Symbolic Policy and Alcohol Abuse Prevention in Youth

ERIC Educational Resources Information Center

Ogenchuk, Marcella

2009-01-01

In Canada, the prevalence of alcohol use among school-age students has emerged as a leading public health issue. Though governments at all levels have called for inter-organizational collaboration to address the issue, the representation of youth interests by key community groups is critical to the efficacy of those initiatives. This article…

A Practice-Based Critique of English as a Lingua Franca

ERIC Educational Resources Information Center

Park, Joseph Sung-Yul; Wee, Lionel

2011-01-01

This paper identifies several key issues that have emerged through the debate over English as a Lingua Franca (ELF), and suggests a practice-based perspective--which treats language not as a fixed system but as an emergent product of speakers' practices--as a guide for reconsidering some fundamental assumptions of the ELF research project. In…

Exploring the key predictors of retention in emergency nurses.

PubMed

Sawatzky, Jo-Ann V; Enns, Carol L

2012-07-01

To explore the factors that predict the retention of nurses working in emergency departments. The escalating shortage of nurses is one of the most critical issues facing specialty areas, such as the emergency department. Therefore, it is important to identify the key influencing and intermediary factors that affect emergency department nurses' intention to leave. As part of a larger study, a cross-sectional survey was completed by 261 registered nurses working in the 12 designated emergency departments within rural, urban community and tertiary hospitals in Manitoba, Canada. Twenty-six per cent of the respondents will probably/definitely leave their current emergency department jobs within the next year. Engagement was the key predictor of intention to leave (P < 0.001). Engagement was also associated with job satisfaction, compassion satisfaction, compassion fatigue, and burnout (P < 0.05). In an ordinal least-squares model (R(2) = 0.44), nursing management, professional practice, collaboration with physicians, staffing resources and shift work emerged as significant influencing factors for engagement. Engagement plays a central role in emergency department nurses intention to leave. Addressing the factors that influence engagement may reduce emergency department nurses' intention to leave. This study highlights the value of research-based evidence as the foundation for developing innovative strategies for the retention of emergency department nurses. © 2012 Blackwell Publishing Ltd.

Training and Developing an Age Diverse Workforce in SMEs: The Need for a Strategic Approach

ERIC Educational Resources Information Center

Beaver, Graham; Hutchings, Kate

2005-01-01

Purpose: The purpose of this paper is to examine the importance of strategic human resource development (HRD) in small and medium-sized enterprises (SMEs) with specific reference to key issues around training, development and education as well as an emerging issue of significance, age diversity management. Design/Methodology/Approach: The approach…

Improving access to emergent spinal care through knowledge translation: an ethnographic study.

PubMed

Webster, Fiona; Fehlings, Michael G; Rice, Kathleen; Malempati, Harsha; Fawaz, Khaled; Nicholls, Fred; Baldeo, Navindra; Reeves, Scott; Singh, Anoushka; Ahn, Henry; Ginsberg, Howard; Yee, Albert J

2014-04-14

For patients and family members, access to timely specialty medical care for emergent spinal conditions is a significant stressor to an already serious condition. Timing to surgical care for emergent spinal conditions such as spinal trauma is an important predictor of outcome. However, few studies have explored ethnographically the views of surgeons and other key stakeholders on issues related to patient access and care for emergent spine conditions. The primary study objective was to determine the challenges to the provision of timely care as well as to identify areas of opportunities to enhance care delivery. An ethnographic study of key administrative and clinical care providers involved in the triage and care of patients referred through CritiCall Ontario was undertaken utilizing standard methods of qualitative inquiry. This comprised 21 interviews with people involved in varying capacities with the provision of emergent spinal care, as well as qualitative observations on an orthopaedic/neurosurgical ward, in operating theatres, and at CritiCall Ontario's call centre. Several themes were identified and organized into categories that range from inter-professional collaboration through to issues of hospital-level resources and the role of relationships between hospitals and external organizations at the provincial level. Underlying many of these issues is the nature of the medically complex emergent spine patient and the scientific evidentiary base upon which best practice care is delivered. Through the implementation of knowledge translation strategies facilitated from this research, a reduction of patient transfers out of province was observed in the one-year period following program implementation. Our findings suggest that competing priorities at both the hospital and provincial level create challenges in the delivery of spinal care. Key stakeholders recognized spinal care as aligning with multiple priorities such as emergent/critical care, medical through surgical, acute through rehabilitative, disease-based (i.e. trauma, cancer), and wait times initiatives. However, despite newly implemented strategies, there continues to be increasing trends over time in the number of spinal CritiCall Ontario referrals. This reinforces the need for ongoing inter-professional efforts in care delivery that take into account the institutional contexts that may constrain individual or team efforts.

Service delivery innovation for hospital emergency management using rich organizational modelling.

PubMed

Dhakal, Yogit; Bhuiyan, Moshiur; Prasad, Pwc; Krishna, Aneesh

2018-04-01

The purpose of this article is to identify and assess service delivery issues within a hospital emergency department and propose an improved model to address them. Possible solutions and options to these issues are explored to determine the one that best fits the context. In this article, we have analysed the emergency department's organizational models through i* strategic dependency and rational modelling technique before proposing updated models that could potentially drive business process efficiencies. The results produced by the models, framework and improved patient journey in the emergency department were evaluated against the statistical data revealed from a reputed government organization related to health, to ensure that the key elements of the issues such as wait time, stay time/throughput, workload and human resource are resolved. The result of the evaluation was taken as a basis to determine the success of the project. Based on these results, the article recommends implementing the concept on actual scenario, where a positive result is achievable.

Education and Poverty in the Global Development Agenda: Emergence, Evolution and Consolidation

ERIC Educational Resources Information Center

Tarabini, Aina

2010-01-01

The objective of this paper is to analyse the role of education and poverty in the current global development agenda. It intends to analyse the emergence, evolution and consolidation of a global agenda, which attributes a key role to education in the fight against poverty. With this objective, the paper addresses four main issues: first, it…

E-DECIDER Disaster Response and Decision Support Cyberinfrastructure: Technology and Challenges

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Parker, J. W.; Pierce, M. E.; Wang, J.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2014-12-01

Timely delivery of critical information to decision makers during a disaster is essential to response and damage assessment. Key issues to an efficient emergency response after a natural disaster include rapidly processing and delivering this critical information to emergency responders and reducing human intervention as much as possible. Essential elements of information necessary to achieve situational awareness are often generated by a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. A key challenge is the current state of practice does not easily support information sharing and technology interoperability. NASA E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) has worked with the California Earthquake Clearinghouse and its partners to address these issues and challenges by adopting the XChangeCore Web Service Data Orchestration technology and participating in several earthquake response exercises. The E-DECIDER decision support system provides rapid delivery of advanced situational awareness data products to operations centers and emergency responders in the field. Remote sensing and hazard data, model-based map products, information from simulations, damage detection, and crowdsourcing is integrated into a single geospatial view and delivered through a service oriented architecture for improved decision-making and then directly to mobile devices of responders. By adopting a Service Oriented Architecture based on Open Geospatial Consortium standards, the system provides an extensible, comprehensive framework for geospatial data processing and distribution on Cloud platforms and other distributed environments. While the Clearinghouse and its partners are not first responders, they do support the emergency response community by providing information about the damaging effects earthquakes. It is critical for decision makers to maintain a situational awareness that is knowledgeable of potential and current conditions, possible impacts on populations and infrastructure, and other key information. E-DECIDER and the Clearinghouse have worked together to address many of these issues and challenges to deliver interoperable, authoritative decision support products.

Overview of Variable Renewable Energy Regulatory Issues: A Clean Energy Regulators Initiative Report

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

Miller, M.; Cox, S.

This CERI report aims to provide an introductory overview of key regulatory issues associated with the deployment of renewable energy -- particularly variable renewable energy (VRE) sources such wind and solar power. The report draws upon the research and experiences from various international contexts, and identifies key ideas that have emerged from the growing body of VRE deployment experience and regulatory knowledge. The report assumes basic familiarity with regulatory concepts, and although it is not written for a technical audience, directs the reader to further reading when available. VRE deployment generates various regulatory issues: substantive, procedural, and public interest issues,more » and the report aims to provide an empirical and technical grounding for all three types of questions as appropriate.« less

Teaching Public Administration: Key Themes 1996-2016

ERIC Educational Resources Information Center

Fenwick, John

2018-01-01

In this article, the aim is to explore some of the key themes to emerge in the journal during the past two decades. Each selected theme will be reviewed in the light of issues raised in particular papers. The aim of this approach is, first, to facilitate reflection upon the contribution of the journal as its subject matter has moved from a concern…

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

ERIC Educational Resources Information Center

Birren, James E.; And Others

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

Invited Review: Challenges of Residential and Community Care--"The Times They Are a-Changin"

ERIC Educational Resources Information Center

Jackson, R.

2011-01-01

This paper seeks to examine a number of issues which relate to the provision of appropriate and high-quality residential and community care for people with an intellectual disability. A number of key themes emerging from this Special Issue of the "Journal of Intellectual Disability Research" are identified and explored: (1) normalisation; (2)…

A Healthy New World: Emergent Opportunities for Clinical Psychologists in the Patient Protection and Affordable Care Act

PubMed Central

Beidas, Rinad S.; Manderscheid, Ronald W.

2014-01-01

The Patient Protection and Affordable Care Act (ACA) is radically transforming the health and mental health care landscape. Emergent opportunities exist for clinical psychologists to redefine their role in healthcare. We reflect on the Chor and colleagues article (this issue) elucidating key issues for psychologists, and present additional recommendations for consideration. Specifically, we highlight three points: (1) moving beyond just training and hoping; (2) recovery, not just symptom reduction; and (3) it’s a healthy new world. Under each of these points, we suggest tactics for how to achieve these goals. PMID:24954983

Stem cell research ethics: consensus statement on emerging issues.

PubMed

Caulfield, Timothy; Ogbogu, Ubaka; Nelson, Erin; Einsiedel, Edna; Knoppers, Bartha; McDonald, Michael; Brunger, Fern; Downey, Robin; Fernando, Kanchana; Galipeau, Jacques; Geransar, Rose; Griener, Glenn; Grenier, Glenn; Hyun, Insoo; Isasi, Rosario; Kardel, Melanie; Knowles, Lori; Kucic, Terrence; Lotjonen, Salla; Lyall, Drew; Magnus, David; Mathews, Debra J H; Nisbet, Matthew; Nisker, Jeffrey; Pare, Guillaume; Pattinson, Shaun; Pullman, Daryl; Rudnicki, Michael; Williams-Jones, Bryn; Zimmerman, Susan

2007-10-01

This article is a consensus statement by an international interdisciplinary group of academic experts and Canadian policy-makers on emerging ethical, legal and social issues in human embryonic stem cells (hESC) research in Canada. The process of researching consensus included consultations with key stakeholders in hESC research (regulations, stem cell researchers, and research ethics experts), preparation and distribution of background papers, and an international workshop held in Montreal in February 2007 to discuss the papers and debate recommendations. The recommendations provided in the consensus statement focus on issues of immediate relevance to Canadian policy-makers, including informed consent to hESC research, the use of fresh embryos in research, management of conflicts of interest, and the relevance of public opinion research to policy-making.

Educational Policies for Integrating College Competencies and Workforce Needs: Cases from Brazil, Mongolia, Ukraine, and the United States. Issue Brief

ERIC Educational Resources Information Center

Bastedo, Michael; Batkhuyag, Batjargal; Prates, Eufrasio; Prytula, Yaroslav

2009-01-01

In the past decade, the role of higher education in workforce development has emerged as a key issue around the world. Leading authorities inside and outside of government have begun questioning whether colleges and universities are preparing graduates with the competencies and skills necessary to compete in a dynamic global economy. As part of a…

From an Analytical Framework for Understanding the Innovation Process in Higher Education to an Emerging Research Field of Innovations in Higher Education

ERIC Educational Resources Information Center

Cai, Yuzhuo

2017-01-01

While studies dealing with issues related to innovations in higher education proliferate, there has been little consensus on key concepts and central issues for research. To respond to the challenges, this paper calls for developing a new research field--studies on innovations in higher education, by integrating two disciplines, namely innovation…

Beyond the Year of the Family: Defining the Agenda. St. Catharine's Conference (Windsor, England, February 1995). St. Catharine's Conference Report No. 47.

ERIC Educational Resources Information Center

Greenhalgh, Claire

This report summarizes papers presented and the resulting discussions at a conference focused on key issues emerging from the 1994 United Nations International Year of the Family and how these issues should be reflected in policies for families in Great Britain. The papers addressed the following topics: (1) specific achievements of the United…

Mental Health Counselor Preparation: Experts' Opinions.

ERIC Educational Resources Information Center

Ginter, Earl J.

1991-01-01

Explored mental health counselors' and counselor educators' perceptions of the training mental health counselors receive. Qualitative interviews were conducted with 12 mental health counselors or counselor educators. Key issues that emerged from interviews concerned licensure movement, what distinguishes mental health counseling, variability of…

Science in Emergency Response at CDC: Structure and Functions.

PubMed

Iskander, John; Rose, Dale A; Ghiya, Neelam D

2017-09-01

Recent high-profile activations of the US Centers for Disease Control and Prevention (CDC) Emergency Operations Center (EOC) include responses to the West African Ebola and Zika virus epidemics. Within the EOC, emergency responses are organized according to the Incident Management System, which provides a standardized structure and chain of command, regardless of whether the EOC activation occurs in response to an outbreak, natural disaster, or other type of public health emergency. By embedding key scientific roles, such as the associate director for science, and functions within a Scientific Response Section, the current CDC emergency response structure ensures that both urgent and important science issues receive needed attention. Key functions during emergency responses include internal coordination of scientific work, data management, information dissemination, and scientific publication. We describe a case example involving the ongoing Zika virus response that demonstrates how the scientific response structure can be used to rapidly produce high-quality science needed to answer urgent public health questions and guide policy. Within the context of emergency response, longer-term priorities at CDC include both streamlining administrative requirements and funding mechanisms for scientific research.

Adapting Modeling & SImulation for Network Enabled Operations

DTIC Science & Technology

2011-03-01

vari- ety of new business and organizational models. The relatively rapid rise of online book stores and more recently eBooks came to many as a...articulating critical research issues ; • working to strengthen command and control research infrastructure; • sponsoring a series of workshops and...designed to acquaint senior military personnel and civilians with these emerging issues . The CCRP Publication Series is a key element of this effort

Translating research into licensed vaccines and validated and licensed diagnostic tests.

PubMed

Hill, R E; Foley, P L; Clough, N E; Ludemann, L R; Murtle, D C

2013-01-01

The USDA Center for Veterinary Biologics (CVB) has the regulatory authority to issue licenses and permits that allow the marketing of pure, safe, potent, and effective veterinary biological products. Under the standard licensing or permitting process, a manufacturer develops, characterizes, and evaluates a product prior to licensure. The CVB evaluates the submitted information, inspects the manufacturing facilities and methods of production and testing, and confirms key product test results through independent testing. This complete and comprehensive evaluation may not be possible during the emergence of a new animal disease or in response to an introduction of a significant transboundary animal disease agent. Processes are in place in the US that allow for more rapid availability of veterinary products in an emerging or emergency animal health situation. But, it can be advantageous to attain preapproval of products prior to their anticipated need. In this article, issues associated with obtaining approval for use of a biological product under emerging or emergency conditions are discussed.

Misconceptions about Psychological Science: A Review

ERIC Educational Resources Information Center

Hughes, Sean; Lyddy, Fiona; Lambe, Sinead

2013-01-01

This article provides an overview of the available evidence on psychological misconceptions, including key findings, current directions and emerging issues for investigation. We begin by defining misconceptions and then examine their prevalence and persistence, discuss their implications for student learning and highlight potential strategies to…

Enhancing security and improving interoperability in healthcare information systems.

PubMed

Gritzalis, D A

1998-01-01

Security is a key issue in healthcare information systems, since most aspects of security become of considerable or even critical importance when handling healthcare information. In addition, the intense need for information exchange has revealed interoperability of systems and applications as another key issue. Standardization can play an important role towards both these issues. In this paper, relevant standardization activities are briefly presented, and existing and emerging healthcare information security standards are identified and critically analysed. The analysis is based on a framework which has been developed for this reason. Therefore, the identification of gaps and inconsistencies in current standardization, the description of the conflicts of standards with legislation, and the analysis of implications of these standards to user organizations, are the main results of this paper.

Emerging issues in biodiversity & conservation management: The need for a palaeoecological perspective

NASA Astrophysics Data System (ADS)

Froyd, C. A.; Willis, K. J.

2008-09-01

The study of Quaternary environmental change is directly applicable to on-going issues of global conservation. Palaeoecological research techniques provide the tools to address some of the key questions presently being asked by conservation ecologists and land management organizations. But is this type of analysis currently being utilized to its full potential? Are the results of palaeoenvironmental analyses routinely applied to practical issues of natural resource management, and if not what can be done to expand the application of this research within the conservation community? This paper reviews recent developments in the application of the analysis of late Quaternary environmental change to key environmental issues of biodiversity and conservation management and examines areas which could be strengthened in the future including: (i) determination of baselines and natural ecosystem variability; (ii) understanding ecological thresholds and resilience; (iii) climate change conservation strategies; (iv) biological invasions; and (v) conservation and culture.

Personal Health, Person-centred Health and Personalised Medicine - Concepts, Consumers, Confusion and Challenges in the Informatics World.

PubMed

Rigby, M

2012-01-01

To define and assess 'Consumer Health Informatics' and related emergent issues in an era of new media and of personalisation of care, and from this to define what actions need to be taken to optimise benefits and address risks. Definition of key concepts; review of health personalisation, emergent health information and communication technologies and knowledge sources available to citizens and social media; and identification of unresolved issues threatening optimal use of each. A structured review supported by citations and examples. Several new aspects of consumer health informatics are emerging, including new knowledge sources, feedback on treatments and care providers, on-line videos, and a new generation of patient experience sites including those which are for profit and seek to influence treatment paradigms. Not just the information usage, but also the potential social challenges and malicious abuses, are global issues, and also transcend the traditional health community and thus should be addressed in partnership with other global agencies.

[Science in a crisis. Medical countermeasures in Ebola virus disease, 2016: lessons learned and perspectives].

PubMed

Malvy, D

2016-10-01

In 2013, the world began to witness an unprecedented Ebola epidemic in West Africa that was smoldering by early 2016. Under this urgent circumstance, the global scientific community organized and made progress in identifying potential preventive countermeasures and therapeutics and accelerated the development of those promising interventions. Trials of experimental interventions soon emerged as a key component of the global response. Hence, an interdisciplinary issue ensued concerning how best to assess clinical safety and effectiveness of potential interventions prior to or concurrent with their broad use in humans. Key issues rely on the close collaboration between research and clinical teams involved in care in the field. Indeed, it is of prime importance to consider cultural dimensions when aiming to build trust within communities and flexibility to adapt trial procedures to field constraints. Trials implemented during the outbreak crisis illustrates challenging inputs for producing scientific and ethical gains for the benefits of vulnerable populations in the context of an international emerging or re-emerging infectious disease event. This includes rapid implementation of clinical research studies from the early phase of the next global outbreak on the basis of practical and ready-to-apply innovative methodological framework built during interepidemic periods.

Prevent and "British Values"

ERIC Educational Resources Information Center

Kenny, Alex; Ghale, Baljeet

2015-01-01

At the recent National Union of Teachers' conference the role of the Prevent strategy and the introduction of "British Values" in the Office for Standards in Education, Children's Services and Skills framework emerged as key issues for delegates. Two of the speeches made at the conference are presented here.

Attending to scalar ethical issues in emerging approaches to environmental health research and practice.

PubMed

Buse, Chris G; Smith, Maxwell; Silva, Diego S

2018-06-04

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter's conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance.

The role of socioscientific issues in biology teaching: from the perspective of teachers

NASA Astrophysics Data System (ADS)

Tidemand, Sofie; Nielsen, Jan Alexis

2017-01-01

Previous research has documented that students who engage with socioscientific issues can acquire some of the complex competences and skills typically related to scientific literacy. But an emerging field of research on science teachers' understanding and use of socioscientific issues, has documented that a range of challenges hinders the uptake of socioscientific issues. In this study, we investigated the interpretation and implementation of socioscientific issues among Danish biology teachers. We conducted five in-depth group interviews and validated the emergent themes from the teachers' talk-in-interaction by distributing a questionnaire. Our findings suggest that the participating teachers generally harbour a content-centred interpretation of socioscientific issues which manifests itself in at least three separate ways. First, the teachers generally use socioscientific issues as a vehicle to teach factual biological content. Second, the teachers emphasised mastery of factual content in their assessment. Third, the teachers tended to reduce socioscientific issues to specific biological contents in a way may preclude students from engaging with the real socioscientific issue. Our findings are particularly significant for science educators, policy-makers and curriculum designers, as we argue that key aspects of this content-centred interpretation may be a coping strategy used to navigate a divided curriculum.

Patient mobility in the global marketplace: a multidisciplinary perspective

PubMed Central

Lunt, Neil; Mannion, Russell

2014-01-01

There is a growing global market in healthcare and patients. And while there is a small body of evidence emerging around this phenomenon commonly known as medical tourism there remain significant unanswered policy and research questions which need to be addressed. We outline some of the key issues set against the six key disciplinary preoccupations of the journal: epidemiology, health economics, health policy ethics, politics of health, health management, and health policy. PMID:24847479

The emerging understanding of magnetic reconnection through laboratory experiments, theory and modeling and in situ satellite measurements

NASA Astrophysics Data System (ADS)

Drake, James F.

2015-08-01

Magnetic reconnection is the driver of explosive energy release in laboratory, space and astrophysical plasma systems. It plays a centralrole in such diverse phenomena as solar and stellar flares, flares in pulsar nebulae, gamma ray bursts and possibly even in the productionof energetic particles in supernova shocks. The close interaction of scientists doing laboratory experiments, in situ satellite measurements and theory and modeling has led to remarkable progress on key issues such as the mechanisms for fast energy release and heating and particle acceleration. There are, however, many open issues. The talk will address the emerging understanding of reconnection as well as areas where significant uncertainty remains. The role of new laboratory experiments such as FLARE at PPPL and the recently launched four-spacecraft MMS mission in resolving open issues will be discussed.

Introduction to special issue: moving forward in pediatric neuropsychology.

PubMed

Daly, Brian P; Giovannetti, Tania; Zabel, T Andrew; Chute, Douglas L

2011-08-01

This special issue of The Clinical Neuropsychologist focuses on advances in the emerging subspecialty of pediatric neuropsychology. The national and international contributions in this issue cover a range of key clinical, research, training, and professional issues specific to pediatric neuropsychology. The genesis for this project developed out of a series of talks at the Philadelphia Pediatric Neuropsychology Symposium in 2010, hosted by the Stein Family Fellow, the Department of Psychology of the College of Arts and Sciences at Drexel University, and the Philadelphia Neuropsychology Society. Articles that explore clinical practice issue focus on the assessment of special medical populations with congenital and/or acquired central nervous system insults. Research articles investigate the core features of developmental conditions, the use of technology in neuropsychological research studies, and large sample size genomic, neuropsychological, and imaging studies of under-represented populations. The final series of articles examine new considerations in training, advocacy, and subspecialty board certification that have emerged in pediatric neuropsychology. This introductory article provides an overview of the articles in this special issue and concluding thoughts about the future of pediatric neuropsychology.

The GROG: A Journal of Navy Medical History and Culture. Issue 38, 2013

DTIC Science & Technology

2013-01-01

Health Care Clinic, Okinawa, Japan). Among this unique group, Fran- cis Pierce holds the distinction of being the only Corpsman to be im...have an emergency payment authorization. Tie pets in the yard, leave house keys on the dining room table, and stand by in front of your house, ready...lockers. The bagroom would care for their seabags. Patients remained on stretchers on Ward M until the Emergency Room notified them of available

The work programme of NERIS in post-accident recovery.

PubMed

Schneider, T; Andronopoulos, S; Camps, J; Duranova, T; Gallego, E; Gering, F; Isnard, O; Maître, M; Murith, C; Oughton, D; Raskob, W

2018-01-01

NERIS is the European platform on preparedness for nuclear and radiological emergency response and recovery. Created in 2010 with 57 organisations from 28 different countries, the objectives of the platform are to: improve the effectiveness and coherency of current approaches to preparedness; identify further development needs; improve 'know how' and technical expertise; and establish a forum for dialogue and methodological development. The NERIS Strategic Research Agenda is now structured with three main challenges: (i) radiological impact assessments during all phases of nuclear and radiological events; (ii) countermeasures and countermeasure strategies in emergency and recovery, decision support, and disaster informatics; and (iii) setting up a multi-faceted framework for preparedness for emergency response and recovery. The Fukushima accident has highlighted some key issues for further consideration in NERIS research activities, including: the importance of transparency of decision-making processes at local, regional, and national levels; the key role of access to environmental monitoring; the importance of dealing with uncertainties in assessment and management of the different phases of the accident; the use of modern social media in the exchange of information; the role of stakeholder involvement processes in both emergency and recovery situations; considerations of societal, ethical, and economic aspects; and the reinforcement of education and training for various actors. This paper emphasises the main issues at stake for NERIS for post-accident management.

Do no harm: toward contextually appropriate psychosocial support in international emergencies.

PubMed

Wessells, Michael G

2009-11-01

In the aftermath of international emergencies caused by natural disasters or armed conflicts, strong needs exist for psychosocial support on a large scale. Psychologists have developed and applied frameworks and tools that have helped to alleviate suffering and promote well-being in emergency settings. Unfortunately, psychological tools and approaches are sometimes used in ways that cause unintended harm. In a spirit of prevention and wanting to support critical self-reflection, the author outlines key issues and widespread violations of the do no harm imperative in emergency contexts. Prominent issues include contextual insensitivity to issues such as security, humanitarian coordination, and the inappropriate use of various methods; the use of an individualistic orientation that does not fit the context and culture; an excessive focus on deficits and victimhood that can undermine empowerment and resilience; the use of unsustainable, short-term approaches that breed dependency, create poorly trained psychosocial workers, and lack appropriate emphasis on prevention; and the imposition of outsider approaches. These and related problems can be avoided by the use of critical self-reflection, greater specificity in ethical guidance, a stronger evidence base for intervention, and improved methods of preparing international humanitarian psychologists. Copyright 2009 by the American Psychological Association

Towards systemic sustainable performance of TBI care systems: emergency leadership frontiers.

PubMed

Caro, Denis H J

2010-11-10

Traumatic brain injuries (TBIs) continue as a twenty-first century subterranean and almost invisible scourge internationally. TBI care systems provide a safety net for survival, recovery, and reintegration into social communities from this scourge, particularly in Canada, the European Union, and the USA. This paper examines the underlying issues of systemic performance and sustainability of TBI care systems, in the light of decreasing care resources and increasing demands for services. This paper reviews the extant literature on TBI care systems, systems reengineering, and emergency leadership literature. This paper presents a seven care layer paradigm, which forms the essence of systemic performance in the care of patients with TBIs. It also identifies five key strategic drivers that hold promise for the future systemic sustainability of TBI care systems. Transformational leadership and engagement from the international emergency medical community is the key to generating positive change. The sustainability/performance care framework is relevant and pertinent for consideration internationally and in the context of other emergency medical populations.

Towards systemic sustainable performance of TBI care systems: emergency leadership frontiers

PubMed Central

2010-01-01

Background Traumatic brain injuries (TBIs) continue as a twenty-first century subterranean and almost invisible scourge internationally. TBI care systems provide a safety net for survival, recovery, and reintegration into social communities from this scourge, particularly in Canada, the European Union, and the USA. Aims This paper examines the underlying issues of systemic performance and sustainability of TBI care systems, in the light of decreasing care resources and increasing demands for services. Methods This paper reviews the extant literature on TBI care systems, systems reengineering, and emergency leadership literature. Results This paper presents a seven care layer paradigm, which forms the essence of systemic performance in the care of patients with TBIs. It also identifies five key strategic drivers that hold promise for the future systemic sustainability of TBI care systems. Conclusions Transformational leadership and engagement from the international emergency medical community is the key to generating positive change. The sustainability/performance care framework is relevant and pertinent for consideration internationally and in the context of other emergency medical populations. PMID:21373305

Sociocultural Perspectives on Transition to School from Pacific Islands Early Childhood Centres.

ERIC Educational Resources Information Center

Podmore, Valerie N.; Sauvao, Le'Autuli'ilagi M.; Mapa, Lia

2003-01-01

Summarizes research investigating children's transition to primary school from Pacific early childhood centers in New Zealand. Key issues emerging from the review include continuity of Pacific Islands languages and culture between home, early childhood center, and school; home-school partnership; teachers' and parents' expectations regarding…

75 FR 34452 - Center for Drug Evaluation and Research Data Standards Plan; Availability for Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... identifies key objectives for a data standards program at CDER, processes to be developed to ensure... public health mission. At present, the lack of standardized data affects CDER's review processes by...-emerging issues. Standardization of data submissions, a requirement for electronic submissions, and a...

Developing Intercultural Competence in Multilingual and Multicultural Student Groups

ERIC Educational Resources Information Center

Krajewski, Sabine

2011-01-01

Internationalization and intercultural competence are key issues in higher education institutions across the globe. In times of accelerating globalization, intercultural competence emerges as one of the most desirable graduate capabilities for those who are likely to work in international environments. This article focuses on the development of…

Imagineering: Key to Educational Futures.

ERIC Educational Resources Information Center

Glines, Don

The emerging global and societal conditions demand more than the rhetoric of restructuring, reform, change, and innovation. Educators must adopt the spirit of astronauts to confront the issues directly, create a desirable future for learning, and overcome the inertia of the existing school system. The proposal for the Minnesota Experimental City…

Best Practices, Best Thinking, and Emerging Issues in School Leadership.

ERIC Educational Resources Information Center

Owings, William A., Ed.; Kaplan, Leslie S., Ed.

This collection of writings presents leading research and key considerations to assist educational leaders in making decisions about new programs and new directions for their schools. Twenty-six chapters make up the book: (1) "Changing Demographics: A Call for Leadership" (Bud Hodgkinson); (2) "Media and Political Misrepresentation of Public…

Natural gas 1998: Issues and trends

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

NONE

Natural Gas 1998: Issues and Trends provides a summary of the latest data and information relating to the US natural gas industry, including prices, production, transmission, consumption, and the financial and environmental aspects of the industry. The report consists of seven chapters and five appendices. Chapter 1 presents a summary of various data trends and key issues in today`s natural gas industry and examines some of the emerging trends. Chapters 2 through 7 focus on specific areas or segments of the industry, highlighting some of the issues associated with the impact of natural gas operations on the environment. 57 figs.,more » 18 tabs.« less

Society for Academic Emergency Medicine Statement on Plagiarism.

PubMed

Asher, Shellie L; Iserson, Kenneth V; Merck, Lisa H

2017-10-01

The integrity of the research enterprise is of the utmost importance for the advancement of safe and effective medical practice for patients and for maintaining the public trust in health care. Academic societies and editors of journals are key participants in guarding scientific integrity. Avoiding and preventing plagiarism helps to preserve the scientific integrity of professional presentations and publications. The Society for Academic Emergency Medicine (SAEM) Ethics Committee discusses current issues in scientific publishing integrity and provides a guideline to avoid plagiarism in SAEM presentations and publications. © 2017 by the Society for Academic Emergency Medicine.

Emerging technology: A key enabler for modernizing pharmaceutical manufacturing and advancing product quality.

PubMed

O'Connor, Thomas F; Yu, Lawrence X; Lee, Sau L

2016-07-25

Issues in product quality have produced recalls and caused drug shortages in United States (U.S.) in the past few years. These quality issues were often due to outdated manufacturing technologies and equipment as well as lack of an effective quality management system. To ensure consistent supply of safe, effective and high-quality drug products available to the patients, the U.S. Food and Drug Administration (FDA) supports modernizing pharmaceutical manufacturing for improvements in product quality. Specifically, five new initiatives are proposed here to achieve this goal. They include: (i) advancing regulatory science for pharmaceutical manufacturing; (ii) establishing a public-private institute for pharmaceutical manufacturing innovation; (iii) creating incentives for investment in the technological upgrade of manufacturing processes and facilities; (iv) leveraging external expertise for regulatory quality assessment of emerging technologies; and (v) promoting the international harmonization of approaches for expediting the global adoption of emerging technologies. Published by Elsevier B.V.

Cloud-assisted mobile-access of health data with privacy and auditability.

PubMed

Tong, Yue; Sun, Jinyuan; Chow, Sherman S M; Li, Pan

2014-03-01

Motivated by the privacy issues, curbing the adoption of electronic healthcare systems and the wild success of cloud service models, we propose to build privacy into mobile healthcare systems with the help of the private cloud. Our system offers salient features including efficient key management, privacy-preserving data storage, and retrieval, especially for retrieval at emergencies, and auditability for misusing health data. Specifically, we propose to integrate key management from pseudorandom number generator for unlinkability, a secure indexing method for privacy-preserving keyword search which hides both search and access patterns based on redundancy, and integrate the concept of attribute-based encryption with threshold signing for providing role-based access control with auditability to prevent potential misbehavior, in both normal and emergency cases.

Work–Family Conflict and Health Among Working Parents: Potential Linkages for Family Studies and Social Neuroscience

PubMed Central

Grzywacz, Joseph G.; Smith, Amy M.

2016-01-01

In this paired article the authors review research on paid work, parenting, and health in order to isolate fundamental questions and issues that remain unaddressed. Next, consistent with the theme of this special issue, the authors introduce social neuroscience and highlight how this emerging multidisciplinary science offers substantial promise for advancing key unresolved issues in the paid work, parenting, and health literature. The article concludes with suggestions for promising areas of research wherein family scientists and social neuroscientists could build collaborative research to address gaps in the work–family literature. PMID:27840467

Rethinking Professional Standards to Promote Professional Learning

ERIC Educational Resources Information Center

Forde, Christine; McMahon, Margery Anne; Hamilton, Gillian; Murray, Rosa

2016-01-01

This article explores some of the key issues that emerged in the revision of the professional standards in Scottish education. The revision of the professional standards was part of a wider project to build teacher professional learning in ways that had an impact on practice and on pupil learning. The article begins by examining the international…

Adopting National Vocational Qualifications in the Offshore Industry: A Case Study.

ERIC Educational Resources Information Center

Fuller, Alison; John, Debbie

1994-01-01

From a case study of the introduction of National Vocational Qualifications (NVQs) in the British petroleum industry emerged three key issues: (1) their credibility depends on how closely they reflect employment standards; (2) context is important; and (3) although NVQs should provide wider access to opportunities, the offshore industry's…

Co-Sleeping during Infancy and Early Childhood: Key Findings and Future Directions

ERIC Educational Resources Information Center

Goldberg, Wendy A.; Keller, Meret A.

2007-01-01

Emergent themes from this special issue on parent-child co-sleeping are featured in this concluding article. Each of the pieces in this collection addressed one or more of the following themes: methodologies for studying parent-infant co-sleeping, physical and social characteristics of the child's sleep environment, associations between sleep…

Journeys into Inner/Outer Space: Reflections on the Methodological Challenges of Negotiating Insider/Outsider Status in International Educational Research

ERIC Educational Resources Information Center

Savvides, Nicola; Al-Youssef, Joanna; Colin, Mindy; Garrido, Cecilia

2014-01-01

This article highlights key theoretical and methodological issues and implications of being an insider/outsider when undertaking qualitative research in international educational settings. It first addresses discourses of "self" and "other," noting that identity and belonging emerge from fluid engagement between researchers and…

Reflections on Practical Approaches to Involving Children and Young People in the Data Analysis Process

ERIC Educational Resources Information Center

Coad, Jane; Evans, Ruth

2008-01-01

This article reflects on key methodological issues emerging from children and young people's involvement in data analysis processes. We outline a pragmatic framework illustrating different approaches to engaging children, using two case studies of children's experiences of participating in data analysis. The article highlights methods of…

Smooth Transfer: A Once Mundane Administrative Issue Re-Emerges as a Key Tool for Equity

ERIC Educational Resources Information Center

Purcell, Francesca B.

2006-01-01

Undergraduate transfer is a messy and too-often frustrating part of college for faculty, staff and, above all, the students themselves. Students are discouraged by unclear and complicated curriculum requirements. Faculty are reluctant to accept courses from another institution and question the preparedness of transfer students. Advisors are…

Global Climate Change: What Has Science Education Got to Do with It?

ERIC Educational Resources Information Center

Sharma, Ajay

2012-01-01

Despite a near universal consensus among scientists regarding the perils of climate change for human civilizations, climate change has not emerged as a key issue among science educators. This position paper advocates for the centrality of climate change in science education. Using Polanyi's critique of market in capitalist societies, it positions…

Abuse of Disabled Children in Ghana

ERIC Educational Resources Information Center

Kassah, Alexander Kwesi; Kassah, Bente Lilljan Lind; Agbota, Tete Kobla

2012-01-01

Even though disabled children are targets of various forms of abuse, such issues remain mostly undocumented open secrets in many countries including Ghana. The article is based on a qualitative data provided by three key informants. Six stories emerged from the data and are discussed in terms of four main forms of abuse. Labelling theories are…

Microscale Synthesis of Chiral Alcohols via Asymmetric Catalytic Transfer Hydrogenation

ERIC Educational Resources Information Center

Peeters, Christine M.; Deliever, Rik; De Vos, Dirk

2009-01-01

Synthesis of pure enantiomers is a key issue in industry, especially in areas connected to life sciences. Catalytic asymmetric synthesis has emerged as a powerful and practical tool. Here we describe an experiment on racemic reduction and asymmetric reduction via a catalytic hydrogen transfer process. Acetophenone and substituted acetophenones are…

Teacher Education in Bhutan: Highlights and Challenges for Reform

ERIC Educational Resources Information Center

VanBalkom, W. Duffie; Sherman, Ann

2010-01-01

Bhutan is embarking on a comprehensive education reform process, with teachers and teacher education at the centre of a number of initiatives. This study describes the current state of affairs based on interviews with key informants and semi-structured focus groups in Bhutan. Several major themes emerged, including issues of quality of students…

Identifying Employer Needs from Accounting Information Systems Programs

ERIC Educational Resources Information Center

Dillon, Thomas W.; Kruck, S. E.

2008-01-01

As the need for new hires with accounting and information technology knowledge increases, a new major in accounting information systems (AIS) has emerged. This new AIS degree is a hybrid of accounting concepts and common business subjects combined with key information technology issues. Employers were presented with 56 core content areas found in…

The Role of Culture in English Language Education: Key Challenges

ERIC Educational Resources Information Center

Holliday, Adrian

2009-01-01

English language education is in the process of change regarding teacher identity and the ownership of English. Cultural issues are implicated in this change. Critical cosmopolitan approaches in the social sciences are critiquing the primacy of national cultures which they consider a Western imposition on the emergent identities of the Periphery.…

Mental health and psychosocial support in crisis and conflict: report of the Mental Health Working Group.

PubMed

Allden, K; Jones, L; Weissbecker, I; Wessells, M; Bolton, P; Betancourt, T S; Hijazi, Z; Galappatti, A; Yamout, R; Patel, P; Sumathipala, A

2009-01-01

The Working Group on Mental Health and Psychosocial Support was convened as part of the 2009 Harvard Humanitarian Action Summit. The Working Group chose to focus on ethical issues in mental health and psychosocial research and programming in humanitarian settings. The Working Group built on previous work and recommendations, such as the Inter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings. The objective of this working group was to address one of the factors contributing to the deficiency of research and the need to develop the evidence base on mental health and psychosocial support interventions during complex emergencies by proposing ethical research guidelines. Outcomes research is vital for effective program development in emergency settings, but to date, no comprehensive ethical guidelines exist for guiding such research efforts. Working Group members conducted literature reviews which included peer-reviewed publications, agency reports, and relevant guidelines on the following topics: general ethical principles in research, cross-cultural issues, research in resource-poor countries, and specific populations such as trauma and torture survivors, refugees, minorities, children and youth, and the mentally ill. Working Group members also shared key points regarding ethical issues encountered in their own research and fieldwork. The group adapted a broad definition of the term "research", which encompasses needs assessments and data gathering, as well as monitoring and evaluation. The guidelines are conceptualized as applying to formal and informal processes of assessment and evaluation in which researchers as well as most service providers engage. The group reached consensus that it would be unethical not to conduct research and evaluate outcomes of mental health and psychosocial interventions in emergency settings, given that there currently is very little good evidence base for such interventions. Overarching themes and issues generated by the group for further study and articulation included: purpose and benefits of research, issues of validity, neutrality, risk, subject selection and participation, confidentiality, consent, and dissemination of results. The group outlined several key topics and recommendations that address ethical issues in conducting mental health and psychosocial research in humanitarian settings. The group views this set of recommendations as a living document to be further developed and refined based on input from colleagues representing different regions of the globe with an emphasis on input from colleagues from low-resource countries.

Emergency medical service attitudes toward geriatric prehospital care and continuing medical education in geriatrics.

PubMed

Peterson, Lars-Kristofer N; Fairbanks, Rollin J; Hettinger, Aaron Z; Shah, Manish N

2009-03-01

To understand the opinions of emergency medical service (EMS) providers regarding their ability to care for older adults, the domains of geriatric medicine in which they need more training, and the modality through which continuing education could be best delivered. Qualitative study using key informant interviews. Prehospital EMS system in Rochester, New York. EMS providers, EMS instructors and administrators, emergency physicians, and geriatricians. Semistructured interviews were conducted using an interview guide that addressed knowledge and skill deficiencies, recommendations for improvement of geriatrics continuing education, and delivery methods of education. Participant responses were generally congruous despite the diverse backgrounds, and redundancy was achieved rapidly. All participants perceived a deficit in EMS education on the care of older adults, particularly related to communications with patients and skilled nursing facility staff. All desired more geriatric continuing education for EMS providers, especially in communications and psychosocial issues. Education was desired in various modalities. Further geriatric continuing education for EMS providers is needed. Some specific topics relate to medical issues, but a large proportion involve communications and psychosocial issues. Education should be delivered in a variety of modalities to meet the needs of the EMS community. Emerging on-line video technologies may bridge the gap between learners preferring classroom-based modailities and those preferring self-study modules.

Training initiatives within the AFHSC-Global Emerging Infections Surveillance and Response System: support for IHR (2005)

PubMed Central

2011-01-01

Training is a key component of building capacity for public health surveillance and response, but has often been difficult to quantify. During fiscal 2009, the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) supported 18 partner organizations in conducting 123 training initiatives in 40 countries for 3,130 U.S. military, civilian and host-country personnel. The training assisted with supporting compliance with International Health Regulations, IHR (2005). Training activities in pandemic preparedness, outbreak investigation and response, emerging infectious disease (EID) surveillance and pathogen diagnostic techniques were expanded significantly. By engaging local health and other government officials and civilian institutions, the U.S. military’s role as a key stakeholder in global public health has been strengthened and has contributed to EID-related surveillance, research and capacity-building initiatives specified elsewhere in this issue. Public health and emerging infections surveillance training accomplished by AFHSC-GEIS and its Department of Defense (DoD) partners during fiscal 2009 will be tabulated and described. PMID:21388565

Satellite Power System (SPS)

NASA Technical Reports Server (NTRS)

Edler, H. G.

1978-01-01

Potential organizational options for a solar power satellite system (SPS) were investigated. Selection and evaluation criteria were determined to include timeliness, reliability, and adequacy to contribute meaningfully to the U.S. supply; political feasibility (both national and international); and cost effectiveness (including environmental and other external costs). Based on these criteria, four organizational alternatives appeared to offer reasonable promise as potential options for SPS. A large number of key issues emerged as being factors which would influence the final selection process. Among these issues were a variety having to do with international law, international institutions, environmental controls, economics, operational flexibility, congressional policies, commercial-vs-governmental ownership, national dedication, and national and operational stategic issues.

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…

Investigating the Effect of Users' Tagging Motivation on the Digital Educational Resources Metadata Descriptions

ERIC Educational Resources Information Center

Zervas, Panagiotis; Sampson, Demetrios G.; Aristeidou, Maria

2012-01-01

Over the past years, several Open Educational Resources (OERs) initiatives have been emerged worldwide aiming to create, share and reuse digital educational resources among educational communities. As a result, organizing, offering and accessing these resources over the web have been key issues for both the research and the educational community.…

Long-term trends in climate and hydrology in an agricultural headwater watershed of central Pennsylvania, USA

USDA-ARS?s Scientific Manuscript database

Climate change has emerged as a key issue facing agriculture and water resources in the US. Long-term (1968-2012) temperature, precipitation and streamflow data from a small (7.3 km2) watershed in east-central Pennsylvania was used to examine climatic and hydrologic trends in the context of recent c...

IN Like Flint: How the Innovation Incubator at UM-Flint Fosters Social Entrepreneurship in a City Remaking Itself

ERIC Educational Resources Information Center

Custer, Nic

2015-01-01

This paper focuses on how the University of Michigan-Flint's Innovation Incubator supports emerging for-profit businesses and nonprofit organizations through programming, business plan development, and ongoing mentorship. The Incubator is especially interested in supporting start-ups that address key social issues in the surrounding community,…

Expanding Understanding of HIV/AIDS and Employment: Perspectives of Focus Groups

ERIC Educational Resources Information Center

Conyers, Liza M.

2004-01-01

The employment-related issues and concerns of 46 individuals with HIV/AIDS diagnoses were explored using grounded theory methods. Participants, who ranged in age from 22 to 58 years, represented diverse ethnic backgrounds reflective of the emerging demographics of HIV and were at various stages of the employment process. The key categories that…

Perspectives on Student Development. New Directions for Community Colleges, Number 67.

ERIC Educational Resources Information Center

Deegan, William L., Ed.; O'Banion, Terry, Ed.

1989-01-01

This collection of articles examines the history of student development practices, reviews key issues that have emerged in the field, and proposes paths of action for the future. The volume includes: (1) "Student Development Philosophy: A Perspective on the Past and Future," by Terry O'Banion, which reviews the history of student development; (2)…

Transformations in Higher Education in Agricultural and Food Sciences in Central and Eastern Europe.

ERIC Educational Resources Information Center

Ruffio, P.; Barloy, J.

1995-01-01

From an analysis of educational reform and the teaching crisis in agricultural/food sciences in Central and Eastern Europe emerged three key issues: (1) redefinition of the role of agricultural/food science managers; (2) replacement of production orientation with a comprehensive approach to rural development; and (3) recognition of the educational…

Supporting interoperability of collaborative networks through engineering of a service-based Mediation Information System (MISE 2.0)

NASA Astrophysics Data System (ADS)

Benaben, Frederick; Mu, Wenxin; Boissel-Dallier, Nicolas; Barthe-Delanoe, Anne-Marie; Zribi, Sarah; Pingaud, Herve

2015-08-01

The Mediation Information System Engineering project is currently finishing its second iteration (MISE 2.0). The main objective of this scientific project is to provide any emerging collaborative situation with methods and tools to deploy a Mediation Information System (MIS). MISE 2.0 aims at defining and designing a service-based platform, dedicated to initiating and supporting the interoperability of collaborative situations among potential partners. This MISE 2.0 platform implements a model-driven engineering approach to the design of a service-oriented MIS dedicated to supporting the collaborative situation. This approach is structured in three layers, each providing their own key innovative points: (i) the gathering of individual and collaborative knowledge to provide appropriate collaborative business behaviour (key point: knowledge management, including semantics, exploitation and capitalisation), (ii) deployment of a mediation information system able to computerise the previously deduced collaborative processes (key point: the automatic generation of collaborative workflows, including connection with existing devices or services) (iii) the management of the agility of the obtained collaborative network of organisations (key point: supervision of collaborative situations and relevant exploitation of the gathered data). MISE covers business issues (through BPM), technical issues (through an SOA) and agility issues of collaborative situations (through EDA).

Emergency planning and management in health care: priority research topics.

PubMed

Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

2014-06-01

Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

Emotion theory and research: highlights, unanswered questions, and emerging issues.

PubMed

Izard, Carroll E

2009-01-01

Emotion feeling is a phase of neurobiological activity, the key component of emotions and emotion-cognition interactions. Emotion schemas, the most frequently occurring emotion experiences, are dynamic emotion-cognition interactions that may consist of momentary/situational responding or enduring traits of personality that emerge over developmental time. Emotions play a critical role in the evolution of consciousness and the operations of all mental processes. Types of emotion relate differentially to types or levels of consciousness. Unbridled imagination and the ability for sympathetic regulation of empathy may represent both potential gains and losses from the evolution and ontogeny of emotion processes and consciousness. Unresolved issues include psychology's neglect of levels of consciousness that are distinct from access or reflective consciousness and use of the term "unconscious mind" as a dumpster for all mental processes that are considered unreportable. The relation of memes and the mirror neuron system to empathy, sympathy, and cultural influences on the development of socioemotional skills are unresolved issues destined to attract future research.

Emotion Theory and Research: Highlights, Unanswered Questions, and Emerging Issues

PubMed Central

Izard, Carroll E.

2009-01-01

Emotion feeling is a phase of neurobiological activity, the key component of emotions and emotion-cognition interactions. Emotion schemas, the most frequently occurring emotion experiences, are dynamic emotion-cognition interactions that may consist of momentary/ situational responding or enduring traits of personality that emerge over developmental time. Emotions play a critical role in the evolution of consciousness and the operations of all mental processes. Types of emotion relate differentially to types or levels of consciousness. Unbridled imagination and the ability for sympathetic regulation of empathy may represent both potential gains and losses from the evolution and ontogeny of emotion processes and consciousness. Unresolved issues include psychology’s neglect of levels of consciousness that are distinct from access or reflective consciousness and use of the term “unconscious mind” as a dumpster for all mental processes that are considered unreportable. The relation of memes and the mirror neuron system to empathy, sympathy, and cultural influences on the development of socioemotional skills are unresolved issues destined to attract future research. PMID:18729725

Assessing regional public health preparedness: a new tool for considering cross-border issues.

PubMed

Jones, Maggie; O'Carroll, Patrick; Thompson, Jack; D'Ambrosio, Luann

2008-01-01

To provide regional, state, and local public health officials a conceptual framework and checklist for assessing regional public health emergency preparedness, specifically in regard to cross-border public health preparedness needs. The project had four phases that are as follows: defining the scope, conducting a literature review, soliciting expert opinion, and creating the assessment framework and checklist. A conceptual framework was developed to define the scope of the project on the basis of the kinds of resources likely to be shared across borders in a public health response (eg, data, supplies, staff), in support of the public health functions likely to be important in a health emergency (eg, epidemiology, laboratory). A literature review was then conducted to identify key articles and tools addressing regional preparedness. Key informant interviews (n = 23) were conducted with public health and emergency management professionals in the Pacific Northwest to identify a set of systems, agreements, and protocols that should be systematically considered in assessing regional public health preparedness. Using the literature review and themes from interviews, a checklist was developed. A checklist was developed for use by public health leaders, which recommends 24 specific agreements, protocols, systems, and management structures that should be considered to foster cross-border public health preparedness. Regional public health preparedness represents not only the sum of state-level preparedness of the states in a region but also the capacity of those states to collaborate across state and international borders during a public health emergency. This checklist provides a tool to systematically consider cross-border preparedness issues.

The Evolution of Integrated Assessment and Emerging Challenges in the Assessment of Human and Natural System Interactions

NASA Astrophysics Data System (ADS)

Clarke, L.

2017-12-01

Integrated assessment (IA) modeling and research has a long history, spanning over 30 years since its inception and addressing a wide range of contemporary issues along the way. Over the last decade, IA modeling and research has emerged as one of the primary analytical methods for understanding the complex interactions between human and natural systems, from the interactions between energy, water, and land/food systems to the interplay between health, climate, and air pollution. IA modeling and research is particularly well-suited for the analysis of these interactions because it is a discipline that strives to integrate representations of multiple systems into consistent computational platforms or frameworks. In doing so, it explicitly confronts the many tradeoffs that are frequently necessary to manage complexity and computational cost while still representing the most important interactions and overall, coupled system behavior. This talk explores the history of IA modeling and research as a means to better understand its role in the assessment of contemporary issues at the confluence of human and natural systems. It traces the evolution of IA modeling and research from initial exploration of long-term emissions pathways, to the role of technology in the global evolution of the energy system, to the key linkages between land and energy systems and, more recently, the linkages with water, air pollution, and other key systems and issues. It discusses the advances in modeling that have emerged over this evolution and the biggest challenges that still present themselves as we strive to better understand the most important interactions between human and natural systems and the implications of these interactions for human welfare and decision making.

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

PubMed

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

2009-08-01

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

Assessment of state- and territorial-level preparedness capacity for serving deaf and hard-of-hearing populations in disasters.

PubMed

Ivey, Susan L; Tseng, Winston; Dahrouge, Donna; Engelman, Alina; Neuhauser, Linda; Huang, Debbie; Gurung, Sidhanta

2014-01-01

Substantial evidence exists that emergency preparedness and response efforts are not effectively reaching populations with functional and access needs, especially barriers related to literacy, language, culture, or disabilities. More than 36 million Americans are Deaf or hard of hearing (Deaf/HH). These groups experienced higher risks of injury, death, and property loss in recent disasters than the general public. We conducted a participatory research study to examine national recommendations on preparedness communication for the Deaf/HH. We assessed whether previous recommendations regarding the Deaf/HH have been incorporated into state- and territorial-level emergency operations plans (EOPs), interviewed state- and territorial-level preparedness directors about capacity to serve the Deaf/HH, and proposed strategies to benefit Deaf/HH populations during emergencies. We analyzed 55 EOPs and 50 key informant (KI) interviews with state directors. Fifty-five percent of EOPs mentioned vulnerable populations; however, only 31% specifically mentioned Deaf/HH populations in their plan. Study findings indicated significant relationships among the following factors: a state-level KI's familiarity with communication issues for the Deaf/HH, making relay calls (i.e., calls to services to relay communication between Deaf and hearing people), and whether the KI's department provides trainings about serving Deaf/HH populations in emergencies. We found significant associations between a state's percentage of Deaf/HH individuals and a KI's familiarity with Deaf/HH communication issues and provision by government of any disability services to Deaf/HH populations in emergencies. Further, we found significant relationships between KIs attending training on serving the Deaf/HH and familiarity with Deaf/HH communication issues, including how to make relay calls. This study provides new knowledge that can help emergency agencies improve their preparedness training, planning, and capacity to serve Deaf/HH populations in emergencies.

Medical Malpractice and the Sports Medicine Clinician

PubMed Central

White, Richard A.

2008-01-01

More individuals are participating in athletics today than ever before. Physicians treating athletes confront unique diagnostic and treatment challenges and an increased risk of legal liability. The key areas regarding liability are preparticipation examinations, determination of eligibility, evaluation of significant on-field injuries, and information disclosure. The issues surrounding preparticipation physicals and determination of eligibility are closely linked. Physicians must be prepared to seek guidance from specialists, particularly when there are cardiac, spinal, or neurologic issues. Appropriate on-field evaluation of potential concussions, spinal injuries, and heat stroke are key areas of concern for the physician. Privacy issues have become more complex in the age of federal regulation. Physicians and all athletic staff should be aware of privacy laws and ensure proper consent documentation is obtained from all athletes or their parents. All athletic programs should develop a plan that details roles and procedures to be followed in a medical emergency. Sports caregivers must take affirmative steps that better protect their patients from harm and physicians from legal liability. PMID:18989733

Ethical Issues in Social Media Research for Public Health.

PubMed

Hunter, Ruth F; Gough, Aisling; O'Kane, Niamh; McKeown, Gary; Fitzpatrick, Aine; Walker, Tom; McKinley, Michelle; Lee, Mandy; Kee, Frank

2018-03-01

Social media (SM) offer huge potential for public health research, serving as a vehicle for surveillance, delivery of health interventions, recruitment to trials, collection of data, and dissemination. However, the networked nature of the data means they are riddled with ethical challenges, and no clear consensus has emerged as to the ethical handling of such data. This article outlines the key ethical concerns for public health researchers using SM and discusses how these concerns might best be addressed. Key issues discussed include privacy; anonymity and confidentiality; authenticity; the rapidly changing SM environment; informed consent; recruitment, voluntary participation, and sampling; minimizing harm; and data security and management. Despite the obvious need, producing a set of prescriptive guidelines for researchers using SM is difficult because the field is evolving quickly. What is clear, however, is that the ethical issues connected to SM-related public health research are also growing. Most importantly, public health researchers must work within the ethical principles set out by the Declaration of Helsinki that protect individual users first and foremost.

Developing and Establishing School-Based Sexual Health Services: Issues for School Nursing Practice

ERIC Educational Resources Information Center

Hayter, Mark; Owen, Jenny; Cooke, Jo

2012-01-01

School-based sexual health clinics are emerging as one of the key ways to promote sexual health among young people, and school nurses play an important role in developing and delivering these services. This study used a qualitative design to explore the experiences of health professionals and policy makers involved in setting up such services in…

Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

ERIC Educational Resources Information Center

Macdonald, Marilyn; Lang, Ariella; MacDonald, Jo-Anne

2011-01-01

The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be…

Research Trends in Mobile Learning in Higher Education: A Systematic Review of Articles (2011-2015)

ERIC Educational Resources Information Center

Krull, Greig; Duart, Josep M.

2017-01-01

The potential and use of mobile devices in higher education has been a key issue for educational research and practice since the widespread adoption of these devices. Due to the evolving nature and affordances of mobile technologies, it is an area that requires ongoing investigation. This study aims to identify emerging trends in mobile learning…

Neoliberal Discourses and the Local Policy Implementation of an English Literacy and Civics Education Program

ERIC Educational Resources Information Center

López, Dina

2015-01-01

The issue of language, specifically access to English, has emerged as a key concern for both U.S. policy-makers and immigrant communities alike. Many of these debates are framed by neoliberal and human capital perspectives, which view English as a set of skills and linguistic capital that are inextricably tied to employment opportunities and…

Accreditation of Online and Distance Learning Programs: Online GIS Education Program Experience

ERIC Educational Resources Information Center

Cabuk Anaper, Saye Nihan; Ulucay, D. Melike Taner; Cabuk, Alper

2013-01-01

The quality issue emerged as a topic of concern for the goods and product market has also become a key element in services like higher education. With the rise of the mobility of students, academicians and graduates, the quality and the compatibility of education systems have recently been subject to much debate. Moreover, the huge role of higher…

Best Practices for Mental Health in Child Welfare: Parent Support and Youth Empowerment Guidelines

ERIC Educational Resources Information Center

Romanelli, Lisa Hunter; Hoagwood, Kimberly E.; Kaplan, Sandra J.; Kemp, Susan P.; Hartman, Robert L.; Trupin, Casey; Soto, Wilfredo; Pecora, Peter J.; LaBarrie, Theresa L.; Jensen, Peter S.

2009-01-01

This paper, the second in a series of two guideline papers emerging from the 2007 Best Practices for Mental Health in Child Welfare Consensus Conference, provides an overview of the key issues related to parent support and youth empowerment in child welfare and presents consensus guidelines in these important areas. The paper also discusses some…

HESS Opinions "On forecast (in)consistency in a hydro-meteorological chain: curse or blessing?"

NASA Astrophysics Data System (ADS)

Pappenberger, F.; Cloke, H. L.; Persson, A.; Demeritt, D.

2011-07-01

Flood forecasting increasingly relies on numerical weather prediction forecasts to achieve longer lead times. One of the key difficulties that is emerging in constructing a decision framework for these flood forecasts is what to dowhen consecutive forecasts are so different that they lead to different conclusions regarding the issuing of warnings or triggering other action. In this opinion paper we explore some of the issues surrounding such forecast inconsistency (also known as "Jumpiness", "Turning points", "Continuity" or number of "Swings"). In thsi opinion paper we define forecast inconsistency; discuss the reasons why forecasts might be inconsistent; how we should analyse inconsistency; and what we should do about it; how we should communicate it and whether it is a totally undesirable property. The property of consistency is increasingly emerging as a hot topic in many forecasting environments.

Dilemmas and challenges for the shelter sector: lessons learned from the Sphere revision process.

PubMed

Saunders, Graham

2004-06-01

Key dilemmas and challenges for those involved in the shelter sector are described, based on issues that emerged from the extensive global consultative process undertaken to inform the revision of the Sphere handbook. The range of perspectives on the major themes is presented, with suggestions as to how these issues could be progressed. Themes include the poor definition of the sector and the lack of a consistent approach among the leading shelter actors; the absence of a common terminology; the conflict between "temporary" versus "durable" solutions; the disconnect between technical advisers and the field; the need for greater recognition of local coping strategies and the local context; the involvement of recipients and host governments in policy development; the need for better "how-to" guidance; and the limited incorporation of the emerging themes of livelihoods etc. to date.

Participatory monitoring and evaluation approaches that influence decision-making: lessons from a maternal and newborn study in Eastern Uganda.

PubMed

Kananura, Rornald Muhumuza; Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Bumba, Ahmed; Mulekwa, Godfrey; Nakiganda-Busiku, Dinah; Oo, Htet Nay Lin; Kiwanuka, Suzanne Namusoke; George, Asha; Peters, David H

2017-12-28

The use of participatory monitoring and evaluation (M&E) approaches is important for guiding local decision-making, promoting the implementation of effective interventions and addressing emerging issues in the course of implementation. In this article, we explore how participatory M&E approaches helped to identify key design and implementation issues and how they influenced stakeholders' decision-making in eastern Uganda. The data for this paper is drawn from a retrospective reflection of various M&E approaches used in a maternal and newborn health project that was implemented in three districts in eastern Uganda. The methods included qualitative and quantitative M&E techniques such as  key informant interviews, formal surveys and supportive supervision, as well as participatory approaches, notably participatory impact pathway analysis. At the design stage, the M&E approaches were useful for identifying key local problems and feasible local solutions and informing the activities that were subsequently implemented. During the implementation phase, the M&E approaches provided evidence that informed decision-making and helped identify emerging issues, such as weak implementation by some village health teams, health facility constraints such as poor use of standard guidelines, lack of placenta disposal pits, inadequate fuel for the ambulance at some facilities, and poor care for low birth weight infants. Sharing this information with key stakeholders prompted them to take appropriate actions. For example, the sub-county leadership constructed placenta disposal pits, the district health officer provided fuel for ambulances, and health workers received refresher training and mentorship on how to care for newborns. Diverse sources of information and perspectives can help researchers and decision-makers understand and adapt evidence to contexts for more effective interventions. Supporting districts to have crosscutting, routine information generating and sharing platforms that bring together stakeholders from different sectors is therefore crucial for the successful implementation of complex development interventions.

Advances Made in the Next Generation of Satellite Networks

NASA Technical Reports Server (NTRS)

Bhasin, Kul B.

1999-01-01

Because of the unique networking characteristics of communications satellites, global satellite networks are moving to the forefront in enhancing national and global information infrastructures. Simultaneously, broadband data services, which are emerging as the major market driver for future satellite and terrestrial networks, are being widely acknowledged as the foundation for an efficient global information infrastructure. In the past 2 years, various task forces and working groups around the globe have identified pivotal topics and key issues to address if we are to realize such networks in a timely fashion. In response, industry, government, and academia undertook efforts to address these topics and issues. A workshop was organized to provide a forum to assess the current state-of-the-art, identify key issues, and highlight the emerging trends in the next-generation architectures, data protocol development, communication interoperability, and applications. The Satellite Networks: Architectures, Applications, and Technologies Workshop was hosted by the Space Communication Program at the NASA Lewis Research Center in Cleveland, Ohio. Nearly 300 executives and technical experts from academia, industry, and government, representing the United States and eight other countries, attended the event (June 2 to 4, 1998). The program included seven panels and invited sessions and nine breakout sessions in which 42 speakers presented on technical topics. The proceedings covers a wide range of topics: access technology and protocols, architectures and network simulations, asynchronous transfer mode (ATM) over satellite networks, Internet over satellite networks, interoperability experiments and applications, multicasting, NASA interoperability experiment programs, NASA mission applications, and Transmission Control Protocol/Internet Protocol (TCP/IP) over satellite: issues, relevance, and experience.

Need for "conflict version" of primary surgery: war surgery in the era of low-intensity conflicts.

PubMed

Morikawa, Masahiro J

2006-01-01

The conventional wars between nations have widely been replaced by low-intensity conflicts within nations today, resulting in different patterns of injuries and practice of surgical care. A blurred front line, protracted durations of violence, indiscriminant fighting, and the emergence of specific surgical problems characterize low-intensity conflicts. In protracted conflicts with limited resources, surgical outcomes depend on many factors other than surgical skills, such as social/cultural values and economical feasibility. This paper examines how the characteristics of current conflicts affect surgical practice and will address key issues to evolve care to adapt to these changes. Key issues are (1) need for comprehensive surgical skills, (2) importance of improving local capacities, (3) long-term impact of trauma, and (4) limited access to information required to improve surgical skills.

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

PubMed

Baker, Paul M A; Moon, Nathan W

2008-01-01

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

Radiation Effects on Emerging Technologies: Implications of Space Weather Risk Management

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.; Barth, Janet L.

2000-01-01

As NASA and its space partners endeavor to develop a network of satellites capable of supporting humankind's needs for advanced space weather prediction and understanding, one of the key challenges is to design a space system to operate in the natural space radiation environment In this paper, we present a description of the natural space radiation environment, the effects of interest to electronic or photonic systems, and a sample of emerging technologies and their specific issues. We conclude with a discussion of operations in the space radiation hazard and considerations for risk management.

A systematic review and thematic synthesis of qualitative studies on maternal emergency transport in low- and middle-income countries.

PubMed

Wilson, Amie; Hillman, Sarah; Rosato, Mikey; Skelton, John; Costello, Anthony; Hussein, Julia; MacArthur, Christine; Coomarasamy, Arri

2013-09-01

Most maternal deaths are preventable with emergency obstetric care; therefore, ensuring access is essential. There is little focused information on emergency transport of pregnant women. The literature on emergency transport of pregnant women in low- and middle-income countries (LMICs) was systematically reviewed and synthesized to explore current practices, barriers, and facilitators for transport utilization. MEDLINE, EMBASE, BNI, Cochrane Library, CINAHL, African Index Medicus, ASSIA, QUALIDATA, RHL, and Science Citation Index (inception to April 2012) were searched without language restriction. Studies using qualitative methodology and reporting on emergency transportation in LMICs were included. Thematic framework and synthesis through examination and translation of common elements were used to analyze and synthesize the data. Twenty-nine articles were included. Eight major themes were identified: time for transport; transport options; geography; local support; autonomy; culture; finance; and ergonomics. Key issues were transport availability; transport speed; terrain; meteorology; support; dependence for decision making; cultural issues; cost; and lack of safe, comfortable positioning during transport. Themes should be appreciated within local contexts to illuminate barriers and facilitators. Potential solutions include motorcycle ambulance programs, collaboration with taxi services, community education, subsidies, and vehicle maintenance. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

PubMed

Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J

2008-08-01

The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

Local initiatives to access emergency obstetric and neonatal care in Burkina Faso.

PubMed

Yaméogo, Wambi M E; Ouédraogo, Talatou M; Kouanda, Seni

2016-11-01

To describe the various local initiatives to access emergency obstetric and neonatal care in Burkina Faso. An existing framework was used to review the three processes for local initiatives: emergence, formulation, and implementation. Multiple case studies were conducted, followed by literature review and semi-structured interviews with key informants. Sixteen districts had implemented local initiatives, including cost sharing, free care for women and children, and free care for delivery and cesareans. Most districts (n=10) had implemented the cost-sharing intervention. These initiatives were initiated by local actors as well as nongovernmental organizations. The profile of those involved led to different ways of handling the emergence and formulation processes. At implementation, these initiatives faced many issues including late payment of contributions, low involvement of local governments, and equity in participation. There are some issues in the implementation and sustainability of the local initiatives. Although many initiatives exist, these are unable to fully address the financial barriers to care. However, these initiatives highlight context-based financial barriers that must be taken into account to accelerate universal access to health care. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Cyber resilience: a review of critical national infrastructure and cyber security protection measures applied in the UK and USA.

PubMed

Harrop, Wayne; Matteson, Ashley

This paper presents cyber resilience as key strand of national security. It establishes the importance of critical national infrastructure protection and the growing vicarious nature of remote, well-planned, and well executed cyber attacks on critical infrastructures. Examples of well-known historical cyber attacks are presented, and the emergence of 'internet of things' as a cyber vulnerability issue yet to be tackled is explored. The paper identifies key steps being undertaken by those responsible for detecting, deterring, and disrupting cyber attacks on critical national infrastructure in the United Kingdom and the USA.

E3: Organizing for Environment, Energy, and the Economy in the Executive Branch of the U.S. Government.

ERIC Educational Resources Information Center

Carnegie Commission on Science, Technology, and Government, New York, NY.

A Task Force created in 1989 was asked to provide the Carnegie Commission on Science, Technology, and Government with a brief statement outlining both functional needs in environment and energy and institutional forms to enhance the government's capability to address the emergent issues. One key need the Task Force has identified is for a greater…

Purpose in Life: A Brief Review of the Literature and Its Implications for School Guidance Programs

ERIC Educational Resources Information Center

Yuen, Mantak; Lee, Queenie A. Y.; Kam, Jason; Lau, Patrick S. Y.

2017-01-01

Purpose in life has emerged as an important notion in positive psychology. It is regarded as a factor that can contribute to any individual's wellbeing. Based on a review of the literature, the authors discuss key issues that pertain to purpose in life, including how the construct is defined and conceptualised, its importance in living a…

"You Ain't Going to Say...I've Got a Problem down There": Workplace-Based Prostate Health Promotion with Men

ERIC Educational Resources Information Center

Dolan, Alan; Staples, Victoria; Summer, Sylvie; Hundt, Gillian Lewando

2005-01-01

Prostate health has emerged as a key health issue for men. Nearly 10000 men die from prostate cancer each year and many more live with non-cancerous, but debilitating, prostate conditions. Despite the widespread prevalence, evidence suggests that men lack knowledge about male cancers and conditions, and are more likely to ignore signs and delay…

Implementation science approaches for integrating eHealth research into practice and policy.

PubMed

Glasgow, Russell E; Phillips, Siobhan M; Sanchez, Michael A

2014-07-01

To summarize key issues in the eHealth field from an implementation science perspective and to highlight illustrative processes, examples and key directions to help more rapidly integrate research, policy and practice. We present background on implementation science models and emerging principles; discuss implications for eHealth research; provide examples of practical designs, measures and exemplar studies that address key implementation science issues; and make recommendations for ways to more rapidly develop and test eHealth interventions as well as future research, policy and practice. The pace of eHealth research has generally not kept up with technological advances, and many of our designs, methods and funding mechanisms are incapable of providing the types of rapid and relevant information needed. Although there has been substantial eHealth research conducted with positive short-term results, several key implementation and dissemination issues such as representativeness, cost, unintended consequences, impact on health inequities, and sustainability have not been addressed or reported. Examples of studies in several of these areas are summarized to demonstrate this is possible. eHealth research that is intended to translate into policy and practice should be more contextual, report more on setting factors, employ more responsive and pragmatic designs and report results more transparently on issues important to potential adopting patients, clinicians and organizational decision makers. We outline an alternative development and assessment model, summarize implementation science findings that can help focus attention, and call for different types of more rapid and relevant research and funding mechanisms. Published by Elsevier Ireland Ltd.

Newborn screening by tandem mass spectrometry: ethical and social issues.

PubMed

Avard, Denise; Vallance, Hilary; Greenberg, Cheryl; Potter, Beth

2007-01-01

Emerging technologies like Tandem Mass Spectrometry (TMS) enable multiple tests on a single blood sample and allow the expansion of Newborn Screening (NBS) to include various metabolic diseases. Introducing TMS for NBS raises important social and ethical questions: what are the criteria for adding disorders to screening panels? What evidence justifies expansion of screening? How can equity in NBS access and standards be ensured? How can policy standards be set, given the multiplicity of stakeholders? To address emerging issues, policy-makers, patient advocates, clinicians and researchers had a workshop during the 2005 Garrod Symposium. The participants received a summary of the discussion and understood the workshop's goal was to provide a basis for further discussion. This article contributes to this ongoing discussion. Several proposed recommendations assert the centrality of including social and ethical issues in the assessment of whether or not to introduce TMS. The article outlines five key recommendations for advancing the NBS agenda: national public health leadership; transparency; increased national consistency in NBS strategy, including minimum standards; collaboration between the federal and provincial/territorial governments and diverse stakeholders; and supporting research and/or programs based on effectiveness, which integrate ethical and social issues into assessment.

Aptamer based electrochemical sensors for emerging environmental pollutants

PubMed Central

Hayat, Akhtar; Marty, Jean L.

2014-01-01

Environmental contaminants monitoring is one of the key issues in understanding and managing hazards to human health and ecosystems. In this context, aptamer based electrochemical sensors have achieved intense significance because of their capability to resolve a potentially large number of problems and challenges in environmental contamination. An aptasensor is a compact analytical device incorporating an aptamer (oligonulceotide) as the sensing element either integrated within or intimately associated with a physiochemical transducer surface. Nucleic acid is well known for the function of carrying and passing genetic information, however, it has found a key role in analytical monitoring during recent years. Aptamer based sensors represent a novelty in environmental analytical science and there are great expectations for their promising performance as alternative to conventional analytical tools. This review paper focuses on the recent advances in the development of aptamer based electrochemical sensors for environmental applications with special emphasis on emerging pollutants. PMID:25019067

Aptamer based electrochemical sensors for emerging environmental pollutants

NASA Astrophysics Data System (ADS)

Hayat, Akhtar; Marty, Jean Louis

2014-06-01

Environmental contaminants monitoring is one of the key issues in understanding and managing hazards to human health and ecosystems. In this context, aptamer based electrochemical sensors have achieved intense significance because of their capability to resolve a potentially large number of problems and challenges in environmental contamination. An aptasensor is a compact analytical device incorporating an aptamer (oligonulceotide) as the sensing element either integrated within or intimately associated with a physiochemical transducer surface. Nucleic acid is well known for the function of carrying and passing genetic information, however, it has found a key role in analytical monitoring during recent years. Aptamer based sensors represent a novelty in environmental analytical science and there are great expectations for their promising performance as alternative to conventional analytical tools. This review paper focuses on the recent advances in the development of aptamer based electrochemical sensors for environmental applications with special emphasis on emerging pollutants.

The emergence and effectiveness of global health networks: findings and future research.

PubMed

Shiffman, Jeremy; Schmitz, Hans Peter; Berlan, David; Smith, Stephanie L; Quissell, Kathryn; Gneiting, Uwe; Pelletier, David

2016-04-01

Global health issues vary in the amount of attention and resources they receive. One reason is that the networks of individuals and organizations that address these issues differ in their effectiveness. This article presents key findings from a research project on the emergence and effectiveness of global health networks addressing tobacco use, alcohol harm, maternal mortality, neonatal mortality, tuberculosis and pneumonia. Although networks are only one of many factors influencing priority, they do matter, particularly for shaping the way the problem and solutions are understood, and convincing governments, international organizations and other global actors to address the issue. Their national-level effects vary by issue and are more difficult to ascertain. Networks are most likely to produce effects when (1) their members construct a compelling framing of the issue, one that includes a shared understanding of the problem, a consensus on solutions and convincing reasons to act and (2) they build a political coalition that includes individuals and organizations beyond their traditional base in the health sector, a task that demands engagement in the politics of the issue, not just its technical aspects. Maintaining a focused frame and sustaining a broad coalition are often in tension: effective networks find ways to balance the two challenges. The emergence and effectiveness of a network are shaped both by its members' decisions and by contextual factors, including historical influences (e.g. prior failed attempts to address the problem), features of the policy environment (e.g. global development goals) and characteristics of the issue the network addresses (e.g. its mortality burden). Their proliferation raises the issue of their legitimacy. Reasons to consider them legitimate include their members' expertise and the attention they bring to neglected issues. Reasons to question their legitimacy include their largely elite composition and the fragmentation they bring to global health governance. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2016; all rights reserved.

The emergence and effectiveness of global health networks: findings and future research

PubMed Central

Shiffman, Jeremy; Peter Schmitz, Hans; Berlan, David; Smith, Stephanie L; Quissell, Kathryn; Gneiting, Uwe; Pelletier, David

2016-01-01

Global health issues vary in the amount of attention and resources they receive. One reason is that the networks of individuals and organizations that address these issues differ in their effectiveness. This article presents key findings from a research project on the emergence and effectiveness of global health networks addressing tobacco use, alcohol harm, maternal mortality, neonatal mortality, tuberculosis and pneumonia. Although networks are only one of many factors influencing priority, they do matter, particularly for shaping the way the problem and solutions are understood, and convincing governments, international organizations and other global actors to address the issue. Their national-level effects vary by issue and are more difficult to ascertain. Networks are most likely to produce effects when (1) their members construct a compelling framing of the issue, one that includes a shared understanding of the problem, a consensus on solutions and convincing reasons to act and (2) they build a political coalition that includes individuals and organizations beyond their traditional base in the health sector, a task that demands engagement in the politics of the issue, not just its technical aspects. Maintaining a focused frame and sustaining a broad coalition are often in tension: effective networks find ways to balance the two challenges. The emergence and effectiveness of a network are shaped both by its members’ decisions and by contextual factors, including historical influences (e.g. prior failed attempts to address the problem), features of the policy environment (e.g. global development goals) and characteristics of the issue the network addresses (e.g. its mortality burden). Their proliferation raises the issue of their legitimacy. Reasons to consider them legitimate include their members’ expertise and the attention they bring to neglected issues. Reasons to question their legitimacy include their largely elite composition and the fragmentation they bring to global health governance. PMID:27067141

Psychosocial assistance after environmental accidents: a policy perspective.

PubMed Central

Becker, S M

1997-01-01

There is a substantial body of literature on psychosocial impacts of chemical and nuclear accidents. Less attention, however, has been focused on the program and policy issues that are connected with efforts to provide psychosocial assistance to the victims of such accidents. Because psychosocial assistance efforts are certain to be an essential part of the response to future environmental emergencies, it is vital that relevant program and policy issues by more fully considered. This article discusses the highly complex nature of contamination situations and highlights some of the key policy issues that are associated with the provision of psychosocial services after environmental accidents. One issue concerns the potential for assistance efforts to become objects of conflict. In the context of the intense controversy typically associated with chemical or nuclear accidents, and with debates over the causation of illness usually at the center of environmental accidents, psychosocial assistance services may themselves become contested terrain. Other significant program and policy issues include determining how to interface with citizen self-help and other voluntary groups, addressing the problem of stigma, and deciding how to facilitate stakeholder participation in the shaping of service provision. This article offers a series of policy proposals that may help smooth the way for psychosocial assistance programs in future environmental emergencies. PMID:9467082

Comprehensive genomic studies: emerging regulatory, strategic, and quality assurance challenges for biorepositories.

PubMed

McDonald, Sandra A; Mardis, Elaine R; Ota, David; Watson, Mark A; Pfeifer, John D; Green, Jonathan M

2012-07-01

As part of the molecular revolution sweeping medicine, comprehensive genomic studies are adding powerful dimensions to medical research. However, their power exposes new regulatory, strategic, and quality assurance challenges for biorepositories. A key issue is that unlike other research techniques commonly applied to banked specimens, nucleic acid sequencing, if sufficiently extensive, yields data that could identify a patient. This evolving paradigm renders the concepts of anonymized and anonymous specimens increasingly outdated. The challenges for biorepositories in this new era include refined consent processes and wording, selection and use of legacy specimens, quality assurance procedures, institutional documentation, data sharing, and interaction with institutional review boards. Given current trends, biorepositories should consider these issues now, even if they are not currently experiencing sample requests for genomic analysis. We summarize our current experiences and best practices at Washington University Medical School, St Louis, MO, our perceptions of emerging trends, and recommendations.

Comprehensive Genomic Studies: Emerging Regulatory, Strategic, and Quality Assurance Challenges for Biorepositories

PubMed Central

McDonald, Sandra A.; Mardis, Elaine R.; Ota, David; Watson, Mark A.; Pfeifer, John D.; Green, Jonathan M.

2012-01-01

As part of the molecular revolution sweeping medicine, comprehensive genomic studies are adding powerful dimensions to medical research. However, their power exposes new regulatory, strategic, and quality assurance challenges for biorepositories. A key issue is that unlike other research techniques commonly applied to banked specimens, nucleic acid sequencing, if sufficiently extensive, yields data that could identify a patient. This evolving paradigm renders the concepts of anonymized and anonymous specimens increasingly outdated. The challenges for biorepositories in this new era include refined consent processes and wording, selection and use of legacy specimens, quality assurance procedures, institutional documentation, data sharing, and interaction with institutional review boards. Given current trends, biorepositories should consider these issues now, even if they are not currently experiencing sample requests for genomic analysis. We summarize our current experiences and best practices at Washington University Medical School, St Louis, MO, our perceptions of emerging trends, and recommendations. PMID:22706855

Assessing the need for a new nationally representative household panel survey in the United States

PubMed Central

Moffitt, Robert; Schoeni, Robert F.; Brown, Charles; Chase-Lansdale, P. Lindsay; Couper, Mick P.; Diez-Roux, Ana V.; Hurst, Erik; Seltzer, Judith A.

2015-01-01

We introduce this special issue on the critical matter of whether the existing household panel surveys in the U.S. are adequate to address the important emerging social science and policy questions of the next few decades. We summarize the conference papers which address this issue in different domains. The papers detail many new and important emerging research questions but also identify key limitations in existing panels in addressing those questions. To address these limitations, we consider the advantages and disadvantages of initiating a new, general-purpose omnibus household panel in the U.S. We also discuss the particular benefits of starting new panels that have specific targeted domains such as child development, population health and health care. We also develop a list of valuable enhancements to existing panels which could address many of their limitations. PMID:26688609

Footwear Experiences of People With Chronic Musculoskeletal Diseases.

PubMed

Hendry, Gordon J; Brenton-Rule, Angela; Barr, Georgina; Rome, Keith

2015-08-01

Foot pain and deformities are frequently reported by people with chronic musculoskeletal diseases, but only limited research has been conducted to explore the key issues concerning footwear difficulties in this population. The aim of this study is to explore, identify, and describe the main issues surrounding the footwear experiences of people with chronic musculoskeletal diseases. A qualitative manifest content analysis of open-ended survey responses concerning footwear experiences was conducted from a national footwear survey of people with chronic musculoskeletal diseases in New Zealand. Eighty-five respondents submitted usable responses. Specific statements in the text were identified as units of analysis prior to coding and organizing these units into emerging mutually exclusive categories. Content analysis was independently undertaken by 3 researchers, and the final categories and coding were achieved through consensus. Frequencies of assigned units of analysis were calculated in order to obtain a quantitative description for each category. Four categories encompassing a total of 9 subcategories related to the footwear experiences of respondents emerged from the qualitative data content analysis: difficulty finding appropriate footwear; dissatisfaction with therapeutic footwear provision and foot care access; high costs of footwear, foot care, and self-care; and satisfaction with therapeutic footwear and foot care. Key categories describing the important issues surrounding the footwear experiences of respondents with chronic musculoskeletal diseases were identified, which may provide important targets for improving footwear and foot care services and self-management strategies. © 2015, American College of Rheumatology.

Sex- and gender-specific research priorities in cardiovascular resuscitation: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Resuscitation Research Workgroup.

PubMed

Wigginton, Jane G; Perman, Sarah M; Barr, Gavin C; McGregor, Alyson J; Miller, Andrew C; Napoli, Anthony M; Napoli, Anthony F; Safdar, Basmah; Weaver, Kevin R; Deutsch, Steven; Kayea, Tami; Becker, Lance

2014-12-01

Significant sex and gender differences in both physiology and psychology are readily acknowledged between men and women; however, data are lacking regarding differences in their responses to injury and treatment and in their ultimate recovery and survival. These variations remain particularly poorly defined within the field of cardiovascular resuscitation. A better understanding of the interaction between these important factors may soon allow us to dramatically improve outcomes in disease processes that currently carry a dismal prognosis, such as sudden cardiac arrest. As part of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," our group sought to identify key research questions and knowledge gaps pertaining to both sex and gender in cardiac resuscitation that could be answered in the near future to inform our understanding of these important issues. We combined a monthly teleconference meeting of interdisciplinary stakeholders from largely academic institutions with a focused interest in cardiovascular outcomes research, an extensive review of the existing literature, and an open breakout session discussion on the recommendations at the consensus conference to establish a prioritization of the knowledge gaps and relevant research questions in this area. We identified six priority research areas: 1) out-of-hospital cardiac arrest epidemiology and outcome, 2) customized resuscitation drugs, 3) treatment role for sex steroids, 4) targeted temperature management and hypothermia, 5) withdrawal of care after cardiac arrest, and 6) cardiopulmonary resuscitation training and implementation. We believe that exploring these key topics and identifying relevant questions may directly lead to improved understanding of sex- and gender-specific issues seen in cardiac resuscitation and ultimately improved patient outcomes. © 2014 by the Society for Academic Emergency Medicine.

MASS MEDIA COMMUNICATION OF EMERGENCY ISSUES AND COUNTERMEASURES IN A NUCLEAR ACCIDENT: FUKUSHIMA REPORTING IN EUROPEAN NEWSPAPERS.

PubMed

Gallego, Eduardo; Cantone, Marie Claire; Oughton, Deborah H; Perko, Tanja; Prezelj, Iztok; Tomkiv, Yevgeniya

2017-04-01

This paper presents the results of a large study of 1340 articles published by two major newspapers in six European countries (Belgium, Italy, Norway, Slovenia, Spain and Russia) in the first 2 months after the Fukushima Daiichi nuclear disaster. The focus of the analysis is on the application and overall impact of protective actions, both during the emergency phase and later, how the newspapers describe those actions, which differences were apparent between countries and what recommendations can be extracted in order to improve general communication about these issues. A clear lesson is that, even under uncertainty and recognising limitations, responsible authorities need to provide transparent, clear and understandable information to the public and the mass media right from the beginning of the early phase of any nuclear emergency. Clear, concise messages should be given. Mass media could play a key role in reassuring the public if the countermeasures are clearly explained. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Secure Multicast Framework in Large and High-Mobility Network Groups

NASA Astrophysics Data System (ADS)

Lee, Jung-San; Chang, Chin-Chen

With the widespread use of Internet applications such as Teleconference, Pay-TV, Collaborate tasks, and Message services, how to construct and distribute the group session key to all group members securely is becoming and more important. Instead of adopting the point-to-point packet delivery, these emerging applications are based upon the mechanism of multicast communication, which allows the group member to communicate with multi-party efficiently. There are two main issues in the mechanism of multicast communication: Key Distribution and Scalability. The first issue is how to distribute the group session key to all group members securely. The second one is how to maintain the high performance in large network groups. Group members in conventional multicast systems have to keep numerous secret keys in databases, which makes it very inconvenient for them. Furthermore, in case that a member joins or leaves the communication group, many involved participants have to change their own secret keys to preserve the forward secrecy and the backward secrecy. We consequently propose a novel version for providing secure multicast communication in large network groups. Our proposed framework not only preserves the forward secrecy and the backward secrecy but also possesses better performance than existing alternatives. Specifically, simulation results demonstrate that our scheme is suitable for high-mobility environments.

The nitrogen-vacancy colour centre in diamond

NASA Astrophysics Data System (ADS)

Doherty, Marcus W.; Manson, Neil B.; Delaney, Paul; Jelezko, Fedor; Wrachtrup, Jörg; Hollenberg, Lloyd C. L.

2013-07-01

The nitrogen-vacancy (NV) colour centre in diamond is an important physical system for emergent quantum technologies, including quantum metrology, information processing and communications, as well as for various nanotechnologies, such as biological and sub-diffraction limit imaging, and for tests of entanglement in quantum mechanics. Given this array of existing and potential applications and the almost 50 years of NV research, one would expect that the physics of the centre is well understood, however, the study of the NV centre has proved challenging, with many early assertions now believed false and many remaining issues yet to be resolved. This review represents the first time that the key empirical and ab initio results have been extracted from the extensive NV literature and assembled into one consistent picture of the current understanding of the centre. As a result, the key unresolved issues concerning the NV centre are identified and the possible avenues for their resolution are examined.

Barriers to vocational effectiveness in ACT: staff perspectives.

PubMed

Waynor, William R; Pratt, Carlos W

2011-01-01

Assertive community treatment (ACT), for persons with serious mental illness, includes a vocational focus as an important aspect of community integration. Nevertheless, research suggests that ACT does not assist significant numbers of consumers in achieving employment goals. A two-step survey of New Jersey ACT team members was designed to identify the key issues that hinder ACT staff members in assisting consumers with obtaining employment. Survey items were categorized into three sections: (a) staff attitudes, (b) consumer barriers, and (c) staff barriers to working on employment. The initial survey asked staff members to rate items in each of these categories. Highly rated items were used in a subsequent paired comparison survey to determine the relative importance of each. This method highlighted the following issues: four staff attitude items-(a) returning to work is positive, (b) employment is key to recovery, (c) abstinence from substance abuse is needed to work, and (d) consumers are too ill to work; four consumer barrier items-(a) fear of loss of Social Security Administration benefits, (b) symptoms related to the illness, (c) lack of motivation, and (d) poor social skills; and three barriers to working on employment issues items-(a) clinical issues take priority, (b) other case management issues takes priority, and (c) too many emergencies. The implications for staff training are discussed.

Telemental Health for Children and Adolescents: An Overview of Legal, Regulatory, and Risk Management Issues.

PubMed

Kramer, Gregory M; Luxton, David D

2016-04-01

The use of technology to provide telemental healthcare continues to increase; however, little has been written about the legal and regulatory issues involved in providing this form of care to children and adolescents. This article reviews existing laws and regulations to summarize the risk management issues relevant to providing telemental healthcare to children and adolescents. There are several legal and regulatory areas in which telemental health clinicians need to have awareness. These areas include: 1) Licensure, 2) malpractice liability, 3) credentialing and privileging, 4) informed consent, 5) security and privacy, and 6) emergency management. Although legal and regulatory challenges remain in providing telemental healthcare to children and adolescents, it is possible to overcome these challenges with knowledge of the issues and appropriate risk management strategies. We provide general knowledge of these key legal and regulatory issues, along with some risk management recommendations.

Factors impacting on psychological wellbeing of international students in the health professions: A scoping review.

PubMed

McKenna, Lisa; Robinson, Eddie; Penman, Joy; Hills, Danny

2017-09-01

There are increasing numbers of international students undertaking health professional courses, particularly in Western countries. These courses not only expose students to the usual stresses and strains of academic learning, but also require students to undertake clinical placements and practice-based learning. While much is known about general issues facing international students, less is known about factors that impact on those studying in the health professions. To explore what is known about factors that influence the psychological wellbeing of international students in the health professions. A scoping review. A range of databases were searched, including CINAHL, Medline, Scopus, Proquest and ERIC, as well as grey literature, reference lists and Google Scholar. The review included qualitative or quantitative primary peer reviewed research studies that focused on international undergraduate or postgraduate students in the health professions. The core concept underpinning the review was psychological issues, with the outcome being psychological and/or social wellbeing. Thematic analysis across studies was used to identify key themes emerging. A total of 13 studies were included in the review, from the disciplines of nursing, medicine and speech-language pathology. Four key factor groups emerged from the review: negotiating structures and systems, communication and learning, quality of life and self-care, and facing discrimination and social isolation. International health professional students face similar issues to other international students. The nature of their courses, however, also requires negotiating different health care systems, and managing a range of clinical practice issues including with communication, and isolation and discrimination from clinical staff and patients. Further research is needed to specifically explore factors impacting on student well-being and how international students can be appropriately prepared and supported for their encounters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health reform: the human resource challenges for Central Asian Commonwealth of Independent States (CIS) countries.

PubMed

Parfitt, Barbara

2009-01-01

This paper examines the key human resource issues for health amongst mid-level workers in Central Asia CIS countries. It focuses on Azerbaijan, Tajikistan and Uzbekistan highlighting the human resource issues that are evident within these countries and illustrating how they differ from those described in the sub-Saharan developing countries. The key human resource issue highlighted by the World Health Organization Report [WHO. (2006). World Health Report: Working together for health. Geneva: WHO] was the scarcity of health workers. Four million health care workers were identified as essential if the health services of the world are able to meet current health needs. The primary area of need highlighted was in Africa. Africa bears the greatest burden of disease but has the lowest number of health care workers. In the CIS countries in Central Asia different human resource issues have emerged. The Soviet health care system was comprehensive but labour intensive it had a primarily acute and a specialist disease focused approach with little investment in primary and community health care. It was unsustainable and the legacy that it left the new Central Asian emerging nations was of a large workforce with poor levels of competence and outdated approaches to providing care along with a crumbling infrastructure. In response to this situation health reform has been introduced which focuses on a family model of primary health care with family doctors supported by Family Health Nurses. This approach is beginning to make a difference to the morbidity and mortality of the populations but still has a long way to go before its full benefits are realised.

A position statement on mental health in the post-2015 development agenda

PubMed Central

2014-01-01

Background The Millennium Development Goals have guided development co-operation in the 15 years up to 2015, achieving some significant progress in the priorities on which they focused. As the framework for the post-2015 development agenda is negotiated, this article reviews the evidence for the place of mental health in broader development issues that have already been outlined in the run-up to 2015. Discussion If mental health is going to be recognised as having an essential role in development, there needs to be a consensus on priorities for advocacy. Various key issues emerged from a survey of stakeholders in the Movement for Global Mental Health (MGMH), leading to a Position Statement, which is now available for use by advocates. The priorities that emerged were increasing access to mental health services, and addressing human rights abuse, stigma, and exclusion. Summary Mental health is a cross-cutting issue, and including it in frameworks for action will increase the likelihood of achieving global priorities for development such as poverty reduction, economic development, improved health, and ensuring the most vulnerable in society are not left behind. PMID:25050137

Key issues and challenges in developing a pedagogical intervention in the simulation skills center--an action research study.

PubMed

Reierson, Inger Åse; Hvidsten, Anne; Wighus, Marianne; Brungot, Solvor; Bjørk, Ida Torunn

2013-07-01

Simulation skills centers (SSC) are considered important learning arenas for preparing and qualifying nursing students. Limited clinical placements and claims of diminished learning opportunities raise concerns that newly educated nurses lack proficiency in many psychomotor skills. Accordingly, there is an increased focus on learning in the SSC. However, it has been questioned if the pedagogical underpinning of teaching and learning in the SSC is missing or unclear. At a bachelor nursing education in Norway, there was a desire to change practice and enhance learning in the SSC by systematic use of The Model of Practical Skill Performance (Bjørk and Kirkevold, 2000). A participatory action research design was chosen. A pedagogical intervention was developed and implemented in 2010 in a cohort of eighty-seven first year bachelor nursing students during their basic nursing skill course. The intervention is shortly described. This article reports key issues and challenges that emerged during development of the new intervention. Data to inform the study were collected via thorough meeting minutes and the project leader's logbook, and analyzed using fieldnotes analysis. Six key issues and challenges were identified. These are presented and discussed consecutively in light of their importance for development and implementation of the new intervention. Copyright © 2013 Elsevier Ltd. All rights reserved.

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…

School Food Unwrapped: What's Available and What Our Kids Actually Are Eating. Research Brief. Publication #2008-40

ERIC Educational Resources Information Center

Hair, Elizabeth; Ling, Thomson; Wandner, Laura

2008-01-01

Childhood obesity has emerged as a critical health problem of the 21st century. The seriousness of this issue stems from the grave health consequences of overweight and obesity that begin in child-hood and persist later in life. In light of these consequences, public health officials and others have begun to focus on schools as key settings in…

Understanding men's health and illness: a gender-relations approach to policy, research, and practice.

PubMed

Schofield, T; Connell, R W; Walker, L; Wood, J F; Butland, D L

2000-05-01

Men's health has emerged as an important public concern that may require new kinds of healthcare interventions and increased resources. Considerable uncertainty and confusion surround prevailing understandings of men's health, particularly those generated by media debate and public policy, and health research has often operated on oversimplified assumptions about men and masculinity. A more useful way of understanding men's health is to adopt a gender-relations approach. This means examining health concerns in the context of men's and women's interactions with each other, and their positions in the larger, multidimensional structure of gender relations. Such an approach raises the issue of differences among men, which is a key issue in recent research on masculinity and an important health issue. The gender-relations approach offers new ways of addressing practical issues of healthcare for men in college environments.

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

PubMed

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

2013-03-01

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

ARkStorm@Tahoe: Stakeholder perspectives on vulnerabilities and preparedness for an extreme storm event in the greater Lake Tahoe, Reno, and Carson City region

USGS Publications Warehouse

Albano, Christine M.; Cox, Dale A.; Dettinger, Michael; Shaller, Kevin; Welborn, Toby L.; McCarthy, Maureen

2014-01-01

Atmospheric rivers (ARs) are strongly linked to extreme winter precipitation events in the Western U.S., accounting for 80 percent of extreme floods in the Sierra Nevada and surrounding lowlands. In 2010, the U.S. Geological Survey developed the ARkStorm extreme storm scenario for California to quantify risks from extreme winter storms and to allow stakeholders to better explore and mitigate potential impacts. To explore impacts on natural resources and communities in montane and adjacent environments, we downscaled the scenario to the greater Lake Tahoe, Reno and Carson City region of northern Nevada and California. This ArkStorm@Tahoe scenario was presented at six stakeholder meetings, each with a different geographic and subject matter focus. Discussions were facilitated by the ARkStorm@Tahoe team to identify social and ecological vulnerabilities to extreme winter storms, science and information needs, and proactive measures that might minimize impacts from this type of event. Information collected in these meetings was used to develop a tabletop emergency response exercise and set of recommendations for increasing resilience to extreme winter storm events in both Tahoe and the downstream communities of Northern Nevada.Over 300 individuals participated in ARkStorm@Tahoe stakeholder meetings and the emergency response exercise, including representatives from emergency response, natural resource and ecosystem management, health and human services, public utilities, and businesses. Interruption of transportation, communications, and lack of power and backup fuel supplies were identified as the most likely and primary points of failure across multiple sectors and geographies, as these interruptions have cascading effects on natural and human systems by impeding emergency response efforts. Other key issues that arose in discussions included contamination risks to water supplies and aquatic ecosystems, especially in the Tahoe Basin and Pyramid Lake, interagency coordination, credentialing, flood management, and coordination of health and human services during such an event. Mitigation options were identified for each of the key issues. Several science needs were identified, particularly the need for improved flood inundation maps. Finally, key lessons learned were identified and may help to increase preparedness, response and recovery from extreme storms in the future.

Communicating the threat of emerging infections to the public.

PubMed Central

Freimuth, V.; Linnan, H. W.; Potter, P.

2000-01-01

Communication theory and techniques, aided by the electronic revolution, provide new opportunities and challenges for the effective transfer of laboratory, epidemiologic, surveillance, and other public health data to the public who funds them. We review the applicability of communication theory, particularly the audience-source-message-channel meta-model, to emerging infectious disease issues. Emergence of new infectious organisms, microbial resistance to therapeutic drugs, and increased emphasis on prevention have expanded the role of communication as a vital component of public health practice. In the absence of cure, as in AIDS and many other public health problems, an effectively crafted and disseminated prevention message is the key control measure. Applying communication theory to disease prevention messages can increase the effectiveness of the messages and improve public health. PMID:10905966

An ethical framework for the management of pain in the emergency department.

PubMed

Venkat, Arvind; Fromm, Christian; Isaacs, Eric; Ibarra, Jordan

2013-07-01

Pain is a ubiquitous problem, affecting more than 100 million individuals in the United States chronically and many more in the acute setting. Up to three-quarters of patients presenting to the emergency department (ED) report pain as a key component of their reasons for requiring acute care. While pain management is a fundamental component of emergency medicine (EM), there are numerous attitudinal and structural barriers that have been identified to effectively providing pain control in the ED. Coupled with public demands and administrative mandates, concerns surrounding ED pain management have reached a crisis level that should be considered an ethical issue in the profession of EM. In this article, the authors propose an ethical framework based on a combination of virtue, narrative, and relationship theories that can be used to address the clinical dilemmas that arise in managing pain in ED patients. © 2013 by the Society for Academic Emergency Medicine.

EAACI position paper on occupational rhinitis

PubMed Central

Moscato, Gianna; Vandenplas, Olivier; Van Wijk, Roy Gerth; Malo, Jean-Luc; Perfetti, Luca; Quirce, Santiago; Walusiak, Jolanta; Castano, Roberto; Pala, Gianni; Gautrin, Denyse; De Groot, Hans; Folletti, Ilenia; Yacoub, Mona Rita; Siracusa, Andrea

2009-01-01

The present document is the result of a consensus reached by a panel of experts from European and non-European countries on Occupational Rhinitis (OR), a disease of emerging relevance which has received little attention in comparison to occupational asthma. The document covers the main items of OR including epidemiology, diagnosis, management, socio-economic impact, preventive strategies and medicolegal issues. An operational definition and classification of OR tailored on that of occupational asthma, as well as a diagnostic algorithm based on steps allowing for different levels of diagnostic evidence are proposed. The needs for future research are pointed out. Key messages are issued for each item. PMID:19257881

Assessment of State- and Territorial-Level Preparedness Capacity for Serving Deaf and Hard-of-Hearing Populations in Disasters

PubMed Central

Tseng, Winston; Dahrouge, Donna; Engelman, Alina; Neuhauser, Linda; Huang, Debbie; Gurung, Sidhanta

2014-01-01

Objectives Substantial evidence exists that emergency preparedness and response efforts are not effectively reaching populations with functional and access needs, especially barriers related to literacy, language, culture, or disabilities. More than 36 million Americans are Deaf or hard of hearing (Deaf/HH). These groups experienced higher risks of injury, death, and property loss in recent disasters than the general public. We conducted a participatory research study to examine national recommendations on preparedness communication for the Deaf/HH. Methods We assessed whether previous recommendations regarding the Deaf/HH have been incorporated into state- and territorial-level emergency operations plans (EOPs), interviewed state- and territorial-level preparedness directors about capacity to serve the Deaf/HH, and proposed strategies to benefit Deaf/HH populations during emergencies. We analyzed 55 EOPs and 50 key informant (KI) interviews with state directors. Results Fifty-five percent of EOPs mentioned vulnerable populations; however, only 31% specifically mentioned Deaf/HH populations in their plan. Study findings indicated significant relationships among the following factors: a state-level KI's familiarity with communication issues for the Deaf/HH, making relay calls (i.e., calls to services to relay communication between Deaf and hearing people), and whether the KI's department provides trainings about serving Deaf/HH populations in emergencies. We found significant associations between a state's percentage of Deaf/HH individuals and a KI's familiarity with Deaf/HH communication issues and provision by government of any disability services to Deaf/HH populations in emergencies. Further, we found significant relationships between KIs attending training on serving the Deaf/HH and familiarity with Deaf/HH communication issues, including how to make relay calls. Conclusion This study provides new knowledge that can help emergency agencies improve their preparedness training, planning, and capacity to serve Deaf/HH populations in emergencies. PMID:24587549

Developing a Research Agenda to Optimize Diagnostic Imaging in the Emergency Department: An Executive Summary of the 2015 Academic Emergency Medicine Consensus Conference.

PubMed

Marin, Jennifer R; Mills, Angela M

2015-12-01

The 2015 Academic Emergency Medicine (AEM) consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The specific aims of the conference were to: 1) understand the current state of evidence regarding emergency department (ED) diagnostic imaging utilization and identify key opportunities, limitations, and gaps in knowledge; 2) develop a consensus-driven research agenda emphasizing priorities and opportunities for research in ED diagnostic imaging; and 3) explore specific funding mechanisms available to facilitate research in ED diagnostic imaging. Over a 2-year period, the executive committee and other experts in the field convened regularly to identify specific areas in need of future research. Six content areas within emergency diagnostic imaging were identified prior to the conference and served as the breakout groups on which consensus was achieved: clinical decision rules; use of administrative data; patient-centered outcomes research; training, education, and competency; knowledge translation and barriers to imaging optimization; and comparative effectiveness research in alternatives to traditional computed tomography use. The executive committee invited key stakeholders to assist with planning and to participate in the consensus conference to generate a multidisciplinary agenda. There were 164 individuals involved in the conference spanning various specialties, including emergency medicine (EM), radiology, surgery, medical physics, and the decision sciences. This issue of AEM is dedicated to the proceedings of the 16th annual AEM consensus conference as well as original research related to emergency diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

Transforming care: medical practice design and information technology.

PubMed

Kilo, Charles M

2005-01-01

The transformation of the medical practice is possible today because of the advancement of system design knowledge coupled with innovations in information technology (IT). Examples of such transformed care are present today, and they are creating a roadmap for others. Those efforts are also elucidating critical issues in the use of IT to advance health care quality. Connectivity, electronic integration, and knowledge management are the key functionalities emerging as levers to promote this transformation.

U.S. Trade Policy: Competing in a Global Economy. Choices for the 21st Century. Alternatives for Public Debate and Policy Development.

ERIC Educational Resources Information Center

Brown Univ., Providence, RI. Center for Foreign Policy Development.

This document contains a student text, teacher outline, and lesson plan that places beliefs and values at the center of the national discussion on trade policy. The focus of the unit is particularly relevant with the emergence of U.S. trade policy as a vital public issue. In 1993, two key elements of U.S. trade policy--the North American Free…

Skill Transfer and Virtual Training for IND Response Decision-Making: Analysis of Decision-Making Skills for Large Scale Incidents

DTIC Science & Technology

2016-01-01

issues comes from the Fukushima Daiichi nuclear disaster (2011). The local medical health professional on staff at the U.S. embassy in Tokyo was not...distribution unlimited. This page intentionally left blank. iii EXECUTIVE SUMMARY An improvised nuclear device (IND...from the phase one analysis are as follows : • There is strong consistency in both the key decisions and underlying skills emphasized by emergency

Prism. Volume 3, Number 1

DTIC Science & Technology

2011-12-01

negotiating adversaries. With regard to the key issues of gover - nance, the following are likely to be some of the major points of contention, and...among the players in the various groups as much as between them. The critical points of gover - nance as they emerged from the study include, for...arrangements for Afghanistan’s future gover - nance must be agreed to among Afghans if the future is to see success. Afghan groups would therefore be

Etudes sociales 30. Sujet B: Interaction entre nations. Cahier de l'eleve. Edition finale = Social Studies 30. Subject B: Interaction between Nations. Student Workbook. Final Edition.

ERIC Educational Resources Information Center

Alberta Dept. of Education, Edmonton. Curriculum Branch.

In this Alberta (Canada) student workbook, four history units are presented for study. These are: (1) Between Two Wars (1919-1936); (2) World War II; (3) The Emergence and Interaction of the Superpowers; and (4) Contemporary World Interactions. Advice is offered to students in each unit along with information about key events and issues during…

An integrated and dynamic optimisation model for the multi-level emergency logistics network in anti-bioterrorism system

NASA Astrophysics Data System (ADS)

Liu, Ming; Zhao, Lindu

2012-08-01

Demand for emergency resources is usually uncertain and varies quickly in anti-bioterrorism system. Besides, emergency resources which had been allocated to the epidemic areas in the early rescue cycle will affect the demand later. In this article, an integrated and dynamic optimisation model with time-varying demand based on the epidemic diffusion rule is constructed. The heuristic algorithm coupled with the MATLAB mathematical programming solver is adopted to solve the optimisation model. In what follows, the application of the optimisation model as well as a short sensitivity analysis of the key parameters in the time-varying demand forecast model is presented. The results show that both the model and the solution algorithm are useful in practice, and both objectives of inventory level and emergency rescue cost can be controlled effectively. Thus, it can provide some guidelines for decision makers when coping with emergency rescue problem with uncertain demand, and offers an excellent reference when issues pertain to bioterrorism.

BIM based virtual environment for fire emergency evacuation.

PubMed

Wang, Bin; Li, Haijiang; Rezgui, Yacine; Bradley, Alex; Ong, Hoang N

2014-01-01

Recent building emergency management research has highlighted the need for the effective utilization of dynamically changing building information. BIM (building information modelling) can play a significant role in this process due to its comprehensive and standardized data format and integrated process. This paper introduces a BIM based virtual environment supported by virtual reality (VR) and a serious game engine to address several key issues for building emergency management, for example, timely two-way information updating and better emergency awareness training. The focus of this paper lies on how to utilize BIM as a comprehensive building information provider to work with virtual reality technologies to build an adaptable immersive serious game environment to provide real-time fire evacuation guidance. The innovation lies on the seamless integration between BIM and a serious game based virtual reality (VR) environment aiming at practical problem solving by leveraging state-of-the-art computing technologies. The system has been tested for its robustness and functionality against the development requirements, and the results showed promising potential to support more effective emergency management.

Ethical considerations for vaccination programmes in acute humanitarian emergencies

PubMed Central

Hardie, Kate; Selgelid, Michael J; Waldman, Ronald J; Strebel, Peter; Rees, Helen; Durrheim, David N

2013-01-01

Abstract Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice. PMID:23599553

Integrating horizon scanning and strategic risk prioritisation using a weight of evidence framework to inform policy decisions.

PubMed

Garnett, K; Lickorish, F A; Rocks, S A; Prpich, G; Rathe, A A; Pollard, S J T

2016-08-01

Poor connection between data on emerging issues and credible policy decisions continues to challenge governments, and is only likely to grow as demands on time and resources increase. Here we summarise recent efforts to integrate horizon scanning and risk prioritisation approaches to better connect emerging issues to the political discourse on environmental and food-related issues. Our categorisation of insights including potential future risks and opportunities to inform policy discussions has emerged from a structured three-year programme of horizon scanning for a UK pan-governmental futures partnership led by the Department for Environment, Food and Rural Affairs (Defra). Our efforts to integrate horizon scanning and risk prioritisation, utilising a qualitative weight of evidence framework, has created a systematic process for identifying all signals of potential future change with significant impact for the strategic mission and underlying values of policy actors. Our approach encourages an exploration of factors out of the control of organisations, recognising that resilience depends on the flexibility of management strategies and the preparedness to deal with a variety of unexpected outcomes. We discuss how this approach addresses key cultural and evaluative challenges that policy actors have had in embedding horizon scanning in evidence-based policy processes, and suggest further developments to build confidence in the use of horizon scanning for strategic planning. Copyright © 2016 Elsevier B.V. All rights reserved.

Reaching kids: partnering with preschools and schools to improve children's health.

PubMed

2009-11-01

As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) convened a group of grantmakers and education experts on May 27, 2009, for an informative discussion about ways in which preschools and schools are working to improve outcomes related to children's health. The Issue Dialogue Reaching Kids: Partnering with Preschools and Schools to Improve Children's Health synthesized the latest research on health-related issues affecting children's educational outcomes. It also provided illustrative examples of foundation-driven initiatives aimed at promoting collaborations between the health and education sectors to improve children's health and development outcomes. This Issue Brief summarizes background materials compiled for the meeting and highlights key themes and findings that emerged from the day's discussion among meeting participants.

Simulation based training in a publicly funded home birth programme in Australia: A qualitative study.

PubMed

Kumar, Arunaz; Nestel, Debra; Stoyles, Sally; East, Christine; Wallace, Euan M; White, Colleen

2016-02-01

Birth at home is a safe and appropriate choice for healthy women with a low risk pregnancy. However there is a small risk of emergencies requiring immediate, skilled management to optimise maternal and neonatal outcomes. We developed and implemented a simulation workshop designed to run in a home based setting to assist with emergency training for midwives and paramedical staff. The workshop was evaluated by assessing participants' satisfaction and response to key learning issues. Midwifery and emergency paramedical staff attending home births participated in a simulation workshop where they were required to manage birth emergencies in real time with limited availability of resources to suit the setting. They completed a pre-test and post-test evaluation form exploring the content and utility of the workshops. Content analysis was performed on qualitative data regarding the most important learning from the simulation activity. A total of 73 participants attended the workshop (midwifery=46, and paramedical=27). There were 110 comments, made by 49 participants. The most frequently identified key learning elements were related to communication (among midwives, paramedical and hospital staff and with the woman's partner), followed by recognising the role of other health care professionals, developing an understanding of the process and the importance of planning ahead. Home birth simulation workshop was found to be a useful tool by staff that provide care to women who are having a planned home birth. Developing clear communication and teamwork were found to be the key learning principles guiding their practice. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

On the emergence of the structure of physics

NASA Astrophysics Data System (ADS)

Majid, S.

2018-04-01

We consider Hilbert's problem of the axioms of physics at a qualitative or conceptual level. This is more pressing than ever as we seek to understand how both general relativity and quantum theory could emerge from some deeper theory of quantum gravity, and in this regard I have previously proposed a principle of self-duality or quantum Born reciprocity as a key structure. Here, I outline some of my recent work around the idea of quantum space-time as motivated by this non-standard philosophy, including a new toy model of gravity on a space-time consisting of four points forming a square. This article is part of the theme issue `Hilbert's sixth problem'.

On the emergence of the structure of physics.

PubMed

Majid, S

2018-04-28

We consider Hilbert's problem of the axioms of physics at a qualitative or conceptual level. This is more pressing than ever as we seek to understand how both general relativity and quantum theory could emerge from some deeper theory of quantum gravity, and in this regard I have previously proposed a principle of self-duality or quantum Born reciprocity as a key structure. Here, I outline some of my recent work around the idea of quantum space-time as motivated by this non-standard philosophy, including a new toy model of gravity on a space-time consisting of four points forming a square.This article is part of the theme issue 'Hilbert's sixth problem'. © 2018 The Author(s).

Building Community Resilience to Disasters: A Way Forward to Enhance National Health Security.

PubMed

Chandra, Anita; Acosta, Joie; Howard, Stefanie; Uscher-Pines, Lori; Williams, Malcolm; Yeung, Douglas; Garnett, Jeffrey; Meredith, Lisa S

2011-01-01

Community resilience, or the sustained ability of a community to withstand and recover from adversity, has become a key policy issue at federal, state, and local levels, including in the National Health Security Strategy. Because resources are limited in the wake of an emergency, it is increasingly recognized that resilience is critical to a community's ability to reduce long recovery periods after an emergency. This article shares details of a report that provides a roadmap for federal, state, and local leaders who are developing plans to enhance community resilience for health security threats and describes options for building community resilience in key areas. Based on findings from a literature review and a series of community and regional focus groups, the authors provide a definition of community resilience in the context of national health security and a set of eight levers and five core components for building resilience. They then describe suggested activities that communities are pursuing and may want to strengthen for community resilience, and they identify challenges to implementation.

Building Community Resilience to Disasters

PubMed Central

Chandra, Anita; Acosta, Joie; Howard, Stefanie; Uscher-Pines, Lori; Williams, Malcolm; Yeung, Douglas; Garnett, Jeffrey; Meredith, Lisa S.

2011-01-01

Abstract Community resilience, or the sustained ability of a community to withstand and recover from adversity, has become a key policy issue at federal, state, and local levels, including in the National Health Security Strategy. Because resources are limited in the wake of an emergency, it is increasingly recognized that resilience is critical to a community's ability to reduce long recovery periods after an emergency. This article shares details of a report that provides a roadmap for federal, state, and local leaders who are developing plans to enhance community resilience for health security threats and describes options for building community resilience in key areas. Based on findings from a literature review and a series of community and regional focus groups, the authors provide a definition of community resilience in the context of national health security and a set of eight levers and five core components for building resilience. They then describe suggested activities that communities are pursuing and may want to strengthen for community resilience, and they identify challenges to implementation. PMID:28083162

From war on terror to war on weather? Rethinking humanitarianism in a new era of chronic emergencies.

PubMed

Munslow, Barry; O'Dempsey, Tim

2010-01-01

This special issue of Third World Quarterly makes a case for redirecting attention and resources away from the 'war on terror' and focussing as a matter of urgency on the causes and consequences of global climate change. Global climate change must be recognised as an issue of national and international security. Increased competition for scarce resources and migration are key factors in the propagation of many of today's chronic complex humanitarian emergencies. The relentless growth of megacities in natural disaster hotspots places unprecedented numbers of vulnerable people at risk of disease and death. The Earth's fragile ecosystem has reached a critical tipping point. Today's most urgent need is for a collective endeavour on the part of the international community to redirect resources, enterprise and creativity away from the war on terror and to earnestly redeploy these in seeking solutions to the far greater and increasingly imminent threats that confront us as a consequence of global climate change.

Exploration of metastability and hidden phases in correlated electron crystals visualized by femtosecond optical doping and electron crystallography

PubMed Central

Han, Tzong-Ru T.; Zhou, Faran; Malliakas, Christos D.; Duxbury, Phillip M.; Mahanti, Subhendra D.; Kanatzidis, Mercouri G.; Ruan, Chong-Yu

2015-01-01

Characterizing and understanding the emergence of multiple macroscopically ordered electronic phases through subtle tuning of temperature, pressure, and chemical doping has been a long-standing central issue for complex materials research. We report the first comprehensive studies of optical doping–induced emergence of stable phases and metastable hidden phases visualized in situ by femtosecond electron crystallography. The electronic phase transitions are triggered by femtosecond infrared pulses, and a temperature–optical density phase diagram is constructed and substantiated with the dynamics of metastable states, highlighting the cooperation and competition through which the macroscopic quantum orders emerge. These results elucidate key pathways of femtosecond electronic switching phenomena and provide an important new avenue to comprehensively investigate optical doping–induced transition states and phase diagrams of complex materials with wide-ranging applications. PMID:26601190

Drivers, dynamics, and control of emerging vector-borne zoonotic diseases

PubMed Central

Kilpatrick, A. Marm; Randolph, Sarah E.

2013-01-01

Emerging vector-borne diseases represent an important issue for global health. Many vector-borne pathogens have appeared in new regions in the past two decades, and many endemic diseases have increased in incidence. Although introductions and local emergence are frequently considered distinct processes, many emerging endemic pathogens are in fact invading at a local scale coincident with habitat change. We highlight key differences in the dynamics and disease burden that result from increased pathogen transmission following habitat change compared with the introduction of pathogens to new regions. Truly in situ emergence is commonly driven by changes in human factors as much as by enhanced enzootic cycles whereas pathogen invasion results from anthropogenic trade and travel and suitable conditions for a pathogen, including hosts, vectors, and climate. Once established, ecological factors related to vector characteristics shape the evolutionary selective pressure on pathogens that may result in increased use of humans as transmission hosts. We describe challenges inherent in the control of vector-borne zoonotic diseases and some emerging non-traditional strategies that may be more effective in the long term. PMID:23200503

Peto's paradox and the promise of comparative oncology

PubMed Central

Nunney, Leonard; Maley, Carlo C.; Breen, Matthew; Hochberg, Michael E.; Schiffman, Joshua D.

2015-01-01

The past several decades have seen a paradigm shift with the integration of evolutionary thinking into studying cancer. The evolutionary lens is most commonly employed in understanding cancer emergence, tumour growth and metastasis, but there is an increasing realization that cancer defences both between tissues within the individual and between species have been influenced by natural selection. This special issue focuses on discoveries of these deeper evolutionary phenomena in the emerging area of ‘comparative oncology’. Comparing cancer dynamics in different tissues or species can lead to insights into how biology and ecology have led to differences in carcinogenesis, and the diversity, incidence and lethality of cancers. In this introduction to the special issue, we review the history of the field and outline how the contributions use empirical, comparative and theoretical approaches to address the processes and patterns associated with ‘Peto's paradox’, the lack of a statistical relationship of cancer incidence with body size and longevity. This burgeoning area of research can help us understand that cancer is not only a disease but is also a driving force in biological systems and species life histories. Comparative oncology will be key to understanding globally important health issues, including cancer epidemiology, prevention and improved therapies. PMID:26056361

[On the issue of organization of consultative medical care on hospital stage].

PubMed

2011-01-01

The study picked out several groups of in-demand specialties of consulting physicians. It is proposed to elaborate specific model of hospital consultative medical care providing the possibility of counseling by the most in-demand specialists already on the level of admission department. The key target is to avoid the involvement of less in-demand specialists at the expense of organization the specialized consultative crew on the basis on emergency medical care.

Long-term trends in climate and hydrology in an agricultural headwater watershed of central Pennsylvania, USA

Treesearch

Ray B. Bryant; Haiming Lu; Kyle R. Elkin; Anthony R. Buda; Amy S. Collick; Gordon J. Folmar; Peter J. Kleinman

2016-01-01

Climate change has emerged as a key issue facing agriculture and water resources in the US. Long-term (1968-2012) temperature, precipitation and streamflow data from a small (7.3 km2) watershed in east-central Pennsylvania was used to examine climatic and hydrologic trends in the context of recent climate change. Annual mean temperatures increased 0.38°C per decade,...

Technologies for Achieving Field Ubiquitous Computing

NASA Astrophysics Data System (ADS)

Nagashima, Akira

Although the term “ubiquitous” may sound like jargon used in information appliances, ubiquitous computing is an emerging concept in industrial automation. This paper presents the author's visions of field ubiquitous computing, which is based on the novel Internet Protocol IPv6. IPv6-based instrumentation will realize the next generation manufacturing excellence. This paper focuses on the following five key issues: 1. IPv6 standardization; 2. IPv6 interfaces embedded in field devices; 3. Compatibility with FOUNDATION fieldbus; 4. Network securities for field applications; and 5. Wireless technologies to complement IP instrumentation. Furthermore, the principles of digital plant operations and ubiquitous production to support the above key technologies to achieve field ubiquitous systems are discussed.

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.

Prototype Training Materials for Acceptance Criteria of Maintenance ASAP Events Occurring Within Social Context

NASA Technical Reports Server (NTRS)

Taylor, J. C.

2004-01-01

The aviation maintenance community is at a crossroads with respect to implementing the Aviation Safety Action Program (ASAP). While there is considerable interest, several key issues have emerged that cast doubt on how to assure a successful implementation, including buy-in from all levels of the company and training for key participants. There are two objectives for the present report. The first is to provide an examination of limits (or more properly, examples) of the degree of acceptability of more problematic events for risk-based decisions within the current ASAP guidelines. The second objective is to apply these limits of community standards to a set of further refined ASAP training scenarios.

Framing global health: the governance challenge.

PubMed

McInnes, Colin; Kamradt-Scott, Adam; Lee, Kelley; Reubi, David; Roemer-Mahler, Anne; Rushton, Simon; Williams, Owain David; Woodling, Marie

2012-01-01

With the emergence of global health comes governance challenges which are equally global in nature. This article identifies some of the initial limitations in analyses of global health governance (GHG) before discussing the focus of this special supplement: the framing of global health issues and the manner in which this impacts upon GHG. Whilst not denying the importance of material factors (such as resources and institutional competencies), the article identifies how issues can be framed in different ways, thereby creating particular pathways of response which in turn affect the potential for and nature of GHG. It also identifies and discusses the key frames operating in global health: evidence-based medicine, human rights, security, economics and development.

“I Need my Own Place to get Better”: Patient Perspectives on the Role of Housing in Potentially Preventable Hospitalizations

PubMed Central

Quensell, Michelle L.; Taira, Deborah A.; Seto, Todd B.; Braun, Kathryn L.; Sentell, Tetine L.

2017-01-01

Objective To analyze patient perspectives on the role of housing in their potentially preventable hospitalization. Methods Individuals admitted with cardiovascular-or diabetes-related diagnoses (n = 90) in a major medical center in Hawai‘i completed an in-person interview eliciting patient perspectives on key factors leading to hospitalization. Using the framework approach, two independent coders identified themes. This study focused on housing-related findings. Results Overall, 23% of participants reported housing as a precipitating factor to their hospitalization, including 12 with no regular place to stay. Four housing-related themes emerged: challenges meeting basic needs, complex chronic care management difficulties, stigma and relationship with provider, and stress and other mental health issues. Discussion Almost 25% of patients identified housing as a key factor to their hospital stay. Patient-reported themes highlight specific mechanisms by which housing challenges may lead to hospitalization. Addressing housing issues could help reduce the number and associated cost burden of preventable hospitalizations. PMID:28529224

Effects of Educational Messaging on Urgent and Emergent Care–Seeking Behaviors Among Publicly Insured Populations

PubMed Central

Cambon, Jesse; Cordier, Tristan; Munnich, Elizabeth L.; Renda, Andrew; Kapur, Bobby; Hoxhaj, Shkelzen; Williams, Meredith

2018-01-01

Background The impact of messaging campaigns on influencing urgent care– and emergent care–seeking behaviors, including the use of in-network providers, is not well-understood. Although out-of-network healthcare utilization can have negative financial consequences for patients in narrow network Affordable Care Act plans, individuals with time-sensitive medical conditions, and especially patients visiting the emergency department, may not think about out-of-network issues. Inappropriate or avoidable emergency department visits can also create unnecessary costs for patients. Objective To evaluate the impact of 5 messaging strategies to educate individuals about the use of in-network providers and when care should be sought in the emergency department, urgent care center, or other sites of care. Methods Using a retrospective analysis, individuals aged ≥18 years who were enrolled in an individually purchased Affordable Care Act–compliant Humana plan as of July 1, 2015, were randomized to 1 of 5 messaging arms (e-mail, magnet mailer with or without e-mail, and key-tag mailer with or without e-mail) or to a control group. The outreach was implemented and evaluated in 2 distinct, geographically defined populations of Orlando, Palm Beach, and Tampa, Florida (Population 1); and Atlanta, Georgia, and San Antonio and Austin, Texas (Population 2). The relative number of each emergency department, urgent care, and out-of-network visits during follow-up was modeled using negative binomial regression. Cox proportional hazard models were used to calculate the risk for ≥1 of each visit type (assessed separately) and high emergency department utilization (defined as ≥3 visits during follow-up) relative to the control, while accounting for variable follow-up time. Results The relative numbers of each visit type assessed were not significantly different for any message group compared with the control in either population. The risk for an emergency department visit was 4% lower in the e-mail arm of Population 2 (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.94–0.99; P = .005) and 7% lower in the e-mail/key-tag arm of Population 1 (HR, 0.93; 95% CI, 0.89–0.97; P = .001). The risk for high emergency department utilization was significantly reduced by the key-tag, magnet, and e-mail/key-tag strategies in Population 1, but no impact was found in Population 2. Conclusion Despite the mixed results, the study provides new insights into how different messaging strategies could be used to educate patients and influence healthcare utilization decisions by people with health insurance. PMID:29915641

Summary of the EMA Joint Regulators/Industry QbD workshop (London, UK; 28-29 January 2014).

PubMed

Cook, Graham; France, Georges; Holte, Øyvind; Lorenti, Giampiero; Tainsh, David

2016-01-01

This paper summarizes the discussions and insights gained from the key themes that emerged during the Quality by Design (QbD) Workshop held at the European Medicines Agency (EMA) offices in London, UK, on 28-29 January 2014. Industry and regulators shared practical experiences from six case studies (five approved small molecule products and one phase 3 biotechnological product) based on QbD submissions by five companies (AstraZeneca, GlaxoSmithKline, Novartis, NovoNordisk, and Pfizer).The case studies covered a range of different development, regulatory submission, and post-approval aspects of QbD and were developed through confidential discussions between the company representatives and regulators. Key themes that emerged from the workshop discussions were: 1. presentation of information in submissions (development story and the presentation of information in marketing authorization applications; risk assessment and criticality); 2. development aspects (design space; use of models; control strategy); and 3. post-approval aspects (lifecycle management; dossier-quality system interactions; handling of deviations). Many aspects of QbD for biotechnological products are similar to small molecules, but there are some important differences highlighted in this paper.The final section of the paper discusses some proposals for future developments to address the issues that were identified. This paper summarizes the discussions and insights gained from the key themes that emerged during the Quality by Design (QbD) Workshop held at the European Medicines Agency offices in London, UK, on 28-29 January 2014. Industry and regulators shared practical experiences from six case studies (five approved small-molecule products and one phase 3 biotechnological product) based on QbD submissions by five companies (AstraZeneca, GlaxoSmithKline, Novartis, NovoNordisk, and Pfizer).The case studies covered a range of different development, regulatory submission, and post-approval aspects of QbD and were developed through confidential discussions between the company representatives and regulators. Key themes that emerged from the workshop discussions were: 1. presentation of information in submissions (development story and the presentation of information in marketing authorization applications; risk assessment and criticality); 2. development aspects (design space; use of models; control strategy); and 3. post-approval aspects (lifecycle management; dossier-quality system interactions; handling of deviations). Many aspects of QbD for biotechnological products are similar to small molecules, but there are some important differences highlighted in this paper.The final section of the paper discusses some proposals for future developments to address the issues that were identified. © PDA, Inc. 2016.

GOVERNING GENETIC DATABASES: COLLECTION, STORAGE AND USE

PubMed Central

Gibbons, Susan M.C.; Kaye, Jane

2008-01-01

This paper provides an introduction to a collection of five papers, published as a special symposium journal issue, under the title: “Governing Genetic Databases: Collection, Storage and Use”. It begins by setting the scene, to provide a backdrop and context for the papers. It describes the evolving scientific landscape around genetic databases and genomic research, particularly within the biomedical and criminal forensic investigation fields. It notes the lack of any clear, coherent or coordinated legal governance regime, either at the national or international level. It then identifies and reflects on key cross-cutting issues and themes that emerge from the five papers, in particular: terminology and definitions; consent; special concerns around population genetic databases (biobanks) and forensic databases; international harmonisation; data protection; data access; boundary-setting; governance; and issues around balancing individual interests against public good values. PMID:18841252

National GAP Conference 2007-Discussion Groups Report

USGS Publications Warehouse

Ratz, Joan M.; Lamb, Berton Lee

2010-01-01

We led two discussion groups during the 2007 National GAP Conference. These discussion groups provided information to help develop a survey of National Gap Analysis Program (GAP) data users. One group discussed technical issues, and the second group discussed the use of GAP data for decisionmaking. Themes emerging from the technical issues group included concerns about data quality, need for information on how to use data, and passive data distribution. The decisionmaking discussion included a wide range of topics including the need to understand presentation of information, the need to connect with and understand users of data, the revision of GAP's mission, and the adaptability of products and data. The decisionmaking group also raised concerns regarding technical issues. One conclusion is that a deep commitment to ongoing information transfer and support is a key component of success for the GAP program.

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

PubMed Central

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

2011-01-01

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

75 FR 44781 - Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

...; File No. 265-26] Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues AGENCY: Commodity... Meeting of Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues. SUMMARY: The Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues will hold a public meeting on August 11, 2010, from 9 a.m...

75 FR 66362 - Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-28

...; File No. 265-26] Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues AGENCY: Commodity... meeting of Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues. SUMMARY: The Joint CFTC-SEC Advisory Committee on Emerging Regulatory Issues will hold a public meeting on November 5, 2010, from 9 a.m...

Global quality imaging: emerging issues.

PubMed

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

2011-07-01

Quality imaging may be described as "a timely access to and delivery of integrated and appropriate procedures, in a safe and responsive practice, and a prompt delivery of an accurately interpreted report by capable personnel in an efficient, effective, and sustainable manner." For this article, radiation safety is considered as one of the key quality elements. The stakeholders are the drivers of quality imaging. These include those that directly provide or use imaging procedures and others indirectly supporting the system. Imaging is indispensable in health care, and its use has greatly expanded worldwide. Globalization, consumer sophistication, communication and technological advances, corporatization, rationalization, service outsourcing, teleradiology, workflow modularization, and commoditization are reshaping practice. This article defines the emerging issues; an earlier article in the May 2011 issue described possible improvement actions. The issues that could threaten the quality use of imaging for all countries include workforce shortage; increased utilization, population radiation exposure, and cost; practice changes; and efficiency drive and budget constraints. In response to these issues, a range of quality improvement measures, strategies, and actions are used to maximize the benefits and minimize the risks. The 3 measures are procedure justification, optimization of image quality and radiation protection, and error prevention. The development and successful implementation of such improvement actions require leadership, collaboration, and the active participation of all stakeholders to achieve the best outcomes that we all advocate. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

SAFRR Tsunami Scenarios and USGS-NTHMP Collaboration

NASA Astrophysics Data System (ADS)

Ross, S.; Wood, N. J.; Cox, D. A.; Jones, L.; Cheung, K. F.; Chock, G.; Gately, K.; Jones, J. L.; Lynett, P. J.; Miller, K.; Nicolsky, D.; Richards, K.; Wein, A. M.; Wilson, R. I.

2015-12-01

Hazard scenarios provide emergency managers and others with information to help them prepare for future disasters. The SAFRR Tsunami Scenario, published in 2013, modeled a hypothetical but plausible tsunami, created by an Mw9.1 earthquake occurring offshore from the Alaskan peninsula, and its impacts on the California coast. It presented the modeled inundation areas, current velocities in key ports and harbors, physical damage and repair costs, economic consequences, environmental impacts, social vulnerability, emergency management, and policy implications for California associated with the scenario tsunami. The intended users were those responsible for making mitigation decisions before and those who need to make rapid decisions during future tsunamis. It provided the basis for many exercises involving, among others, NOAA, the State of Washington, several counties in California, and the National Institutes of Health. The scenario led to improvements in the warning protocol for southern California and highlighted issues that led to ongoing work on harbor and marina safety. Building on the lessons learned in the SAFRR Tsunami Scenario, another tsunami scenario is being developed with impacts to Hawaii and to the source region in Alaska, focusing on the evacuation issues of remote communities with primarily shore parallel roads, and also on the effects of port closures. Community exposure studies in Hawaii (Ratliff et al., USGS-SIR, 2015) provided background for selecting these foci. One complicated and important aspect of any hazard scenario is defining the source event. The USGS is building collaborations with the National Tsunami Hazard Mitigation Program (NTHMP) to consider issues involved in developing a standardized set of tsunami sources to support hazard mitigation work. Other key USGS-NTHMP collaborations involve population vulnerability and evacuation modeling.

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

NASA Technical Reports Server (NTRS)

Davison, Hayley J.; Hansman, R. John

2001-01-01

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

A Survey of Workplace Violence Across 65 U.S. Emergency Departments

PubMed Central

Kansagra, Susan M.; Rao, Sowmya R.; Sullivan, Ashley F.; Gordon, James A.; Magid, David J.; Kaushal, Rainu; Camargo, Carlos A.; Blumenthal, David

2012-01-01

Objectives Workplace violence is a concerning issue. Healthcare workers represent a significant portion of the victims, especially those who work in the emergency department (ED). The objective of this study was to examine ED workplace violence and staff perceptions of physical safety. Methods Data were obtained from the National Emergency Department Safety Study (NEDSS), which surveyed staff across 69 U.S. EDs including physicians, residents, nurses, nurse practitioners, and physician assistants. The authors also conducted surveys of key informants (one from each site) including ED chairs, medical directors, nurse managers, and administrators. The main outcome measures included physical attacks against staff, frequency of guns or knives in the ED, and staff perceptions of physical safety. Results A total of 5,695 staff surveys were distributed, and 3,518 surveys from 65 sites were included in the final analysis. One-fourth of surveyed ED staff reported feeling safe sometimes, rarely, or never. Key informants at the sampled EDs reported a total of 3,461 physical attacks (median of 11 attacks per ED) over the 5-year period. Key informants at 20% of EDs reported that guns or knives were brought to the ED on a daily or weekly basis. In multivariate analysis, nurses were less likely to feel safe “most of the time” or “always” when compared to other surveyed staff. Conclusions This study showed that violence and weapons in the ED are common, and nurses were less likely to feel safe than other ED staff. PMID:18976337

Screening and detection of elder abuse: Research opportunities and lessons learned from emergency geriatric care, intimate partner violence, and child abuse.

PubMed

Beach, Scott R; Carpenter, Christopher R; Rosen, Tony; Sharps, Phyllis; Gelles, Richard

2016-01-01

This article provides an overview of elder abuse screening and detection methods for community-dwelling and institutionalized older adults, including general issues and challenges for the field. Then, discussions of applications in emergency geriatric care, intimate partner violence (IPV), and child abuse are presented to inform research opportunities in elder abuse screening. The article provides descriptions of emerging screening and detection methods and technologies from the emergency geriatric care and IPV fields. We also discuss the variety of potential barriers to effective screening and detection from the viewpoint of the older adult, caregivers, providers, and the health care system, and we highlight the potential harms and unintended negative consequences of increased screening and mandatory reporting. We argue that research should continue on the development of valid screening methods and tools, but that studies of perceived barriers and potential harms of elder abuse screening among key stakeholders should also be conducted.

Grief and Women: Stillbirth in the Social Context of India

PubMed Central

Roberts, Lisa R.; Anderson, Barbara A.; Lee, Jerry W.; Montgomery, Susanne B.

2015-01-01

INTRODUCTION Few in Western society would argue the potentially devastating impact of stillbirth related grief; but in many developing countries where stillbirth remains the highest in the world, perinatal grief is barely recognized as an issue. The purpose of this study was to explore how poor, rural central Indian women perceive and cope with stillbirths. METHODS Seventeen key informant interviews and two focus groups (N = 33) with local health care providers, family members, and women who experienced stillbirth were conducted over a 1-month period in 2011 and then systematically coded for emerging themes using grounded theory methods to explore how women experienced stillbirth. RESULTS Although usually never talked about and not recognized as an issue, perinatal grief emerged as a significant shared experience by all. The perceptions of stillbirth-related grief emerged in three major themes and bear evidence of gender and power issues and indicate that local social norms negatively factor heavily into their perinatal grief experiences. DISCUSSION The findings in this richly textured study add to the limited literature regarding rural, central Indian women's experiences with stillbirth and factors influencing their resulting perinatal grief. In light of the void of recognition of this phenomenon in Indian society, a better understanding of the context in which poor Indian women experience perinatal grief will be a first step toward developing much needed culturally rooted interventions to positively impact the women's abilities to better cope with stillbirth in the context of their realities. PMID:26594592

Implantable electronics: emerging design issues and an ultra light-weight security solution.

PubMed

Narasimhan, Seetharam; Wang, Xinmu; Bhunia, Swarup

2010-01-01

Implantable systems that monitor biological signals require increasingly complex digital signal processing (DSP) electronics for real-time in-situ analysis and compression of the recorded signals. While it is well-known that such signal processing hardware needs to be implemented under tight area and power constraints, new design requirements emerge with their increasing complexity. Use of nanoscale technology shows tremendous benefits in implementing these advanced circuits due to dramatic improvement in integration density and power dissipation per operation. However, it also brings in new challenges such as reliability and large idle power (due to higher leakage current). Besides, programmability of the device as well as security of the recorded information are rapidly becoming major design considerations of such systems. In this paper, we analyze the emerging issues associated with the design of the DSP unit in an implantable system. Next, we propose a novel ultra light-weight solution to address the information security issue. Unlike the conventional information security approaches like data encryption, which come at large area and power overhead and hence are not amenable for resource-constrained implantable systems, we propose a multilevel key-based scrambling algorithm, which exploits the nature of the biological signal to effectively obfuscate it. Analysis of the proposed algorithm in the context of neural signal processing and its hardware implementation shows that we can achieve high level of security with ∼ 13X lower power and ∼ 5X lower area overhead than conventional cryptographic solutions.

Revitalizing Personalized Medicine: Respecting Biomolecular Complexities Beyond Gene Expression

PubMed Central

Jayachandran, D; Ramkrishna, U; Skiles, J; Renbarger, J; Ramkrishna, D

2014-01-01

Despite recent advancements in “omic” technologies, personalized medicine has not realized its fullest potential due to isolated and incomplete application of gene expression tools. In many instances, pharmacogenomics is being interchangeably used for personalized medicine, when actually it is one of the many facets of personalized medicine. Herein, we highlight key issues that are hampering the advancement of personalized medicine and highlight emerging predictive tools that can serve as a decision support mechanism for physicians to personalize treatments. PMID:24739991

RNAi-based GM plants: food for thought for risk assessors.

PubMed

Ramon, Matthew; Devos, Yann; Lanzoni, Anna; Liu, Yi; Gomes, Ana; Gennaro, Andrea; Waigmann, Elisabeth

2014-12-01

RNA interference (RNAi) is an emerging technology that offers new opportunities for the generation of new traits in genetically modified (GM) plants. Potential risks associated with RNAi-based GM plants and issues specific to their risk assessment were discussed during an international scientific workshop (June 2014) organized by the European Food Safety Authority (EFSA). Selected key outcomes of the workshop are reported here. © 2014 Society for Experimental Biology, Association of Applied Biologists and John Wiley & Sons Ltd.

Recommendations for Nanomedicine Human Subjects Research Oversight: An Evolutionary Approach for an Emerging Field

PubMed Central

Fatehi, Leili; Wolf, Susan M.; McCullough, Jeffrey; Hall, Ralph; Lawrenz, Frances; Kahn, Jeffrey P.; Jones, Cortney; Campbell, Stephen A.; Dresser, Rebecca S.; Erdman, Arthur G.; Haynes, Christy L.; Hoerr, Robert A.; Hogle, Linda F.; Keane, Moira A.; Khushf, George; King, Nancy M.P.; Kokkoli, Efrosini; Marchant, Gary; Maynard, Andrew D.; Philbert, Martin; Ramachandran, Gurumurthy; Siegel, Ronald A.; Wickline, Samuel

2015-01-01

The nanomedicine field is fast evolving toward complex, “active,” and interactive formulations. Like many emerging technologies, nanomedicine raises questions of how human subjects research (HSR) should be conducted and the adequacy of current oversight, as well as how to integrate concerns over occupational, bystander, and environmental exposures. The history of oversight for HSR investigating emerging technologies is a patchwork quilt without systematic justification of when ordinary oversight for HSR is enough versus when added oversight is warranted. Nanomedicine HSR provides an occasion to think systematically about appropriate oversight, especially early in the evolution of a technology, when hazard and risk information may remain incomplete. This paper presents the consensus recommendations of a multidisciplinary, NIH-funded project group, to ensure a science-based and ethically informed approach to HSR issues in nanomedicine, and integrate HSR analysis with analysis of occupational, bystander, and environmental concerns. We recommend creating two bodies, an interagency Human Subjects Research in Nanomedicine (HSR/N) Working Group and a Secretary’s Advisory Committee on Nanomedicine (SAC/N). HSR/N and SAC/N should perform 3 primary functions: (1) analysis of the attributes and subsets of nanomedicine interventions that raise HSR challenges and current gaps in oversight; (2) providing advice to relevant agencies and institutional bodies on the HSR issues, as well as federal and federal-institutional coordination; and (3) gathering and analyzing information on HSR issues as they emerge in nanomedicine. HSR/N and SAC/N will create a home for HSR analysis and coordination in DHHS (the key agency for relevant HSR oversight), optimize federal and institutional approaches, and allow HSR review to evolve with greater knowledge about nanomedicine interventions and greater clarity about attributes of concern. PMID:23289677

Using a Delphi approach to develop a strategy for A&E in defence nursing.

PubMed

Kenward, Gary; Berry, Andy; Despres, Julian; McLeod, Judith

The Armed Forces has seen an increase in the number of operational deployments overseas and a greater demand for Accident and Emergency (A&E) trained nurses. This article describes a modified Delphi study used to contribute to the development of a strategy for emergency nursing in the Defence Nursing Services. Twenty-eight A&E specialists took part and the key issues raised were recruitment and retention, staff development, new roles, research priorities, increased internal recruitment of A&E nurses to meet operational demands, and the need for a structured career pathway to help retention. The most pressing areas requiring research were evaluation of the nurse practitioner role, clinical competencies and managing heat injuries in the operational setting. The modified Delphi study provided a valuable and detailed insight into the challenges and aspirations of the military A&E nursing cadre and has assisted in developing a strategy for emergency nursing.

Information technologies and the sharing of disaster knowledge: the critical role of professional culture.

PubMed

Marincioni, Fausto

2007-12-01

A comparative survey of a diverse sample of 96 US and Italian emergency management agencies shows that the diffusion of new information technologies (IT) has transformed disaster communications. Although these technologies permit access to and the dissemination of massive amounts of disaster information with unprecedented speed and efficiency, barriers rooted in the various professional cultures still hinder the sharing of disaster knowledge. To be effective the available IT must be attuned to the unique settings and professional cultures of the local emergency management communities. Findings show that available technology, context, professional culture and interaction are key factors that affect the knowledge transfer process. Cultural filters appear to influence emergency managers' perceptions of their own professional roles, their vision of the applicability of technology to social issues, and their perspective on the transferability of disaster knowledge. Four cultural approaches to the application of IT to disaster communications are defined: technocentric; geographic,; anthropocentric; and ecocentric.

Developmental models for estimating ecological responses to environmental variability: structural, parametric, and experimental issues.

PubMed

Moore, Julia L; Remais, Justin V

2014-03-01

Developmental models that account for the metabolic effect of temperature variability on poikilotherms, such as degree-day models, have been widely used to study organism emergence, range and development, particularly in agricultural and vector-borne disease contexts. Though simple and easy to use, structural and parametric issues can influence the outputs of such models, often substantially. Because the underlying assumptions and limitations of these models have rarely been considered, this paper reviews the structural, parametric, and experimental issues that arise when using degree-day models, including the implications of particular structural or parametric choices, as well as assumptions that underlie commonly used models. Linear and non-linear developmental functions are compared, as are common methods used to incorporate temperature thresholds and calculate daily degree-days. Substantial differences in predicted emergence time arose when using linear versus non-linear developmental functions to model the emergence time in a model organism. The optimal method for calculating degree-days depends upon where key temperature threshold parameters fall relative to the daily minimum and maximum temperatures, as well as the shape of the daily temperature curve. No method is shown to be universally superior, though one commonly used method, the daily average method, consistently provides accurate results. The sensitivity of model projections to these methodological issues highlights the need to make structural and parametric selections based on a careful consideration of the specific biological response of the organism under study, and the specific temperature conditions of the geographic regions of interest. When degree-day model limitations are considered and model assumptions met, the models can be a powerful tool for studying temperature-dependent development.

Collective movement in ecology: from emerging technologies to conservation and management.

PubMed

Westley, Peter A H; Berdahl, Andrew M; Torney, Colin J; Biro, Dora

2018-05-19

Recent advances in technology and quantitative methods have led to the emergence of a new field of study that stands to link insights of researchers from two closely related, but often disconnected disciplines: movement ecology and collective animal behaviour. To date, the field of movement ecology has focused on elucidating the internal and external drivers of animal movement and the influence of movement on broader ecological processes. Typically, tracking and/or remote sensing technology is employed to study individual animals in natural conditions. By contrast, the field of collective behaviour has quantified the significant role social interactions play in the decision-making of animals within groups and, to date, has predominantly relied on controlled laboratory-based studies and theoretical models owing to the constraints of studying interacting animals in the field. This themed issue is intended to formalize the burgeoning field of collective movement ecology which integrates research from both movement ecology and collective behaviour. In this introductory paper, we set the stage for the issue by briefly examining the approaches and current status of research in these areas. Next, we outline the structure of the theme issue and describe the obstacles collective movement researchers face, from data acquisition in the field to analysis and problems of scale, and highlight the key contributions of the assembled papers. We finish by presenting research that links individual and broad-scale ecological and evolutionary processes to collective movement, and finally relate these concepts to emerging challenges for the management and conservation of animals on the move in a world that is increasingly impacted by human activity.This article is part of the theme issue 'Collective movement ecology'. © 2018 The Author(s).

Quality of life in HIV/AIDS.

PubMed

Basavaraj, K H; Navya, M A; Rashmi, R

2010-07-01

Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected persons. Existing data suggest that physical manifestations, antiretroviral therapy, psychological well-being, social support systems, coping strategies, spiritual well-being, and psychiatric comorbidities are important predictors of QOL in this population. Consequently, the impact of HIV infection on the dimensions of QOL, including physical and emotional well-being, social support systems, and life roles, has emerged as a key issue for persons infected with HIV.

Quality of life in HIV/AIDS

PubMed Central

Basavaraj, K. H.; Navya, M. A.; Rashmi, R.

2010-01-01

Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected persons. Existing data suggest that physical manifestations, antiretroviral therapy, psychological well-being, social support systems, coping strategies, spiritual well-being, and psychiatric comorbidities are important predictors of QOL in this population. Consequently, the impact of HIV infection on the dimensions of QOL, including physical and emotional well-being, social support systems, and life roles, has emerged as a key issue for persons infected with HIV. PMID:21716787

BIM Based Virtual Environment for Fire Emergency Evacuation

PubMed Central

Rezgui, Yacine; Ong, Hoang N.

2014-01-01

Recent building emergency management research has highlighted the need for the effective utilization of dynamically changing building information. BIM (building information modelling) can play a significant role in this process due to its comprehensive and standardized data format and integrated process. This paper introduces a BIM based virtual environment supported by virtual reality (VR) and a serious game engine to address several key issues for building emergency management, for example, timely two-way information updating and better emergency awareness training. The focus of this paper lies on how to utilize BIM as a comprehensive building information provider to work with virtual reality technologies to build an adaptable immersive serious game environment to provide real-time fire evacuation guidance. The innovation lies on the seamless integration between BIM and a serious game based virtual reality (VR) environment aiming at practical problem solving by leveraging state-of-the-art computing technologies. The system has been tested for its robustness and functionality against the development requirements, and the results showed promising potential to support more effective emergency management. PMID:25197704

Networks as systems.

PubMed

Best, Allan; Berland, Alex; Greenhalgh, Trisha; Bourgeault, Ivy L; Saul, Jessie E; Barker, Brittany

2018-03-19

Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders. Sampling was purposive and at a senior level, focusing on board members, executive directors, funders, and academics. Data were analyzed thematically with reference to systems theory and Shiffman's theory of network development. Findings Five key lessons emerged: effective management and leadership are critical; networks need to balance "tight" and "loose" approaches to their structure and processes; an active communication strategy is key to create and maintain support; the goals, priorities, and membership must be carefully focused; and the network needs to support shared measurement of progress on agreed-upon goals. Shiffman's middle-range network theory is a useful tool when guided by the principles of complex systems that illuminate dynamic situations and shifting interests as global alliances evolve. Research limitations/implications This study was implemented at the end of the ten-year funding cycle. A more continuous evaluation throughout the term would have provided richer understanding of issues. Experience and perspectives at the country level were not assessed. Practical implications Design and management of large, complex networks requires ongoing attention to key issues like leadership, and flexible structures and processes to accommodate the dynamic reality of these networks. Originality/value This case study builds on growing interest in the role of networks to foster large-scale change. The particular value rests on the longitudinal perspective on the evolution of a large, complex global network, and the use of theory to guide understanding.

The challenge of spin–orbit-tuned ground states in iridates: a key issues review

NASA Astrophysics Data System (ADS)

Cao, Gang; Schlottmann, Pedro

2018-04-01

Effects of spin–orbit interactions in condensed matter are an important and rapidly evolving topic. Strong competition between spin–orbit, on-site Coulomb and crystalline electric field interactions in iridates drives exotic quantum states that are unique to this group of materials. In particular, the ‘J eff  =  ½’ Mott state served as an early signal that the combined effect of strong spin–orbit and Coulomb interactions in iridates has unique, intriguing consequences. In this Key Issues Review, we survey some current experimental studies of iridates. In essence, these materials tend to defy conventional wisdom: absence of conventional correlations between magnetic and insulating states, avoidance of metallization at high pressures, ‘S-shaped’ I–V characteristic, emergence of an odd-parity hidden order, etc. It is particularly intriguing that there exist conspicuous discrepancies between current experimental results and theoretical proposals that address superconducting, topological and quantum spin liquid phases. This class of materials, in which the lattice degrees of freedom play a critical role seldom seen in other materials, evidently presents some profound intellectual challenges that call for more investigations both experimentally and theoretically. Physical properties unique to these materials may help unlock a world of possibilities for functional materials and devices. We emphasize that, given the rapidly developing nature of this field, this Key Issues Review is by no means an exhaustive report of the current state of experimental studies of iridates.

The Dawning of the Ethics of Environmental Robots.

PubMed

van Wynsberghe, Aimee; Donhauser, Justin

2017-10-23

Environmental scientists and engineers have been exploring research and monitoring applications of robotics, as well as exploring ways of integrating robotics into ecosystems to aid in responses to accelerating environmental, climatic, and biodiversity changes. These emerging applications of robots and other autonomous technologies present novel ethical and practical challenges. Yet, the critical applications of robots for environmental research, engineering, protection and remediation have received next to no attention in the ethics of robotics literature to date. This paper seeks to fill that void, and promote the study of environmental robotics. It provides key resources for further critical examination of the issues environmental robots present by explaining and differentiating the sorts of environmental robotics that exist to date and identifying unique conceptual, ethical, and practical issues they present.

Labour migration and the single European market: a synthetic and prospective note.

PubMed

Ardittis, S

1990-12-01

"The present paper is an attempt to analyse and forecast the following major issues relating to migration in Europe after 1992: (i) the evolution and structure of intra-European flows in the forthcoming single European market; (ii) the integration, after 1992, of established immigrant communities, including ethnic minorities and second generation groups; (iii) future immigration from non-EC member states.... The article explains that, in addition to policy-related mutations inherent in the completion of the internal market, other factors (demographic changes and insufficient enrolment of national graduate students in key disciplines) and issues (emergence of atypical groups such as second generation and Eastern European migrants), are due to generate new patterns and modified interests in European labour migration after 1992." excerpt

International recruitment of health workers: British lessons for Europe? Emerging concerns and future research recommendations.

PubMed

Lozano, Mariona; Meardi, Guglielmo; Martín-Artiles, Antonio

2015-01-01

Immigration as a solution to staff and skill shortages in the health system is increasingly on the agenda in the European Union. This article highlights the related social and policy dilemmas by comparing a new destination country with an old destination country: Spain and the United Kingdom. After describing the challenges met by the United Kingdom, we ask how well-prepared Spain is to face the same issues. In particular, attention is paid to the occupational mobility of health workers after entry and to how immigration as a staffing solution poses new political and social challenges. Through a review of background information regarding the immigration of health workers in the two countries and the preliminary analysis of 15 exploratory interviews, we aim to identify the primary trends and key concerns for future analysis. Although our interviews only allow us to draw tentative conclusions, they do highlight emerging issues to be explored in the near future. Our conclusions show that many of the problems traditionally encountered in the United Kingdom are now emerging in Spain, suggesting scope for further collaboration among government, employers, and other stakeholders across the European Union. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

Parametric Modeling of the Safety Effects of NextGen Terminal Maneuvering Area Conflict Scenarios

NASA Technical Reports Server (NTRS)

Rogers, William H.; Waldron, Timothy P.; Stroiney, Steven R.

2011-01-01

The goal of this work was to analytically identify and quantify the issues, challenges, technical hurdles, and pilot-vehicle interface issues associated with conflict detection and resolution (CD&R)in emerging operational concepts for a NextGen terminal aneuvering area, including surface operations. To this end, the work entailed analytical and trade studies focused on modeling the achievable safety benefits of different CD&R strategies and concepts in the current and future airport environment. In addition, crew-vehicle interface and pilot performance enhancements and potential issues were analyzed based on review of envisioned NextGen operations, expected equipage advances, and human factors expertise. The results of perturbation analysis, which quantify the high-level performance impact of changes to key parameters such as median response time and surveillance position error, show that the analytical model developed could be useful in making technology investment decisions.

Dancing around death: hospitalist-patient communication about serious illness.

PubMed

Anderson, Wendy G; Kools, Susan; Lyndon, Audrey

2013-01-01

Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient's understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues.

Dancing Around Death: Hospitalist-Patient Communication About Serious Illness

PubMed Central

Anderson, Wendy G.; Kools, Susan; Lyndon, Audrey

2012-01-01

Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient’s understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues. PMID:23034778

Issues deserve attention in encapsulating probiotics: Critical review of existing literature.

PubMed

Chen, Jun; Wang, Qi; Liu, Cheng-Mei; Gong, Joshua

2017-04-13

Probiotic bacteria are being increasingly added to food for developing products with health-promoting properties. However, the efficacy of probiotics in commercial products is often questioned due to the loss of their viability during shelf storage and in human gastrointestinal tracts. Encapsulation of probiotics has been expected to provide protection to probiotics, but not many commercial products contain encapsulated and viable probiotic cells owing to various reasons. To promote the development and application of encapsulation technologies, this paper has critically reviewed previous publications with a focus on the areas where studies have fallen short, including insufficient consideration of structural effects of encapsulating material, general defects in encapsulating methods and issues in evaluation methodologies and risk assessments for application. Corresponding key issues that require further studies are highlighted. Some emerging trends in the field, such as current treads in encapsulating material and recently advanced encapsulation techniques, have also been discussed.

Handling Emergency Management in [an] Object Oriented Modeling Environment

NASA Technical Reports Server (NTRS)

Tokgoz, Berna Eren; Cakir, Volkan; Gheorghe, Adrian V.

2010-01-01

It has been understood that protection of a nation from extreme disasters is a challenging task. Impacts of extreme disasters on a nation's critical infrastructures, economy and society could be devastating. A protection plan itself would not be sufficient when a disaster strikes. Hence, there is a need for a holistic approach to establish more resilient infrastructures to withstand extreme disasters. A resilient infrastructure can be defined as a system or facility that is able to withstand damage, but if affected, can be readily and cost-effectively restored. The key issue to establish resilient infrastructures is to incorporate existing protection plans with comprehensive preparedness actions to respond, recover and restore as quickly as possible, and to minimize extreme disaster impacts. Although national organizations will respond to a disaster, extreme disasters need to be handled mostly by local emergency management departments. Since emergency management departments have to deal with complex systems, they have to have a manageable plan and efficient organizational structures to coordinate all these systems. A strong organizational structure is the key in responding fast before and during disasters, and recovering quickly after disasters. In this study, the entire emergency management is viewed as an enterprise and modelled through enterprise management approach. Managing an enterprise or a large complex system is a very challenging task. It is critical for an enterprise to respond to challenges in a timely manner with quick decision making. This study addresses the problem of handling emergency management at regional level in an object oriented modelling environment developed by use of TopEase software. Emergency Operation Plan of the City of Hampton, Virginia, has been incorporated into TopEase for analysis. The methodology used in this study has been supported by a case study on critical infrastructure resiliency in Hampton Roads.

Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses

PubMed Central

Gutmanis, Iris; Beynon, Charlene; Tutty, Leslie; Wathen, C Nadine; MacMillan, Harriet L

2007-01-01

Background Intimate partner violence against women (IPV) has been identified as a serious public health problem. Although the health care system is an important site for identification and intervention, there have been challenges in determining how health care professionals can best address this issue in practice. We surveyed nurses and physicians in 2004 regarding their attitudes and behaviours with respect to IPV, including whether they routinely inquire about IPV, as well as potentially relevant barriers, facilitators, experiential, and practice-related factors. Methods A modified Dillman Tailored Design approach was used to survey 1000 nurses and 1000 physicians by mail in Ontario, Canada. Respondents were randomly selected from professional directories and represented practice areas pre-identified from the literature as those most likely to care for women at the point of initial IPV disclosure: family practice, obstetrics and gynecology, emergency care, maternal/newborn care, and public health. The survey instrument had a case-based scenario followed by 43 questions asking about behaviours and resources specific to woman abuse. Results In total, 931 questionnaires were returned; 597 by nurses (59.7% response rate) and 328 by physicians (32.8% response rate). Overall, 32% of nurses and 42% of physicians reported routinely initiating the topic of IPV in practice. Principal components analysis identified eight constructs related to whether routine inquiry was conducted: preparedness, self-confidence, professional supports, abuse inquiry, practitioner consequences of asking, comfort following disclosure, practitioner lack of control, and practice pressures. Each construct was analyzed according to a number of related issues, including clinician training and experience with woman abuse, area of practice, and type of health care provider. Preparedness emerged as a key construct related to whether respondents routinely initiated the topic of IPV. Conclusion The present study provides new insight into the factors that facilitate and impede clinicians' decisions to address the issue of IPV with their female patients. Inadequate preparation, both educational and experiential, emerged as a key barrier to routine inquiry, as did the importance of the "real world" pressures associated with the daily context of primary care practice. PMID:17250771

What factors influence physiotherapy service provision in rural communities? A pilot study.

PubMed

Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

2014-06-01

To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

Structural violence and marginalisation. The sexual and reproductive health experiences of separated young people on the move. A rapid review with relevance to the European humanitarian crisis.

PubMed

Mason-Jones, A J; Nicholson, P

2018-05-01

To explore the main sexual and reproductive health (SRH) issues for separated young migrants. We conducted a rapid review. The search for articles published between 2000 and June 2017 including peer-reviewed and 'grey' published literature from a range of databases including MEDLINE, AMED, Embase, ASSIA, Scopus, Web of Science and websites of international organisations (Missing Children Alliance, United Nations Population Fund (UNFPA), World Health Organization (WHO), United Nations Human Rights Council (UNHRC), Human Rights Watch, United Nations Children's Fund (UNICEF) and FBX Centre for Health and Human Rights) took place over 4 months. Themes emerging from the included studies and articles were synthesised. We found 44 articles from a range of countries of which 64% were peer-reviewed and 36% were from 'grey' literature. Structural violence and marginalisation were the key analytical themes that emerged and included young people's vulnerability to violence, unmet knowledge and service needs, barriers and stigma and poor SRH outcomes. This is the first known review to summarise the key SRH issues for separated young migrants. As Europe hosts the greatest number of separated young people in recent history, their unique SRH concerns risk being overlooked. Public health practitioners and policy makers are encouraged to challenge the gaps that exist in their services. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

"Through the looking glass": optical physics, issues, and the evolution of neuroendoscopy.

PubMed

Zada, Gabriel; Liu, Charles; Apuzzo, Michael L J

2013-02-01

Although the concept of endoscopy has existed for centuries, a practical, working neuroendoscopic system did not emerge until last century, as a result of numerous contributions and refinements in optical technology, illumination sources, and instrumentation. Modern neuroendoscopy would not be a flourishing field, as it is today, without the dedication, innovation, and implementation of emerging technology by key contributors including Maximilian Nitze, Walter Dandy, and Harold Hopkins. Despite several inherent and unique limitations, neuroendoscopic surgery is now performed for a variety of intraventricular, skull base, and spinal operations. In this review, the history of neuroendoscopy, key players who envisioned how the inner workings of the human body could be visualized "through the looking glass," and current state and future potential for neuroendoscopic surgery are discussed. Future directions of neuroendoscopic surgery will likely be guided by further miniaturization in camera and optical technology, innovations in surgical instrumentation design, the introduction of robotics, multi-port minimally invasive surgery, and an enhanced ability to perform bimanual microdissection. Copyright © 2012 Elsevier Inc. All rights reserved.

Models of Integrating Physical Therapists into Family Health Teams in Ontario, Canada: Challenges and Opportunities

PubMed Central

Mandoda, Shilpa; Landry, Michel D.

2011-01-01

ABSTRACT Purpose: To explore the potential for different models of incorporating physical therapy (PT) services within the emerging network of family health teams (FHTs) in Ontario and to identify challenges and opportunities of each model. Methods: A two-phase mixed-methods qualitative descriptive approach was used. First, FHTs were mapped in relation to existing community-based PT practices. Second, semi-structured key-informant interviews were conducted with representatives from urban and rural FHTs and from a variety of community-based PT practices. Interviews were digitally recorded, transcribed verbatim, and analyzed using a categorizing/editing approach. Results: Most participants agreed that the ideal model involves embedding physical therapists directly into FHTs; in some situations, however, partnering with an existing external PT provider may be more feasible and sustainable. Access and funding remain the key issues, regardless of the model adopted. Conclusion: Although there are differences across the urban/rural divide, there exist opportunities to enhance and optimize existing delivery models so as to improve client access and address emerging demand for community-based PT services. PMID:22654231

Integration of Technology-based Behavioral Health Interventions in Substance Abuse and Addiction Services

PubMed Central

Ramsey, Alex

2015-01-01

The past decade has witnessed revolutionary changes to the delivery of health services, ushered in to a great extent by the introduction of electronic health record systems. More recently, a new class of technological advancements—technology-based behavioral health interventions, which involve the delivery of evidence-informed practices via computers, web-based applications, mobile phones, wearable sensors, or other technological platforms—has emerged and is primed to once again radically shift current models for behavioral healthcare. Despite the promise and potential of these new therapeutic approaches, a greater understanding of the impact of technology-based interventions on cornerstone issues of mental health and addiction services—namely access, quality, and cost—is needed. The current review highlights 1) relevant conceptual frameworks that guide this area of research, 2) key studies that inform the relevance of technology-based interventions for behavioral healthcare access, quality, and cost, 3) pressing methodological issues that require attention, 4) unresolved questions that warrant further investigation, and 5) practical implications that underscore important new directions for this emerging area of research. PMID:26161047

Integration of Technology-based Behavioral Health Interventions in Substance Abuse and Addiction Services.

PubMed

Ramsey, Alex

2015-08-01

The past decade has witnessed revolutionary changes to the delivery of health services, ushered in to a great extent by the introduction of electronic health record systems. More recently, a new class of technological advancements-technology-based behavioral health interventions, which involve the delivery of evidence-informed practices via computers, web-based applications, mobile phones, wearable sensors, or other technological platforms-has emerged and is primed to once again radically shift current models for behavioral healthcare. Despite the promise and potential of these new therapeutic approaches, a greater understanding of the impact of technology-based interventions on cornerstone issues of mental health and addiction services-namely access, quality, and cost -is needed. The current review highlights 1) relevant conceptual frameworks that guide this area of research, 2) key studies that inform the relevance of technology-based interventions for behavioral healthcare access, quality, and cost, 3) pressing methodological issues that require attention, 4) unresolved questions that warrant further investigation, and 5) practical implications that underscore important new directions for this emerging area of research.

A qualitative meta-synthesis of emergency department staff experiences of violence and aggression.

PubMed

Ashton, Rebecca Angharad; Morris, Lucy; Smith, Ian

2018-01-08

Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue. A meta-ethnographic approach was used to review papers. Four concepts were identified: 'The inevitability of violence and aggression'; 'Staff judgments about why they face violence and aggression'; 'Managing in isolation'; and 'Wounded heroes'. Staff resigned themselves to the inevitability of violence and aggression, doing this due to a perceived lack of support from the organisation. Staff made judgements about the reasons for violent incidents which impacted on how they coped and subsequently tolerated the aggressor. Staff often felt isolated when managing violence and aggression. Key recommendations included: Staff training in understanding violence and aggression and clinical supervision. Violence and aggression in the ED can often be an overwhelming yet inevitable experience for staff. A strong organisational commitment to reducing violence and aggression is imperative. Copyright © 2017 Elsevier Ltd. All rights reserved.

Distributed virtual environment for emergency medical training

NASA Astrophysics Data System (ADS)

Stytz, Martin R.; Banks, Sheila B.; Garcia, Brian W.; Godsell-Stytz, Gayl M.

1997-07-01

In many professions where individuals must work in a team in a high stress environment to accomplish a time-critical task, individual and team performance can benefit from joint training using distributed virtual environments (DVEs). One professional field that lacks but needs a high-fidelity team training environment is the field of emergency medicine. Currently, emergency department (ED) medical personnel train by using words to create a metal picture of a situation for the physician and staff, who then cooperate to solve the problems portrayed by the word picture. The need in emergency medicine for realistic virtual team training is critical because ED staff typically encounter rarely occurring but life threatening situations only once in their careers and because ED teams currently have no realistic environment in which to practice their team skills. The resulting lack of experience and teamwork makes diagnosis and treatment more difficult. Virtual environment based training has the potential to redress these shortfalls. The objective of our research is to develop a state-of-the-art virtual environment for emergency medicine team training. The virtual emergency room (VER) allows ED physicians and medical staff to realistically prepare for emergency medical situations by performing triage, diagnosis, and treatment on virtual patients within an environment that provides them with the tools they require and the team environment they need to realistically perform these three tasks. There are several issues that must be addressed before this vision is realized. The key issues deal with distribution of computations; the doctor and staff interface to the virtual patient and ED equipment; the accurate simulation of individual patient organs' response to injury, medication, and treatment; and an accurate modeling of the symptoms and appearance of the patient while maintaining a real-time interaction capability. Our ongoing work addresses all of these issues. In this paper we report on our prototype VER system and its distributed system architecture for an emergency department distributed virtual environment for emergency medical staff training. The virtual environment enables emergency department physicians and staff to develop their diagnostic and treatment skills using the virtual tools they need to perform diagnostic and treatment tasks. Virtual human imagery, and real-time virtual human response are used to create the virtual patient and present a scenario. Patient vital signs are available to the emergency department team as they manage the virtual case. The work reported here consists of the system architectures we developed for the distributed components of the virtual emergency room. The architectures we describe consist of the network level architecture as well as the software architecture for each actor within the virtual emergency room. We describe the role of distributed interactive simulation and other enabling technologies within the virtual emergency room project.

Plant mediated green synthesis: modified approaches.

PubMed

Das, Ratul Kumar; Brar, Satinder Kaur

2013-11-07

Plant mediated green synthesis of different metallic nanoparticles has emerged as one of the options for implementation of green chemistry principles, and successfully made an important contribution towards green nanotechnology. However, beyond the synthesis and application aspects, the science of green synthesis has carried some wrong perceptions in an unforeseen fashion. In this review, some of the key issues related to the green synthesis of metallic nanoparticles employing plants as reducing/capping agents have been addressed. Random selection of plants and its overall impact on the different aspects of green synthesis have been discussed. Emphasis is given to the setting of some standard selection criteria to be adopted for selecting a plant for use in green synthesis. How selection of a plant can positively or negatively influence both procedure and products of a green synthesis process is the prime concern of this article. In addition to selection, the key issue of biocompatibility associated with green synthesized metallic nanoparticles has been considered. Both selection of plant and biocompatibility were reconsidered for their minute details in terms of synthesis, analysis and data interpretation in the green synthesis approach. The key factors capable of fine tuning the core meaning of "green" in the synthesis of any metallic nanoparticles were taken into consideration. This article is an effort towards keeping the core meaning of green synthesis.

Behaviour change for better health: nutrition, hygiene and sustainability.

PubMed

Newson, Rachel S; Lion, Rene; Crawford, Robert J; Curtis, Valerie; Elmadfa, Ibrahim; Feunekes, Gerda I J; Hicks, Cheryl; van Liere, Marti; Lowe, C Fergus; Meijer, Gert W; Pradeep, B V; Reddy, K Srinath; Sidibe, Myriam; Uauy, Ricardo

2013-01-01

As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled 'Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability'. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today's environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes - particularly in developing and emerging countries - imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public-private partnerships.

Behaviour change for better health: nutrition, hygiene and sustainability

PubMed Central

2013-01-01

As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled ‘Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability’. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today’s environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes – particularly in developing and emerging countries – imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public–private partnerships. PMID:23530770

Making sense in a complex landscape: how the Cynefin Framework from Complex Adaptive Systems Theory can inform health promotion practice.

PubMed

Van Beurden, Eric K; Kia, Annie M; Zask, Avigdor; Dietrich, Uta; Rose, Lauren

2013-03-01

Health promotion addresses issues from the simple (with well-known cause/effect links) to the highly complex (webs and loops of cause/effect with unpredictable, emergent properties). Yet there is no conceptual framework within its theory base to help identify approaches appropriate to the level of complexity. The default approach favours reductionism--the assumption that reducing a system to its parts will inform whole system behaviour. Such an approach can yield useful knowledge, yet is inadequate where issues have multiple interacting causes, such as social determinants of health. To address complex issues, there is a need for a conceptual framework that helps choose action that is appropriate to context. This paper presents the Cynefin Framework, informed by complexity science--the study of Complex Adaptive Systems (CAS). It introduces key CAS concepts and reviews the emergence and implications of 'complex' approaches within health promotion. It explains the framework and its use with examples from contemporary practice, and sets it within the context of related bodies of health promotion theory. The Cynefin Framework, especially when used as a sense-making tool, can help practitioners understand the complexity of issues, identify appropriate strategies and avoid the pitfalls of applying reductionist approaches to complex situations. The urgency to address critical issues such as climate change and the social determinants of health calls for us to engage with complexity science. The Cynefin Framework helps practitioners make the shift, and enables those already engaged in complex approaches to communicate the value and meaning of their work in a system that privileges reductionist approaches.

Drinking water and health research: a look to the future in the United States and globally.

PubMed

Sobsey, Mark D

2006-01-01

Drinking water supplies continue to be a major source of human disease and death globally because many of them remain unsafe and vulnerable. Greater efforts are needed to address the key issues and questions which influence the provision of safe drinking water. Efforts are needed to re-evaluate and set new and better priorities for drinking water research and practice. More stakeholders need to be included in the processes of identifying key issues and setting priorities for safe drinking water. The overall approach to drinking water research and the provision of safe drinking water needs to become more rational and scientific, and become more visionary and anticipatory of the ever-present and emerging risks to drinking water safety. Collectively, we need to do a better job of making safe water available, accessible and affordable for all. One such approach to safe water for all is household water treatment and safe storage, which is being promoted globally by the World Health Organization and many other stakeholders and partners to reduce the global burden of waterborne disease.

Space rescue system definition (system performance analysis and trades)

NASA Astrophysics Data System (ADS)

Housten, Sam; Elsner, Tim; Redler, Ken; Svendsen, Hal; Wenzel, Sheri

This paper addresses key technical issues involved in the system definition of the Assured Crew Return Vehicle (ACRV). The perspective on these issues is that of a prospective ACRV contractor, performing system analysis and trade studies. The objective of these analyses and trade studies is to develop the recovery vehicle system concept and top level requirements. The starting point for this work is the definition of the set of design missions for the ACRV. This set of missions encompasses three classes of contingency/emergency (crew illness/injury, space station catastrophe/failure, transportation element catastrophe/failure). The need is to provide a system to return Space Station crew to Earth quickly (less than 24 hours) in response to randomly occurring contingency events over an extended period of time (30 years of planned Space Station life). The main topics addressed and characterized in this paper include the following: Key Recovery (Rescue) Site Access Considerations; Rescue Site Locations and Distribution; Vehicle Cross Range vs Site Access; On-orbit Loiter Capability and Vehicle Design; and Water vs. Land Recovery.

Microorganisms: Good or Evil, MIRRI Provides Biosecurity Awareness.

PubMed

Smith, David; Martin, Dunja; Novossiolova, Tatyana

2017-03-01

The life-science community is a key stakeholder in the effort to ensure that the advances in biotechnology are not misused. Unfortunately, to date, the engagement of life scientists with issues of biosecurity has been limited. Microorganisms have been harnessed for the benefit of humankind but in the wrong hands could be used in direct or indirect acts against humans, livestock, crops, food, water infrastructure and other economically valuable entities. The Microbial Resources Research Infrastructure in its preparatory phase has addressed the topic implementing a code of conduct as part of its programme of prevention of malicious use and continues to work with the international community to raise awareness of best practice to avoid misuse of microorganisms. Biosecurity has become a major concern for several countries creating numerous activities to put in place counter measures, risk assessment, legislation and emergency response. The goal is to implement measures to protect us against malicious use of microorganisms, their products, information and technology transfer. Through this paper, we wish to discuss some of the activities that are underway, mention key educational tools and provide scientists with information on addressing biosecurity issues.

Emergency management response to a warning-level Alaska-source tsunami impacting California: Chapter J in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Miller, Kevin M.; Long, Kate

2013-01-01

This chapter is directed towards two audiences: Firstly, it targets nonemergency management readers, providing them with insight on the process and challenges facing emergency managers in responding to tsunami Warning, particularly given this “short fuse” scenario. It is called “short fuse” because there is only a 5.5-hour window following the earthquake before arrival of the tsunami within which to evaluate the threat, disseminate alert and warning messages, and respond. This action initiates a period when crisis communication is of paramount importance. An additional dynamic that is important to note is that within 15 minutes of the earthquake, the National Oceanic and Atmospheric Administration (NOAA) and the National Weather Service (NWS) will issue alert bulletins for the entire Pacific Coast. This is one-half the time actually presented by recent tsunamis from Japan, Chile, and Samoa. Second, the chapter provides emergency managers at all levels with insights into key considerations they may need to address in order to augment their existing plans and effectively respond to tsunami events. We look at emergency management response to the tsunami threat from three perspectives:“Top Down” (Threat analysis and Alert/Warning information from the Federal agency charged with Alert and Warning) “Bottom Up” (Emergency management’s Incident Command approach to responding to emergencies and disasters based on the needs of impacted local jurisdictions) “Across Time” (From the initiating earthquake event through emergency response) We focus on these questions: What are the government roles, relationships, and products that support Tsunami Alert and Warning dissemination? (Emergency Planning and Preparedness.) What roles, relationships, and products support emergency management response to Tsunami Warning and impact? (Engendering prudent public safety response.) What are the key emergency management activities, considerations, and challenges brought out by the SAFRR tsunami scenario? (Real emergencies) How do these activities, considerations, and challenges play out as the tsunami event unfolds across the “life” of the event? (Lessons)

An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

PubMed

Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

2017-01-01

Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

Emerging perspectives in social neuroscience and neuroeconomics of aging

PubMed Central

Mather, Mara

2011-01-01

This article introduces the special issue of ‘Social Cognitive and Affective Neuroscience’ on Aging Research, and offers a broad conceptual and methodological framework for considering advances in life course research in social neuroscience and neuroeconomics. The authors highlight key areas of inquiry where aging research is raising new insights about how to conceptualize and examine critical questions about the links between cognition, emotion and motivation in social and economic behavior, as well as challenges that need to be addressed when taking a life course perspective in these fields. They also point to several emerging approaches that hold the potential for addressing these challenges, through bridging approaches from laboratory and population-based science, bridging inquiry across life stages and expanding measurement of core psychological phenotypes. PMID:21482573

Infrastructure to support learning health systems: are we there yet? Innovative solutions and lessons learned from American Recovery and Reinvestment Act CER investments.

PubMed

Holve, Erin; Segal, Courtney

2014-11-01

The 11 big health data networks participating in the AcademyHealth Electronic Data Methods Forum represent cutting-edge efforts to harness the power of big health data for research and quality improvement. This paper is a comparative case study based on site visits conducted with a subset of these large infrastructure grants funded through the Recovery Act, in which four key issues emerge that can inform the evolution of learning health systems, including the importance of acknowledging the challenges of scaling specialized expertise needed to manage and run CER networks; the delicate balance between privacy protections and the utility of distributed networks; emerging community engagement strategies; and the complexities of developing a robust business model for multi-use networks.

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

PubMed

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

2015-01-01

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

Analysis Insights: Energy Storage - Possibilities for Expanding Electric Grid Flexibility

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

2016-02-01

NREL Analysis Insights mines our body of analysis work to synthesize topical insights and key findings. In this issue, we explore energy storage and the role it is playing and could potentially play in increasing grid flexibility and renewable energy integration. We explore energy storage as one building block for a more flexible power system, policy and R and D as drivers of energy storage deployment, methods for valuing energy storage in grid applications, ways that energy storage supports renewable integration, and emerging opportunities for energy storage in the electric grid.

Satellite Networks: Architectures, Applications, and Technologies

NASA Technical Reports Server (NTRS)

Bhasin, Kul (Compiler)

1998-01-01

Since global satellite networks are moving to the forefront in enhancing the national and global information infrastructures due to communication satellites' unique networking characteristics, a workshop was organized to assess the progress made to date and chart the future. This workshop provided the forum to assess the current state-of-the-art, identify key issues, and highlight the emerging trends in the next-generation architectures, data protocol development, communication interoperability, and applications. Presentations on overview, state-of-the-art in research, development, deployment and applications and future trends on satellite networks are assembled.

Industrial Waste Heat Recovery - Potential Applications, Available Technologies and Crosscutting R&D Opportunities

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

Thekdi, Arvind; Nimbalkar, Sachin U.

2015-01-01

The purpose of this report was to explore key areas and characteristics of industrial waste heat and its generation, barriers to waste heat recovery and use, and potential research and development (R&D) opportunities. The report also provides an overview of technologies and systems currently available for waste heat recovery and discusses the issues or barriers for each. Also included is information on emerging technologies under development or at various stages of demonstrations, and R&D opportunities cross-walked by various temperature ranges, technology areas, and energy-intensive process industries.

Valve-regulated lead/acid batteries

NASA Astrophysics Data System (ADS)

Rand, D. A. J.; Holden, L. S.; May, G. J.; Newnham, R. H.; Peters, K.

Given the growing importance of valve-regulated lead/acid technology in many existing and emerging market areas, an expert panel was assembled at the Sixth Asian Battery Conference to answer questions from delegates on various technical and operational aspects of such batteries. Key issues included: advantantages; performance and reliability; thermal runaway; and failure modes. The interaction between the audience and the panel was both vigorous and informative. Overwhelmingly, it was agreed that valve-regulated technology has come of age and offers a dynamic solution to many of the world's energy-storage requirements and opportunities.

Worldwide Emerging Environmental Issues Affecting the U.S. Military. January 2010 Report

DTIC Science & Technology

2010-01-01

key farmland in Africa on a long-term basis. The report notes that it is critical to ensure that such contracts promote shared food security ...Technological Advances with Environmental Security Implications………………..4 6.1 New Detection and Cleanup Techniques…………………………………………...…4 6.2...Regulatory Regime might be adjusted to Include Nanomaterials…..6 7.2 Monopoly over Rare Earth Elements Raises Security and Environmental Concerns…..7

Diagnosing acute pulmonary embolism with computed tomography: imaging update.

PubMed

Devaraj, Anand; Sayer, Charlie; Sheard, Sarah; Grubnic, Sisa; Nair, Arjun; Vlahos, Ioannis

2015-05-01

Acute pulmonary embolism is recognized as a difficult diagnosis to make. It is potentially fatal if undiagnosed, yet increasing referral rates for imaging and falling diagnostic yields are topics which have attracted much attention. For patients in the emergency department with suspected pulmonary embolism, computed tomography pulmonary angiography (CTPA) is the test of choice for most physicians, and hence radiology has a key role to play in the patient pathway. This review will outline key aspects of the recent literature regarding the following issues: patient selection for imaging, the optimization of CTPA image quality and dose, preferred pathways for pregnant patients and other subgroups, and the role of CTPA beyond diagnosis. The role of newer techniques such as dual-energy CT and single-photon emission-CT will also be discussed.

Unnatural selection: talent identification and development in sport.

PubMed

Abbott, Angela; Button, Chris; Pepping, Gert-Jan; Collins, Dave

2005-01-01

The early identification of talented individuals has become increasingly important across many performance domains. Current talent identification (TI) schemes in sport typically select on the basis of discrete, unidimensional measures at unstable periods in the athlete's development. In this article, the concept of talent is revised as a complex, dynamical system in which future behaviors emerge from an interaction of key performance determinants such as psychological behaviors, motor abilities, and physical characteristics. Key nonlinear dynamics concepts are related to TI approaches such as sensitivity to initial conditions, transitions, and exponential behavioral distributions. It is concluded that many TI models place an overemphasis on early identification rather than the development of potentially talented performers. A generic model of talent identification and development is proposed that addresses these issues and provides direction for future research.

Infectious diseases in oyster aquaculture require a new integrated approach

PubMed Central

Lupo, Coralie; Whittington, Richard J.

2016-01-01

Emerging diseases pose a recurrent threat to bivalve aquaculture. Recently, massive mortality events in the Pacific oyster Crassostrea gigas associated with the detection of a microvariant of the ostreid herpesvirus 1 (OsHV-1µVar) have been reported in Europe, Australia and New Zealand. Although the spread of disease is often viewed as a governance failure, we suggest that the development of protective measures for bivalve farming is presently held back by the lack of key scientific knowledge. In this paper, we explore the case for an integrated approach to study the management of bivalve disease, using OsHV-1 as a case study. Reconsidering the key issues by incorporating multidisciplinary science could provide a holistic understanding of OsHV-1 and increase the benefit of research to policymakers. PMID:26880845

Barriers to the operation of mental health legislation in Australian emergency departments: a qualitative analysis.

PubMed

Jelinek, George; Mackinlay, Claire; Weiland, Tracey; Hill, Nicole; Gerdtz, Marie

2011-06-01

This study aimed to describe the perceived barriers faced by emergency clinicians in utilising mental health legislation in Australian hospital emergency departments. A semi-structured interview methodology was used to assess what barriers emergency department doctors and nurses perceive in the operation of mental health legislation. Key findings from the interview data were drawn in accordance with the most commonly represented themes. A total of 36 interviews were conducted with 20 members of the Australasian College for Emergency Medicine and 16 members of the College for Emergency Nursing Australasia representing the various Australian jurisdictions. Most concerning to clinicians were the effects of access block and overcrowding on the appropriate use of mental health legislation, and the substandard medical care that mental health patients received as a result of long periods in the emergency department. Many respondents were concerned about the lack of applicability of mental health legislation to the emergency department environment, variation in legislation between States and Territories causing problems for clinicians working interstate, and a lack of knowledge and training in mental health legislation. Many felt that clarification of legislative issues around duty of care and intoxicated or violent patients was required. The authors conclude that access block has detrimental effects on emergency mental health care as it does in other areas of emergency medicine. Consideration should be given to uniform national mental health legislation to better serve the needs of people with mental health emergencies.

Follow-on biologics: data exclusivity and the balance between innovation and competition.

PubMed

Grabowski, Henry

2008-06-01

Legislation to create a regulatory pathway for follow-on biologics is currently being considered by the United States Congress. A critical issue in this respect is the period of data exclusivity for innovator companies before a follow-on competitor can rely in part on data obtained for an original biologic for an abbreviated approval. Given the nature of patents on biologics, the period of data exclusivity is anticipated to have a key role in determining how quickly follow-on competitors emerge, and consequently also on the time available for originator companies to recoup their investment. With this issue in mind, this article discusses factors influencing return on investment on biologic research and development. A break-even analysis for a representative portfolio of biologics provides support for a substantial data exclusivity period.

[General organizational issues in disaster health response].

PubMed

Pacifici, L E; Riccardo, F; De Rosa, A G; Pacini, A; Nardi, L; Russo, G; Scaroni, E

2007-01-01

Recent studies show how in the 2004-2005 period there has been an increase in natural disasters of 18% worldwide. According to a renowned author planning for disaster response is as valid as the starting hypothesis. The study of an inductive mental process in disaster response planning is the key to avoiding the invention and re-invention of the wheel for each emergency. Research in this field however is hampered by different factors one of which is data collection that during disaster response requires specific training. Standardization of data collection models with limitation of the number of variables is required as is taking into account problems related to people migration and subsequent sampling problems and retrospective analysis. Moreover poor attention to the training of the volunteers employed on the field is an issue to be considered.

Drug use as a driver of HIV Risks: Re-emerging and emerging issues

PubMed Central

El-Bassel, Nabila; Shaw, Stacey A.; Dasgupta, Anindita; Strathdee, Steffanie A.

2014-01-01

Purpose of Review We reviewed papers published in 2012–2013 that focused on re-emerging and emerging injection and non-injection drug use trends driving HIV risk behaviors and transmission in some parts of the world. Recent Findings While HIV incidence has declined in many countries, HIV epidemics remain at troubling levels among key drug using populations including females who inject drugs (FWID), FWID who trade sex, sex partners of people who inject drugs (SP-PWID), young PWID, and people who use non-injection drugs in a number of low- and middle- income countries such as in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa. Summary HIV epidemics occur within contexts of global economic and political forces, including poverty, human rights violations, discrimination, drug policies, trafficking, and other multi-level risk environments. Trends of injection and non-injection drug use and risk environments driving HIV epidemics in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa call for political will to improve HIV and substance use service delivery, access to combination HIV prevention, and harm reduction programs. PMID:24406532

How Can We Mobilize Action to Realize UHC in Asia?

PubMed

Akaza, Hideyuki; Kawahara, Norie; Fukuda, Takashi; Horie, Shigeo; Thabrany, Hasbullah; Nozaki, Shinjiro

2017-11-26

The 2016 World Cancer Congress, organised by UICC, was held in Paris in November 2016, under the theme “Mobilizing action – Inspiring Change.” As part of Track 4 presentations on the theme of “Strengthening cancer control: optimizing outcomes of health systems,” UICC-Asian Regional Office (UICC-ARO) held a symposium to discuss the issue of mobilizing action to realize UHC in Asia. Introducing the symposium, Hideyuki Akaza noted that universal health coverage (UHC) is included in the Sustainable Development Goals and one of the key issues for achieving UHC will be how to balance patient needs with the economic burden of cancer. Speakers from Japan and Indonesia addressed various issues, including the current status and challenges for medical economic evaluation in Asia, the importance of resource stratification, prospects for precision medicine, and the outlook for cancer control and UHC in developing and emerging countries in Asia. Key issues raised included how to respond to the rising costs of treating cancer as new and increasingly expensive drugs come to the market. Speakers and participants noted that health technology assessment programs are being developed around Asia in order to evaluate the cost-effectiveness of drugs in the face of budgetary constraints within increasingly pressurized national health systems. The importance of screening and early detection was also noted as effective means that have the potential to reduce reliance on expensive drugs for advanced cancers. The symposium was chaired jointly by Hideyuki Akaza and Shinjiro Nozaki (WHO Kobe Centre). Creative Commons Attribution License

Enabling heterogenous multi-scale database for emergency service functions through geoinformation technologies

NASA Astrophysics Data System (ADS)

Bhanumurthy, V.; Venugopala Rao, K.; Srinivasa Rao, S.; Ram Mohan Rao, K.; Chandra, P. Satya; Vidhyasagar, J.; Diwakar, P. G.; Dadhwal, V. K.

2014-11-01

Geographical Information Science (GIS) is now graduated from traditional desktop system to Internet system. Internet GIS is emerging as one of the most promising technologies for addressing Emergency Management. Web services with different privileges are playing an important role in dissemination of the emergency services to the decision makers. Spatial database is one of the most important components in the successful implementation of Emergency Management. It contains spatial data in the form of raster, vector, linked with non-spatial information. Comprehensive data is required to handle emergency situation in different phases. These database elements comprise core data, hazard specific data, corresponding attribute data, and live data coming from the remote locations. Core data sets are minimum required data including base, thematic, infrastructure layers to handle disasters. Disaster specific information is required to handle a particular disaster situation like flood, cyclone, forest fire, earth quake, land slide, drought. In addition to this Emergency Management require many types of data with spatial and temporal attributes that should be made available to the key players in the right format at right time. The vector database needs to be complemented with required resolution satellite imagery for visualisation and analysis in disaster management. Therefore, the database is interconnected and comprehensive to meet the requirement of an Emergency Management. This kind of integrated, comprehensive and structured database with appropriate information is required to obtain right information at right time for the right people. However, building spatial database for Emergency Management is a challenging task because of the key issues such as availability of data, sharing policies, compatible geospatial standards, data interoperability etc. Therefore, to facilitate using, sharing, and integrating the spatial data, there is a need to define standards to build emergency database systems. These include aspects such as i) data integration procedures namely standard coding scheme, schema, meta data format, spatial format ii) database organisation mechanism covering data management, catalogues, data models iii) database dissemination through a suitable environment, as a standard service for effective service dissemination. National Database for Emergency Management (NDEM) is such a comprehensive database for addressing disasters in India at the national level. This paper explains standards for integrating, organising the multi-scale and multi-source data with effective emergency response using customized user interfaces for NDEM. It presents standard procedure for building comprehensive emergency information systems for enabling emergency specific functions through geospatial technologies.

Evidence-based management of Kawasaki disease in the emergency department.

PubMed

Seaton, Kara K; Kharbanda, Anupam

2015-01-01

Kawasaki disease, also known as mucocutaneous lymph node syndrome, was first described in Japan in 1967. It is currently the leading cause of acquired heart disease in children in the United States. Untreated Kawasaki disease may lead to the formation of coronary artery aneurysms and sudden cardiac death in children. This vasculitis presents with fever for ≥ 5 days, plus a combination of key criteria. Because each of the symptoms commonly occurs in other childhood illnesses, the disease can be difficult to diagnose, especially in children who present with an incomplete form of the disease. At this time, the etiology of the disease remains unknown, and there is no single diagnostic test to confirm the diagnosis. This issue reviews the presentation, diagnostic criteria, and management of Kawasaki disease in the emergency department. Emergency clinicians should consider Kawasaki disease as a diagnosis in pediatric patients presenting with prolonged fever, as prompt evaluation and management can significantly decrease the risk of serious cardiac sequelae.

Medical advancements: emergency contraception (EC). Medico-legal implications of EC on adolescents.

PubMed

Signore, F; Napoletano, S; Bruti, V; di Luca, N M

2018-01-01

The article's main focus is documenting what the best options are in order to make sure that minors are allowed to play a key role in the management of issues arising from the use of emergency contraception. In that regard, there is a lack of clean-cut legislative measures and, although there are several legal and ethical norms designed to get parents or legal guardians involved in such decisions, there seems to be an increasingly widespread tendency to give weight to the minor's will, thus acknowledging her decision-making capacity. Lastly, the paper's authors undertake a thorough examination as to what the duties of doctors are, and the measures that need to be put in place in order to safeguard the minor patients' conditions. They arrive at the conclusion that emergency contraception is suitable for minors even in absence of the stated consent from their parents or guardians, but it is of utmost importance to implement adequate measures aimed at the provision of proper care, prevention and education.

A Survey Of Architectural Approaches for Managing Embedded DRAM and Non-volatile On-chip Caches

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

Mittal, Sparsh; Vetter, Jeffrey S; Li, Dong

Recent trends of CMOS scaling and increasing number of on-chip cores have led to a large increase in the size of on-chip caches. Since SRAM has low density and consumes large amount of leakage power, its use in designing on-chip caches has become more challenging. To address this issue, researchers are exploring the use of several emerging memory technologies, such as embedded DRAM, spin transfer torque RAM, resistive RAM, phase change RAM and domain wall memory. In this paper, we survey the architectural approaches proposed for designing memory systems and, specifically, caches with these emerging memory technologies. To highlight theirmore » similarities and differences, we present a classification of these technologies and architectural approaches based on their key characteristics. We also briefly summarize the challenges in using these technologies for architecting caches. We believe that this survey will help the readers gain insights into the emerging memory device technologies, and their potential use in designing future computing systems.« less

The information needs of patients receiving procedural sedation in a hospital emergency department.

PubMed

Revell, Sue; Searle, Judy; Thompson, Shona

2017-07-01

This research investigated the information needs of patients receiving ED procedural sedation to determine the best format to consistently deliver key information in a way acceptable to all involved. Of particular interest was the question concerning patients' need for receiving written information. A descriptive exploratory study gathered qualitative data through face-to-face interviews and focus groups involving patients, nurses and medical staff. Individual interviews were conducted with eight adult patients following procedural sedation. They identified very few gaps in terms of specific information they needed pertaining to procedural sedation and rejected the need for receiving information in a written format. Their information needs related to a central concern for safety and trust. Focus groups, reflecting on the findings from patients, were conducted with five ED nurses and four emergency medicine consultants/registrars who regularly provided procedural sedation. Themes that emerged from the analysis of data from all three groups identified the issues concerning patient information needs as being: competence and efficiency of staff; explanations of procedures and progress; support person presence; and medico-legal issues. The research confirms that the quality of the patient's ED experience, specifically related to procedural sedation, is enhanced by ED staff, especially nurses, providing them with ongoing and repeated verbal information relevant to their circumstances. Copyright © 2017 Elsevier Ltd. All rights reserved.

The 2017 Academic Emergency Medicine Consensus Conference: Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcomes.

PubMed

Bond, William F; Hui, Joshua; Fernandez, Rosemarie

2018-02-01

Over the past decade, emergency medicine (EM) took a lead role in healthcare simulation in part due to its demands for successful interprofessional and multidisciplinary collaboration, along with educational needs in a diverse array of cognitive and procedural skills. Simulation-based methodologies have the capacity to support training and research platforms that model micro-, meso-, and macrosystems of healthcare. To fully capitalize on the potential of simulation-based research to improve emergency healthcare delivery will require the application of rigorous methods from engineering, social science, and basic science disciplines. The Academic Emergency Medicine (AEM) Consensus Conference "Catalyzing System Change Through Healthcare Simulation: Systems, Competency, and Outcome" was conceived to foster discussion among experts in EM, engineering, and social sciences, focusing on key barriers and opportunities in simulation-based research. This executive summary describes the overall rationale for the conference, conference planning, and consensus-building approaches and outlines the focus of the eight breakout sessions. The consensus outcomes from each breakout session are summarized in proceedings papers published in this issue of Academic Emergency Medicine. Each paper provides an overview of methodologic and knowledge gaps in simulation research and identifies future research targets aimed at improving the safety and quality of healthcare. © 2017 by the Society for Academic Emergency Medicine.

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

PubMed

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

2018-04-01

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

Using complexity science and negotiation theory to resolve boundary-crossing water issues

NASA Astrophysics Data System (ADS)

Islam, Shafiqul; Susskind, Lawrence

2018-07-01

Many water governance and management issues are complex. The complexity of these issues is related to crossing of multiple boundaries: political, social and jurisdictional, as well as physical, ecological and biogeochemical. Resolution of these issues usually requires interactions of many parties with conflicting values and interests operating across multiple boundaries and scales to make decisions. The interdependence and feedback among interacting variables, processes, actors and institutions are hard to model and difficult to forecast. Thus, decision-making related to complex water problems needs be contingent and adaptive. This paper draws on a number of ideas from complexity science and negotiation theory that may make it easier to cope with the complexities and difficulties of managing boundary crossing water disputes. It begins with the Water Diplomacy Framework that was developed and tested over the past several years. Then, it uses three key ideas from complexity science (interdependence and interconnectedness; uncertainty and feedback; emergence and adaptation) and three from negotiation theory (stakeholder identification and engagement; joint fact finding; and value creation through option generation) to show how application of these ideas can help enhance effectiveness of water management.

Global perspectives on nursing and its contribution to healthcare and health policy: thoughts on an emerging policy model.

PubMed

Shamian, Judith

2014-12-01

We know from rigorous evidence that nurses can exert an incredible impact on the everyday lives of people and their health. Nurses can also contribute in much wider spheres of influence by applying their knowledge and skills to address broader issues affecting population health across communities, nations and globally. Despite the prevalence of so many vexing health and social issues, nurses often fail to think globally, or even regionally, when they are lobbying for change. And while much political influence is local, some issues are simply too complex to rely on local influence alone. Importantly in all this, we must acknowledge the ways these complex health issues are shaped by economic and political agendas and not necessarily by healthcare agendas. As such, the nursing community has to act globally and locally, both within and outside of the nursing arena. This paper explores early thinking about an evolving model of spheres--or "bubbles"--of policy influence in which nurses can and must operate to more effectively impact key global health and healthcare challenges.

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

PubMed

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

2015-10-15

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

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

PubMed Central

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

2015-01-01

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

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

Stein, Steven L.; Lesperance, Ann M.; Upton, Jaki F.

On October 9, 2008, federal, state and local policy makers, emergency managers, and medical and public health officials convened in Seattle, Washington, for a workshop on Addressing the Federal-State-Local Interface Issues During a Catastrophic Event Such as an Anthrax Attack. The day-long symposium was aimed at generating a dialogue about recovery and restoration through a discussion of the associated challenges that impact entire communities, including people, infrastructure, and critical systems. The Principal Federal Official (PFO) provided an overview of the role of the PFO in a catastrophic event. A high-level summary of an anthrax scenario was presented. The remainder ofmore » the day was focused on interactive discussions among federal, state and local emergency management experts in the areas of: • Decision-making, prioritization, and command and control • Public health/medical services • Community resiliency and continuity of government. Key topics and issues that resulted from discussions included: • Local representation in the Joint Field Office (JFO) • JFO transition to the Long-Term Recovery Office • Process for prioritization of needs • Process for regional coordination • Prioritization - process and federal/military intervention • Allocation of limited resources • Re-entry decision and consistency • Importance of maintaining a healthy hospital system • Need for a process to establish a consensus on when it is safe to re-enter. This needs to be across all jurisdictions including the military. • Insurance coverage for both private businesses and individuals • Interaction between the government and industry. The symposium was sponsored by the Interagency Biological Restoration Demonstration, a collaborative regional program jointly funded by the U.S. Department of Homeland Security and the U.S. Department of Defense. To aid the program’s efforts and inform the development of blueprint for recovery from a biological incident, this report presents the key issues identified at the symposium.« less

Discovery of 3-{5-[(6-Amino-1H-pyrazolo[3,4-b]pyridine-3-yl)methoxy]-2-chlorophenoxy}-5-chlorobenzonitrile (MK-4965): A Potent, Orally Bioavailable HIV-1 Non-Nucleoside Reverse Transcriptase Inhibitor with Improved Potency against Key Mutant Viruses

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

Tucker, Thomas J.; Sisko, John T.; Tynebor, Robert M.

2009-07-10

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) have been shown to be a key component of highly active antiretroviral therapy (HAART). The use of NNRTIs has become part of standard combination antiviral therapies producing clinical outcomes with efficacy comparable to other antiviral regimens. There is, however, a critical issue with the emergence of clinical resistance, and a need has arisen for novel NNRTIs with a broad spectrum of activity against key HIV-1 RT mutations. Using a combination of traditional medicinal chemistry/SAR analyses, crystallography, and molecular modeling, we have designed and synthesized a series of novel, highly potent NNRTIs that possess broad spectrummore » antiviral activity and good pharmacokinetic profiles. Further refinement of key compounds in this series to optimize physical properties and pharmacokinetics has resulted in the identification of 8e (MK-4965), which has high levels of potency against wild-type and key mutant viruses, excellent oral bioavailability and overall pharmacokinetics, and a clean ancillary profile.« less

Local implementation of the Essence of Care benchmarks.

PubMed

Jones, Sue

To understand clinical practice benchmarking from the perspective of nurses working in a large acute NHS trust and to determine whether the nurses perceived that their commitment to Essence of Care led to improvements in care, the factors that influenced their role in the process and the organisational factors that influenced benchmarking. An ethnographic case study approach was adopted. Six themes emerged from the data. Two organisational issues emerged: leadership and the values and/or culture of the organisation. The findings suggested that the leadership ability of the Essence of Care link nurses and the value placed on this work by the organisation were key to the success of benchmarking. A model for successful implementation of the Essence of Care is proposed based on the findings of this study, which lends itself to testing by other organisations.

Brain matters: from environmental ethics to environmental neuroethics.

PubMed

Cabrera, Laura Y; Tesluk, Jordan; Chakraborti, Michelle; Matthews, Ralph; Illes, Judy

2016-02-15

The ways in which humans affect and are affected by their environments have been studied from many different perspectives over the past decades. However, it was not until the 1970s that the discussion of the ethical relationship between humankind and the environment formalized as an academic discipline with the emergence of environmental ethics. A few decades later, environmental health emerged as a discipline focused on the assessment and regulation of environmental factors that affect living beings. Our goal here is to begin a discussion specifically about the impact of modern environmental change on biomedical and social understandings of brain and mental health, and to align this with ethical considerations. We refer to this focus as Environmental Neuroethics, offer a case study to illustrate key themes and issues, and conclude by offering a five-tier framework as a starting point of analysis.

Impact of individual behaviour change on the spread of emerging infectious diseases.

PubMed

Yan, Q L; Tang, S Y; Xiao, Y N

2018-03-15

Human behaviour plays an important role in the spread of emerging infectious diseases, and understanding the influence of behaviour changes on epidemics can be key to improving control efforts. However, how the dynamics of individual behaviour changes affects the development of emerging infectious disease is a key public health issue. To develop different formula for individual behaviour change and introduce how to embed it into a dynamic model of infectious diseases, we choose A/H1N1 and Ebola as typical examples, combined with the epidemic reported cases and media related news reports. Thus, the logistic model with the health belief model is used to determine behaviour decisions through the health belief model constructs. Furthermore, we propose 4 candidate infectious disease models without and with individual behaviour change and use approximate Bayesian computation based on sequential Monte Carlo method for model selection. The main results indicate that the classical compartment model without behaviour change and the model with average rate of behaviour change depicted by an exponential function could fit the observed data best. The results provide a new way on how to choose an infectious disease model to predict the disease prevalence trend or to evaluate the influence of intervention measures on disease control. However, sensitivity analyses indicate that the accumulated number of hospital notifications and deaths could be largely reduced as the rate of behaviour change increases. Therefore, in terms of mitigating emerging infectious diseases, both media publicity focused on how to guide people's behaviour change and positive responses of individuals are critical. Copyright © 2017 John Wiley & Sons, Ltd.

The emergency telephone conversation in the context of the older person in suicidal crisis: a qualitative study.

PubMed

Deuter, Kate; Procter, Nicholas; Rogers, John

2013-01-01

Suicide in older people is a significant public health issue with a predicted future increase. Contemporary research directs considerable attention toward physical, mental, and social risk factors that contribute to suicidality in older people; still, little is understood about the fundamental meanings that older people in suicidal crisis attribute to these factors. The aim of this qualitative study was to describe, analyze, and compare counselors' and older peoples' perceptions of the suicidal crisis during an emergency telephone conversation. Data collection consisted of individual interviews with telephone counselors (N = 7) working within an emergency mental health triage service, and listening to telephone calls (N = 14) received by the service responding to people aged 65 years and over in suicidal crisis. Triangulation of the two data sets resulted in the emergence of three key themes. We found (1) congruence in the way risk factors were perceived by counselors and communicated during telephone conversations, (2) dissension between counselors' perceptions of end-of-life issues and older people's feelings of ambivalence about wanting to die and not knowing what to do and (3) the need for working side-by-side with the older person, exploring acute changes and immediate capacity for change. An explicit focus on risk factors alone may preclude counselors from gaining a deeper understanding of suicidal crisis in an older person's life. This research has begun to capture and illuminate how telephone counselors can deliver effective crisis intervention as older people struggle and make meaning through their suffering.

Sediment source fingerprinting as an aid to catchment management: A review of the current state of knowledge and a methodological decision-tree for end-users

USGS Publications Warehouse

Collins, A.L; Pulley, S.; Foster, I.D.L; Gellis, Allen; Porto, P.; Horowitz, A.J.

2017-01-01

The growing awareness of the environmental significance of fine-grained sediment fluxes through catchment systems continues to underscore the need for reliable information on the principal sources of this material. Source estimates are difficult to obtain using traditional monitoring techniques, but sediment source fingerprinting or tracing procedures, have emerged as a potentially valuable alternative. Despite the rapidly increasing numbers of studies reporting the use of sediment source fingerprinting, several key challenges and uncertainties continue to hamper consensus among the international scientific community on key components of the existing methodological procedures. Accordingly, this contribution reviews and presents recent developments for several key aspects of fingerprinting, namely: sediment source classification, catchment source and target sediment sampling, tracer selection, grain size issues, tracer conservatism, source apportionment modelling, and assessment of source predictions using artificial mixtures. Finally, a decision-tree representing the current state of knowledge is presented, to guide end-users in applying the fingerprinting approach.

Assessing the role of mini-applications in predicting key performance characteristics of scientific and engineering applications

DOE PAGES

Barrett, R. F.; Crozier, P. S.; Doerfler, D. W.; ...

2014-09-28

Computational science and engineering application programs are typically large, complex, and dynamic, and are often constrained by distribution limitations. As a means of making tractable rapid explorations of scientific and engineering application programs in the context of new, emerging, and future computing architectures, a suite of miniapps has been created to serve as proxies for full scale applications. Each miniapp is designed to represent a key performance characteristic that does or is expected to significantly impact the runtime performance of an application program. In this paper we introduce a methodology for assessing the ability of these miniapps to effectively representmore » these performance issues. We applied this methodology to four miniapps, examining the linkage between them and an application they are intended to represent. Herein we evaluate the fidelity of that linkage. This work represents the initial steps required to begin to answer the question, ''Under what conditions does a miniapp represent a key performance characteristic in a full app?''« less

How Contexts and Issues Influence the Use of Policy-Relevant Research Syntheses: A Critical Interpretive Synthesis

PubMed Central

Moat, Kaelan A; Lavis, John N; Abelson, Julia

2013-01-01

Context Evidence briefs have emerged as a promising approach to synthesizing the best available research evidence for health system policymakers and stakeholders. An evidence brief may draw on systematic reviews and many other types of policy-relevant information, including local data and studies, to describe a problem, options for addressing it, and key implementation considerations. We conducted a systematic review to examine the ways in which context- and issue-related factors influence the perceived usefulness of evidence briefs among their intended users. Methods We used a critical interpretive synthesis approach to review both empirical and nonempirical literature and to develop a model that explains how context and issues influence policymakers’ and stakeholders’ views of the utility of evidence briefs prepared for priority policy issues. We used a “compass” question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, HealthSTAR, IPSA, MEDLINE, OAIster (gray literature), ProQuest A&I Theses, ProQuest (Sociological Abstracts, Applied Social Sciences Index and Abstracts, Worldwide Political Science Abstracts, International Bibliography of Social Sciences, PAIS, Political Science), PsychInfo, Web of Science, and WilsonWeb (Social Science Abstracts). Finally, we used a grounded and interpretive analytic approach to synthesize the results. Findings Of the 4,461 papers retrieved, 3,908 were excluded and 553 were assessed for “relevance,” with 137 included in the initial sample of papers to be analyzed and an additional 23 purposively sampled to fill conceptual gaps. Several themes emerged: (1) many established types of “evidence” are viewed as useful content in an evidence brief, along with several promising formatting features; (2) contextual factors, particularly the institutions, interests, and values of a given context, can influence views of evidence briefs; (3) whether an issue is polarizing and whether it is salient (or not) and familiar (or not) to actors in the policy arena can influence views of evidence briefs prepared for that issue; (4) influential factors can emerge in several ways (as context driven, issue driven, or a result of issue-context resonance); (5) these factors work through two primary pathways, affecting either the users or the producers of briefs; and (6) these factors influence views of evidence briefs through a variety of mechanisms. Conclusions Those persons funding and preparing evidence briefs need to consider a variety of context- and issue-related factors when deciding how to make them most useful in policymaking. PMID:24028700

Drug Abuse on College Campuses: Emerging Issues. Issues in Prevention

ERIC Educational Resources Information Center

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

2012-01-01

This "Issues in Prevention" focuses on emerging issues concerning drug abuse on college campuses. This issue contains the following articles: (1) Drug Abuse Trends; (2) Q&A With Jim Lange; (3) Bath Salts; (4) Refuse to Abuse; (5) Related Federal Resource; and (6) Higher Education Center Resources.

A Survey on Energy Conserving Mechanisms for the Internet of Things: Wireless Networking Aspects.

PubMed

Abbas, Zeeshan; Yoon, Wonyong

2015-09-25

The Internet of Things (IoT) is an emerging key technology for future industries and everyday lives of people, where a myriad of battery operated sensors, actuators, and smart objects are connected to the Internet to provide services such as mobile healthcare, intelligent transport system, environmental monitoring, etc. Since energy efficiency is of utmost importance to these battery constrained IoT devices, IoT-related standards and research works have focused on the device energy conserving issues. This paper presents a comprehensive survey on energy conserving issues and solutions in using diverse wireless radio access technologies for IoT connectivity, e.g., the 3rd Generation Partnership Project (3GPP) machine type communications, IEEE 802.11ah, Bluetooth Low Energy (BLE), and Z-Wave. We look into the literature in broad areas of standardization, academic research, and industry development, and structurally summarize the energy conserving solutions based on several technical criteria. We also propose future research directions regarding energy conserving issues in wireless networking-based IoT.

A Survey on Energy Conserving Mechanisms for the Internet of Things: Wireless Networking Aspects

PubMed Central

Abbas, Zeeshan; Yoon, Wonyong

2015-01-01

The Internet of Things (IoT) is an emerging key technology for future industries and everyday lives of people, where a myriad of battery operated sensors, actuators, and smart objects are connected to the Internet to provide services such as mobile healthcare, intelligent transport system, environmental monitoring, etc. Since energy efficiency is of utmost importance to these battery constrained IoT devices, IoT-related standards and research works have focused on the device energy conserving issues. This paper presents a comprehensive survey on energy conserving issues and solutions in using diverse wireless radio access technologies for IoT connectivity, e.g., the 3rd Generation Partnership Project (3GPP) machine type communications, IEEE 802.11ah, Bluetooth Low Energy (BLE), and Z-Wave. We look into the literature in broad areas of standardization, academic research, and industry development, and structurally summarize the energy conserving solutions based on several technical criteria. We also propose future research directions regarding energy conserving issues in wireless networking-based IoT. PMID:26404275

Neurodegenerative diseases in the era of targeted therapeutics: how to handle a tangled issue.

PubMed

Tofaris, George K; Schapira, Anthony H V

2015-05-01

Neurodegenerative diseases are age-related and relentlessly progressive with increasing prevalence and no cure or lasting symptomatic therapy. The well-recognized prodromal phase in many forms of neurodegeneration suggests a prolonged period of neuronal compensated dysfunction prior to cell loss that may be amenable to therapeutic intervention. Although most efforts to date have been focused on misfolded toxic proteins, it is now clear that widespread changes in protein homeostasis occur early in these diseases and understanding this fundamental biology is key to the design of targeted therapies. What has emerged from molecular genetics and animal studies is a previously less appreciated association of neurodegenerative diseases with defects in the molecular regulation of protein trafficking between cellular organelles, especially the intricate network of endosomes, lysosomes, autophagosomes and mitochondria. Here we summarized the broader concepts that stemmed from this Special Issue on "Protein Clearance in Neurodegenerative diseases: from mechanisms to therapies". This article is part of a Special Issue entitled 'Neuronal Protein'. Copyright © 2015 Elsevier Inc. All rights reserved.

The Contribution of Maternal Stress to Preterm Birth: Issues and Considerations

PubMed Central

Wadhwa, Pathik D.; Entringer, Sonja; Buss, Claudia; Lu, Michael C.

2011-01-01

Preterm birth represents the most significant problem in maternal-child health. The ongoing search to elucidate its underlying causes and pathophysiological mechanisms has identified maternal stress as a variable of interest. Based on emerging models of causation of complex common disorders, we suggest that the effects of maternal stress on risk of preterm birth may, for the most part, vary as a function of context. In this paper we focus on select key issues and questions that highlight the need to develop a better understanding of which particular subgroups of pregnant women, under what circumstances, and at which stage(s) of gestation, may be especially vulnerable to the potentially detrimental effects of maternal stress. Our discussion addresses issues related to the characterization and assessment of maternal stress and candidate biological (maternal-placental-fetal endocrine, immune, vascular and genetic) mechanisms. We propose the adoption of newer approaches (ecological momentary assessment) and a life-course perspective to further our understanding of the contribution of maternal stress to preterm birth. PMID:21890014

Marine Environmental Emergencies in the North Pacific Ocean: Lessons Learned from Recent Oil Spills.

PubMed

Yim, Un Hyuk; Short, Jeffrey

2017-07-01

Increasing marine vessel traffic, and oil and gas exploration and development throughout the North Pacific basin brings increasing risks of oil spills. Recognizing the serious challenges presented to response authorities, this Special Issue was organized by the North Pacific Marine Science Organization to provide an introduction to the current state of scientific understanding regarding the environmental effects of oil spills. Because interactions of spilled oils with biota and their habitats are complex, the most serious environmental damages from these spills are not necessarily those of greatest immediate concern by the public. Our overarching goal for this Special Issue is to provide an efficient introduction to the most important ways that oil spills can harm biota, habitats, and ecosystems through invited, targeted mini-reviews augmented by original research articles. We provide a brief background on the challenges posed by large oil spills to response authorities, summarize findings from the articles published in this Special Issue, and highlight some key research needs.

Invasion Science: A Horizon Scan of Emerging Challenges and Opportunities

Treesearch

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

2017-01-01

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

Patient and Physician Perceptions of Drug Safety Information for Sleep Aids: A Qualitative Study.

PubMed

Kesselheim, Aaron S; McGraw, Sarah A; Dejene, Sara Z; Rausch, Paula; Dal Pan, Gerald J; Lappin, Brian M; Zhou, Esther H; Avorn, Jerry; Campbell, Eric G

2017-06-01

The US Food and Drug Administration uses drug safety communications (DSCs) to release emerging information regarding post-market safety issues, but it is unclear the extent of awareness by patients and providers of these communications and their specific recommendations. We conducted semi-structured interviews with patients and physicians to evaluate their awareness and understanding of emerging drug safety information related to two sleep aids: zolpidem or eszopiclone. We conducted interviews with 40 patients and ten physicians recruited from a combination of insurer claims databases and online sources. We evaluated (1) sources of drug safety information; (2) discussions between patients and physicians about the two medications; (3) their knowledge of the DSC; and (4) preferences for learning about future drug safety information. Interviews were transcribed and analyzed thematically. Patients cited their physicians, pharmacy inserts, and the Internet as sources of drug safety information. Physicians often referred to medical journals and online medical sources. Most patients reported being aware of information contained in the DSC summaries they were read. Almost all patients and physicians reported discussing side effects during patient-provider conversations, but almost no patients mentioned that physicians had communicated with them key messaging from the DSCs at issue: the risk of next-morning impairment with zolpidem and the lower recommended initial dose for women. Some risks of medications are effectively communicated to patients and physicians; however, there is still a noticeable gap between information issued by the Food and Drug Administration and patient and physician awareness of this knowledge, as well as patients' decisions to act on this information. Disseminators of emerging drug safety information should explore ways of providing user-friendly resources to patients and healthcare professionals that can update them on new risks in a timely manner.

Emergency management training program: Guide to good practice

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

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

Emergency management training program: Guide to good practice

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

Not Available

1991-07-01

The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate componentsmore » of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.« less

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

Treesearch

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

1989-01-01

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

The new WHO decision-making framework on vaccine use in acute humanitarian emergencies: MSF experience in Minkaman, South Sudan.

PubMed

Rull, Monica; Masson, Sophie; Peyraud, Nicolas; Simonelli, Marco; Ventura, Alexandre; Dorion, Claire; Luquero, Francisco J; Uzzeni, Florent; Cigleneki, Iza

2018-01-01

The main causes of death during population movements can be prevented by addressing the population's basic needs. In 2013, the World Health Organization (WHO) issued a framework for decision making to help prioritize vaccinations in acute humanitarian emergencies. This article describes MSF's experience of applying this framework in addition to addressing key population needs in a displacement setting in Minkaman, South Sudan. Military clashes broke out in South Sudan in December 2013. By May 2014, Minkaman, a village in the Lakes State, hosted some 85,000 displaced people. MSF arrived in Minkaman on 28 December 2013 and immediately provided interventions to address the key humanitarian needs (health care, access to drinking water, measles vaccination). The WHO framework was used to identify priority vaccines: those preventing outbreaks (measles, polio, oral cholera vaccine, and vaccine against meningococcal meningitis A (MenAfrivac®)) and those reducing childhood morbidity and mortality (pentavalent vaccine that combines diphtheria, tetanus, whooping cough, hepatitis B, and Haemophilus influenzae type B; pneumococcal vaccine; and rotavirus vaccine). By mid-March, access to primary and secondary health care was ensured, including community health activities and the provision of safe water. Mass vaccination campaigns against measles, polio, cholera, and meningitis had been organized. Vaccination campaigns against the main deadly childhood diseases, however, were not in place owing to lack of authorization by the Ministry of Health (MoH). The first field use of the new WHO framework for prioritizing vaccines in acute emergencies is described. Although MSF was unable to implement the full package of priority vaccines because authorization could not be obtained from the MoH, a series of mass vaccination campaigns against key epidemic-prone diseases was successfully implemented within a complex emergency context. Together with covering the population's basic needs, this might have contributed to reducing mortality levels below the emergency threshold and to the absence of epidemics. For the WHO framework to be used to its full potential it must not only be adapted for field use but, most importantly, national decision makers should be briefed on the framework and its practical implementation.

Simulated interprofessional education: an analysis of teaching and learning processes.

PubMed

van Soeren, Mary; Devlin-Cop, Sandra; Macmillan, Kathleen; Baker, Lindsay; Egan-Lee, Eileen; Reeves, Scott

2011-11-01

Simulated learning activities are increasingly being used in health professions and interprofessional education (IPE). Specifically, IPE programs are frequently adopting role-play simulations as a key learning approach. Despite this widespread adoption, there is little empirical evidence exploring the teaching and learning processes embedded within this type of simulation. This exploratory study provides insight into the nature of these processes through the use of qualitative methods. A total of 152 clinicians, 101 students and 9 facilitators representing a range of health professions, participated in video-recorded role-plays and debrief sessions. Videotapes were analyzed to explore emerging issues and themes related to teaching and learning processes related to this type of interprofessional simulated learning experience. In addition, three focus groups were conducted with a subset of participants to explore perceptions of their educational experiences. Five key themes emerged from the data analysis: enthusiasm and motivation, professional role assignment, scenario realism, facilitator style and background and team facilitation. Our findings suggest that program developers need to be mindful of these five themes when using role-plays in an interprofessional context and point to the importance of deliberate and skilled facilitation in meeting desired learning outcomes.

Devolution's policy impact on non-emergency medical transportation in State Children's Health Insurance Programs.

PubMed

Borders, Stephen; Blakely, Craig; Ponder, Linda; Raphael, David

2011-01-01

Proponents of devolution often maintain that the transfer of power and authority of programs enables local officials to craft policy solutions that better align with the needs of their constituents. This article provides one of the first empirical evaluations of this assumption as it relates to non-emergency medical transportation (NEMT) in the State Children's Health Insurance Program (SCHIP). NEMT programs meet a critical need in the areas in which they serve, directly targeting this single key access barrier to care. Yet states have great latitude in making such services available. The authors utilize data from 32 states to provide a preliminary assessment of devolution's consequences and policy impact on transportation-related access to care. Their findings provide mixed evidence on devolution's impact on policy outcomes. Proponents of devolution can find solace in the fact that several states have gone beyond federally mandated minimum requirements to offer innovative programs to remove transportation barriers to care. Detractors of devolution will find continued pause on several key issues, as a number of states do not offer NEMT to their SCHIP populations while cutting services and leaving over $7 billion in federal matching funding unspent.

Lessons learned from more than two decades of research on emerging contaminants in the environment.

PubMed

Noguera-Oviedo, Katia; Aga, Diana S

2016-10-05

In the last twenty years, thousands of research papers covering different aspects of emerging contaminants have been published, ranging from environmental occurrence to treatment and ecological effects. Emerging contaminants are environmental pollutants that have been investigated widely only in the last two decades and include anthropogenic and naturally occurring chemicals such as pharmaceuticals and personal care products and their metabolites, illicit drugs, engineered nanomaterials, and antibiotic resistance genes. The advancement in our knowledge on emerging contaminants has been the result of the appearance of highly sensitive and powerful analytical instrumentation that rapidly developed, allowing identification and trace quantification of unknown contaminants in complex environmental matrices. High efficiency chromatographic separations coupled to high-resolution mass spectrometers have become more common in environmental laboratories and are the pillars of environmental research, increasing our awareness and understanding of the presence of emerging contaminants in the environment, their transformation and fate, and the complex ecological consequences that they pose on exposed biological systems. This introductory paper for the Virtual Thematic Issue on Emerging Contaminants presents a brief literature overview on key research milestones in the area of emerging contaminants, focusing on pharmaceuticals and personal care products and endocrine disrupting compounds, and highlighting selected research papers previously published in the Journal of Hazardous Materials during the period of January 2012 to December 2015. Copyright © 2016 Elsevier B.V. All rights reserved.

Application of Network Analysis to Identify and Map Relationships between Information Systems in the context of Arctic Sustainability

NASA Astrophysics Data System (ADS)

Kontar, Y. Y.

2017-12-01

The Arctic Council is an intergovernmental forum promoting cooperation, coordination and interaction among the Arctic States and indigenous communities on issues of sustainable development and environmental protection in the North. The work of the Council is primarily carried out by six Working Groups: Arctic Contaminants Action Program, Arctic Monitoring and Assessment Programme, Conservation of Arctic Flora and Fauna, Emergency Prevention, Preparedness and Response, Protection of the Arctic Marine Environment, and Sustainable Development Working Group. The Working Groups are composed of researchers and representatives from government agencies. Each Working Group issues numerous scientific assessments and reports on a broad field of subjects, from climate change to emergency response in the Arctic. A key goal of these publications is to contribute to policy-making in the Arctic. Complex networks of information systems and the connections between the diverse elements within the systems have been identified via network analysis. This allowed to distinguish data sources that were used in the composition of the primary publications of the Working Groups. Next step is to implement network analysis to identify and map the relationships between the Working Groups and policy makers in the Arctic.

Where are they now? Cash and Counseling successes and challenges over time

PubMed Central

Simon-Rusinowitz, Lori; Schwartz, Abby J.; Loughlin, Dawn; Sciegaj, Mark; Mahoney, Kevin J.; Donkoh, Yaw

2014-01-01

The positive results of the Cash & Counseling Demonstration and Evaluation (CCDE) led to the funding of a replication project that included 12 more states in 2008. Since then, the political and economic environments have changed. The authors sought to investigate how well the three original and 12 replication CCDE programs are coping with current challenges, and how their experiences may inform the growth and sustainability of emerging participant-directed programs. Semistructured telephone interviews were conducted with the 15 Cash & Counseling state program administrators. Key topics addressed included: successful aspects of state programs, biggest challenges for each program, and information program administrators would like to learn from state colleagues. Themes related to budget issues (e.g., staff shortages and program funding cuts) and non-budget related issues (e.g., understanding of program operations) emerged from the interviews. State program administrators also discussed program successes. To promote the sustainability and growth of participant-directed programs, existing participant-directed programs should be tied to national policy trends as well as review whether or not the programs address participant-directed principles. The development of new participant-directed programs should be based on other states’ experiences as discussed in this paper. PMID:25750590

Multi-stakeholder perspectives on access, availability and utilization of emergency obstetric care services in Lagos, Nigeria: A mixed-methods study

PubMed Central

Wright, Kikelomo; Sonoiki, Olatunji; Ilozumba, Onaedo; Ajayi, Babatunde; Okikiolu, Olawunmi; Akinola, Oluwarotimi

2017-01-01

Globally, Nigeria is the second most unsafe country to be pregnant, with Lagos, its economic nerve center having disproportionately higher maternal deaths than the national average. Emergency obstetric care (EmOC) is effective in reducing pregnancyrelated morbidities and mortalities. This mixed-methods study quantitatively assessed women’s satisfaction with EmOC received and qualitatively engaged multiple key stakeholders to better understand issues around EmOC access, availability and utilization in Lagos. Qualitative interviews revealed that regarding access, while government opined that EmOC facilities have been strategically built across Lagos, women flagged issues with difficulty in access, compounded by perceived high EmOC cost. For availability, though health workers were judged competent, they appeared insufficient, overworked and felt poorly remunerated. Infrastructure was considered inadequate and paucity of blood and blood products remained commonplace. Although pregnant women positively rated the clinical aspects of care, as confirmed by the survey, satisfaction gaps remained in the areas of service delivery, care organization and responsiveness. These areas of discordance offer insight to opportunities for improvements, which would ensure that every woman can access and use quality EmOC that is sufficiently available. PMID:29456825

A Hybrid Satellite-Terrestrial Approach to Aeronautical Communication Networks

NASA Technical Reports Server (NTRS)

Kerczewski, Robert J.; Chomos, Gerald J.; Griner, James H.; Mainger, Steven W.; Martzaklis, Konstantinos S.; Kachmar, Brian A.

2000-01-01

Rapid growth in air travel has been projected to continue for the foreseeable future. To maintain a safe and efficient national and global aviation system, significant advances in communications systems supporting aviation are required. Satellites will increasingly play a critical role in the aeronautical communications network. At the same time, current ground-based communications links, primarily very high frequency (VHF), will continue to be employed due to cost advantages and legacy issues. Hence a hybrid satellite-terrestrial network, or group of networks, will emerge. The increased complexity of future aeronautical communications networks dictates that system-level modeling be employed to obtain an optimal system fulfilling a majority of user needs. The NASA Glenn Research Center is investigating the current and potential future state of aeronautical communications, and is developing a simulation and modeling program to research future communications architectures for national and global aeronautical needs. This paper describes the primary requirements, the current infrastructure, and emerging trends of aeronautical communications, including a growing role for satellite communications. The need for a hybrid communications system architecture approach including both satellite and ground-based communications links is explained. Future aeronautical communication network topologies and key issues in simulation and modeling of future aeronautical communications systems are described.

Developing prehospital clinical practice guidelines for resource limited settings: why re-invent the wheel?

PubMed

McCaul, Michael; de Waal, Ben; Hodkinson, Peter; Pigoga, Jennifer L; Young, Taryn; Wallis, Lee A

2018-02-05

Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, the volume of literature is not matched by research into alternative methods of CPG development using existing CPG documents-a specific issue for guideline development groups in low- and middle-income countries. We report on how we developed a context specific prehospital CPG using an alternative guideline development method. Difficulties experienced and lessons learnt in applying existing global guidelines' recommendations to a national context are highlighted. The project produced the first emergency care CPG for prehospital providers in Africa. It included > 270 CPGs and produced over 1000 recommendations for prehospital emergency care. We encountered various difficulties, including (1) applicability issues: few pre-hospital CPGs applicable to Africa, (2) evidence synthesis: heterogeneous levels of evidence classifications and (3) guideline quality. Learning points included (1) focusing on key CPGs and evidence mapping, (2) searching other resources for CPGs, (3) broad representation on CPG advisory boards and (4) transparency and knowledge translation. Re-inventing the wheel to produce CPGs is not always feasible. We hope this paper will encourage further projects to use existing CPGs in developing guidance to improve patient care in resource-limited settings.

Health and Social Care workers' perceptions of NPS use in Northern Ireland.

PubMed

Campbell, Anne; O Neill, Nina; Higgins, Kathryn

2017-02-01

The EU Early Warning System currently monitors more than 560 new psychoactive substances, far outweighing the total number of illicit drugs under international control. Due to the recent emergence of NPS and rapidly changing nature of the market, evidence about the way in which the emerging drugs are managed in health and social care settings is limited. The study adopted a mixed methods design, utilising a cross sectional survey and telephone interviews to capture data from staff working in drug and alcohol related services in statutory and voluntary sectors, across the five Health and Social Care (HSC) Trust areas in Northern Ireland. 196 staff participated in the survey and 13 participated in follow up in telephone interviews between August and November 2015. Study respondents reported that addressing NPS related issues with service users was a key aspect of their daily role and function. Levels of injecting behaviours were also viewed as relatively high by study participants. Almost all workers used harm reduction as their primary approach when working with service users and the majority of respondents called for additional practical training in relation to addressing drug interactions and intervening with NPS related issues. Copyright © 2016 Elsevier B.V. All rights reserved.

Formation of a Volunteer Harmful Algal Bloom Network in British Columbia, Canada, Following an Outbreak of Diarrhetic Shellfish Poisoning

PubMed Central

McIntyre, Lorraine; Cassis, David; Haigh, Nicola

2013-01-01

Evidence for shellfish toxin illness in British Columbia (BC) on the west coast of Canada can be traced back to 1793. For over two hundred years, domestically acquired bivalve shellfish toxin illnesses in BC were solely ascribed to paralytic shellfish poisonings caused by algal blooms of Alexandrium. This changed in 2011, when BC experienced its first outbreak of diarrhetic shellfish poisoning (DSP). As a result of this outbreak, Canada’s first DSP symposium was held in November, 2012, in North Vancouver, BC. Three of the objectives of the symposium were to provide a forum to educate key stakeholders on this emerging issue, to identify research and surveillance priorities and to create a DSP network. The purpose of this paper is to review what is known about shellfish poisoning in BC and to describe a novel volunteer network that arose following the symposium. The newly formed network was designed for industry shellfish growers to identify harmful algae bloom events, so that they may take actions to mitigate the effects of harmful blooms on shellfish morbidity. The network will also inform public health and regulatory stakeholders of potentially emerging issues in shellfish growing areas. PMID:24172211

Infectious diseases in oyster aquaculture require a new integrated approach.

PubMed

Pernet, Fabrice; Lupo, Coralie; Bacher, Cédric; Whittington, Richard J

2016-03-05

Emerging diseases pose a recurrent threat to bivalve aquaculture. Recently, massive mortality events in the Pacific oyster Crassostrea gigas associated with the detection of a microvariant of the ostreid herpesvirus 1 (OsHV-1µVar) have been reported in Europe, Australia and New Zealand. Although the spread of disease is often viewed as a governance failure, we suggest that the development of protective measures for bivalve farming is presently held back by the lack of key scientific knowledge. In this paper, we explore the case for an integrated approach to study the management of bivalve disease, using OsHV-1 as a case study. Reconsidering the key issues by incorporating multidisciplinary science could provide a holistic understanding of OsHV-1 and increase the benefit of research to policymakers. © 2016 The Author(s).

Theorizing Land Cover and Land Use Changes: The Case of Tropical Deforestation

NASA Technical Reports Server (NTRS)

Walker, Robert

2004-01-01

This article addresses land-cover and land-use dynamics from the perspective of regional science and economic geography. It first provides an account of the so-called spatially explicit model, which has emerged in recent years as a key empirical approach to the issue. The article uses this discussion as a springboard to evaluate the potential utility of von Thuenen to the discourse on land-cover and land-use change. After identifying shortcomings of current theoretical approaches to land use in mainly urban models, the article filters a discussion of deforestation through the lens of bid-rent and assesses its effectiveness in helping us comprehend the destruction of tropical forest in the Amazon basin. The article considers the adjustments that would have to be made to existing theory to make it more useful to the empirical issues.

Why eyewitnesses fail

PubMed Central

Albright, Thomas D.

2017-01-01

Eyewitness identifications play an important role in the investigation and prosecution of crimes, but it is well known that eyewitnesses make mistakes, often with serious consequences. In light of these concerns, the National Academy of Sciences recently convened a panel of experts to undertake a comprehensive study of current practice and use of eyewitness testimony, with an eye toward understanding why identification errors occur and what can be done to prevent them. The work of this committee led to key findings and recommendations for reform, detailed in a consensus report entitled Identifying the Culprit: Assessing Eyewitness Identification. In this review, I focus on the scientific issues that emerged from this study, along with brief discussions of how these issues led to specific recommendations for additional research, best practices for law enforcement, and use of eyewitness evidence by the courts. PMID:28739937

A future for systems and computational neuroscience in France?

PubMed

Faugeras, Olivier; Frégnac, Yves; Samuelides, Manuel

2007-01-01

This special issue of the Journal of Physiology, Paris, is an outcome of NeuroComp'06, the first French conference in Computational Neuroscience. The preparation for this conference, held at Pont-à-Mousson in October 2006, was accompanied by a survey which has resulted in an up-to-date inventory of human resources and labs in France concerned with this emerging new field of research (see team directory in http://neurocomp.risc.cnrs.fr/). This thematic JPP issue gathers some of the key scientific presentations made on the occasion of this first interdisciplinary meeting, which should soon become recognized as a yearly national conference representative of a new scientific community. The present introductory paper presents the general scientific context of the conference and reviews some of the historical and conceptual foundations of Systems and Computational Neuroscience in France.

Innovation: an emerging focus from cells to societies.

PubMed

Hochberg, Michael E; Marquet, Pablo A; Boyd, Robert; Wagner, Andreas

2017-12-05

Innovations are generally unexpected, often spectacular changes in phenotypes and ecological functions. The contributions to this theme issue are the latest conceptual, theoretical and experimental developments, addressing how ecology, environment, ontogeny and evolution are central to understanding the complexity of the processes underlying innovations. Here, we set the stage by introducing and defining key terms relating to innovation and discuss their relevance to biological, cultural and technological change. Discovering how the generation and transmission of novel biological information, environmental interactions and selective evolutionary processes contribute to innovation as an ecosystem will shed light on how the dominant features across life come to be, generalize to social, cultural and technological evolution, and have applications in the health sciences and sustainability.This article is part of the theme issue 'Process and pattern in innovations from cells to societies'. © 2017 The Author(s).

Innovation: an emerging focus from cells to societies

PubMed Central

Boyd, Robert

2017-01-01

Innovations are generally unexpected, often spectacular changes in phenotypes and ecological functions. The contributions to this theme issue are the latest conceptual, theoretical and experimental developments, addressing how ecology, environment, ontogeny and evolution are central to understanding the complexity of the processes underlying innovations. Here, we set the stage by introducing and defining key terms relating to innovation and discuss their relevance to biological, cultural and technological change. Discovering how the generation and transmission of novel biological information, environmental interactions and selective evolutionary processes contribute to innovation as an ecosystem will shed light on how the dominant features across life come to be, generalize to social, cultural and technological evolution, and have applications in the health sciences and sustainability. This article is part of the theme issue ‘Process and pattern in innovations from cells to societies’. PMID:29061887

The Impact of Legalizing and Regulating Weed: Issues with Study Design and Emerging Findings in the USA.

PubMed

Hunt, Priscillia E; Miles, Jeremy

2017-01-01

Evaluations of the impact of medical and recreational marijuana laws rely on quasi- or natural experiments in which researchers exploit changes in the law and attempt to determine the impact of these changes on outcomes. This chapter reviews three key issues of causal inference in observational studies with respect to estimating of impact of medical or recreational laws on marijuana use-intervention definition, outcome measurement, and random assignment of study participants. We show that studies tend to use the same statistical approach (differences-in-differences) and yet find differential impacts of medical marijuana laws on adult use in particular. We demonstrate that these seemingly conflicting findings may be due to different years of analysis, ages of the study sample in each year, and assignment of jurisdictions to the control group versus treatment group.

Materials for lithium-ion battery safety.

PubMed

Liu, Kai; Liu, Yayuan; Lin, Dingchang; Pei, Allen; Cui, Yi

2018-06-01

Lithium-ion batteries (LIBs) are considered to be one of the most important energy storage technologies. As the energy density of batteries increases, battery safety becomes even more critical if the energy is released unintentionally. Accidents related to fires and explosions of LIBs occur frequently worldwide. Some have caused serious threats to human life and health and have led to numerous product recalls by manufacturers. These incidents are reminders that safety is a prerequisite for batteries, and serious issues need to be resolved before the future application of high-energy battery systems. This Review aims to summarize the fundamentals of the origins of LIB safety issues and highlight recent key progress in materials design to improve LIB safety. We anticipate that this Review will inspire further improvement in battery safety, especially for emerging LIBs with high-energy density.

Materials for lithium-ion battery safety

PubMed Central

Liu, Kai

2018-01-01

Lithium-ion batteries (LIBs) are considered to be one of the most important energy storage technologies. As the energy density of batteries increases, battery safety becomes even more critical if the energy is released unintentionally. Accidents related to fires and explosions of LIBs occur frequently worldwide. Some have caused serious threats to human life and health and have led to numerous product recalls by manufacturers. These incidents are reminders that safety is a prerequisite for batteries, and serious issues need to be resolved before the future application of high-energy battery systems. This Review aims to summarize the fundamentals of the origins of LIB safety issues and highlight recent key progress in materials design to improve LIB safety. We anticipate that this Review will inspire further improvement in battery safety, especially for emerging LIBs with high-energy density. PMID:29942858

Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland.

PubMed

Sugrue, M; Maier, R; Moore, E E; Boermeester, M; Catena, F; Coccolini, F; Leppaniemi, A; Peitzman, A; Velmahos, G; Ansaloni, L; Abu-Zidan, F; Balfe, P; Bendinelli, C; Biffl, W; Bowyer, M; DeMoya, M; De Waele, J; Di Saverio, S; Drake, A; Fraga, G P; Hallal, A; Henry, C; Hodgetts, T; Hsee, L; Huddart, S; Kirkpatrick, A W; Kluger, Y; Lawler, L; Malangoni, M A; Malbrain, M; MacMahon, P; Mealy, K; O'Kane, M; Loughlin, P; Paduraru, M; Pearce, L; Pereira, B M; Priyantha, A; Sartelli, M; Soreide, K; Steele, C; Thomas, S; Vincent, J L; Woods, L

2017-01-01

Opportunities to improve emergency surgery outcomes exist through guided better practice and reduced variability. Few attempts have been made to define optimal care in emergency surgery, and few clinically derived key performance indicators (KPIs) have been published. A summit was therefore convened to look at resources for optimal care of emergency surgery. The aim of the Donegal Summit was to set a platform in place to develop guidelines and KPIs in emergency surgery. The project had multidisciplinary global involvement in producing consensus statements regarding emergency surgery care in key areas, and to assess feasibility of producing KPIs that could be used to monitor process and outcome of care in the future. Forty-four key opinion leaders in emergency surgery, across 7 disciplines from 17 countries, composed evidence-based position papers on 14 key areas of emergency surgery and 112 KPIs in 20 acute conditions or emergency systems. The summit was successful in achieving position papers and KPIs in emergency surgery. While position papers were limited by non-graded evidence and non-validated KPIs, the process set a foundation for the future advancement of emergency surgery.

A range/depth modulation transfer function (RMTF) framework for characterizing 3D imaging LADAR performance

NASA Astrophysics Data System (ADS)

Staple, Bevan; Earhart, R. P.; Slaymaker, Philip A.; Drouillard, Thomas F., II; Mahony, Thomas

2005-05-01

3D imaging LADARs have emerged as the key technology for producing high-resolution imagery of targets in 3-dimensions (X and Y spatial, and Z in the range/depth dimension). Ball Aerospace & Technologies Corp. continues to make significant investments in this technology to enable critical NASA, Department of Defense, and national security missions. As a consequence of rapid technology developments, two issues have emerged that need resolution. First, the terminology used to rate LADAR performance (e.g., range resolution) is inconsistently defined, is improperly used, and thus has become misleading. Second, the terminology does not include a metric of the system"s ability to resolve the 3D depth features of targets. These two issues create confusion when translating customer requirements into hardware. This paper presents a candidate framework for addressing these issues. To address the consistency issue, the framework utilizes only those terminologies proposed and tested by leading LADAR research and standards institutions. We also provide suggestions for strengthening these definitions by linking them to the well-known Rayleigh criterion extended into the range dimension. To address the inadequate 3D image quality metrics, the framework introduces the concept of a Range/Depth Modulation Transfer Function (RMTF). The RMTF measures the impact of the spatial frequencies of a 3D target on its measured modulation in range/depth. It is determined using a new, Range-Based, Slanted Knife-Edge test. We present simulated results for two LADAR pulse detection techniques and compare them to a baseline centroid technique. Consistency in terminology plus a 3D image quality metric enable improved system standardization.

Case Study: The Role of eLearning in Midwifery Pre-Service Education in Ghana.

PubMed

Appiagyei, Martha; Trump, Alison; Danso, Evans; Yeboah, Alex; Searle, Sarah; Carr, Catherine

The issues and challenges of implementing eLearning in pre-service health education were explored through a pilot study conducted in six nurse-midwifery education programs in Ghana. Case-based, interactive computer mediated eLearning modules, targeted to basic emergency and obstetrical signal functions, were delivered both online and offline using a free-for-use eLearning platform, skoool HE(®). Key success factors included broad stakeholder support, an established curriculum and student and tutor interest. Challenges included infrastructure limitations, large class sizes and added workloads for tutors and information technology staff. National scale up is planned.

Introduction: MicroRNAs in human reproduction: small molecules with crucial regulatory roles.

PubMed

Imbar, Tal; Galliano, Daniela; Pellicer, Antonio; Laufer, Neri

2014-06-01

MicroRNAs constitute a large family of approximately 21-nucleotide-long, noncoding RNAs. They emerged more than 20 years ago as key posttranscriptional regulators of gene expression. The regulatory role of these small RNA molecules has recently begun to be explored in the human reproductive system. In this issue's Views and Reviews, the authors present the current knowledge regarding the involvement of microRNAs in several aspects of human reproduction and discuss its future implications for clinical practice. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Improving performance through an organizational culture of employee expertise.

PubMed

Jacobs, R L

1996-01-01

Managers can do many things to improve organizational performance, but the accomplishments of the most skillful employees often are most important. This article makes the point that managers should be aware of employee expertise and its relationship to organizational performance. The article also describes the components of an organizational culture of employee expertise. An organizational culture of employee expertise builds on the learning organization metaphor that has frequently appeared in the management literature. How employees develop expertise to do their jobs is emerging as a critical issue for organizations, and managers will likely play a key role in that process.

Integrated Distributed Directory Service for KSC

NASA Technical Reports Server (NTRS)

Ghansah, Isaac

1997-01-01

This paper describes an integrated distributed directory services (DDS) architecture as a fundamental component of KSC distributed computing systems. Specifically, an architecture for an integrated directory service based on DNS and X.500/LDAP has been suggested. The architecture supports using DNS in its traditional role as a name service and X.500 for other services. Specific designs were made in the integration of X.500 DDS for Public Key Certificates, Kerberos Security Services, Network-wide Login, Electronic Mail, WWW URLS, Servers, and other diverse network objects. Issues involved in incorporating the emerging Microsoft Active Directory Service MADS in KSC's X.500 were discussed.

ERCMExpress. Volume 2, Issue 3

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

This issue of the Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress" promotes emergency exercises as an effective way to validate school safety plans. Simulations of emergency situations, or emergency exercises, are integral to a sound school safety plan. They offer opportunities for district and schools to…

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

PubMed

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

2002-03-01

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

Guidance for Catastrophic Emergency Situations Involving Asbestos

EPA Pesticide Factsheets

This document addresses the types of asbestos issues that may arise during catastrophic events and how EPA has addressed such issues. It replaces the Guidelines for Catastrophic Emergency Situations Involving Asbestos which was issued in 1992.

Prevalence and risk factors of workplace violence against health care workers in emergency department in Ismailia, Egypt.

PubMed

Abdellah, Rasha Farouk; Salama, Khaled Morsy

2017-01-01

Emergency department is one of the high-risk areas, where violence against health care workers (HCWs) is a prevalent and serious problem. Violence has negative effects on HCWs, and therefore on the quality of care provided in emergency department. This study aimed to determine the prevalence, types, sources and risk factors of violence reported by HCWs in emergency department. A cross-sectional study was conducted using a standardized questionnaire developed by the WHO. One hundred thirty four questionnaires were included in this study (94.4% response rate). WPV was reported by 59.7% of HCWs. Verbal violence was the most reported (58.2%), compared to physical violence (15.7%). The most reported reasons for violence were waiting time and that patient and family expectations not being met. Only 29.5% of HCWs who experienced verbal violence and 23.8% of who experienced physical violence reported it to hospital authority. About 75% of HCW thought that work place violence could be prevented, and about 60% said that no action was taken against the attacker by hospital authority. Violence against HCWs in emergency department is a significant issue that cannot be ignored. There are multiple reasons. The key point in dealing with the problem is to treat its specific causes.

The first 24 hours of the World Trade Center attacks of 2001--the Centers for Disease Control and Prevention emergency phase response.

PubMed

Cruz, Miguel A; Burger, Ronald; Keim, Mark

2007-01-01

On 11 September 2001, terrorists hijacked two passenger planes and crashed them into the two towers of the World Trade Center (WTC) in New York City. These synchronized attacks were the largest act of terrorism ever committed on US soil. The impacts, fires, and subsequent collapse of the towers killed and injured thousands of people. Within minutes after the first plane crashed into the WTC, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, initiated one of the largest public health responses in its history. Staff of the CDC provided technical assistance on several key public health issues. During the acute phase of the event, CDC personnel assisted with: (1) assessing hospital capacity; (2) establishing injury and disease surveillance activities; (3) deploying emergency coordinators/liaisons to facilitate inter-agency coordination with the affected jurisdictions; and (4) arranging rapid delivery of emergency medical supplies, therapeutics, and personal protective equipment. This incident highlighted the need for adequate planning for all potential hazards and the importance of interagency and interdepartmental coordination in preparing for and responding to public health emergencies.

The Beneficial Role of Mobility for the Emergence of Innovation.

PubMed

Armano, Giuliano; Javarone, Marco Alberto

2017-05-11

Innovation is a key ingredient for the evolution of several systems, including social and biological ones. Focused investigations and lateral thinking may lead to innovation, as well as serendipity and other random discovery processes. Some individuals are talented at proposing innovation (say innovators), while others at deeply exploring proposed novelties, at getting further insights on a theory, or at developing products, services, and so on (say developers). This separation in terms of innovators and developers raises an issue of paramount importance: under which conditions a system is able to maintain innovators? According to a simple model, this work investigates the evolutionary dynamics that characterize the emergence of innovation. In particular, we consider a population of innovators and developers, in which agents form small groups whose composition is crucial for their payoff. The latter depends on the heterogeneity of the formed groups, on the amount of innovators they include, and on an award-factor that represents the policy of the system for promoting innovation. Under the hypothesis that a "mobility" effect may support the emergence of innovation, we compare the equilibria reached by our population in different cases. Results confirm the beneficial role of "mobility", and the emergence of further interesting phenomena.

Pediatric residents' experiences of a clinical rotation in Adolescent Medicine

PubMed Central

2010-01-01

Background Although Adolescent Medicine is a pediatric subspecialty, it addresses many issues that differ from other aspects of pediatrics clinical training. The aim of this study was to explore the general experiences of pediatric residents during their rotations in Adolescent Medicine. Methods Qualitative methods were applied. Semi-structured individual interviews were conducted with pediatric residents who had completed a rotation in Adolescent Medicine. Emergent themes were identified. Results Three key themes emerged: gaining exposure, taking on a professional role, and achieving self-awareness. Subcategories were also identified. There was particular emphasis on the multidisciplinary team and the biopsychosocial approach to adolescent health care. Conclusions The experiences in Adolescent Medicine reflected residents' learning, notably gains in the "non-expert" as well as "medical expert" physician competencies. Future studies should explore how the interprofessional nature of an Adolescent Medicine team and the patient populations themselves contribute to this learning. PMID:21122143

Molecular digital pathology: progress and potential of exchanging molecular data.

PubMed

Roy, Somak; Pfeifer, John D; LaFramboise, William A; Pantanowitz, Liron

2016-09-01

Many of the demands to perform next generation sequencing (NGS) in the clinical laboratory can be resolved using the principles of telepathology. Molecular telepathology can allow facilities to outsource all or a portion of their NGS operation such as cloud computing, bioinformatics pipelines, variant data management, and knowledge curation. Clinical pathology laboratories can electronically share diverse types of molecular data with reference laboratories, technology service providers, and/or regulatory agencies. Exchange of electronic molecular data allows laboratories to perform validation of rare diseases using foreign data, check the accuracy of their test results against benchmarks, and leverage in silico proficiency testing. This review covers the emerging subject of molecular telepathology, describes clinical use cases for the appropriate exchange of molecular data, and highlights key issues such as data integrity, interoperable formats for massive genomic datasets, security, malpractice and emerging regulations involved with this novel practice.

Multidisciplinary, interdisciplinary, or dysfunctional? Team working in mixed-methods research.

PubMed

O'Cathain, Alicia; Murphy, Elizabeth; Nicholl, Jon

2008-11-01

Combining qualitative and quantitative methods in a single study-otherwise known as mixed-methods research-is common. In health research these projects can be delivered by research teams. A typical scenario, for example, involves medical sociologists delivering qualitative components and researchers from medicine or health economics delivering quantitative components. We undertook semistructured interviews with 20 researchers who had worked on mixed-methods studies in health services research to explore the facilitators of and barriers to exploiting the potential of this approach. Team working emerged as a key issue, with three models of team working apparent: multidisciplinary, interdisciplinary, and dysfunctional. Interdisciplinary research was associated with integration of data or findings from the qualitative and quantitative components in both the final reports and the peer-reviewed publications. Methodological respect between team members and a principal investigator who valued integration emerged as essential to achieving integrated research outcomes.

White LEDs and modules in chip-on-board technology for general lighting

NASA Astrophysics Data System (ADS)

Hartmann, Paul; Wenzl, Franz P.; Sommer, Christian; Pachler, Peter; Hoschopf, Hans; Schweighart, Marko; Hartmann, Martin; Kuna, Ladislav; Jakopic, Georg; Leising, Guenther; Tasch, Stefan

2006-08-01

At present, light-emitting diode (LED) modules in various shapes are developed and designed for the general lighting, advertisement, emergency lighting, design and architectural markets. To compete with and to surpass the performance of traditional lighting systems, enhancement of Lumen output and the white light quality as well as the thermal management and the luminary integration are key factors for success. Regarding these issues, white LEDs based on the chip-on-board (COB) technology show pronounced advantages. State-of-the-art LEDs exploiting this technology are now ready to enter the general lighting segments. We introduce and discuss the specific properties of the Tridonic COB technology dedicated for general lighting. This technology, in combination with a comprehensive set of tools to improve and to enhance the Lumen output and the white light quality, including optical simulation, is the scaffolding for the application of white LEDs in emerging areas, for which an outlook will be given.

Carbon dioxide recycling: emerging large-scale technologies with industrial potential.

PubMed

Quadrelli, Elsje Alessandra; Centi, Gabriele; Duplan, Jean-Luc; Perathoner, Siglinda

2011-09-19

This Review introduces this special issue of ChemSusChem dedicated to CO(2) recycling. Its aim is to offer an up-to-date overview of CO(2) chemical utilization (inorganic mineralization, organic carboxylation, reduction reactions, and biochemical conversion), as a continuation and extension of earlier books and reviews on this topic, but with a specific focus on large-volume routes and projects/pilot plants that are currently emerging at (pre-)industrial level. The Review also highlights how some of these routes will offer a valuable opportunity to introduce renewable energy into the existing energy and chemical infrastructure (i.e., "drop-in" renewable energy) by synthesis of chemicals from CO(2) that are easy to transport and store. CO(2) conversion therefore has the potential to become a key pillar of the sustainable and resource-efficient production of chemicals and energy from renewables. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A conceptual model for the development process of confirmatory adaptive clinical trials within an emergency research network.

PubMed

Mawocha, Samkeliso C; Fetters, Michael D; Legocki, Laurie J; Guetterman, Timothy C; Frederiksen, Shirley; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

2017-06-01

Adaptive clinical trials use accumulating data from enrolled subjects to alter trial conduct in pre-specified ways based on quantitative decision rules. In this research, we sought to characterize the perspectives of key stakeholders during the development process of confirmatory-phase adaptive clinical trials within an emergency clinical trials network and to build a model to guide future development of adaptive clinical trials. We used an ethnographic, qualitative approach to evaluate key stakeholders' views about the adaptive clinical trial development process. Stakeholders participated in a series of multidisciplinary meetings during the development of five adaptive clinical trials and completed a Strengths-Weaknesses-Opportunities-Threats questionnaire. In the analysis, we elucidated overarching themes across the stakeholders' responses to develop a conceptual model. Four major overarching themes emerged during the analysis of stakeholders' responses to questioning: the perceived statistical complexity of adaptive clinical trials and the roles of collaboration, communication, and time during the development process. Frequent and open communication and collaboration were viewed by stakeholders as critical during the development process, as were the careful management of time and logistical issues related to the complexity of planning adaptive clinical trials. The Adaptive Design Development Model illustrates how statistical complexity, time, communication, and collaboration are moderating factors in the adaptive design development process. The intensity and iterative nature of this process underscores the need for funding mechanisms for the development of novel trial proposals in academic settings.

Rethinking risk assessment for emerging technology first-in-human trials.

PubMed

Genske, Anna; Engel-Glatter, Sabrina

2016-03-01

Recent progress in synthetic biology (SynBio) has enabled the development of novel therapeutic opportunities for the treatment of human disease. In the near future, first-in-human trials (FIH) will be indicated. FIH trials mark a key milestone in the translation of medical SynBio applications into clinical practice. Fostered by uncertainty of possible adverse events for trial participants, a variety of ethical concerns emerge with regards to SynBio FIH trials, including 'risk' minimization. These concerns are associated with any FIH trial, however, due to the novelty of the approach, they become more pronounced for medical applications of emerging technologies (emTech) like SynBio. To minimize potential harm for trial participants, scholars, guidelines, regulations and policy makers alike suggest using 'risk assessment' as evaluation tool for such trials. Conversely, in the context of emTech FIH trials, we believe it to be at least questionable to contextualize uncertainty of potential adverse events as 'risk' and apply traditional risk assessment methods. Hence, this issue needs to be discussed to enable alterations of the evaluation process before the translational phase of SynBio applications begins. In this paper, we will take the opportunity to start the debate and highlight how a misunderstanding of the concept of risk, and the possibilities and limitations of risk assessment, respectively, might impair decision-making by the relevant regulatory authorities and research ethics committees, and discuss possible solutions to tackle the issue.

Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

PubMed

Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

2018-01-05

Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

Dating Violence among College Students: Key Issues for College Counselors

ERIC Educational Resources Information Center

Murray, Christine E.; Kardatzke, Kerrie N.

2007-01-01

The authors present a review of literature examining dating violence among college students. They describe 6 key issues related to dating violence among college students that affect college counselors' work. These key issues relate to the incidence and prevalence of physical, sexual, and psychological violence in college students' dating…

Patient care transitions from the emergency department to the medicine ward: evaluation of a standardized electronic signout tool.

PubMed

Gonzalo, Jed D; Yang, Julius J; Stuckey, Heather L; Fischer, Christopher M; Sanchez, Leon D; Herzig, Shoshana J

2014-08-01

To evaluate the impact of a new electronic handoff tool for emergency department to medicine ward patient transfers over a 1-year period. Prospective mixed-methods analysis of data submitted by medicine residents following admitting shifts before and after eSignout implementation. University-based, tertiary-care hospital. Internal medicine resident physicians admitting patients from the emergency department. An electronic handoff tool (eSignout) utilizing automated paging communication and responsibility acceptance without mandatory verbal communication between emergency department and medicine ward providers. (i) Incidence of reported near misses/adverse events, (ii) communication of key clinical information and quality of verbal communication and (iii) characterization of near misses/adverse events. Seventy-eight of 80 surveys (98%) and 1058 of 1388 surveys (76%) were completed before and after eSignout implementation. Compared with pre-intervention, residents in the post-intervention period reported similar number of shifts with a near miss/adverse event (10.3 vs. 7.8%; P = 0.27), similar communication of key clinical information, and improved verbal signout quality, when it occurred. Compared with the former process requiring mandatory verbal communication, 93% believed the eSignout was more efficient and 61% preferred the eSignout. Patient safety issues related to perceived sufficiency/accuracy of diagnosis, treatment or disposition, and information quality. The eSignout was perceived as more efficient and preferred over the mandatory verbal signout process. Rates of reported adverse events were similar before and after the intervention. Our experience suggests electronic platforms with optional verbal communication can be used to standardize and improve the perceived efficiency of patient handoffs. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Emergency medicine in the developing world: a Delphi study.

PubMed

Hodkinson, Peter W; Wallis, Lee A

2010-07-01

Emergency medicine (EM) as a specialty has developed rapidly in the western world, but remains largely immature in developing nations. There is an urgent need for emergency services, but no clear guidelines are available on the priorities for establishing EM in the developing world. This study seeks to establish consensus on key areas of EM development in developing world settings, with respect to scope of EM, staffing needs, training requirements, and research priorities. A three-round Delphi study was conducted via e-mail. A panel was convened of 50 EM specialists or equivalent, with experience in or interest in EM in the developing world. In the first round, panelists provided free-text statements on scope, staffing, training, and research priorities for EM in the developing world. A five-point Likert scale was used to rate agreement with the statements in Rounds 2 and 3. Consensus statements are presented as a series of synopsis statements for each of the four major themes. A total of 168 of 208 statements (81%) had reached consensus at the end of the study. Key areas in which consensus was reached included EM being a specialist-driven service, with substantial role for nonphysicians. International training courses should be adapted to local needs. EM research in developing countries should be clinically driven and focus on local issues of importance. The scope and function of EM and relationships with other specialties are defined. Unambiguous principles are laid out for the development of the specialty in developing world environments. The next step required in this process is translation into practical guidelines for the development of EM in developing world settings where they may be used to drive policy, protocols, and research. 2010 by the Society for Academic Emergency Medicine

2011 Quantum Control of Light & Matter Gordon Research Conference (July 31-August 5, 2011, Mount Holyoke College, South Hadley, MA)

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

Thomas Weinacht

2011-08-05

Quantum control of light and matter is the quest to steer a physical process to a desirable outcome, employing constructive and destructive interference. Three basic questions address feasibility of quantum control: (1) The problem of controllability, does a control field exist for a preset initial and target state; (2) Synthesis, constructively finding the field that leads to the target; and (3) Optimal Control Theory - optimizing the field that carries out this task. These continue to be the fundamental theoretical questions to be addressed in the conference. How to realize control fields in the laboratory is an ongoing challenge. Thismore » task is very diverse viewing the emergence of control scenarios ranging from attoseconds to microseconds. How do the experimental observations reflect on the theoretical framework? The typical arena of quantum control is an open environment where much of the control is indirect. How are control scenarios realized in dissipative open systems? Can new control opportunities emerge? Can one null decoherence effects? An ideal setting for control is ultracold matter. The initial and final state can be defined more precisely. Coherent control unifies many fields of physical science. A lesson learned in one field can reflect on another. Currently quantum information processing has emerged as a primary target of control where the key issue is controlling quantum gate operation. Modern nonlinear spectroscopy has emerged as another primary field. The challenge is to unravel the dynamics of molecular systems undergoing strong interactions with the environment. Quantum optics where non-classical fields are to be generated and employed. Finally, coherent control is the basis for quantum engineering. These issues will be under the limelight of the Gordon conference on Quantum Control of Light and Matter.« less

A Cluster-Based Framework for the Security of Medical Sensor Environments

NASA Astrophysics Data System (ADS)

Klaoudatou, Eleni; Konstantinou, Elisavet; Kambourakis, Georgios; Gritzalis, Stefanos

The adoption of Wireless Sensor Networks (WSNs) in the healthcare sector poses many security issues, mainly because medical information is considered particularly sensitive. The security mechanisms employed are expected to be more efficient in terms of energy consumption and scalability in order to cope with the constrained capabilities of WSNs and patients’ mobility. Towards this goal, cluster-based medical WSNs can substantially improve efficiency and scalability. In this context, we have proposed a general framework for cluster-based medical environments on top of which security mechanisms can rely. This framework fully covers the varying needs of both in-hospital environments and environments formed ad hoc for medical emergencies. In this paper, we further elaborate on the security of our proposed solution. We specifically focus on key establishment mechanisms and investigate the group key agreement protocols that can best fit in our framework.

Neutrality and Robustness in Evo-Devo: Emergence of Lateral Inhibition

PubMed Central

Munteanu, Andreea; Solé, Ricard V.

2008-01-01

Embryonic development is defined by the hierarchical dynamical process that translates genetic information (genotype) into a spatial gene expression pattern (phenotype) providing the positional information for the correct unfolding of the organism. The nature and evolutionary implications of genotype–phenotype mapping still remain key topics in evolutionary developmental biology (evo-devo). We have explored here issues of neutrality, robustness, and diversity in evo-devo by means of a simple model of gene regulatory networks. The small size of the system allowed an exhaustive analysis of the entire fitness landscape and the extent of its neutrality. This analysis shows that evolution leads to a class of robust genetic networks with an expression pattern characteristic of lateral inhibition. This class is a repertoire of distinct implementations of this key developmental process, the diversity of which provides valuable clues about its underlying causal principles. PMID:19023404

Navigating political minefields: partnerships in organizational case study research.

PubMed

Moll, Sandra

2012-01-01

The purpose of this paper is to examine key challenges associated with conducting politically sensitive research within a workplace setting, and to highlight strategic partnerships that can be developed to address these challenges. The author's research on employee mental health issues within a large healthcare facility serves as the foundation for identification and description of "political minefields" that investigators may encounter when conducting organizational case study research. Key methodological principles from the literature on qualitative case study research will frame discussion of how to understand and address political sensitivities in the research process. The benefits of conducting organizational case study research will be outlined, followed by discussion of methodological challenges that can emerge in negotiating entry, collecting data (gatekeepers, researcher reflexivity, participant authenticity and non-maleficence), and communicating research findings. Courage, collaboration and clear communication with stakeholders at all levels of the organization are critical to the success of workplace based case study research.

CEO perceptions of competition--and strategic response in hospital markets.

PubMed

Alexander, J A; Burns, L R; Morrisey, M A; Johnson, V

2001-06-01

Physician-organization integration (POI) has emerged as a key issue for hospitals and health systems seeking to improve the quality and cost-effectiveness of care. Although competition and managed care are often cited as primary market drivers of the adoption of POI strategies, prior research has shown only weak associations between these market attributes and POI. This article argues that the role of key organizational decision makers has not been adequately accounted for in explaining strategic change. The study examines the role of hospital CEO perceptions of competition in predicting the adoption of five different approaches to POI. CEO perceptions of general market competition are explained by a combination of market and organizational attributes. Furthermore, when controlling for objective characteristics of the environment and organization, CEO perceptions of competition have consistent, statistically significant associations with four of five measures of POI examined.

Competencies of front-line managers in supported accommodation: issues for practice and future research.

PubMed

Clement, Tim; Bigby, Christine

2012-06-01

Front-line managers of supported accommodation for people with intellectual disability are assumed to have a key role in the realisation of outcomes for service users. Yet, their job has been little researched. A job analysis from Minnesota that identified 142 competencies required of effective front-line managers was used to examine what was expected of the equivalent position in Victoria, Australia. These competencies formed the basis of semistructured interviews with an extreme sample of 16 high-performing house supervisors and 5 more senior managers. Ninety-two percent of the original competences were retained, with changes in language and terminology to reflect the local context. Emergent findings highlighted the importance of house supervisors' "orientations." The findings support the proposition that the front-line manager's job is underpinned by core competencies and that the role merits further study. Issues of wider significance for human service organisations and researchers are discussed.

Advances in Multi-Sensor Information Fusion: Theory and Applications 2017.

PubMed

Jin, Xue-Bo; Sun, Shuli; Wei, Hong; Yang, Feng-Bao

2018-04-11

The information fusion technique can integrate a large amount of data and knowledge representing the same real-world object and obtain a consistent, accurate, and useful representation of that object. The data may be independent or redundant, and can be obtained by different sensors at the same time or at different times. A suitable combination of investigative methods can substantially increase the profit of information in comparison with that from a single sensor. Multi-sensor information fusion has been a key issue in sensor research since the 1970s, and it has been applied in many fields. For example, manufacturing and process control industries can generate a lot of data, which have real, actionable business value. The fusion of these data can greatly improve productivity through digitization. The goal of this special issue is to report innovative ideas and solutions for multi-sensor information fusion in the emerging applications era, focusing on development, adoption, and applications.

Modulated Raman Spectroscopy for Enhanced Cancer Diagnosis at the Cellular Level

PubMed Central

De Luca, Anna Chiara; Dholakia, Kishan; Mazilu, Michael

2015-01-01

Raman spectroscopy is emerging as a promising and novel biophotonics tool for non-invasive, real-time diagnosis of tissue and cell abnormalities. However, the presence of a strong fluorescence background is a key issue that can detract from the use of Raman spectroscopy in routine clinical care. The review summarizes the state-of-the-art methods to remove the fluorescence background and explores recent achievements to address this issue obtained with modulated Raman spectroscopy. This innovative approach can be used to extract the Raman spectral component from the fluorescence background and improve the quality of the Raman signal. We describe the potential of modulated Raman spectroscopy as a rapid, inexpensive and accurate clinical tool to detect the presence of bladder cancer cells. Finally, in a broader context, we show how this approach can greatly enhance the sensitivity of integrated Raman spectroscopy and microfluidic systems, opening new prospects for portable higher throughput Raman cell sorting. PMID:26110401

Cultural relativism: occupation and independence reconsidered.

PubMed

Whiteford, G E; Wilcock, A A

2000-12-01

In this article, findings from a qualitative study of a cohort of occupational therapy students in Auckland, New Zealand are presented. The study focussed on the experiences of students as they learned to work with people from different social and cultural backgrounds over a 3-year period. As well as identifying curriculum and teaching/learning processes that enhance intercultural competence development, the data that emerged from the study also highlight important issues about how occupation and independence are conceptualised across cultures. A review of the trans-disciplinary and occupational therapy literature dealing with theoretical, conceptual and educational issues relating to cross-cultural practice is followed by a presentation of narrative extracts that address the key concepts of occupation and independence. These are then discussed with reference to relevant occupational therapy literature. In conclusion, implications for future research and practice are explored focussing on a need for occupation and independence to be reconsidered as culturally relative constructions.

Exploring Socio-Technical Insights for Safe Nursing Handover.

PubMed

Wong, Ming Chao; Yee, Kwang Chien; Turner, Paul

2017-01-01

Current efforts to improve nursing handover frequently use prescriptive approaches based on research evidence of handover issues within a single nursing ward or nursing specialty. Despite reported handover improvement, few studies adequately consider the transferability of results to other nursing handover environments or acknowledge the unique attributes that supported sustained improvement. With the increasing diffusion of electronic tools it has become even more critical to ensure that socio-technical issues that may impact on the quality and safety of nursing handovers are identified. This paper describes a qualitative research project that examined nursing handover in three different wards - General Medicine, General Surgery and Department of Emergency Medicine in a tertiary teaching hospital. Through conduct of a detailed analysis of nursing handover processes, this paper highlights the similarities and differences in the handover among the three different wards and presents five key socio-technical insights to support safe nursing handover.

From 'trust us' to participatory governance: Deliberative publics and science policy.

PubMed

Burgess, Michael M

2014-01-01

The last 20 years have seen a shift from the view that publics need to be educated so that they trust science and its governance to the recognition that publics possess important local knowledge and the capacity to understand technical information sufficiently to participate in policy decisions. There are now a variety of approaches to increasing the role of publics and advocacy groups in the policy and governance of science and biotechnology. This article considers recent experiences that demonstrate that it is possible to bring together those with policy making responsibility and diverse publics to co-produce policy and standards of practice that are technically informed, incorporate wide social perspectives and explicitly involve publics in key decisions. Further, the process of deliberation involving publics is capable of being incorporated into governance structures to enhance the capacity to respond to emerging issues with levels of public engagement that are proportionate to the issues.

The thermodynamic origin of hysteresis in insertion batteries

NASA Astrophysics Data System (ADS)

Dreyer, Wolfgang; Jamnik, Janko; Guhlke, Clemens; Huth, Robert; Moškon, Jože; Gaberšček, Miran

2010-05-01

Lithium batteries are considered the key storage devices for most emerging green technologies such as wind and solar technologies or hybrid and plug-in electric vehicles. Despite the tremendous recent advances in battery research, surprisingly, several fundamental issues of increasing practical importance have not been adequately tackled. One such issue concerns the energy efficiency. Generally, charging of 1010-1017 electrode particles constituting a modern battery electrode proceeds at (much) higher voltages than discharging. Most importantly, the hysteresis between the charge and discharge voltage seems not to disappear as the charging/discharging current vanishes. Herein we present, for the first time, a general explanation of the occurrence of inherent hysteretic behaviour in insertion storage systems containing multiple particles. In a broader sense, the model also predicts the existence of apparent equilibria in battery electrodes, the sequential particle-by-particle charging/discharging mechanism and the disappearance of two-phase behaviour at special experimental conditions.

Teen dating violence: building a research program through collaborative insights.

PubMed

Mulford, Carrie F; Blachman-Demner, Dara R

2013-06-01

The National Institute of Justice (NIJ) has an emerging portfolio of research in the area of teen dating violence (also known as adolescent relationship abuse). This article begins with a discussion of the developments that prompted NIJ to focus on teen dating violence. Next, the article highlights specific accomplishments and contributions that NIJ has made to helping develop knowledge and scientific understanding of adolescent relationship abuse, particularly around the prevention of teen dating violence perpetration and victimization. This is followed by a presentation of some of the key findings from NIJ-funded research. We then move to a discussion of some of the complex issues around definition, measurement and research methods and how NIJ has been involved in addressing those issues. The article concludes with some thoughts about the intersection of teen dating violence research, policy, and practice and highlights several research gaps that are in need of additional attention.

Mathematics lecturing in the digital age

NASA Astrophysics Data System (ADS)

Trenholm, Sven; Alcock, Lara; Robinson, Carol L.

2012-09-01

In this article, we consider the transformation of tertiary mathematics lecture practice. We undertake a focused examination of the related research with two goals in mind. First, we document this research, reviewing the findings of key studies and noting that reflective pieces on individual practice as well as surveys are more prevalent than empirical studies. Second, we investigate issues related to the transformation of lecture practice by the emergence of e-lectures. We discuss the latter in terms of claims about the efficiencies offered by new technologies and contrast these with possible disadvantages in terms of student engagement in a learning community. Overall findings indicate that while survey results appear to trumpet the value of e-lecture provision, empirical study results appear to call that value into question. Two explanatory theoretical frameworks are presented. Issues concerning the instructional context (e.g. the nature of mathematical thinking), inherent complexities and recommendations for implementation are discussed.

Cultural issues in post-disaster reconstruction: the case of Typhoon Morakot in Taiwan.

PubMed

Lin, Jen-Jen; Lin, Wan-I

2016-10-01

Most members of Taiwan's indigenous communities live in areas that are prone to natural disasters. Yet, due to their marginalised cultural, economic and political status, each time such calamities strike, any assistance they receive is usually provided without considering their actual needs. The areas hardest hit by Typhoon Morakot in August 2009 were the indigenous villages in the southern and eastern parts of the island. After the initial emergency relief efforts had been completed, there remained the highly challenging task of reconstruction and the resettlement of those who lost their homes and livelihoods. This paper examines the cultural conflicts that arose during the reconstruction process, with special emphasis on the participation of Taiwan's indigenous communities and their capacity for resilience. It was found that community participation and identification are key issues in effective disaster governance. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

The current state of nursing performance measurement, public reporting, and value-based purchasing.

PubMed

Kurtzman, Ellen T; Dawson, Ellen M; Johnson, Jean E

2008-08-01

Over the last decade, there has been a substantial investment in holding health care providers accountable for the quality of care provided in hospitals and other settings of care. This investment has been realized through the proliferation of national policies that address performance measurement, public reporting, and value-based purchasing. Although nurses represent the largest segment of the health care workforce and despite their acknowledged role in patient safety and health care outcomes, they have been largely absent from policy setting in these areas. This article provides an analysis of current nursing performance measurement and public reporting initiatives and presents a summary of emerging trends in value-based purchasing, with an emphasis on activities in the United States. The article synthesizes issues of relevance to advancing the current climate for nursing quality and concludes with key issues for future policy setting.

The thermodynamic origin of hysteresis in insertion batteries.

PubMed

Dreyer, Wolfgang; Jamnik, Janko; Guhlke, Clemens; Huth, Robert; Moskon, Joze; Gaberscek, Miran

2010-05-01

Lithium batteries are considered the key storage devices for most emerging green technologies such as wind and solar technologies or hybrid and plug-in electric vehicles. Despite the tremendous recent advances in battery research, surprisingly, several fundamental issues of increasing practical importance have not been adequately tackled. One such issue concerns the energy efficiency. Generally, charging of 10(10)-10(17) electrode particles constituting a modern battery electrode proceeds at (much) higher voltages than discharging. Most importantly, the hysteresis between the charge and discharge voltage seems not to disappear as the charging/discharging current vanishes. Herein we present, for the first time, a general explanation of the occurrence of inherent hysteretic behaviour in insertion storage systems containing multiple particles. In a broader sense, the model also predicts the existence of apparent equilibria in battery electrodes, the sequential particle-by-particle charging/discharging mechanism and the disappearance of two-phase behaviour at special experimental conditions.

Climate variability and change in high elevation regions: Past, present & future

USGS Publications Warehouse

Diaz, Henry F.; Grosjean, Martin; Graumlich, Lisa J.

2003-01-01

This special issue of Climatic Change contains a series of research and review articles, arising from papers that were presented and discussed at a workshop held in Davos, Switzerland on 25–28 June 2001. The workshop was titled ‘Climate Change at High Elevation Sites: Emerging Impacts’, and was convened to reprise an earlier conference on the same subject that was held in Wengen, Switzerland in 1995 (Diaz et al., 1997). The Davos meeting had as its main goals, a discussion of the following key issues: (1) reviewing recent climatic trends in high elevation regions of the world, (2) assessing the reliability of various biological indicators as indicators of climatic change, and (3) assessing whether physical impacts of climatic change in high elevation areas are becoming evident, and to discuss a range of monitoring strategies needed to observe and to understand the nature of any changes.

Promoting public health messages: Should we move beyond fear-evoking appeals in road safety?

PubMed

Lewis, Ioni M; Watson, Barry; White, Katherine M; Tay, Richard

2007-01-01

Road traffic injury is one of the most significant global public health issues of the 21st century. The extent to which negative, fear-evoking messages represent effective persuasive strategies remains a contentious public and empirical issue. Nevertheless, negative, fear-based appeals represent a frequently used approach in Australasian road safety advertising. The authors conducted a series of focus groups with 16 licensed drivers to explore the potential utility of appeals to emotions other than fear. More specifically, they sought to explore the utility of positive emotional appeals, such as those incorporating humor. The themes emerging from the qualitative analysis suggested that both emotion and the provision of strategies are key components contributing to the overall persuasiveness of a road safety advertisement. Overall, it appears there is support for researchers and health advertising practitioners to provide further attention to the role that positive emotional appeals might play in future campaigns.

Path forward: emerging issues and challenges.

PubMed

Gillen, Matt; Gittleman, Janie L

2010-06-01

The NIOSH Construction Program worked with industry stakeholders to develop a National Occupational Safety and Health Construction Agenda to target future research and activities. The Program and its partners are also cognizant that new developments can emerge over time and that research can play an important role in helping to understand and address these emerging issues. Examples of emerging issues relevant to construction safety and health are described. These include: (a) climate change and energy considerations; (b) green construction developments and opportunities; (c) new materials; (d) changes in industry structure and practice; (e) workforce developments and disparities; (f) injury underreporting and cost and risk shifting; and (g) increased interest in addressing root causes. Responding to emerging issues while maintaining a focus on fundamental longstanding issues represents an ongoing challenge for researchers and industry organizations. Additional research to understand the diffusion and adoption of research by the industry is also needed. Research accomplished to date provides a strong foundation for addressing future industry needs and trends. (c) 2010 Elsevier Ltd. All rights reserved.

Organization, execution and evaluation of the 2014 Academic Emergency Medicine consensus conference on Gender-Specific Research in Emergency Care - an executive summary.

PubMed

Safdar, Basmah; Greenberg, Marna R

2014-12-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the results of the 2014 consensus conference as well as related original research with the goal of bringing high-quality equitable care to male and female emergency patients. © 2014 by the Society for Academic Emergency Medicine.

Critical world educational issues of the next two decades

NASA Astrophysics Data System (ADS)

Coombs, Philip H.

1982-06-01

This article gives a pre-publication summary of some key findings that have emerged from a recent far-ranging reappraisal of the World Educational Crisis that first struck in the late 1960's. This extensively documented study demonstrates that the original crisis broadened and deepened considerably in the 1970's, in both developed and developing countries, and will confront virtually all nations in the 1980's and 1990's with a galaxy of critical educational issues. The author (who directed the reappraisal study for the International Council for Educational Development) briefly examines a few of these issues here. They relate specifically to the explosive worldwide growth of learning needs, education's growing financial squeeze, proliferating maladjustments between education and employment, festering educational disparities and inequalities, and the urgent need to revitalize and reorient international educational cooperation in order to cope with these future critical issues common to all countries. The author emphasizes that the great changes taking place in the world of education make it mandatory for all nations to develop more comprehensive, flexible and innovative educational strategies that will encompass the evolving life-long learning needs of the whole society and all modes and types of learning.

Client counseling in orthopedic emergencies.

PubMed

Brackenridge, S S; Kirby, B M; Johnson, S W

1995-09-01

Important client communication issues associated with most orthopedic emergencies are addressed. Information on client communication and support, providing a prognosis, discussing economic concerns, discharge planning, euthanasia, and client grief is presented. The issue of animal abuse as a cause of orthopedic emergencies also is examined.

2015 White Paper on recent issues in bioanalysis: focus on new technologies and biomarkers (Part 1 - small molecules by LCMS).

PubMed

Welink, Jan; Fluhler, Eric; Hughes, Nicola; Arnold, Mark; Garofolo, Fabio; Bustard, Mark; Coppola, Laura; Dhodda, Raj; Evans, Christopher; Gleason, Carol; Haidar, Sam; Hayes, Roger; Heinig, Katja; Katori, Noriko; Blaye, Olivier Le; Li, Wenkui; Liu, Guowen; Lima Santos, Gustavo Mendes; Meng, Min; Nicholson, Bob; Savoie, Natasha; Skelly, Michael; Sojo, Luis; Tampal, Nilufer; de Merbel, Nico van; Verhaeghe, Tom; Vinter, Stephen; Wickremsinhe, Enaksha; Whale, Emma; Wilson, Amanda; Witte, Bärbel; Woolf, Eric

2015-01-01

The 2015 9th Workshop on Recent Issues in Bioanalysis (9th WRIB) took place in Miami, Florida with participation of over 600 professionals from pharmaceutical and biopharmaceutical companies, biotechnology companies, contract research organizations and regulatory agencies worldwide. It is once again a 5-day week long event - a full immersion bioanalytical week - specifically designed to facilitate sharing, reviewing, discussing and agreeing on approaches to address the most current issues of interest in bioanalysis. The topics covered included both small and large molecules, and involved LCMS, hybrid LBA/LCMS, LBA approaches including the focus on biomarkers and immunogenicity. This 2015 White Paper encompasses recommendations that emerged from the extensive discussions held during the workshop, and is aimed to provide the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to advance scientific excellence, improve quality and deliver better regulatory compliance. Due to its length, the 2015 edition of this comprehensive White Paper has been divided into three parts. Part 1 covers the recommendations for small molecule bioanalysis using LCMS. Part 2 (hybrid LBA/LCMS and regulatory agencies' inputs) and Part 3 (large molecule bioanalysis using LBA, biomarkers and immunogenicity) will also be published in volume 7 of Bioanalysis, issues 23 and 24, respectively.

2016 White Paper on recent issues in bioanalysis: focus on biomarker assay validation (BAV): (Part 3 - LBA, biomarkers and immunogenicity).

PubMed

Richards, Susan; Amaravadi, Lakshmi; Pillutla, Renuka; Birnboeck, Herbert; Torri, Albert; Cowan, Kyra J; Papadimitriou, Apollon; Garofolo, Fabio; Satterwhite, Christina; Piccoli, Steven; Wu, Bonnie; Krinos-Fiorotti, Corinna; Allinson, John; Berisha, Flora; Cocea, Laurent; Croft, Stephanie; Fraser, Stephanie; Galliccia, Fabrizio; Gorovits, Boris; Gupta, Swati; Gupta, Vinita; Haidar, Sam; Hottenstein, Charles; Ishii-Watabe, Akiko; Jani, Darshana; Kadavil, John; Kamerud, John; Kramer, Daniel; Litwin, Virginia; Lima Santos, Gustavo Mendes; Nelson, Robert; Ni, Yan; Pedras-Vasconcelos, João; Qiu, Yongchang; Rhyne, Paul; Safavi, Afshin; Saito, Yoshiro; Savoie, Natasha; Scheibner, Kara; Schick, Eginhard; Siguenza, Patricia Y; Smeraglia, John; Staack, Roland F; Subramanyam, Meena; Sumner, Giane; Thway, Theingi; Uhlinger, David; Ullmann, Martin; Vitaliti, Alessandra; Welink, Jan; Whiting, Chan C; Xue, Li; Zeng, Rong

2016-12-01

The 2016 10th Workshop on Recent Issues in Bioanalysis (10th WRIB) took place in Orlando, Florida with participation of close to 700 professionals from pharmaceutical/biopharmaceutical companies, biotechnology companies, contract research organizations, and regulatory agencies worldwide. WRIB was once again a weeklong event - A Full Immersion Week of Bioanalysis for PK, Biomarkers and Immunogenicity. As usual, it is specifically designed to facilitate sharing, reviewing, discussing and agreeing on approaches to address the most current issues of interest including both small and large molecules involving LCMS, hybrid LBA/LCMS, and LBA approaches, with the focus on PK, biomarkers and immunogenicity. This 2016 White Paper encompasses recommendations emerging from the extensive discussions held during the workshop, and is aimed to provide the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to enable advances in scientific excellence, improved quality and better regulatory compliance. This White Paper is published in 3 parts due to length. This part (Part 3) discusses the recommendations for large molecule bioanalysis using LBA, biomarkers and immunogenicity. Parts 1 (small molecule bioanalysis using LCMS) and Part 2 (Hybrid LBA/LCMS and regulatory inputs from major global health authorities) have been published in the Bioanalysis journal, issues 22 and 23, respectively.

A qualitative exploration of the perceptions and information needs of public health inspectors responsible for food safety

PubMed Central

2010-01-01

Background In Ontario, local public health inspectors play an important frontline role in protecting the public from foodborne illness. This study was an in-depth exploration of public health inspectors' perceptions of the key food safety issues in public health, and their opinions and needs with regards to food safety information resources. Methods Four focus group discussions were conducted with public health inspectors from the Central West region of Ontario, Canada during June and July, 2008. A questioning route was used to standardize qualitative data collection. Audio recordings of sessions were transcribed verbatim and data-driven content analysis was performed. Results A total of 23 public health inspectors participated in four focus group discussions. Five themes emerged as key food safety issues: time-temperature abuse, inadequate handwashing, cross-contamination, the lack of food safety knowledge by food handlers and food premise operators, and the lack of food safety information and knowledge about specialty foods (i.e., foods from different cultures). In general, participants reported confidence with their current knowledge of food safety issues and foodborne pathogens. Participants highlighted the need for a central source for food safety information, access to up-to-date food safety information, resources in different languages, and additional food safety information on specialty foods. Conclusions The information gathered from these focus groups can provide a basis for the development of resources that will meet the specific needs of public health inspectors involved in protecting and promoting food safety. PMID:20553592

Governing stem cell banks and registries: emerging issues.

PubMed

Isasi, Rosario M; Knoppers, Bartha M

2009-01-01

The expansion of national and international research efforts in stem cell research is increasingly paired with the trend of establishing stem cell banks and registries. In jurisdictions crossing the spectrum of restrictive to liberal stem cell policies, banks and registries are emerging as an essential resource for transnational access to quality-controlled and ethically sourced stem cell lines. In this study, we report the preliminary findings of a survey of stem cell banks participating in the International Stem Cell Forum's International Stem Cell Banking Initiative (ISCBI). The questionnaire circulated to all ISCBI members addressed both general issues surrounding research policies (e.g., national policies regulating the permissibility of conducting embryonic stem cell research (hESCR)) and, more specifically, issues relating to the governance of stem cell banking projects. The results of the questionnaire were complemented by scholarly research conducted by the authors. This article provides an overview of the current international hESC banking landscape (I). For this purpose, the policy and governance approaches adopted in the surveyed stem cell banks at the national level will be analyzed and areas of convergence and variance will be identified (II). It is beyond the scope of this paper to provide a comprehensive analysis of the wide range of possible governance approaches, policy responses, and their implications. However, we want to provide a starting point for discussion surrounding key questions and challenges as concerns provenance, access, and deposit of hESC lines (III). Finally, while our analysis is focused on research grade hESCs, the lessons to be gleaned from this examination will encourage further thought, analysis, and research into the issues raised in the banking and governance of other sources of stem cell lines (e.g., SCNT, parthenogenesis, iPs) (IV).

RESEARCH INTO EMERGING WASTE ISSUES

EPA Science Inventory

The purpose of this project is to investigate emerging waste issues. In particular, 2 issues have been raised in the last year that have major implications for the waste disposal industry: 1) waste gasification; and 2) proliferation of electronics waste.

APPCD loaned a h...

ERCMExpress. Volume 2, Issue 8

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

This issue of ERCMExpress provides direction to schools and school districts in "Creating Emergency Management Plans." To ensure the safety of students, faculty and staff, schools and school districts nationwide should create comprehensive, multi-hazard emergency management plans that focus on the four phases of emergency management--…

Mapping Resilience Pathways of Indigenous Youth in Five Circumpolar Communities

PubMed Central

Allen, James; Hopper, Kim; Wexler, Lisa; Kral, Michael; Rasmus, Stacy; Nystad, Kristine

2014-01-01

This introduction to the special issue Indigenous Youth Resilience in the Arctic reviews relevant resilience theory and research, with particular attention to Arctic Indigenous youth. The role of social determinants and community resilience processes in Indigenous circumpolar settings are overviewed, as are emergent Indigenous resilience frameworks. The distinctive role for qualitative inquiry in understanding these frameworks is emphasized, as is the uniquely informative lens youth narratives offer in understanding Indigenous, cultural, and community resilience processes during times of social transition. We then describe key elements of the Circumpolar Indigenous Pathways to Adulthood study cross-site methods, including sampling, design, procedures, and analytic strategies. PMID:23965730

Perovskite Solar Cells and Devices at EPFL Valais Wallis.

PubMed

Nazeeruddin, Mohammad Khaja

2016-09-22

Stability required! Perovskite solar cells have emerged as one of the most exciting fields of research, owing to their impressive rise in power conversion efficiency surpassing 22% in six short years of research. Current research is focused on ways to improve stability of perovskite-based devices, a key characteristic required to bring this technology from the lab into the market. In this Editorial, guest editor Prof. Mohammad Khaja Nazeeruddin describes the context of this Special Issue, and summarizes the work being performed in his research group toward this low-cost near-future photovoltaic technology. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Find-me and eat-me signals in apoptotic cell clearance: progress and conundrums

PubMed Central

2010-01-01

Everyday we turnover billions of cells. The quick, efficient, and immunologically silent disposal of the dying cells requires a coordinated orchestration of multiple steps, through which phagocytes selectively recognize and engulf apoptotic cells. Recent studies have suggested an important role for soluble mediators released by apoptotic cells that attract phagocytes (“find-me” signals). New information has also emerged on multiple receptors that can recognize phosphatidylserine, the key “eat-me” signal exposed on the surface of apoptotic cells. This perspective discusses recent exciting progress, gaps in our understanding, and the conflicting issues that arise from the newly acquired knowledge. PMID:20805564

Impact of Recent Hardware and Software Trends on High Performance Transaction Processing and Analytics

NASA Astrophysics Data System (ADS)

Mohan, C.

In this paper, I survey briefly some of the recent and emerging trends in hardware and software features which impact high performance transaction processing and data analytics applications. These features include multicore processor chips, ultra large main memories, flash storage, storage class memories, database appliances, field programmable gate arrays, transactional memory, key-value stores, and cloud computing. While some applications, e.g., Web 2.0 ones, were initially built without traditional transaction processing functionality in mind, slowly system architects and designers are beginning to address such previously ignored issues. The availability, analytics and response time requirements of these applications were initially given more importance than ACID transaction semantics and resource consumption characteristics. A project at IBM Almaden is studying the implications of phase change memory on transaction processing, in the context of a key-value store. Bitemporal data management has also become an important requirement, especially for financial applications. Power consumption and heat dissipation properties are also major considerations in the emergence of modern software and hardware architectural features. Considerations relating to ease of configuration, installation, maintenance and monitoring, and improvement of total cost of ownership have resulted in database appliances becoming very popular. The MapReduce paradigm is now quite popular for large scale data analysis, in spite of the major inefficiencies associated with it.

A review of what is an emerging contaminant

PubMed Central

2014-01-01

A review is presented of how one defines emerging contaminants and what can be included in that group of contaminants which is preferably termed “contaminants of emerging concern”. An historical perspective is given on the evolution of the issues surrounding emerging contaminants and how environmental scientists have tackled this issue. This begins with global lead contamination from the Romans two millennia ago, moves on to arsenic-based and DDT issues and more recently to pharmaceuticals, cyanotoxins, personal care products, nanoparticles, flame retardants, etc. Contaminants of emerging concern will remain a moving target as new chemical compounds are continuously being produced and science continuously improves its understanding of current and past contaminants. PMID:24572188

Conference on Gender-specific Research in Emergency Care: An Executive Summary

PubMed Central

Safdar, Basmah; Greenberg, Marna Rayl

2015-01-01

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, “Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes,” convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex-and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the results of the 2014 consensus conference as well as related original research with the goal of bringing high-quality equitable care to male and female emergency patients. PMID:25420469

Emerging ICT implementation issues in aged care.

PubMed

Kapadia, Vasvi; Ariani, Arni; Li, Junhua; Ray, Pradeep K

2015-11-01

Demand for aged care services continues to soar as a result of an aging population. This increasing demand requires more residential aged care facilities and healthcare workforce. One recommended solution is to keep older people in their homes longer and support their independent life through the use of information and communication technologies (ICT). However, the aged care sector is still in the early stages of adopting ICT. The aim of this study was to identify the key issues that affect the adoption of ICT in the aged care sector. A systematic literature review was undertaken and involved four steps. The first two steps aimed to identify and select relevant articles. Data was then extracted from the selected articles and identified issues were analyzed and grouped into three major categories. ICT adoption issues were categorized into different perspectives, representing older people, health professionals and management. Our findings showed that all three groups were mostly concerned with issues around behavior, cost and lack of technical skills. Findings reported in this study will help decision makers at aged care settings to systematically understand issues related to ICT adoption and thus proactively introduce interventions to improve use of ICT in this sector. On the basis of our findings, we suggest future research focus on the examination of aged care workflow and assessment of return on ICT investment. Copyright © 2015. Published by Elsevier Ireland Ltd.

Building Stronger State Partnerships with the US Department of Energy (Energy Assurance)

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

Mike Keogh

2011-09-30

From 2007 until 2011, the National Association of Regulatory Utility Commissioners (NARUC) engaged in a partnership with the National Energy Technology Lab (NETL) to improve State-Federal coordination on electricity policy and energy assurance issues. This project allowed State Public Utility Commissioners and their staffs to engage on the most cutting-edge level in the arenas of energy assurance and electricity policy. Four tasks were outlined in the Statement of Performance Objectives: Task 1 - Training for Commissions on Critical Infrastructure Topics; Task 2 - Analyze and Implement Recommendations on Energy Assurance Issues; Task 3 - Ongoing liaison activities & outreach tomore » build stronger networks between federal agencies and state regulators; and Task 4 - Additional Activities. Although four tasks were prescribed, in practice these tasks were carried out under two major activity areas: the critical infrastructure and energy assurance partnership with the US Department of Energy's Infrastructure Security and Emergency Response office, and the National Council on Electricity Policy, a collaborative which since 1994 has brought together State and Federal policymakers to address the most pressing issues facing the grid from restructuring to smart grid implementation. On Critical Infrastructure protection, this cooperative agreement helped State officials yield several important advances. The lead role on NARUC's side was played by our Committee on Critical Infrastructure Protection. Key lessons learned in this arena include the following: (1) Tabletops and exercises work - They improve the capacity of policymakers and their industry counterparts to face the most challenging energy emergencies, and thereby equip these actors with the capacity to face everything up to that point as well. (2) Information sharing is critical - Connecting people who need information with people who have information is a key success factor. However, exposure of critical infrastructure information to bad actors also creates new vulnerabilities. (3) Tensions exist between the transparency-driven basis of regulatory activity and the information-protection requirements of asset protection. (4) Coordination between states is a key success factor - Because comparatively little federal authority exists over electricity and other energy infrastructure, the interstate nature of these energy grids defy centralized command and control governance. Patchwork responses are a risk when addressed at a state-by-state level. Coordination is the key to ensuring consistent response to shared threats. In Electricity Policy, the National Council on Electricity Policy continued to make important strides forward. Coordinated electricity policy among States remains the best surrogate for an absent national electricity policy. In every area from energy efficiency to clean coal, State policies are driving the country's electricity policy, and regional responses to climate change, infrastructure planning, market operation, and new technology deployment depend on a forum for bringing the States together.« less

Sediment source fingerprinting as an aid to catchment management: A review of the current state of knowledge and a methodological decision-tree for end-users.

PubMed

Collins, A L; Pulley, S; Foster, I D L; Gellis, A; Porto, P; Horowitz, A J

2017-06-01

The growing awareness of the environmental significance of fine-grained sediment fluxes through catchment systems continues to underscore the need for reliable information on the principal sources of this material. Source estimates are difficult to obtain using traditional monitoring techniques, but sediment source fingerprinting or tracing procedures, have emerged as a potentially valuable alternative. Despite the rapidly increasing numbers of studies reporting the use of sediment source fingerprinting, several key challenges and uncertainties continue to hamper consensus among the international scientific community on key components of the existing methodological procedures. Accordingly, this contribution reviews and presents recent developments for several key aspects of fingerprinting, namely: sediment source classification, catchment source and target sediment sampling, tracer selection, grain size issues, tracer conservatism, source apportionment modelling, and assessment of source predictions using artificial mixtures. Finally, a decision-tree representing the current state of knowledge is presented, to guide end-users in applying the fingerprinting approach. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Human Trafficking: How Nurses Can Make a Difference.

PubMed

Scannell, Meredith; MacDonald, Andrea E; Berger, Amanda; Boyer, Nichole

Human trafficking is a human rights violation and a global health problem. Victims of human trafficking have medical and mental health sequelae requiring specific healthcare interventions. Healthcare professionals may be the initial contact that these victims make outside the world of trafficking. Healthcare professionals are key agents in the identification of human trafficking, which is essential in eliminating this public health problem. Unfortunately, healthcare professionals are not always able to detect signs of human trafficking. Failure to detect results in missed opportunities to assist victims. This is a case report of a victim of human trafficking who presented to an emergency department with medical and mental health issues. Despite numerous encounters with different healthcare professionals, signs and symptoms of human trafficking were not identified. Skilled assessment made by a forensic nurse alerted the healthcare team to clear features of human trafficking associated with this person. Through this case report we illustrate the key role the nurse played in identifying signs of human trafficking. Improvement of human trafficking educational programs is highlighted as a key adjunct to improving detection and facilitating the proper treatment of victims.

The public's belief in climate change and its human cause are increasing over time.

PubMed

Milfont, Taciano L; Wilson, Marc S; Sibley, Chris G

2017-01-01

Polls examining public opinion on the subject of climate change are now commonplace, and one-off public opinion polls provide a snapshot of citizen's opinions that can inform policy and communication strategies. However, cross-sectional polls do not track opinions over time, thus making it impossible to ascertain whether key climate change beliefs held by the same group of individuals are changing or not. Here we examine the extent to which individual's level of agreement with two key beliefs ("climate change is real" and "climate change is caused by humans") remain stable or increase/decrease over a six-year period in New Zealand using latent growth curve modelling (n = 10,436). Data were drawn from the New Zealand Attitudes and Values Study, a probabilistic national panel study, and indicated that levels of agreement to both beliefs have steadily increased over the 2009-2015 period. Given that climate change beliefs and concerns are key predictors of climate change action, our findings suggest that a combination of targeted endeavors, as well as serendipitous events, may successfully convey the emergency of the issue.

Health Economics of Nutrition Intervention in Asia: Cost of Malnutrition.

PubMed

Mizumoto, Kaori; Murakami, Genki; Oshidari, Kenro; Trisnantoro, Laksono; Yoshiike, Nobuo

2015-01-01

Asia has recorded the fastest economic growth in the world. However, some countries are still struggling with economic stagnation and poverty. Even in the emerging countries, there are economic disparities between urban and rural areas within a country. Reflecting the situations, nutritional issues in Asia came to be the antithetical situation of excess and insufficiency. The rate of overweight and obesity keeps increasing, especially in emerging countries. Meanwhile, underweight is still a critical problem in the region. Although the importance of nutrition is well recognized for social and economic development, it is difficult to identify the immediate outcome of nutrition interventions. Evidence-based decision-making is an important element of quality health care and efficiency and effectiveness are always key words. Along with enhanced attention to accountability and transparency of budget use in health services, attention to the economic evaluation of nutrition interventions has increased in recent years. In this symposium, we will review the current situation of nutritional issues and economic evaluation of nutrition interventions in Asia through experience of an international organization, the basis and trends for health care economics, and also efforts have been made in an Asian country. Discussion will be made about efficient and effective ways to evaluate projects/programmes for nutrition improvement.

HESS Opinions "On forecast (in)consistency in a hydro-meteorological chain: curse or blessing?"

NASA Astrophysics Data System (ADS)

Pappenberger, F.; Cloke, H. L.; Persson, A.; Demeritt, D.

2011-01-01

Flood forecasting increasingly relies on Numerical Weather Prediction (NWP) forecasts to achieve longer lead times (see Cloke et al., 2009; Cloke and Pappenberger, 2009). One of the key difficulties that is emerging in constructing a decision framework for these flood forecasts is when consecutive forecasts are different, leading to different conclusions regarding the issuing of forecasts, and hence inconsistent. In this opinion paper we explore some of the issues surrounding such forecast inconsistency (also known as "jumpiness", "turning points", "continuity" or number of "swings"; Zoster et al., 2009; Mills and Pepper, 1999; Lashley et al., 2008). We begin by defining what forecast inconsistency is; why forecasts might be inconsistent; how we should analyse it; what we should do about it; how we should communicate it and whether it is a totally undesirable property. The property of consistency is increasingly emerging as a hot topic in many forecasting environments (for a limited discussion on NWP inconsistency see Persson, 2011). However, in this opinion paper we restrict the discussion to a hydro-meteorological forecasting chain in which river discharge forecasts are produced using inputs from NWP. In this area of research (in)consistency is receiving recent interest and application (see e.g., Bartholmes et al., 2008; Pappenberger et al., 2011).

Using exercises to identify Veterans Health Administration priorities for disaster response: findings from the New Madrid Earthquake training exercise.

PubMed

Gin, June L; Chan, Edward W; Brewster, Pete; Mitchell, Michael N; Ricci, Karen A; Afable, Melissa K; Dobalian, Aram

2013-01-01

Emergency managers are often charged with prioritizing the relative importance of key issues and tasks associated with disaster response. However, little work has been done to identify specific ways that the decision-making process can be improved. This exercise was conducted with 220 employees of the US Department of Veterans Affairs, who were asked to assign priority rankings to a list of possible options of the most important issues to address after a hypothetical disaster scenario impacting a Veterans Affairs Medical Center. We found that groups that were assigned to represent perspectives farther from the impacted site had less agreement in their identification of the top priorities than those assigned to the impacted facility. These findings suggest that greater geographic and administrative proximity to the impacted site may generate greater clarity and certainty about priority setting. Given the complex structure of many organizations, and the multiple levels of group decision making and coordination likely to be needed during disasters, research to better understand training needs with respect to decision making is essential to improve preparedness. Relatively simple modifications to exercises, as outlined here, could provide valuable information to better understand emergency management decision making across multiple organizational levels.

Taking action against ocean acidification: a review of management and policy options.

PubMed

Billé, Raphaël; Kelly, Ryan; Biastoch, Arne; Harrould-Kolieb, Ellycia; Herr, Dorothée; Joos, Fortunat; Kroeker, Kristy; Laffoley, Dan; Oschlies, Andreas; Gattuso, Jean-Pierre

2013-10-01

Ocean acidification has emerged over the last two decades as one of the largest threats to marine organisms and ecosystems. However, most research efforts on ocean acidification have so far neglected management and related policy issues to focus instead on understanding its ecological and biogeochemical implications. This shortfall is addressed here with a systematic, international and critical review of management and policy options. In particular, we investigate the assumption that fighting acidification is mainly, but not only, about reducing CO2 emissions, and explore the leeway that this emerging problem may open in old environmental issues. We review nine types of management responses, initially grouped under four categories: preventing ocean acidification; strengthening ecosystem resilience; adapting human activities; and repairing damages. Connecting and comparing options leads to classifying them, in a qualitative way, according to their potential and feasibility. While reducing CO2 emissions is confirmed as the key action that must be taken against acidification, some of the other options appear to have the potential to buy time, e.g. by relieving the pressure of other stressors, and help marine life face unavoidable acidification. Although the existing legal basis to take action shows few gaps, policy challenges are significant: tackling them will mean succeeding in various areas of environmental management where we failed to a large extent so far.

Taking Action Against Ocean Acidification: A Review of Management and Policy Options

NASA Astrophysics Data System (ADS)

Billé, Raphaël; Kelly, Ryan; Biastoch, Arne; Harrould-Kolieb, Ellycia; Herr, Dorothée; Joos, Fortunat; Kroeker, Kristy; Laffoley, Dan; Oschlies, Andreas; Gattuso, Jean-Pierre

2013-10-01

Ocean acidification has emerged over the last two decades as one of the largest threats to marine organisms and ecosystems. However, most research efforts on ocean acidification have so far neglected management and related policy issues to focus instead on understanding its ecological and biogeochemical implications. This shortfall is addressed here with a systematic, international and critical review of management and policy options. In particular, we investigate the assumption that fighting acidification is mainly, but not only, about reducing CO2 emissions, and explore the leeway that this emerging problem may open in old environmental issues. We review nine types of management responses, initially grouped under four categories: preventing ocean acidification; strengthening ecosystem resilience; adapting human activities; and repairing damages. Connecting and comparing options leads to classifying them, in a qualitative way, according to their potential and feasibility. While reducing CO2 emissions is confirmed as the key action that must be taken against acidification, some of the other options appear to have the potential to buy time, e.g. by relieving the pressure of other stressors, and help marine life face unavoidable acidification. Although the existing legal basis to take action shows few gaps, policy challenges are significant: tackling them will mean succeeding in various areas of environmental management where we failed to a large extent so far.

Emerging applications of nanotechnology for diagnosis and therapy of disease: a review.

PubMed

Bayford, Richard; Rademacher, Tom; Roitt, Ivan; Wang, Scarlet Xiaoyan

2017-07-24

Nanotechnology is of increasing interest in the fields of medicine and physiology over recent years. Its application could considerably improve disease detection and therapy, and although the potential is considerable, there are still many challenges that need to be addressed before it is accepted in routine clinical use. This review focuses on emerging applications that nanotechnology could enhance or provide new approaches in diagnoses and therapy. The main focus of recent research centres on targeted therapies and enhancing imaging; however, the introduction of nanomaterial into the human body must be controlled, as there are many issues with possible toxicity and long-term effects. Despite these issues, the potential for nanotechnology to provide new methods of combating cancer and other disease conditions is considerable. There are still key challenges for researchers in this field, including the means of delivery and targeting in the body to provide effective treatment for specific disease conditions. Nanoparticles are difficult to measure due to their size and physical properties; hence there is still a great need to improve physiological measurement methods in the field to ascertain how effective their use is in the human subject. This review is a brief snapshot into the fast changing research field of measurement and physiological links to nanoparticle use and its potential in the future.

Mobile-health: A review of current state in 2015.

PubMed

Silva, Bruno M C; Rodrigues, Joel J P C; de la Torre Díez, Isabel; López-Coronado, Miguel; Saleem, Kashif

2015-08-01

Health telematics is a growing up issue that is becoming a major improvement on patient lives, especially in elderly, disabled, and chronically ill. In recent years, information and communication technologies improvements, along with mobile Internet, offering anywhere and anytime connectivity, play a key role on modern healthcare solutions. In this context, mobile health (m-Health) delivers healthcare services, overcoming geographical, temporal, and even organizational barriers. M-Health solutions address emerging problems on health services, including, the increasing number of chronic diseases related to lifestyle, high costs of existing national health services, the need to empower patients and families to self-care and handle their own healthcare, and the need to provide direct access to health services, regardless of time and place. Then, this paper presents a comprehensive review of the state of the art on m-Health services and applications. It surveys the most significant research work and presents a deep analysis of the top and novel m-Health services and applications proposed by industry. A discussion considering the European Union and United States approaches addressing the m-Health paradigm and directives already published is also considered. Open and challenging issues on emerging m-Health solutions are proposed for further works. Copyright © 2015 Elsevier Inc. All rights reserved.

Arsenic and Environmental Health: State of the Science and ...

EPA Pesticide Factsheets

Background: Exposure to inorganic and organic arsenic compounds is a major public health problem that affects hundreds of millions of people worldwide. Exposure to arsenic is associated with cancer and noncancer effects in nearly every organ in the body, and evidence is mounting for health effects at lower levels of arsenic exposure than previously thought. Building from a tremendous knowledge base with > 1,000 scientific papers published annually with “arsenic” in the title, the question becomes, what questions would best drive future research directions? Objectives: The objective is to discuss emerging issues in arsenic research and identify data gaps across disciplines. Methods: The National Institutes of Health’s National Institute of Environmental Health Sciences Superfund Research Program convened a workshop to identify emerging issues and research needs to address the multi-faceted challenges related to arsenic and environmental health. This review summarizes information captured during the workshop. Discussion: More information about aggregate exposure to arsenic is needed, including the amount and forms of arsenic found in foods. New strategies for mitigating arsenic exposures and related health effects range from engineered filtering systems to phytogenetics and nutritional interventions. Furthermore, integration of omics data with mechanistic and epidemiological data is a key step toward the goal of linking biomarkers of exposure and suscepti

Video techniques and data compared with observation in emergency trauma care

PubMed Central

Mackenzie, C; Xiao, Y

2003-01-01

Video recording is underused in improving patient safety and understanding performance shaping factors in patient care. We report our experience of using video recording techniques in a trauma centre, including how to gain cooperation of clinicians for video recording of their workplace performance, identify strengths of video compared with observation, and suggest processes for consent and maintenance of confidentiality of video records. Video records are a rich source of data for documenting clinician performance which reveal safety and systems issues not identified by observation. Emergency procedures and video records of critical events identified patient safety, clinical, quality assurance, systems failures, and ergonomic issues. Video recording is a powerful feedback and training tool and provides a reusable record of events that can be repeatedly reviewed and used as research data. It allows expanded analyses of time critical events, trauma resuscitation, anaesthesia, and surgical tasks. To overcome some of the key obstacles in deploying video recording techniques, researchers should (1) develop trust with video recorded subjects, (2) obtain clinician participation for introduction of a new protocol or line of investigation, (3) report aggregated video recorded data and use clinician reviews for feedback on covert processes and cognitive analyses, and (4) involve multidisciplinary experts in medicine and nursing. PMID:14645896

76 FR 26290 - Science Advisory Board Staff Office; Notification of a Public Teleconference of the Chartered...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... report entitled ``SAB Review of EPA's Reanalysis of Key Issues Related to Dioxin Toxicity and Response to... of EPA's Reanalysis of Key Issues Related to Dioxin Toxicity and Response to NAS Comments.'' The SAB... Reanalysis of Key Issues Related to Dioxin Toxicity and Response to NAS Comments.'' To conduct this review...

Prospects for public participation on nuclear risks and policy options: innovations in governance practices for sustainable development in the European Union.

PubMed

O'Connor, M; van den Hove, S

2001-09-14

We outline the potential participative governance and risk management in application to technological choices in the nuclear sector within the European Union (EU). Well-conducted public participation, stakeholder consultation and deliberation procedures can enhance the policy process and improve the robustness of strategies dealing with high-stakes investment and risk management challenges. Key nuclear issues now confronting EU member states are: public concern with large-scale environmental and health issues; the Chernobyl accident (and others less catastrophic) whose effect has been to erode public confidence and trust in the nuclear sector; the maturity of the nuclear plant, hence the emerging prominence of waste transportation, reprocessing and disposal issues as part of historical liability within the EU; the nuclear energy heritage of central and eastern European candidate countries to EU accession. The obligatory management of inherited technological risks and uncertainties on large temporal and geographical scales, is a novel feature of technology assessment and governance. Progress in the nuclear sector will aid the development of methodologies for technological foresight and risk governance in fields other than the nuclear alone.

Emerging and recurrent issues in drug development.

PubMed

Anello, C

This paper reviews several emerging and recurrent issues relating to the drug development process. These emerging issues include changes to the FDA regulatory environment, internationalization of drug development, advances in computer technology and visualization tools, and efforts to incorporate meta-analysis methodology. Recurrent issues include: renewed interest in statistical methods for handling subgroups in the design and analysis of clinical trials; renewed interest in alternatives to the 'intention-to-treat' analysis in the presence of non-compliance in randomized clinical trials; renewed interest in methodology to address the multiplicities resulting from a variety of sources inherent in the drug development process, and renewed interest in methods to assure data integrity. These emerging and recurrent issues provide a continuing challenge to the international community of statisticians involved in drug development. Moreover, the involvement of statisticians with different perspectives continues to enrich the field and contributes to improvement in the public health.

Iraq Reconstruction: Lessons from Auditing U.S.-funded Stabilization and Reconstruction Activities

DTIC Science & Technology

2012-10-01

Emergency Response Program: Hotel Construction Successfully Completed, but Project Management Issues Remain 09-025 7/26/2009 Commander’s Emergency...Emergency Response Pro- gram: Hotel Construction Completed, but Project Management Issues Remain,” 7/26/2009. 47. SIGIR Audit 11-003, “Iraqi Security Forces

ERCMExpress. Volume 2, Issue 1

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

This issue of the Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress" focuses on integrating students with special needs and disabilities into emergency response and crisis management planning. Meeting the needs of students with disabilities and special needs in the event of an emergency does not have to be…

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

PubMed

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

2017-01-01

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

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

PubMed

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

2016-06-01

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

Components of Comprehensive School and School District Emergency Management Plans. Helpful Hints for School Emergency Management. Volume 2, Issue 2, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. This issue describes and contains a checklist that can assist schools and school districts in developing a new emergency management plan or refreshing their current one. To use the checklist, individuals should consider…

Editorial: emerging issues in sociotechnical systems thinking and workplace safety.

PubMed

Noy, Y Ian; Hettinger, Lawrence J; Dainoff, Marvin J; Carayon, Pascale; Leveson, Nancy G; Robertson, Michelle M; Courtney, Theodore K

2015-01-01

The burden of on-the-job accidents and fatalities and the harm of associated human suffering continue to present an important challenge for safety researchers and practitioners. While significant improvements have been achieved in recent decades, the workplace accident rate remains unacceptably high. This has spurred interest in the development of novel research approaches, with particular interest in the systemic influences of social/organisational and technological factors. In response, the Hopkinton Conference on Sociotechnical Systems and Safety was organised to assess the current state of knowledge in the area and to identify research priorities. Over the course of several months prior to the conference, leading international experts drafted collaborative, state-of-the-art reviews covering various aspects of sociotechnical systems and safety. These papers, presented in this special issue, cover topics ranging from the identification of key concepts and definitions to sociotechnical characteristics of safe and unsafe organisations. This paper provides an overview of the conference and introduces key themes and topics. Sociotechnical approaches to workplace safety are intended to draw practitioners' attention to the critical influence that systemic social/organisational and technological factors exert on safety-relevant outcomes. This paper introduces major themes addressed in the Hopkinton Conference within the context of current workplace safety research and practice challenges.

Editorial: emerging issues in sociotechnical systems thinking and workplace safety

PubMed Central

Noy, Y. Ian; Hettinger, Lawrence J.; Dainoff, Marvin J.; Carayon, Pascale; Leveson, Nancy G.; Robertson, Michelle M.; Courtney, Theodore K.

2015-01-01

The burden of on-the-job accidents and fatalities and the harm of associated human suffering continue to present an important challenge for safety researchers and practitioners. While significant improvements have been achieved in recent decades, the workplace accident rate remains unacceptably high. This has spurred interest in the development of novel research approaches, with particular interest in the systemic influences of social/organisational and technological factors. In response, the Hopkinton Conference on Sociotechnical Systems and Safety was organised to assess the current state of knowledge in the area and to identify research priorities. Over the course of several months prior to the conference, leading international experts drafted collaborative, state-of-the-art reviews covering various aspects of sociotechnical systems and safety. These papers, presented in this special issue, cover topics ranging from the identification of key concepts and definitions to sociotechnical characteristics of safe and unsafe organisations. This paper provides an overview of the conference and introduces key themes and topics. Practitioner Summary: Sociotechnical approaches to workplace safety are intended to draw practitioners' attention to the critical influence that systemic social/organisational and technological factors exert on safety-relevant outcomes. This paper introduces major themes addressed in the Hopkinton Conference within the context of current workplace safety research and practice challenges. PMID:25819595

On data processing required to derive mobility patterns from passively-generated mobile phone data

PubMed Central

Wang, Feilong; Chen, Cynthia

2018-01-01

Passively-generated mobile phone data is emerging as a potential data source for transportation research and applications. Despite the large amount of studies based on the mobile phone data, only a few have reported the properties of such data, and documented how they have processed the data. In this paper, we describe two types of common mobile phone data: Call Details Record (CDR) data and sightings data, and propose a data processing framework and the associated algorithms to address two key issues associated with the sightings data: locational uncertainty and oscillation. We show the effectiveness of our proposed methods in addressing these two issues compared to the state of art algorithms in the field. We also demonstrate that without proper processing applied to the data, the statistical regularity of human mobility patterns—a key, significant trait identified for human mobility—is over-estimated. We hope this study will stimulate more studies in examining the properties of such data and developing methods to address them. Though not as glamorous as those directly deriving insights on mobility patterns (such as statistical regularity), understanding properties of such data and developing methods to address them is a fundamental research topic on which important insights are derived on mobility patterns. PMID:29398790

Teaching professionalism in the digital age on the psychiatric consultation-liaison service.

PubMed

Baer, Wendy; Schwartz, Ann C

2011-01-01

The rapid emergence of social media, including Facebook and YouTube, have added a new dimension to defining, teaching, and role modeling professionalism in the medical field. Explicit and consistent role modeling of professional behaviors are needed to encourage the development of professional physicians. The purpose of this article is to investigate the challenges and opportunities at the interface of professionalism and social media for physicians. The medical literature via PubMed was reviewed with key words including "Facebook," "YouTube," "social media," "digital media," and key issues are discussed. Our residency program was surveyed regarding their experiences with digital media in medical practice and the findings are discussed. Sample topics and relevant, thought provoking questions generated from our practices are outlined. Case vignettes are offered to exemplify issues with regard to professionalism raised by digital and social media in medical practice. Social media sites offer great opportunity to widely distribute valuable health care information as well as provide physicians with a venue to de-stress. In this new digital age, trainees and lifelong learners must learn to be mindful of professionalism while using social media in order to protect their privacy as well as the image of physicians. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

What Curriculum for the 21st Century?

ERIC Educational Resources Information Center

New Things Considered, 1990

1990-01-01

"New Things Considered" reports on emerging trends and issues in education to policymakers and participants in SEDL-SCAN, an emerging issues tracking system being pilot tested by the Southwest Educational Development Laboratory's Policy Information Service and the State of New Mexico. This issue presents brief summaries of the thinking of…

A view of software management issues

NASA Technical Reports Server (NTRS)

Manley, J. H.

1985-01-01

The Software Development Environment (SDE) Panel addressed key programmatic, scope, and structural issues raised by its members and the general audience regarding the proposed software development environment for the Space Station program. The general team approach taken by this group led to a consensus on 18 recommendations to NASA mangament regarding the acquisition and definition of the SDE. This approach was keyed by the initial issues presentation given to the general audience. Additional issues (for a total of 23) were developed by the panelists in their first closed session from which key areas were selected and discussed in open session. These discussions led to key recommendations which are summarized and described.

Overcrowding and diversion in the emergency department: the health care safety net unravels.

PubMed

Velianoff, George D

2002-03-01

Emergency department overcrowding and diversion of patients are serious problems that are symptomatic of larger health care system issues. Downsizing, government regulations, managed care, increased numbers of uninsured, and reimbursement decreases are issues that have created the overcrowding and diversion issues. The Emergency Medical Treatment and Active Labor Act (EMTALA), poor operations and hospital processes, unavailable inpatient beds and closures, consolidations and workforce shortages are also contributors to the overcrowding and diversion issues. Options and solutions are proposed to alleviate the problem, however, greater collaboration, changed work environments, and reimbursement structures need to be developed and instituted. The safety net of the US health system is unraveling, and without intervention, the emergency department will not be able to provide services to the public at any level of quality and efficiency.

The limits of public communication coordination in a nuclear emergency: lessons from media reporting on the Fukushima case.

PubMed

Prezelj, Iztok; Perko, Tanja; Cantone, Marie C; Gallego, Eduardo; Tomkiv, Yevgeniya; Oughton, Deborah H

2016-06-01

Coordination of public communication has become a key issue in management of complex emergencies, and is a matter of debate between nuclear emergency management professionals. A particular problem is when inconsistent information is sent to the media and public by official sources from different levels, which has led to calls for a more coordinated approach. The IAEA created guidelines recommending a one-voice communication approach that provides clear, consistent and coordinated information by relevant stakeholders. The reviewed theory on the emergency communication coordination and the empirical results in this paper demonstrate some challenges regarding the feasibility of the above stated goal. This paper explores the communication process in the two-month period of the Fukushima nuclear emergency by using a quantitative comparative content and discourse analysis of 1340 printed media articles on the Fukushima nuclear disaster from two major newspapers in Spain ('El País' and 'El Mundo'), Italy ('Corriere della Sera' and 'La Repubblica'), Norway ('Aftenposten' and 'Dagsavisen'), Slovenia ('Delo' and 'Večer'), Belgium ('Le Soir' and 'De Standaard') and Russia ('Komsomolskaya Pravda' and 'Izvestiya'). The results show that it will be difficult to achieve a truly coordinated approach and one-voice communication in severe nuclear and radiological emergency due to the communication difficulties created by the dispersion of information sources, a broad and dispersed focus of the reported information, partially subjective and conflicting media reporting. The paper suggests ways to improve public communication coordination in nuclear and radiological disasters.

The Virtual Learning Commons: An Emerging Technology for Learning About Emerging Technologies

NASA Astrophysics Data System (ADS)

Pennington, D. D.; Del Rio, N.; Fierro, C.; Gandara, A.; Garcia, A.; Garza, J.; Giandoni, M.; Ochoa, O.; Padilla, E.; Salamah, S.

2013-12-01

The Virtual Learning Commons (VLC), funded by the National Science Foundation Office of Cyberinfrastructure CI-Team Program, is a combination of semantic, visualization, and social media tools that support knowledge sharing and innovation across research disciplines. The explosion of new scientific tools and techniques challenges the ability of researchers to be aware of emerging technologies that might benefit them. Even when aware, it can be difficult to understand enough about emerging technologies to become potential adopters or re-users. Often, emerging technologies have little documentation, especially about the context of their use. The VLC tackles this challenge by providing mechanisms for individuals and groups of researchers to collectively organize Web resources through social bookmarking, and engage each other around those collections in order to a) learn about potentially relevant technologies that are emerging; and b) get feedback from other researchers on innovative ideas and designs. Concurrently, developers of emerging technologies can learn about potential users and the issues they encounter, and they can analyze the impact of their tools on other projects. The VLC aims to support the 'fuzzy front end' of innovation, where novel ideas emerge and there is the greatest potential for impact on research design. It is during the fuzzy front end that conceptual collisions across disciplines and exposure to diverse perspectives provide opportunity for creative thinking that can lead to inventive outcomes. This presentation will discuss the innovation theories that have informed design of the VLC, and hypotheses about the flow of information in virtual settings that can enable the process of innovation. The presentation will include a brief demonstration of key capabilities within the VLC that enable learning about emerging technologies, including the technologies that are presented in this session.

The emergence of trust in clinics of alternative medicine.

PubMed

Pedersen, Inge Kryger; Hansen, Vibeke Holm; Grünenberg, Kristina

2016-01-01

Demands for alternative medicine have increased since the 1970s in nations in which western scientific evidence has become the basis for health care. This paradox has been the impetus to examine how trust emerges in clinics of alternative medicine. Alternative practitioners are self-regulated and the clients pay out of their own pockets to attend non-authorised treatments with very limited scientific evidence of their effects. Trust is a key issue in this context. However, only a few studies have dealt with the ways in which alternative practitioners win their clients' trust. Drawing on three qualitative studies and informing the empirical findings with a sociological concept of trust, this article provides new empirical insights on how trust emerges in Danish clinics of acupuncture, reflexology and homeopathy. The analysis demonstrates how trust is situational and emerges through both clients' susceptibility and practitioners' individual skill development and strategies, as well as from objects, place and space. Trust is developed on relational and bodily as well as material grounds. It is argued that the dynamics and elements of trust identified do not only minimalise uncertainties but sometimes convert these uncertainties into productive new ways for clients to address their ailments, life circumstances and perspectives. © 2015 Foundation for the Sociology of Health & Illness.

Risks of emerging infectious diseases: evolving threats in a changing area, the mediterranean basin.

PubMed

Vittecoq, M; Thomas, F; Jourdain, E; Moutou, F; Renaud, F; Gauthier-Clerc, M

2014-02-01

The Mediterranean basin is a biodiversity hotspot; it has historically had a large human presence that has shaped ecosystems for millennia. As the cradle of many civilizations, the area was one of the main theatres for transitions that punctuated both human and pathogen histories, which are intimately linked. Today we are living through another great historical transition summarized in the expression 'global changes'. In this context, we are witnessing a rise in the emergence of pathogens widely associated with aforementioned global changes. The Mediterranean basin might be especially vulnerable to this phenomenon due to the acute consequences global changes will have in this key intercontinental interface region. In addition, Arab revolutions and European economic crisis are creating both sanitary issues and presenting new opportunities to improve infectious disease control and prevention in the region. The aim of this review is to identify the impacts that ongoing changes might have on the risk of infectious disease emergence in the Mediterranean basin. We focussed on three key domains undergoing transformations: (i) resources, namely safe drinking water and animal products, (ii) socio-economic factors including health inequalities within countries and poor sanitary conditions linked to ongoing conflicts and (iii) movements of people and goods that are reshaped by current changes and are intimately linked to the risk of disease proliferation. Building on recent examples, we try to identify upcoming challenges and discuss ways to meet them in the light of existing international human and veterinary health guidelines and their possible improvements. © 2012 Blackwell Verlag GmbH.

Identification of Barriers to Pediatric Care in Limited-Resource Settings: A Simulation Study.

PubMed

Shilkofski, Nicole; Hunt, Elizabeth A

2015-12-01

Eighty percent of the 10 million annual deaths in children aged <5 years in developing countries are estimated to be avoidable, with improvements in education for pediatric emergency management being a key factor. Education must take into account cultural considerations to be effective. Study objectives were: (1) to use simulation to identify factors posing barriers to patient care in limited resource settings (LRS); and (2) to understand how simulations in LRS can affect communication and decision-making processes. A qualitative study was conducted at 17 different sites in 12 developing countries in Asia, Latin America, and Africa. Data from observations of 68 in situ simulated pediatric emergencies were coded for thematic analysis. Sixty-two different "key informants" were interviewed regarding perceived benefit of simulations. Coding of observations and interviews yielded common themes: impact of culture on team hierarchy, impact of communication and language barriers on situational awareness, systematic emergency procedures, role delineation, shared cognition and resource awareness through simulation, logistic barriers to patient care, and use of recognition-primed decision-making by experienced clinicians. Changes in clinical environments were implemented as a result of simulations. Ad hoc teams in LRS face challenges in caring safely for patients; these include language and cultural barriers, as well as environmental and resource constraints. Engaging teams in simulations may promote improved communication, identification of systems issues and latent threats to target for remediation. There may be a role for training novices in use of recognition-primed or algorithmic decision-making strategies to improve rapidity and efficiency of decisions in LRS. Copyright © 2015 by the American Academy of Pediatrics.

Supplying emergency contraception to adolescents: the nurse's role.

PubMed

Hopkins, Craig

2014-12-02

This article explores issues surrounding the supply of emergency contraception to adolescents to reduce the risk of unintended pregnancy. It explains the female reproductive cycle, and describes the types of emergency contraception that may be supplied following unprotected sexual intercourse or contraception failure. The aftercare that should be offered to adolescents following the supply of emergency contraception is discussed, alongside issues surrounding the safeguarding of children and vulnerable adults.

Canadian Rural/Remote Primary Care Physicians Perspectives on Child/Adolescent Mental Health Care Service Delivery

PubMed Central

Zayed, Richard; Davidson, Brenda; Nadeau, Lucie; Callanan, Terrence S.; Fleisher, William; Hope-Ross, Lindsay; Espinet, Stacey; Spenser, Helen R.; Lipton, Harold; Srivastava, Amresh; Lazier, Lorraine; Doey, Tamison; Khalid-Khan, Sarosh; McKerlie, Ann; Stretch, Neal; Flynn, Roberta; Abidi, Sabina; St. John, Kimberly; Auclair, Genevieve; Liashko, Vitaly; Fotti, Sarah; Quinn, Declan; Steele, Margaret

2016-01-01

Introduction: Primary Care Physicians (PCP) play a key role in the recognition and management of child/adolescent mental health struggles. In rural and under-serviced areas of Canada, there is a gap between child/adolescent mental health needs and service provision. Methods: From a Canadian national needs assessment survey, PCPs’ narrative comments were examined using quantitative and qualitative approaches. Using the phenomenological method, individual comments were drawn upon to illustrate the themes that emerged. These themes were further analyzed using chi-square to identify significant differences in the frequency in which they were reported. Results: Out of 909 PCPs completing the survey, 39.38% (n = 358) wrote comments. Major themes that emerged were: 1) psychiatrist access, including issues such as long waiting lists, no child/adolescent psychiatrists available, no direct access to child/adolescent psychiatrists; 2) poor communication/continuity, need for more systemized/transparent referral processes, and need to rely on adult psychiatrists; and, 3) referral of patients to other mental health professionals such as paediatricians, psychologists, and social workers. Conclusions: Concerns that emerged across sites primarily revolved around lack of access to care and systems issues that interfere with effective service delivery. These concerns suggest potential opportunities for future improvement of service delivery. Implications: Although the survey only had one comment box located at the end, PCPs wrote their comments throughout the survey. Further research focusing on PCPs’ expressed written concerns may give further insight into child/adolescent mental health care service delivery systems. A comparative study targeting urban versus rural regions in Canada may provide further valuable insights. PMID:27047554

Implementation of pre-exposure prophylaxis for human immunodeficiency virus infection: progress and emerging issues in research and policy.

PubMed

Cáceres, Carlos F; Borquez, Annick; Klausner, Jeffrey D; Baggaley, Rachel; Beyrer, Chris

2016-01-01

In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives. Those guidelines present a timely challenge to health systems for the scaling up of not only treatment for every person living with HIV infection but also the offer of PrEP to those at substantial risk. Delivery and uptake of both universal antiretroviral therapy (ART) and PrEP will require nation-wide commitment and could reinvigorate health systems to develop more comprehensive "combination prevention" programmes and support wider testing linked to both treatments and other prevention options for populations at highest risk who are currently not accessing services. Various gaps in current health systems will need to be addressed to achieve strategic scale-up of PrEP, including developing prioritization strategies, strengthening drug regulations, determining cost and funding sources, training health providers, supporting user adherence and creating demand. The initial steps in the scale-up of PrEP globally suggest feasibility, acceptability and likely impact. However, to prevent setbacks in less well-resourced settings, countries will need to anticipate and address challenges such as operational and health systems barriers, drug cost and regulatory policies, health providers' openness to prescribing PrEP to populations at substantial risk, demand and legal and human rights issues. Emerging problems will require creative solutions and will continue to illustrate the complexity of PrEP implementation.

Implementation of pre-exposure prophylaxis for human immunodeficiency virus infection: progress and emerging issues in research and policy

PubMed Central

Cáceres, Carlos F; Borquez, Annick; Klausner, Jeffrey D; Baggaley, Rachel; Beyrer, Chris

2016-01-01

Background In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. Discussion The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives. Those guidelines present a timely challenge to health systems for the scaling up of not only treatment for every person living with HIV infection but also the offer of PrEP to those at substantial risk. Delivery and uptake of both universal antiretroviral therapy (ART) and PrEP will require nation-wide commitment and could reinvigorate health systems to develop more comprehensive “combination prevention” programmes and support wider testing linked to both treatments and other prevention options for populations at highest risk who are currently not accessing services. Various gaps in current health systems will need to be addressed to achieve strategic scale-up of PrEP, including developing prioritization strategies, strengthening drug regulations, determining cost and funding sources, training health providers, supporting user adherence and creating demand. Conclusions The initial steps in the scale-up of PrEP globally suggest feasibility, acceptability and likely impact. However, to prevent setbacks in less well-resourced settings, countries will need to anticipate and address challenges such as operational and health systems barriers, drug cost and regulatory policies, health providers’ openness to prescribing PrEP to populations at substantial risk, demand and legal and human rights issues. Emerging problems will require creative solutions and will continue to illustrate the complexity of PrEP implementation. PMID:27760685

The eMERGE Network: a consortium of biorepositories linked to electronic medical records data for conducting genomic studies.

PubMed

McCarty, Catherine A; Chisholm, Rex L; Chute, Christopher G; Kullo, Iftikhar J; Jarvik, Gail P; Larson, Eric B; Li, Rongling; Masys, Daniel R; Ritchie, Marylyn D; Roden, Dan M; Struewing, Jeffery P; Wolf, Wendy A

2011-01-26

The eMERGE (electronic MEdical Records and GEnomics) Network is an NHGRI-supported consortium of five institutions to explore the utility of DNA repositories coupled to Electronic Medical Record (EMR) systems for advancing discovery in genome science. eMERGE also includes a special emphasis on the ethical, legal and social issues related to these endeavors. The five sites are supported by an Administrative Coordinating Center. Setting of network goals is initiated by working groups: (1) Genomics, (2) Informatics, and (3) Consent & Community Consultation, which also includes active participation by investigators outside the eMERGE funded sites, and (4) Return of Results Oversight Committee. The Steering Committee, comprised of site PIs and representatives and NHGRI staff, meet three times per year, once per year with the External Scientific Panel. The primary site-specific phenotypes for which samples have undergone genome-wide association study (GWAS) genotyping are cataract and HDL, dementia, electrocardiographic QRS duration, peripheral arterial disease, and type 2 diabetes. A GWAS is also being undertaken for resistant hypertension in ≈ 2,000 additional samples identified across the network sites, to be added to data available for samples already genotyped. Funded by ARRA supplements, secondary phenotypes have been added at all sites to leverage the genotyping data, and hypothyroidism is being analyzed as a cross-network phenotype. Results are being posted in dbGaP. Other key eMERGE activities include evaluation of the issues associated with cross-site deployment of common algorithms to identify cases and controls in EMRs, data privacy of genomic and clinically-derived data, developing approaches for large-scale meta-analysis of GWAS data across five sites, and a community consultation and consent initiative at each site. Plans are underway to expand the network in diversity of populations and incorporation of GWAS findings into clinical care. By combining advanced clinical informatics, genome science, and community consultation, eMERGE represents a first step in the development of data-driven approaches to incorporate genomic information into routine healthcare delivery.

Key lessons for designing health literacy professional development courses.

PubMed

Naccarella, Lucio; Murphy, Bernice

2018-02-01

Health literacy courses for health professionals have emerged in response to health professionals' perceived lack of understanding of health literacy issues, and their failure to routinely adopt health literacy practices. Since 2013 in Victoria, Australia, the Centre for Culture, Ethnicity and Health has delivered an annual health literacy demonstration training course that it developed. Course development and delivery partners included HealthWest Partnership and cohealth. The courses are designed to develop the health literacy knowledge, skills and organisational capacity of the health and community services sector in the western metropolitan region of Melbourne. This study presents key learnings from evaluation data from three health literacy courses using Wenger's professional educational learning design framework. The framework has three educational learning architecture components (engagement, imagination and alignment) and four educational learning architecture dimensions (participation, emergent, local/global, identification). Participatory realist evaluation approaches and qualitative methods were used. The evaluations revealed that the health literacy courses are developing leadership in health literacy, building partnerships among course participants, developing health literacy workforce knowledge and skills, developing ways to use and apply health literacy resources and are serving as a catalyst for building organisational infrastructure. Although the courses were not explicitly developed or implemented using Wenger's educational learning design pedagogic features, the course structure (i.e. facilitation role of course coordinators, providing safe learning environments, encouraging small group work amongst participants, requiring participants to conduct mini-projects and sponsor organisation buy-in) provided opportunities for engagement, imagination and alignment. Wenger's educational learning design framework can inform the design of future key pedagogic features of health literacy courses.

Current and Emerging Ethical Issues in Counseling: A Delphi Study of Expert Opinions

ERIC Educational Resources Information Center

Herlihy, Barbara; Dufrene, Roxane L.

2011-01-01

A Delphi study was conducted to ascertain the opinions of panel experts regarding the most important current and emerging ethical issues facing the counseling profession. Expert opinions on ethical issues in counselor preparation also were sought. Eighteen panelists responded to 3 rounds of data collection interspersed with feedback. Themes that…

75 FR 51240 - New England Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... definition that may be considered in Amendment 15 based on results from the recent stock assessment. If time permits the Committee may discuss other issues. Although non-emergency issues not contained in this agenda... issues arising after publication of this notice that require emergency action under section 305(c) of the...

Education Studies: Issues & Critical Perspectives

ERIC Educational Resources Information Center

Kassem, Derek; Mufti, Emmanuel; Robinson, John

2006-01-01

This major text for Education Studies students provides a critical account of key issues in education today. The text features: (1) A critical analysis of key issues in Education Studies to encourage students' thinking about education in the broadest terms; (2) Themed sections with introductions to link the issues discussed in each chapter; (3)…

MO-D-BRB-02: SBRT Treatment Planning and Delivery

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

Yang, Y.

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (inmore » particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.« less

Reaction to Psychological Maltreatment in Schools: Emerging Issues for Counselors.

ERIC Educational Resources Information Center

Remley, Theodore P., Jr.

1989-01-01

Responds to Lynda Neese's "Psychological Maltreatment in Schools: Emerging Issues for Counselors." Discusses the legal system's lack of involvement in instances of psychological maltreatment and the implications for school counselors. (BH)

[An investigation of the application of hygienic standards for the design of industrial enterprises (GBZ 1-2010)].

PubMed

Lu, Y; Zhang, M

2016-08-20

Objective: To study the applicability, the high frequency used content, the feasibility, and issues needed to be solved of the standard of GBZ 1-2010, aiming to provide technical evidence for the revision of GBZ1. Methods: In the study, the data were collected by referring to the literature database and the questionnaire from June 2013 to June 2015. There were 2 surveys carried out in the study, with methods including questionnaire survey and specific interview. The investigation methods include the paper version of the questionnaire by mail, the electronic version of the questionnaire by e-mail, and the online survey. And 111 questionnaires were collected. Results: In total, the applicability survey (the first survey) received 156 suggestions covering 76 items from 23 facilities, and 13 key technical issues were summarized to be solved as priorities. In the application survey (the second survey) , the leading three jobs using GBZ 1-2010 were the occupational hazards evaluation for constructive project (82.0%) , lecturing/training (65.8%) , occupational hazards monitoring (64.9%) , respectively. The high frequency used contents of GBZ 1-2010 were the sixth part "the basic hygienic requirements for workplace" (90.1%) , the fifth part "site selection, overall layout and workshop design" (87.4%) , the seventh part "the basic hygienic requirements for welfare room" (85.6%) , respectively. In the results of feasibility, scores of the fourth part "the general rules" , the fifth part "site selection, overall layout and workshop design" , the sixth part "the basic hygienic requirements for workplace" , the seventh part "the basic hygienic requirements for welfare room" , the eighth "emergency rescue" , annex A "the correct use instructions" , annex B "buffer zone standards for industrial enterprises" were 2.6, 3.1, 3.5, 3.8, 3.2, 3.3, 2.6, respectively. Among 111 questionnaires, the parts needed to be modified as priories were the fifth part "site selection, overall layout and workshop design" (51.4%) , and the sixth part "the basic hygienic requirements for workplace" (51.4%) . In results of the key technical issues needed to be modified of GBZ 1-2010, the contents needed to be added as priories were the occupational prevention and control requirements of biological factors (51.4%) , technical parameters of dust in workplace (48.7%) , technical parameters of hazardous agents in workplace (46.9%) , the quality and quantity requirements of fresh air (46.0%) , the setting conditions of the emergency rescue station (46.0%) , the hygienic design requirements of joint workshops and the evidence (45.1%) , and requirements for medical emergency rescue personnel equipped and qualified (45.1%) . Conclusion: GBZ 1-2010 is feasible and practical, mainly used by occupational health technical service organizations in the occupational hazards evaluation for constructive project, lecturing/training, occupational hazards monitoring, et al. GBZ 1 plays a directive role in government decision-making, control of constructive projects from the beginning, training and capacity building of occupational health professionals, and the prevention and treatment of occupational diseases in enterprises, needing to strengthen the implementation of GBZ 1. And on the basis of the above key technical issues to be revised, international cooperation and exchanges should be strengthened, so that it is adapted to the development of the modern enterprise system.

Strategies of Educational Decentralization: Key Questions and Core Issues.

ERIC Educational Resources Information Center

Hanson, E. Mark

1998-01-01

Explains key issues and forces that shape organization and management strategies of educational decentralization, using examples from Colombia, Venezuela, Argentina, Nicaragua, and Spain. Core decentralization issues include national and regional goals, planning, political stress, resource distribution, infrastructure development, and job…

A new era of emergency care: planning and design consideration.

PubMed

Zilm, Frank

2007-01-01

Emergency care is one of the most complex, rapidly growing areas of ambulatory care. Providers need to consider new issues related to management of low-acuity patients, capacity for surge events, and the need to integrate patient focused care into the emergency department environment. This article explores these issues and discusses basic organizational topologies for facilities.

Emergence, Learning Difficulties, and Misconceptions in Chemistry Undergraduate Students' Conceptualizations of Acid Strength

ERIC Educational Resources Information Center

Tümay, Halil

2016-01-01

Philosophical debates about chemistry have clarified that the issue of emergence plays a critical role in the epistemology and ontology of chemistry. In this article, it is argued that the issue of emergence has also significant implications for understanding learning difficulties and finding ways of addressing them in chemistry. Particularly, it…

2015 White Paper on recent issues in bioanalysis: focus on new technologies and biomarkers (Part 2 - hybrid LBA/LCMS and input from regulatory agencies).

PubMed

Ackermann, Brad; Neubert, Hendrik; Hughes, Nicola; Garofolo, Fabio; Abberley, Lee; Alley, Stephen C; Brown-Augsburger, Patricia; Bustard, Mark; Chen, Lin-Zhi; Heinrich, Julia; Katori, Noriko; Kaur, Surinder; Kirkovsky, Leo; Laterza, Omar F; Le Blaye, Olivier; Lévesque, Ann; Santos, Gustavo Mendes Lima; Olah, Timothy; Savoie, Natasha; Skelly, Michael; Spitz, Susan; Szapacs, Matthew; Tampal, Nilufer; Wang, Jian; Welink, Jan; Wieling, Jaap; Haidar, Sam; Vinter, Stephen; Whale, Emma; Witte, Bärbel

2015-12-01

The 2015 9th Workshop on Recent Issues in Bioanalysis (9th WRIB) took place in Miami, Florida with participation of over 600 professionals from pharmaceutical and biopharmaceutical companies, biotechnology companies, contract research organizations and regulatory agencies worldwide. It is once again a 5-day week long event - a full immersion bioanalytical week - specifically designed to facilitate sharing, reviewing, discussing and agreeing on approaches to address the most current issues of interest in bioanalysis. The topics covered included both small and large molecules, and involved LCMS, hybrid LBA/LCMS, LBA approaches including the focus on biomarkers and immunogenicity. This 2015 White Paper encompasses recommendations that emerged from the extensive discussions held during the workshop, and is aimed at providing the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to advance scientific excellence, improve quality and deliver better regulatory compliance. Due to its length, the 2015 edition of this comprehensive White Paper has been divided into three parts. Part 2 covers the recommendations for hybrid LBA/LCMS and regulatory agencies' inputs. Part 1 (small molecule bioanalysis using LCMS) and Part 3 (large molecule bioanalysis using LBA, biomarkers and immunogenicity) will be published in volume 7 of Bioanalysis, issues 22 and 24, respectively.

2016 White Paper on recent issues in bioanalysis: focus on biomarker assay validation (BAV): (Part 2 - Hybrid LBA/LCMS and input from regulatory agencies).

PubMed

Song, An; Lee, Anita; Garofolo, Fabio; Kaur, Surinder; Duggan, Jeff; Evans, Christopher; Palandra, Joe; Donato, Lorella Di; Xu, Keyang; Bauer, Ronald; Bustard, Mark; Chen, Linzhi; Cocea, Laurent; Croft, Stephanie; Galliccia, Fabrizio; Haidar, Sam; Hughes, Nicola; Ishii-Watabe, Akiko; Islam, Rafiqul; Jones, Barry; Kadavil, John; Krantz, Carsten; Lima Santos, Gustavo Mendes; Olah, Timothy; Pedras-Vasconcelos, João; Staelens, Ludovicus; Saito, Yoshiro; Savoie, Natasha; Scheibner, Kara; Spitz, Susan; Tampal, Nilufer; Thomas, Eric; Vinter, Stephen; Wakelin-Smith, Jason; Welink, Jan; Zeng, Jianing; Zhou, Shaolian

2016-12-01

The 2016 10th Workshop on Recent Issues in Bioanalysis (10 th WRIB) took place in Orlando, Florida with participation of close to 700 professionals from pharmaceutical/biopharmaceutical companies, biotechnology companies, contract research organizations, and regulatory agencies worldwide. WRIB was once again a 5-day, weeklong event - A Full Immersion Week of Bioanalysis including Biomarkers and Immunogenicity. As usual, it is specifically designed to facilitate sharing, reviewing, discussing and agreeing on approaches to address the most current issues of interest including both small and large molecules involving LCMS, hybrid LBA/LCMS, and LBA approaches, with the focus on biomarkers and immunogenicity. This 2016 White Paper encompasses recommendations emerging from the extensive discussions held during the workshop, and is aimed to provide the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to enable advances in scientific excellence, improved quality and better regulatory compliance. This White Paper is published in 3 parts due to length. This part (Part 2) discusses the recommendations for Hybrid LBA/LCMS and regulatory inputs from major global health authorities. Parts 1 (small molecule bioanalysis using LCMS) and Part 3 (large molecule bioanalysis using LBA, biomarkers and immunogenicity) have been published in the Bioanalysis journal, issues 22 and 23, respectively.

2016 White Paper on recent issues in bioanalysis: focus on biomarker assay validation (BAV) (Part 1 - small molecules, peptides and small molecule biomarkers by LCMS).

PubMed

Yang, Eric; Welink, Jan; Cape, Stephanie; Woolf, Eric; Sydor, Jens; James, Christopher; Goykhman, Dina; Arnold, Mark; Addock, Neil; Bauer, Ronald; Buonarati, Michael; Ciccimaro, Eugene; Dodda, Raj; Evans, Christopher; Garofolo, Fabio; Hughes, Nicola; Islam, Rafiq; Nehls, Corey; Wilson, Amanda; Briscoe, Chad; Bustard, Mark; Coppola, Laura; Croft, Stephanie; Drexler, Dieter; Ferrari, Luca; Fraier, Daniela; Jenkins, Rand; Kadavil, John; King, Lloyd; Li, Wenkui; Lima Santos, Gustavo Mendes; Musuku, Adrien; Ramanathan, Ragu; Saito, Yoshiro; Savoie, Natasha; Summerfield, Scott; Sun, Rachel; Tampal, Nilufer; Vinter, Steve; Wakelin-Smith, Jason; Yue, Qin

2016-10-07

The 2016 10 th Workshop on Recent Issues in Bioanalysis (10 th WRIB) took place in Orlando, Florida with participation of close to 700 professionals from pharmaceutical/biopharmaceutical companies, biotechnology companies, contract research organizations, and regulatory agencies worldwide. WRIB was once again a 5-day, weeklong event - A Full Immersion Week of Bioanalysis including Biomarkers and Immunogenicity. As usual, it was specifically designed to facilitate sharing, reviewing, discussing and agreeing on approaches to address the most current issues of interest including both small and large molecule analysis involving LCMS, hybrid LBA/LCMS, and LBA approaches, with the focus on biomarkers and immunogenicity. This 2016 White Paper encompasses recommendations emerging from the extensive discussions held during the workshop, and is aimed to provide the bioanalytical community with key information and practical solutions on topics and issues addressed, in an effort to enable advances in scientific excellence, improved quality and better regulatory compliance. This white paper is published in 3 parts due to length. This part (Part 1) discusses the recommendations for small molecules, peptides and small molecule biomarkers by LCMS. Part 2 (Hybrid LBA/LCMS and regulatory inputs from major global health authorities) and Part 3 (large molecule bioanalysis using LBA, biomarkers and immunogenicity) will be published in the Bioanalysis journal, issue 23.

Biometric Methods for Secure Communications in Body Sensor Networks: Resource-Efficient Key Management and Signal-Level Data Scrambling

NASA Astrophysics Data System (ADS)

Bui, Francis Minhthang; Hatzinakos, Dimitrios

2007-12-01

As electronic communications become more prevalent, mobile and universal, the threats of data compromises also accordingly loom larger. In the context of a body sensor network (BSN), which permits pervasive monitoring of potentially sensitive medical data, security and privacy concerns are particularly important. It is a challenge to implement traditional security infrastructures in these types of lightweight networks since they are by design limited in both computational and communication resources. A key enabling technology for secure communications in BSN's has emerged to be biometrics. In this work, we present two complementary approaches which exploit physiological signals to address security issues: (1) a resource-efficient key management system for generating and distributing cryptographic keys to constituent sensors in a BSN; (2) a novel data scrambling method, based on interpolation and random sampling, that is envisioned as a potential alternative to conventional symmetric encryption algorithms for certain types of data. The former targets the resource constraints in BSN's, while the latter addresses the fuzzy variability of biometric signals, which has largely precluded the direct application of conventional encryption. Using electrocardiogram (ECG) signals as biometrics, the resulting computer simulations demonstrate the feasibility and efficacy of these methods for delivering secure communications in BSN's.

Twenty years of research on water management issues in the Danube Macro-region - past developments and future directions.

PubMed

Feldbacher, Eva; Paun, Mihaela; Reckendorfer, Walter; Sidoroff, Manuela; Stanica, Adrian; Strimbu, Bogdan; Tusa, Iris; Vulturescu, Viorel; Hein, Thomas

2016-12-01

The Danube River-Danube Delta-Black Sea (DBS) region has witnessed major political, social and economic changes during the past three decades, which have profoundly affected the riverine, coastal and marine systems, their water management situation and the development of related research programmes. We reviewed the research activities in the DBS system of the past twenty years to determine the main funding bodies and to assess key research areas and how they varied over time and geographic region. As data basis we used a metadatabase filled with 478 projects addressing environmental and water management issues in the Danube River Basin, covering also the Danube Delta and the north-western Black Sea. As overall outcome extensive research efforts in the field of water management could be proven for the past two decades, despite the tumultuous times of political and economic transformations. One of the main findings was that EU funded projects played a key role for the development of transboundary research collaboration and were also the scientifically most productive one's. Historically, nutrient pollution was the main problem addressed, shifting to pollution in a broader sense and hydromorphological alterations in recent years. The newly arising challenges of climate change impacts and sediment management became important research questions in the last years, too. Most research was performed in the thematic field of navigation, followed by restoration and biodiversity issues. To meet all of the already identified and newly emerging challenges in the DBS System, cross-border and integrated (river-delta-sea) research activities are of major importance and have to be further promoted. We thus suggest drawing up a regional DBS Research Agenda linked to key challenges in water management to strengthen research collaboration and advance targeted scientific projects, an approach fostering also the scientific capacity in the region. Copyright © 2015 Elsevier B.V. All rights reserved.

Factors enhancing career satisfaction among female emergency physicians.

PubMed

Clem, Kathleen J; Promes, Susan B; Glickman, Seth W; Shah, Anand; Finkel, Michelle A; Pietrobon, Ricardo; Cairns, Charles B

2008-06-01

Attrition rates in emergency medicine have been reported as high as 25% in 10 years. The number of women entering emergency medicine has been increasing, as has the number of female medical school graduates. No studies have identified factors that increase female emergency physician career satisfaction. We assess career satisfaction in women emergency physicians in the American College of Emergency Physicians (ACEP) and identify factors associated with career satisfaction. The survey questionnaire was developed by querying 3 groups: (1) ACEP women in the American Association of Women Emergency Physicians, the (2) Society for Academic Emergency Medicine Mentoring Women Interest Group, and (3) nonaffiliated female emergency physicians. Their responses were categorized into 6 main areas: schedule, relationships with colleagues, administrative support and mentoring, patient/work-related issues, career advancement opportunities, and financial. The study cohort for the survey included all female members of ACEP with a known e-mail address. All contact with survey recipients was exclusively through the e-mail that contained a uniform resource locator link to the survey itself. Two thousand five hundred two ACEP female members were sent the uniform resource locator link. The Web survey was accessed a total of 1,851 times, with a total of 1,380 surveys completed, an overall response rate of 56%. Most women were satisfied with their career as an emergency physician, 492 (35.5%) very satisfied, 610 (44.0%) satisfied, 154 (11.1%) neutral, 99 (7.1%) not satisfied, and 31 (2.3%) very unsatisfied. Significant factors for career satisfaction included amount of recognition at work, career advancement, schedule flexibility, and the fairness of financial compensation. Workplace factors associated with high satisfaction included academic practice setting and sex-equal opportunity for advancement and sex-equal financial compensation. Most of the ACEP female physicians surveyed were satisfied with their career choice of emergency medicine. Opportunities for career advancement, fairness in financial compensation, and schedule flexibility were key factors in career satisfaction among female emergency physicians.

Emerging Issues in the Utilization of Weblogs in Higher Education Classrooms

ERIC Educational Resources Information Center

Ayao-ao, Shirley

2014-01-01

This paper examines the emerging issues in the utilization of weblogs in Philippine higher education and how these issues affect the performance of students. This study used a modified Delphi method. The Delphi panel consisted of 12 experts in the integration of technology, particularly blogs, in their teaching. The study yielded the following…

Re: School Finance Reform: Emerging Issues and Needed Research. Occasional Paper #7.

ERIC Educational Resources Information Center

Odden, Allan

Several new school finance reform issues are emerging that require further analysis. The first issue is the impact of previous school finance reforms especially regarding their fiscal, programmatic, and governance effects. More analysis is also needed of the effects of the composition of the property tax base and the structure of state…

Molecular communication among biological nanomachines: a layered architecture and research issues.

PubMed

Nakano, Tadashi; Suda, Tatsuya; Okaie, Yutaka; Moore, Michael J; Vasilakos, Athanasios V

2014-09-01

Molecular communication is an emerging communication paradigm for biological nanomachines. It allows biological nanomachines to communicate through exchanging molecules in an aqueous environment and to perform collaborative tasks through integrating functionalities of individual biological nanomachines. This paper develops the layered architecture of molecular communication and describes research issues that molecular communication faces at each layer of the architecture. Specifically, this paper applies a layered architecture approach, traditionally used in communication networks, to molecular communication, decomposes complex molecular communication functionality into a set of manageable layers, identifies basic functionalities of each layer, and develops a descriptive model consisting of key components of the layer for each layer. This paper also discusses open research issues that need to be addressed at each layer. In addition, this paper provides an example design of targeted drug delivery, a nanomedical application, to illustrate how the layered architecture helps design an application of molecular communication. The primary contribution of this paper is to provide an in-depth architectural view of molecular communication. Establishing a layered architecture of molecular communication helps organize various research issues and design concerns into layers that are relatively independent of each other, and thus accelerates research in each layer and facilitates the design and development of applications of molecular communication.

Online epistemic communities: theoretical and methodological directions for understanding knowledge co-elaboration in new digital spaces.

PubMed

Détienne, Françoise; Barcellini, Flore; Baker, Michael; Burkhardt, Jean-Marie; Fréard, Dominique

2012-01-01

This paper presents, illustrates and discusses a generic framework for studying knowledge co-elaboration in online epistemic communities ("OECs"). Our approach is characterised by: considering knowledge co-elaboration as a design activity; distinguishing discussion and production spaces in OECs; characterising participation via the notion of role; fine-grained analyses of meaning, content and communicative functions in interactions. On this basis, three key issues for ergonomics research on OECs are discussed and illustrated by results from our previous studies on OSS and Wikipedia. One issue concerns the interrelation between design (task) and regulation. Whereas design task-oriented activity is distributed among participants, we illustrate that OCEs function with specialised emerging roles of group regulation. However, the task-oriented activity also functions at an interpersonal level, as an interplay of knowledge-based discussion with negotiation of competencies. Another issue concerns the foci of activity on the (designed) knowledge object. Based on a generic task model, we illustrate asymmetry and distinctiveness in tasks' foci of participants. The last issue concerns how design-use mediation is ensured by specific forms of mediation roles in OECs. Finally we discuss the degree of generality of our framework and draw some perspectives for extending our framework to other OECs.

The quest for engaging AmI: Patient engagement and experience design tools to promote effective assisted living.

PubMed

Triberti, Stefano; Barello, Serena

2016-10-01

Recent research highlights that patient engagement, conceived as a patient's behavioral, cognitive and emotional commitment to his own care management, is a key issue while implementing new technologies in the healthcare process. Indeed, eHealth interventions may systematically fail when the patient's subjective experience has not been taken into consideration since the first steps of the technology design. In the present contribution, we argue that such an issue is more and more crucial as regarded to the field of Ambient Intelligence (AmI). Specifically, the exact concept of technologies embedded in the patients' surrounding environment implies a strong impact on their everyday life, which can be perceived as a limitation to autonomy and privacy, and therefore refused or even openly opposed by the final users. The present contribution tackles this issue directly, highlighting: (1) a theoretical framework to include patient engagement in the design of AmI technologies; (2) assessment measures for patient engagement while developing and testing the effectiveness of AmI prototypes for healthcare. Finally (3) this contribution provides an overview of the main issues emerging while implementing AmI technologies and suggests specific design solutions to address them. Copyright © 2016 Elsevier Inc. All rights reserved.

A procedure for rapid issue of red cells for emergency use.

PubMed

Weiskopf, Richard B; Webb, Mary; Stangle, Deena; Klinbergs, Gunter; Toy, Pearl

2005-04-01

A College of American Pathologists Q-Probe revealed that the median turnaround times for emergency requests for red blood cells from the operating room were 30 minutes to release of cells from the blood bank and 34 minutes to delivery to the operating room. These times may not be adequate to permit the red cells to provide sufficiently rapid delivery of oxygen in massively bleeding patients. To improve the time from emergency request for red cells to delivery to the operating room. A new emergency issue program was implemented for only the operating rooms; emergency issue to all other hospital locations remained unchanged. Six units of group O Rh-negative red blood cells (RBCs) are maintained in the blood bank in a separate basket with transfusion forms containing the unit numbers and expiration dates and a bag with one blood tubing segment from each unit. The times to issue and to delivery to the operating room suite were compared with time to issue of 2 group O Rh-negative RBCs for other hospital locations using the older system during the same time period and with the time to issue of 2 units to all other hospital locations during the preceding 2 years. A university hospital. Time between emergency request for red cells and delivery to the operating room. The time between blood bank notification and arrival in the operating room of the 6 units of RBCs was significantly shorter than the time required to just issue (not including delivery time) 2 units of RBCs to other hospital locations. With the new procedure, 82% of units issued reached the operating room within 2 minutes of request, 91% arrived within 3 minutes, and 100% arrived within 4 minutes. These percentages are significantly higher than those for only issue of blood (without delivery) using the older issuing procedure for all hospital locations during the previous 2 years (37%, 49%, and 66%, respectively; P = .007, .009, and .02, respectively) and for other locations during the same 7-month period (29%, 46%, and 73%, respectively; P = .004, .01, and .09, respectively). Time (mean [95% confidence interval]) from blood bank notification to delivery of RBCs to the operating room suite (2.1 [1.6-2.6] minutes, of which approximately 50-60 seconds is attributable to delivery time) was less than issue times (not including delivery times) using the older issuing procedure for other hospital locations during the same period (4.1 [3.1-5.0] minutes; P = .007). An emergency issue procedure can be used to issue several units of RBCs within 1 minute and have them delivered to the operating room within 2 minutes while maintaining sufficient controls and providing required information to satisfy patient and blood bank requirements.

Policy Making to Build Relationships: A Grounded Theory Analysis of Interviews and Documents Relating to H1N1, Ebola, and the U.S. Public Health Preparedness Network.

PubMed

Myers, Nathan

2016-01-01

In the last five years, the American public health emergency preparedness and response system has been tested by two significant threats, H1N1 and Ebola. While neither proved as dangerous as initially feared, these viruses highlighted on-going issues with collaborations in the field of public health and health care. Strengths were identified within the network, but also challenges that must be resolved before the U.S. faces a major pandemic. Employing interview data from public health emergency response practitioners and documentary evidence from the H1N1 and Ebola responses, this qualitative analysis uses the grounded theory approach to identify key areas for collaborative improvement. The grounded theory developed calls for a stronger policy framework at the federal level to facilitate more collaboration between U.S. agencies and facilitate more collaboration at the state and local level.

The importance of individual variation in the dynamics of animal collective movements.

PubMed

Del Mar Delgado, Maria; Miranda, Maria; Alvarez, Silvia J; Gurarie, Eliezer; Fagan, William F; Penteriani, Vincenzo; di Virgilio, Agustina; Morales, Juan Manuel

2018-05-19

Animal collective movements are a key example of a system that links two clearly defined levels of organization: the individual and the group. Most models investigating collective movements have generated coherent collective behaviours without the inclusion of individual variability. However, new individual-based models, together with emerging empirical information, emphasize that within-group heterogeneity may strongly influence collective movement behaviour. Here we (i) review the empirical evidence for individual variation in animal collective movements, (ii) explore how theoretical investigations have represented individual heterogeneity when modelling collective movements and (iii) present a model to show how within-group heterogeneity influences the collective properties of a group. Our review underscores the need to consider variability at the level of the individual to improve our understanding of how individual decision rules lead to emergent movement patterns, and also to yield better quantitative predictions of collective behaviour.This article is part of the theme issue 'Collective movement ecology'. © 2018 The Author(s).

A Global Perspective

PubMed Central

Harrison, Mark

2015-01-01

Summary The emergence of global history has been one of the more notable features of academic history over the past three decades. Although historians of disease were among the pioneers of one of its earlier incarnations—world history—the recent “global turn” has made relatively little impact on histories of health, disease, and medicine. Most continue to be framed by familiar entities such as the colony or nation-state or are confined to particular medical “traditions.” This article aims to show what can be gained from taking a broader perspective. Its purpose is not to replace other ways of seeing or to write a new “grand narrative” but to show how transnational and transimperial approaches are vital to understanding some of the key issues with which historians of health, disease, and medicine are concerned. Moving on from an analysis of earlier periods of integration, the article offers some reflections on our own era of globalization and on the emerging field of global health. PMID:26725408

History, applications, methodological issues and perspectives for the use of environmental DNA (eDNA) in marine and freshwater environments.

PubMed

Díaz-Ferguson, Edgardo E; Moyer, Gregory R

2014-12-01

Genetic material (short DNA fragments) left behind by species in nonliving components of the environment (e.g. soil, sediment, or water) is defined as environmental DNA (eDNA). This DNA has been previously described as particulate DNA and has been used to detect and describe microbial communities in marine sediments since the mid-1980's and phytoplankton communities in the water column since the early-1990's. More recently, eDNA has been used to monitor invasive or endangered vertebrate and invertebrate species. While there is a steady increase in the applicability of eDNA as a monitoring tool, a variety of eDNA applications are emerging in fields such as forensics, population and community ecology, and taxonomy. This review provides scientist with an understanding of the methods underlying eDNA detection as well as applications, key methodological considerations, and emerging areas of interest for its use in ecology and conservation of freshwater and marine environments.

A Global Perspective: Reframing the History of Health, Medicine, and Disease.

PubMed

Harrison, Mark

2015-01-01

The emergence of global history has been one of the more notable features of academic history over the past three decades. Although historians of disease were among the pioneers of one of its earlier incarnations-world history-the recent "global turn" has made relatively little impact on histories of health, disease, and medicine. Most continue to be framed by familiar entities such as the colony or nation-state or are confined to particular medical "traditions." This article aims to show what can be gained from taking a broader perspective. Its purpose is not to replace other ways of seeing or to write a new "grand narrative" but to show how transnational and transimperial approaches are vital to understanding some of the key issues with which historians of health, disease, and medicine are concerned. Moving on from an analysis of earlier periods of integration, the article offers some reflections on our own era of globalization and on the emerging field of global health.

The history of MF59(®) adjuvant: a phoenix that arose from the ashes.

PubMed

O'Hagan, Derek T; Ott, Gary S; Nest, Gary Van; Rappuoli, Rino; Giudice, Giuseppe Del

2013-01-01

The first clinical trial of an MF59(®)-adjuvanted influenza vaccine (Novartis) was conducted 20 years ago in 1992. The product that emerged (Fluad(®), Novartis) was licensed first in Italy in 1997 and is now licensed worldwide in 30 countries. US licensure is expected in the coming years. By contrast, many alternative adjuvanted vaccines have failed to progress. The key decisions that allowed MF59 to succeed in such a challenging environment are highlighted here and the lessons that were learned along the way are discussed. MF59 was connected to vaccines that did not succeed and was perceived as a 'failure' before it was a success. Importantly, it never failed for safety reasons and was always well tolerated. Even when safety issues have emerged for alternative adjuvants, careful analysis of the substantial safety database for MF59 have shown that there are no significant concerns with widespread use, even in more 'sensitive' populations.

Recent advances in sequence assembly: principles and applications.

PubMed

Chen, Qingfeng; Lan, Chaowang; Zhao, Liang; Wang, Jianxin; Chen, Baoshan; Chen, Yi-Ping Phoebe

2017-11-01

The application of advanced sequencing technologies and the rapid growth of various sequence data have led to increasing interest in DNA sequence assembly. However, repeats and polymorphism occur frequently in genomes, and each of these has different impacts on assembly. Further, many new applications for sequencing, such as metagenomics regarding multiple species, have emerged in recent years. These not only give rise to higher complexity but also prevent short-read assembly in an efficient way. This article reviews the theoretical foundations that underlie current mapping-based assembly and de novo-based assembly, and highlights the key issues and feasible solutions that need to be considered. It focuses on how individual processes, such as optimal k-mer determination and error correction in assembly, rely on intelligent strategies or high-performance computation. We also survey primary algorithms/software and offer a discussion on the emerging challenges in assembly. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Metrics Survey of Industry-Sponsored Clinical Trials in Canada and Comparator Jurisdictions between 2005 and 2010

PubMed Central

Leclerc, Jean-Marie; Laberge, Normand; Marion, Jean

2012-01-01

Industry-sponsored clinical trials play a key role in the development of therapies. This survey suggests that between 2005 and 2010, research-based pharmaceutical firms worldwide initiated fewer trials and recruited fewer subjects annually. In contrast, at the country level, the clinical trial activity of such firms increased in emerging countries and in Japan. Canada's trend in the number of new trials followed that of the global industry, but the trend in new sites and newly recruited subjects fell below the global rate. Informal comparisons point to potential issues for Canada in such areas as site capacity, cost per subject and time to first subject-in. When compared to certain Western European countries and the United States, Canada remained well positioned on a number of metrics. Nonetheless, Canada faces mounting challenges from both traditional locations and emerging countries and may require coordinated efforts to remain a place of choice to conduct trials. PMID:23968618

Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response.

PubMed

Jacobsen, Kathryn H; Aguirre, A Alonso; Bailey, Charles L; Baranova, Ancha V; Crooks, Andrew T; Croitoru, Arie; Delamater, Paul L; Gupta, Jhumka; Kehn-Hall, Kylene; Narayanan, Aarthi; Pierobon, Mariaelena; Rowan, Katherine E; Schwebach, J Reid; Seshaiyer, Padmanabhan; Sklarew, Dann M; Stefanidis, Anthony; Agouris, Peggy

2016-03-01

As the Ebola outbreak in West Africa wanes, it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. Our interdisciplinary team identified key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, we need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems in order to improve local and international responses to epidemics, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list highlights research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten global public health and security.

Evaluation of awareness and preparedness of school Principals and teachers on earthquake reduction effects issues - State's actions

NASA Astrophysics Data System (ADS)

Kourou, Assimina; Ioakeimidou, Anastasia; Mokos, Vasileios; Bakas, Konstantinos

2013-04-01

It is generally accepted that the effects of the disasters can be mainly reduced if people are aware, well informed and motivated towards a culture of disaster prevention and resilience. Particularly, in earthquake prone countries, a continuous update and education of the public, on earthquake risk management issues, is essential. Schools can play a crucial role concerning training and building a disaster prevention culture, among various community groups. Principals and teachers have a key role to play in any school-wide initiative through developing and reviewing awareness policy, developing and revising emergency response plans, holding emergency drills and training the students. During the last decade, the Greek State have done a lot of efforts in order to better educate teachers and students in disaster preparedness and management, such as: a. implementation of the E.P.P.O.'s educational project "Earthquake Protection at Schools" which is addressed mainly to school Principals. The project started right after the 1999 earthquake in Athens. b. publication of educational material for students, teachers and people with disabilities and publication of guidelines concerning the development of emergency plans. c. implementation of projects and elaboration of innovative and mobile experiential educational material connected with school curricula. The aim of the present study is to assess levels of awareness and preparedness concerning earthquake protection issues, as well as risk mitigation behaviours, undertaken by teachers at individual, family and workplace level. Furthermore, the assessment of teachers' current levels of earthquake awareness and preparedness, could lead to conclusions about the effectiveness of State's current Policy. In this framework, specific questionnaires were developed and were addressed to Principals and teachers who were responsible for the preparation of their School Emergency Preparedness Plans. The sample of the survey comprises of primary and secondary schools of 9 different prefectures of Greece. Approximately 1.100 responses have been gathered. The analysis of the results indicated that approximately 60% of the surveyed teachers have experienced at least one earthquake at school, which is expected due to Greece's high seismicity (50% of the released seismic energy in Europe). Additionally, the level of knowledge of surveyed teachers on earthquake protection measures is very high. A significant majority of the teachers, were reported being familiar with the identification and reduction of non structural hazards at their home, and the development of School's Emergency Plans. On the other hand, approximately the 25% of the responders were not aware of their school emergency plan or they claimed that such a plan does not exist at their schools. These teachers have not participated in any earthquake school drill. Thus, even though a lot of State's initiatives have been implemented till now to build awareness towards earthquakes and establish a preparedness status for prospective earthquakes in school community, there are still proposed actions to be taken in order to improve the teachers' ability to plan or implement activities concerning earthquake management issues.

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

NASA Technical Reports Server (NTRS)

McGuire, Robert E.

2011-01-01

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

Psychotherapy-based supervision models in an emerging competency-based era: a commentary.

PubMed

Falender, Carol A; Shafranske, Edward P

2010-03-01

As psychology engages in a cultural shift to competency-based education and training supervision practice is being transformed to the use of competency frames and the application of benchmark competencies. In this issue, psychotherapy-based models of supervision are conceptualized in a competency framework. This paper reflects on the translation of key components of each psychotherapy-based supervision approach in terms of foundational and functional competencies articulated in the Competencies Benchmarks (Fouad et al., 2009). The commentary concludes with a discussion of implications for supervision practice and identifies directions for future articulation and development, including evidence-based psychotherapy supervision. PsycINFO Database Record (c) 2010 APA, all rights reserved

Nitride micro-LEDs and beyond--a decade progress review.

PubMed

Jiang, H X; Lin, J Y

2013-05-06

Since their inception, micro-size light emitting diode (µLED) arrays based on III-nitride semiconductors have emerged as a promising technology for a range of applications. This paper provides an overview on a decade progresses on realizing III-nitride µLED based high voltage single-chip AC/DC-LEDs without power converters to address the key compatibility issue between LEDs and AC power grid infrastructure; and high-resolution solid-state self-emissive microdisplays operating in an active driving scheme to address the need of high brightness, efficiency and robustness of microdisplays. These devices utilize the photonic integration approach by integrating µLED arrays on-chip. Other applications of nitride µLED arrays are also discussed.

A Semantic Grid Oriented to E-Tourism

NASA Astrophysics Data System (ADS)

Zhang, Xiao Ming

With increasing complexity of tourism business models and tasks, there is a clear need of the next generation e-Tourism infrastructure to support flexible automation, integration, computation, storage, and collaboration. Currently several enabling technologies such as semantic Web, Web service, agent and grid computing have been applied in the different e-Tourism applications, however there is no a unified framework to be able to integrate all of them. So this paper presents a promising e-Tourism framework based on emerging semantic grid, in which a number of key design issues are discussed including architecture, ontologies structure, semantic reconciliation, service and resource discovery, role based authorization and intelligent agent. The paper finally provides the implementation of the framework.

The politics of silicosis in interwar Spain: Republican and Francoist approaches to occupational health.

PubMed

Menéndez-Navarro, Alfredo

2008-01-01

This article explores the emergence and recognition of silicosis as an occupational disease in interwar Spain. Following International Labour Office guidelines, growing international concerns and local medical evidence, Republican administrators provided the first health care facilities to silicosis sufferers, who eventually became entitled to compensation under the Law of Occupational Diseases (1936), poorly implemented due to the outbreak of the Civil War (1936-39). Silicosis became a priority issue on the political agenda of the new dictatorial regime because it affected lead and coalmining, key sectors for autarchic policies. The Silicosis Scheme (1941) provided compensation for sufferers, although benefits were minimised by its narrow coverage and the application of tight criteria.

Advocacy, promotion and e-learning: Supercourse for zoonosis.

PubMed

Matibag, Gino C; Igarashi, Manabu; La Porte, Ron E; Tamashiro, Hiko

2005-09-01

This paper discusses the history of emerging infectious diseases, risk communication and perception, and the Supercourse lectures as means to strengthen the concepts and definition of risk management and global governance of zoonosis. The paper begins by outlining some of the key themes and issues in infectious diseases, highlighting the way which historical analysis challenges ideas of the 'newness' of some of these developments. It then discusses the role of risk communication to public accountability. The bulk of the paper presents an overview of developments of the Internet-based learning system through the Supercourse lectures that may prove to be a strong arm for the promotion of the latest medical information particularly to developing countries.

Nicotine addiction through a neurogenomic prism

PubMed Central

Caron, Lorraine; Karkazis, Katrina; Raffin, Thomas A.; Swan, Gary; Koenig, Barbara A.

2008-01-01

Studies are under way to examine the neurogenetic factors contributing to smoking behaviors. The combined approaches of genomics, molecular biology, neuroscience, and pharmacology are expected to fuel developments in pharmacogenetics, to create new genetic tests, and ultimately to provide the basis for innovative strategies for smoking cessation and prevention. The emergence of a neurogenomic understanding of nicotine addiction is likely to induce fundamental changes in popular, clinical, and public health views of smoking, which could significantly shape existing practices and policies to reduce tobacco use. Still a nascent area of research, nicotine addiction provides an excellent case study through which to anticipate key ethical and policy issues in both behavioral genetics and the neurogenomics of addictive behaviors. PMID:16036275

Scaling Laws of Microactuators and Potential Applications of Electroactive Polymers in MEMS

NASA Technical Reports Server (NTRS)

Liu, Chang; Bar-Cohen, Y.

1999-01-01

Besides the scale factor that distinguishes the various species, fundamentally biological muscles changes little between species, indicating a highly optimized system. Electroactive polymer actuators offer the closest resemblance to biological muscles, however besides the large actuation displacement these materials are falling short with regards to the actuation force. As improved materials are emerging it is becoming necessary to address key issues such as the need for effective electromechanical modeling and guiding parameters in scaling the actuators. In this paper, we will review the scaling laws for three major actuation mechanisms that are of relevance to micro electromechanical systems: electrostatic actuation, magnetic actuation, thermal bimetallic actuation, and piezoelectric actuation.

Twenty-five years of HIV: lessons for low prevalence scenarios.

PubMed

Sawires, Sharif; Birnbaum, Nina; Abu-Raddad, Laith; Szekeres, Greg; Gayle, Jacob

2009-07-01

During the initial quarter century since the discovery of HIV, international response has focused on high prevalence scenarios and concentrated epidemics. Until recently, the theoretical underpinnings of HIV prevention were largely based on these responses-the assumption that inadequate responses to concentrated epidemics within low prevalence populations could rapidly lead to generalized epidemics. The limits of these assumptions for HIV prevention in low prevalence scenarios have become evident. While examples of rapid HIV diffusion in once low prevalence scenarios exist, emergence of generalized epidemics are less likely for much of the world. This paper reviews several key issues and advances in biomedical and behavioural HIV prevention to date and highlights relevance to low prevalence scenarios.

Developing a health information network within an integrated delivery system: a case study.

PubMed

Wager, K A; Heda, S; Austin, C J

1997-05-01

Changes in the health care environment, such as the growth of integrated delivery systems and the proliferation of managed care, are having a profound impact on the way in which health care organizations manage both clinical and financial information. Health information networks (HINs) are emerging to support the goals and internal needs of integrated delivery systems. In this environment, health care managers must assume a leadership role in planning for the development of HINs. The article provides an overview of the principal issues that should be addressed in an organization's information systems plan when a HIN is being developed and includes a case study that illustrates the key points discussed.

Label-free electrical detection of DNA hybridization using carbon nanotubes and graphene

PubMed Central

Fu, Dongliang; Li, Lain-Jong

2010-01-01

The interface between biosystems and nanomaterials is emerging for detection of various biomolecules and subtle cellular activities. In particular, the development of cost-effective and sequence-selective DNA detection is urgent for the diagnosis of genetic or pathogenic diseases. Graphene-based nanocarbon materials, such as carbon nanotubes and thin graphene layers, have been employed as biosensors because they are biocompatible, extraordinarily sensitive, and promising for large-area detection. Electrical and label-free detection of DNA can be achieved by monitoring the conductance change of devices fabricated from these carbon materials. Here, the recent advances in this research area are briefly reviewed. The key issues and perspectives of future development are also discussed. PMID:22110861

A remote condition monitoring system for wind-turbine based DG systems

NASA Astrophysics Data System (ADS)

Ma, X.; Wang, G.; Cross, P.; Zhang, X.

2012-05-01

In this paper, a remote condition monitoring system is proposed, which fundamentally consists of real-time monitoring modules on the plant side, a remote support centre and the communications between them. The paper addresses some of the key issues related on the monitoring system, including i) the implementation and configuration of a VPN connection, ii) an effective database system to be able to handle huge amount of monitoring data, and iii) efficient data mining techniques to convert raw data into useful information for plant assessment. The preliminary results have demonstrated that the proposed system is practically feasible and can be deployed to monitor the emerging new energy generation systems.

Particulate delivery systems for vaccination against bioterrorism agents and emerging infectious pathogens

PubMed Central

Fan, Yuchen; Moon, James J.

2016-01-01

Bioterrorism agents that can be easily transmitted with high mortality rates and cause debilitating diseases pose major threats to national security and public health. The recent Ebola virus outbreak in West Africa and ongoing Zika virus outbreak in Brazil, now spreading throughout Latin America, are case examples of emerging infectious pathogens that have incited widespread fear and economic and social disruption on a global scale. Prophylactic vaccines would provide effective countermeasures against infectious pathogens and biological warfare agents. However, traditional approaches relying on attenuated or inactivated vaccines have been hampered by their unacceptable levels of reactogenicity and safety issues, whereas subunit antigen-based vaccines suffer from suboptimal immunogenicity and efficacy. In contrast, particulate vaccine delivery systems offer key advantages, including efficient and stable delivery of subunit antigens, co-delivery of adjuvant molecules to bolster immune responses, low reactogenicity due to the use of biocompatible biomaterials, and robust efficiency to elicit humoral and cellular immunity in systemic and mucosal tissues. Thus, vaccine nanoparticles and microparticles are promising platforms for clinical development of biodefense vaccines. In this review, we summarize the current status of research efforts to develop particulate vaccine delivery systems against bioterrorism agents and emerging infectious pathogens. PMID:27038091

Meeting the challenges of medical countermeasure development

PubMed Central

Maher, Carmen; Hu‐Primmer, Jean; MacGill, Tracy; Courtney, Brooke; Borio, Luciana

2012-01-01

Summary Despite substantial investments since the events of 2001, much work remains to prepare the nation for a chemical, biological, radiological or nuclear (CBRN) attack or to respond to an emerging infectious disease threat. Following a 2010 review of the US Public Health Emergency Medical Countermeasures Enterprise, FDA launched its Medical Countermeasures initiative (MCMi) to facilitate the development and availability of medical products to counter CBRN and emerging disease threats. As a regulatory agency, FDA has a unique and critical part to play in this national undertaking. Using a three‐pillar approach, FDA is addressing key challenges associated with the regulatory review process for medical countermeasures; gaps in regulatory science for MCM development and evaluation; and issues related to the legal, regulatory and policy framework for an effective public health response. Filling the gaps in the MCM Enterprise is a huge national undertaking, requiring the collaboration of all stakeholders, including federal partners, current and prospective developers of medical countermeasures, relevant research organizations, and state and local responders. Especially critical to success are an appreciation of the long timelines, risks and high costs associated with developing medical countermeasures – and the systems to deliver them – and the requisite support of all stakeholders, including national leadership. PMID:22925432

Assessing the professional development needs of public health educators in light of changing competencies.

PubMed

Demers, Anne Roesler; Mamary, Edward

2008-10-01

Because of the need for a well-trained public health workforce, professional competencies have been recently revised by the Institute of Medicine and the National Health Educator Competencies Update Project. This study compared the self-identified training needs of public health educators with the updated competencies and assessed employer support for continuing education. A convenience sample of public health educators was recruited from an e-mail list of San Jose State University master of public health alumni. Respondents completed a Web-based survey that elicited information on emerging trends in public health education, training needs, and employer support for continuing education. Concerns about funding cuts and privatization of resources emerged as a theme. Key trends reported were an increase in information technology, the need for policy advocacy skills, and the importance of a lifespan approach to health issues. Primary areas for training were organization development, evaluation, and management. Although most employers were reported to support continuing education, less than two-thirds of respondents were reimbursed for expenses. These findings have implications for both research and practice. Innovative technologies should be developed to address health education professionals' training needs, and emerging themes should be incorporated into curricula for students.

[Current situation of pediatric emergency in tertiary and teaching hospitals in 15 provinces, municipalities and autonomous regions in China Mainland].

PubMed

2014-12-01

Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland. A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012. Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data. The main problems existing in pediatric emergency include: imperfect pediatric emergency settings; short of key equipment; key rescue techniques are not popularized, acute shortage of emergency pediatricians and inadequate monitoring and management of pediatric emergency. The major ways to solve the predicament in pediatric emergency should include: the policy and financial support from national and local government; training pediatricians, especially urgent training of emergency pediatricians; improving pediatric emergency development and management.

Research Ethics in Emerging Forms of Online Learning: Issues Arising from a Hypothetical Study on a MOOC

ERIC Educational Resources Information Center

Esposito, Antonella

2012-01-01

This paper is concerned with how research ethics is evolving along with emerging online research methods and settings. In particular, it focuses on ethics issues implied in a hypothetical virtual ethnography study aiming to gain insights on participants' experience in an emergent context of networked learning, namely a MOOC--Massive Online Open…

The Role of Health in Climate Litigation

PubMed Central

Simmens, Samuel J.; Glicksman, Robert; Paddock, LeRoy; Kim, Daniel; Whited, Brittany

2018-01-01

Objectives. To examine how the courts, which play a critical role in shaping public policy, consider public health in climate change and coal-fired power plant lawsuits. Methods. We coded US local, state, and federal court decisions relating to climate change and coal-fired power plants from 1990 to 2016 (n = 873) and qualitatively investigated 139 cases in which litigants raised issues concerning the health impacts of climate change. We also conducted 78 interviews with key litigants, advocates, industry representatives, advising scientists, and legal experts. Results. Health has been a critical consideration in key climate lawsuits, but in a minority of cases. Litigants have presented health arguments most frequently and effectively in terms of airborne exposures. Health impacts have typically been used to gain standing and argue that the evidence for government actions is insufficient. Conclusions. The courts represent a pivotal branch of government in shaping climate policy. Increasing inclusion of health concerns in emergent areas of litigation could help drive more effective climate policymaking. PMID:29698089

Efficient and Scalable Graph Similarity Joins in MapReduce

PubMed Central

Chen, Yifan; Zhang, Weiming; Tang, Jiuyang

2014-01-01

Along with the emergence of massive graph-modeled data, it is of great importance to investigate graph similarity joins due to their wide applications for multiple purposes, including data cleaning, and near duplicate detection. This paper considers graph similarity joins with edit distance constraints, which return pairs of graphs such that their edit distances are no larger than a given threshold. Leveraging the MapReduce programming model, we propose MGSJoin, a scalable algorithm following the filtering-verification framework for efficient graph similarity joins. It relies on counting overlapping graph signatures for filtering out nonpromising candidates. With the potential issue of too many key-value pairs in the filtering phase, spectral Bloom filters are introduced to reduce the number of key-value pairs. Furthermore, we integrate the multiway join strategy to boost the verification, where a MapReduce-based method is proposed for GED calculation. The superior efficiency and scalability of the proposed algorithms are demonstrated by extensive experimental results. PMID:25121135

Efficient and scalable graph similarity joins in MapReduce.

PubMed

Chen, Yifan; Zhao, Xiang; Xiao, Chuan; Zhang, Weiming; Tang, Jiuyang

2014-01-01

Along with the emergence of massive graph-modeled data, it is of great importance to investigate graph similarity joins due to their wide applications for multiple purposes, including data cleaning, and near duplicate detection. This paper considers graph similarity joins with edit distance constraints, which return pairs of graphs such that their edit distances are no larger than a given threshold. Leveraging the MapReduce programming model, we propose MGSJoin, a scalable algorithm following the filtering-verification framework for efficient graph similarity joins. It relies on counting overlapping graph signatures for filtering out nonpromising candidates. With the potential issue of too many key-value pairs in the filtering phase, spectral Bloom filters are introduced to reduce the number of key-value pairs. Furthermore, we integrate the multiway join strategy to boost the verification, where a MapReduce-based method is proposed for GED calculation. The superior efficiency and scalability of the proposed algorithms are demonstrated by extensive experimental results.

Origins of life: a problem for physics, a key issues review

NASA Astrophysics Data System (ADS)

Imari Walker, Sara

2017-09-01

The origins of life stands among the great open scientific questions of our time. While a number of proposals exist for possible starting points in the pathway from non-living to living matter, these have so far not achieved states of complexity that are anywhere near that of even the simplest living systems. A key challenge is identifying the properties of living matter that might distinguish living and non-living physical systems such that we might build new life in the lab. This review is geared towards covering major viewpoints on the origin of life for those new to the origin of life field, with a forward look towards considering what it might take for a physical theory that universally explains the phenomenon of life to arise from the seemingly disconnected array of ideas proposed thus far. The hope is that a theory akin to our other theories in fundamental physics might one day emerge to explain the phenomenon of life, and in turn finally permit solving its origins.

An exploration of the assessment experiences of new academics as they engage with a community of practice in higher education.

PubMed

Garrow, Amanda; Tawse, Stephen

2009-08-01

This paper considers a phenomenological research study that attempted to explore how new academics were introduced to the assessment process within a Higher Education context. Two key educational perspectives have shaped the interpretation of the studies findings. These are Nonaka and Takeuchi's [Nonaka, I., Takeuchi, H., 1995. The Knowledge Creating Company: How Japanese Companies Create the Dynamics of Innovation. Oxford University Press, New York] model of knowledge conversion and Lave and Wenger's work on communities of practice (1991, 2002). Three key findings emerged from this work. Firstly, the study highlights a number of issues relating to the types of support and guidance that new academics receive. These were divided into formal and informal types that either promoted conformity or facilitated challenge. Secondly, the study suggests that the ways in which experienced academic staff communicate their assessment knowledge and interact with new academics may require further consideration. Finally, the study raises questions about the type of academic that the organisation would wish to develop.

The A to Z of pharmaceutical cocrystals: a decade of fast-moving new science and patents.

PubMed

Almarsson, Örn; Peterson, Matthew L; Zaworotko, Michael

2012-07-01

From aspirin to zoledronic acid, pharmaceutical cocrystals emerged in the past decade as a promising new weapon in the arsenal of drug development. Resurgence of interest in multicomponent crystal compositions has led to significant advances in the science of cocrystal design and discovery. These advances have built upon crystal engineering, which provides a deep understanding of supramolecular interactions between molecules that govern crystal packing and physicochemical properties of crystalline materials. Concomitantly, the patent landscape of pharmaceutical cocrystals developed rapidly in the last decade. This review presents a broad survey of patents issued in the area of pharmaceutical cocrystals. In addition, the review contains analyses of key patents in the area involving compositions and methodologies. Along the way, the main events of the past decade representing a renaissance of cocrystals of pharmaceutical materials are chronicled. Future directions in the area are discussed in light of key pending patent applications and recent publications of seminal interest.

Paradoxical Vocal Cord Motion in Pediatric Patients.

PubMed

Palla, John; Friedman, Aaron D

2016-05-01

Paradoxical vocal cord motion (PVCM), also termed vocal cord dysfunction, is a poorly understood disorder of episodic dyspnea characterized by inappropriate vocal cord adduction during inspiration and potentially during expiration. It can coexist or be confused with asthma, so appropriate diagnosis is key to optimizing treatment success. Although many patients with PVCM may have underlying psychologic issues, there is emerging evidence to suggest that this entity is not psychogenic in every patient. Both laryngeal irritants and exercise have been identified as additional contributing factors in PVCM. Diagnosis of PVCM requires awake laryngoscopic confirmation. However, many patients do not exhibit signs of PVCM during this examination, despite provocation during testing. Therefore, clinical history remains key in determining which patients should proceed with behavioral therapy under the guidance of a speech pathologist. In addition, treatment may include limiting patient exposure to potential sources of laryngeal irritation. Refractory patients may benefit from psychologic assessment and treatment. [Pediatr Ann. 2016;45(5):e184-e188.]. Copyright 2016, SLACK Incorporated.

Outcomes of an International Workshop on Preconception Expanded Carrier Screening: Some Considerations for Governments.

PubMed

Molster, Caron M; Lister, Karla; Metternick-Jones, Selina; Baynam, Gareth; Clarke, Angus John; Straub, Volker; Dawkins, Hugh J S; Laing, Nigel

2017-01-01

Consideration of expanded carrier screening has become an emerging issue for governments. However, traditional criteria for decision-making regarding screening programs do not incorporate all the issues relevant to expanded carrier screening. Further, there is a lack of consistent guidance in the literature regarding the development of appropriate criteria for government assessment of expanded carrier screening. Given this, a workshop was held to identify key public policy issues related to preconception expanded carrier screening, which governments should consider when deciding whether to publicly fund such programs. In June 2015, a satellite workshop was held at the European Society of Human Genetics Conference. It was structured around two design features: (1) the provision of information from a range of perspectives and (2) small group deliberations on the key issues that governments need to consider and the benefits, risks, and challenges of implementing publicly funded whole-population preconception carrier screening. Forty-one international experts attended the workshop. The deliberations centered primarily on the conditions to be tested and the elements of the screening program itself. Participants expected only severe conditions to be screened but were concerned about the lack of a consensus definition of "severe." Issues raised regarding the screening program included the purpose, benefits, harms, target population, program acceptability, components of a program, and economic evaluation. Participants also made arguments for consideration of the accuracy of screening tests. A wide range of issues require careful consideration by governments that want to assess expanded carrier screening. Traditional criteria for government decision-making regarding screening programs are not a "best fit" for expanded carrier screening and new models of decision-making with appropriate criteria are required. There is a need to define what a "severe" condition is, to build evidence regarding the reliability and accuracy of screening tests, to consider the equitable availability and downstream effects on and costs of follow-up interventions for those identified as carriers, and to explore the ways in which the components of a screening program would be impacted by unique features of expanded carrier screening.

“Dude, You’re Such a Slut!” Barriers and Facilitators of Sexual Communication Among Young Gay Men and Their Best Friends

PubMed Central

McDavitt, Bryce; Mutchler, Matt G.

2014-01-01

Conversations with friends are a crucial source of information about sexuality for young gay men, and a key way that sexual health norms are shared during emerging adulthood. However, friends can only provide this support if they are able to talk openly about sexuality. We explored this issue through qualitative interviews with an ethnically diverse sample of young gay men and their best friends. Using theories of sexual scripts, stigma, and emerging adulthood, we examined how conversations about sex could be obstructed or facilitated by several key factors, including judgmentalism, comfort/discomfort, and receptivity. Gay male friends sometimes spoke about unprotected sex in judgmental ways (e.g., calling a friend “slut” or “whore” for having sex without condoms). In some cases, this language could be used playfully, while in others it had the effect of shaming a friend and obstructing further communication about sexual risk. Female friends were rarely openly judgmental, but often felt uncomfortable talking about gay male sexuality, which could render this topic taboo. Sexual communication was facilitated most effectively when friends encouraged it through humor or supportive questioning. Drawing on these findings, we show how judgmentalism and discomfort may generate sexual scripts with contradictory norms, and potentially obstruct support from friends around sexual exploration during a period of life when it may be most developmentally important. PMID:25419044

Continuing professional development needs of nursing and allied health professionals with responsibility for prescribing.

PubMed

Weglicki, Robert S; Reynolds, Julie; Rivers, Peter H

2015-01-01

Continuing professional development (CPD) for non-medical prescribers is recognised as being pivotal in maintaining up -to -date knowledge and skills influencing prescribing competence. This study was, therefore, designed to ascertain the aspirations, priorities and preferred mode of CPD for non-medical prescribers. Qualitative data were derived from semi-structured in-depth interviews and a focus group given by 16 allied health professionals working in primary and secondary care settings. A topic guide was used to cover clinical decision-making (including difficult decisions), legal aspects of prescribing and diagnostic issues. A content analysis of the verbatim transcripts enabled four key emerging themes to be identified, thus offering a basis for developing a greater understanding of the CPD needs of non-medical prescribers. The four key emerging themes identified are the following: Theme 1: "Personal anxiety undermining confidence to prescribe", Theme 2: "External barriers and other factors that exacerbate anxiety", Theme 3: "Need for support identified through coping strategies", and Theme 4: "Preferred mode or style of learning". The findings suggest that anxiety and lack of confidence in non-medical prescribing pose a significant challenge for CPD. Strategies that are most likely to improve prescribing confidence are through a blended learning approach. Local higher education and workplace employer collaboration is an appropriate step forward to achieve this. Copyright © 2014 Elsevier Ltd. All rights reserved.

Older men, work and health.

PubMed

Granville, G; Evandrou, M

2010-05-01

To consider the complex interrelationships between work and health among older men, drawing out the importance of considering gender difference in approaches to occupational medicine. The method used in the literature search was to review national and international research published in English since 1990 on the health and work of older men. Journal articles were the primary source. Databases used included Web of Science, CSA Illumina Social Sciences, CINAHL, Medline and ANGINFO. The review of the evidence was structured in terms of key themes emerging from the literature into which issues of gender, ethnicity, age and socio-economic inequalities were cross cut. The current paper now focuses on two of those themes that have particular relevance to occupational medicine: work-caused and work-related ill-health, and secondly promoting workplace health. It begins by setting the scene with a profile of older men in the labour market. Two key themes emerge from the review, which are of particular significance. One is the central role that work plays in the lives and identity of men and therefore the impact this has on their health, both in and out of work. Secondly, the occupational histories of men expose them to work-related and work-caused ill-health, which has consequences for life expectancy and chronic disease in old age. These findings have implications for future research, policy formulation and implementation, and for public health practice.

Native Peoples-Native Homelands Climate Change Workshop: Lessons Learned

NASA Technical Reports Server (NTRS)

Maynard, Nancy G.

2003-01-01

The Native Peoples-Native Homelands Climate Change Workshop was held on October 28 through November 01,1998, as part of a series of workshops being held around the U.S. to improve the understanding of the potential consequences of climate variability and change for the Nation. This workshop was specifically designed by Native Peoples to examine the impacts of climate change and extreme weather variability on Native Peoples and Native Homelands from an indigenous cultural and spiritual perspective and to develop recommendations as well as identify potential response actions. The workshop brought together interested Native Peoples, representatives of Tribal governments, traditional elders, Tribal leaders, natural resource managers, Tribal College faculty and students, and climate scientists fiom government agencies and universities. It is clear that Tribal colleges and universities play a unique and critical role in the success of these emerging partnerships for decision-making in addition to the important education function for both Native and non-Native communities such as serving as a culturally-appropriate vehicle for access, analysis, control, and protection of indigenous cultural and intellectual property. During the discussions between scientists and policy-makers from both Native and non-Native communities, a number of important lessons emerged which are key to building more effective partnerships between Native and non-Native communities for collaboration and decision-making for a more sustainable future. This talk summarizes the key issues, recommendations, and lessons learned during this workshop.

On euthanasia, resistance, and redemption: the moralities and politics of a hospice.

PubMed

Broom, Alex

2012-02-01

Euthanasia/assisted dying, the desire to hasten death, and religious supportive care at the end of life are controversial issues that have been heavily debated within the academic and medical communities. Little research has been done on hospice patients' views, despite hospices being political spaces, espousing a range of perspectives on assisted dying, religiosity, and "good deaths." In this article I document the presence, articulation, and significance of these issues as perceived and experienced by 20 hospice inpatients in the last 4 weeks of their lives. Key themes to emerge included polarization in desire for hastened death and assisted dying in the hospice; the hospice as a morally bound space situated within particular notions of "dying well"; and the divisive character of religion as part of formalized hospice care. Theoretically, the participants' perspectives on euthanasia/assisted dying and religiosity in the hospice provide a means of unpacking and revealing the moral economy of modern dying practices and the institutional governance and production of "timely deaths."

Mitochondria in the nervous system: From health to disease, Part I.

PubMed

Polster, Brian M; Carrì, Maria Teresa; Beart, Philip M

2017-10-01

In Part I of this Special Issue on "Mitochondria in the Nervous System: From Health to Disease", the editors bring together contributions from experts in brain mitochondrial research to provide an up-to-date overview of mitochondrial functioning in physiology and pathology. The issue provides cutting edge reviews on classical areas of mitochondrial biology that include energy substrate utilization, calcium handling, mitochondria-endoplasmic reticulum communication, and cell death regulation. Additional reviews and original research articles touch upon key mitochondrial defects seen across multiple neurodegenerative conditions, including fragmentation, loss of respiratory capacity, calcium overload, elevated reactive oxygen species generation, perturbed NAD + metabolism, altered protein acetylation, and compromised mitophagy. Emerging links between the genetics of neurodegenerative disorders and disruption in mitochondrial function are discussed, and a new mouse model of Complex I deficiency is described. Finally, novel ways to rescue mitochondrial structure and function in acute and chronic brain injury are explored. Copyright © 2017. Published by Elsevier Ltd.

International organizations and migrant health in Europe.

PubMed

Kentikelenis, Alexander E; Shriwise, Amanda

International organizations have defined and managed different aspects of migrant health issues for decades, yet we lack a systematic understanding of how they reach decisions and what they do on the ground. The present article seeks to clarify the state of knowledge on the relationship between international organizations and migrant health in Europe. To do so, we review the operations of six organizations widely recognized as key actors in the field of migrant health: the European Commission, the Regional Office for Europe of the World Health Organization, the International Organization on Migration, Médecins du Monde, Médecins Sans Frontières, and the Open Society Foundation. We find that international organizations operate in a complementary fashion, with each taking on a unique role in migrant health provision. States often rely on international organizations as policy advisors or sub-contractors for interventions, especially in the case of emergencies. These linkages yield a complex web of relationships, which can vary depending on the country under consideration or the health policy issue in question.

Community psychology practice: expanding the impact of psychology's work.

PubMed

Wolff, Tom

2014-11-01

This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Political incentives towards replacing animal testing in nanotechnology?

PubMed

Sauer, Ursula G

2009-01-01

The Treaty of Lisbon requests the European Union and the Member States to pay full regard to animal welfare issues when implementing new policies. The present article discusses how these provisions are met in the emerging area of nanotechnology. Political action plans in Europe take into account animal welfare issues to some extent. Funding programmes promote the development of non-animal test methods, however only in the area of nanotoxicology and also here not sufficiently to "pay full regard" to preventing animal testing, let alone to bring about a paradigm change in toxicology or in biomedical research as such. Ethical deliberations on nanotechnology, which influence future policies, so far do not address animal welfare at all. Considering that risk assessment of nanoproducts is conceived as a key element to protect human dignity, ethical deliberations should address the choice of the underlying testing methods and call for basing nanomaterial safety testing upon the latest scientific--and ethically acceptable--technologies. Finally, public involvement in the debate on nanotechnology should take into account information on resulting animal experiments.

Management and integration of engineering and construction activities: Lessons learned from the AP1000{sup R} nuclear power plant China project

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

McCullough, M. C.; Ebeling-Koning, D.; Evans, M. C.

2012-07-01

The lessons learned during the early phase of design engineering and construction activities for the AP1000 China Project can be applied to any project involving multiple disciplines and multiple organizations. Implementation of a first-of-a-kind design to directly support construction activities utilizing resources assigned to design development and design delivery creates challenges with prioritization of activities, successful closure of issues, and communication between site organizations and the home office. To ensure successful implementation, teams were assigned and developed to directly support construction activities including prioritization of activities, site communication and ensuring closure of site emergent issues. By developing these teams, themore » organization is better suited to meet the demands of the construction schedule while continuing with design evolution of a standard plant and engineering delivery for multiple projects. For a successful project, proper resource utilization and prioritization are key for overcoming obstacles and ensuring success of the engineering organization. (authors)« less

Workplace discrimination and disfigurement: the national EEOC ADA research project.

PubMed

Tartaglia, Alexander; McMahon, Brian T; West, Steven L; Belongia, Lisa

2005-01-01

Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with disfigurement is documented. Key dimensions of workplace discrimination involving Americans with disfigurement and persons with missing limbs are compared and contrasted. Specifically, the researchers examine demographic characteristics of Charging Parties; the industry designation, location and size of Respondents/employers; the discrimination Issue (i.e., type of adverse action) alleged to occur; and the legal outcome or Resolution of these allegations. Charging Parties with disfigurement who are female or between 30 and 39 years of age are more likely to encounter employment discrimination than their counterparts with missing limbs. Harassment and Non-wage Benefits are the Issues that emerge in higher proportion. Allegations derived from persons with disfigurement are more common in among mid-size employers, those located in the South, or those in Retail or Service industries. Following investigation, allegations derived from persons with disfigurement are less likely to have Merit Resolutions than those brought by Charging Parties with missing limbs.

Informing watershed connectivity barrier prioritization decisions: A synthesis

USGS Publications Warehouse

McKay, S. K.; Cooper, A. R.; Diebel, M.W.; Elkins, D.; Oldford, G.; Roghair, C.; Wieferich, Daniel J.

2017-01-01

Water resources and transportation infrastructure such as dams and culverts provide countless socio-economic benefits; however, this infrastructure can also disconnect the movement of organisms, sediment, and water through river ecosystems. Trade-offs associated with these competing costs and benefits occur globally, with applications in barrier addition (e.g. dam and road construction), reengineering (e.g. culvert repair), and removal (e.g. dam removal and aging infrastructure). Barrier prioritization provides a unique opportunity to: (i) restore and reconnect potentially large habitat patches quickly and effectively and (ii) avoid impacts prior to occurrence in line with the mitigation hierarchy (i.e. avoid then minimize then mitigate). This paper synthesizes 46 watershed-scale barrier planning studies and presents a procedure to guide barrier prioritization associated with connectivity for aquatic organisms. We focus on practical issues informing prioritization studies such as available data sets, methods, techniques, and tools. We conclude with a discussion of emerging trends and issues in barrier prioritization and key opportunities for enhancing the body of knowledge.

Paediatric stroke: pressing issues and promising directions.

PubMed

Kirton, Adam; deVeber, Gabrielle

2015-01-01

Stroke occurs across the lifespan with unique issues in the fetus, neonate, and child. The past decade has seen substantial advances in paediatric stroke research and clinical care, but many unanswered questions and controversies remain. The pathobiology of perinatal stroke needs to be better understood if prevention strategies are to be realised. Similarly, enhanced understanding of the mechanisms underlying childhood stroke, including cerebral arteriopathies, could inform the development of mechanism-specific treatments. Emerging clinical trials, including studies of neonatal sinovenous thrombosis and childhood arterial stroke, offer the hope of evidence-based treatment options in the near future. Early recognition of stroke in children is a key educational target for both the public and health-care professionals, and has translational potential to advance the application of neuroprotective, thrombolytic, and antithrombotic interventions and rehabilitation strategies to the earliest possible timepoints after stroke onset, improving outcomes and quality of life for affected children and their families. Copyright © 2015 Elsevier Ltd. All rights reserved.

Youth with Mental Health Disorders: Issues and Emerging Responses. Also: Wraparound Milwaukee Program: Suicide Prevention in Juvenile Facilities.

ERIC Educational Resources Information Center

Juvenile Justice, 2000

2000-01-01

This issue of Juvenile Justice presents three main articles. "Youth with Mental Health Disorders: Issues and Emerging Responses" (J. J. Cocozza and K. Skowyra) discusses tragic mass homicides by juveniles, documented cases of neglect and inadequate services, and federal policy focusing on providing systems of care for at-risk juveniles that have…

Evacuation in emergencies: An annotated guide to research

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

Vogt, B.M.; Sorensen, J.H.

1987-02-01

The purpose of this literature review was to explore the relevant sources of knowledge regarding evacuation related issues among recent work published in the social sciences and emergency planning fields. In organizing the material, we looked primarily for articles that included either a theoretical or empirical basis for the findings. By empirical, we mean that the findings were based on data taken from actual research gained through surveys, questionnaires, interviews or a combination of these, and the use of secondary sources. The theoretical material consisted of work that built on past research or which explored the use of models. Somemore » conceptual work, raising issues not covered by the general format, were included if they attempted to synthesize aspects of the literature now segmented or which asked additional questions about topics related to but not necessarily within the strict realm of research studies. The material was divided as to the emphasis placed on the individual or the organizational level of behavior. Empirically the individual, family or household response is easier to assess because of the bias that may intrude when individuals of organizations or agencies involved in the evacuation process are interviewed regarding their official status. The annotations of the literature as well as the specific key findings from each study, where appropriate, are organized by hazard type. An author index is provided.« less

Public health in Canada: Evolution, meaning and a new paradigm for respiratory therapy

PubMed Central

West, Andrew J

2013-01-01

Chronic disease burden in Canada poses an imminent public health threat. The impact of respiratory disease in Canada alone is significant, affecting one in five and leading any other cause of repeat hospitalization in all age groups. Public health action is considered to be an important means of addressing these issues. Historical understanding of health has evolved to support the adoption of paradigms by professions that recognize the limitations of medical intervention in addressing the fundamental basis of disease when compared with the broader public health perspective. Several key historical events have shaped this understanding in the Canadian context including the Lalonde and Epp reports, and public health emergencies such as the severe acute respiratory syndrome outbreak in 2003. The profession of respiratory therapy has historically existed within a medicalized paradigm of practice; however, forces both internal and external to the profession are pressuring it to consider adopting broader social-and population-based approaches. As a rapidly evolving profession, there is a need to explore emerging areas of practice opportunities in the discipline. Investigating alternative knowledge and ideology can ensure that effective strategies for addressing the contemporary respiratory heath needs of Canadians are undertaken. The present article explores the rationale for a public health- and population-based approach to health in general, and its applicability to the respiratory therapist’s role in addressing respiratory health-related issues in Canada. PMID:26078595

Cooperation, collective action, and the archeology of large-scale societies.

PubMed

Carballo, David M; Feinman, Gary M

2016-11-01

Archeologists investigating the emergence of large-scale societies in the past have renewed interest in examining the dynamics of cooperation as a means of understanding societal change and organizational variability within human groups over time. Unlike earlier approaches to these issues, which used models designated voluntaristic or managerial, contemporary research articulates more explicitly with frameworks for cooperation and collective action used in other fields, thereby facilitating empirical testing through better definition of the costs, benefits, and social mechanisms associated with success or failure in coordinated group action. Current scholarship is nevertheless bifurcated along lines of epistemology and scale, which is understandable but problematic for forging a broader, more transdisciplinary field of cooperation studies. Here, we point to some areas of potential overlap by reviewing archeological research that places the dynamics of social cooperation and competition in the foreground of the emergence of large-scale societies, which we define as those having larger populations, greater concentrations of political power, and higher degrees of social inequality. We focus on key issues involving the communal-resource management of subsistence and other economic goods, as well as the revenue flows that undergird political institutions. Drawing on archeological cases from across the globe, with greater detail from our area of expertise in Mesoamerica, we offer suggestions for strengthening analytical methods and generating more transdisciplinary research programs that address human societies across scalar and temporal spectra. © 2016 Wiley Periodicals, Inc.

The rise of cancer in urban India: Cultural understandings, structural inequalities and the emergence of the clinic.

PubMed

Broom, Alex; Doron, Assa

2012-05-01

Cancer services in India have evolved and expanded significantly in recent years, with a surge in the availability of biomedical oncological treatment facilities for certain cohorts of the Indian population in urban areas. Despite significant and sustained economic development in many areas of India, major issues persist in the delivery of cancer care, even in the context of relatively prosperous urban populations. This article explores the dilemmas evident in Indian cancer care as perceived by a group of Indian oncology clinicians. Specifically, the interviews focused on their perspectives on the key challenges facing cancer patients, particularly in relation to help-seeking and access to care. The main concerns that emerged in the interviews were: (a) practical constraint (i.e. access and treatment); (b) cultural values (i.e. communication, stigma and the clinic); and (c) structural conditions (i.e. inequalities related to place, gender and class). We unpack these as important elements of cancer care in contemporary India, and present Farmer's notion of structural violence, among other concepts, as potentially useful for understanding some facets of this social problem. We conclude that without a greater understanding of social and cultural issues shaping cancer care in India, little progress will be made in coping with a disease that is set to become a major burden within an increasingly prosperous and ageing population.

Emergency communication and information issues in terrorist events involving radioactive materials.

PubMed

Becker, Steven M

2004-01-01

With the threat posed by terrorism involving radioactive materials now high on the nation's agenda, local, state, and federal agencies are moving to enhance preparedness and response capabilities. Crucial to these efforts is the development of effective risk communication strategies. This article reports findings from an ongoing study of risk communication issues in nuclear/radiological terrorism situations. It is part of a larger CDC-funded effort that aims to better understand communication challenges associated with weapons of mass destruction terrorism incidents. Presented here are formative research findings from 16 focus groups (n = 163) in which a multi-part, hypothetical radioactive materials terrorism situation was discussed. Twelve of the focus groups were carried out with members of the general public (drawn from a variety of ethnic backgrounds and geographic locations), and four groups were composed of first responders, hospital emergency department personnel, and public health professionals. One aim of the focus groups was to elicit detailed information on people's knowledge, views, perceptions, reactions, and concerns related to a nuclear/radiological terrorism event, and to better understand people's specific information needs and preferred information sources. A second aim was to pretest draft informational materials prepared by CDC and NIOSH. Key findings for the public and professional groups are presented, and the implications of the research for developing messages in radiological/nuclear terrorism situations are explored.

Donation after cardiac death and the emergency department: ethical issues.

PubMed

Simon, Jeremy R; Schears, Raquel M; Padela, Aasim I

2014-01-01

Organ donation after cardiac death (DCD) is increasingly considered as an option to address the shortage of organs available for transplantation, both in the United States and worldwide. The procedures for DCD differ from procedures for donation after brain death and are likely less familiar to emergency physicians (EPs), even as this process is increasingly involving emergency departments (EDs). This article explores the ED operational and ethical issues surrounding this procedure. © 2013 by the Society for Academic Emergency Medicine.

NGNP High Temperature Materials White Paper

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

Lew Lommers; George Honma

2012-08-01

This white paper is one in a series of white papers that address key generic issues of the combined construction and operating license (COL) pre-application program key generic issues for the Next Generation Nuclear Plant reactor using the prismatic block fuel technology. The purpose of the pre-application program interactions with the NRC staff is to reduce the time required for COL application review by identifying and addressing key regulatory issues and, if possible, obtaining agreements for their resolution

Implementing large-scale programmes to optimise the health workforce in low- and middle-income settings: a multicountry case study synthesis.

PubMed

Gopinathan, Unni; Lewin, Simon; Glenton, Claire

2014-12-01

To identify factors affecting the implementation of large-scale programmes to optimise the health workforce in low- and middle-income countries. We conducted a multicountry case study synthesis. Eligible programmes were identified through consultation with experts and using Internet searches. Programmes were selected purposively to match the inclusion criteria. Programme documents were gathered via Google Scholar and PubMed and from key informants. The SURE Framework - a comprehensive list of factors that may influence the implementation of health system interventions - was used to organise the data. Thematic analysis was used to identify the key issues that emerged from the case studies. Programmes from Brazil, Ethiopia, India, Iran, Malawi, Venezuela and Zimbabwe were selected. Key system-level factors affecting the implementation of the programmes were related to health worker training and continuing education, management and programme support structures, the organisation and delivery of services, community participation, and the sociopolitical environment. Existing weaknesses in health systems may undermine the implementation of large-scale programmes to optimise the health workforce. Changes in the roles and responsibilities of cadres may also, in turn, impact the health system throughout. © 2014 John Wiley & Sons Ltd.

Coalition Building for Adult Literacy: Historical and Organizational Perspectives.

ERIC Educational Resources Information Center

Newman, Anabel P.; Lehman, Bernadette

Selected successful literacy coalitions were examined to identify key issues and trends in coalition building. The six key issues identified (focus and functions, funding, governance, membership, key figures, and evaluation) were used as a framework to review the early efforts, current activities, and future visions of literacy coalitions…

New Borns...Getting a Good Start.

ERIC Educational Resources Information Center

Huraux-Rendu, Christine; And Others

1991-01-01

This issue of Children in the Tropics analyzes key issues relating to protecting the health of newborn infants. Many of the suggestions offered concern rudimentary health care situations in developing countries. Key issues are addressed in four sections. The first section discusses the early care and first medical examination of infants born in…

Key Terrain: Application to the Layers of Cyberspace

DTIC Science & Technology

2017-03-01

in the early stages and exploration into better integrating military strategies could prove beneficial to those working to develop relevant and...200 words) The concept of key terrain is a common fixture in military strategy and tactics. The emergence of cyberspace, with characteristics unseen...concept of key terrain is a common fixture in military strategy and tactics. The emergence of cyberspace, with characteristics unseen in any

Issues and challenges of curriculum reform to competency-based curricula in Africa: A meta-synthesis.

PubMed

Muraraneza, Claudine; Mtshali, Ntombifikile Gloria; Mukamana, Donatilla

2017-03-01

Although in recent decades reforms to undergraduate nursing and midwifery education have increasingly been guided by the concept of competency-based curriculum in a drive to produce competent graduates in the African context, the topic remains poorly researched in-depth. The related issues and challenges need to be explored in the interest of evidence-based practice. This article stems from a systematic review of qualitative literature on the design and implementation of competency-based curriculum. Data was inductively analyzed using constant comparison. The two categories that emerged were: (i) the need for a paradigm shift to competency-based curriculum; and (ii) the associated issues and challenges, such as a shift from informative to transformative learning, lack or limited of involvement of key stakeholders in curriculum development, focus on hospital-oriented education, lack of preparation of educators, and inappropriate resources. While ongoing reform of nursing and midwifery education continues, much still needs to be done - in particular, extensive financial investment to increase the capacity of educators, mentors and infrastructure, and the development of collaborative frameworks between nursing and midwifery and higher educational councils. © 2016 John Wiley & Sons Australia, Ltd.

HIV Prevention Research Ethics: An Introduction to the Special Issue

PubMed Central

Fisher, Celia B.

2018-01-01

This special issue of the journal of Empirical Research on Human Research Ethics represents a sampling of projects fostered through the NIDA-funded Fordham University HIV Prevention Research Ethics Institute. The first three articles employ processes of co-learning to give voice to the experiences of individuals recovering from substance abuse and engaged in sex work who have participated in HIV prevention studies in the United States, India, and the Philippines. The fourth article describes a unique community-based approach to the development of research ethics training modules designed to increase participation of American Indian and Alaskan Native (AI/AN) tribal members as partners in research on health disparities. The last two articles focus a critical scholarly lens on two underexamined areas confronting IRB review of HIV research: The emerging and continuously changing ethical challenges of using social media sites for recruitment into HIV prevention research, and the handling of research-related complaints from participants involving perceived research harms or research experiences that do not accord with their initial expectations. Together, the articles in this special issue identify key ethical crossroads and provide suggestions for best practices that respect the values and merit the trust of research participants. PMID:24572078

An author's guide to publication ethics: a review of emerging standards in biomedical journals.

PubMed

Roberts, Jason

2009-04-01

Universal definitions of ethical issues related to medical publishing have remained somewhat elusive. Training in the art of writing for medical journals is inconsistent and most commonly informal, involving collaborative efforts between mentors and students. This approach inadvertently may perpetuate erroneous assumptions as to what constitutes acceptable behavior. In contrast to instruction on composition, ethical considerations related to the publication of a paper are likely to receive little attention. Even so, consequent to the ever-increasing scrutiny from the media and government agencies, journals are recognizing the need for greater transparency in peer review and are thus more inclined to enforce ethical standards. Understanding that some apparent ethical contraventions are the result of confusion or a lack of knowledge, some journals are assuming the responsibility of educating their community about ethical issues in publishing. This paper reviews the key ethical issues (eg, authorship criteria, conflicts of interest, redundant publication, data access and biases in data reporting, image manipulation) that authors should consider before submitting a manuscript. It also surveys some of the policies of the most highly cited clinical medical journals. In the future, authors can anticipate that their submissions will be required to meet an expanding array of ethical standards.

Independence as a practice issue in occupational therapy: the safety clause.

PubMed

Russell, Cherry; Fitzgerald, Maureen H; Williamson, Peter; Manor, Debra; Whybrow, Samantha

2002-01-01

This article reports findings from interviews that explored the meanings occupational therapists attach to independence as a value and a therapeutic goal in interactions with elderly clients. Through a historical review of the literature, we trace the changing use of this term and identify two analytically distinct concepts associated with it: independence as self-reliance in activity and independence as autonomy, self-determination, or choice. We show how the latter has emerged in contemporary service contexts to represent an ideal of client-centered practice for persons with chronic disabilities, such as frail elderly clients. Using a "critical incident" interview approach with 12 Australian occupational therapists, we identified the therapists' explicit and implicit understandings of independence as a value concept and practice issue. Our findings suggest that a mismatch often exists between idealized and practice-based talk about independence and that therapists narrativize this opposition around what we call "the safety clause." That is, therapists invoke concerns about safety and duty of care as a caveat to implementing their independence ideals and justifying the retention of professional control. We identify key issues that therapists need to address if the rhetoric of independence-related client-centered practice is to be achieved in reality.

Invasive meningococcal disease--improving management through structured review of cases in the Hunter New England area, Australia.

PubMed

Guimont, Chantal; Hullick, Carolyn; Durrheim, David; Ryan, Nick; Ferguson, John; Massey, Peter

2010-03-01

Invasive meningococcal disease (IMD) is the most common infectious cause of death in childhood in developed countries. This disease may cause severe disability or death if a patient is sub-optimally managed. An audit was performed in Australia of all 2005-06 notified IMD cases to elicit correctable issues. Over the 2 year period, 24 cases were notified in the Hunter New England Health area. These cases were reviewed by an expert panel to highlight key correctable issues in recognition and management of IMD. The 24 patients were aged between 1 month and 70 years. Thirteen (54%) were children and 14 (58%) were women. Six (25%) cases developed complications, two being severe (one death, one limb amputations). These patients had risk factors for IMD. The emergency department average delay between assessment and administration of antibiotics was 57.8 min. There were avoidable factors identified in both patients with a poor outcome. Length of delay in initiating antibiotic therapy has been associated with poor outcome, thus the delay in our series is of concern. The audit highlighted many potentially correctable issues in the medical, laboratory and public health management of IMD cases.

Application of summative content analysis to a postal questionnaire.

PubMed

Griffiths, Thomas Howard

2016-01-01

Content analysis of replies to closed questions in questionnaires can be undertaken to understand remarks that may explain the responses, provide illustrative examples of issues raised in the questionnaire, define new issues or issues of importance that were not covered in the questionnaire and inform the design of new questions in future surveys. To discuss the usefulness of summative content analysis to free text in postal questionnaires. Content analysis provides useful comparative insights between two respondent groups in the case example provided. Five themes emerged: poor understanding of the concept of 'patient lateral transfer work technique' and the direct instrument nursing observation (DINO) instrument's key directions; outcomes of patient transfer; positive responses; manual handling risk; and poor translation into English of DINO. Respondents need an opportunity to clarify their responses to questionnaires using free text, to provide insight into their understanding of the question being asked, understanding of the concept or construct being discussed, and data triangulation through the confirmation of item responses and free-text comments. Responses to questions in a postal questionnaire and the opportunity for free-text commentary by respondents enable the identification of hidden meanings behind tickbox responses to questions.

After-Action Reports: Capturing Lessons Learned and Identifying Areas for Improvement. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 1, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This issue of "Lessons Learned" addresses after-action reports, which are an integral part of the emergency preparedness planning continuum and support effective crisis response. After-action reports have a threefold purpose. They…

Addressing the gap between public health emergency planning and incident response

PubMed Central

Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

2013-01-01

Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response. PMID:28228983

Deployment Effects of Marine Renewable Energy Technologies: Wave Energy Scenarios

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

Mirko Previsic

2010-06-17

Given proper care in siting, design, deployment, operation and maintenance, wave energy conversion could become one of the more environmentally benign sources of electricity generation. In order to accelerate the adoption of these emerging hydrokinetic and marine energy technologies, navigational and environmental concerns must be identified and addressed. All developing hydrokinetic projects involve a wide variety of stakeholders. One of the key issues that site developers face as they engage with this range of stakeholders is that, due to a lack of technical certainty, many of the possible conflicts (e.g., shipping and fishing) and environmental issues are not well-understood,. Inmore » September 2008, re vision consulting, LLC was selected by the Department of Energy (DoE) to apply a scenario-based assessment to the emerging hydrokinetic technology sector in order to evaluate the potential impact of these technologies on the marine environment and navigation constraints. The project’s scope of work includes the establishment of baseline scenarios for wave and tidal power conversion at potential future deployment sites. The scenarios capture variations in technical approaches and deployment scales to properly identify and characterize environmental effects and navigational effects. The goal of the project is to provide all stakeholders with an improved understanding of the potential range of technical attributes and potential effects of these emerging technologies and focus all stakeholders on the critical issues that need to be addressed. By identifying and addressing navigational and environmental concerns in the early stages of the industry’s development, serious mistakes that could potentially derail industry-wide development can be avoided. This groundwork will also help in streamlining siting and associated permitting processes, which are considered key hurdles for the industry’s development in the U.S. today. Re vision is coordinating its efforts with two other project teams funded by DoE which are focused on regulatory issues (Pacific Energy Ventures) and navigational issues (PCCI). The results of this study are structured into three reports: (1) Wave power scenario description (2) Tidal power scenario description (3) Framework for Identifying Key Environmental Concerns This is the first report in the sequence and describes the results of conceptual feasibility studies of wave power plants deployed in Humboldt County, California and Oahu, Hawaii. These two sites contain many of the same competing stakeholder interactions identified at other wave power sites in the U.S. and serve as representative case studies. Wave power remains at an early stage of development. As such, a wide range of different technologies are being pursued by different manufacturers. In order to properly characterize potential effects, it is useful to characterize the range of technologies that could be deployed at the site of interest. An industry survey informed the process of selecting representative wave power devices. The selection criteria requires that devices are at an advanced stage of development to reduce technical uncertainties, and that enough data are available from the manufacturers to inform the conceptual design process of this study. Further, an attempt is made to cover the range of different technologies under development to capture variations in potential environmental effects. Table 1 summarizes the selected wave power technologies. A number of other developers are also at an advanced stage of development, but are not directly mentioned here. Many environmental effects will largely scale with the size of the wave power plant. In many cases, the effects of a single device may not be measurable, while larger scale device arrays may have cumulative impacts that differ significantly from smaller scale deployments. In order to characterize these effects, scenarios are established at three deployment scales which nominally represent (1) a small pilot deployment, (2) a small commercial deployment, and (3) a large commercial scale plant. It is important to understand that the purpose of this study was to establish baseline scenarios based on basic device data that was provided to use by the manufacturer for illustrative purposes only.« less

Principles and practices board. Issue Analysis 98-1. Compliance with laws and regulations for healthcare organizations. Healthcare Financial Management Association.

PubMed

1998-09-01

This is the third Issue Analysis of HFMA's Principles and Practices (P&P) Board. The P&P Board writes an Issue Analysis in response to the need for practical information on emerging issues in healthcare financial management. An Issue Analysis is factual but not authoritative. It is not sent out for public comment and provides the healthcare industry short-term assistance on emerging issues. The purpose of P&P Board Issue Analysis 98-1, Compliance with Laws and Regulations for Healthcare Organizations, is to help healthcare financial managers understand their responsibility to implement and maintain an effective internal control system to ensure compliance with laws and regulations.

Zika in Twitter: Temporal Variations of Locations, Actors, and Concepts

PubMed Central

Vraga, Emily; Lamprianidis, Georgios; Radzikowski, Jacek; Delamater, Paul L; Jacobsen, Kathryn H; Pfoser, Dieter; Croitoru, Arie; Crooks, Andrew

2017-01-01

Background The recent Zika outbreak witnessed the disease evolving from a regional health concern to a global epidemic. During this process, different communities across the globe became involved in Twitter, discussing the disease and key issues associated with it. This paper presents a study of this discussion in Twitter, at the nexus of location, actors, and concepts. Objective Our objective in this study was to demonstrate the significance of 3 types of events: location related, actor related, and concept related, for understanding how a public health emergency of international concern plays out in social media, and Twitter in particular. Accordingly, the study contributes to research efforts toward gaining insights on the mechanisms that drive participation, contributions, and interaction in this social media platform during a disease outbreak. Methods We collected 6,249,626 tweets referring to the Zika outbreak over a period of 12 weeks early in the outbreak (December 2015 through March 2016). We analyzed this data corpus in terms of its geographical footprint, the actors participating in the discourse, and emerging concepts associated with the issue. Data were visualized and evaluated with spatiotemporal and network analysis tools to capture the evolution of interest on the topic and to reveal connections between locations, actors, and concepts in the form of interaction networks. Results The spatiotemporal analysis of Twitter contributions reflects the spread of interest in Zika from its original hotspot in South America to North America and then across the globe. The Centers for Disease Control and World Health Organization had a prominent presence in social media discussions. Tweets about pregnancy and abortion increased as more information about this emerging infectious disease was presented to the public and public figures became involved in this. Conclusions The results of this study show the utility of analyzing temporal variations in the analytic triad of locations, actors, and concepts. This contributes to advancing our understanding of social media discourse during a public health emergency of international concern. PMID:28428164

A recommended epidemiological study design for examining the adverse health effects among emergency workers who experienced the TEPCO fukushima daiichi NPP accident in 2011.

PubMed

Yasui, Shojiro

2016-01-01

Results from medical examinations conducted in 2012 of workers who were engaged in radiation work in 2012 as a result of the 2011 Fukushima Daiichi Nuclear Power Plant (NPP) accident showed that the prevalence of abnormal findings was 4.21%, 3.23 points higher than the 0.98% that was found prior to the accident in the jurisdiction area of the labor inspection office which holds jurisdiction over the NPP. The Ministry of Health, Labour and Welfare (MHLW) concluded that the 2010 and 2012 data cannot be easily compared because 70% of the enterprises within the jurisdiction of the office that reported the 2012 results were different from those that did so in 2010. In addition, although the radiation workers' estimated average dose weighted by number of workers was 3.66 times higher than decontamination workers' dose, the prevalence among radiation workers was only 1.14 times higher than that among decontamination workers. Based on the results of the medical examinations, however, the MHLW decided to implement an epidemiological study on the health effects of radiation exposure on all emergency workers. This article explains key issues of the basic design of the study recommended by the expert meeting established in the MHLW and also identifies challenges that could not be resolved and thus required further consideration by the study researchers. The major issues included: (a) study methods and target group; (b) evaluation of cumulative doses; (c) health effects (end points); (d) control of confounding factors; and (e) study implementation framework. Identified key challenges that required further deliberation were: (a) preventing arbitrary partisan analysis; (b) ensuring a high participation rate; (c) inquiry about the medical radiation doses; and (d) the preparedness of new analytical technology. The study team formulated and implemented the pilot study in 2014 and started the full-scale study in April 2015 with funding from a research grant from the MHLW.

Suicide prevention in primary care: General practitioners' views on service availability

PubMed Central

2010-01-01

Background Primary care may be a key setting for suicide prevention. However, comparatively little is known about the services available in primary care for suicide prevention. The aims of the current study were to describe services available in general practices for the management of suicidal patients and to examine GPs views on these services. We carried out a questionnaire and interview study in the North West of England. We collected data on GPs views of suicide prevention generally as well as local mental health service provision. Findings During the study period (2003-2005) we used the National Confidential Inquiry Suicide database to identify 286 general practitioners (GPs) who had registered patients who had died by suicide. Data were collected from GPs and practice managers in 167 practices. Responses suggested that there was greater availability of services and training for general mental health issues than for suicide prevention specifically. The three key themes which emerged from GP interviews were: barriers accessing primary or secondary mental health services; obstacles faced when referring a patient to mental health services; managing change within mental health care services Conclusions Health professionals have an important role to play in preventing suicide. However, GPs expressed concerns about the quality of primary care mental health service provision and difficulties with access to secondary mental health services. Addressing these issues could facilitate future suicide prevention in primary care. PMID:20920302

Prospects and applications near ferroelectric quantum phase transitions: a key issues review.

PubMed

Chandra, P; Lonzarich, G G; Rowley, S E; Scott, J F

2017-11-01

The emergence of complex and fascinating states of quantum matter in the neighborhood of zero temperature phase transitions suggests that such quantum phenomena should be studied in a variety of settings. Advanced technologies of the future may be fabricated from materials where the cooperative behavior of charge, spin and current can be manipulated at cryogenic temperatures. The progagating lattice dynamics of displacive ferroelectrics make them appealing for the study of quantum critical phenomena that is characterized by both space- and time-dependent quantities. In this key issues article we aim to provide a self-contained overview of ferroelectrics near quantum phase transitions. Unlike most magnetic cases, the ferroelectric quantum critical point can be tuned experimentally to reside at, above or below its upper critical dimension; this feature allows for detailed interplay between experiment and theory using both scaling and self-consistent field models. Empirically the sensitivity of the ferroelectric T c 's to external and to chemical pressure gives practical access to a broad range of temperature behavior over several hundreds of Kelvin. Additional degrees of freedom like charge and spin can be added and characterized systematically. Satellite memories, electrocaloric cooling and low-loss phased-array radar are among possible applications of low-temperature ferroelectrics. We end with open questions for future research that include textured polarization states and unusual forms of superconductivity that remain to be understood theoretically.

Mass and Elite Views on Nuclear Security: US National Security Surveys 1993-1999

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

HERRON,KERRY G.; JENKINS-SMITH,HANK C.; HUGHES,SCOTT D.

This is the fourth report in an ongoing series of studies examining how US perspectives about nuclear security are evolving in the post-Cold War era. In Volume 1 the authors present findings from a nationwide telephone survey of randomly selected members of the US general public conducted from 13 September to 14 October 1999. Results are compared to findings from previous surveys in this series conducted in 1993, 1995, and 1997, and trends are analyzed. Key areas of investigation reported in Volume 1 include evolving perceptions of nuclear weapons risks and benefits, preferences for related policy and spending issues, andmore » views about three emerging issue areas: deterrent utility of precision guided munitions; response options to attacks in which mass casualty weapons are used; and expectations about national missile defenses. In this volume they relate respondent beliefs about nuclear security to perceptions of nuclear risks and benefits and to policy preferences. They develop causal models to partially explain key preferences, and they employ cluster analysis to group respondents into four policy relevant clusters characterized by similar views and preferences about nuclear security within each cluster. Systematic links are found among respondent demographic characteristics, perceptions of nuclear risks and benefits, policy beliefs, and security policy and spending preferences. In Volume 2 they provide analysis of in-depth interviews with fifty members of the US security policy community.« less

Prospects and applications near ferroelectric quantum phase transitions: a key issues review

NASA Astrophysics Data System (ADS)

Chandra, P.; Lonzarich, G. G.; Rowley, S. E.; Scott, J. F.

2017-11-01

The emergence of complex and fascinating states of quantum matter in the neighborhood of zero temperature phase transitions suggests that such quantum phenomena should be studied in a variety of settings. Advanced technologies of the future may be fabricated from materials where the cooperative behavior of charge, spin and current can be manipulated at cryogenic temperatures. The progagating lattice dynamics of displacive ferroelectrics make them appealing for the study of quantum critical phenomena that is characterized by both space- and time-dependent quantities. In this key issues article we aim to provide a self-contained overview of ferroelectrics near quantum phase transitions. Unlike most magnetic cases, the ferroelectric quantum critical point can be tuned experimentally to reside at, above or below its upper critical dimension; this feature allows for detailed interplay between experiment and theory using both scaling and self-consistent field models. Empirically the sensitivity of the ferroelectric T c’s to external and to chemical pressure gives practical access to a broad range of temperature behavior over several hundreds of Kelvin. Additional degrees of freedom like charge and spin can be added and characterized systematically. Satellite memories, electrocaloric cooling and low-loss phased-array radar are among possible applications of low-temperature ferroelectrics. We end with open questions for future research that include textured polarization states and unusual forms of superconductivity that remain to be understood theoretically.

Emerging Roles of the Nucleolus in Regulating the DNA Damage Response: The Noncanonical DNA Repair Enzyme APE1/Ref-1 as a Paradigmatical Example

PubMed Central

Antoniali, Giulia; Lirussi, Lisa; Poletto, Mattia

2014-01-01

Abstract Significance: An emerging concept in DNA repair mechanisms is the evidence that some key enzymes, besides their role in the maintenance of genome stability, display also unexpected noncanonical functions associated with RNA metabolism in specific subcellular districts (e.g., nucleoli). During the evolution of these key enzymes, the acquisition of unfolded domains significantly amplified the possibility to interact with different partners and substrates, possibly explaining their phylogenetic gain of functions. Recent Advances: After nucleolar stress or DNA damage, many DNA repair proteins can freely relocalize from nucleoli to the nucleoplasm. This process may represent a surveillance mechanism to monitor the synthesis and correct assembly of ribosomal units affecting cell cycle progression or inducing p53-mediated apoptosis or senescence. Critical Issues: A paradigm for this kind of regulation is represented by some enzymes of the DNA base excision repair (BER) pathway, such as apurinic/apyrimidinic endonuclease 1 (APE1). In this review, the role of the nucleolus and the noncanonical functions of the APE1 protein are discussed in light of their possible implications in human pathologies. Future Directions: A productive cross-talk between DNA repair enzymes and proteins involved in RNA metabolism seems reasonable as the nucleolus is emerging as a dynamic functional hub that coordinates cell growth arrest and DNA repair mechanisms. These findings will drive further analyses on other BER proteins and might imply that nucleic acid processing enzymes are more versatile than originally thought having evolved DNA-targeted functions after a previous life in the early RNA world. Antioxid. Redox Signal. 20, 621–639. PMID:23879289

Business continuity in blood services: two case studies from events with potentially catastrophic effect on the national provision of blood components.

PubMed

Morgan, S J; Rackham, R A; Penny, S; Lawson, J R; Walsh, R J; Ismay, S L

2015-02-01

NHS Blood and Transplant (NHSBT) and the Australian Red Cross Blood Service (ARCBS) are national blood establishments providing blood components to England and North Wales, and Australia, respectively. In 2012, both services experienced potentially catastrophic challenges to key assets. NHSBT suffered a flood that closed the largest blood-manufacturing centre in Europe, whilst ARCBS experienced the failure of a data centre network switch that rendered the national blood management system inaccessible for 42 h. This paper describes both crisis events, including the immediate actions, recovery procedures and lessons learned. Both incidents triggered emergency response plans. These included hospital reprovisioning and recovery from the incident. Once normal services had been restored, both events were subjected to root cause analysis (RCA) and production of 'lessons learned' reports. In both scenarios, the key enablers of rapid recovery were established emergency plans, clear leadership and the support of a flexible workforce. Product issues to hospitals were unaffected, and there were no abnormal trends in hospital complaints. RCA identified the importance of risk mitigations that require co-operation with external organizations. Reviews of both events identified opportunities to enhance business resilience through prior identification of external risks and improvements to contingency plans, for example by implementing mass messaging to staff and other stakeholders. Blood establishment emergency plans tend to focus on responding to mass casualty events. However, consolidation of manufacturing to fewer sites combined with a reliance on national IT systems increases the impact of loss of function. Blood services should develop business continuity plans which include prevention of such losses, and the maintenance of services and disaster recovery. © 2014 International Society of Blood Transfusion.

Emergency medical services responders’ perceptions of the effect of stress and anxiety on patient safety in the out-of-hospital emergency care of children: a qualitative study

PubMed Central

Hansen, Matthew; O'Brien, Kerth; Dickinson, Caitlin; Meckler, Garth; Engle, Phil; Lambert, William; Jui, Jonathan

2017-01-01

Objective Prehospital emergency medical services (EMS) providers report anxiety as the second most common contributor to paediatric patient safety events. The objective of this study was to understand how EMS providers perceive the effect of stress and anxiety on paediatric out-of-hospital patient safety. Setting This was a nationwide study of EMS providers from 44 of 50 (88%) US states. Participants A total of 753 eligible EMS professionals, including emergency medical technicians, emergency department physicians and nurses (general and paediatric), and respiratory therapists who participate in out-of-hospital transports. Primary and secondary outcome measures Outcomes included responses to: (1) clinical situations where heightened stress or anxiety was likely to contribute to safety events, (2) aspects of these clinical situations that cause stress or anxiety and (3) how stress or anxiety may lead to paediatric safety events. Results EMS providers reported that the clinical situations where stress and anxiety were more likely to contribute to paediatric patient safety events were trauma, respiratory distress and cardiac issues. Key themes were: (1) provider sympathy or identification with children, (2) difficulty seeing an innocent child hurt and the inherent value of children and (3) insufficient exposure to paediatric emergencies. Conclusions Caring for paediatric emergencies creates unique stresses on providers that may affect patient safety. Many of the factors reported to cause provider stress and anxiety are inherent attributes of children and therefore not modifiable. Tools that support care during stressful conditions such as cognitive aids may help to mitigate anxiety in the prehospital care of children. Further research is needed to identify opportunities for and attributes of interventions. PMID:28246139

Recommended minimal emergency equipment and resources for schools: national consensus group report.

PubMed

Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

2003-06-01

Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.

An evaluation of the role played by remote sensing technology following the World Trade Center attack

NASA Astrophysics Data System (ADS)

Huyck, Charles K.; Adams, Beverley J.; Kehrlein, David I.

2003-06-01

Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dense, yet relatively small area, made the combination of imagery and mapped data strategically useful. This paper reviews the role played by aerial photography, satellite imagery, and LIDAR data at Ground Zero. It examines how emergency managers utilized these datasets, and identifies significant problems that were encountered. It goes on to explore additional ways in which imagery could have been used, while presenting recommendations for more effective use in future disasters and Homeland Security applications. To plan adequately for future events, it was important to capture knowledge from individuals who responded to the World Trade Center attack. In recognition, interviews with key emergency management and geographic information system (GIS) personnel provide the basis of this paper. Successful techniques should not be forgotten, or serious problems dismissed. Although widely used after September 11th, it is important to recognize that with better planning, remote sensing and GIS could have played an even greater role. Together with a data acquisition timeline, an expanded discussion of these issues is available in the MCEER/NSF report “Emergency Response in the Wake of the World Trade Center Attack; The Remote Sensing Perspective” (Huyck and Adams, 2002)

7 CFR 3430.310 - Allocation of AFRI funds.

Code of Federal Regulations, 2014 CFR

2014-01-01

... integrated multifunctional projects in an appropriate manner and in accordance with the allocation... agricultural sciences. (d) Rapid Response Food and Agricultural Science for Emergency Issues Awards. The Secretary may allocate some funding to address emergency issues in the food and agricultural sciences as...

7 CFR 3430.310 - Allocation of AFRI funds.

Code of Federal Regulations, 2012 CFR

2012-01-01

... integrated multifunctional projects in an appropriate manner and in accordance with the allocation... agricultural sciences. (d) Rapid Response Food and Agricultural Science for Emergency Issues Awards. The Secretary may allocate some funding to address emergency issues in the food and agricultural sciences as...

7 CFR 3430.310 - Allocation of AFRI funds.

Code of Federal Regulations, 2013 CFR

2013-01-01

... integrated multifunctional projects in an appropriate manner and in accordance with the allocation... agricultural sciences. (d) Rapid Response Food and Agricultural Science for Emergency Issues Awards. The Secretary may allocate some funding to address emergency issues in the food and agricultural sciences as...

NEW DISINFECTION BY-PRODUCT ISSUES: EMERGING DBP'S AND ALTERNATIVE ROUTES OF EXPOSURE

EPA Science Inventory

This paper discusses current issues with drinking water disinfection by-products (DBPs), which include emerging (unregulated) DBPs that can be formed at greater levels with alternative disinfectants (as compared to chlorine) and routes of human exposure (which include inhalation ...