and enablers for the case study findings involved twelve professionals in the three countries. Finally, thirteen stakeholders participated in a mock decision-making meeting in England. Views about the best methods of stakeholder involvement vary internationally. Stakeholders make valuable contributions in all stages of HTA; assisting decision making about interventions, comparators, research questions; providing evidence and insights into findings, gap analyses and applicability assessments. Key challenges exist regarding inclusivity, time, and resource use. Stakeholder involvement is feasible and worthwhile throughout HTA, sometimes providing unique insights. Various methods can be used to include stakeholders, although challenges exist. Recognition of stakeholder expertise and further guidance about stakeholder consultation methods is needed.

The role of women in nuclear - attracting public participation in regulatory decision-making process

NASA Astrophysics Data System (ADS)

Mohamad Jais, Azlina; Hassan, Najwa

2018-01-01

Public participation is vital in demonstrating transparency and enhancing effectiveness of a nuclear regulatory process. As such, it is necessary for nuclear practitioners to involve the public in key nuclear delivery milestones. This paper specifically discusses challenges faced in attracting public participation throughout the nuclear regulatory decision-making process, and highlights the roles of women in nuclear (WiN) in initiating the said public discourse.

Human Capital: Building the Information Technology Workforce To Achieve Results. Testimony before the Subcommittee on Technology and Procurement Policy, Committee on Government Reform, U.S. House of Representatives.

ERIC Educational Resources Information Center

Walker, David M.

The Comptroller General of the United States testified before Congress regarding the General Accounting Office's (GAO's) framework for building the information technology (IT) work force to achieve results. The following were among the key points of his testimony: (1) the federal government is facing pervasive human capital challenges that are…

Implementation of Prolonged Exposure in the Army: Is Consultation Necessary for Effective Dissemination

DTIC Science & Technology

2015-10-01

study team implemented various efforts to re-educate providers regarding the goal of the study, including holding individual provider meetings...of these changes was developed in direct response to the challenges faced at Ft. Carson, but these changes required IRB approval, resulting in...constitutes a key step towards the ultimate goal of increased access to evidence-based treatment among soldiers suffering from PTSD and related

Aligning American Higher Education with a Twenty-First-Century Public Agenda. Examining the National Purposes of American Higher Education: A Leadership Approach to Policy Reform

ERIC Educational Resources Information Center

Duderstadt, James J.

2009-01-01

Today higher education faces the challenge of reconsidering and realigning its public agenda to serve better an era in which educated people, the knowledge they produce, and the innovation and entrepreneurial skills they possess have become the keys to economic prosperity, national security, and social well-being. The imperatives of expanding…

Beyond Welfare and Work First: Building Services and Systems To Support California's Working Poor and Hard-to-Place. Conference Highlights (Sacramento, CA, January 17-19, 2001).

ERIC Educational Resources Information Center

Bliss, Steven

This publication highlights key messages and themes of a conference to discuss critical questions, challenges, and opportunities facing California's welfare and workforce development systems. It is intended as a resource manual that presents the most up-to-date thinking on how policies and services can be designed to better meet the needs of…

48 CFR 1480.903 - Award in the face of challenge.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Award in the face of challenge. 1480.903 Section 1480.903 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR... Award in the face of challenge. (a) Award of a contract in the face of challenge may be made on the...

48 CFR 1480.903 - Award in the face of challenge.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Award in the face of challenge. 1480.903 Section 1480.903 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR... Award in the face of challenge. (a) Award of a contract in the face of challenge may be made on the...

Understanding the menstrual hygiene management challenges facing displaced girls and women: findings from qualitative assessments in Myanmar and Lebanon.

PubMed

Schmitt, Margaret L; Clatworthy, David; Ratnayake, Ruwan; Klaesener-Metzner, Nicole; Roesch, Elizabeth; Wheeler, Erin; Sommer, Marni

2017-01-01

There is a significant gap in empirical evidence on the menstrual hygiene management (MHM) challenges faced by adolescent girls and women in emergency contexts, and on appropriate humanitarian response approaches to meet their needs in diverse emergency contexts. To begin filling the gap in the evidence, we conducted a study in two diverse contexts (Myanmar and Lebanon), exploring the MHM barriers facing girls and women, and the various relevant sectoral responses being conducted (e.g. water, sanitation and hygiene (WASH), Protection, Health, Education and Camp Management). Two qualitative assessments were conducted: one in camps for internally displaced populations in Myanmar, and one with refugees living in informal settlements and host communities in Lebanon. Key informant interviews were conducted with emergency response staff in both sites, and focus group discussion and participatory mapping activities conducted with adolescent girls and women. Key findings included that there was insufficient access to safe and private facilities for MHM coupled with displacement induced shifts in menstrual practices by girls and women. Among staff, there was a narrow interpretation of what an MHM response includes, with a focus on supplies; significant interest in understanding what an improved MHM response would include and acknowledgement of limited existing MHM guidance across various sectors; and insufficient consultation with beneficiaries, related to discomfort asking about menstruation, and limited coordination between sectors. There is a significant need for improved guidance across all relevant sectors for improving MHM response in emergency context, along with increased evidence on effective approaches for integrating MHM into existing responses.

Institutional design and organizational practice for universal coverage in lesser-developed countries: challenges facing the Lao PDR.

PubMed

Ahmed, Shakil; Annear, Peter Leslie; Phonvisay, Bouaphat; Phommavong, Chansaly; Cruz, Valeria de Oliveira; Hammerich, Asmus; Jacobs, Bart

2013-11-01

There is now widespread acceptance of the universal coverage approach, presented in the 2010 World Health Report. There are more and more voices for the benefit of creating a single national risk pool. Now, a body of literature is emerging on institutional design and organizational practice for universal coverage, related to management of the three health-financing functions: collection, pooling and purchasing. While all countries can move towards universal coverage, lower-income countries face particular challenges, including scarce resources and limited capacity. Recently, the Lao PDR has been preparing options for moving to a single national health insurance scheme. The aim is to combine four different social health protection schemes into a national health insurance authority (NHIA) with a single national fund- and risk-pool. This paper investigates the main institutional and organizational challenges related to the creation of the NHIA. The paper uses a qualitative approach, drawing on the World Health Organization's institutional and Organizational Assessment for Improving and Strengthening health financing (OASIS) conceptual framework for data analysis. Data were collected from a review of key health financing policy documents and from 17 semi-structured key informant interviews. Policy makers and advisors are confronting issues related to institutional arrangements, funding sources for the authority and government support for subsidies to the demand-side health financing schemes. Compulsory membership is proposed, but the means for covering the informal sector have not been resolved. While unification of existing schemes may be the basis for creating a single risk pool, challenges related to administrative capacity and cross-subsidies remain. The example of Lao PDR illustrates the need to include consideration of national context, the sequencing of reforms and the time-scale appropriate for achieving universal coverage. Copyright © 2013 Elsevier Ltd. All rights reserved.

Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom

PubMed Central

Devlin, Alison M; McGee-Lennon, Marilyn; O’Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O’Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan

2016-01-01

Objective To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Materials and Methods Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Results Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. Conclusions The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. PMID:26254480

Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom.

PubMed

Devlin, Alison M; McGee-Lennon, Marilyn; O'Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O'Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan; Mair, Frances S

2016-01-01

To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program-a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit-led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

The changing model of big pharma: impact of key trends.

PubMed

Gautam, Ajay; Pan, Xiaogang

2016-03-01

Recent years have seen exciting breakthroughs in biomedical sciences that are producing truly novel therapeutics for unmet patient needs. However, the pharmaceutical industry is also facing significant barriers in the form of pricing and reimbursement, continued patent expirations and challenging market dynamics. In this article, we have analyzed data from the 1995-2015 period, on key aspects such as revenue distribution, research units, portfolio mix and emerging markets to identify four key trends that help to understand the change in strategic focus, realignment of R&D footprint, the shift from primary care toward specialty drugs and biologics and the growth of emerging markets as major revenue drivers for big pharma. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

About-face on face recognition ability and holistic processing

PubMed Central

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

2015-01-01

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

About-face on face recognition ability and holistic processing.

PubMed

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

2015-01-01

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

A study of a museum-school partnership

NASA Astrophysics Data System (ADS)

Wojton, Mary Ann

Partnerships between museums and schools never have been more important than they are today. Schools, especially urban schools, are facing challenges, including low student achievement and difficulty obtaining funding. Partners can help schools overcome these challenges by sharing educational and financial resources. Nearly 11,000 American museums spend more than $1 billion annually to provide over 18 million instructional hours for k-12 educational programs such as professional development for teachers, guided field trips, and staff visits to schools. Museums would seem like natural partners for challenged urban schools. Yet museums and schools struggle to establish and maintain effective partnerships. This study examined a partnership between a science center and an urban elementary school to provide additional knowledge and resources for those in the field to overcome these challenges in order to create relationships that help students. Using qualitative methods with interpretive descriptive purposes (Erickson, 1986; Glesne, 1999; Lincoln & Guba, 2000), the research design is based on several methods of data collection, including face-to-face, semi-structured interviews; observations; written text; and field notes. Participants in this study included students, parents, teachers, school administrators and museum educators. In addition, adult representatives of community organizations were interviewed to determine the impact of the partnership on the community. The study found that an effective partnership will have four basic elements: mutual goals, communication plan, key leader support, planning and research, and four interpersonal elements: personal responsibility, honesty, communication at the intimate level, and trust. Partners may have difficulty developing these to their fullest extent due to time limitations. No partnership is perfect. By creating strong interpersonal relationships, partners can mitigate challenges caused by limited basic elements and increase the likelihood that their partnership will be effective.

Oscillatory vapour shielding of liquid metal walls in nuclear fusion devices.

PubMed

van Eden, G G; Kvon, V; van de Sanden, M C M; Morgan, T W

2017-08-04

Providing an efficacious plasma facing surface between the extreme plasma heat exhaust and the structural materials of nuclear fusion devices is a major challenge on the road to electricity production by fusion power plants. The performance of solid plasma facing surfaces may become critically reduced over time due to progressing damage accumulation. Liquid metals, however, are now gaining interest in solving the challenge of extreme heat flux hitting the reactor walls. A key advantage of liquid metals is the use of vapour shielding to reduce the plasma exhaust. Here we demonstrate that this phenomenon is oscillatory by nature. The dynamics of a Sn vapour cloud are investigated by exposing liquid Sn targets to H and He plasmas at heat fluxes greater than 5 MW m -2 . The observations indicate the presence of a dynamic equilibrium between the plasma and liquid target ruled by recombinatory processes in the plasma, leading to an approximately stable surface temperature.Vapour shielding is one of the interesting mechanisms for reducing the heat load to plasma facing components in fusion reactors. Here the authors report on the observation of a dynamic equilibrium between the plasma and the divertor liquid Sn surface leading to an overall stable surface temperature.

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

Wei, Xiaoliang; Duan, Wentao; Huang, Jinhua

Nonaqueous redox flow batteries are promising in pursuit of high-energy storage systems owing to the broad voltage window, but currently are facing key challenges such as poor cycling stability and lack of suitable membranes. Here we report a new nonaqueous all-organic flow chemistry that demonstrates an outstanding cell cycling stability primarily because of high chemical persistency of the organic radical redox species and their good compatibility with the supporting electrolyte. A feasibility study shows that Daramic® and Celgard® porous separators can lead to high cell conductivity in flow cells thus producing remarkable cell efficiency and material utilization even at highmore » current operations. This result suggests that the thickness and pore size are the key performance-determining factors for porous separators. With the greatly improved flow cell performance, this new flow system largely addresses the above mentioned challenges and the findings may greatly expedite the development of durable nonaqueous flow batteries.« less

Hydropower Modeling Challenges

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

Stoll, Brady; Andrade, Juan; Cohen, Stuart

Hydropower facilities are important assets for the electric power sector and represent a key source of flexibility for electric grids with large amounts of variable generation. As variable renewable generation sources expand, understanding the capabilities and limitations of the flexibility from hydropower resources is important for grid planning. Appropriately modeling these resources, however, is difficult because of the wide variety of constraints these plants face that other generators do not. These constraints can be broadly categorized as environmental, operational, and regulatory. This report highlights several key issues involving incorporating these constraints when modeling hydropower operations in terms of production costmore » and capacity expansion. Many of these challenges involve a lack of data to adequately represent the constraints or issues of model complexity and run time. We present several potential methods for improving the accuracy of hydropower representation in these models to allow for a better understanding of hydropower's capabilities.« less

Meso and micro level workforce challenges in psychiatric rehabilitation.

PubMed

Reifels, Lennart; Pirkis, Jane

2012-01-01

Results of an exploratory study are presented which examined workforce challenges in Australia's most established psychiatric rehabilitation sector. The study had the two-fold aim of investigating workforce challenges at an organizational ("meso") level and at the level of direct-service workers' daily practice ("micro"). Data from 23 key informant interviews conducted with service managers and long-serving staff were analyzed through basic descriptive and thematic analyses. Organizations faced significant annual staff turnover (25.6%), specific staff supply shortages, and challenges in recruiting staff with adequate experience and longevity to match the complexity of client issues. Workers equally encountered challenges in this increasingly complex and rapidly changing field of work. CONCLUSIONS & IMPLICATIONS FOR PRACTICE: Workforce strategies designed to attract/retain experienced staff can improve workforce cohesiveness and sustainability, as can training and support activities aimed at equipping staff to reflect on and operate in dynamic and changing work environments.

A conceptual framework toward identifying and analyzing challenges to the advancement of pharmacy.

PubMed

Bader, Lina R; McGrath, Simon; Rouse, Michael J; Anderson, Claire

Pharmacists and health care professionals are faced with increasing and changing health care needs around the world. To meet these demands, they are required to continuously upgrade and develop their professions. Reprofessionalization is therefore crucial to the successful delivery of health services, but traditional theories might provide little practical guidance to evaluating the overall status of a profession. This study proposes a new conceptual framework of three interrelated professional sectors: education, regulation and practice, and uses it to identify and analyze challenges facing the pharmacy profession in Jordan. A multiple-method qualitative study comprised of semi-structured interviews and focus groups was conducted in Amman, Jordan. To explore and identify the challenges, a purposively recruited cross-sector sample of 53 key informants, stakeholders and pharmacists were interviewed. Interview transcripts were translated and analyzed using QSR NVivo 10. Thematic analysis identified eight main challenges facing pharmacy in Jordan. The original participants were then invited to participate in focus groups, the purpose of which was to validate the interview findings, map them against the conceptual framework and discuss recommendations for development. The eight validated challenges span the following areas: graduates preparedness for practice, pharmacy education accreditation and quality assurance, pre-registration requirements, workforce development, workforce planning, remuneration and wage rate, pharmacy assistants, and Pharm.D. pharmacists. Focus group participants used the framework to map each of the challenges to the primary sector-to-sector disconnect that they perceived to explain it. A list of recommendations addressing each of the challenges was also devised. The framework was found to offer valuable insight as an explanatory and diagnostic tool in policy-relevant research. By emphasizing the processual and contextual nature of reprofessionalization, the framework presents an alternative approach to traditional theories. This study also raises important questions regarding the status of pharmacy in Jordan and aims to provide guidance for local development and much-needed reprofessionalization drives. Copyright © 2016 Elsevier Inc. All rights reserved.

From Online Student to Online Instructor: Assistive Strategies

ERIC Educational Resources Information Center

McKnight, Jodi

2012-01-01

With the influx of online learning opportunities, online students and instructors are faced with a variety of challenges. Online students face the same challenges as do face-to-face learners, but by facing them in an online context, the interpretations of those challenges can lead to the success or failure of their overall educational experience.…

Young men's perspectives on family support and disclosure of same-sex attraction

PubMed Central

Carpineto, Julie; Kubicek, Katrina; Weiss, George; Iverson, Ellen; Kipke, Michele D

2011-01-01

Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM’s (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support. PMID:21423842

Embedding gender equality into institutional strategy.

PubMed

Ahmed, S

2017-01-01

The SiS (Sex in Science) Programme on the WGC (Wellcome Genome Campus) was established in 2011. Key participants include the Wellcome Trust Sanger Institute, EMB-EBI (EMBL-European Bioinformatics Institute), Open Targets and Elixir. The key objectives are to catalyse cultural change, develop partnerships, communicate activities and champion our women in science work at a national and international level (http://www.sanger.ac.uk/about/sex-science). In this paper, we highlight some of the many initiatives that have taken place since 2013, to address gender inequality at the highest levels; the challenges we have faced and how we have overcome these, and the future direction of travel.

Experiences from the implementation of a biosafety system in Slovenia.

PubMed

Milavec, Mojca; Racman, Darja Stanic

2007-09-01

The development and implementation of an effective national biosafety system is important for several key reasons: to ensure safe access to products of modern biotechnology, to build public confidence, to encourage the growth of domestic modern biotechnology, and to comply with international standards and agreements. There is no single best approach in the development and implementation of a national biosafety system and each country is faced with unique challenges. Slovenia is a small country and a new EU Member State. However, it has developed and implemented an efficient national biosafety system. The key elements of this system are administrative procedure, risk assessment, enforcement, and public participation and information.

Young men's perspectives on family support and disclosure of same-sex attraction.

PubMed

Carpineto, Julie; Kubicek, Katrina; Weiss, George; Iverson, Ellen; Kipke, Michele D

2008-06-01

Young men who have sex with men (YMSM) face myriad challenges when deciding to disclose their sexual orientation to family members. Key to this decision is consideration of how disclosure may influence the support they receive from family. This paper explores a diverse sample of YMSM's (N = 43) perspectives on disclosure of their same-sex attractions to key family members and its impact on family support. Several stages/categories of disclosure are described and some YMSM seemed to continue to move between categories. Additionally, relationships after disclosure included negotiations between the expression of their sexual orientation and the maintenance of family support.

The Relationship of Leadership Styles, Gender and Years of Experience of Middle School Principals in North Carolina on Achievement and Growth Trends on the End of Grade Exams

ERIC Educational Resources Information Center

Brooks, Morris, Jr.

2009-01-01

Leadership is an ever changing process and principals play a key role in the instructional focus of a school which often times created success in instruction (Riordan, 2003). Principals face different challenges today while improving schools and student academic achievement. The perceptions of an effective school leader has changed over the years…

Foreword

NASA Astrophysics Data System (ADS)

Bergheau, Jean-Michel; Drapier, Sylvain; Feulvarch, Éric; Ponthot, Jean-Philippe

2016-04-01

In the face of increasingly fierce global competition, industrial companies must develop products more and more quickly and cheaply. In such a context, the numerical simulation of manufacturing processes is a big challenge and a key factor for success. Indeed, numerical simulation enables the control of manufacturing processes and of the consequences that they induce on the manufactured parts in terms of material modifications, geometrical changes or residual stresses, each of them playing an important role in the lifetime of the component.

When the globe is your classroom: teaching and learning about large-scale environmental change online

NASA Astrophysics Data System (ADS)

Howard, E. A.; Coleman, K. J.; Barford, C. L.; Kucharik, C.; Foley, J. A.

2005-12-01

Understanding environmental problems that cross physical and disciplinary boundaries requires a more holistic view of the world - a "systems" approach. Yet it is a challenge for many learners to start thinking this way, particularly when the problems are large in scale and not easily visible. We will describe our online university course, "Humans and the Changing Biosphere," which takes a whole-systems perspective for teaching regional to global-scale environmental science concepts, including climate, hydrology, ecology, and human demographics. We will share our syllabus and learning objectives and summarize our efforts to incorporate "best" practices for online teaching. We will describe challenges we have faced, and our efforts to reach different learner types. Our goals for this presentation are: (1) to communicate how a systems approach ties together environmental sciences (including climate, hydrology, ecology, biogeochemistry, and demography) that are often taught as separate disciplines; (2) to generate discussion about challenges of teaching large-scale environmental processes; (3) to share our experiences in teaching these topics online; (4) to receive ideas and feedback on future teaching strategies. We will explain why we developed this course online, and share our experiences about benefits and challenges of teaching over the web - including some suggestions about how to use technology to supplement face-to-face learning experiences (and vice versa). We will summarize assessment data about what students learned during the course, and discuss key misconceptions and barriers to learning. We will highlight the role of an online discussion board in creating classroom community, identifying misconceptions, and engaging different types of learners.

Long-range strategic planning: a case study.

PubMed

Moller-Tiger, D

1999-05-01

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

My46: a web-based tool for self-guided management of genomic test results in research and clinical settings

PubMed Central

Tabor, Holly K.; Jamal, Seema M.; Yu, Joon-Ho; Crouch, Julia M.; Shankar, Aditi G.; Dent, Karin M.; Anderson, Nick; Miller, Damon A.; Futral, Brett T.; Bamshad, Michael J.

2016-01-01

A major challenge to implementing precision medicine is the need for an efficient and cost-effective strategy for returning individual genomic test results that is easily scalable and can be incorporated into multiple models of clinical practice. My46 is a web-based tool for managing the return of genetic results that was designed and developed to support a wide range of approaches to results disclosure, ranging from traditional face-to-face disclosure to self-guided models. My46 has five key functions: set and modify results return preferences, return results, educate, manage return of results, and assess return of results. These key functions are supported by six distinct modules and a suite of features that enhance the user experience, ease site navigation, facilitate knowledge sharing, and enable results return tracking. My46 is a potentially effective solution for returning results and supports current trends toward shared decision-making between patient and provider and patient-driven health management. PMID:27632689

Key Action Items for the Stem Cell Field: Looking Ahead to 2014

PubMed Central

Knoepfler, Paul S.

2013-01-01

Abstract The stem cell field is at a critical juncture in late 2013. We find ourselves buoyed by building momentum for both transformative basic science discoveries and clinical translation of stem cells. Cellular reprogramming has given the field exciting new avenues as well. The overall prospect of novel stem cell–based therapies becoming a reality for patients in the coming years has never seemed higher. At the same time, we face serious challenges. Some of these challenges, such as stem cell tourism, are familiar to us, although even those are evolving in ways that require adaptability and action by the stem cell field. Other new challenges are also emerging, including an urgent need for formal physician training in stem cells, regulatory compliance balanced with innovation and U.S. Food and Drug Administration reform, and savvy educational outreach. Looking ahead to 2014, both the challenges and opportunities for the stem cell field require a proactive, thoughtful approach to maximize the potential for a positive impact from stem cell advances. In this study, I discuss the key action items for the field as we look ahead to the coming year and beyond. PMID:24147571

Key action items for the stem cell field: looking ahead to 2014.

PubMed

Knoepfler, Paul S

2013-12-01

The stem cell field is at a critical juncture in late 2013. We find ourselves buoyed by building momentum for both transformative basic science discoveries and clinical translation of stem cells. Cellular reprogramming has given the field exciting new avenues as well. The overall prospect of novel stem cell-based therapies becoming a reality for patients in the coming years has never seemed higher. At the same time, we face serious challenges. Some of these challenges, such as stem cell tourism, are familiar to us, although even those are evolving in ways that require adaptability and action by the stem cell field. Other new challenges are also emerging, including an urgent need for formal physician training in stem cells, regulatory compliance balanced with innovation and U.S. Food and Drug Administration reform, and savvy educational outreach. Looking ahead to 2014, both the challenges and opportunities for the stem cell field require a proactive, thoughtful approach to maximize the potential for a positive impact from stem cell advances. In this study, I discuss the key action items for the field as we look ahead to the coming year and beyond.

Overcoming Challenges in School-Wide Survey Administration.

PubMed

Rasberry, Catherine N; Rose, India; Kroupa, Elizabeth; Hebert, Andrew; Geller, Amanda; Morris, Elana; Lesesne, Catherine A

2018-01-01

School-based surveys provide a useful method for gathering data from youth. Existing literature offers many examples of data collection through school-based surveys, and a small subset of literature describes methodological approaches or general recommendations for health promotion professionals seeking to conduct school-based data collection. Much less is available on real-life logistical challenges (e.g., minimizing disruption in the school day) and corresponding solutions. In this article, we fill that literature gap by offering practical considerations for the administration of school-based surveys. The protocol and practical considerations outlined in the article are based on a survey conducted with 11,681 students from seven large, urban public high schools in the southeast United States. We outline our protocol for implementing a school-based survey that was conducted with all students school-wide, and we describe six types of key challenges faced in conducting the survey: consent procedures, scheduling, locating students within the schools, teacher failure to administer the survey, improper administration of the survey, and minimizing disruption. For each challenge, we offer our key lessons learned and associated recommendations for successfully implementing school-based surveys, and we provide relevant tools for practitioners planning to conduct their own surveys in schools.

'She's my sister-in-law, my visitor, my friend' -- challenges of staff identity in home follow-up in an HIV trial in Western Kenya.

PubMed

Madiega, Philister Adhiambo; Jones, Gemma; Prince, Ruth Jane; Geissler, Paul Wenzel

2013-04-01

Identities ascribed to research staff in face-to-face encounters with participants have been raised as key ethical challenge in transnational health research. 'Misattributed' identities that do not just deviate from researchers' self-image, but obscure unequivocal aspects of researcher identity - e.g. that they are researchers - are a case of such ethical problem. Yet, the reasonable expectation of unconcealed identity can conflict with another ethical premise: confidentiality; this poses challenges to staff visiting participants at home. We explore these around a case study of 'follow-up' staff, observed during an ethnographic study of a Kenyan HIV 'trial community', which included participant observation, conversations, and interviews with staff (n = 79) and participants (n = 89). We found that because of the need to maintain confidentiality and because of some suspicions towards researchers, research staff drew upon alternative identities - presenting themselves to non-participants as relatives or friends, rather than as researchers. Several staff experienced this as necessary but uncomfortable. Simultaneously, staff and participants forged close relations in line with their fictional identities, which however also posed challenges because they entailed personal responsibilities that were difficult to live up to, due to limited resources, and the trial's limited duration. Similar challenges may arise in transnational HIV treatment programmes and should be explored further in that context. © 2013 Blackwell Publishing Ltd.

A new method for generating an invariant iris private key based on the fuzzy vault system.

PubMed

Lee, Youn Joo; Park, Kang Ryoung; Lee, Sung Joo; Bae, Kwanghyuk; Kim, Jaihie

2008-10-01

Cryptographic systems have been widely used in many information security applications. One main challenge that these systems have faced has been how to protect private keys from attackers. Recently, biometric cryptosystems have been introduced as a reliable way of concealing private keys by using biometric data. A fuzzy vault refers to a biometric cryptosystem that can be used to effectively protect private keys and to release them only when legitimate users enter their biometric data. In biometric systems, a critical problem is storing biometric templates in a database. However, fuzzy vault systems do not need to directly store these templates since they are combined with private keys by using cryptography. Previous fuzzy vault systems were designed by using fingerprint, face, and so on. However, there has been no attempt to implement a fuzzy vault system that used an iris. In biometric applications, it is widely known that an iris can discriminate between persons better than other biometric modalities. In this paper, we propose a reliable fuzzy vault system based on local iris features. We extracted multiple iris features from multiple local regions in a given iris image, and the exact values of the unordered set were then produced using the clustering method. To align the iris templates with the new input iris data, a shift-matching technique was applied. Experimental results showed that 128-bit private keys were securely and robustly generated by using any given iris data without requiring prealignment.

Physician-entrepreneurship: a user's manual, part 1: critical questions for early-stage medical ventures.

PubMed

Lexa, Frank James; Lexa, Frank J

2005-07-01

The medical field is one of the most exciting in America for entrepreneurs. Radiologists and other medical practitioners are in a unique position to take advantage of opportunities to invent and create innovative products and services. Physicians have led many of the most important revolutionary and evolutionary changes that have occurred in the field in the past 100 years. However, many radiologists find the process of entrepreneurship a daunting one and are often deterred from acting on their ideas. This article addresses the key issues and challenges that entrepreneurs face when embarking on new enterprises. Although most of these issues face all entrepreneurs at this stage, this article focuses on medical innovation and its particular challenges. This article concentrates on the kinds of questions that physician-entrepreneurs need to ask before jumping in, the types of common pitfalls that await those who don't address these issues, and some answers to seek if you are to beat the odds and succeed.

Wrestling with the complexity of evaluation for organizations at the boundary of science, policy and practice.

PubMed

Pitt, Ruth; Wyborn, Carina; Page, Glenn; Hutton, Jonathon; Virah Sawmy, Malika; Ryan, Melanie; Gallagher, Louise

2018-04-16

Boundary organizations have been promoted as a measure to improve the effectiveness of conservation efforts by building stronger relationships between scientists, policy makers, industry and practitioners (Cook et al. 2013). While their promise has been discussed in theory, the work of and expectations for boundary organizations are less defined in practice. Biodiversity conservation is characterized by complexity, uncertainty, dissent and tight budgets, so boundary organizations face the challenging task of demonstrating their value to diverse stakeholders. This paper examines the challenges that boundary organizations face when seeking to evaluate their work. While no 'off-the-shelf' solution is available for a given boundary organization, many lessons can be learned from the evaluation literature. This paper synthesizes key areas of decision making to underpin the choice of evaluation approaches, with the aim of encouraging more productive conversations about evaluation of boundary organizations and the projects they deliver. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Blended learning: strengths, challenges, and lessons learned in an interprofessional training program.

PubMed

Lotrecchiano, G R; McDonald, P L; Lyons, L; Long, T; Zajicek-Farber, M

2013-11-01

This field report outlines the goals of providing a blended learning model for an interdisciplinary training program for healthcare professionals who care for children with disabilities. The curriculum blended traditional face-to-face or on-site learning with integrated online interactive instruction. Credit earning and audited graduate level online coursework, community engagement experiences, and on-site training with maternal and child health community engagement opportunities were blended into a cohesive program. The training approach emphasized adult learning principles in different environmental contexts integrating multiple components of the Leadership Education in Neurodevelopmental and Related Disabilities Program. This paper describes the key principles adopted for this blended approach and the accomplishments, challenges, and lessons learned. The discussion offers examples from training content, material gathered through yearly program evaluation, as well as university course evaluations. The lessons learned consider the process and the implications for the role of blended learning in this type of training program with suggestions for future development and adoption by other programs.

Balancing professional and personal satisfaction of nurse managers: current and future perspectives in a changing health care system.

PubMed

Thorpe, Karran; Loo, Robert

2003-09-01

The objectives of this research were to explore and describe emerging new roles of First-Line Nurse Managers (F-LNMs i.e. individuals who oversee the daily operations of nursing units, regardless of their titles) in one Canadian province, identify their requisite knowledge, skills, competencies, and determine the training and development needs of these managers. F-LNMs, recognized as key players in health care systems, face major challenges (e.g. continuing organizational change, lack of resources) daily. These challenges affect their ability to achieve quality work experiences for their staff members and quality of nursing care for their patients and for themselves. The research design entails a triangulation of investigators (nursing and management), methods (interviews and a Delphi Study), samples (interviews with 26 F-LNMs and a Delphi Study with 62 panelists), and data (qualitative and quantitative). Institutions were randomly selected and then F-LNMs were randomly selected to participate in personal interviews and the remaining F-LNMs, along with nominated senior administrators, were invited to participate in the Delphi Study. Key findings relate to role changes (e.g. job enlargement and emphasis on efficiency), challenges (e.g. staffing and retention, frustrations), and recommendations for administrators (e.g. provide resources, training and development) and educators (e.g. link education to organizational needs). Ultimately, organizational changes and challenges affect how F-LNMs perceive their future professional (e.g. providing quality of patient care) and personal (e.g. high quality of life) satisfaction levels. This research suggests that the role of F-LNMs continues to evolve, consistent with the changing health care system. F-LNMs face challenges that compromise performance of their functions as they believe their work should be completed. To enhance satisfaction in their roles, F-LNMs express a desire for balance in their professional and personal lives.

Perception of Cervical Cancer Patients on their Financial Challenges in Western Kenya.

PubMed

Owenga, Jane A; Nyambedha, Erick Otieno

2018-04-10

The number of cervical cancer cases is reported to increase among women of reproductive age in the recent past with patients facing challenges with care and management of the illness. However, little is known about the financial challenges these patients undergo in contexts such as western Kenya. This study assessed financial challenges and sources of financial assistance for cervical cancer patients in western Kenya. A cross-sectional study involving 334 cervical cancer patients was conducted in Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu from September 2014 to February 2015. Structured questionnaire, in-depth interview guide and key informant interview guide were used to collect data. Quantitative data was analyzed using Statistical Package for Social Scientists (SPSS) Version 20 at a statistical significance of P ≤ 0.05, descriptive statistics and crosstabulations were performed. For qualitative data, the responses were transcribed verbatim and the content was then analyzed by searching for emerging themes on the financial challenges faced by cervical cancer patients. Qualitative data was presented in textual form with verbatim reports for illustrations. The key financial challenges from the study were costs of medication 291 (87%), cost of travel 281 (84%) and cost of diagnostic tests 250 (75%). Other costs incurred by the patients were cost of cloths and wigs 91 (27%), and cost of home and child care 80 (24%). Most 304 (91%) of the cervical cancer patients admitted and referred to JOOTRH did not have insurance cover and only 30 (9%) had National Hospital Insurance Fund cover which catered for only bed component of inpatient costs. Results showed that no patient received any assistance from well-wishers. Only a few received assistance from charity organizations 43 (13%), friends 91 (27%) and colleagues 31 (9%). Some patients received some assistance from relatives 32 (10%) and church 32 (10%). Cervical cancer patients experience several financial challenges yet only few of them had insurance cover which catered for only bed component of inpatient costs. There is a need for the Kenyan health care system to develop mechanisms for provision of financial support for cervical cancer patients.

The intricate relationship between a medical school and a teaching hospital: A case study in Uganda.

PubMed

Mubuuke, Aloysius Gonzaga; Businge, Francis; Mukule, Emmanuel

2014-01-01

The relationship between medical schools and teaching hospitals is full of opportunities but also challenges even though they have complementary goals that could enhance each other. Although medical schools and teaching hospitals may face some similar challenges around the world, there could be context-specific observations that differ in resource-rich versus resource-limited settings. The purpose of this study was to investigate factors that are perceived to have influenced the relationship between a medical school and a teaching hospital in Uganda, a resource-limited setting. This was a cross-sectional, descriptive study in which key informant individual interviews were conducted with senior administrators and senior staff members of the Mulago Hospital and Makerere University Medical School. The interviews explored factors perceived to have favoured the working relationship between the two institutions, challenges faced and likely future opportunities. Both quantitative and qualitative data were generated. Thematic analysis was used with the qualitative data. Respondents reported a strained relationship between the two institutions, with unfavourable factors far outweighing the favourable factors influencing the relationship. Key negative reported factors included having different administrative set-ups, limited opportunities to share funds and to forge research collaborations, unexploited potential of sharing human resources to address staff shortages, as well as a lack of a memorandum of understanding between the two institutions. This study identifies barriers in the existing relationship between a teaching hospital and medical college in a resource-poor country. It proposes a collaborative model, rather than competitive model, for the two institutions that may work in both resource-limited and resource-rich settings.

Scaling-up HIV responses with key populations in West Africa.

PubMed

Wheeler, Tisha; Wolf, R Cameron; Kapesa, Laurent; Cheng Surdo, Alison; Dallabetta, Gina

2015-03-01

Despite decades of HIV responses in pockets of West and Central Africa (WCA), the HIV response with key populations remains an understudied area. Recently, there has been a proliferation of studies highlighting epidemiologic and behavioral data that challenge attitudes of complacency among donors and country governments uncomfortable in addressing key populations. The articles in this series highlight new studies that provide a better understanding of the epidemiologic and structural burden facing key populations in the WCA region and how to improve responses through more effective targeting. Key populations face pervasive structural barriers including institutional and sexual violence and an intersection of stigma, criminalization, and marginalization as sexual minorities. Despite decades of smaller interventions that have shown the importance of integrated services for key populations, there remains incongruent provision of outreach or testing or family planning pointing to sustained risk. There remains an incongruent resource provision for key populations where they shoulder the burden of HIV and their access to services alone could turn around HIV epidemics within the region. These proximal and distal determinants must be addressed in regional efforts, led by the community, and resourced for scale, targeting those most at risk for the acquisition and transmission of HIV. This special issue builds the knowledge base for the region focusing on interventions that remove barriers to service access including treatment uptake for those living with HIV. Better analysis and use of data for strategic planning are shown to lead to more effective targeting of prevention, care, and HIV treatment programs with key populations. These articles further demonstrate the immediate need for comprehensive action to address HIV among key populations throughout the WCA region.

Integrating International Engineering Organizations For Successful ISS Operations

NASA Technical Reports Server (NTRS)

Blome, Elizabeth; Duggan, Matt; Patten, L.; Pieterek, Hhtrud

2006-01-01

The International Space Station (ISS) is a multinational orbiting space laboratory that is built in cooperation with 16 nations. The design and sustaining engineering expertise is spread worldwide. As the number of Partners with orbiting elements on the ISS grows, the challenge NASA is facing as the ISS integrator is to ensure that engineering expertise and data are accessible in a timely fashion to ensure ongoing operations and mission success. Integrating international engineering teams requires definition and agreement on common processes and responsibilities, joint training and the emergence of a unique engineering team culture. ISS engineers face daunting logistical and political challenges regarding data sharing requirements. To assure systematic information sharing and anomaly resolution of integrated anomalies, the ISS Partners are developing multi-lateral engineering interface procedures. Data sharing and individual responsibility are key aspects of this plan. This paper describes several examples of successful multilateral anomaly resolution. These successes were used to form the framework of the Partner to Partner engineering interface procedures, and this paper describes those currently documented multilateral engineering processes. Furthermore, it addresses the challenges experienced to date, and the forward work expected in establishing a successful working relationship with Partners as their hardware is launched.

Pandemic policy and planning considerations for universities: findings from a tabletop exercise.

PubMed

Beaton, Randal; Stergachis, Andy; Thompson, Jack; Osaki, Carl; Johnson, Clark; Charvat, Steven J; Marsden-Haug, Nicola

2007-12-01

The potential for a novel influenza virus to cause a pandemic represents a significant threat to global health. Planning for pandemic flu, as compared to planning for other types of hazards, presents some unique challenges to businesses, communities, and education institutions. To identify and address the challenges that may be faced by major metropolitan universities during a flu pandemic, a tabletop exercise was developed, offered, and evaluated. Its purpose was to assess existing University of Washington (UW) plans and policies for responding to an influenza pandemic. On May 31, 2006, more than 50 participants, including UW administrators and unit leaders and a number of key external partners, participated in a tabletop exercise designed to simulate all phases of an influenza pandemic. This exercise revealed existing gaps in university pandemic influenza plans and policies, including issues related to isolation and quarantine, continuity of operations, disaster mental health services, integration of volunteers into a disaster response, tracking travel of university students and personnel, communication problems, and ways to meet the needs of resident and foreign students and faculty during an outbreak. Policy and planning recommendations are offered that address each of these challenges faced by UW as well as other major research universities and colleges.

Learning Competitive Intelligence from a Bunch of Screwballs

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

Troy Hiltbrand

Idaho National Laboratory is the Department of Energy’s (DOE) lead lab for nuclear energy research and is dedicated to supporting the advancement of missions in nuclear energy research, energy and environment, and national security. The laboratory is operated by Battelle Energy Alliance (BEA) and participates both independently and jointly with other labs in the support of work for the DOE and other government organizations. The Information Management department is a key support organization whose purpose is to enable the three key areas supporting the Laboratory mission, Nuclear Energy, National and Homeland Security, and Energy and Environment, are successful. The challengemore » that we face is having relevant information about what these key areas of the Laboratory are working on and how we can best support them in achieving overall mission success. In addition, one of the major challenges that they face comes with knowing their customers and their customer’s needs so that they can successfully execute on their mission. Technology Application Organizations today are dependent on understanding their customers and competitors so that they can respond accordingly, but this can be a difficult and vexing challenge. Customers do not always reveal all of their needs and competitors rarely come out and reveal what they are doing, but this does not mean that hints about their plans are not abundant in information that is readily available. The challenge has always been how to keep track of all that is happening and converting that into useful information. Taking the lead from the “Screwball Division” from World War II, we have the tools available to automate this process and start to mine the Internet to get clues of what our customers and competitors are actively working on. By looking at what is being said and relating that to what else is being said, we can build competitive intelligence and act upon this to further our organizational objectives.« less

The Life Story Experience of "Migrant Dentists" in Australia: Potential Implications for Health Workforce Governance and International Cooperation

PubMed Central

Balasubramanian, Madhan; Spencer, A. John; Short, Stephanie D.; Watkins, Keith; Chrisopoulos, Sergio; Brennan, David S.

2017-01-01

Background: The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration. Methods: A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale. Results: A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years. Conclusion: Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward. PMID:28812824

Challenges and opportunities in healthcare volunteer management: insights from volunteer administrators.

PubMed

Rogers, Sean E; Rogers, Carmen M; Boyd, Karen D

2013-01-01

Volunteer administrators from 105 hospitals in five states in the northeast and southern United States provided open-ended survey responses about what they perceived to be the most pressing challenges and opportunities facing healthcare volunteer management. Taken together, these 105 hospitals used a total of 39,008 volunteers and 5.3 million volunteer hours during a 12-month period between 2010 and 2011. A qualitative content analysis of administrator responses suggests that primary challenges include volunteer recruitment and retention, administrative issues, and operational difficulties brought about by the current economic crisis. Key opportunities include more explicitly linking the volunteer function to hospital outcomes and community impact, expanding volunteer recruitment pools and roles and jobs, and developing organizational support for volunteers and making the volunteer management function more efficient and effective.

Disability and accommodation in the healthcare workplace.

PubMed

Niccolini, Robert R; Basu, Nina

2009-04-01

Employers in the healthcare industry face unique challenges regarding compliance with the Americans with Disabilities Act (ADA). Healthcare employers must reasonably accommodate employees in complex and often physically challenging positions, while ensuring safe and effective patient care. These challenges have become even more difficult with the recent passage of the ADA Amendments Act of 2008 (ADAAA), which significantly expands the definition and scope of "disability" under the ADA, and legislatively reverses several key Supreme Court decisions favorable to employers. Although the ultimate impact of the ADAAA remains to be determined, this article will help employers and their counsel understand how federal disability discrimination laws may affect their businesses going forward, with an analysis of the language of the ADAAA, case law under the ADA, and guidance from the Equal Employment Opportunity Commission (EEOC).

The Challenge to Soviet Interests in Eastern Europe, Romania, Hungary, East Germany.

DTIC Science & Technology

1984-12-01

they trust Kadar to control its political impact. The key question, then, is how Kadar’s program of economic and political liberalization will fare... How can Moscow reconcile its somewhat contradictory goals of stabil- ity and control in Eastern Europe in the next decade? What problems is it...likely to face in Eastern Europe and how will these affect Soviet interests in the area? What are the prospects for some restructuring of its relations

The Center for Devices and Radiological health: an update.

PubMed

Donawa, M

2001-12-01

At a recent medical device conference, Dr. David Feigal, the Director of the Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) stated that one-third of the CDRH staff will retire in five years. This is only one of many challenges that the Center faces.This article discusses key factors shaping current FDA device policies and programmes, the CDRH strategic plan, the continuing importance of the standards programme, and CDRH harmonisation activities.

Reaching consensus on reporting patient and public involvement (PPI) in research: methods and lessons learned from the development of reporting guidelines

PubMed Central

Brett, Jo; Staniszewska, Sophie; Simera, Iveta; Seers, Kate; Mockford, Carole; Goodlad, Susan; Altman, Doug; Moher, David; Barber, Rosemary; Denegri, Simon; Entwistle, Andrew Robert; Littlejohns, Peter; Suleman, Rashida; Thomas, Victoria; Tysall, Colin

2017-01-01

Introduction Patient and public involvement (PPI) is inconsistently reported in health and social care research. Improving the quality of how PPI is reported is critical in developing a higher quality evidence base to gain a better insight into the methods and impact of PPI. This paper describes the methods used to develop and gain consensus on guidelines for reporting PPI in research studies (updated version of the Guidance for Reporting Patient and Public Involvement (GRIPP2)). Methods There were three key stages in the development of GRIPP2: identification of key items for the guideline from systematic review evidence of the impact of PPI on health research and health services, a three-phase online Delphi survey with a diverse sample of experts in PPI to gain consensus on included items and a face-to-face consensus meeting to finalise and reach definitive agreement on GRIPP2. Challenges and lessons learnt during the development of the reporting guidelines are reported. Discussion The process of reaching consensus is vital within the development of guidelines and policy directions, although debate around how best to reach consensus is still needed. This paper discusses the critical stages of consensus development as applied to the development of consensus for GRIPP2 and discusses the benefits and challenges of consensus development. PMID:29061613

Better Lives for Dogs: Incorporating Human Behaviour Change Into a Theory of Change to Improve Canine Welfare Worldwide.

PubMed

Reed, Karen; Upjohn, Melissa M

2018-01-01

The world's estimated 600 million dogs face a range of welfare issues which vary according to local context and locally accepted norms regarding attitudes towards dogs. Dogs Trust Worldwide, an international Non-Governmental Organisation which works to improve canine welfare, is applying a Theory of Change framework to define and unpick key challenges faced when collaborating with local partners to achieve its mission. We describe the Theory of Change approach and the importance of Human Behaviour Change within this. We identify questions which need to be addressed as part of articulating our ways of working with partner organisations and acknowledge issues around generating evidence to measure the impact our work has on the ultimate beneficiaries.

Community-based participatory research in Little Haiti: challenges and lessons learned.

PubMed

Kobetz, Erin; Menard, Janelle; Diem, Joshua; Barton, Betsy; Blanco, Jenny; Pierre, Larry; Auguste, Pascale D; Etienne, Marie; Brewster, Cheryl

2009-01-01

Community-based participatory research (CBPR) is an effective methodology for developing relevant interventions with socially marginalized communities. However, implementing CBPR methods is challenging for several reasons. This paper presents challenges encountered in the context of an ongoing CBPR initiative in Little Haiti in Miami, Florida, and describes the solutions used to address them. We sought to describe the challenges faced and lessons learned while conducting CBPR in Little Haiti. Community-academic partnerships were created to guide the creation of culturally relevant cancer interventions and research. Historical distrust of research, cultural constructions of health and illness, and literacy issues are key considerations when developing partnerships with Haitian and other marginalized, immigrant communities. Partnerships are fostered over time through demonstrated mutual commitment to improving health and building community capacity. Communities must play an active role throughout the research process to ensure that studies are culturally relevant, and ensuing intervention, sustainable.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Institutions and the implementation of tobacco control in Brazil.

PubMed

Lencucha, Raphael; Drope, Jeffrey; Bialous, Stella Aguinaga; Richter, Ana Paula; Silva, Vera Luiza da Costa E

2017-10-19

This research examines the institutional features of Brazil's National Commission for the Implementation of the Framework Convention on Tobacco Control (CONICQ) and how these institutional features have facilitated and hindered its ability to foster intersectoral tobacco control. In particular, we evaluate the key institutional features of CONICQ starting from when it was one of the key drivers of change and improvements in early tobacco control policies, which helped to make Brazil a world leader in this area. We also examine how the committee has evolved, as tobacco control has improved and particularly elucidate some of the major challenges that it faces to bring together often disparate government sectors to generate public health policies.

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions

PubMed Central

2013-01-01

Background Angola is one of the African countries with the highest morbidity and mortality rates and a devastating lack of human resources for health, including nursing. The World Health Organization stimulates and takes technical cooperation initiatives for human resource education and training in health and education, with a view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with nursing education institutions perceive the challenges nursing education is facing in Angola. Methods After consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with professional nursing education institutions in Angola were invited to participate in the study by email. Data were collected in February 2009 through the focus group technique. The group of participants was focused on the central question: what are the challenges faced for nursing education in your country? To register and understand the information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using content analysis. Results Fourteen nurses participated in the meeting, most of whom were affiliated with technical nursing education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources, bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions they present are predominantly centered on the valuation of nursing professionals, which implies cultural and attitude changes. Conclusions Public health education policies need to be established in Angola, including action guidelines that permit effective nursing activities. Professional education institutions need further regularizations and nurses need to be acknowledged as key elements for the qualitative enhancement of health services in the country. PMID:23866740

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions.

PubMed

Marchi-Alves, Leila Maria; Ventura, Carla A Arena; Trevizan, Maria Auxiliadora; Mazzo, Alessandra; de Godoy, Simone; Mendes, Isabel Amélia Costa

2013-07-17

Angola is one of the African countries with the highest morbidity and mortality rates and a devastating lack of human resources for health, including nursing. The World Health Organization stimulates and takes technical cooperation initiatives for human resource education and training in health and education, with a view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with nursing education institutions perceive the challenges nursing education is facing in Angola. After consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with professional nursing education institutions in Angola were invited to participate in the study by email. Data were collected in February 2009 through the focus group technique. The group of participants was focused on the central question: what are the challenges faced for nursing education in your country? To register and understand the information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using content analysis. Fourteen nurses participated in the meeting, most of whom were affiliated with technical nursing education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources,bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions they present are predominantly centered on the valuation of nursing professionals, which implies cultural and attitude changes. Public health education policies need to be established in Angola, including action guidelines that permit effective nursing activities. Professional education institutions need further regularizations and nurses need to be acknowledged as key elements for the qualitative enhancement of health services in the country.

Understanding Leadership in Schools Facing Challenging Circumstances: A Chilean Case Study

ERIC Educational Resources Information Center

Ahumada, Luis; Galdames, Sergio; Clarke, Simon

2016-01-01

During the last 10 years, research into schools facing challenging circumstances has attracted the attention of researchers around the world. The aim of this study was to understand the challenges that school leaders face as they per form their work, the nature of the context in which these challenges arise, the strategies school leaders adopt to…

Conducting health survey research in a deep rural South African community: challenges and adaptive strategies.

PubMed

Casale, Marisa; Lane, Tyler; Sello, Lebo; Kuo, Caroline; Cluver, Lucie

2013-04-24

In many parts of the developing world, rural health requires focused policy attention, informed by reliable, representative health data. Yet there is surprisingly little published material to guide health researchers who face the unique set of hurdles associated with conducting field research in remote rural areas. In this paper we provide a detailed description of the key challenges encountered during health survey field research carried out in 2010 in a deep rural site in KwaZulu-Natal, South Africa. The aim of the field research was to collect data on the health of children aged 10 to 17 years old, and their primary adult caregivers, as part of a larger national health survey; the research was a collaboration between several South African and foreign universities, South African national government departments, and various NGO partners. In presenting each of the four fieldwork challenges encountered on this site, we describe the initial planning decisions made, the difficulties faced when implementing these in the field, and the adaptive strategies we used to respond to these challenges. We reflect on learnings of potential relevance for the research community. Our four key fieldwork challenges were scarce research capacity, staff relocation tensions, logistical constraints, and difficulties related to community buy-in. Addressing each of these obstacles required timely assessment of the situation and adaptation of field plans, in collaboration with our local NGO partner. Adaptive strategies included a greater use of local knowledge; the adoption of tribal authority boundaries as the smallest geopolitical units for sampling; a creative developmental approach to capacity building; and planned, on-going engagement with multiple community representatives. We argue that in order to maintain high scientific standards of research and manage to 'get the job done' on the ground, it is necessary to respond to fieldwork challenges that arise as a cohesive team, with timely, locally-relevant, and often creative, solutions. Budgeting sufficient time and project resources for capacity building and community buy-in processes is also essential when working in remote communities unaccustomed to research. Documenting and sharing field experiences can provide valuable information for other researchers planning to conduct fieldwork in similar contexts.

Space and the Third Offset Symposium - Summary Report

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

Bahney, B.

The Third Offset Workshop explored the nature of the challenges and opportunities facing the United States as it is increasingly forced to integrate space into defense strategy as well as deterrence and strategic stability frameworks. Participants broadly agreed that Washington’s deep ties to allies and partners, as well as its history of leveraging an innovative U.S private sector, will be enduring competitive advantages against potential rivals into the foreseeable future. Yet panelists also highlighted key challenges from Russia and China’s rapid integration of space capabilities into conventional and nuclear warfighting, the pronounced growth in Chinese and Russian counterspace capabilities, andmore » tensions in the U.S.-Russia relationship.« less

Advanced manufacturing: Technology and international competitiveness

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

Tesar, A.

1995-02-01

Dramatic changes in the competitiveness of German and Japanese manufacturing have been most evident since 1988. All three countries are now facing similar challenges, and these challenges are clearly observed in human capital issues. Our comparison of human capital issues in German, Japanese, and US manufacturing leads us to the following key judgments: Manufacturing workforces are undergoing significant changes due to advanced manufacturing technologies. As companies are forced to develop and apply these technologies, the constituency of the manufacturing workforce (especially educational requirements, contingent labor, job content, and continuing knowledge development) is being dramatically and irreversibly altered. The new workforcemore » requirements which result due to advanced manufacturing require a higher level of worker sophistication and responsibility.« less

Challenges Facing a Deaf Family Member Concerning a Loved One’s Dying

PubMed Central

Kehl, Karen A.; Gartner, Constance M.

2010-01-01

Individuals who are Deaf face challenges both similar and unique from those faced by hearing individuals when a family member is dying. This study was guided by the question “What are the challenges faced by a Deaf family member when a loved one is dying?” Methods - This qualitative study is guided by critical theory and an interpretive perspective. Robert, a college-educated older adult who has been Deaf from birth was interviewed in American Sign Language using a death history format. Results – There are challenges for Deaf family members that affect communication with both the dying person and health care professionals. Patient-family communication issues included physical challenges and financial challenges. Lack of cultural competence concerning the Deaf community created challenges communicating with professionals. Decision-making was also a challenge. Conclusions These findings provide a framework for future research concerning the needs of Deaf individuals facing the end of life and provide guidance for clinicians. PMID:19910395

‘SHE'S MY SISTER-IN-LAW, MY VISITOR, MY FRIEND’ – CHALLENGES OF STAFF IDENTITY IN HOME FOLLOW-UP IN AN HIV TRIAL IN WESTERN KENYA

PubMed Central

Madiega, Philister Adhiambo; Jones, Gemma; Prince, Ruth Jane; Geissler, Paul Wenzel

2013-01-01

Identities ascribed to research staff in face-to-face encounters with participants have been raised as key ethical challenge in transnational health research. ‘Misattributed’ identities that do not just deviate from researchers' self-image, but obscure unequivocal aspects of researcher identity – e.g. that they are researchers – are a case of such ethical problem. Yet, the reasonable expectation of unconcealed identity can conflict with another ethical premise: confidentiality; this poses challenges to staff visiting participants at home. We explore these around a case study of ‘follow-up’ staff, observed during an ethnographic study of a Kenyan HIV ‘trial community’, which included participant observation, conversations, and interviews with staff (n = 79) and participants (n = 89). We found that because of the need to maintain confidentiality and because of some suspicions towards researchers, research staff drew upon alternative identities – presenting themselves to non-participants as relatives or friends, rather than as researchers. Several staff experienced this as necessary but uncomfortable. Simultaneously, staff and participants forged close relations in line with their fictional identities, which however also posed challenges because they entailed personal responsibilities that were difficult to live up to, due to limited resources, and the trial's limited duration. Similar challenges may arise in transnational HIV treatment programmes and should be explored further in that context. PMID:23521821

Workplace Learning: The Role of Canadian Colleges and Institutes in Meeting Canada's Professional, Technical and Trade Skills Challenges = L'apprentissage en milieu de travail: Le role des colleges et instituts canadiens face aux defis canadiens en matiere des competences professionnels et techniques.

ERIC Educational Resources Information Center

Malcolmson, Lorna, Ed.

2002-01-01

This issue examines selected topics in vocational education in Canadian community colleges. It focuses on the central themes of community college and industry partnerships, vocational education assessment, and vocational and workplace education pedagogical models. Articles include: (1) "Industry and Colleges: Key Partners in Meeting Canada's…

State politics and the creation of health insurance exchanges.

PubMed

Jones, David K; Greer, Scott L

2013-08-01

Health insurance exchanges are a key component of the Affordable Care Act. Each exchange faces the challenge of minimizing friction with existing policies, coordinating churn between programs, and maximizing take-up. State-run exchanges would likely be better positioned to address these issues than a federally run exchange, yet only one third of states chose this path. Policymakers must ensure that their exchange-whether state or federally run-succeeds. Whether this happens will greatly depend on the political dynamics in each state.

Marketing to the consumer: perspectives from the pharmaceutical industry.

PubMed

David, C

2001-01-01

Individualized health management is one of the most exciting challenges facing health care marketing today. Greater access to health information has empowered consumers to take more control of their health needs, creating a whole new landscape for marketers, manufacturers, and service providers. Customization is the key to creating marketing campaigns that successfully target today's health-conscious consumers. Drawing on individualized market intelligence and available genetic information, pharmaceutical companies are learning to tailor products to meet the needs of this growing market.

Swedish Defence Acquisition Transformation - A Research Agenda

DTIC Science & Technology

2015-04-30

levels. Areas of Key Challenges That FMV Faces (Ekström, 2012, p. 39) The sourcing issues include “How should what to make, what to buy , and how...to buy , be decided?”; “How should Value-for-Money (VfM) be calculated?”; “How should risk sharing, reward sharing, and information sharing, be...to buy what is needed cost effectively— which should not be taken to mean “at least cost”—and in accordance with Defence’s quality and schedule

Roadmap on structured light

NASA Astrophysics Data System (ADS)

Rubinsztein-Dunlop, Halina; Forbes, Andrew; Berry, M. V.; Dennis, M. R.; Andrews, David L.; Mansuripur, Masud; Denz, Cornelia; Alpmann, Christina; Banzer, Peter; Bauer, Thomas; Karimi, Ebrahim; Marrucci, Lorenzo; Padgett, Miles; Ritsch-Marte, Monika; Litchinitser, Natalia M.; Bigelow, Nicholas P.; Rosales-Guzmán, C.; Belmonte, A.; Torres, J. P.; Neely, Tyler W.; Baker, Mark; Gordon, Reuven; Stilgoe, Alexander B.; Romero, Jacquiline; White, Andrew G.; Fickler, Robert; Willner, Alan E.; Xie, Guodong; McMorran, Benjamin; Weiner, Andrew M.

2017-01-01

Structured light refers to the generation and application of custom light fields. As the tools and technology to create and detect structured light have evolved, steadily the applications have begun to emerge. This roadmap touches on the key fields within structured light from the perspective of experts in those areas, providing insight into the current state and the challenges their respective fields face. Collectively the roadmap outlines the venerable nature of structured light research and the exciting prospects for the future that are yet to be realized.

[Diabetes type 1 therapy individualization among children suffering from autism spectrum disorder].

PubMed

Kamińska, Halla; Jarosz-Chobot, Przemysława

2011-01-01

Over the last years studies suggest an association between type 1 diabetes (DM1) and autism spectrum disorder (ASD). In this case study two children suffering from DM 1 and ASD were presented. Both are treated in the Centrum Zdrowia Dziecka in Katowice, Poland. The authors highligh everyday problems and challenges that patients, tutors and doctors have to face. The key to effective treatment is its individualization connected with proper education of the patient and his caregivers.

FERMILAB ACCELERATOR R&D PROGRAM TOWARDS INTENSITY FRONTIER ACCELERATORS : STATUS AND PROGRESS

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

Shiltsev, Vladimir

2016-11-15

The 2014 P5 report indicated the accelerator-based neutrino and rare decay physics research as a centrepiece of the US domestic HEP program at Fermilab. Operation, upgrade and development of the accelerators for the near- term and longer-term particle physics program at the Intensity Frontier face formidable challenges. Here we discuss key elements of the accelerator physics and technology R&D program toward future multi-MW proton accelerators and present its status and progress. INTENSITY FRONTIER ACCELERATORS

State Politics and the Creation of Health Insurance Exchanges

PubMed Central

Greer, Scott L.

2013-01-01

Health insurance exchanges are a key component of the Affordable Care Act. Each exchange faces the challenge of minimizing friction with existing policies, coordinating churn between programs, and maximizing take-up. State-run exchanges would likely be better positioned to address these issues than a federally run exchange, yet only one third of states chose this path. Policymakers must ensure that their exchange—whether state or federally run—succeeds. Whether this happens will greatly depend on the political dynamics in each state. PMID:23763405

Negotiation: a necessary art for dental practice.

PubMed

Fitzpatrick, William G; Renshaw, John; Batchelor, Paul

2012-01-01

This brief paper explains why the art of negotiation has become far more important for general dental practitioners. It explains that negotiations take place with patients, with practice staff, and with funding agencies such as Primary Care Trusts. It sets out the principles for successful negotiation and gives two examples of how they can be applied. It concludes that negotiation is a skill that can be learned and that it will be a key skill as the profession faces future challenges.

Cancer care management through a mobile phone health approach: key considerations.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

2013-01-01

Greater use of mobile phone devices seems inevitable because the health industry and cancer care are facing challenges such as resource constraints, rising care costs, the need for immediate access to healthcare data of types such as audio video texts for early detection and treatment of patients and increasing remote aids in telemedicine. Physicians, in order to study the causes of cancer, detect cancer earlier, act in prevention measures, determine the effectiveness of treatment and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive and timely cancer data. Mobile devices provide opportunities and can play an important role in consulting, diagnosis, treatment, and quick access to health information. There easy carriage make them perfect tools for healthcare providers in cancer care management. Key factors in cancer care management systems through a mobile phone health approach must be considered such as human resources, confidentiality and privacy, legal and ethical issues, appropriate ICT and provider infrastructure and costs in general aspects and interoperability, human relationships, types of mobile devices and telecommunication related points in specific aspects. The successful implementation of mobile-based systems in cancer care management will constantly face many challenges. Hence, in applying mobile cancer care, involvement of users and considering their needs in all phases of project, providing adequate bandwidth, preparation of standard tools that provide maximum mobility and flexibility for users, decreasing obstacles to interrupt network communications, and using suitable communication protocols are essential. It is obvious that identifying and reducing barriers and strengthening the positive points will have a significant role in appropriate planning and promoting the achievements of mobile cancer care systems. The aim of this article is to explain key points which should be considered in designing appropriate mobile health systems in cancer care as an approach for improving cancer care management.

Challenges for fuel cells as stationary power resource in the evolving energy enterprise

NASA Astrophysics Data System (ADS)

Rastler, Dan

The primary market challenges for fuel cells as stationary power resources in evolving energy markets are reviewed. Fuel cell power systems have significant barriers to overcome in their anticipated role as decentralized energy power systems. Market segments for fuel cells include combined heat and power; low-cost energy, premium power; peak shaving; and load management and grid support. Understanding the role and fit of fuel cell systems in evolving energy markets and the highest value applications are a major challenge for developers and government funding organizations. The most likely adopters of fuel cell systems and the challenges facing each adopter in the target market segment are reviewed. Adopters include generation companies, utility distribution companies, retail energy service providers and end-users. Key challenges include: overcoming technology risk; achieving retail competitiveness; understanding high value markets and end-user needs; distribution and service channels; regulatory policy issues; and the integration of these decentralized resources within the electrical distribution system.

A qualitative study of the current situation of elderly care in Iran: what can we do for the future?

PubMed

Goharinezhad, Salime; Maleki, Mohammadreza; Baradaran, Hamid Reza; Ravaghi, Hamid

2016-01-01

With the successful improvement of global health systems and social security in societies, the world is now advancing toward aging. All countries have to face the phenomenon of population aging sooner or later depending on their degree of development; however, elderly care is predicted to soon become a major concern for developing countries such as Iran. This study was conducted to identify the challenges of elderly care in Iran and to help policymakers develop roadmaps for the future through providing a clearer image of the current state of affairs in this area of healthcare. This study has adopted a framework approach to qualitative data analysis. For this purpose, 37 semi-structured interviews were conducted in 2015 with a number of key informants in elderly care who were familiar with the process at macro-, meso-, and micro-levels. Maximum variation purposive sampling was performed to select the study samples. A conceptual framework was designed using a review of the literature, and key issues were then identified for data analysis. The elderly care process yielded five major challenges, including policymaking, access, technical infrastructure, integrity and coordination, and health-based care services. According to the stakeholders of elderly care in Iran, the current care system is not well-suited for meeting the needs of the elderly, as the elderly tend to receive the services they need sporadically and in a non-coherent manner. Given the rapid growth of the elderly population in the coming decades, it is the authorities' job to concentrate on the challenges faced by the health system and to use foresight methods for the comprehensive and systematical management of the issue.

Lessons learned from national food fortification projects: experiences from Morocco, Uzbekistan, and Vietnam.

PubMed

Wirth, James P; Laillou, Arnaud; Rohner, Fabian; Northrop-Clewes, Christine A; Macdonald, Barbara; Moench-Pfanner, Regina

2012-12-01

Fortification of staple foods has been repeatedly recommended as an effective approach to reduce micronutrient deficiencies. With the increased number of fortification projects globally, there is a need to share practical lessons learned relating to their implementation and responses to project-related and external challenges. To document the achievements, challenges, lessons learned, and management responses associated with national fortification projects in Morocco, Uzbekistan, and Vietnam. Independent end-of-project evaluations conducted for each project served as the primary data source and contain the history of and project activities undertaken for, each fortification project. Other sources, including national policy documents, project reports from the Global Alliance for Improved Nutrition (GAIN) and other stakeholders, industry assessments, and peer-reviewed articles, were used to document the current responses to challenges and future project plans. All projects had key achievements related to the development of fortification standards and the procurement of equipment for participating industry partners. Mandatory fortification of wheat flour was a key success in Morocco and Uzbekistan. Ensuring the quality of fortified foods was a common challenge experienced across the projects, as were shifts in consumption patterns and market structures. Adjustments were made to the projects' design to address the challenges faced. National fortification projects are dynamic and must be continually modified in response to specific performance issues and broader shifts in market structure and consumption patterns.

International involvement and national health governance: the basic benefit package in Tajikistan.

PubMed

Rechel, Bernd; Khodjamurodov, Ghafur

2010-06-01

Tajikistan, a Central Asian state of 7.4 million inhabitants, is facing particular health policy challenges: not only is the country the poorest of the former Soviet republics, but its capacity to deal with post-communist transition and economic crisis has been further undermined through civil war and large-scale migration. This paper, examining the introduction of the basic benefit package and formal co-payments, elucidates how international involvement in Tajikistan's health sector has impacted on national health governance. Based on documentary sources and information provided by key informants, we find that external agencies have both strengthened and weakened national health governance. Although they have played a major part in supporting Tajikistan's health sector, these efforts have often been fragmented, as donor coordination was at times less than optimal. A key challenge for national health governance is the limited technical and institutional capacity of the Ministry of Health and further efforts are needed to build national capacity. Copyright 2010 Elsevier Ltd. All rights reserved.

Performance Analysis, Design Considerations, and Applications of Extreme-Scale In Situ Infrastructures

DOE PAGES

Ayachit, Utkarsh; Bauer, Andrew; Duque, Earl P. N.; ...

2016-11-01

A key trend facing extreme-scale computational science is the widening gap between computational and I/O rates, and the challenge that follows is how to best gain insight from simulation data when it is increasingly impractical to save it to persistent storage for subsequent visual exploration and analysis. One approach to this challenge is centered around the idea of in situ processing, where visualization and analysis processing is performed while data is still resident in memory. Our paper examines several key design and performance issues related to the idea of in situ processing at extreme scale on modern platforms: Scalability, overhead,more » performance measurement and analysis, comparison and contrast with a traditional post hoc approach, and interfacing with simulation codes. We illustrate these principles in practice with studies, conducted on large-scale HPC platforms, that include a miniapplication and multiple science application codes, one of which demonstrates in situ methods in use at greater than 1M-way concurrency.« less

Spatially generalizable representations of facial expressions: Decoding across partial face samples.

PubMed

Greening, Steven G; Mitchell, Derek G V; Smith, Fraser W

2018-04-01

A network of cortical and sub-cortical regions is known to be important in the processing of facial expression. However, to date no study has investigated whether representations of facial expressions present in this network permit generalization across independent samples of face information (e.g., eye region vs mouth region). We presented participants with partial face samples of five expression categories in a rapid event-related fMRI experiment. We reveal a network of face-sensitive regions that contain information about facial expression categories regardless of which part of the face is presented. We further reveal that the neural information present in a subset of these regions: dorsal prefrontal cortex (dPFC), superior temporal sulcus (STS), lateral occipital and ventral temporal cortex, and even early visual cortex, enables reliable generalization across independent visual inputs (faces depicting the 'eyes only' vs 'eyes removed'). Furthermore, classification performance was correlated to behavioral performance in STS and dPFC. Our results demonstrate that both higher (e.g., STS, dPFC) and lower level cortical regions contain information useful for facial expression decoding that go beyond the visual information presented, and implicate a key role for contextual mechanisms such as cortical feedback in facial expression perception under challenging conditions of visual occlusion. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interdisciplinary interpretations and applications of the concept of scale in landscape research.

PubMed

Higgins, Sarah; Mahon, Marie; McDonagh, John

2012-12-30

The spatial dimensions of many social, economic and environmental challenges facing 21st century societies can be addressed through the idea of landscape. The European Landscape Convention--ELC (Council of Europe, 2000--Article 1a) views landscape as representing not simply the environment, but the world "as perceived by people". As a concept, landscape is increasingly understood as uniting the physical, mental, natural and cultural dimensions of human existence; good quality landscapes are thus integral to our well-being. The problems and challenges facing our landscapes require greater understanding of how they function and change, as well as their meanings and values. Scholars working in the area of landscape research have increasingly advocated the need to enhance integrative approaches between the natural, human and applied sciences. However, drawing together the collective insights from across the sciences presents a range of conceptual and methodological issues. The question of scale as it pertains to different scientific realms is a key example of this kind of challenge to integrative approaches. The multi-scale nature of the social, environmental and economic challenges embedded in the landscape demands that scholars address these key issues of scale in their research. The aim of this paper is to review how the concept of scale has been interpreted and applied within the arena of landscape research, focussing specifically on three of the principal disciplinary contributors--ecology/landscape ecology, geography and spatial planning. The objective of this discussion is to synthesise scalar issues that feature within and across these perspectives, to better understand how they impact on the way landscape is conceptualised and thus produced through academic and related policy discourses. It seeks out points of tension as well as convergence when dealing with scale. It reflects on academic, policy and practice-related concerns that would form part of longer-term holistic strategies for landscape protection, planning and management in line with those being advocated by the ELC. Copyright © 2012 Elsevier Ltd. All rights reserved.

Towards sustainable and multifunctional agriculture in farmland landscapes: Lessons from the integrative approach of a French LTSER platform.

PubMed

Bretagnolle, Vincent; Berthet, Elsa; Gross, Nicolas; Gauffre, Bertrand; Plumejeaud, Christine; Houte, Sylvie; Badenhausser, Isabelle; Monceau, Karine; Allier, Fabrice; Monestiez, Pascal; Gaba, Sabrina

2018-06-15

Agriculture is currently facing unprecedented challenges: ensuring food, fiber and energy production in the face of global change, maintaining the economic performance of farmers and preserving natural resources such as biodiversity and associated key ecosystem services for sustainable agriculture. Addressing these challenges requires innovative landscape scale farming systems that account for changing economic and environmental targets. These novel agricultural systems need to be recognized, accepted and promoted by all stakeholders, including local residents, and supported by public policies. Agroecosystems should be considered as socio-ecological systems and alternative farming systems should be based on ecological principles while taking societal needs into account. This requires an in-depth knowledge of the multiple interactions between sociological and ecological dynamics. Long Term Socio-Ecological Research platforms (LTSER) are ideal for acquiring this knowledge as they (i) are not constrained by traditional disciplinary boundaries, (ii) operate at a large spatial scale involving all stakeholders, and (iii) use systemic approaches to investigate biodiversity and ecosystem services. This study presents the socio-ecological research strategy from the LTSER "Zone Atelier Plaine & Val de Sèvre" (ZA PVS), a large study area where data has been sampled since 1994. Its global aim is to identify effective solutions for agricultural development and the conservation of biodiversity in farmlands. Three main objectives are targeted by the ZAPVS. The first objective is intensive monitoring of landscape features, the main taxa present and agricultural practices. The second objective is the experimental investigation, in real fields with local farmers, of important ecosystem functions and services, in relation to pesticide use, crop production and farming socio-economic value. The third aim is to involve stakeholders through participatory research, citizen science and the dissemination of scientific results. This paper underlines the relevance of LTSERs for addressing agricultural challenges, while acknowledging that there are some yet unsolved key challenges. Copyright © 2018 Elsevier B.V. All rights reserved.

Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists

PubMed Central

Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

2010-01-01

The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of ‘off-label prescribing’ and ‘indication creep’ behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists. PMID:20716234

Cost-effectiveness analysis and efficient use of the pharmaceutical budget: the key role of clinical pharmacologists.

PubMed

Edlin, Richard; Round, Jeff; Hulme, Claire; McCabe, Christopher

2010-09-01

The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of 'off-label prescribing' and 'indication creep' behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists.

Transferring of speech movements from video to 3D face space.

PubMed

Pei, Yuru; Zha, Hongbin

2007-01-01

We present a novel method for transferring speech animation recorded in low quality videos to high resolution 3D face models. The basic idea is to synthesize the animated faces by an interpolation based on a small set of 3D key face shapes which span a 3D face space. The 3D key shapes are extracted by an unsupervised learning process in 2D video space to form a set of 2D visemes which are then mapped to the 3D face space. The learning process consists of two main phases: 1) Isomap-based nonlinear dimensionality reduction to embed the video speech movements into a low-dimensional manifold and 2) K-means clustering in the low-dimensional space to extract 2D key viseme frames. Our main contribution is that we use the Isomap-based learning method to extract intrinsic geometry of the speech video space and thus to make it possible to define the 3D key viseme shapes. To do so, we need only to capture a limited number of 3D key face models by using a general 3D scanner. Moreover, we also develop a skull movement recovery method based on simple anatomical structures to enhance 3D realism in local mouth movements. Experimental results show that our method can achieve realistic 3D animation effects with a small number of 3D key face models.

Social-ecological innovation in remote mountain areas: Adaptive responses of forest-dependent communities to the challenges of a changing world.

PubMed

Melnykovych, Mariana; Nijnik, Maria; Soloviy, Ihor; Nijnik, Albert; Sarkki, Simo; Bihun, Yurij

2018-02-01

To better understand how constantly changing human-environment interactions could be better organized to respond to current challenges, we examined the Ukrainian Carpathians as an example case of complex forest social-ecological systems (FSES). We did it by interviewing diverse and relevant local stakeholder (N=450). In particular, we strived to: i) outline how people and nature are linked and interact in coupled FSES; ii) examine the preferences of stakeholders on the forests and associated ecosystem services (ES); iii) map key drivers threatening well-being of FSES and iv) identify potential responses to address the challenges at a local scale. To answer these questions we followed a mixed method route by integrating qualitative (participatory) and quantitative data collection and analyses, with further application of a Driving Force-Pressure-State-Impact-Response (DPSIR) framework in combination with the ES approach in order to assess benefits, threats to these benefits, and responses regarding the studied FSES. We found that the key benefit from FSES is timber and non-wood forest products (like berries and mushrooms), but also various regulating services were ranked highly by respondents. To explore social-ecological innovation, with potential responses of forest-dependent communities to challenges they face, we employed a commonly used assumption that governance must fit to the particular characteristics of FSES in order to enable sustainability. For the particular case of the Ukrainian Carpathians, we identified and discussed the following five nonconformities or "misfits" threatening sustainability: 1) Spatial misfit in legislation; 2) Poor contextualization; 3) Trap of the single ES; 4) Participatory misfit; and 5) Robbing the commons. By conceptualizing those key threats, we proposed responses for sustainability. The findings contributed to an advanced understanding of complex FSES, their key challenges and potential solutions in order to secure well-being of people and nature in coupled social-ecological systems, in the conditions of a changing world. Copyright © 2017 Elsevier B.V. All rights reserved.

Lifestyle modification in the management of the metabolic syndrome: achievements and challenges

PubMed Central

Grave, Riccardo Dalle; Calugi, Simona; Centis, Elena; Marzocchi, Rebecca; Ghoch, Marwan El; Marchesini, Giulio

2010-01-01

Lifestyle modification based on behavior therapy is the most important and effective strategy to manage the metabolic syndrome. Modern lifestyle modification therapy combines specific recommendations on diet and exercise with behavioral and cognitive strategies. The intervention may be delivered face-to-face or in groups, or in groups combined with individual sessions. The main challenge of treatment is helping patients maintain healthy behavior changes in the long term. In the last few years, several strategies have been evaluated to improve the long-term effect of lifestyle modification. Promising results have been achieved by combining lifestyle modification with pharmacotherapy, using meals replacement, setting higher physical activity goals, and long-term care. The key role of cognitive processes in the success/failure of weight loss and maintenance suggests that new cognitive procedures and strategies should be included in the traditional lifestyle modification interventions, in order to help patients build a mind-set favoring long-term lifestyle changes. These new strategies raise optimistic expectations for an effective treatment of metabolic syndrome with lifestyle modifications, provided public health programs to change the environment where patients live support them. PMID:21437107

Infrastructure and the Virtual Observatory

NASA Astrophysics Data System (ADS)

Dowler, P.; Gaudet, S.; Schade, D.

2011-07-01

The modern data center is faced with architectural and software engineering challenges that grow along with the challenges facing observatories: massive data flow, distributed computing environments, and distributed teams collaborating on large and small projects. By using VO standards as key components of the infrastructure, projects can take advantage of a decade of intellectual investment by the IVOA community. By their nature, these standards are proven and tested designs that already exist. Adopting VO standards saves considerable design effort, allows projects to take advantage of open-source software and test suites to speed development, and enables the use of third party tools that understand the VO protocols. The evolving CADC architecture now makes heavy use of VO standards. We show examples of how these standards may be used directly, coupled with non-VO standards, or extended with custom capabilities to solve real problems and provide value to our users. In the end, we use VO services as major parts of the core infrastructure to reduce cost rather than as an extra layer with additional cost and we can deliver more general purpose and robust services to our user community.

The face of conservation responding to a dynamically changing world.

PubMed

Wiederholt, Ruscena; Trainor, Anne M; Michel, Nicole; Shirey, Patrick D; Swaisgood, Ronald R; Tallamy, Doug; Cook-Patton, Susan C

2015-09-01

In its 40-year history, the science of conservation has faced unprecedented challenges in terms of environmental damage and rapid global change, and environmental problems are only increasing as greater demands are placed on limited natural resources. Conservation science has been adapting to keep pace with these changes. Here, we highlight contemporary and emerging trends and innovations in conservation science that we believe represent the most effective responses to biodiversity threats. We focus on specific areas where conservation science has had to adjust its approach to address emerging threats to biodiversity, including habitat destruction and degradation, climate change, declining populations and invasive species. We also document changes in attitudes, norms and practices among conservation scientists. A key component to success is engaging and maintaining public support for conservation, which can be facilitated through the use of technology. These recent trends in conservation and management are innovative and will assist in optimizing conservation strategies, increasing our leverage with the general public and tackling our current environmental challenges. © 2015 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

Manufacturing of glassy thin shell for adaptive optics: results achieved

NASA Astrophysics Data System (ADS)

Poutriquet, F.; Rinchet, A.; Carel, J.-L.; Leplan, H.; Ruch, E.; Geyl, R.; Marque, G.

2012-07-01

Glassy thin shells are key components for the development of adaptive optics and are part of future & innovative projects such as ELT. However, manufacturing thin shells is a real challenge. Even though optical requirements for the front face - or optical face - are relaxed compared to conventional passive mirrors, requirements concerning thickness uniformity are difficult to achieve. In addition, process has to be completely re-defined as thin mirror generates new manufacturing issues. In particular, scratches and digs requirement is more difficult as this could weaken the shell, handling is also an important issue due to the fragility of the mirror. Sagem, through REOSC program, has recently manufactured different types of thin shells in the frame of European projects: E-ELT M4 prototypes and VLT Deformable Secondary Mirror (VLT DSM).

A network architecture supporting consistent rich behavior in collaborative interactive applications.

PubMed

Marsh, James; Glencross, Mashhuda; Pettifer, Steve; Hubbold, Roger

2006-01-01

Network architectures for collaborative virtual reality have traditionally been dominated by client-server and peer-to-peer approaches, with peer-to-peer strategies typically being favored where minimizing latency is a priority, and client-server where consistency is key. With increasingly sophisticated behavior models and the demand for better support for haptics, we argue that neither approach provides sufficient support for these scenarios and, thus, a hybrid architecture is required. We discuss the relative performance of different distribution strategies in the face of real network conditions and illustrate the problems they face. Finally, we present an architecture that successfully meets many of these challenges and demonstrate its use in a distributed virtual prototyping application which supports simultaneous collaboration for assembly, maintenance, and training applications utilizing haptics.

Setting up a clinical trial for a novel disease: a case study of the Doxycycline for the Treatment of Nodding Syndrome Trial – challenges, enablers and lessons learned

PubMed Central

Anguzu, Ronald; Akun, Pamela R; Ogwang, Rodney; Shour, Abdul Rahman; Sekibira, Rogers; Ningwa, Albert; Nakamya, Phellister; Abbo, Catherine; Mwaka, Amos D; Opar, Bernard; Idro, Richard

2018-01-01

ABSTRACT A large amount of preparation goes into setting up trials. Different challenges and lessons are experienced. Our trial, testing a treatment for nodding syndrome, an acquired neurological disorder of unknown cause affecting thousands of children in Eastern Africa, provides a unique case study. As part of a study to determine the aetiology, understand pathogenesis and develop specific treatment, we set up a clinical trial in a remote district hospital in Uganda. This paper describes our experiences and documents supportive structures (enablers), challenges faced and lessons learned during set-up of the trial. Protocol development started in September 2015 with phased recruitment of a critical study team. The team spent 12 months preparing trial documents, procurement and training on procedures. Potential recruitment sites were pre-visited, and district and local leaders met as key stakeholders. Key enablers were supportive local leadership and investment by the district and Ministry of Health. The main challenges were community fears about nodding syndrome, adverse experiences of the community during previous research and political involvement. Other challenges included the number and delays in protocol approvals and lengthy procurement processes. This hard-to-reach area has frequent power and Internet fluctuations, which may affect cold chains for study samples, communication and data management. These concerns decreased with a pilot community engagement programme. Experiences and lessons learnt can reduce the duration of processes involved in trial-site set-up. A programme of community engagement and local leader involvement may be key to the success of a trial and in reducing community opposition towards participation in research. PMID:29382251

Setting up a clinical trial for a novel disease: a case study of the Doxycycline for the Treatment of Nodding Syndrome Trial - challenges, enablers and lessons learned.

PubMed

Anguzu, Ronald; Akun, Pamela R; Ogwang, Rodney; Shour, Abdul Rahman; Sekibira, Rogers; Ningwa, Albert; Nakamya, Phellister; Abbo, Catherine; Mwaka, Amos D; Opar, Bernard; Idro, Richard

2018-01-01

A large amount of preparation goes into setting up trials. Different challenges and lessons are experienced. Our trial, testing a treatment for nodding syndrome, an acquired neurological disorder of unknown cause affecting thousands of children in Eastern Africa, provides a unique case study. As part of a study to determine the aetiology, understand pathogenesis and develop specific treatment, we set up a clinical trial in a remote district hospital in Uganda. This paper describes our experiences and documents supportive structures (enablers), challenges faced and lessons learned during set-up of the trial. Protocol development started in September 2015 with phased recruitment of a critical study team. The team spent 12 months preparing trial documents, procurement and training on procedures. Potential recruitment sites were pre-visited, and district and local leaders met as key stakeholders. Key enablers were supportive local leadership and investment by the district and Ministry of Health. The main challenges were community fears about nodding syndrome, adverse experiences of the community during previous research and political involvement. Other challenges included the number and delays in protocol approvals and lengthy procurement processes. This hard-to-reach area has frequent power and Internet fluctuations, which may affect cold chains for study samples, communication and data management. These concerns decreased with a pilot community engagement programme. Experiences and lessons learnt can reduce the duration of processes involved in trial-site set-up. A programme of community engagement and local leader involvement may be key to the success of a trial and in reducing community opposition towards participation in research.

Key Aspects of a Sustainable Health Insurance System in Germany.

PubMed

Pelster, Matthias; Hagemann, Vera; Laporte Uribe, Franziska

2016-06-01

The main goals of health-care systems are to improve the health of the population they serve, respond to people's legitimate expectations, and offer fair financing. As a result, the health system in Germany is subject to continuous adaption as well as public and political discussions about its design. This paper analyzes the key challenges for the German health-care system and the underlying factors driving these challenges. We aim to identify possible solutions to put the German health-care system in a better position to face these challenges. We utilize a broad array of methods to answer these questions, including a review of the published and grey literature on health-care planning in Germany, semi-structured interviews with stakeholders in the system, and an online questionnaire. We find that the most urgent (and manageable) aspects that merit attention are holistic hospital planning, initiatives to increase (administrative) innovation in the health-care system, incentives to increase prevention, and approaches to increase analytical quality assurance. We found that hospital planning, innovation, quality control, and prevention, are considered to be the topics most in need of attention in the German health system.

Engineering the System and Technical Integration

NASA Technical Reports Server (NTRS)

Blair, J. C.; Ryan, R. S.; Schutzenhofer, L. A.

2011-01-01

Approximately 80% of the problems encountered in aerospace systems have been due to a breakdown in technical integration and/or systems engineering. One of the major challenges we face in designing, building, and operating space systems is: how is adequate integration achieved for the systems various functions, parts, and infrastructure? This Contractor Report (CR) deals with part of the problem of how we engineer the total system in order to achieve the best balanced design. We will discuss a key aspect of this question - the principle of Technical Integration and its components, along with management and decision making. The CR will first provide an introduction with a discussion of the Challenges in Space System Design and meeting the challenges. Next is an overview of Engineering the System including Technical Integration. Engineering the System is expanded to include key aspects of the Design Process, Lifecycle Considerations, etc. The basic information and figures used in this CR were presented in a NASA training program for Program and Project Managers Development (PPMD) in classes at Georgia Tech and at Marshall Space Flight Center (MSFC). Many of the principles and illustrations are extracted from the courses we teach for MSFC.

Challenges and opportunities associated with waste management in India

PubMed Central

Kumar, Sunil; Smith, Stephen R.; Fowler, Geoff; Velis, Costas; Kumar, S. Jyoti; Arya, Shashi; Rena; Kumar, Rakesh

2017-01-01

India faces major environmental challenges associated with waste generation and inadequate waste collection, transport, treatment and disposal. Current systems in India cannot cope with the volumes of waste generated by an increasing urban population, and this impacts on the environment and public health. The challenges and barriers are significant, but so are the opportunities. This paper reports on an international seminar on ‘Sustainable solid waste management for cities: opportunities in South Asian Association for Regional Cooperation (SAARC) countries’ organized by the Council of Scientific and Industrial Research-National Environmental Engineering Research Institute and the Royal Society. A priority is to move from reliance on waste dumps that offer no environmental protection, to waste management systems that retain useful resources within the economy. Waste segregation at source and use of specialized waste processing facilities to separate recyclable materials has a key role. Disposal of residual waste after extraction of material resources needs engineered landfill sites and/or investment in waste-to-energy facilities. The potential for energy generation from landfill via methane extraction or thermal treatment is a major opportunity, but a key barrier is the shortage of qualified engineers and environmental professionals with the experience to deliver improved waste management systems in India. PMID:28405362

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

NASA Astrophysics Data System (ADS)

Wopschall, Steven Robert

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

Meeting challenges related to the dietary assessment of ethnic minority populations.

PubMed

Garduño-Diaz, S D; Husain, W; Ashkanani, F; Khokhar, S

2014-08-01

Migrants from the Indian subcontinent comprise the largest minority group in the UK. With the process of migration come alterations in lifestyle and eating habits. The present study aimed to disseminate the valuable information, experiences and challenges faced by researchers who conduct studies with ethnic minority groups in the area of diet and nutritional surveys, with an emphasis on migrant South Asians. The findings reported are the result of research carried out during 2008-2012, involving 1100 face-to-face dietary recalls conducted in the UK among South Asian children (aged 1.5-11 years; n = 300) and adults (≥30 years; n = 100). Factors to consider when planning and carrying out diet and nutrition survey studies among migrant South Asians were identified and include the employment of culture-specific tools, visual aid reinforcement and the involvement of key community members and translators to facilitate recruitment and data collection. One of the best practices found when working with minority groups was the use of incentives and tangible benefits to reward study participants. It was also found that constant communication and follow-up of the study participants improved the quality of the data and the likelihood of maintaining links with community members for future studies. From the results of in-house studies and a revision of practices reported in earlier literature, two 24-h face-to-face dietary recalls are recommended as the optimal method for the dietary assessment of migrant South Asians. To complement this assessment, ethnic-specific food frequency questionnaires such as that developed and successfully implemented among South Asians in the present study must be employed. © 2013 The British Dietetic Association Ltd.

E-Mentoring the Online Doctoral Student from the Dissertation Prospectus through Dissertation Completion

ERIC Educational Resources Information Center

Black, Ronald

2017-01-01

Faculty who mentor online doctoral candidates face many of the same challenges and opportunities as those mentoring doctoral candidates in traditional, face-to-face modalities. The main difference is that E-Mentoring is based on interacting in the online space rather than interacting face-to-face, which may present challenges for both the…

Enabling a sustainable and prosperous future through science and innovation in the bioeconomy at Agriculture and Agri-Food Canada.

PubMed

Sarkar, Sara F; Poon, Jacquelyne S; Lepage, Etienne; Bilecki, Lori; Girard, Benoit

2018-01-25

Science and innovation are important components underpinning the agricultural and agri-food system in Canada. Canada's vast geographical area presents diverse, regionally specific requirements in addition to the 21st century agricultural challenges facing the overall sector. As the broader needs of the agricultural landscape have evolved and will continue to do so in the next few decades, there is a trend in place to transition towards a sustainable bioeconomy, contributing to reducing greenhouse gas emission and our dependency on non-renewable resources. We highlight some of the key policy drivers on an overarching national scale and those specific to agricultural research and innovation that are critical to fostering a supportive environment for innovation and a sustainable bioeconomy. As well, we delineate some major challenges and opportunities facing agriculture in Canada, including climate change, sustainable agriculture, clean technologies, and agricultural productivity, and some scientific initiatives currently underway to tackle these challenges. The use of various technologies and scientific efforts, such as Next Generation Sequencing, metagenomics analysis, satellite image analysis and mapping of soil moisture, and value-added bioproduct development will accelerate scientific development and innovation and its contribution to a sustainable and prosperous bioeconomy. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Sustainability appraisal of water governance regimes: the case of Guanacaste, Costa Rica.

PubMed

Kuzdas, Christopher; Wiek, Arnim; Warner, Benjamin; Vignola, Raffaele; Morataya, Ricardo

2014-08-01

Sustainability appraisals produce evidence for how well water governance regimes operate and where problems exist. This evidence is particularly relevant for regions that face water scarcity and conflicts. In this study, we present a criteria-based and participatory sustainability appraisal of water governance in a region with such characteristics-the dry tropics of NW Costa Rica. Data collection included 47 interviews and three stakeholder workshops. The appraisal was conducted through a collaborative and iterative process between researchers and stakeholders. Out of the 25 sustainability criteria used, seven posed a significant challenge for the governance regime. We found challenges faced by the governance regime primarily clustered around and were re-enforced by failing coordination related to the use, management, and protection of groundwater resources; and inadequate leadership to identify collective goals and to constructively deliberate alternative ways of governing water with diverse groups. The appraisal yielded some positive impact in the study area, yet we found its application provided only limited strategic information to support broader problem-solving efforts. Insights from this study suggest key starting points for sustainable water governance in the Central American dry tropics, including investing in increasingly influential collective organizations that are already active in water governance; and leveraging policy windows that can be used to build confidence and disperse more governing authority to regional and local governing actors that are in-tune with the challenges faced in the dry tropics. We conclude the article with reflections on how to produce research results that are actionable for sustainable water governance.

Sustainability Appraisal of Water Governance Regimes: The Case of Guanacaste, Costa Rica

NASA Astrophysics Data System (ADS)

Kuzdas, Christopher; Wiek, Arnim; Warner, Benjamin; Vignola, Raffaele; Morataya, Ricardo

2014-08-01

Sustainability appraisals produce evidence for how well water governance regimes operate and where problems exist. This evidence is particularly relevant for regions that face water scarcity and conflicts. In this study, we present a criteria-based and participatory sustainability appraisal of water governance in a region with such characteristics—the dry tropics of NW Costa Rica. Data collection included 47 interviews and three stakeholder workshops. The appraisal was conducted through a collaborative and iterative process between researchers and stakeholders. Out of the 25 sustainability criteria used, seven posed a significant challenge for the governance regime. We found challenges faced by the governance regime primarily clustered around and were re-enforced by failing coordination related to the use, management, and protection of groundwater resources; and inadequate leadership to identify collective goals and to constructively deliberate alternative ways of governing water with diverse groups. The appraisal yielded some positive impact in the study area, yet we found its application provided only limited strategic information to support broader problem-solving efforts. Insights from this study suggest key starting points for sustainable water governance in the Central American dry tropics, including investing in increasingly influential collective organizations that are already active in water governance; and leveraging policy windows that can be used to build confidence and disperse more governing authority to regional and local governing actors that are in-tune with the challenges faced in the dry tropics. We conclude the article with reflections on how to produce research results that are actionable for sustainable water governance.

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

ERIC Educational Resources Information Center

DuBose, Cheryl O.

2017-01-01

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

The Sisters of Mercy in the Crimean War: Lessons for Catholic health care

PubMed Central

Paradis, Mary Raphael; Hart, Edith Mary; O’Brien, Mary Judith

2017-01-01

In 1856, an appeal went out to nurses in both England and Ireland, and especially to religious nurses, to care for the troops fighting in the Crimean War. The Sisters of Mercy, founded in 1831 by Venerable Catherine McAuley, answered that call. This article describes the enormous challenges the Sisters faced in that mission, which was a test of their nursing skills, flexibility, organizational ability, and their spirit of mercy. The challenges they faced professionally and as religious Sisters, the manner in which they faced those challenges, and their spiritual lives as religious women shaped their ability to give comprehensive care. Some applications are made to the challenges which religious communities and organizations working in health care face in our country at this time. Summary: This article describes the challenges faced by a group of Sisters of Mercy from England and Ireland who volunteered to serve as nurses in the Crimean War from 1856 to 1858. Applications are made to challenges which are faced by religious communities and organizations in the current secular healthcare environment. PMID:28392597

The Sisters of Mercy in the Crimean War: Lessons for Catholic health care.

PubMed

Paradis, Mary Raphael; Hart, Edith Mary; O'Brien, Mary Judith

2017-02-01

In 1856, an appeal went out to nurses in both England and Ireland, and especially to religious nurses, to care for the troops fighting in the Crimean War. The Sisters of Mercy, founded in 1831 by Venerable Catherine McAuley, answered that call. This article describes the enormous challenges the Sisters faced in that mission, which was a test of their nursing skills, flexibility, organizational ability, and their spirit of mercy. The challenges they faced professionally and as religious Sisters, the manner in which they faced those challenges, and their spiritual lives as religious women shaped their ability to give comprehensive care. Some applications are made to the challenges which religious communities and organizations working in health care face in our country at this time. Summary: This article describes the challenges faced by a group of Sisters of Mercy from England and Ireland who volunteered to serve as nurses in the Crimean War from 1856 to 1858. Applications are made to challenges which are faced by religious communities and organizations in the current secular healthcare environment.

Efficiency and factors influencing efficiency of Community Health Strategy in providing Maternal and Child Health services in Mwingi District, Kenya: an expert opinion perspective

PubMed Central

Nzioki, Japheth Mativo; Onyango, Rosebella Ogutu; Ombaka, James Herbert

2015-01-01

Introduction Community Health Strategy (CHS) is a new Primary Health Care (PHC) model in Kenya, designed to provide PHC services in Kenya. In 2011, CHS was initiated in Mwingi district as one of the components of APHIA plus kamili program. The objectives of this study was to evaluate the efficiency of the CHS in providing MCH services in Mwingi district and to establish the factors influencing efficiency of the CHS in providing MCH services in the district. Methods This was a qualitative study. Fifteen Key informants were sampled from key stakeholders. Sampling was done using purposive and maximum variation sampling methods. Semi-structured in-depth interviews were used for data collection. Data was managed and analyzed using NVIVO. Framework analysis and quasi statistics were used in data analysis. Results Expert opinion data indicated that the CHS was efficient in providing MCH services. Factors influencing efficiency of the CHS in provision of MCH services were: challenges facing Community Health Workers (CHWs), Social cultural and economic factors influencing MCH in the district, and motivation among CHWs. Conclusion Though CHS was found to be efficient in providing MCH services, this was an expert opinion perspective, a quantitative Cost Effectiveness Analysis (CEA) to confirm these findings is recommended. To improve efficiency of the CHS in the district, challenges facing CHWs and Social cultural and economic factors that influence efficiency of the CHS in the district need to be addressed. PMID:26090046

78 FR 17276 - Agency Information Collection Activities: Proposed Request and Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-20

... information collection in field offices via personal contact (face-to-face or telephone interview) using the... voice recognition technology, or by keying in responses using a telephone key pad. The SSIMWR allows... Development Worksheets: Face-to-Face Interview and Telephone Interview--20 CFR 416.204(b) and 422.135--0960...

77 FR 76591 - Agency Information Collection Activities: Proposed Request and Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... voice recognition technology, or by keying in responses using a telephone key pad. The SSIMWR allows... Worksheets: Face-to-Face Interview and Telephone Interview--20 CFR 416.204(b) and 422.135--0960- 0780. SSA... each interview either over the telephone or through a face-to-face discussion with the centenarian...

Deep brain stimulation and ethics: perspectives from a multisite qualitative study of Canadian neurosurgical centers.

PubMed

Bell, Emily; Maxwell, Bruce; McAndrews, Mary Pat; Sadikot, Abbas; Racine, Eric

2011-12-01

Deep brain stimulation (DBS) is an approved neurosurgical intervention for motor disorders such as Parkinson disease. The emergence of psychiatric uses for DBS combined with the fact that it is an invasive and expensive procedure creates important ethical and social challenges in the delivery of care that need further examination. We endeavored to examine health care provider perspectives on ethical and social challenges encountered in DBS. Health care providers working in Canadian DBS surgery programs participated in a semistructured interview to identify and characterize ethical and social challenges of DBS. A content analysis of the interviews was conducted. Several key ethical issues, such as patient screening and resource allocation, were identified by members of neurosurgical teams. Providers described challenges in selecting patients for DBS on the basis of unclear evidence-based guidance regarding behavioral issues or cognitive criteria. Varied contexts of resource allocation, including some very challenging schemas, were also reported. In addition, the management of patients in the community was highlighted as a source of ethical and clinical complexity, given the need for coordinated long-term care. This study provides insights into the complexity of ethical challenges that providers face in the use of DBS across different neurosurgical centers. We propose actions for health care providers for the long-term care and postoperative monitoring of patients with DBS. More data on patient perspectives in DBS would complement the understanding of key challenges, as well as contribute to best practices, for patient selection, management, and resource allocation. Copyright © 2011 Elsevier Inc. All rights reserved.

Different perspectives on the key challenges facing rural health: The challenges of power and knowledge.

PubMed

Malatzky, Christina; Bourke, Lisa

2018-05-25

To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.

Health and health-care systems in southeast Asia: diversity and transitions.

PubMed

Chongsuvivatwong, Virasakdi; Phua, Kai Hong; Yap, Mui Teng; Pocock, Nicola S; Hashim, Jamal H; Chhem, Rethy; Wilopo, Siswanto Agus; Lopez, Alan D

2011-01-29

Southeast Asia is a region of enormous social, economic, and political diversity, both across and within countries, shaped by its history, geography, and position as a major crossroad of trade and the movement of goods and services. These factors have not only contributed to the disparate health status of the region's diverse populations, but also to the diverse nature of its health systems, which are at varying stages of evolution. Rapid but inequitable socioeconomic development, coupled with differing rates of demographic and epidemiological transitions, have accentuated health disparities and posed great public health challenges for national health systems, particularly the control of emerging infectious diseases and the rise of non-communicable diseases within ageing populations. While novel forms of health care are evolving in the region, such as corporatised public health-care systems (government owned, but operating according to corporate principles and with private-sector participation) and financing mechanisms to achieve universal coverage, there are key lessons for health reforms and decentralisation. New challenges have emerged with rising trade in health services, migration of the health workforce, and medical tourism. Juxtaposed between the emerging giant economies of China and India, countries of the region are attempting to forge a common regional identity, despite their diversity, to seek mutually acceptable and effective solutions to key regional health challenges. In this first paper in the Lancet Series on health in southeast Asia, we present an overview of key demographic and epidemiological changes in the region, explore challenges facing health systems, and draw attention to the potential for regional collaboration in health. Copyright © 2011 Elsevier Ltd. All rights reserved.

Venture Capital Investment in the Life Sciences in Switzerland.

PubMed

Hosang, Markus

2014-12-01

Innovation is one of the main driving factors for continuous and healthy economic growth and welfare. Switzerland as a resource-poor country is particularly dependent on innovation, and the life sciences, which comprise biotechnologies, (bio)pharmaceuticals, medical technologies and diagnostics, are one of the key areas of innovative strength of Switzerland. Venture capital financing and venture capitalists (frequently called 'VCs') and investors in public equities have played and still play a pivotal role in financing the Swiss biotechnology industry. In the following some general features of venture capital investment in life sciences as well as some opportunities and challenges which venture capital investors in Switzerland are facing are highlighted. In addition certain means to counteract these challenges including the 'Zukunftsfonds Schweiz' are discussed.

Community in Online Higher Education: Challenges and Opportunities

ERIC Educational Resources Information Center

Arasaratnam-Smith, Lily A.; Northcote, Maria

2017-01-01

Exploring the challenges and opportunities associated with the concepts of community and communication in online higher education, this paper reconsiders the intention to replicate face-to-face learning and teaching strategies in online learning environments. Rather than beginning with the assumption that face-to-face education is the prototype…

Operational research as implementation science: definitions, challenges and research priorities.

PubMed

Monks, Thomas

2016-06-06

Operational research (OR) is the discipline of using models, either quantitative or qualitative, to aid decision-making in complex implementation problems. The methods of OR have been used in healthcare since the 1950s in diverse areas such as emergency medicine and the interface between acute and community care; hospital performance; scheduling and management of patient home visits; scheduling of patient appointments; and many other complex implementation problems of an operational or logistical nature. To date, there has been limited debate about the role that operational research should take within implementation science. I detail three such roles for OR all grounded in upfront system thinking: structuring implementation problems, prospective evaluation of improvement interventions, and strategic reconfiguration. Case studies from mental health, emergency medicine, and stroke care are used to illustrate each role. I then describe the challenges for applied OR within implementation science at the organisational, interventional, and disciplinary levels. Two key challenges include the difficulty faced in achieving a position of mutual understanding between implementation scientists and research users and a stark lack of evaluation of OR interventions. To address these challenges, I propose a research agenda to evaluate applied OR through the lens of implementation science, the liberation of OR from the specialist research and consultancy environment, and co-design of models with service users. Operational research is a mature discipline that has developed a significant volume of methodology to improve health services. OR offers implementation scientists the opportunity to do more upfront system thinking before committing resources or taking risks. OR has three roles within implementation science: structuring an implementation problem, prospective evaluation of implementation problems, and a tool for strategic reconfiguration of health services. Challenges facing OR as implementation science include limited evidence and evaluation of impact, limited service user involvement, a lack of managerial awareness, effective communication between research users and OR modellers, and availability of healthcare data. To progress the science, a focus is needed in three key areas: evaluation of OR interventions, embedding the knowledge of OR in health services, and educating OR modellers about the aims and benefits of service user involvement.

Ineffective Healthcare Technology Management in Benin’s Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems

PubMed Central

Houngbo, P. Thierry; De Cock Buning, Tjard; Bunders, Joske; Coleman, Harry L. S.; Medenou, Daton; Dakpanon, Laurent; Zweekhorst, Marjolein

2017-01-01

Background: Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin’s public health sector, as well as the ability of key actors within the sector to address these problems. Methods: We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin’s health system, was used as a conceptual framework. Results: The findings of the first survey show that 85% of key actors in Benin’s HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection – categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework – and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development. Conclusion: The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin’s HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development. PMID:28949474

What Factors Contribute to Intimate Partner Violence Against Women in Urban, Conflict-Affected Settings? Qualitative Findings from Abidjan, Côte d'Ivoire.

PubMed

Cardoso, L F; Gupta, J; Shuman, S; Cole, H; Kpebo, D; Falb, K L

2016-04-01

Rapid urbanization is a key driver of the unique set of health risks facing urban populations. One of the most critical health hazards facing urban women is intimate partner violence (IPV). In post-conflict urban areas, women may face an even greater risk of IPV. Yet, few studies have examined the IPV experiences of urban-dwelling, conflict-affected women, including those who have been internally displaced. This study qualitatively examined the social and structural characteristics of the urban environment that contributed to the IPV experiences of women residing in post-conflict Abidjan, Côte d'Ivoire. Ten focus groups were conducted with men and women, both internally displaced (IDPs) and non-displaced. Lack of support networks, changing gender roles, and tensions between traditional gender norms and those of the "modern" city were reported as key contributors to IPV. Urban poverty and with it unemployment, food insecurity, and housing instability also played a role. Finally, IDPs faced heightened vulnerability to IPV as a result of displacement and discrimination. The relationship between economic strains and IPV are similar to other conflict-affected settings, but Abidjan's urban environment presented other unique characteristics contributing to IPV. Understanding these factors is crucial to designing appropriate services for women and for implementing IPV reduction interventions in urban areas. Strengthening formal and informal mechanisms for help-seeking, utilizing multi-modal interventions that address economic stress and challenge inequitable gender norms, as well as tailoring programs specifically for IDPs, are some considerations for IPV program planning focused on conflict-affected women in urban areas.

Beyond Fossil Fuels: Options and Challenges

NASA Astrophysics Data System (ADS)

Thompson, Levi T.

2007-05-01

Securing our nation’s energy supply is arguably the most important challenge we face. The source and amount of energy that is available impacts nearly every aspect of our lives including our mobility, health and welfare. Presently, the U.S. depends heavily on foreign energy resources. For example, in 2006, nearly 60 percent of the crude oil consumed in the U.S. was imported; approximately one-quarter of this oil comes from the Persian Gulf. With growing demands from emerging economies, declining environmental quality and potential for global conflict, there is a pressing need to develop a more sustainable energy strategy. This presentation will review options for a sustainable energy economy including the use of hydrogen and fuel cells, and describe some of the key challenges To cite this abstract, use the following reference: http://meetings.aps.org/link/BAPS.2007.OSS07.A1.2

A proposed reductionist solution to address the methodological challenges of inconsistent reflexology maps and poor experimental controls in reflexology research: a discussion paper.

PubMed

Jones, Jenny; Thomson, Patricia; Lauder, William; Leslie, Stephen J

2013-03-01

Reflexology is a complex massage intervention, based on the concept that specific areas of the feet (reflex points) correspond to individual internal organs within the body. Reflexologists trained in the popular Ingham reflexology method claim that massage to these points, using massage techniques unique to reflexology, stimulates an increase in blood supply to the corresponding organ. Reflexology researchers face two key methodological challenges that need to be addressed if a specific treatment-related hemodynamic effect is to be scientifically demonstrated. The first is the problem of inconsistent reflexology foot maps; the second is the issue of poor experimental controls. This article proposes a potential experimental solution that we believe can address both methodological challenges and in doing so, allow any specific hemodynamic treatment effect unique to reflexology to experimentally reveal itself.

Magnetic resonance microscopy: concepts, challenges, and state-of-the-art.

PubMed

Gimi, Barjor

2006-01-01

Recent strides in targeted therapy and regenerative medicine have created a need to identify molecules and metabolic pathways implicated in a disease and its treatment. These molecules and pathways must be discerned at the cellular level to meaningfully reveal the biochemical underpinnings of the disease and to identify key molecular targets for therapy. Magnetic resonance (MR) techniques are well suited for molecular and functional imaging because of their noninvasive nature and their versatility in extracting physiological, biochemical, and functional information over time. However, MR is an insensitive technique; MR microscopy seeks to increase detection sensitivity, thereby localizing biochemical and functional information at the level of single cells or small cellular clusters. Here, we discuss some of the challenges facing MR microscopy and the technical and phenomenological strategies used to overcome these challenges. Some of the applications of MR microscopy are highlighted in this chapter.

Conservation biology in Asia: the major policy challenges.

PubMed

McNeely, Jeffrey A; Kapoor-Vijay, Promila; Zhi, Lu; Olsvig-Whittaker, Linda; Sheikh, Kashif M; Smith, Andrew T

2009-08-01

With about half the world's human population and booming economies, Asia faces numerous challenges to its biodiversity. The Asia Section of the Society for Conservation Biology has identified some key policy issues in which significant progress can be made. These include developing new sources of funding for forest conservation; identifying potential impacts of energy alternatives on the conservation of biodiversity; curbing the trade in endangered species of plants and animals; a special focus on the conservation of mountain biodiversity; enhancing relevant research; ensuring that conservation biology contributes to major international conventions and funding mechanisms; using conservation biology to build a better understanding of zoonotic diseases; more effectively addressing human-animal conflicts; enhancing community-based conservation; and using conservation biology to help address the pervasive water-deficit problems in much of Asia. These challenges can be met through improved regional cooperation among the relevant stakeholders.

THE CHALLENGING ROLE OF A READING COACH, A CAUTIONARY TALE.

PubMed

Al Otaiba, Stephanie; Hosp, John L; Smartt, Susan; Dole, Janice A

2008-04-01

The purpose of this case study is to describe the challenges one coach faced during the initial implementation of a coaching initiative involving 33 teachers in an urban, high-poverty elementary school. Reading coaches are increasingly expected to play a key role in the professional development efforts to improve reading instruction in order to improve reading achievement for struggling readers. Data sources included initial reading scores for kindergarten and first-graders, pretest and posttest scores of teachers' knowledge, a teacher survey, focus group interviews, project documents, and field notes. Data were analyzed using a mixed methods approach. Findings revealed several challenges that have important implications for research and practice: that teachers encountered new information about teaching early reading that conflicted with their current knowledge, this new information conflicted with their core reading program, teachers had differing perceptions of the role of the reading coach that affected their feelings about the project, and reform efforts are time-intensive.

The psychosocial challenges of solid organ transplant recipients during childhood.

PubMed

Annunziato, Rachel A; Jerson, Bradley; Seidel, Jordan; Glenwick, David S

2012-11-01

A large proportion of pediatric solid organ transplant recipients are young children, yet dedicated studies on the challenges faced by these patients are sparse. The present article aims to provide a summary of key considerations for pediatric solid organ transplant teams, describing what challenges are more likely for younger patients and how they might identify and address these circumstances. Our findings suggest that the mental health of patients and caregivers, issues at school, neurocognitive difficulties, and self-management are areas of particular relevance for children. We offer several recommendations that stem from these identified areas of concern. Dedicated focus on the well-being of younger patients could in the long-term stave off adverse events that are often associated with adolescence. In the short-term, certainly intervening in any of these domains could lead to improved quality of life during childhood. © 2012 John Wiley & Sons A/S.

Overview of the critical disaster management challenges faced during Van 2011 earthquakes.

PubMed

Tolon, Mert; Yazgan, Ufuk; Ural, Derin N; Goss, Kay C

2014-01-01

On October 23, 2011, a M7.2 earthquake caused damage in a widespread area in the Van province located in eastern Turkey. This strong earthquake was followed by a M5.7 earthquake on November 9, 2011. This sequence of damaging earthquakes led to 644 fatalities. The management during and after these earthquake disaster imposed many critical challenges. In this article, an overview of these challenges is presented based on the observations by the authors in the aftermath of this disaster. This article presents the characteristics of 2011 Van earthquakes. Afterward, the key information related to the four main phases (ie, preparedness, mitigation, response, and recovery) of the disaster in Van is presented. The potential strategies that can be taken to improve the disaster management practice are identified, and a set of recommendations are proposed to improve the existing situation.

Global survey of hospital pharmacy practice.

PubMed

Doloresco, Fred; Vermeulen, Lee C

2009-03-01

The current state of hospital pharmacy practice around the globe and key issues facing international hospital pharmacy practice were studied. This survey assessed multiple aspects of hospital pharmacy practice within each of the Member States recognized by the United Nations. An official respondent from each nation was identified by a structured nomination process. The survey instrument was developed; pilot tested; translated into English, French, and Spanish; and distributed in July 2007. The nature, scope, and breadth of hospital pharmacy practices in medication procurement, prescribing, preparation and distribution, administration, outcomes monitoring, and human resources and training were evaluated. Descriptive statistics were used to characterize the responses. Eighty-five countries (44% of the 192 Member States) responded to the survey. The respondent sample of countries was representative of all nations in terms of population, geographic region, World Health Organization region, and level of economic development. In addition to qualifying the nature of hospital pharmacy practice, the survey highlighted numerous challenges facing the profession of pharmacy in the hospital setting around the globe, including access to medicines and adequately trained pharmacists. While the practice of hospital pharmacy differs from country to country, many nations face similar challenges, regardless of their population, location, or wealth. These survey results provide a basis for identifying opportunities for growth and development, as well as for international collaboration, to advance the profession of pharmacy and ensure that patients worldwide receive the care that they deserve.

Evaluation of a 'virtual' approach to commissioning health research.

PubMed

McCourt, Christine A; Morgan, Philip A; Youll, Penny

2006-10-18

The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated) approach to health research commissioning. This had been introduced experimentally in a DOH programme--the 'Health of Londoners Programme'--in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face) commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66); structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. There is potential for using computer-mediated communication within the research commissioning process. This may enhance access, effectiveness and transparency of decision-making but further development is needed for this to be fully realised, including attention to process as well as the computer-mediated medium.

Evaluation of a 'virtual' approach to commissioning health research

PubMed Central

McCourt, Christine A; Morgan, Philip A; Youll, Penny

2006-01-01

Background The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated) approach to health research commissioning. This had been introduced experimentally in a DOH programme – the 'Health of Londoners Programme' – in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. Methods A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face) commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66); structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. Results The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. Conclusion There is potential for using computer-mediated communication within the research commissioning process. This may enhance access, effectiveness and transparency of decision-making but further development is needed for this to be fully realised, including attention to process as well as the computer-mediated medium. PMID:17049079

Opportunities and Challenges for Drug Development: Public-Private Partnerships, Adaptive Designs and Big Data.

PubMed

Yildirim, Oktay; Gottwald, Matthias; Schüler, Peter; Michel, Martin C

2016-01-01

Drug development faces the double challenge of increasing costs and increasing pressure on pricing. To avoid that lack of perceived commercial perspective will leave existing medical needs unmet, pharmaceutical companies and many other stakeholders are discussing ways to improve the efficiency of drug Research and Development. Based on an international symposium organized by the Medical School of the University of Duisburg-Essen (Germany) and held in January 2016, we discuss the opportunities and challenges of three specific areas, i.e., public-private partnerships, adaptive designs and big data. Public-private partnerships come in many different forms with regard to scope, duration and type and number of participants. They range from project-specific collaborations to strategic alliances to large multi-party consortia. Each of them offers specific opportunities and faces distinct challenges. Among types of collaboration, investigator-initiated studies are becoming increasingly popular but have legal, ethical, and financial implications. Adaptive trial designs are also increasingly discussed. However, adaptive should not be used as euphemism for the repurposing of a failed trial; rather it requires carefully planning and specification before a trial starts. Adaptive licensing can be a counter-part of adaptive trial design. The use of Big Data is another opportunity to leverage existing information into knowledge useable for drug discovery and development. Respecting limitations of informed consent and privacy is a key challenge in the use of Big Data. Speakers and participants at the symposium were convinced that appropriate use of the above new options may indeed help to increase the efficiency of future drug development.

Opportunities and Challenges for Drug Development: Public–Private Partnerships, Adaptive Designs and Big Data

PubMed Central

Yildirim, Oktay; Gottwald, Matthias; Schüler, Peter; Michel, Martin C.

2016-01-01

Drug development faces the double challenge of increasing costs and increasing pressure on pricing. To avoid that lack of perceived commercial perspective will leave existing medical needs unmet, pharmaceutical companies and many other stakeholders are discussing ways to improve the efficiency of drug Research and Development. Based on an international symposium organized by the Medical School of the University of Duisburg-Essen (Germany) and held in January 2016, we discuss the opportunities and challenges of three specific areas, i.e., public–private partnerships, adaptive designs and big data. Public–private partnerships come in many different forms with regard to scope, duration and type and number of participants. They range from project-specific collaborations to strategic alliances to large multi-party consortia. Each of them offers specific opportunities and faces distinct challenges. Among types of collaboration, investigator-initiated studies are becoming increasingly popular but have legal, ethical, and financial implications. Adaptive trial designs are also increasingly discussed. However, adaptive should not be used as euphemism for the repurposing of a failed trial; rather it requires carefully planning and specification before a trial starts. Adaptive licensing can be a counter-part of adaptive trial design. The use of Big Data is another opportunity to leverage existing information into knowledge useable for drug discovery and development. Respecting limitations of informed consent and privacy is a key challenge in the use of Big Data. Speakers and participants at the symposium were convinced that appropriate use of the above new options may indeed help to increase the efficiency of future drug development. PMID:27999543

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

PubMed

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

2017-09-01

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

Facilitating the improved management of waste in South Africa through a national waste information system

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

Godfrey, Linda

2008-07-01

Developing a waste information system (WIS) for a country is more than just about collecting routine data on waste; it is about facilitating the improved management of waste by providing timely, reliable information to the relevant role-players. It is a means of supporting the waste governance challenges facing South Africa - challenges ranging from strategic waste management issues at national government to basic operational challenges at local government. The paper addresses two hypotheses. The first is that the identified needs of government can provide a platform from which to design a national WIS framework for a developing country such asmore » South Africa, and the second is that the needs for waste information reflect greater, currently unfulfilled challenges in the sustainable management of waste. Through a participatory needs analysis process, it is shown that waste information is needed by the three spheres of government, to support amongst others, informed planning and decision-making, compliance monitoring and enforcement, community participation through public access to information, human, infrastructure and financial resource management and policy development. These needs for waste information correspond closely with key waste management challenges currently facing the country. A shift in governments approach to waste, in line with national and international policy, is evident from identified current and future waste information needs. However, the need for information on landfilling remains entrenched within government, possibly due to the poor compliance of landfill sites in South Africa and the problems around the illegal disposal of both general and hazardous waste.« less

The role of structural dynamics in the design and operations of space systems: The history, the lessons, the technical challenges of the future

NASA Technical Reports Server (NTRS)

Ryan, Robert S.

1994-01-01

Structural dynamics and its auxiliary fields are the most progressive and challenging areas space system engineering design and operations face. Aerospace systems are dependent on structural dynamicists for their success. Past experiences (history) are colored with many dynamic issues, some producing ground or flight test failures. The innovation and creativity that was brought to these issues and problems are the aura from the past that lights the path to the future. Using this illumination to guide understanding of the dynamic phenomena and designing for its potential occurrence are the keys to successful space systems. Our great paradox, or challenge, is how we remain in depth specialists, yet become generalists to the degree that we make good team members and set the right priorities. This paper will deal with how we performed with acclaim in the past, the basic characteristics of structural dynamics (loads cycle, for example), and the challenges of the future.

Issues and Challenges Facing Flexible Lithium-Ion Batteries for Practical Application.

PubMed

Cha, Hyungyeon; Kim, Junhyeok; Lee, Yoonji; Cho, Jaephil; Park, Minjoon

2017-12-27

With the advent of flexible electronics, lithium-ion batteries have become a key component of high performance energy storage systems. Thus, considerable effort is made to keep up with the development of flexible lithium-ion batteries. To date, many researchers have studied newly designed batteries with flexibility, however, there are several significant challenges that need to be overcome, such as degradation of electrodes under external load, poor battery performance, and complicated cell preparation procedures. In addition, an in-depth understanding of the current challenges for flexible batteries is rarely addressed in a systematical and practical way. Herein, recent progress and current issues of flexible lithium-ion batteries in terms of battery materials and cell designs are reviewed. A critical overview of important issues and challenges for the practical application of flexible lithium-ion batteries is also provided. Finally, the strategies are discussed to overcome current limitations of the practical use of flexible lithium-based batteries, providing a direction for future research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Developing a Robust Strategy for Implementing a Water Resources Master Plan in Lima, Peru

NASA Astrophysics Data System (ADS)

Kalra, N.; Groves, D.; Bonzanigo, L.; Molina-Perez, E.

2015-12-01

Lima, the capital of Peru, faces significant water stress. It is the fifth largest metropolitan area in Latin America, and the second largest desert city in the world. The city has developed a Master Plan of major investment projects to improve water reliability until 2040. Yet key questions remain. Is the Master Plan sufficient for ensuring reliability in the face of deeply uncertain future climate change and demand? How do uncertain budget and project feasibility conditions shape Lima's options? How should the investments in the plan be prioritized, and can some be delayed? Lima is not alone in facing these planning challenges. Governments invest billions of dollars annually in long-term projects. Yet deep uncertainties pose formidable challenges to making near-term decisions that make long-term sense. The World Bank has spearheaded a community of practice on methods for Decision Making Under Deep Uncertainty (DMU). This pilot project in Peru is the first in-depth application of DMU techniques to water supply planning in a developing country. It builds on prior analysis done in New York, California, and for the Colorado River, yet shows how these methods can be applied in regions which do not have as advanced data or tools available. The project combines three methods in particular -- Robust Decision Making, Decision Scaling, and Adaptive Pathways -- to help Lima implement its Master Plan in a way that is robust, no-regret, and adaptive. It was done in close partnership with SEDAPAL, the water utility company in Lima, and in coordination with other national WRM and meteorological agencies. This talk will: Present the planning challenges Lima and other cities face, including climate change Describe DMU methodologies and how they were applied in collaboration with SEDAPAL Summarize recommendations for achieving long-term water reliability in Lima Suggest how these methodologies can benefit other investment projects in developing countries.

Can the usage of human growth hormones affect facial appearance and the accuracy of face recognition systems?

NASA Astrophysics Data System (ADS)

Rose, Jake; Martin, Michael; Bourlai, Thirimachos

2014-06-01

In law enforcement and security applications, the acquisition of face images is critical in producing key trace evidence for the successful identification of potential threats. The goal of the study is to demonstrate that steroid usage significantly affects human facial appearance and hence, the performance of commercial and academic face recognition (FR) algorithms. In this work, we evaluate the performance of state-of-the-art FR algorithms on two unique face image datasets of subjects before (gallery set) and after (probe set) steroid (or human growth hormone) usage. For the purpose of this study, datasets of 73 subjects were created from multiple sources found on the Internet, containing images of men and women before and after steroid usage. Next, we geometrically pre-processed all images of both face datasets. Then, we applied image restoration techniques on the same face datasets, and finally, we applied FR algorithms in order to match the pre-processed face images of our probe datasets against the face images of the gallery set. Experimental results demonstrate that only a specific set of FR algorithms obtain the most accurate results (in terms of the rank-1 identification rate). This is because there are several factors that influence the efficiency of face matchers including (i) the time lapse between the before and after image pre-processing and restoration face photos, (ii) the usage of different drugs (e.g. Dianabol, Winstrol, and Decabolan), (iii) the usage of different cameras to capture face images, and finally, (iv) the variability of standoff distance, illumination and other noise factors (e.g. motion noise). All of the previously mentioned complicated scenarios make clear that cross-scenario matching is a very challenging problem and, thus, further investigation is required.

Techno-economic, location, and carbon emission analysis of thermochemical biomass to transportation fuels

NASA Astrophysics Data System (ADS)

Wright, Mark Mba

There are significant technological and systemic challenges faced by today's advanced biofuel industry. These challenges stem from the current state-of-technology and from the system (consumer market, infrastructure, environment...) in which this emerging industry is being developed. The state-of-technology will improve with continued efforts in technology development, but novel approaches are required to investigate the systemic challenges that limit the adoption of advanced biofuels. The motivation of this dissertation is to address the question of how to find cost-effective, sustainable, and environmentally responsible pathways for the production of biofuels. Economic competitiveness, long-term viability, and benign environmental impact are key for biofuels to be embraced by industry, government, and consumers. Techno-economic, location, and carbon emission analysis are research methodologies that help address each of these issues. The research approach presented in this dissertation is to combine these three methodologies into a holistic study of advanced biofuel technologies. The value of techno-economic, location, and carbon emission analysis is limited when conducted in isolation because of current public perception towards energy technologies. Energy technologies are evaluated based on multiple criteria with a significant emphasis on the three areas investigated in this study. There are important aspects within each of these fields that could significantly limit the value of advances in other fields of study. Therefore, it is necessary that future research in advanced biofuels always consider the systemic challenges faced by novel developments.

Nursing simulation: a community experience.

PubMed

Gunowa, Neesha Oozageer; Elliott, Karen; McBride, Michelle

2018-04-02

The education sector faces major challenges in providing learning experiences so that newly qualified nurses feel adequately prepared to work in a community setting. With this in mind, higher education institutions need to develop more innovative ways to deliver the community-nurse experience to student nurses. This paper presents and explores how simulation provides an opportunity for educators to support and evaluate student performance in an environment that models a complete patient encounter in the community. Following the simulation, evaluative data were collated and the answers analysed to identify key recommendations.

Enter the Dragon: China Regains Its Place in the World and a U.S. Strategy for Cooperation and Confidence Building

DTIC Science & Technology

2010-10-27

chaos phobia (a deep fear of political chaos and instability); and (6) the fact that the community is paramount over the individual. 22 Scobell...A key fact to remember about China as she faces these myriad challenges is that she does so virtually alone, being a member of no large alliances...These steps should be taken in the context of a continued strong and flexible U.S. military presence in the region and awareness of the reality that the

Acquired pathology of the pediatric spine and spinal cord.

PubMed

Palasis, Susan; Hayes, Laura L

2015-09-01

Pediatric spine pathology poses a diagnostic challenge for radiologists. Acquired spine pathology often yields nonspecific signs and symptoms in children, especially in the younger age groups, and diagnostic delay can carry significant morbidity. This review is focused on some of the more common diagnostic dilemmas we face when attempting to evaluate and diagnose acquired pediatric spine anomalies in daily practice. An understanding of some of the key differentiating features of these disease processes in conjunction with pertinent history, physical exam, and advanced imaging techniques can indicate the correct diagnosis.

The Contemporary Significance of the Holocaust for Australian Psychiatry.

PubMed

Robertson, Michael; Light, Edwina; Lipworth, Wendy; Walter, Garry

2016-01-01

In this paper we survey briefly the components of the Holocaust directly relevant to the psychiatric profession and identify the main themes of relevance to contemporary psychiatry. The ‘euthanasia’ program; the persecution of lesbian, gay, bisexual, transgender, and intersex (LGBTI) citizens; and the complex relationship between the psychiatric profession and Nazi state are the main themes to emerge from this survey. We then compare this period with key themes in the history of Australian psychiatry and link these themes to some of the contemporary ethical challenges the profession faces.

Social Inclusion Through Para sport: A Critical Reflection on the Current State of Play.

PubMed

Bantjes, Jason; Swartz, Leslie

2018-05-01

Medicine has played an integral role in both the inception and development of the Paralympic Games. Sports physicians are well positioned to continue to influence the development of the paralympic movement and to help focus the movement on its agenda to promote social inclusion. This article looks critically at some of the key challenges that the paralympic movement faces in its quest to promote social inclusion, and considers the role of sports medicine in this process. Copyright © 2018 Elsevier Inc. All rights reserved.

Micro-Scale Avionics Thermal Management

NASA Technical Reports Server (NTRS)

Moran, Matthew E.

2001-01-01

Trends in the thermal management of avionics and commercial ground-based microelectronics are converging, and facing the same dilemma: a shortfall in technology to meet near-term maximum junction temperature and package power projections. Micro-scale devices hold the key to significant advances in thermal management, particularly micro-refrigerators/coolers that can drive cooling temperatures below ambient. A microelectromechanical system (MEMS) Stirling cooler is currently under development at the NASA Glenn Research Center to meet this challenge with predicted efficiencies that are an order of magnitude better than current and future thermoelectric coolers.

Challenges of Virtual School Leadership

ERIC Educational Resources Information Center

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

2015-01-01

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

Defining teaching hospitals' GME strategy in response to new financial and market challenges.

PubMed

Wray, J L; Sadowski, S M

1998-04-01

The authors present an overview of current graduate medical education (GME) issues, particularly the financial challenges to teaching hospitals resulting from the Balanced Budget and Tax Payer Relief Acts of 1997 and other recent market-driven factors. They describe in detail the nature of Medicare GME payments before and after the 1997 legislation, with specific examples, and explain the negative financial impact of the legislation and aspects of the legislation that are designed to alleviate that impact. Other factors influencing GME program size and composition are also discussed, including oversupplies or shortages of physicians, the concern that teaching hospitals are using public funds to train international medical graduates, changing training requirements, etc. The authors also describe a recent consulting assignment during which they assisted a major teaching hospital to develop a GME strategy that was responsive to the organization's mission and patients and that took into account future GME financing challenges. Detailed explanations are given of how the consultants analyzed the hospital's GME programs and finances, developed and ranked key institution-specific program criteria (strategic, organizational and operational, and financial), and, in consultation with all key stakeholders, formulated a GME strategy specific to the institution's needs. The authors conclude by cautioning that each institution's GME strategy will be different, but that it is important for institutions to develop such strategies to better face future challenges.

Challenges Faced by Female-Students in Engineering-Education

ERIC Educational Resources Information Center

Madara, Diana Starovoytova; Cherotich, Sharon

2016-01-01

Gender-related challenges in learning technical courses are universal phenomenon. These challenges could restrain female students from achieving their fullest potential. The main focus of this study, therefore, is to examine self-recognized challenges faced by undergraduate female students in pursuing engineering at the School of Engineering…

Conducting health survey research in a deep rural South African community: challenges and adaptive strategies

PubMed Central

2013-01-01

Background In many parts of the developing world, rural health requires focused policy attention, informed by reliable, representative health data. Yet there is surprisingly little published material to guide health researchers who face the unique set of hurdles associated with conducting field research in remote rural areas. Methods In this paper we provide a detailed description of the key challenges encountered during health survey field research carried out in 2010 in a deep rural site in KwaZulu-Natal, South Africa. The aim of the field research was to collect data on the health of children aged 10 to 17 years old, and their primary adult caregivers, as part of a larger national health survey; the research was a collaboration between several South African and foreign universities, South African national government departments, and various NGO partners. In presenting each of the four fieldwork challenges encountered on this site, we describe the initial planning decisions made, the difficulties faced when implementing these in the field, and the adaptive strategies we used to respond to these challenges. We reflect on learnings of potential relevance for the research community. Results Our four key fieldwork challenges were scarce research capacity, staff relocation tensions, logistical constraints, and difficulties related to community buy-in. Addressing each of these obstacles required timely assessment of the situation and adaptation of field plans, in collaboration with our local NGO partner. Adaptive strategies included a greater use of local knowledge; the adoption of tribal authority boundaries as the smallest geopolitical units for sampling; a creative developmental approach to capacity building; and planned, on-going engagement with multiple community representatives. Conclusions We argue that in order to maintain high scientific standards of research and manage to ‘get the job done’ on the ground, it is necessary to respond to fieldwork challenges that arise as a cohesive team, with timely, locally-relevant, and often creative, solutions. Budgeting sufficient time and project resources for capacity building and community buy-in processes is also essential when working in remote communities unaccustomed to research. Documenting and sharing field experiences can provide valuable information for other researchers planning to conduct fieldwork in similar contexts. PMID:23618363

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

ERIC Educational Resources Information Center

Silvernail, David L.; Linet, Sarah R.

2014-01-01

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

Challenges in adapting existing clinical natural language processing systems to multiple, diverse health care settings.

PubMed

Carrell, David S; Schoen, Robert E; Leffler, Daniel A; Morris, Michele; Rose, Sherri; Baer, Andrew; Crockett, Seth D; Gourevitch, Rebecca A; Dean, Katie M; Mehrotra, Ateev

2017-09-01

Widespread application of clinical natural language processing (NLP) systems requires taking existing NLP systems and adapting them to diverse and heterogeneous settings. We describe the challenges faced and lessons learned in adapting an existing NLP system for measuring colonoscopy quality. Colonoscopy and pathology reports from 4 settings during 2013-2015, varying by geographic location, practice type, compensation structure, and electronic health record. Though successful, adaptation required considerably more time and effort than anticipated. Typical NLP challenges in assembling corpora, diverse report structures, and idiosyncratic linguistic content were greatly magnified. Strategies for addressing adaptation challenges include assessing site-specific diversity, setting realistic timelines, leveraging local electronic health record expertise, and undertaking extensive iterative development. More research is needed on how to make it easier to adapt NLP systems to new clinical settings. A key challenge in widespread application of NLP is adapting existing systems to new clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Increasing the relevance of research to health care managers: hospital CEO imperatives for improving quality and lowering costs.

PubMed

Alexander, Jeffrey A; Hearld, Larry R; Jiang, H Joanna; Fraser, Irene

2007-01-01

Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. This article attempts to identify how hospital leaders view key determinants of hospital quality and costs, as well as the fundamental ways these leaders "think" about solutions to quality and cost issues in their organizations. The objective of this analysis is to better inform the research agenda and approaches pursued by health services research so that this research reflects the "realities" of practice in hospitals. We conducted a series of semistructured interviews with a convenience sample of eight hospital and three health system leaders. Questions focused on current and future challenges facing hospitals as they relate to hospital quality, costs, and efficiency, and potential solutions to those challenges. Nine major organizational and managerial factors emerged from the interviews, including staffing, evidence-based practice, information technology, data availability and benchmarking, and leadership. Hospital leaders tend to think about these factors systemically and consider process-related factors as the important drivers of cost and quality. The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.

Floods and droughts: friends or foes?

NASA Astrophysics Data System (ADS)

Prudhomme, Christel

2017-04-01

Water hazards are some of the biggest threats to lives and livelihoods globally, causing serious damages to society and infrastructure. But floods and droughts are an essential part of the hydrological regime that ensures fundamental ecosystem functions, providing natural ways to bring in nutrients, flush out pollutants and enabling soils, rivers and lakes natural biodiversity to thrive. Traditionally, floods and droughts are too often considered separately, with scientific advance in process understanding, modelling, statistical characterisation and impact assessment are often done independently, possibly delaying the development of innovative methods that could be applied to both. This talk will review some of the key characteristics of floods and droughts, highlighting differences and commonalties, losses and benefits, with the aim of identifying future key research challenges faced by both current and next generation of hydrologists.

Peptide and protein nanoparticle conjugates: versatile platforms for biomedical applications.

PubMed

Spicer, Christopher D; Jumeaux, Coline; Gupta, Bakul; Stevens, Molly M

2018-05-21

Peptide- and protein-nanoparticle conjugates have emerged as powerful tools for biomedical applications, enabling the treatment, diagnosis, and prevention of disease. In this review, we focus on the key roles played by peptides and proteins in improving, controlling, and defining the performance of nanotechnologies. Within this framework, we provide a comprehensive overview of the key sequences and structures utilised to provide biological and physical stability to nano-constructs, direct particles to their target and influence their cellular and tissue distribution, induce and control biological responses, and form polypeptide self-assembled nanoparticles. In doing so, we highlight the great advances made by the field, as well as the challenges still faced in achieving the clinical translation of peptide- and protein-functionalised nano-drug delivery vehicles, imaging species, and active therapeutics.

Integrative methods for analyzing big data in precision medicine.

PubMed

Gligorijević, Vladimir; Malod-Dognin, Noël; Pržulj, Nataša

2016-03-01

We provide an overview of recent developments in big data analyses in the context of precision medicine and health informatics. With the advance in technologies capturing molecular and medical data, we entered the area of "Big Data" in biology and medicine. These data offer many opportunities to advance precision medicine. We outline key challenges in precision medicine and present recent advances in data integration-based methods to uncover personalized information from big data produced by various omics studies. We survey recent integrative methods for disease subtyping, biomarkers discovery, and drug repurposing, and list the tools that are available to domain scientists. Given the ever-growing nature of these big data, we highlight key issues that big data integration methods will face. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Developing a Strategic Program for Chilean Health Information Technology: Environmental Scan and Key Informant Interviews.

PubMed

Taylor, Erin Audrey; Fischer, Shira H; Gracner, Tadeja; Tejeda, Ivo; Kim, Alice; Chavez-Herrerias, Emilio; de la Guardia, Fernando Hoces

2016-06-20

As part of an effort to assist Chile in developing a strategic program to foster the development of the health information technology (health IT) sector over the next five to ten years, this study assesses the current state of health IT adoption and implementation in Chile, as well as the challenges and opportunities facing the sector over the coming years. The authors conducted an environmental scan and ten key informant interviews and found that there are a number of successful health IT projects and strategies for further development currently underway in Chile, but that the successful projects are generally localized within specific health care providers and lack integration. These and other challenges suggest significant potential for the Ministry of Economy and other stakeholders to take specific actions designed to encourage further development of the health IT sector in Chile over the coming years. The next phase of this effort will use the results from this study to develop a roadmap for the Ministry of Economy to encourage health IT development in Chile over the short, medium, and long terms.

Innovations in health service organization and delivery in northern rural and remote regions: a review of the literature.

PubMed

Mitton, Craig; Dionne, Francois; Masucci, Lisa; Wong, Sabrina; Law, Susan

2011-01-01

To identify and review innovations relevant to improving access, quality, efficiency and/or effectiveness in the organization and delivery of health care services in rural and remote areas. Literature review. Key bibliographic databases that index health research were searched: MEDLINE, EMBASE and CINAHL. Other databases relevant to Arctic health were also accessed. Abstracts were assessed for relevancy and full articles were reviewed and categorized according to emergent themes. Many innovations in delivering services to rural and remote areas were identified, particularly in the public health realm. These innovations were grouped into 4 key themes: organizational structure of health services; utilization of telehealth and ehealth; medical transportation; and public health challenges. Despite the challenges facing rural and remote regions, there is a distinctly positive message from this broad literature review. Evidence-based initiatives exist across a range of areas - which include operational efficiency and integration, access to care, organizational structure, public health, continuing education and workforce composition - that have the potential to positively impact health care quality and health-related outcomes.

The Inter-Life project: researching the potential of art, design and virtual worlds as a vehicle for assisting young people with key life changes and transitions.

PubMed

Lally, Victor; Sclater, Madeleine

2013-06-01

Careers work in the twenty-first century faces a key challenge in terms of digital technologies: to evaluate their potential for careers work in challenging settings. Given the rapidity of developments, technologies require evaluation in research innovations and naturalistic settings. Virtual worlds offer potential for careers and guidance work, and the therapeutic domain. To illustrate this, we present examples in which young people explore their feelings and ideas, plans and difficulties, while preparing for film-making. During this they develop important life transition skills. We argue that the power of virtual worlds - to support emotional and cognitive engagement - could be utilised in practice settings. We conclude that they are serious candidates as digital tools in the careers and guidance domain. We need intermediate runaway objects which are less spectacular and more inviting… bringing together the big and the small, the impossible and the possible, the future-oriented activity level vision and the here and now consequential action. (Engeström, 2009, p. 305 and p. 328).

The Inter-Life project: researching the potential of art, design and virtual worlds as a vehicle for assisting young people with key life changes and transitions

PubMed Central

Lally, Victor; Sclater, Madeleine

2013-01-01

Careers work in the twenty-first century faces a key challenge in terms of digital technologies: to evaluate their potential for careers work in challenging settings. Given the rapidity of developments, technologies require evaluation in research innovations and naturalistic settings. Virtual worlds offer potential for careers and guidance work, and the therapeutic domain. To illustrate this, we present examples in which young people explore their feelings and ideas, plans and difficulties, while preparing for film-making. During this they develop important life transition skills. We argue that the power of virtual worlds – to support emotional and cognitive engagement – could be utilised in practice settings. We conclude that they are serious candidates as digital tools in the careers and guidance domain. We need intermediate runaway objects which are less spectacular and more inviting… bringing together the big and the small, the impossible and the possible, the future-oriented activity level vision and the here and now consequential action. (Engeström, 2009, p. 305 and p. 328) PMID:24009408

Food commodity pipeline management in transitional settings: challenges and lessons learned from the first USAID food development program in South Sudan

PubMed Central

Tappis, Hannah; Doocy, Shannon; Amoako, Stephen

2013-01-01

ABSTRACT Despite decades of support for international food assistance programs by the U.S. Agency for International Development (USAID) Office of Food for Peace, relatively little is known about the commodity pipeline and management issues these programs face in post-conflict and politically volatile settings. Based on an audit of the program's commodity tracking system and interviews with 13 key program staff, this case study documents the experiences of organizations implementing the first USAID-funded non-emergency (development) food assistance program approved for Sudan and South Sudan. Key challenges and lessons learned in this experience about food commodity procurement, transport, and management may help improve the design and implementation of future development food assistance programs in a variety of complex, food-insecure settings around the world. Specifically, expanding shipping routes in complex political situations may facilitate reliable and timely commodity delivery. In addition, greater flexibility to procure commodities locally, rather than shipping U.S.-procured commodities, may avoid unnecessary shipping delays and reduce costs. PMID:25276532

The value of the WIRHE Scholarship Programme in training health professionals for rural areas: Views of participants

PubMed Central

2017-01-01

Introduction Rural hospitals in South Africa, as elsewhere, face enduring shortages of, and challenges in attracting and retaining, suitably qualified staff. The Wits Initiative for Rural Health Education (WIRHE), based at the University of the Witwatersrand but covering three universities, is a rural scholarship programme established to find local solutions to these challenges in the North West and Mpumalanga provinces. The purpose of this evaluation was to ascertain whether the WIRHE project was achieving its objectives. Methods This article draws from an evaluation commissioned by the Swiss-South African Cooperative Initiative, a major funder of the programme when WIRHE was launched in 2003. Qualitative interviews were conducted either as face-to-face meetings or telephonically with 21 WIRHE students and graduates. Content analysis was undertaken to identify common themes. Results There was a consistency in the findings as the students and graduates reported similar experiences. Many of the participants were overwhelmed by their initial challenges of having to adapt to a different language, an institutional culture and resources that they previously did not have access to. The participants acknowledged the role of WIRHE staff in facilitating the transition from home to university and, in particular, the value of the financial and academic support. The geographic distance to Wits presented a challenge for the Pretoria- and Sefako Makgatho-based students. The holiday work affirmed clinical advantages for WIRHE students and heightened students’ interest in becoming healthcare workers. Conclusion WIRHE’s key success factors are the financial, academic and emotional support offered to students. WIRHE achieved its objectives based on a principled strategic approach and an understanding that students from rural backgrounds are more likely to return to rural areas. The study supports the value of structured support programmes for students of rural origin as they pursue their studies. PMID:29041799

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

PubMed

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

2015-12-18

Randomised controlled trials (RCTs) have a reputation for being inherently difficult to deliver as planned and often face unforeseen challenges and delays, particularly in relation to organisational and governance difficulties, participant interest, constraints due to allocation of costs, local investigator interest and lengthy bureaucracy. Recruitment is often difficult and the challenges faced often impact on the cost and delivery of a successful trial within the funded period. This paper reflects upon the challenges faced in delivering a pragmatic RCT of weight loss maintenance in a community setting and suggests some potential solutions. The weight loss maintenance in adults trial aimed to evaluate the impact of a 12 month, individually tailored weight maintenance intervention on BMI 3 years from randomisation. Participants were recruited primarily from participant identification centres (PICs)-GP surgeries, exercise on referral schemes and slimming world. The intervention was delivered in community settings. A recruitment strategy implementation plan was drafted to address and monitor poor recruitment. Delays in opening and recruitment were experienced early on. Some were beyond the control of the study team such as; disagreement over allocation of national health service costs and PIC classification as well as difficulties in securing support from research networks. That the intervention was delivered in community settings was often at the root of these issues. Key items to address at the design stage of future trials include feasibility of eligibility criteria. The most effective element of the recruitment implementation plan was to refocus sources of recruitment and target only those who could fulfil the eligibility criteria immediately. Learnings from this trial should be kept in mind by those designing similar studies in the future. Considering potential governance, cost and research network support implications at the design stage of pragmatic trials of any community-based complex intervention is paramount. The appropriateness and viability of inclusion criteria also require careful consideration as does use of a targeted advertising strategy. ISRCTN35774128, 12/01/2010.

A Primer on Observational Measurement.

PubMed

Girard, Jeffrey M; Cohn, Jeffrey F

2016-08-01

Observational measurement plays an integral role in a variety of scientific endeavors within biology, psychology, sociology, education, medicine, and marketing. The current article provides an interdisciplinary primer on observational measurement; in particular, it highlights recent advances in observational methodology and the challenges that accompany such growth. First, we detail the various types of instrument that can be used to standardize measurements across observers. Second, we argue for the importance of validity in observational measurement and provide several approaches to validation based on contemporary validity theory. Third, we outline the challenges currently faced by observational researchers pertaining to measurement drift, observer reactivity, reliability analysis, and time/expense. Fourth, we describe recent advances in computer-assisted measurement, fully automated measurement, and statistical data analysis. Finally, we identify several key directions for future observational research to explore.

Literature review: issues surrounding education of English-as-a-Second Language (ESL) nursing students.

PubMed

Choi, Liza Lai Shan

2005-07-01

Examined in this article are the challenges faced by English-as-a-Second Language (ESL) nursing students. Nursing faculties need to address these challenges to meet the increasing diversity of the health care system. A key concern is the ability of ESL nursing students to communicate effectively in English. The Cummins model for English language acquisition provides a template for ESL nursing students to bridge this communication barrier. The literature suggests some particular needs of ESL nursing students can be met through modification of nursing programs. Further research into factors affecting the quality of nursing education for ESL students is warranted. A quantitative analysis is required to see if there exists a positive correlation between improved English language acquisition and academic success by ESL nursing students.

Eating For Two: How Metabolism Establishes Interspecies Interactions in the Gut

PubMed Central

Fischbach, Michael A.; Sonnenburg, Justin L.

2011-01-01

In bacterial communities, ‘tight economic times’ are the norm. Of the many challenges bacteria face in making a living, perhaps none are more important than generating energy, maintaining redox balance, and acquiring carbon and nitrogen to synthesize primary metabolites. The ability of bacteria to meet these challenges depends heavily on the rest of their community. Indeed, the most fundamental way in which bacteria communicate is by importing the substrates for metabolism and exporting metabolic end products. As an illustration of this principle, we will travel down a carbohydrate catabolic pathway common to many species of Bacteroides, highlighting the interspecies interactions established (often inevitably) at its key steps. We also discuss the metabolic considerations in maintaining the stability of host-associated microbial communities. PMID:22018234

The Complexities of Implementing Cluster Supply Chain - Case Study of JCH

NASA Astrophysics Data System (ADS)

Xue, Xiao; Zhang, Jibiao; Wang, Yang

As a new type of management pattern, "cluster supply chain" (CSC) can help SMEs to face the global challenges through all kinds of collaboration. However, a major challenge in implementing CSC is the gap between theory and practice in the field. In an effort to provide a better understanding of this emerging phenomenon, this paper presents the implementation process of CSC in the context of JingCheng Mechanical & Electrical Holding co., ltd.(JCH) as a case study. The cast study of JCH suggests that the key problems in the practice of cluster supply chain: How do small firms use cluster supply chain? Only after we clarify the problem, the actual construction and operation of cluster supply chain does show successful results as it should be.

A review on solder reflow and flux application for flip chip

NASA Astrophysics Data System (ADS)

Suppiah, Sarveshvaran; Ong, Nestor Rubio; Sauli, Zaliman; Sarukunaselan, Karunavani; Alcain, Jesselyn Barro; Visvanathan, Susthitha Menon; Retnasamy, Vithyacharan

2017-09-01

This paper encompassed of the evolution and key findings, critical technical challenges, solutions and bonding equipment of solder reflow in flip chip bonding. Upon scrutinizing researches done by others, it can be deduced that peak temperature, time above liquidus, soak temperature, soak time, cooling rate and reflow environment played a vital role in achieving the desired bonding profile. In addition, flux is also needed with the purpose of removing oxides/contaminations on bump surface as well as to promote wetting of solder balls. Electromigration and warpage are the two main challenges faced by solder reflow process which can be overcome by the advancement in under bump metallization (UBM) and substrate technology. The review is ended with a brief description of the current equipment used in solder reflow process.

Hypothetical scenario exercises to improve planning and readiness for drinking water quality management during extreme weather events.

PubMed

Deere, Daniel; Leusch, Frederic D L; Humpage, Andrew; Cunliffe, David; Khan, Stuart J

2017-03-15

Two hypothetical scenario exercises were designed and conducted to reflect the increasingly extreme weather-related challenges faced by water utilities as the global climate changes. The first event was based on an extreme flood scenario. The second scenario involved a combination of weather events, including a wild forest fire ('bushfire') followed by runoff due to significant rainfall. For each scenario, a panel of diverse personnel from water utilities and relevant agencies (e.g. health departments) formed a hypothetical water utility and associated regulatory body to manage water quality following the simulated extreme weather event. A larger audience participated by asking questions and contributing key insights. Participants were confronted with unanticipated developments as the simulated scenarios unfolded, introduced by a facilitator. Participants were presented with information that may have challenged their conventional experiences regarding operational procedures in order to identify limitations in current procedures, assumptions, and readily available information. The process worked toward the identification of a list of specific key lessons for each event. At the conclusion of each simulation a facilitated discussion was used to establish key lessons of value to water utilities in preparing them for similar future extreme events. Copyright © 2016 Elsevier Ltd. All rights reserved.

Analysis of pastoralists' perception on challenges and opportunities for sheep and goat production in Northern Kenya.

PubMed

Abdilatif, Mohamed Haji; Onono, Joshua Orungo; Mutua, Florence Kanini

2018-05-16

Small ruminants' production contributes to livelihood of pastoral communities, but this faces myriad constraints. This study aimed at identifying challenges facing producers of small ruminants, prioritizing diseases and their control measures and documenting opportunities for improvement. Sixteen focus group discussions with livestock owners and 13 key informant interviews were done in selected areas in Mandera County, Northern Kenya, and both quantitative and qualitative data collected using a questionnaire guide. Occurrences of diseases (27.4%) and drought (25%) were consistently ranked high in all groups. Other production challenges included increased predation of livestock, inadequate delivery of veterinary services, and increased livestock mortalities. Peste des Petit ruminants was ranked high with a median rank of 21.5%, while contagious caprine pleuropneumonia and sheep and goat pox were ranked second and third, respectively. Other diseases included tick-borne diseases, helminthosis, and pneumonia. Vaccination was ranked as the most effective control strategy for infectious diseases. Other control measures included recitation of Quran and cauterization. However, several opportunities exist for support of small ruminants' production: increased budgetary allocation for disease control by government, initiation of projects that enhance livestock production in the region by government and its development partners. These findings are useful for policy makers for disease control and organizations that are working on projects that focuses on enhancement of pastoralists' resilience, while future research could also identify appropriate technologies that reduces these impacts.

Optimizing Oral Bioavailability in Drug Discovery: An Overview of Design and Testing Strategies and Formulation Options.

PubMed

Aungst, Bruce J

2017-04-01

For discovery teams working toward new, orally administered therapeutic agents, one requirement is to attain adequate systemic exposure after oral dosing, which is best accomplished when oral bioavailability is optimized. This report summarizes the bioavailability challenges currently faced in drug discovery, and the design and testing methods and strategies currently utilized to address the challenges. Profiling of discovery compounds usually includes separate assessments of solubility, permeability, and susceptibility to first-pass metabolism, which are the 3 most likely contributors to incomplete oral bioavailability. An initial assessment of absorption potential may be made computationally, and high throughput in vitro assays are typically performed to prioritize compounds for in vivo studies. The initial pharmacokinetic study is a critical decision point in compound evaluation, and the importance of the effect the dosing vehicle or formulation can have on oral bioavailability, especially for poorly water soluble compounds, is emphasized. Dosing vehicles and bioavailability-enabling formulations that can be used for discovery and preclinical studies are described. Optimizing oral bioavailability within a chemical series or for a lead compound requires identification of the barrier limiting bioavailability, and methods used for this purpose are outlined. Finally, a few key guidelines are offered for consideration when facing the challenges of optimizing oral bioavailability in drug discovery. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Is adaptation or transformation needed? Active nanomaterials and risk analysis

NASA Astrophysics Data System (ADS)

Kuzma, Jennifer; Roberts, John Patrick

2016-07-01

Nanotechnology has been a key area of funding and policy for the United States and globally for the past two decades. Since nanotechnology research and development became a focus and nanoproducts began to permeate the market, scholars and scientists have been concerned about how to assess the risks that they may pose to human health and the environment. The newest generation of nanomaterials includes biomolecules that can respond to and influence their environments, and there is a need to explore whether and how existing risk-analysis frameworks are challenged by such novelty. To fill this niche, we used a modified approach of upstream oversight assessment (UOA), a subset of anticipatory governance. We first selected case studies of "active nanomaterials," that are early in research and development and designed for use in multiple sectors, and then considered them under several, key risk-analysis frameworks. We found two ways in which the cases challenge the frameworks. The first category relates to how to assess risk under a narrow framing of the term (direct health and environmental harm), and the second involves the definition of what constitutes a "risk" worthy of assessment and consideration in decision making. In light of these challenges, we propose some changes for risk analysis in the face of active nanostructures in order to improve risk governance.

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

PubMed Central

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

2017-01-01

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

Automated Rock Identification for Future Mars Exploration Missions

NASA Technical Reports Server (NTRS)

Gulick, V. C.; Morris, R. L.; Gazis, P.; Bishop, J. L.; Alena, R.; Hart, S. D.; Horton, A.

2003-01-01

A key task for human or robotic explorers on the surface of Mars is choosing which particular rock or mineral samples should be selected for more intensive study. The usual challenges of such a task are compounded by the lack of sensory input available to a suited astronaut or the limited downlink bandwidth available to a rover. Additional challenges facing a human mission include limited surface time and the similarities in appearance of important minerals (e.g. carbonates, silicates, salts). Yet the choice of which sample to collect is critical. To address this challenge we are developing science analysis algorithms to interface with a Geologist's Field Assistant (GFA) device that will allow robotic or human remote explorers to better sense and explore their surroundings during limited surface excursions. We aim for our algorithms to interpret spectral and imaging data obtained by various sensors. The algorithms, for example, will identify key minerals, rocks, and sediments from mid-IR, Raman, and visible/near-IR spectra as well as from high resolution and microscopic images to help interpret data and to provide high-level advice to the remote explorer. A top-level system will consider multiple inputs from raw sensor data output by imagers and spectrometers (visible/near-IR, mid-IR, and Raman) as well as human opinion to identify rock and mineral samples.

Moving Towards a Common Ground and Flight Data Systems Architecture for NASA's Exploration Missions

NASA Technical Reports Server (NTRS)

Rader. Steve; Kearney, Mike; McVittie, Thom; Smith, Dan

2006-01-01

The National Aeronautics and Space Administration has embarked on an ambitious effort to return man to the moon and then on to Mars. The Exploration Vision requires development of major new space and ground assets and poses challenges well beyond those faced by many of NASA's recent programs. New crewed vehicles must be developed. Compatible supply vehicles, surface mobility modules and robotic exploration capabilities will supplement the manned exploration vehicle. New launch systems will be developed as well as a new ground communications and control infrastructure. The development must take place in a cost-constrained environment and must advance along an aggressive schedule. Common solutions and system interoperability and will be critical to the successful development of the Exploration data systems for this wide variety of flight and ground elements. To this end, NASA has assembled a team of engineers from across the agency to identify the key challenges for Exploration data systems and to establish the most beneficial strategic approach to be followed. Key challenges and the planned NASA approach for flight and ground systems will be discussed in the paper. The described approaches will capitalize on new technologies, and will result in cross-program interoperability between spacecraft and ground systems, from multiple suppliers and agencies.

Perceived benefits and barriers of implementing nursing residency programs in Jordan.

PubMed

AbuAlRub, R F; Abu Alhaija'a, M G

2018-03-02

To explore the challenges that face Jordanian nurses in the first year of employment; and understand the benefits and barriers of implementing a Nursing Residency Program from the perspectives of nurses and key informants. Many researchers reported that novice nurses do not have an adequate level of competence needed in the real clinical practice to meet the increasing demands of healthcare systems. A descriptive qualitative approach using individual interviews and focus group discussions was utilized. The sample was a purposive one that consisted of 30 Jordanian nurses and six key informants. Data were recorded and then transcribed. Content analysis was used to analyze the data. The results revealed several challenges that face nurses in their first year of experience such as reality shock, lack of self-confidence, and burnout and intent to leave. Some of the perceived barriers of implementing the Program were issues concerned with the responsible regulatory body, payment, and monitoring and evaluation. The findings asserted that the implementation of the Nursing Residency Program for new practicing nurses would enhance their competencies and self- confidence; and decrease the rate of reality shock and turnover within the first year of employment. Policy makers, nurse educators, and nurse administrators and clinical nurses need to collaborate to develop a formal system with binding policies and regulations concerning the implementation of Nursing Residency Program. There is also a need to address and modify current orientation programmes offered by hospitals for novice nurses to enhance their transition into clinical practice. © 2018 International Council of Nurses.

Challenges Facing Teachers New to Working in Schools Overseas

ERIC Educational Resources Information Center

Halicioglu, Margaret L.

2015-01-01

This article considers the potential challenges facing teachers moving abroad for the first time, both professional challenges in their school and personal challenges in their private life. It suggests that such teachers embarking on a professional adventure overseas would benefit from careful consideration of the kind of school they will thrive…

An Exploration of Challenges Facing Division III Athletic Directors

ERIC Educational Resources Information Center

Engbers, Jeffrey L.

2011-01-01

The purpose of this study was to establish a basic understanding of the challenges associated with directing athletic programs at NCAA Division III Institutions. Specifically, this study identified the frequency, intensity, and time allocated to common challenges facing the position of the NCAA Division III AD. The challenges were examined using…

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

ERIC Educational Resources Information Center

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

2013-01-01

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

Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunities.

PubMed

Taylor, Kate; Thompson, Sandra; Davis, Robyn

2010-07-01

To review the challenges facing Indigenous and mainstream services in delivering residential rehabilitation services to Indigenous Australians, and explore opportunities to enhance outcomes. A literature review was conducted using keyword searches of databases, on-line journals, articles, national papers, conference proceedings and reports from different organisations, with snowball follow-up of relevant citations. Each article was assessed for quality using recognised criteria. Despite debate about the effectiveness of mainstream residential alcohol rehabilitation treatment, most Indigenous Australians with harmful alcohol consumption who seek help have a strong preference for residential treatment. While there is a significant gap in the cultural appropriateness of mainstream services for Indigenous clients, Indigenous-controlled residential organisations also face issues in service delivery. Limitations and inherent difficulties in rigorous evaluation processes further plague both areas of service provision. With inadequate evidence surrounding what constitutes 'best practice' for Indigenous clients in residential settings, more research is needed to investigate, evaluate and contribute to the further development of culturally appropriate models of best practice. In urban settings, a key area for innovation involves improving the capacity and quality of service delivery through effective inter-agency partnerships between Indigenous and mainstream service providers.

Exploring the Barriers of Home Care Services in Iran: A Qualitative Study

PubMed Central

Heydari, Heshmatolah; Shahsavari, Hooman; Hazini, Abdolrahim; Nasrabadi, Alireza Nikbakht

2016-01-01

With increasing chronic diseases, the use of home care is rising in the world. Home care in Iran has many challenges and to improve that, we should identify the challenges and barriers of home care. The aim of this study was to identify and explore the barriers of home care in Iran. This is a qualitative study with content analysis approach that was conducted in Iran in 2015. Fourteen key informants comprising health policymakers, faculty members, nurses, and physicians as well as patients and families engaged in home care purposefully participated in this study. Data was obtained using face-to-face semistructured interviews. A focus group discussion was also used to complete the findings. Graneheim and Lundman's approach was used for analysis of data and Lincoln and Guba's criteria were used to confirm the trustworthiness of study's findings. The data were divided into three main categories and eight subcategories. Main categories included treatment-based approach in the healthcare system, cultural dimensions, and the lack of adequate infrastructure. A position for home care in the healthcare system, considering cultural dimensions in Iranian society and providing an appropriate infrastructure, can be beneficial to improve the situation of home care services in Iran. PMID:27127677

Facilitators and Barriers to Implementing Clinical Governance: A Qualitative Study among Senior Managers in Iran.

PubMed

Ravaghi, Hamid; Rafiei, Sima; Heidarpour, Peigham; Mohseni, Maryam

2014-09-01

Health care systems should assign quality improvement as their main mission. Clinical governance (CG) is a key strategy to improve quality of health care services. The Iranian Ministry of Health and Medical Education (MOHME) has promoted CG as a framework for safeguarding quality and safety in all hospitals since 2009. The purpose of this study was to explore perceived facilitators and barriers to implementing CG by deputies for curative affairs of Iranian medical universities. A qualitative study was conducted using face to face interviews with a purposeful sample of 43 deputies for curative affairs of Iranian Medical Universities and documents review. Thematic analysis was used to analyze the data. Five themes were explored including: knowledge and attitude toward CG, culture, organizational factors, managerial factors and barriers. The main perceived facilitating factors were adequate knowledge and positive attitude toward CG, supporting culture, managers' commitment, effective communication and well designed incentives. Pe rceived barriers were the reverse of facilitators noted above in addition to insufficient resources, legal challenges, workload and parallel quality programs. Successful implementation of CG in Iran will require identifying barriers and challenges existing in the way of CG implementation and try to mitigate them by using appropriate facilitators.

Tailored combination prevention packages and PrEP for young key populations

PubMed Central

Pettifor, Audrey; Nguyen, Nadia L; Celum, Connie; Cowan, Frances M; Go, Vivian; Hightow-Weidman, Lisa

2015-01-01

Introduction Young key populations, defined in this article as men who have sex with men, transgender persons, people who sell sex and people who inject drugs, are at particularly high risk for HIV. Due to the often marginalized and sometimes criminalized status of young people who identify as members of key populations, there is a need for HIV prevention packages that account for the unique and challenging circumstances they face. Pre-exposure prophylaxis (PrEP) is likely to become an important element of combination prevention for many young key populations. Objective In this paper, we discuss important challenges to HIV prevention among young key populations, identify key components of a tailored combination prevention package for this population and examine the role of PrEP in these prevention packages. Methods We conducted a comprehensive review of the evidence to date on prevention strategies, challenges to prevention and combination prevention packages for young key populations. We focused specifically on the role of PrEP in these prevention packages and on young people under the age of 24, and 18 in particular. Results and discussion Combination prevention packages that include effective, acceptable and scalable behavioural, structural and biologic interventions are needed for all key populations to prevent new HIV infections. Interventions in these packages should meaningfully involve beneficiaries in the design and implementation of the intervention, and take into account the context in which the intervention is being delivered to thoughtfully address issues of stigma and discrimination. These interventions will likely be most effective if implemented in conjunction with strategies to facilitate an enabling environment, including increasing access to HIV testing and health services for PrEP and other prevention strategies, decriminalizing key populations’ practices, increasing access to prevention and care, reducing stigma and discrimination, and fostering community empowerment. PrEP could offer a highly effective, time-limited primary prevention for young key populations if it is implemented in combination with other programs to increase access to health services and encourage the reliable use of PrEP while at risk of HIV exposure. Conclusions Reductions in HIV incidence will only be achieved through the implementation of combinations of interventions that include biomedical and behavioural interventions, as well as components that address social, economic and other structural factors that influence HIV prevention and transmission. PMID:25724507

Challenges of International Students in a Japanese University: Ethnographic Perspectives

ERIC Educational Resources Information Center

Lee, Ju Seong

2017-01-01

The author investigates what challenges four international students (Vietnamese, Filipino, Brazilian, and Chinese) faced and how they coped with these dilemmas in a Japanese language program during the first semester in 2014. Multiple apparatuses (e.g., field notes, face-to-face oral interviews, focal group conversations, and semi-structured…

Strategies and Tools for Public Health Workforce Training Needs Assessments in Diverse and Changing Population Health Contexts.

PubMed

Aidala, Angela A; Cavaliere, Brittney; Cinnick, Samantha

2018-06-07

A key component of the improvement of public health infrastructure in the United States revolves around public health workforce development and training. Workforce challenges faced by the public health system have long been recognized, but there are additional challenges facing any region-wide or cross-jurisdictional effort to accurately assess priority workforce training needs and develop training resources to address those needs. These challenges include structural variability of public health organizations; diverse population health contexts; capturing both topic-specific skill sets and foundational competencies among public health workers; and reaching/representing the target population despite suspicion, disinterest, and/or assessment "fatigue" among employees asked to participate in workforce development surveys. The purpose of this article is to describe the challenges, strategies to meet those challenges, and lessons learned conducting public health workforce training needs assessments by academic and practice partners of the Region 2 Public Health Training Center (R2/PHTC). The R2/PHTC is hosted by the Mailman School of Public Health at Columbia University and serves New York, New Jersey, Puerto Rico, and the US Virgin Islands within its jurisdiction. Strategies for responding to diverse organizational structures and population health contexts across the region; defining training priorities that address both foundational competencies for public health professionals and content-specific training to address local public health needs; reaching/representing target populations of public health workers; and analysis and report writing to encourage rapid response to identified needs and comprehensive workforce development planning are discussed. Lessons learned are likely instructive to other workforce training needs assessments in complex and ever-changing public health environments.

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

NASA Technical Reports Server (NTRS)

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

2006-01-01

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

Using smart materials to solve new challenges in the automotive industry

NASA Astrophysics Data System (ADS)

Gath, Kerrie K.; Maranville, Clay; Tardiff, Janice

2018-03-01

Ford has an extensive history of developing and utilizing smart and innovative materials in its vehicles. In this paper, we present new challenges the automotive industry is facing and explore how intelligent uses of smart materials can help provide solutions. We explore which vehicle attributes may provide most advantageous for the use smart materials, and discuss how smart material have had technical challenges that limit their use. We also look at how smart materials such as gecko inspired adhesion is providing opportunities during the vehicle assembly process by improving manufacturing quality, environmental sustainability, and worker safety. An emerging area for deployment of smart materials may involve autonomous vehicles and mobility solutions, where customer expectations are migrating toward a seamless and adaptive experience leading to new expectations for an enhanced journey. Another area where smart materials are influencing change is interior and exterior design including smart textiles, photochromatic dyes, and thermochromatic materials. The key to advancing smart materials in automotive industry is to capitalize on the smaller niche applications where there will be an advantage over traditional methods. Ford has an extensive history of developing and utilizing smart and innovative materials. Magnetorheological fluids, thermoelectric materials, piezoelectric actuators, and shape memory alloys are all in production. In this paper we present new challenges the automotive industry is facing and explore how intelligent uses of smart materials can help provide solutions. We explore which vehicle attributes may provide most advantageous for the use smart materials, and discuss how smart materials have had technical challenges that limit their use. An emerging area for deployment of smart materials may involve autonomous vehicles and mobility solutions, where customer expectations may require a seamless and adaptive experience for users having various expectations.

Financing of health systems to achieve the health Millennium Development Goals in low-income countries.

PubMed

Fryatt, Robert; Mills, Anne; Nordstrom, Anders

2010-01-30

Concern that underfunded and weak health systems are impeding the achievement of the health Millennium Development Goals in low-income countries led to the creation of a High Level Taskforce on Innovative International Financing for Health Systems in September, 2008. This report summarises the key challenges faced by the Taskforce and its Working Groups. Working Group 1 examined the constraints to scaling up and costs. Challenges included: difficulty in generalisation because of scarce and context-specific health-systems knowledge; no consensus for optimum service-delivery approaches, leading to wide cost differences; no consensus for health benefits; difficulty in quantification of likely efficiency gains; and challenges in quantification of the financing gap owing to uncertainties about financial commitments for health. Working Group 2 reviewed the different innovative mechanisms for raising and channelling funds. Challenges included: variable definitions of innovative finance; small evidence base for many innovative finance mechanisms; insufficient experience in harmonisation of global health initiatives; and inadequate experience in use of international investments to improve maternal, newborn, and child health. The various mechanisms reviewed and finally recommended all had different characteristics, some focusing on specific problems and some on raising resources generally. Contentious issues included the potential role of the private sector, the rights-based approach to health, and the move to results-based aid. The challenges and disagreements that arose during the work of the Taskforce draw attention to the many issues facing decision makers in low-income countries. International donors and recipient governments should work together to improve the evidence base for strengthening health systems, increase long-term commitments, and improve accountability through transparent and inclusive national approaches. Copyright 2010 Elsevier Ltd. All rights reserved.

Challenges to establishing successful partnerships in community health promotion programs: local experiences from the national implementation of healthy eating activity and lifestyle (HEAL™) program.

PubMed

Dennis, Sarah; Hetherington, Sharon A; Borodzicz, Jerrad A; Hermiz, Oshana; Zwar, Nicholas A

2015-04-01

Community-based programs to address physical activity and diet are seen as a valuable strategy to reduce risk factors for chronic disease. Community partnerships are important for successful local implementation of these programs but little is published to describe the challenges of developing partnerships to implement health promotion programs. The aim of this study was to explore the experiences and opinions of key stakeholders on the development and maintenance of partnerships during their implementation of the HEAL™ program. Semi-structured interviews with key stakeholders involved in implementation of HEAL™ in four local government areas. The interviews were transcribed verbatim and analysed thematically. Partnerships were vital to the success of the local implementation. Successful partnerships occurred where the program met the needs of the partnering organisation, or could be adapted to do so. Partnerships took time to develop and were often dependent on key people. Partnering with organisations that had a strong influence in the community could strengthen existing relationships and success. In remote areas partnerships took longer to develop because of fewer opportunities to meet face to face and workforce shortages and this has implications for program funding in these areas. Partnerships are important for the successful implementation of community preventive health programs. They take time to develop, are dependent on the needs of the stakeholders and are facilitated by stable leadership. SO WHAT?: An understanding of the role of partnerships in the implementation of community health programs is important to inform several aspects of program delivery, including flexibility in funding arrangements to allow effective and mutually beneficial partnerships to develop before the implementation phase of the program. It is important that policy makers have an understanding of the time it takes for partnerships to develop and to take this into consideration when programs are funded and implemented in the community.

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

ERIC Educational Resources Information Center

Afridi, Sam

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

Challenges towards realization of health care sector goals of Tanzania development vision 2025: training and deployment of graduate human resource for health.

PubMed

Siril, Nathanael; Kiwara, Angwara; Simba, Daud

2013-06-01

Human resource for health (HRH) is an essential building block for effective and efficient health care system. In Tanzania this component is faced by many challenges which in synergy with others make the health care system inefficient. In vision 2025 the country recognizes the importance of the health care sector in attaining quality livelihood for its citizens. The vision is in its 13th year since its launch. Given the central role of HRH in attainment of this vision, how the HRH is trained and deployed deserves a deeper understanding. To analyze the factors affecting training and deployment process of graduate level HRH of three core cadres; Medical Doctors, Doctor of Dental Surgery and Bachelor of Pharmacy towards realization of development vision 2025. Explorative study design in five training institutions for health and Ministry of Health and Social Welfare (MoHSW) headquarters utilizing in-depth interviews, observations and review of available documents methodology. The training Institutions which are cornerstone for HRH training are understaffed, underfunded (donor dependent), have low admitting capacities and lack co-ordination with other key stakeholders dealing with health. The deployment of graduate level HRH is affected by; limited budget, decision on deployment handled by another ministry rather than MoHSW, competition between health care sector and other sectors and lack of co-ordination between employer, trainers and other key health care sector stakeholders. Awareness on vision 2025 is low in the training institutions. For the vision 2025 health care sector goals to be realized well devised strategies on raising its awareness in the training institutions is recommended. Quality livelihood as stated in vision 2025 will be a forgotten dream if the challenges facing the training and deployment of graduate level HRH will not be addressed timely. It is the authors' view that reduction of donor dependency syndrome, extension of retirement age for academic Staffs in the training institutions for health and synergizing the training and deployment of the graduate level HRH can be among the initial strategies towards addressing these challenges.

Impact of Patient Protection and Affordable Care Act on academic radiology departments' clinical, research, and education missions.

PubMed

Mansoori, Bahar; Vidal, Lorenna L; Applegate, Kimberly; Rawson, James V; Novak, Ronald D; Ros, Pablo R

2013-10-01

The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment. Copyright © 2013. Published by Elsevier Inc.

Comparison of appendicectomy outcomes: acute surgical versus traditional pathway.

PubMed

Pillai, Sandhya; Hsee, Li; Pun, Andy; Mathur, Sachin; Civil, Ian

2013-10-01

The acute surgical unit (ASU) is an evolving novel concept introduced to address the challenge of maintaining key performance indicators (KPIs) in the face of an increasing acute workload. The aim of this retrospective study was to compare the performance of the ASU (from June 2008 to December 2010) at Auckland City Hospital with the traditional model (from January 2006 to May 2008) and benchmark the results against other similar published studies. The analysis was on the basis of KPIs for 1857 appendicectomies, which form a large volume of acute surgical presentations. Our results show significant improvement in length of stay (2.8 days, 2.6 days, P = 0.0001) and proportion of daytime operations (59.4%, 65.8%, P = 0.004), in keeping with other studies on benchmarking. The introduction of ASU has led to significant improvements in some KPIs for appendicectomy outcomes in the face of an increasing workload. © 2013 Royal Australasian College of Surgeons.

Synthesis and microstructure of electrodeposited and sputtered nanotwinned face-centered-cubic metals

DOE PAGES

Bufford, Daniel C.; Wang, Morris; Liu, Yue; ...

2016-04-01

The remarkable properties of nanotwinned (NT) face-centered-cubic (fcc) metals arise directly from twin boundaries, the structures of which can be initially determined by growth twinning during the deposition process. When we understand the synthesis process and its relation to the resulting microstructure, and ultimately to material properties, we realize how key it is to understanding and utilizing these materials. Furthermore, our article presents recent studies on electrodeposition and sputtering methods that produce a high density of nanoscale growth twins in fcc metals. Nanoscale growth twins tend to form spontaneously in monolithic and alloyed fcc metals with lower stacking-fault energies, whilemore » engineered approaches are necessary for fcc metals with higher stacking-fault energies. Finally, growth defects and other microstructural features that influence nanotwin behavior and stability are introduced here, and future challenges in fabricating NT materials are highlighted.« less

Strategies for synchronisation in an evolving telecommunications network

NASA Astrophysics Data System (ADS)

Avery, Rob

1992-06-01

The achievement of precise synchronization in the telecommunications environment is addressed. Transmitting the timing from node to node has been the inherent problem for all digital networks. Traditional network equipment used to transfer synchronization, such as digital switching ststems, adds impairments to the once traceable signal. As the synchronization signals are passed from node to node, they lose stability by passing through intervening clocks. Timing would be an integrated part of all new network and service deployments. New transmission methods, such as the Synchronous Digital Hierarchy (SDH), survivable network topologies and the issues that arise from them, necessitate a review of current network synchronization strategies. Challenges that face the network are itemized. A demonstration of why localized Primary Reference Clocks (PRC) in key nodes and the Synchronization Supply Unit (SSU) clock architecture of transit and local node clocks is a technically and economically viable solution to the issues facing network planners today is given.

HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN IRAN.

PubMed

Mohtasham, Farideh; Majdzadeh, Reza; Jamshidi, Ensiyeh

2017-01-01

Hospitals with health technology assessment (HTA) programs have reported its positive effects on the management of resources and costs. This study aimed to identify the barriers faced by hospital-based HTA (HBHTA) in Iran by inductive content analysis of stakeholders' and decision-makers' points of view. The key individuals and organizations that could provide rich, relevant, and diverse data in response to the research question were purposively selected for the interviews and focus group discussion. Twelve stakeholders from seven public hospitals participated in the interviews. Another eighteen stakeholders from twelve HBHTA-related organizations took part in the focus group discussion. Most of the hospitals' senior management team did not feel the need for HBHTA and believed that in Iran a systematic process like HTA faces many challenges. The stakeholders participating in this study highlighted the significance of certain points that needed to be addressed before establishing HBHTA in Iran.

Return of Individual Research Results & Incidental Findings: Facing the Challenges of Translational Science

PubMed Central

Wolf, Susan M.

2014-01-01

The debate over return of individual research results and incidental findings to research participants is a key frontier in research ethics and practice. Fundamentally, this is a problem of translational science, a question of when information about an individual that is generated in research should be communicated for clinical attention, as the technology itself is moving into clinical care. There is growing consensus that investigators should offer participants at least those individual findings of high clinical importance and actionability. Increasing attention to what information biobanks and secondary researchers owe people who provide data and samples offers an opportunity to treat these source individuals as research partners. Cutting-edge issues include return of results in pediatric populations and return to kin and family, including after death of the proband. Progress will require facing the continuum linking research and clinical care and developing standards and models for return. PMID:23875796

Synthesis and microstructure of electrodeposited and sputtered nanotwinned face-centered-cubic metals

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

Bufford, Daniel C.; Wang, Morris; Liu, Yue

The remarkable properties of nanotwinned (NT) face-centered-cubic (fcc) metals arise directly from twin boundaries, the structures of which can be initially determined by growth twinning during the deposition process. When we understand the synthesis process and its relation to the resulting microstructure, and ultimately to material properties, we realize how key it is to understanding and utilizing these materials. Furthermore, our article presents recent studies on electrodeposition and sputtering methods that produce a high density of nanoscale growth twins in fcc metals. Nanoscale growth twins tend to form spontaneously in monolithic and alloyed fcc metals with lower stacking-fault energies, whilemore » engineered approaches are necessary for fcc metals with higher stacking-fault energies. Finally, growth defects and other microstructural features that influence nanotwin behavior and stability are introduced here, and future challenges in fabricating NT materials are highlighted.« less

Crossing boundaries to improve mental health in the Americas: international collaborative authorship.

PubMed

Killion, Chery M

2007-01-01

A nurse anthropologist with a background in international collaborations attended Project LEAD for two years, which enabled her to continue to serve as an advocate for the mentally ill in Belize. The anthropologist collaborated with a psychiatrist from Belize to develop a cross-cultural, cross-discipline publication, "Mental Health in Belize: A National Priority, " which highlights the work of psychiatric nurse practitioners in the country. The researcher learned to collaborate with her peer in Belize through face to face discussions and e-mail and overcame technological difficulties and cultural barriers to produce an international publication. Project LEAD gave the author a sense of self-discovery and self-knowledge, reinforced core values, and developed a frame of reference for leadership. The author also benefited from discussions by local, national, and international leaders on leadership in terms of its key components, contexts, challenges, triumphs, and styles.

Army Communicator. Volume 32, Number 3, Summer 2007

DTIC Science & Technology

2007-01-01

goal of bringing people from across the Army together to talk about the issues and challenges they are experiencing in the field and try to work out...actually facing the challenges . Each work- shop had a mediator who collected information on issues being faced and suggested solutions to these problems...these possible items that Signal Center actions may be put forth to bring about resolutions to the challenges facing the warfighter in the field. “I

Preprocessing Structured Clinical Data for Predictive Modeling and Decision Support

PubMed Central

Oliveira, Mónica Duarte; Janela, Filipe; Martins, Henrique M. G.

2016-01-01

Summary Background EHR systems have high potential to improve healthcare delivery and management. Although structured EHR data generates information in machine-readable formats, their use for decision support still poses technical challenges for researchers due to the need to preprocess and convert data into a matrix format. During our research, we observed that clinical informatics literature does not provide guidance for researchers on how to build this matrix while avoiding potential pitfalls. Objectives This article aims to provide researchers a roadmap of the main technical challenges of preprocessing structured EHR data and possible strategies to overcome them. Methods Along standard data processing stages – extracting database entries, defining features, processing data, assessing feature values and integrating data elements, within an EDPAI framework –, we identified the main challenges faced by researchers and reflect on how to address those challenges based on lessons learned from our research experience and on best practices from related literature. We highlight the main potential sources of error, present strategies to approach those challenges and discuss implications of these strategies. Results Following the EDPAI framework, researchers face five key challenges: (1) gathering and integrating data, (2) identifying and handling different feature types, (3) combining features to handle redundancy and granularity, (4) addressing data missingness, and (5) handling multiple feature values. Strategies to address these challenges include: cross-checking identifiers for robust data retrieval and integration; applying clinical knowledge in identifying feature types, in addressing redundancy and granularity, and in accommodating multiple feature values; and investigating missing patterns adequately. Conclusions This article contributes to literature by providing a roadmap to inform structured EHR data preprocessing. It may advise researchers on potential pitfalls and implications of methodological decisions in handling structured data, so as to avoid biases and help realize the benefits of the secondary use of EHR data. PMID:27924347

Ethical challenges for accountable care organizations: a structured review.

PubMed

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

2014-10-01

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

Exploring the challenges faced by polytechnic students

NASA Astrophysics Data System (ADS)

Matore, Mohd Effendi @ Ewan Mohd; Khairani, Ahmad Zamri

2015-02-01

This study aims to identify other challenges besides those already faced by students, in seven polytechnics in Malaysia as a continuation to the previous research that had identified 52 main challenges faced by students using the Rasch Model. The explorative study focuses on the challenges that are not included in the Mooney Problem Checklist (MPCL). A total of 121 polytechnic students submitted 183 written responses through the open questions provided. Two hundred fifty two students had responded from a students' perspective on the dichotomous questions regarding their view on the challenges faced. The data was analysed qualitatively using the NVivo 8.0. The findings showed that students from Politeknik Seberang Perai (PSP) gave the highest response, which was 56 (30.6%) and Politeknik Metro Kuala Lumpur (PMKL) had the lowest response of 2 (1.09%). Five dominant challenges were identified, which were the English language (32, 17.5%), learning (14, 7.7%), vehicles (13, 7.1%), information technology and communication (ICT) (13, 7.1%), and peers (11, 6.0%). This article, however, focus on three apparent challenges, namely, English language, vehicles, as well as computer and ICT, as the challenges of learning and peers had been analysed in the previous MPCL. The challenge of English language that had been raised was regarding the weakness in commanding the aspects of speech and fluency. The computer and ICT challenge covered the weakness in mastering ICT and computers, as well as computer breakdowns and low-performance computers. The challenge of vehicles emphasized the unavailability of vehicles to attend lectures and go elsewhere, lack of transportation service in the polytechnic and not having a valid driving license. These challenges are very relevant and need to be discussed in an effort to prepare polytechnics in facing the transformational process of polytechnics.

Crossing Scales and Disciplines to Understand Challenges for Climate Change Adaptation and Water Resources Management in Chile and Californi

NASA Astrophysics Data System (ADS)

Vicuna, S.; Melo, O.; Meza, F. J.; Medellin-Azuara, J.; Herman, J. D.; Sandoval Solis, S.

2017-12-01

California and Chile share similarities in terms of climate, ecosystems, topography and water use. In both regions, the hydro-climatologic system is characterized by a typical Mediterranean climate, rainy winters and dry summers, highly variable annual precipitation, and snowmelt-dependent water supply systems. Water use in both regions has also key similarities, with the highest share devoted to high-value irrigated crops, followed by urban water use and a significant hydropower-driven power supply system. Snowmelt-driven basins in semiarid regions are highly sensitive to climate change for two reasons, temperature effects on snowmelt timing and water resources scarcity in these regions subject to ever-increasing demands. Research in both regions also coincide in terms of the potential climate change impacts. Expected impacts on California and Chile water resources have been well-documented in terms of changes in water supply and water demand, though significant uncertainties remain. Both regions have recently experienced prolonged droughts, providing an opportunity to understand the future challenges and potential adaptive responses under climate change. This study connects researchers from Chile and California with the goal of understanding the problem of how to adapt to climate change impacts on water resources and agriculture at the various spatial and temporal scales. The project takes advantage of the complementary contexts between Chile and California in terms of similar climate and hydrologic conditions, water management institutions, patterns of water consumption and, importantly, a similar challenge facing recent drought scenarios to understand the challenges faced by a changing climate.

Communicative conduct in commercial medicine: initial consultations between plastic surgeons and prospective clients.

PubMed

Mirivel, Julien C

2010-06-01

In this study, I investigated naturally occurring medical interaction in commercial medicine. Drawing on 30+ hours of videotaped data and 9 months of fieldwork in a cosmetic surgery clinic, this analysis focuses on how plastic surgeons interact with patients who seek to alter their bodily appearance. The ethnographically informed discourse analysis reveals how plastic surgeons manage multiple and competing interactive demands. Specifically, I describe plastic surgeons' key strategies for meeting both health-related and institutional goals. In the conclusion, I reflect on the communication challenges that medical professionals and patients face when consumerism and medicine meet.

Research of grasping algorithm based on scara industrial robot

NASA Astrophysics Data System (ADS)

Peng, Tao; Zuo, Ping; Yang, Hai

2018-04-01

As the tobacco industry grows, facing the challenge of the international tobacco giant, efficient logistics service is one of the key factors. How to complete the tobacco sorting task of efficient economy is the goal of tobacco sorting and optimization research. Now the cigarette distribution system uses a single line to carry out the single brand sorting task, this article adopts a single line to realize the cigarette sorting task of different brands. Using scara robot special algorithm for sorting and packaging, the optimization scheme significantly enhances the indicators of smoke sorting system. Saving labor productivity, obviously improve production efficiency.

Paradigms and progress in vocal fold restoration.

PubMed

Ford, Charles N

2008-09-01

Science advances occur through orderly steps, puzzle-solving leaps, or divergences from the accepted disciplinary matrix that occasionally result in a revolutionary paradigm shift. Key advances must overcome bias, criticism, and rejection. Examples in biological science include use of embryonic stem cells, recognition of Helicobacter pylori in the etiology of ulcer disease, and the evolution of species. Our work in vocal fold restoration reflects these patterns. We progressed through phases of tissue replacement with fillers and biological implants, to current efforts at vocal fold regeneration through tissue engineering, and face challenges of a new "systems biology" paradigm embracing genomics and proteomics.

Challenges and Changes Faced by Rural Superintendents

ERIC Educational Resources Information Center

Lamkin, Marcia L.

2006-01-01

This research study was designed to build grounded theory about the challenges faced by rural superintendents. Participating rural superintendents identified five areas that presented a challenge but that also applied to superintendents in other settings: school law, finance, personnel, government mandates, and district or board policies. Further,…

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

PubMed

Dickey, Lore M; Singh, Anneliese A

2017-08-01

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

The Invisible Army

PubMed Central

2017-01-01

ABSTRACT The “invisible army” of clinical microbiologists is facing major changes and challenges. The rate of change in both the science and technology is accelerating with no end in sight, putting pressure on our army to learn and adapt as never before. Health care funding in the United States is undergoing dramatic change which will require a new set of assumptions about how clinical microbiology is practiced here. A major challenge facing the discipline is the replacement of a generation of clinical microbiologists. In my opinion, it is incumbent on us in the invisible army to continue to work with the American Society for Microbiology (ASM) in meeting the future challenges faced by our discipline. In this commentary, I will first discuss some recent history of clinical microbiology within ASM and then some current challenges we face. PMID:28659316

Face Alignment via Regressing Local Binary Features.

PubMed

Ren, Shaoqing; Cao, Xudong; Wei, Yichen; Sun, Jian

2016-03-01

This paper presents a highly efficient and accurate regression approach for face alignment. Our approach has two novel components: 1) a set of local binary features and 2) a locality principle for learning those features. The locality principle guides us to learn a set of highly discriminative local binary features for each facial landmark independently. The obtained local binary features are used to jointly learn a linear regression for the final output. This approach achieves the state-of-the-art results when tested on the most challenging benchmarks to date. Furthermore, because extracting and regressing local binary features are computationally very cheap, our system is much faster than previous methods. It achieves over 3000 frames per second (FPS) on a desktop or 300 FPS on a mobile phone for locating a few dozens of landmarks. We also study a key issue that is important but has received little attention in the previous research, which is the face detector used to initialize alignment. We investigate several face detectors and perform quantitative evaluation on how they affect alignment accuracy. We find that an alignment friendly detector can further greatly boost the accuracy of our alignment method, reducing the error up to 16% relatively. To facilitate practical usage of face detection/alignment methods, we also propose a convenient metric to measure how good a detector is for alignment initialization.

Children at Risk: Global Views on Challenges Facing Children

ERIC Educational Resources Information Center

Neugebauer, Roger

2011-01-01

Members of the World Forum community were invited to respond to the question: "What is the most urgent challenge facing young children in your country?" Here are some of their responses. Jamils Richard Achunji Anguaseh mentions that in Cameroon, young children face lots of insecurity, both from health hazards and poor parenting practices. There…

Challenges in the management of community pharmacies in Malaysia

PubMed Central

2017-01-01

Background: The provision of professional pharmacy services by community pharmacists continues to be limited, particularly in low and middle income countries. It was postulated that multiple management challenges faced by community pharmacists contribute to this situation. Objective: The primary aim of the research was to determine the challenges faced in the management of community pharmacies in Sarawak (the largest state in Malaysia), and practical strategies to cope and overcome the challenges. Methods: Semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling were employed to ensure a diverse group of informants. The interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Data collection, coding, interpretation were carried out iteratively until theoretical saturation. Results: Twenty respondents from different demographic characteristics were recruited. Six major themes were identified. Management challenges faced by community pharmacists traverse five major domains: market competition, legislative issues, customers’ knowledge and expectations, macroeconomic impacts and operational challenges. Most of these challenges require government intervention to be resolved. In the meantime, improving customer service and expanding the range of professional services were seen as the most viable strategies to cope with existing challenges. The main concern is that current legislative and economic landscape may hinder these strategies. Enactment of dispensing separation and more protective measures against market competition were suggested to alleviate the challenges faced. Conclusion: Numerous management challenges faced by community pharmacists that distract them from delivering professional pharmacy services have been highlighted. Urgent affirmative actions by the government are warranted in supporting community pharmacists to realise and maximise their potentials. PMID:28690697

Problems, challenges and promises: perspectives on precision medicine.

PubMed

Duffy, David J

2016-05-01

The 'precision medicine (systems medicine)' concept promises to achieve a shift to future healthcare systems with a more proactive and predictive approach to medicine, where the emphasis is on disease prevention rather than the treatment of symptoms. The individualization of treatment for each patient will be at the centre of this approach, with all of a patient's medical data being computationally integrated and accessible. Precision medicine is being rapidly embraced by biomedical researchers, pioneering clinicians and scientific funding programmes in both the European Union (EU) and USA. Precision medicine is a key component of both Horizon 2020 (the EU Framework Programme for Research and Innovation) and the White House's Precision Medicine Initiative. Precision medicine promises to revolutionize patient care and treatment decisions. However, the participants in precision medicine are faced with a considerable central challenge. Greater volumes of data from a wider variety of sources are being generated and analysed than ever before; yet, this heterogeneous information must be integrated and incorporated into personalized predictive models, the output of which must be intelligible to non-computationally trained clinicians. Drawing primarily from the field of 'oncology', this article will introduce key concepts and challenges of precision medicine and some of the approaches currently being implemented to overcome these challenges. Finally, this article also covers the criticisms of precision medicine overpromising on its potential to transform patient care. © The Author 2015. Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

A Comparison of Recruitment Methods for an mHealth Intervention Targeting Mothers: Lessons from the Growing Healthy Program.

PubMed

Laws, Rachel A; Litterbach, Eloise-Kate V; Denney-Wilson, Elizabeth A; Russell, Catherine G; Taki, Sarah; Ong, Kok-Leong; Elliott, Rosalind M; Lymer, Sharyn J; Campbell, Karen J

2016-09-15

Mobile health (mHealth) programs hold great promise for increasing the reach of public health interventions. However, mHealth is a relatively new field of research, presenting unique challenges for researchers. A key challenge is understanding the relative effectiveness and cost of various methods of recruitment to mHealth programs. The objectives of this study were to (1) compare the effectiveness of various methods of recruitment to an mHealth intervention targeting healthy infant feeding practices, and (2) explore factors influencing practitioner referral to the intervention. The Growing healthy study used a quasi-experimental design with an mHealth intervention group and a concurrent nonrandomized comparison group. Eligibility criteria included: expectant parents (>30 weeks of gestation) or parents with an infant <3 months old, ability to read and understand English, own a mobile phone, ≥18 years old, and living in Australia. Recruitment to the mHealth program consisted of: (1) practitioner-led recruitment through Maternal and Child Health nurses, midwives, and nurses in general practice; (2) face-to-face recruitment by researchers; and (3) online recruitment. Participants' baseline surveys provided information regarding how participants heard about the study, and their sociodemographic details. Costs per participant recruited were calculated by taking into account direct advertising costs and researcher time/travel costs. Practitioner feedback relating to the recruitment process was obtained through a follow-up survey and qualitative interviews. A total of 300 participants were recruited to the mHealth intervention. The cost per participant recruited was lowest for online recruitment (AUD $14) and highest for practice nurse recruitment (AUD $586). Just over half of the intervention group (50.3%, 151/300) were recruited online over a 22-week period compared to practitioner recruitment (29.3%, 88/300 over 46 weeks) and face-to-face recruitment by researchers (7.3%, 22/300 over 18 weeks). No significant differences were observed in participant sociodemographic characteristics between recruitment methods, with the exception that practitioner/face-to-face recruitment resulted in a higher proportion of first-time parents (68% versus 48%, P=.002). Less than half of the practitioners surveyed reported referring to the program often or most of the time. Key barriers to practitioner referral included lack of time, difficulty remembering to refer, staff changes, lack of parental engagement, and practitioner difficulty in accessing the app. Online recruitment using parenting-related Facebook pages was the most cost effective and timely method of recruitment to an mHealth intervention targeting parents of young infants. Consideration needs to be given to addressing practitioner barriers to referral, to further explore if this can be a viable method of recruitment.

A Comparison of Recruitment Methods for an mHealth Intervention Targeting Mothers: Lessons from the Growing Healthy Program

PubMed Central

Litterbach, Eloise-Kate V; Denney-Wilson, Elizabeth A; Russell, Catherine G; Taki, Sarah; Ong, Kok-Leong; Elliott, Rosalind M; Lymer, Sharyn J; Campbell, Karen J

2016-01-01

Background Mobile health (mHealth) programs hold great promise for increasing the reach of public health interventions. However, mHealth is a relatively new field of research, presenting unique challenges for researchers. A key challenge is understanding the relative effectiveness and cost of various methods of recruitment to mHealth programs. Objective The objectives of this study were to (1) compare the effectiveness of various methods of recruitment to an mHealth intervention targeting healthy infant feeding practices, and (2) explore factors influencing practitioner referral to the intervention. Methods The Growing healthy study used a quasi-experimental design with an mHealth intervention group and a concurrent nonrandomized comparison group. Eligibility criteria included: expectant parents (>30 weeks of gestation) or parents with an infant <3 months old, ability to read and understand English, own a mobile phone, ≥18 years old, and living in Australia. Recruitment to the mHealth program consisted of: (1) practitioner-led recruitment through Maternal and Child Health nurses, midwives, and nurses in general practice; (2) face-to-face recruitment by researchers; and (3) online recruitment. Participants’ baseline surveys provided information regarding how participants heard about the study, and their sociodemographic details. Costs per participant recruited were calculated by taking into account direct advertising costs and researcher time/travel costs. Practitioner feedback relating to the recruitment process was obtained through a follow-up survey and qualitative interviews. Results A total of 300 participants were recruited to the mHealth intervention. The cost per participant recruited was lowest for online recruitment (AUD $14) and highest for practice nurse recruitment (AUD $586). Just over half of the intervention group (50.3%, 151/300) were recruited online over a 22-week period compared to practitioner recruitment (29.3%, 88/300 over 46 weeks) and face-to-face recruitment by researchers (7.3%, 22/300 over 18 weeks). No significant differences were observed in participant sociodemographic characteristics between recruitment methods, with the exception that practitioner/face-to-face recruitment resulted in a higher proportion of first-time parents (68% versus 48%, P=.002). Less than half of the practitioners surveyed reported referring to the program often or most of the time. Key barriers to practitioner referral included lack of time, difficulty remembering to refer, staff changes, lack of parental engagement, and practitioner difficulty in accessing the app. Conclusions Online recruitment using parenting-related Facebook pages was the most cost effective and timely method of recruitment to an mHealth intervention targeting parents of young infants. Consideration needs to be given to addressing practitioner barriers to referral, to further explore if this can be a viable method of recruitment. PMID:27634633

Children's representations of school support for HIV-affected peers in rural Zimbabwe.

PubMed

Campbell, Catherine; Andersen, Louise; Mutsikiwa, Alice; Madanhire, Claudius; Skovdal, Morten; Nyamukapa, Constance; Gregson, Simon

2014-04-26

HIV has left many African children caring for sick relatives, orphaned or themselves HIV-positive, often facing immense challenges in the absence of significant support from adults. With reductions in development funding, public sector budgetary constraints, and a growing emphasis on the importance of indigenous resources in the HIV response, international policy allocates schools a key role in 'substituting for families' (Ansell, 2008) in supporting child health and well-being. We explore children's own accounts of the challenges facing their HIV-affected peers and the role of schools in providing such support. Contextualised within a multi-method study of school support for HIV-affected children in rural Zimbabwe, and regarding children's views as a key resource for child-relevant intervention and policy, 128 school children (10-14) wrote a story about an HIV-affected peer and how school assisted them in tackling their problems. Children presented harrowing accounts of negative impacts of HIV on the social, physical and mental well-being of peers, and how these manifested in the school setting. Whilst relationships with fellow learners and teachers were said to provide a degree of support, this was patchy and minimal, generally limited to small-scale and often one-off acts of material help or kindness (e.g. teachers giving children pens and exercise books or peers sharing school lunches), with little potential to impact significantly on the wider social drivers of children's daily challenges. Despite having respect for the enormity of the challenges many HIV-affected peers were coping with, children tended to keep a distance from them. School was depicted as a source of the very bullying, stigma and social exclusion that undermined children's opportunities for well-being in their lives more generally. Our findings challenge glib assumptions that schools can serve as a significant 'indigenous' supports of the health and well-being of HIV-affected children in the absence of a very significant increase in outside training, support and additional resources. Schools are an extension of communities, with members of school communities subject to many of the same deprivations, anxieties and prejudices that drive the health-limiting exclusion, impoverishment and stigmatisation of HIV-affected children in their households and wider communities.

Children’s representations of school support for HIV-affected peers in rural Zimbabwe

PubMed Central

2014-01-01

Background HIV has left many African children caring for sick relatives, orphaned or themselves HIV-positive, often facing immense challenges in the absence of significant support from adults. With reductions in development funding, public sector budgetary constraints, and a growing emphasis on the importance of indigenous resources in the HIV response, international policy allocates schools a key role in ‘substituting for families’ (Ansell, 2008) in supporting child health and well-being. We explore children’s own accounts of the challenges facing their HIV-affected peers and the role of schools in providing such support. Methods Contextualised within a multi-method study of school support for HIV-affected children in rural Zimbabwe, and regarding children’s views as a key resource for child-relevant intervention and policy, 128 school children (10–14) wrote a story about an HIV-affected peer and how school assisted them in tackling their problems. Results Children presented harrowing accounts of negative impacts of HIV on the social, physical and mental well-being of peers, and how these manifested in the school setting. Whilst relationships with fellow learners and teachers were said to provide a degree of support, this was patchy and minimal, generally limited to small-scale and often one-off acts of material help or kindness (e.g. teachers giving children pens and exercise books or peers sharing school lunches), with little potential to impact significantly on the wider social drivers of children’s daily challenges. Despite having respect for the enormity of the challenges many HIV-affected peers were coping with, children tended to keep a distance from them. School was depicted as a source of the very bullying, stigma and social exclusion that undermined children’s opportunities for well-being in their lives more generally. Conclusions Our findings challenge glib assumptions that schools can serve as a significant ‘indigenous’ supports of the health and well-being of HIV-affected children in the absence of a very significant increase in outside training, support and additional resources. Schools are an extension of communities, with members of school communities subject to many of the same deprivations, anxieties and prejudices that drive the health-limiting exclusion, impoverishment and stigmatisation of HIV-affected children in their households and wider communities. PMID:24767247

Optimizing the management of depression: primary care experience.

PubMed

Cameron, Catherine; Habert, Jeff; Anand, Leena; Furtado, Melissa

2014-12-01

This article is intended to identify some of the most important challenges faced by family physicians when treating MDD and to provide practical solutions. Key issues, reviewed from a primary care view point will include: treating to remission (and not just response), identification of high-risk groups, diagnosis, acute treatment approaches (including pharmacotherapy and the management of related side effects), the use of psychotherapy and somatic therapies, assessment of the adequacy of treatment including the assessment of remission, response measurement, optimal follow-up care throughout the phase of treatment, the key components of patient education and strategies for partial/limited response to the first-line antidepressant (switching, augmentation and combination strategies), how to provide support for improved treatment adherence, and approaches to prevent the recurrence of depressive episodes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Scale of organizational learning in schools. Organizational learning is a key element for the development of organizations].

PubMed

López, Verónica; Ahumada, Luis; Olivares, Rodrigo; González, Alvaro

2012-05-01

Organizational learning is a key element for the development of organizations. School organizations are not exempt from this challenge and they currently face a highly dynamic and demanding context of education policies that emphasize the school's ability to learn. Thus, research on organizational learning in educational contexts requires valid instruments that are sensitive to the specifics of schools as organizations. In this study, we adapted and validated a scale of organizational learning in a sample of 119 Chilean municipal schools (N= 1,545). The results suggest a structural model made up of three factors: culture of learning, strategic clarity, and group learning. These factors predicted dimensions of educational achievement, as measured through the National Assessment System of Educational Achievement (SNED). Results are discussed in view of the literature on school improvement.

Is There a Universal Understanding of Vulnerability? Experiences with Russian and Romanian Trainees in Research Ethics

PubMed Central

Loue, Sana; Loff, Bebe

2014-01-01

Vulnerability of participants in research and the provision of special protections for vulnerable research participants are key concepts in research ethics. Despite international consensus requiring special protections for vulnerable research participants, both the concept of vulnerability and the nature and adequacy of strategies to reduce vulnerability remain vague and, consequently, are subject to varying interpretations. We report on observations of the challenges faced in understanding this key concept by 20 Russian and Romanian trainees participating in a one-year M.A. training program in research ethics from 2000 through 2011. We describe how trainees’ understanding of and appreciation for the need for special protections of vulnerable research participants was nurtured. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program. PMID:24384513

Challenges When Introducing Electronic Exam

ERIC Educational Resources Information Center

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

2014-01-01

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

Bridging the Gap: The Challenges of Employing Entrepreneurial Processes within University Settings

ERIC Educational Resources Information Center

Wardale, Dorothy; Lord, Linley

2016-01-01

In Australia and elsewhere, universities face increasing pressure to improve research output and quality, particularly through partnerships with industry. This raises interesting challenges for academic staff with considerable industry experience who are "new" to academe. Some of these challenges were faced by the authors who have been…

Confronting Unsuccessful Practices: Repositioning Teacher Identities in English Education

ERIC Educational Resources Information Center

Vetter, Amy; Hartman, Shana V.; Reynolds, Jeanie M.

2016-01-01

Teacher education programs attempt to prepare preservice teachers for the various challenges faced in the classroom. One particular challenge new teachers face is how to handle unsuccessful practices. This paper argues that confronting ineffective practices require that teachers respond to complex and dynamic challenges, making change difficult…

Challenges Faced by Project Competition Participants and Recommended Solutions

ERIC Educational Resources Information Center

Demirel, Turgay; Baydas, Ozlem; Yilmaz, Rabia M.; Goktas, Yuksel

2013-01-01

The numbers of project competitions and interest in this kind of competition have been steadily increasing in Turkey. Accordingly, it is important to determine what challenges teachers and students may face while preparing themselves for project competitions, so that recommendations may be made to overcome these challenges. This study investigated…

Management, Analysis, and Visualization of Experimental and Observational Data – The Convergence of Data and Computing

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

Bethel, E. Wes; Greenwald, Martin; Kleese van Dam, Kerstin

Scientific user facilities—particle accelerators, telescopes, colliders, supercomputers, light sources, sequencing facilities, and more—operated by the U.S. Department of Energy (DOE) Office of Science (SC) generate ever increasing volumes of data at unprecedented rates from experiments, observations, and simulations. At the same time there is a growing community of experimentalists that require real-time data analysis feedback, to enable them to steer their complex experimental instruments to optimized scientific outcomes and new discoveries. Recent efforts in DOE-SC have focused on articulating the data-centric challenges and opportunities facing these science communities. Key challenges include difficulties coping with data size, rate, and complexity inmore » the context of both real-time and post-experiment data analysis and interpretation. Solutions will require algorithmic and mathematical advances, as well as hardware and software infrastructures that adequately support data-intensive scientific workloads. This paper presents the summary findings of a workshop held by DOE-SC in September 2015, convened to identify the major challenges and the research that is needed to meet those challenges.« less

Management, Analysis, and Visualization of Experimental and Observational Data -- The Convergence of Data and Computing

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

Bethel, E. Wes; Greenwald, Martin; Kleese van Dam, Kersten

Scientific user facilities---particle accelerators, telescopes, colliders, supercomputers, light sources, sequencing facilities, and more---operated by the U.S. Department of Energy (DOE) Office of Science (SC) generate ever increasing volumes of data at unprecedented rates from experiments, observations, and simulations. At the same time there is a growing community of experimentalists that require real-time data analysis feedback, to enable them to steer their complex experimental instruments to optimized scientific outcomes and new discoveries. Recent efforts in DOE-SC have focused on articulating the data-centric challenges and opportunities facing these science communities. Key challenges include difficulties coping with data size, rate, and complexity inmore » the context of both real-time and post-experiment data analysis and interpretation. Solutions will require algorithmic and mathematical advances, as well as hardware and software infrastructures that adequately support data-intensive scientific workloads. This paper presents the summary findings of a workshop held by DOE-SC in September 2015, convened to identify the major challenges and the research that is needed to meet those challenges.« less

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana.

PubMed

Mupara, Lucia U; Lubbe, Johanna C

2016-01-01

Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Regulatory toxicology in the twenty-first century: challenges, perspectives and possible solutions.

PubMed

Tralau, Tewes; Oelgeschläger, Michael; Gürtler, Rainer; Heinemeyer, Gerhard; Herzler, Matthias; Höfer, Thomas; Itter, Heike; Kuhl, Thomas; Lange, Nikola; Lorenz, Nicole; Müller-Graf, Christine; Pabel, Ulrike; Pirow, Ralph; Ritz, Vera; Schafft, Helmut; Schneider, Heiko; Schulz, Thomas; Schumacher, David; Zellmer, Sebastian; Fleur-Böl, Gaby; Greiner, Matthias; Lahrssen-Wiederholt, Monika; Lampen, Alfonso; Luch, Andreas; Schönfelder, Gilbert; Solecki, Roland; Wittkowski, Reiner; Hensel, Andreas

2015-06-01

The advent of new testing systems and "omics"-technologies has left regulatory toxicology facing one of the biggest challenges for decades. That is the question whether and how these methods can be used for regulatory purposes. The new methods undoubtedly enable regulators to address important open questions of toxicology such as species-specific toxicity, mixture toxicity, low-dose effects, endocrine effects or nanotoxicology, while promising faster and more efficient toxicity testing with the use of less animals. Consequently, the respective assays, methods and testing strategies are subject of several research programs worldwide. On the other hand, the practical application of such tests for regulatory purposes is a matter of ongoing debate. This document summarizes key aspects of this debate in the light of the European "regulatory status quo", while elucidating new perspectives for regulatory toxicity testing.

Surveillance of adverse effects following vaccination and safety of immunization programs.

PubMed

Waldman, Eliseu Alves; Luhm, Karin Regina; Monteiro, Sandra Aparecida Moreira Gomes; Freitas, Fabiana Ramos Martin de

2011-02-01

The aim of the review was to analyze conceptual and operational aspects of systems for surveillance of adverse events following immunization. Articles available in electronic format were included, published between 1985 and 2009, selected from the PubMed/Medline databases using the key words "adverse events following vaccine surveillance", "post-marketing surveillance", "safety vaccine" and "Phase IV clinical trials". Articles focusing on specific adverse events were excluded. The major aspects underlying the Public Health importance of adverse events following vaccination, the instruments aimed at ensuring vaccine safety, and the purpose, attributes, types, data interpretation issues, limitations, and further challenges in adverse events following immunization were describe, as well as strategies to improve sensitivity. The review was concluded by discussing the challenges to be faced in coming years with respect to ensuring the safety and reliability of vaccination programs.

Family Resilience in the Military

PubMed Central

Meadows, Sarah O.; Beckett, Megan K.; Bowling, Kirby; Golinelli, Daniela; Fisher, Michael P.; Martin, Laurie T.; Meredith, Lisa S.; Osilla, Karen Chan

2016-01-01

Abstract Military life presents a variety of challenges to military families, including frequent separations and relocations as well as the risks that service members face during deployment; however, many families successfully navigate these challenges. Despite a recent emphasis on family resilience, the U.S. Department of Defense (DoD) does not have a standard and universally accepted definition of family resilience. A standard definition is a necessary for DoD to more effectively assess its efforts to sustain and improve family resilience. RAND authors reviewed the literature on family resilience and, in this study, recommend a definition that could be used DoD-wide. The authors also reviewed DoD policies related to family resilience, reviewed models that describe family resilience and identified key family resilience factors, and developed several recommendations for how family-resilience programs and policies could be managed across DoD. PMID:28083409

NOAA administrator reviews agency progress and challenges

NASA Astrophysics Data System (ADS)

Showstack, Randy

2011-12-01

The approach of the new year is a traditional time to tally up successes, failures, and the path ahead. Jane Lubchenco, administrator of the U.S. National Oceanic and Atmospheric Administration (NOAA), examined some agency advances and significant challenges during the 7 December Union Agency Lecture at the AGU Fall Meeting, during a press briefing, and in an interview with Eos. Lubchenco focused on several key areas including the concern about monitoring, mitigating, and managing extreme events; budgetary pressures the agency faces in current fiscal year (FY) 2012 and in FY 2013, with President Barack Obama on 18 November having signed into law a bill, HR 2112, following congressional agreement on a budget legislation conference report; and NOAA's newly released scientific integrity policy (see "NOAA issues scientific integrity policy," Eos Trans. AGU, 92(50), 467, doi:10.1029/2011EO500004, 2011).

Endangered species and nature conservation: science issues and challenges.

PubMed

Szaro, Robert C

2008-06-01

The issues and challenges facing us in ensuring the survival of as many species and ecosystems as possible call for a renewed research focus to address how to improve management strategies and policy making now and into the future. The key issues to be addressed by activities of the International Union of Forest Research Organization's (IUFRO) Task Force on Endangered Species and Nature Conservation include such issues as: (i) preventing species from being listed by maintaining species populations at sufficient levels that they do not require listing; (ii) recovering threatened and endangered species; (iii) developing management practices and strategies; (iv) balancing actions affecting suites of threatened or endangered species; (v) developing conservation strategies for species without definitive taxonomic treatments; (vi) dealing with global change; (vii) dealing with invasive species; and (viii) restoring critical habitats. © 2008 ISZS, Blackwell Publishing and IOZ/CAS.

Facing Global Challenges with Materials Innovation

NASA Astrophysics Data System (ADS)

Rizzo, Fernando

2017-10-01

The path of society evolution has long been associated with a growing demand for natural resources and continuous environmental degradation. During the last decades, this pace has accelerated considerably, despite the general concern with the legacy being left for the next generations. Looking ahead, the predicted growth of the world population, and the improvement of life conditions in most regions, point to an increasing demand for energy generation, resulting in additional pressure on the Earth's sustainability. Materials have had a key role in decreasing the use of natural resources, by either improving efficiency of existing technologies or enabling the development of radical new ones. The greenhouse effect (CO2 emissions) and the energy crisis are global challenges that can benefit from the development of new materials for the successful implementation of promising technologies and for the imperative replacement of fossil fuels by renewable sources.

Changing times, similar challenges.

PubMed

Baillie, Jonathan

2013-11-01

With IHEEM celebrating its 70th Anniversary this month, HEJ editor, Jonathan Baillie, recently met the Institute's oldest surviving Past-President, Lawrence Turner OBE, who, having in 1964 established a small engineering business producing some of the NHS's earliest nurse call systems from the basement of his three-storey West Midlands home, has since seen the company, Static Systems Group, grow to become one of the U.K. market-leaders in its field. The Institute's President from 1979-1981, he looked back, during a fascinating two-hour discussion, at his time in the role, talked through some of the key technological and other changes he has seen in the past five decades, reflected on an interesting and varied career, and considered some of the very different current-day challenges that today's IHEEM President, and the Institute as a whole, face.

Solar Sail Roadmap Mission GN and C Challenges

NASA Technical Reports Server (NTRS)

Heaton, Andrew F.

2005-01-01

The NASA In-Space Propulsion program is funding development work for solar sails to enhance future scientific opportunities. Key to this effort are scientific solar sail roadmap missions identified by peer review. The two near-term missions of interest are L1 Diamond and Solar Polar Imager. Additionally, the New Millennium Program is sponsoring the Space Technology 9 (ST9) demonstration mission. Solar sails are one of five technologies competing for the ST9 flight demonstration. Two candidate solar sail missions have been identified for a potential ST9 flight. All the roadmap missions and candidate flight demonstration missions face various GN&C challenges. A variety of efforts are underway to address these challenges. These include control actuator design and testing, low thrust optimization studies, attitude control system design and modeling, control-structure interaction studies, trajectory control design, and solar radiation pressure model development. Here we survey the various efforts underway and identify a few of specific recent interest and focus.

THE CHALLENGING ROLE OF A READING COACH, A CAUTIONARY TALE

PubMed Central

AL OTAIBA, STEPHANIE; HOSP, JOHN L.; SMARTT, SUSAN; DOLE, JANICE A.

2011-01-01

The purpose of this case study is to describe the challenges one coach faced during the initial implementation of a coaching initiative involving 33 teachers in an urban, high-poverty elementary school. Reading coaches are increasingly expected to play a key role in the professional development efforts to improve reading instruction in order to improve reading achievement for struggling readers. Data sources included initial reading scores for kindergarten and first-graders, pretest and posttest scores of teachers’ knowledge, a teacher survey, focus group interviews, project documents, and field notes. Data were analyzed using a mixed methods approach. Findings revealed several challenges that have important implications for research and practice: that teachers encountered new information about teaching early reading that conflicted with their current knowledge, this new information conflicted with their core reading program, teachers had differing perceptions of the role of the reading coach that affected their feelings about the project, and reform efforts are time-intensive. PMID:23794791

Caring for Refugee Youth in the School Setting.

PubMed

Johnson, Jennifer Leigh; Beard, Joyce; Evans, Dena

2017-03-01

Annually, over 80,000 refugees enter the United States as a result of political or religious persecution. Of these, approximately 35% to 40% are children and adolescents. Refugees are faced with challenges associated with living conditions, cultural and social norms, and socioeconomic status due to problems occurring in their homelands. These challenges include but are not limited to malnutrition, communicable disease, questionable immunization status, lack of formal education, sexual abuse, violence, torture, human trafficking, homelessness, poverty, and a lack of access to health care. Moreover, the psychological impact of relocation and the stress of acculturation may perpetuate many of these existing challenges, particularly for refugee youth, with limited or underdeveloped coping skills. School nurses are uniquely poised to support refugee youth in the transition process, improve overall health, and facilitate access to primary health services. The purpose of this article is to provide an overview of the unique refugee experience, examine the key health care needs of the population, and present school nurses with timely and relevant resources to assist in caring for refugee youth.

Modelling Glacial Lake Outburst Floods: Key Considerations and Challenges Posed By Climatic Change

NASA Astrophysics Data System (ADS)

Westoby, M.

2014-12-01

The number and size of moraine-dammed supraglacial and proglacial lakes is increasing as a result of contemporary climatic change. Moraine-dammed lakes are capable of impounding volumes of water in excess of 107 m3, and often represent a very real threat to downstream communities and infrastructure, should the bounding moraine fail and produce a catastrophic Glacial Lake Outburst Flood (GLOF). Modelling the individual components of a GLOF, including a triggering event, the complex dam-breaching process and downstream propagation of the flood is incredibly challenging, not least because direct observation and instrumentation of such high-magnitude flows is virtually impossible. We briefly review the current state-of-the-art in numerical GLOF modelling, with a focus on the theoretical and computational challenges associated with reconstructing or predicting GLOF dynamics in the face of rates of cryospheric change that have no historical precedent, as well as various implications for researchers and professionals tasked with the production of hazard maps and disaster mitigation strategies.

Probiotics and prebiotics--perspectives and challenges.

PubMed

Figueroa-González, Ivonne; Quijano, Guillermo; Ramírez, Gerardo; Cruz-Guerrero, Alma

2011-06-01

Owing to their health benefits, probiotics and prebiotics are nowadays widely used in yogurts and fermented milks, which are leader products of functional foods worldwide. The world market for functional foods has grown rapidly in the last three decades, with an estimated size in 2003 of ca US$ 33 billion, while the European market estimation exceeded US$ 2 billion in the same year. However, the production of probiotics and prebiotics at industrial scale faces several challenges, including the search for economical and abundant raw materials for prebiotic production, the low-cost production of probiotics and the improvement of probiotic viability after storage or during the manufacturing process of the functional food. In this review, functional foods based on probiotics and prebiotics are introduced as a key biotechnological field with tremendous potential for innovation. A concise state of the art addressing the fundamentals and challenges for the development of new probiotic- and prebiotic-based foods is presented, the niches for future research being clearly identified and discussed. Copyright © 2011 Society of Chemical Industry.

Challenges faced by public health nursing leaders in hyperturbulent times.

PubMed

Reyes, David J; Bekemeier, Betty; Issel, L Michele

2014-01-01

This study discusses the challenges and characteristics of effective public health nursing leaders in local health departments and barriers to effective leadership during the hyperturbulent conditions of 2008-2010. Participants were drawn from a purposive sample of seven directors of nursing (DON) in six county LHDs in two states for this qualitative study using inductive methods. Semistructured telephone interviews were conducted, using open-ended questions. Data analysis consisted of coding, pattern identification, and theme development, assisted by the use of ATLAS.ti™. Credibility was achieved through intercoder agreement and resonance of the findings with participants. Two underlying challenges emerged: leadership dissonance and leading through ambiguity. Three key effective leadership attributes identified were as follows: collaborative change management, life-long learning, and being visionary. DONs identified extrinsic and intrinsic barriers to leadership effectiveness and leading change in public health systems and PHN practice. Results suggest ways to support PHN leaders in order to overcome barriers to effective leadership such as defined leadership competencies, continuing education, and mentorship opportunities. © 2013 Wiley Periodicals, Inc.

The Life Story Experience of "Migrant Dentists" in Australia: Potential Implications for Health Workforce Governance and International Cooperation.

PubMed

Balasubramanian, Madhan; Spencer, A John; Short, Stephanie D; Watkins, Keith; Chrisopoulos, Sergio; Brennan, David S

2016-10-10

The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration. A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale. A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years. Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

E-counseling as an emerging preventive strategy for hypertension.

PubMed

Nolan, Robert P; Liu, Sam; Payne, Ada Y M

2014-07-01

Lifestyle counseling that includes exercise training, diet modification, and medication adherence is critical to hypertension management. This article summarizes the efficacy of lifestyle counseling interventions in face-to-face, telehealth, and e-counseling settings. It also discusses the therapeutic potential of e-counseling as a preventive strategy for hypertension. The recent proliferation of telehealth and e-counseling programs increases the reach of preventive counseling for patients with cardiovascular disorders. Blood pressure reduction following these interventions is comparable to face-to-face interventions. However, the effectiveness of e-counseling varies depending on the design features of the core protocol. An evidence-based guideline needs to be established that identifies e-counseling components which are independently associated with blood pressure reduction. As the Internet becomes more sophisticated, e-counseling is demonstrating a therapeutic advantage in comparison with other telehealth interventions. Current evidence supports further development of preventive e-counseling programs for hypertension. A pressing challenge for investigators is to specify key evidence-based components of e-counseling that are essential to the core protocol. In order to achieve this goal, it will be necessary to ensure that e-counseling programs are also clinically organized, in order to guide patients through the process of initiating and sustaining therapeutic behavior change.

Virtual Academic Community: Online Education Instructors' Social Presence in Association with Freshman Composition Students' Critical Thinking and Argumentation

ERIC Educational Resources Information Center

Paquette, Paige Fuller

2009-01-01

There is much literature addressing challenges face-to-face freshman composition instructors encounter in developing college courses that foster critical thinking skills crucial to developing written argument. Composition instructors may face challenges in teaching students that writing is a means of making meaning, there are many different…

The Challenges of Adopting the Learning Organisation Philosophy in a Singapore School

ERIC Educational Resources Information Center

Retna, Kala S.; Tee, Ng Pak

2006-01-01

Purpose: To report on a case study that examines how the Learning Organisation (LO) concept can be applied in a Singapore school and the challenges that the school faces in the process. Design/methodology/approach: A qualitative research inquiry was adopted using ethnographic methods. Data includes in-depth face-to-face interviews, observation of…

Challenges Faced by Undergraduate Military Students at American Public University System

ERIC Educational Resources Information Center

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

2014-01-01

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

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

ERIC Educational Resources Information Center

Hakami, Samah Mohammed

2012-01-01

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

New options for national population surveys: The implications of internet and smartphone coverage.

PubMed

Couper, Mick P; Gremel, Garret; Axinn, William; Guyer, Heidi; Wagner, James; West, Brady T

2018-07-01

Challenges to survey data collection have increased the costs of social research via face-to-face surveys so much that it may become extremely difficult for social scientists to continue using these methods. A key drawback to less expensive Internet-based alternatives is the threat of biased results from coverage errors in survey data. The rise of Internet-enabled smartphones presents an opportunity to re-examine the issue of Internet coverage for surveys and its implications for coverage bias. Two questions (on Internet access and smartphone ownership) were added to the National Survey of Family Growth (NSFG), a U.S. national probability survey of women and men age 15-44, using a continuous sample design. We examine 16 quarters (4 years) of data, from September 2012 to August 2016. Overall, we estimate that 82.9% of the target NSFG population has Internet access, and 81.6% has a smartphone. Combined, this means that about 90.7% of U.S. residents age 15-44 have Internet access, via either traditional devices or a smartphone. We find some evidence of compensatory coverage when looking at key race/ethnicity and age subgroups. For instance, while Black teens (15-18) have the lowest estimated rate of Internet access (81.9%) and the lowest rate of smartphone usage (72.6%), an estimated 88.0% of this subgroup has some form of Internet access. We also examine the socio-demographic correlates of Internet and smartphone coverage, separately and combined, as indicators of technology access in this population. In addition, we look at the effect of differential coverage on key estimates produced by the NSFG, related to fertility, family formation, and sexual activity. While this does not address nonresponse or measurement biases that may differ for alternative modes, our paper has implications for possible coverage biases that may arise when switching to a Web-based mode of data collection, either for follow-up surveys or to replace the main face-to-face data collection. Copyright © 2018. Published by Elsevier Inc.

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

ERIC Educational Resources Information Center

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

2016-01-01

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

Leading Schools Facing Challenging Circumstances: Some Insights from Western Australia

ERIC Educational Resources Information Center

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

2016-01-01

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

The Value of Conceptual Models in Coping with Complexity and Interdisciplinarity in Environmental Sciences Education

ERIC Educational Resources Information Center

Fortuin, Karen P. J.; van Koppen, C. S. A.; Leemans, Rik

2011-01-01

Conceptual models are useful for facing the challenges of environmental sciences curriculum and course developers and students. These challenges are inherent to the interdisciplinary and problem-oriented character of environmental sciences curricula. In this article, we review the merits of conceptual models in facing these challenges. These…

CAEP Challenges for a Mid-South U.S. College Teacher Education Program

ERIC Educational Resources Information Center

Moffett, David W.

2016-01-01

What are the challenges faced by a mid-south liberal arts college teacher education program, in its attempt to successfully meet the new Council for the Accreditation of Educator Preparation (CAEP) accreditation requirements? The Investigator studied the Educator Program Provider (EPP) during academic year 2015-2016. The challenges faced by the…

Challenges of Attending E-Learning Studies in Nigeria

ERIC Educational Resources Information Center

Bugi, Stephan Z.

2012-01-01

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

Challenges and Instructional Approaches Impacting the Literacy Performance of English Language Learners

ERIC Educational Resources Information Center

Markham, Paul L.; Gordon, Karen E.

2007-01-01

For English Language Learners (ELLs), the process of becoming literate in English is daunting. Not only are these students faced with the same literacy challenges faced by native English-speaking students, but they are also challenged with extensive diversity issues relating to substantial differences in linguistic, cultural, and academic…

Young persons with visual impairment: challenges of participation.

PubMed

Salminen, Anna-Liisa; Karhula, Maarit E

2014-07-01

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

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

PubMed

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

2010-05-01

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

Scaling up the global nursing health workforce: contributions of an international organization.

PubMed

Rukholm, Ellen E; Stamler, Lynnette Leeseberg; Talbot, Lise R; Bednash, Geraldine; Raines, Fay; Potempa, Kathleen; Nugent, Pauline; Clark, Dame Jill Macleod; Bernhauser, Sue; Parfitt, Barbara

2009-01-01

In this paper key highlights of the scholarly work presented at the Toronto 2008 Global Alliance for Nursing Education & Scholarship (GANES) conference are summarized, challenges opportunities and issues facing nursing education globally arising from the conference discourse are outlined and initial steps are suggested as a way forward to a shared global view of baccalaureate and graduate nursing education and scholarship. This shared view arises from beginning understandings of the issues and opportunities we face globally starting with and building upon the lessons learned from the literature and from the experiences of nursing educators and nursing education organization locally, regionally, nationally and internationally. The theme of the groundbreaking GANES Toronto conference was "Educating the future nursing and health workforce: A global challenge". One hundred seventy delegates from 17 countries attended the event, with over 80 papers presented. A primary focus of GANES is the contribution of a strategic alliance of national nursing education organizations to contribute to nursing education leading practices and policy that address the scaling up of global nursing and health workforce. The founding members of GANES see a clear link between a strong educational infrastructure and strong scholarship activities in nursing and the ability of a society to be healthy and prosperous. Evidence presented at the recent GANES conference supports that belief. Through the strength of partnerships and other capacity-building efforts, member countries can support each other to address the global nursing education and health challenges while respecting the local issues.

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

PubMed

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

2017-06-01

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

Migraine Care Challenges and Strategies in US Uninsured and Underinsured Adults: A Narrative Review, Part 1.

PubMed

Charleston, Larry; Royce, Jeffrey; Monteith, Teshamae S; Broner, Susan W; O'Brien, Hope L; Manrriquez, Salvador L; Robbins, Matthew S

2018-04-01

To review the scope of the problem facing individuals with migraine who are under- or uninsured. In this first of a 2-part narrative review, we will explore migraine epidemiology and the challenges that face this vulnerable population. Implementation of the Affordable Care Act has improved access to health care for many individuals who were previously uninsured, but there are many, particularly those of certain demographics, who are at high risk for worse outcomes. A narrative review was performed after a series of discussions within the Underserved Populations in Headache Medicine Special Interest Section meetings of the American Headache Society. Literature was reviewed for key concepts underpinning conceptual boundaries and a broad overview of the subject matter. Published guidelines, state-specific Medicaid websites, headache quality measurement set, literature review, and expert opinion were used to tailor suggested treatment options and therapeutic strategies. Migraine is common, yet remains underdiagnosed and associated with worse outcomes among those of under-represented backgrounds and those who are underinsured or uninsured. Low socioeconomics may play an important role in the disease progression, characteristics, outcome, and quality of life of patients with migraine and other headache disorders. Other barriers to optimal care include time constraints, lack of access to specialty providers, transportation, and financial limitations. There are many barriers and challenges that affect people with migraine who are underinsured or uninsured, particularly those of under-represented racial backgrounds and of lower socioeconomic status. © 2018 American Headache Society.

Linking at-risk South African girls to sexual violence and reproductive health services: A mixed-methods assessment of a soccer-based HIV prevention program and pilot SMS campaign.

PubMed

Merrill, Katherine G; Merrill, Jamison C; Hershow, Rebecca B; Barkley, Chris; Rakosa, Boitumelo; DeCelles, Jeff; Harrison, Abigail

2018-04-30

Grassroot Soccer developed SKILLZ Street-a soccer-based life skills program with a supplementary SMS platform-to support adolescent girls at risk for HIV, violence, and sexual and reproductive health challenges. We conducted a mixed-methods assessment of preliminary outcomes and implementation processes in three primary schools in Soweto, South Africa, from August to December 2013. Quantitative methods included participant attendance and SMS platform usage tracking, pre/post questionnaires, and structured observation. Qualitative data were collected from program participants, parents, teachers, and a social worker during 6 focus group discussions and 4 in-depth interviews. Of 394 participants enrolled, 97% (n = 382) graduated, and 217 unique users accessed the SMS platform. Questionnaires completed by 213 participants (mean age: 11.9, SD: 3.02 years) alongside qualitative findings showed modest improvements in participants' perceptions of power in relationships and gender equity, self-esteem, self-efficacy to avoid unwanted sex, communication with others about HIV and sex, and HIV-related knowledge and stigma. The coach-participant relationship, safe space, and integration of soccer were raised as key intervention components. Implementation challenges were faced around delivery of soccer-based activities. Findings highlight the relevance and importance of programs like SKILLZ Street in addressing challenges facing adolescent girls in South African townships. Recommendations for future programs are provided. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed

Bear, Daniel

2017-04-01

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

Plant synthetic biology: a new platform for industrial biotechnology.

PubMed

Fesenko, Elena; Edwards, Robert

2014-05-01

Thirty years after the production of the first generation of genetically modified plants we are now set to move into a new era of recombinant crop technology through the application of synthetic biology to engineer new and complex input and output traits. The use of synthetic biology technologies will represent more than incremental additions of transgenes, but rather the directed design of completely new metabolic pathways, physiological traits, and developmental control strategies. The need to enhance our ability to improve crops through new engineering capability is now increasingly pressing as we turn to plants not just for food, but as a source of renewable feedstocks for industry. These accelerating and diversifying demands for new output traits coincide with a need to reduce inputs and improve agricultural sustainability. Faced with such challenges, existing technologies will need to be supplemented with new and far-more-directed approaches to turn valuable resources more efficiently into usable agricultural products. While these objectives are challenging enough, the use of synthetic biology in crop improvement will face public acceptance issues as a legacy of genetically modified technologies in many countries. Here we review some of the potential benefits of adopting synthetic biology approaches in improving plant input and output traits for their use as industrial chemical feedstocks, as linked to the rapidly developing biorefining industry. Several promising technologies and biotechnological targets are identified along with some of the key regulatory and societal challenges in the safe and acceptable introduction of such technology.

Medical Systems Engineering to Support Mars Mission Crew Autonomy

NASA Technical Reports Server (NTRS)

Antonsen, Erik; Mindock, Jennifer

2017-01-01

Human spaceflight missions to Mars face exceptionally challenging resource limitations that far exceed those faced before. Increasing transit times, decreasing opportunity for resupply, communications challenges, and extended time to evacuate a crew to definitive medical care dictate a level of crew autonomy in medical care that is beyond the current medical model. To approach this challenge, a medical systems engineering approach is proposed that relies on a clearly articulated Concept of Operations and risk analysis tools that are in development at NASA. This paper proposes an operational clinical model with key terminology and concepts translated to a controls theory paradigm to frame a common language between clinical and engineering teams. This common language will be used for design and validation of an exploration medical system that is fully integrated into a Mars transit vehicle. This approach merges medical simulation, human factors evaluation techniques, and human-in-the-loop testing in ground based analogs to tie medical hardware and software subsystem performance and overall medical system functionality to metrics of operational medical autonomy. Merging increases in operational clinical autonomy with a more restricted vehicle system resource scenario in interplanetary spaceflight will require an unprecedented level of medical and engineering integration. Full integration of medical capabilities into a Mars vehicle system may require a new approach to integrating medical system design and operations into the vehicle Program structure. Prior to the standing-up of a Mars Mission Program, proof of concept is proposed through the Human Research Program.