Predicting Nursing Facility Transition Candidates Using AID: A Case Study

ERIC Educational Resources Information Center

James, Mary L.; Wiley, Elizabeth; Fries, Brant E.

2007-01-01

Purpose: Although the nursing facility transition literature is growing, little research has analyzed the characteristics of individuals so assisted or compared participants to those who remain institutionalized. This article describes an analytic method that researchers can apply to address these knowledge gaps, using the Arkansas Passages…

Flipped ESL Teacher Professional Development: Embracing Change to Remain Relevant

ERIC Educational Resources Information Center

Razak, Rafiza Abdul; Kaur, Dalwinder; Halili, Siti Hajar; Ramlan, Zahri

2016-01-01

Many traditional professional development programs that are initiated to equip ESL teachers with knowledge and skills have been futile for numerous reasons. This paper addresses a gap in the recent research of ESL teachers' professional development. Literature has revealed many shortcomings of the traditional and online professional development…

Plant and soil consequences of shrub management in a big sagebrush-dominated rangeland ecosystem

USDA-ARS?s Scientific Manuscript database

Soil organic carbon (SOC) responses to shrub management in western US rangelands, especially those dominated by Wyoming big sagebrush (Artemisia tridentata Nutt. ssp. wyomingensis Beetle & Young) in low rainfall areas (<300 mm), remains a major knowledge gap. We sampled vegetation and soils in 2009 ...

Soil organic matter of high-elevation wetlands in a sagebrush ecosystem: Fence-line contrasts

USDA-ARS?s Scientific Manuscript database

Scientific information regarding soil organic carbon (SOC) sequestration in western rangelands, especially those with a sagebrush (Artemisia spp.) component and in lower rainfall areas (<350 mm), remains a major knowledge gap in understanding the effects of land management. We sampled soils from two...

Describing Comprehension: Teachers' Observations of Students' Reading Comprehension

ERIC Educational Resources Information Center

Vander Does, Susan Lubow

2012-01-01

Teachers' observations of student performance in reading are abundant and insightful but often remain internal and unarticulated. As a result, such observations are an underutilized and undervalued source of data. Given the gaps in knowledge about students' reading comprehension that exist in formal assessments, the frequent calls for teachers'…

Do Teachers Misbehave? Aggression in School Teams

ERIC Educational Resources Information Center

Ben Sasson, Dvora; Somech, Anit

2015-01-01

Purpose: Despite growing research on school aggression, significant gaps remain in the authors' knowledge of team aggression, since most studies have mainly explored aggression on the part of students. The purpose of this paper is to focus on understanding the phenomenon of workplace aggression in school teams. Specifically, the purpose of the…

Used fuel extended storage security and safeguards by design roadmap

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

Durbin, Samuel G.; Lindgren, Eric Richard; Jones, Robert

2016-05-01

In the United States, spent nuclear fuel (SNF) is safely and securely stored in spent fuel pools and dry storage casks. The available capacity in spent fuel pools across the nuclear fleet has nearly reached a steady state value. The excess SNF continues to be loaded in dry storage casks. Fuel is expected to remain in dry storage for periods beyond the initial dry cask certification period of 20 years. Recent licensing renewals have approved an additional 40 years. This report identifies the current requirements and evaluation techniques associated with the safeguards and security of SNF dry cask storage. Amore » set of knowledge gaps is identified in the current approaches. Finally, this roadmap identifies known knowledge gaps and provides a research path to deliver the tools and models needed to close the gaps and allow the optimization of the security and safeguards approaches for an interim spent fuel facility over the lifetime of the storage site.« less

Engaging and empowering patients to manage their type 2 diabetes, Part I: a knowledge, attitude, and practice gap?

PubMed

Serrano-Gil, Manuel; Jacob, Stephan

2010-06-01

For over 20 years, the World Health Assembly has recognized diabetes (type 1 and type 2) as a serious threat to national health and economic development and called for action regarding its prevention and control. However, the prevalence of type 2 diabetes continues to rise despite a significant percentage of cases being preventable. Furthermore, data suggest that in many patients diagnosed with type 2 diabetes, glycated hemoglobin (HbA(1c)) levels remain above the agreed international and national target levels, despite the availability of numerous antihyperglycemic agents, the best intentions of both patient and physician, and the support of the wider healthcare team. Part I of this two-part review considers evidence that seems to suggest there is a knowledge, attitude, and practice (KAP) gap in type 2 diabetes, and that although theoretical knowledge of how type 2 diabetes should be managed exists, the attitude of patients and healthcare professionals may influence the practicalities of implementing life-enhancing changes for patients living day-to-day with the condition. Here, we consider why there may be a KAP gap, how type 2 diabetes is currently being assessed and managed, and whether these current management approaches remain valid in the light of recent studies evaluating the impact of lowering current target HbA(1c) levels. This article also explores how encouraging patients to self-manage their disease, as well as engaging all stakeholders in the necessary behavioral changes, can positively influence the long-term treatment outcomes of patients with type 2 diabetes.

Ecology and management of morels harvested from the forests of western North America.

Treesearch

David Pilz; Rebecca McLain; Susan Alexander; Luis Villarreal-Ruiz; Shannon Berch; Tricia L. Wurtz; Catherine G. Parks; Erika McFarlane; Blaze Baker; Randy Molina; Jane E. Smith

2007-01-01

Morels are prized edible mushrooms that fruit, sometimes prolifically, in many forest types throughout western North America. They are collected for personal consumption and commercially harvested as valuable special (nontimber) forest products. Large gaps remain, however, in our knowledge about their taxonomy, biology, ecology, cultivation, safety, and how to manage...

Literature Review on Processing and Analytical Methods for ...

EPA Pesticide Factsheets

Report The purpose of this report was to survey the open literature to determine the current state of the science regarding the processing and analytical methods currently available for recovery of F. tularensis from water and soil matrices, and to determine what gaps remain in the collective knowledge concerning F. tularensis identification from environmental samples.

How does lower urinary tract dysfunction affect sexual function in men and women? ICI-RS 2015-Part 1.

PubMed

Rantell, Angie; Apostolidis, Apostolos; Anding, Ralf; Kirschner-Hermanns, Ruth; Cardozo, Linda

2017-04-01

The aim of this paper is to review the literature on the effect of lower urinary tract symptoms (LUTS) on sexual function and dysfunction. At the International Consultation on Incontinence-Research Society (ICI-RS) in 2015, a multidisciplinary group presented a literature search of what is known about the effect of lower urinary tract dysfunction (LUTD) on sexual function (SF) in men and women. Wider discussions regarding knowledge gaps and ideal research methodology ensued. A body of evidence supports associations between LUTS/urinary incontinence on SF in both men and women, but the true prevalence of the impact of LUTD on SF remains largely unknown. There is still reluctance among health care professionals (HCP's) to discuss SF with patients and often patients who are not asked will not volunteer their problems. A significant knowledge gap in this area remains. Education among HCP's on assessment and treatment of sexual dysfunction and communication skills are essential to encourage, and engage patients with HCP's. Neurourol. Urodynam. 36:949-952, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Canadian practice assessment in chronic obstructive pulmonary disease: respiratory specialist physician perception versus patient reality.

PubMed

Hernandez, Paul; Balter, Meyer S; Bourbeau, Jean; Chan, Charles K; Marciniuk, Darcy D; Walker, Shannon L

2013-01-01

Chronic obstructive pulmonary disease (COPD) is a common respiratory condition and the fourth leading cause of death in Canada. Optimal COPD management requires patients to participate in their care and physician knowledge of patients' perceptions of their disease. A prospective study in which respiratory specialist physicians completed a practice assessment questionnaire and patient assessments for 15 to 20 consecutive patients with COPD. Patients also completed a questionnaire regarding their perceptions of COPD and its management. A total of 58 respiratory specialist physicians from across Canada completed practice assessments and 931 patient assessments. A total of 640 patients with COPD (96% with moderate, severe or very severe disease) completed questionnaires. Symptom burden was high and most patients had experienced a recent exacerbation. Potential COPD care gaps were identified with respect to appropriate medication prescription, lack of an action plan, and access to COPD educators and pulmonary rehabilitation. Perceived knowledge needs and gaps differed between physicians and patients. Despite the dissemination of Canadian and international COPD clinical practice guidelines for more than a decade, potential care gaps remain among patients seen by respiratory specialist physicians. Differing perceptions regarding many aspects of COPD among physicians and patients may contribute to these care gaps.

Understanding the Financial Knowledge Gap: A New Dimension of Inequality in Later Life.

PubMed

Khan, Mohammad Nuruzzaman; Rothwell, David W; Cherney, Katrina; Sussman, Tamara

2017-01-01

To understand individuals' financial behaviors, it is important to understand the financial knowledge gap - the distance between one's objective and subjective financial knowledge. Overestimating one's financial knowledge can lead to risky financial behaviors. To date, limited empirical work has examined how financial knowledge gap varies across age groups. We analyze the size and nature of the financial knowledge gap and its variation across age groups. Using nationally representative data, we find robust evidence that older adults overestimate their financial knowledge. Social workers can assess the financial knowledge gap and educate their clients to protect from financial fraud, exploitation, and abuse.

Bipolar disorders in the Arab world: a critical review.

PubMed

Kronfol, Ziad; Zakaria Khalil, Mostafa; Kumar, Pankaj; Suhre, Karsten; Karam, Elie; McInnis, Melvin

2015-05-01

Bipolar disorders are common psychiatric disorders that affect 1-5% of the population worldwide. Major advances in the epidemiology, pathophysiology, and treatment of the disorders have recently occurred. The majority of published reports, however, originate from the Western hemisphere, mostly Europe and the United States. There is a shortage of data from the Arab world on bipolar disorders. In an era of globalization and rapid communication, it is not clear to what extent research findings pertaining to one part of the world are by necessity applicable to other parts. Psychiatric disorders are known to be affected by the culture in which they occur, and knowledge of variations in illness presentation in different ethnic groups is also increasing. However, knowledge of variations affecting Arab populations remains quite limited. This paper provides a critical review of the literature on bipolar affective disorders in the Arab world, pointing to major gaps in knowledge and future opportunities to fill these gaps. © 2015 New York Academy of Sciences.

Empirical study using network of semantically related associations in bridging the knowledge gap.

PubMed

Abedi, Vida; Yeasin, Mohammed; Zand, Ramin

2014-11-27

The data overload has created a new set of challenges in finding meaningful and relevant information with minimal cognitive effort. However designing robust and scalable knowledge discovery systems remains a challenge. Recent innovations in the (biological) literature mining tools have opened new avenues to understand the confluence of various diseases, genes, risk factors as well as biological processes in bridging the gaps between the massive amounts of scientific data and harvesting useful knowledge. In this paper, we highlight some of the findings using a text analytics tool, called ARIANA--Adaptive Robust and Integrative Analysis for finding Novel Associations. Empirical study using ARIANA reveals knowledge discovery instances that illustrate the efficacy of such tool. For example, ARIANA can capture the connection between the drug hexamethonium and pulmonary inflammation and fibrosis that caused the tragic death of a healthy volunteer in a 2001 John Hopkins asthma study, even though the abstract of the study was not part of the semantic model. An integrated system, such as ARIANA, could assist the human expert in exploratory literature search by bringing forward hidden associations, promoting data reuse and knowledge discovery as well as stimulating interdisciplinary projects by connecting information across the disciplines.

The Multifold Relationship between Memory and Decision Making: An Individual-Differences Study

ERIC Educational Resources Information Center

Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M.; Nilsson, Lars-Göran

2013-01-01

Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 and 80 years of age, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory,…

Vygotsky on Imagination: Why an Understanding of the Imagination Is an Important Issue for Schoolteachers

ERIC Educational Resources Information Center

Gajdamaschko, Natalia

2005-01-01

Lev Vygotsky was an educational theorist and psychologist of extraordinarily wide knowledge whose major writings deal with the entire learning-teaching-development enterprise. Despite wide-ranging interests towards Vygotskian theory, the issue of imagination remains outside of the main line of the general inquiries. Thus there is a gap in that…

Ecohydrological consequences of drought- and infestation-triggered tree die-off: Insights and hypotheses

Treesearch

Henry D. Adams; Charles H. Luce; David D. Breshears; Craig D. Allen; Markus Weiler; V. Cody Hale; Alistair M. S. Smith; Travis E. Huxman

2012-01-01

Widespread, rapid, drought-, and infestation-triggered tree mortality is emerging as a phenomenon affecting forests globally and may be linked to increasing temperatures and drought frequency and severity. The ecohydrological consequences of forest die-off have been little studied and remain highly uncertain. To explore this knowledge gap, we apply the extensive...

Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces.

PubMed

Godier, Lauren R; Fossey, M

2017-09-06

Despite media interest in alleged sexual violence and harassment in the UK military, there remains a paucity of UK-based peer-reviewed research in this area. Ministry of Defence and service-specific reports support the suggestion that UK service personnel may be at risk of experiencing sexual harassment. These reports however highlight a reluctance by service personnel to report sexual harassment through official channels. In this article, we discuss the paucity of UK-based research pertaining to the prevalence and impact of sexual harassment in the military, explore potential reasons for this gap in knowledge and outline future directions and priorities for academic research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Knitting the Threads of Silk through Time: Behçet's Disease—Past, Present, and Future

PubMed Central

Stack, Austin G.; Fraser, Alexander D.

2017-01-01

Behçet's disease (BD) is a chronic relapsing vasculitis that affects vessels of all types and sizes with a broad spectrum of phenotypic heterogeneity and complex immunopathogenesis. Efforts by the scientific community to resolve the unmet needs of BD and gaps in our knowledge have been hampered by considerable challenges that primarily relate to the rare nature of the disease in many parts of the world and its heterogeneity. Controversies remain in many aspects of the disease including the diagnostic criteria, immunopathogenesis and biomarker discovery, geographical variation, and therapeutic considerations. In this review, we highlight recent advances in our scientific understanding of BD, shed new insights into diagnostic and treatment strategies, and discuss residual gaps in our knowledge that will serve as the basis for current and future research. PMID:29081805

Soil erosion assessment - Mind the gap

NASA Astrophysics Data System (ADS)

Kim, Jongho; Ivanov, Valeriy Y.; Fatichi, Simone

2016-12-01

Accurate assessment of erosion rates remains an elusive problem because soil loss is strongly nonunique with respect to the main drivers. In addressing the mechanistic causes of erosion responses, we discriminate between macroscale effects of external factors - long studied and referred to as "geomorphic external variability", and microscale effects, introduced as "geomorphic internal variability." The latter source of erosion variations represents the knowledge gap, an overlooked but vital element of geomorphic response, significantly impacting the low predictability skill of deterministic models at field-catchment scales. This is corroborated with experiments using a comprehensive physical model that dynamically updates the soil mass and particle composition. As complete knowledge of microscale conditions for arbitrary location and time is infeasible, we propose that new predictive frameworks of soil erosion should embed stochastic components in deterministic assessments of external and internal types of geomorphic variability.

Mind the gap: gender differences in child special health care needs.

PubMed

Leiter, Valerie; Rieker, Patricia P

2012-07-01

The gendered nature of special health care needs in childhood is an important yet understudied area. Although gendered differences in the prevalence of special health care needs have been documented, there is less knowledge about the factors which contribute to those differences. Two research questions guide this inquiry. First, is the gender gap consistent across child special health care need indicators? Second, to what extent is the gender gap in special health care needs driven by behavioral conditions? We use multiple indicators from the U.S. National Survey of Children's Health to expand our understanding about the dynamic relationship between gender and childhood health. There are clear gender differences in the prevalence of special health care needs. Boys are more likely than girls to have special health care needs overall and on the five separate components examined (medication, more care than typical, limitations, special therapies, and educational or behavioral problem). This gender gap is dynamic and varies by indicator; while behavioral conditions play a role, it remains even after controlling for behavioral conditions. The reasons for the gender differences appear to be both biological and social but much remains unknown about this pattern.

A cross-sectional study of pandemic influenza health literacy and the effect of a public health campaign

PubMed Central

2012-01-01

Background To ascertain the understanding of 2009 pandemic (H1N1) influenza and relevant infection control measures in an emergency department population and to assess the effectiveness of education campaigns in informing the public about the pandemic. Methods Questionnaires were administered to patients, visitors, non-clinical staff and volunteers. Data were collected on knowledge, preventative measures, information sources, attitudes to government and media reporting, perceived seriousness, behaviour change and intended compliance with future measures. Results were used to construct an overall knowledge score. Results There were 252 participants. Traditional forms of mass media (138 [55%]) remained the principal information source. Approximately 70% (176) accurately described mode of transmission and recommended precautions and 68% (175) reported behaviour change because of the pandemic. Gaps in knowledge included failure to identify certain high risk groups. Recall of government campaigns was significantly associated with a higher knowledge score. 60% (151) thought that authorities and media had exaggerated the threat; only 40% (101) would comply with recommended measures in a future pandemic. Conclusions The knowledge regarding pandemic influenza was high in this population and positively affected by official campaigns. Pandemic planning should address knowledge gaps and the impression that authorities had exaggerated the public-health threat. PMID:22830499

Imaging of acute cervical spine injuries: review and outlook.

PubMed

Tins, B J; Cassar-Pullicino, V N

2004-10-01

Advances in imaging technology have been successfully applied in the emergency trauma setting with great benefit providing early, accurate and efficient diagnoses. Gaps in the knowledge of imaging acute spinal injury remain, despite a vast wealth of useful research and publications on the role of CT and MRI. This article reviews in a balanced manner the main questions that still face the attending radiologist by embracing the current and evolving concepts to help define and provide answers to the following; Imaging techniques -- strengths and weaknesses; what are the implications of a missed cervical spine injury?; who should be imaged?; how should they be imaged?; spinal immobilisation -- help or hazard?; residual open questions; what does all this mean?; and what are the implications for the radiologist? Although there are many helpful guidelines, the residual gaps in the knowledge base result in incomplete answers to the questions posed. The identification of these gaps in knowledge however should act as the initiating stimulus for further research. All too often there is a danger that the performance and productivity of the imaging modalities is the main research focus and not enough attention is given to the two fundamental prerequisites to the assessment of any imaging technology -- the clinical selection criteria for imaging and the level of expertise of the appropriate clinician interpreting the images.

Outcomes of a National Environmental Edutainment Program in High Schools

NASA Astrophysics Data System (ADS)

Lappe, M. D.

2012-12-01

We present results of the first longitudinal evaluation of a nation-wide environmental edutainment program. There has recently been rapid growth in curricula on the environment and climate change, yet few reach large and diverse audiences, and fewer still are evaluated. These results are from high schools participating in the Alliance for Climate Education (ACE) program. ACE is a 3 year-old program that has reached 1.2 million students with an edutainment presentation incorporating music, multi-media, animation, and documentary footage (www.acespace.org). A projected 850 schools across 23 states will see the presentation this year; 6% of schools (3 classes each) are randomly selected to be evaluated. The data described here were collected in Fall 2011 from 1,270 students in 21 schools; the full evaluation will be complete in May 2012. The sample is ethnically and socio-economically diverse — 29% are white, and 46% receive free/reduced lunches (a proxy for socio-economic status). Outcome measures included a test of climate knowledge and intentions to take (and to ask others to take) climate-related actions. The analyses examined direct effects of the ACE program on climate knowledge and intentions, as well as the moderating effects of student gender and age on learning. Before the ACE presentation, boys had significantly higher knowledge scores than girls (54% vs. 48% correct, respectively, p < .001). Afterward, boys and girls both had significantly higher knowledge scores (64% and 63% correct, respectively) and no longer differed from each other in this respect. Before the presentation, girls expressed significantly greater intentions to take climate-related actions than did boys. Afterward, intentions increased significantly in both groups, but the gap between girls and boys remained. The gap-closing pattern was somewhat different for the moderating variable of age. Before the presentation, knowledge and intentions were significantly higher among older students (11th- and 12th-graders) than among younger students (9th- and 10th-graders). Afterward, knowledge and intentions increased significantly in both groups, but the gap between them remained for knowledge and closed for intentions. These promising early results demonstrate how a single well-designed edutaiment presentation can appeal broadly to students and advance environmental education on a large scale.

Menopause Symptoms and Attitudes of African American Women: Closing the Knowledge Gap and Expanding Opportunities for Counseling

ERIC Educational Resources Information Center

Huffman, Shirley B.; Myers, Jane E.; Tingle, Lynne R.; Bond, Lloyd A.

2005-01-01

Menopause, a normal midlife transition for women, remains poorly understood, especially for minority women. A total of 226 African American midlife women completed the Menopause Symptoms List (J. M. Perz, 1997); Menopause Attitude Scale (C. Bowles, 1986); Attitudes Toward Menopause checklist (B. L. Neugarten, V. Wood, R. J. Kraines, & B. Loomes,…

Assessing the carbon consequences of western juniper (Juniperus occidentalis) encroachment across Oregon, USA

Treesearch

John L. Campbell; Robert E. Kennedy; Warren B. Cohen; Richard F. Miller

2012-01-01

Our ability to assess the continental impacts of woody encroachment remains compromised by the paucity of studies quantifying regional encroachment rates. This knowledge gap is especially apparent when it comes to quantifying the impact of woody encroachment on large-scale carbon dynamics. In this study, we use a combination of aerial photography from 1985-1986 and...

Senior University Officials' Approaches to Global Engagement: A Case Study of a Private and a Public Research University

ERIC Educational Resources Information Center

Chan, Shirley

2013-01-01

The phenomenon of globalization has a significant impact on higher education, but the lack of a clear roadmap for how senior university officials should create and implement global engagement strategies and for how these approaches support (or impede) an organizational culture that fosters globalization remains a gap in knowledge in higher…

How will aspen respond to mountain pine beetle? A review of literature and discussion of knowledge gaps

Treesearch

Kristen A. Pelz; Frederick W. Smith

2013-01-01

There has been speculation that quaking aspen (Populus tremuloides) dominance of forests will increase due to mortality caused by mountain pine beetle (Dendroctonus ponderosae) (MPB). High aspen sucker densities have been observed inthe years following MPB-caused pine mortality, but it remains unclear if this disturbance will result in a pulse of aspen...

Picture That: Supporting Sexuality Educators in Narrowing the Knowledge/Practice Gap

ERIC Educational Resources Information Center

Beyers, Christa

2012-01-01

Teaching about sex and relationships is one of the greatest challenges in not only the combating of HIV and AIDS, but also in preparing the youth for responsible sexual behaviour. Although it seems as if teachers to some extent do feel comfortable with the teaching of sexuality education at school, the question however remains as to whether youth…

Irreproducibility in Preclinical Biomedical Research: Perceptions, Uncertainties, and Knowledge Gaps.

PubMed

Jarvis, Michael F; Williams, Michael

2016-04-01

Concerns regarding the reliability of biomedical research outcomes were precipitated by two independent reports from the pharmaceutical industry that documented a lack of reproducibility in preclinical research in the areas of oncology, endocrinology, and hematology. Given their potential impact on public health, these concerns have been extensively covered in the media. Assessing the magnitude and scope of irreproducibility is limited by the anecdotal nature of the initial reports and a lack of quantitative data on specific failures to reproduce published research. Nevertheless, remediation activities have focused on needed enhancements in transparency and consistency in the reporting of experimental methodologies and results. While such initiatives can effectively bridge knowledge gaps and facilitate best practices across established and emerging research disciplines and therapeutic areas, concerns remain on how these improve on the historical process of independent replication in validating research findings and their potential to inhibit scientific innovation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Gaps induced by inversion symmetry breaking and second-generation Dirac cones in graphene/hexagonal boron nitride

DOE PAGES

Wang, Eryin; Lu, Xiaobo; Ding, Shijie; ...

2016-08-22

Graphene/hexagonal boron nitride (h-BN) has emerged as a model van der Waals heterostructure as the superlattice potential, which is induced by lattice mismatch and crystal orientation, gives rise to various novel quantum phenomena, such as the self-similar Hofstadter butterfly states. Although the newly generated second-generation Dirac cones (SDCs) are believed to be crucial for understanding such intriguing phenomena, fundamental knowledge of SDCs, such as locations and dispersion, and the effect of inversion symmetry breaking on the gap opening, still remains highly debated due to the lack of direct experimental results. In this work we report direct experimental results on themore » dispersion of SDCs in 0°-aligned graphene/h-BN heterostructures using angle-resolved photoemission spectroscopy. Our data unambiguously reveal SDCs at the corners of the superlattice Brillouin zone, and at only one of the two superlattice valleys. Moreover, gaps of approximately 100 meV and approximately 160 meV are observed at the SDCs and the original graphene Dirac cone, respectively. Our work highlights the important role of a strong inversion-symmetry-breaking perturbation potential in the physics of graphene/h-BN, and fills critical knowledge gaps in the band structure engineering of Dirac fermions by a superlattice potential.« less

Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

PubMed

Al-Abri, Seif S; Abdel-Hady, Doaa M; Al-Abaidani, Idris S

2016-06-01

Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Outcomes of a Clinic-Based Educational Intervention for Cardiovascular Disease Prevention by Race, Ethnicity, and Urban/Rural Status.

PubMed

Villablanca, Amparo C; Slee, Christina; Lianov, Liana; Tancredi, Daniel

2016-11-01

Heart disease is the leading killer of women and remains poorly recognized in high-risk groups. We assessed baseline knowledge gaps and efficacy of a survey-based educational intervention. Four hundred seventy-two women in clinical settings completed pre-/post-surveys for knowledge of: heart disease as the leading killer, risk factors (general and personal levels), heart attack/stroke symptoms, and taking appropriate emergency action. They received a clinic-based educational intervention delivered by healthcare professionals in the course of their clinical care. Change score analyses tested pre-/post-differences in knowledge after the educational intervention, comparing proportions by race, ethnicity, and urban/nonurban status. Knowledge and awareness was low in all groups, especially for American Indian women (p < 0.05). Awareness was overall highest for heart disease as the leading killer, but it was the lowest for taking appropriate action (13% of Hispanic, 13% of American Indian, 29% of African American, and 18% of nonurban women; p < 0.05). For all women, knowledge of the major risk factors was low (58%) as was knowledge of their personal levels for risk factors (73% awareness for hypertension, 54% for cholesterol, and 50% for diabetes). The intervention was effective (% knowledge gain) in all groups of women, particularly for raising awareness of: (1) heart disease as the leading killer in American Indian (25%), Hispanic (18%), and nonurban (15%) women; (2) taking appropriate action for American Indian (80%), African American (64%), non-Hispanic (55%), and urban (56%) women; (3) heart disease risk factors for Hispanic (56%) and American Indian (47%) women; and (4) heart disease and stroke symptoms in American Indian women (54% and 25%, respectively). Significant knowledge gaps persist for heart disease in high-risk women, suggesting that these gaps and groups should be targeted by educational programs. We specify areas of need, and we demonstrate efficacy of a clinic-based educational intervention that can be of utility to busy healthcare professionals.

Enhanced microbial coalbed methane generation: A review of research, commercial activity, and remaining challenges

USGS Publications Warehouse

Ritter, Daniel J.; Vinson, David S.; Barnhart, Elliott P.; Akob, Denise M.; Fields, Matthew W.; Cunningham, Al B.; Orem, William H.; McIntosh, Jennifer C.

2015-01-01

Coalbed methane (CBM) makes up a significant portion of the world’s natural gas resources. The discovery that approximately 20% of natural gas is microbial in origin has led to interest in microbially enhanced CBM (MECoM), which involves stimulating microorganisms to produce additional CBM from existing production wells. This paper reviews current laboratory and field research on understanding processes and reservoir conditions which are essential for microbial CBM generation, the progress of efforts to stimulate microbial methane generation in coal beds, and key remaining knowledge gaps. Research has been primarily focused on identifying microbial communities present in areas of CBM generation and attempting to determine their function, in-situ reservoir conditions that are most favorable for microbial CBM generation, and geochemical indicators of metabolic pathways of methanogenesis (i.e., acetoclastic or hydrogenotrophic methanogenesis). Meanwhile, researchers at universities, government agencies, and companies have focused on four primary MECoM strategies: 1) microbial stimulation (i.e., addition of nutrients to stimulate native microbes); 2) microbial augmentation (i.e., addition of microbes not native to or abundant in the reservoir of interest); 3) physically increasing microbial access to coal and distribution of amendments; and 4) chemically increasing the bioavailability of coal organics. Most companies interested in MECoM have pursued microbial stimulation: Luca Technologies, Inc., successfully completed a pilot scale field test of their stimulation strategy, while two others, Ciris Energy and Next Fuel, Inc., have undertaken smaller scale field tests. Several key knowledge gaps remain that need to be addressed before MECoM strategies can be implemented commercially. Little is known about the bacterial community responsible for coal biodegradation and how these microorganisms may be stimulated to enhance microbial methanogenesis. In addition, research is needed to understand what fraction of coal is available for biodegradation, and methods need to be developed to determine the extent of in-situ coal biodegradation by MECoM processes for monitoring changes to coal quality. Questions also remain about how well field-scale pilot tests will scale to commercial production, how often amendments will need to be added to maintain new methane generation, and how well MECoM strategies transfer between coal basins with different formation water geochemistries and coal ranks. Addressing these knowledge gaps will be key in determining the feasibility and commercial viability of MECoM technology.

Human Papillomavirus and Cancer Prevention: Gaps in Knowledge and Prospects for Research, Policy, and Advocacy

PubMed Central

Franco, Eduardo L.; de Sanjose, Silvia; Broker, Thomas R.; Stanley, Margaret A.; Chevarie-Davis, Myriam; Isidean, Sandra D.; Schiffman, Mark

2015-01-01

The recognition that human papillomavirus (HPV) infection is the central, necessary cause of cervical cancer paved the way to new fronts of prevention via improved screening methods and HPV vaccination. Much has been learned in all fronts, from the molecular basis of our understanding of how HPV causes disease to the health economics of preventive strategies at the individual and population levels. Progress in other areas of cancer control has yet to show the same multi- and trans-disciplinary gains seen in research on HPV-associated malignancies, which is one of the unequivocal success stories in disease prevention. Yet, as an embarrassment of riches, much more research is needed to fill the gaps in knowledge that remain before we are able to reap the benefits from the knowledge translation from all fronts. Public health research on setting-specific implementation of HPV-based preventive strategies and more concerted advocacy to counter barriers facing the adoption of these strategies are likely to yield major dividends in reducing the burden of HPV-associated diseases. PMID:23199961

Bridging the knowledge gap: from microbiome composition to function.

PubMed

Faith, Jeremiah J

2015-03-01

Despite the wealth of metagenomic sequencing data, the functions of most bacterial genes from the mammalian microbiota have remained poorly understood. In their recent study (Yaung et al 2015), Wang, Gerber, and colleagues present a platform which allows functional mining of bacterial genomes for genes that contribute to fitness in vivo and holds great potential for forward engineering microbes with enhanced colonization abilities in the microbiota.

Post-fledging survival in passerine birds and the value of post-fledging studies to conservation

Treesearch

W. Andrew Cox; Frank R. III Thompson; Allison S. Cox; John Faaborg

2014-01-01

Conservation efforts are most effective when we have complete demographic information for a species of concern. Nevertheless, fundamental gaps in our knowledge of demography still exist for many taxa. For passerine birds, the period of time directly after young birds leave the nest and before they disperse and/or migrate (i.e., the post-fledging period) remains an...

Diagnosing climate change impacts and identifying adaptation strategies by involving key stakeholder organisations and farmers in Sikkim, India: Challenges and opportunities.

PubMed

Azhoni, Adani; Goyal, Manish Kumar

2018-06-01

Narrowing the gap between research, policy making and implementing adaptation remains a challenge in many parts of the world where climate change is likely to severely impact water security. This research aims to narrow this gap by matching the adaptation strategies being framed by policy makers to that of the perspectives of development agencies, researchers and farmers in the Himalayan state of Sikkim in India. Our case study examined the perspectives of various stakeholders for climate change impacts, current adaptation strategies, knowledge gaps and adaptation barriers, particularly in the context of implementing the Sikkim State Action Plan on Climate Change through semi-structured interviews carried out with decision makers in the Sikkim State Government, researchers, consultants, local academia, development agencies and farmers. Using Stakeholders Network Analysis tools, this research unravels the complexities of perceiving climate change impacts, identifying strategies, and implementing adaptation. While farmers are less aware about the global phenomenon of climate change impacts for water security, their knowledge of the local conditions and their close interaction with the State Government Agriculture Department provides them opportunities. Although important steps are being initiated through the Sikkim State Action Plan on Climate Change it is yet to deliver effective means of adaptation implementation and hence, strengthening the networks of close coordination between the various implementing agencies will pay dividends. Knowledge gaps and the need for capacity building identified in this research, based on the understandings of key stakeholders are highly relevant to both the research community and for informing policy. Copyright © 2018 Elsevier B.V. All rights reserved.

Bridging the Gap in Knowledge Transfer between Academia and Practitioners

ERIC Educational Resources Information Center

Gera, Rajat

2012-01-01

Purpose: The paper intends to identify the causes or gaps in transfer of managerial knowledge between academia and practitioners and to develop a framework that overcomes the gaps through knowledge management, information technology and human resource practices. The paper aims to suggest a strategic approach based on the knowledge transfer cycle.…

Experimental Evidence of the Knowledge Gap: Message Arousal, Motivation, and Time Delay

ERIC Educational Resources Information Center

Grabe, Maria Elizabeth; Yegiyan, Narine; Kamhawi, Rasha

2008-01-01

This study experimentally tested the knowledge gap from an information processing perspective. Specifically, knowledge acquisition was investigated under conditions of medium and low news message arousal, with time delay. Results show the persistence of a knowledge gap, particularly for low arousing messages. In fact, at low levels of message…

Arabinogalactan-proteins and the research challenges for these enigmatic plant cell surface proteoglycans

PubMed Central

Tan, Li; Showalter, Allan M.; Egelund, Jack; Hernandez-Sanchez, Arianna; Doblin, Monika S.; Bacic, Antony

2012-01-01

Arabinogalactan-proteins (AGPs) are complex glycoconjugates that are commonly found at the cell surface and in secretions of plants. Their location and diversity of structures have made them attractive targets as modulators of plant development but definitive proof of their direct role(s) in biological processes remains elusive. Here we overview the current state of knowledge on AGPs, identify key challenges impeding progress in the field and propose approaches using modern bioinformatic, (bio)chemical, cell biological, molecular and genetic techniques that could be applied to redress these gaps in our knowledge. PMID:22754559

Gene regulation knowledge commons: community action takes care of DNA binding transcription factors

PubMed Central

Tripathi, Sushil; Vercruysse, Steven; Chawla, Konika; Christie, Karen R.; Blake, Judith A.; Huntley, Rachael P.; Orchard, Sandra; Hermjakob, Henning; Thommesen, Liv; Lægreid, Astrid; Kuiper, Martin

2016-01-01

A large gap remains between the amount of knowledge in scientific literature and the fraction that gets curated into standardized databases, despite many curation initiatives. Yet the availability of comprehensive knowledge in databases is crucial for exploiting existing background knowledge, both for designing follow-up experiments and for interpreting new experimental data. Structured resources also underpin the computational integration and modeling of regulatory pathways, which further aids our understanding of regulatory dynamics. We argue how cooperation between the scientific community and professional curators can increase the capacity of capturing precise knowledge from literature. We demonstrate this with a project in which we mobilize biological domain experts who curate large amounts of DNA binding transcription factors, and show that they, although new to the field of curation, can make valuable contributions by harvesting reported knowledge from scientific papers. Such community curation can enhance the scientific epistemic process. Database URL: http://www.tfcheckpoint.org PMID:27270715

Bridging the gaps: An overview of wood across time and space in diverse rivers

NASA Astrophysics Data System (ADS)

Wohl, Ellen

2017-02-01

Nearly 50 years of research focused on large wood (LW) in rivers provide a basis for understanding how wood enters rivers; how wood decays, breaks, and is transported downstream; and how at least temporarily stable wood influences channel geometry, fluxes of water, sediment, and organic matter, and the abundance and diversity of aquatic and riparian organisms. Field-based studies have led to qualitative conceptual models and to numerical stimulations of river processes involving wood. Numerous important gaps remain, however, in our understanding of wood dynamics. The majority of research on wood in rivers focuses on small- to medium-sized rivers, defined using the ratio of wood piece size to channel width as channels narrower than the locally typical wood-piece length (small) and slightly narrower than the longer wood pieces present (medium). Although diverse geographic regions and biomes are represented by one or a few studies in each region, the majority of research comes from perennial rivers draining temperate conifer forests. Regional syntheses most commonly focus on the Pacific Northwest region of North America where most of these studies originate. Consequently, significant gaps in our understanding include lack of knowledge of wood-related processes in large rivers, dryland rivers, and rivers of the high and low latitudes. Using a wood budget as an organizing framework, this paper identifies other gaps related to wood recruitment, transport, storage, and how beavers influence LW dynamics. With respect to wood recruitment, we lack information on the relative importance of mass tree mortality and transport of buried or surficial downed wood from the floodplain into the channel in diverse settings. Knowledge gaps related to wood transport include transport distances of LW and thresholds for LW mobility in small to medium rivers. With respect to wood storage, we have limited data on longitudinal trends in LW loads within unaltered large and great rivers and on fluctuations in LW load over time intervals greater than a few years. Other knowledge gaps relate to physical and ecological effects of wood, including the magnitude of flow resistance caused by LW; patterns of wood-related sediment storage for diverse river sizes and channel geometry; quantification of channel-floodplain-LW interactions; and potential threshold effects of LW in relation to physical processes and biotic communities. Finally, knowledge gaps are related to management of large wood and river corridors, including understanding the consequences of enormous historical reductions in LW load in rivers through the forested portions of the temperate zone; and how to effectively reintroduce and manage existing LW in river corridors, which includes enhancing public understanding of the importance of LW. Addressing these knowledge gaps requires more case studies from diverse rivers, as well as more syntheses and metadata analyses.

Experience of targeting subsidies on insecticide-treated nets: what do we know and what are the knowledge gaps?

PubMed

Worrall, Eve; Hill, Jenny; Webster, Jayne; Mortimer, Julia

2005-01-01

Widespread coverage of vulnerable populations with insecticide-treated nets (ITNs) constitutes an important component of the Roll Back Malaria (RBM) strategy to control malaria. The Abuja Targets call for 60% coverage of children under 5 years of age and pregnant women by 2005; but current coverage in Africa is unacceptably low. The RBM 'Strategic Framework for Coordinated National Action in Scaling-up Insecticide-Treated Netting Programmes in Africa' promotes coordinated national action and advocates sustained public provision of targeted subsidies to maximise public health benefits, alongside support and stimulation of the private sector. Several countries have already planned or initiated targeted subsidy schemes either on a pilot scale or on a national scale, and have valuable experience which can inform future interventions. The WHO RBM 'Workshop on mapping models for delivering ITNs through targeted subsidies' held in Zambia in 2003 provided an opportunity to share and document these country experiences. This paper brings together experiences presented at the workshop with other information on experiences of targeting subsidies on ITNs, net treatment kits and retreatment services (ITN products) in order to describe alternative approaches, highlight their similarities and differences, outline lessons learnt, and identify gaps in knowledge. We find that while there is a growing body of knowledge on different approaches to targeting ITN subsidies, there are significant gaps in knowledge in crucial areas. Key questions regarding how best to target, how much it will cost and what outcomes (levels of coverage) to expect remain unanswered. High quality, well-funded monitoring and evaluation of alternative approaches to targeting ITN subsidies is vital to develop a knowledge base so that countries can design and implement effective strategies to target ITN subsidies.

An official American Thoracic Society/European Respiratory Society statement: research questions in COPD.

PubMed

Celli, Bartolome R; Decramer, Marc; Wedzicha, Jadwiga A; Wilson, Kevin C; Agustí, Alvar A; Criner, Gerard J; MacNee, William; Make, Barry J; Rennard, Stephen I; Stockley, Robert A; Vogelmeier, Claus; Anzueto, Antonio; Au, David H; Barnes, Peter J; Burgel, Pierre-Regis; Calverley, Peter M; Casanova, Ciro; Clini, Enrico M; Cooper, Christopher B; Coxson, Harvey O; Dusser, Daniel J; Fabbri, Leonardo M; Fahy, Bonnie; Ferguson, Gary T; Fisher, Andrew; Fletcher, Monica J; Hayot, Maurice; Hurst, John R; Jones, Paul W; Mahler, Donald A; Maltais, François; Mannino, David M; Martinez, Fernando J; Miravitlles, Marc; Meek, Paula M; Papi, Alberto; Rabe, Klaus F; Roche, Nicolas; Sciurba, Frank C; Sethi, Sanjay; Siafakas, Nikos; Sin, Don D; Soriano, Joan B; Stoller, James K; Tashkin, Donald P; Troosters, Thierry; Verleden, Geert M; Verschakelen, Johny; Vestbo, Jorgen; Walsh, John W; Washko, George R; Wise, Robert A; Wouters, Emiel F M; ZuWallack, Richard L

2015-06-01

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and resource use worldwide. The goal of this official American Thoracic Society (ATS)/European Respiratory Society (ERS) Research Statement is to describe evidence related to diagnosis, assessment, and management; identify gaps in knowledge; and make recommendations for future research. It is not intended to provide clinical practice recommendations on COPD diagnosis and management. Clinicians, researchers and patient advocates with expertise in COPD were invited to participate. A literature search of Medline was performed, and studies deemed relevant were selected. The search was not a systematic review of the evidence. Existing evidence was appraised and summarised, and then salient knowledge gaps were identified. Recommendations for research that addresses important gaps in the evidence in all areas of COPD were formulated via discussion and consensus. Great strides have been made in the diagnosis, assessment and management of COPD, as well as understanding its pathogenesis. Despite this, many important questions remain unanswered. This ATS/ERS research statement highlights the types of research that leading clinicians, researchers and patient advocates believe will have the greatest impact on patient-centred outcomes. Copyright ©ATS/ERS 2015.

The gap in scientific knowledge and role of science communication in South Korea.

PubMed

Chang, Jeong-Heon; Kim, Sei-Hill; Kang, Myung-Hyun; Shim, Jae Chul; Ma, Dong Hoon

2017-01-01

Using data from a national survey of South Koreans, this study explores the role of science communication in enhancing three different forms of scientific knowledge ( factual, procedural, and subjective). We first assess learning effects, looking at the extent to which citizens learn science from different channels of communication (interpersonal discussions, traditional newspapers, television, online newspapers, and social media). We then look into the knowledge gap hypothesis, investigating how different communication channels can either widen or narrow the gap in knowledge between social classes. Television was found to function as a "knowledge leveler," narrowing the gap between highly and less educated South Koreans. The role of online newspapers in science learning is pronounced in our research. Reading newspapers online indicated a positive relationship to all three measures of knowledge. Contrary to the knowledge-leveling effect of television viewing, reading online newspapers was found to increase, rather than decrease, the gap in knowledge. Implications of our findings are discussed in detail.

Bridging the knowledge gap: from microbiome composition to function

PubMed Central

Faith, Jeremiah J

2015-01-01

Despite the wealth of metagenomic sequencing data, the functions of most bacterial genes from the mammalian microbiota have remained poorly understood. In their recent study (Yaung et al 2015), Wang, Gerber, and colleagues present a platform which allows functional mining of bacterial genomes for genes that contribute to fitness in vivo and holds great potential for forward engineering microbes with enhanced colonization abilities in the microbiota. PMID:26148349

Towards an understanding of the link between environmental emissions and human body burdens of PCBs using CoZMoMAN.

PubMed

Breivik, Knut; Czub, Gertje; McLachlan, Michael S; Wania, Frank

2010-01-01

Different factors affect how organic contaminants released into the environment over time distribute and accumulate, enter various food-chains, and potentially cause toxic effects in wildlife and humans. A sound chemical risk assessment thus requires the determination of the quantitative relationship between emissions and human exposure. This study aimed to assess the extent of the quantitative and mechanistic understanding of the link between environmental emissions and human body burdens for polychlorinated biphenyls (PCBs) in the western part of the Baltic Sea drainage basin and to identify any remaining knowledge gaps. An integrated, non-steady state model calculating human body burden from environmental emissions (CoZMoMAN) was created by linking the multi-compartment environmental fate model CoZMo-POP 2 with the human food chain bioaccumulation model ACC-HUMAN. CoZMoMAN predicted concentrations of seven PCB congeners in 11 key model compartments to typically within a factor of 2 to 4 of measured values, although larger discrepancies are noted for soils and humans. We conclude that whereas the most important processes which link emissions of PCBs to human body burdens are quite well understood in this region, some critical knowledge gaps related to the time trend of historical emissions remain to be addressed.

DNA barcoding in diverse educational settings: five case studies

PubMed Central

Imondi, Ralph; James, Karen; Spencer, Diana; Steinke, Dirk

2016-01-01

Despite 250 years of modern taxonomy, there remains a large biodiversity knowledge gap. Most species remain unknown to science. DNA barcoding can help address this gap and has been used in a variety of educational contexts to incorporate original research into school curricula and informal education programmes. A growing body of evidence suggests that actively conducting research increases student engagement and retention in science. We describe case studies in five different educational settings in Canada and the USA: a programme for primary and secondary school students (ages 5–18), a year-long professional development programme for secondary school teachers, projects embedding this research into courses in a post-secondary 2-year institution and a degree-granting university, and a citizen science project. We argue that these projects are successful because the scientific content is authentic and compelling, DNA barcoding is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and online tools exist that allow participants to contribute high-quality data to the international research effort. Evidence of success includes the broad adoption of these programmes and assessment results demonstrating that participants are gaining both knowledge and confidence. There are exciting opportunities for coordination among educational projects in the future. This article is part of the themed issue ‘From DNA barcodes to biomes’. PMID:27481792

DNA barcoding in diverse educational settings: five case studies.

PubMed

Henter, Heather J; Imondi, Ralph; James, Karen; Spencer, Diana; Steinke, Dirk

2016-09-05

Despite 250 years of modern taxonomy, there remains a large biodiversity knowledge gap. Most species remain unknown to science. DNA barcoding can help address this gap and has been used in a variety of educational contexts to incorporate original research into school curricula and informal education programmes. A growing body of evidence suggests that actively conducting research increases student engagement and retention in science. We describe case studies in five different educational settings in Canada and the USA: a programme for primary and secondary school students (ages 5-18), a year-long professional development programme for secondary school teachers, projects embedding this research into courses in a post-secondary 2-year institution and a degree-granting university, and a citizen science project. We argue that these projects are successful because the scientific content is authentic and compelling, DNA barcoding is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and online tools exist that allow participants to contribute high-quality data to the international research effort. Evidence of success includes the broad adoption of these programmes and assessment results demonstrating that participants are gaining both knowledge and confidence. There are exciting opportunities for coordination among educational projects in the future.This article is part of the themed issue 'From DNA barcodes to biomes'. © 2016 The Authors.

Challenges of Bystander Intervention in Male-Dominated Professional Sport: Lessons From the Australian Football League.

PubMed

Corboz, Julienne; Flood, Michael; Dyson, Sue

2016-03-01

Programs aimed at preventing violence against women have increasingly adopted bystander approaches, yet large gaps remain in our knowledge about what drives bystanders to act or not, particularly in settings where there is an increased risk of violence against women occurring. This article contributes to this gap by examining data from research with professional male athletes from the Australian Football League. Drawing from a mixed methods approach, including a survey and interviews with football players, we outline some of the challenges to bystander intervention faced by professional athletes and discuss some of the possible similarities and differences between these and other groups of men. © The Author(s) 2015.

Executive summary of NIH workshop on the Use and Biology of Energy Drinks: Current Knowledge and Critical Gaps

PubMed Central

Sorkin, Barbara C; Camp, Kathryn M; Haggans, Carol J; Deuster, Patricia A; Haverkos, Lynne; Maruvada, Padma; Witt, Ellen; Coates, Paul M

2014-01-01

Sales of energy drinks in the United States reached $12.5 billion in 2012. Emergency department visits related to consumption of these products have increased sharply, and while these numbers remain small relative to product sales, they raise important questions regarding biological and behavioral effects. Although some common ingredients of energy drinks have been extensively studied (e.g., caffeine, B vitamins, sugars, inositol), data on other ingredients (e.g., taurine) are limited. Summarized here are data presented elsewhere in this issue on the prevalence and patterns of caffeine-containing energy drink use, the effects of these products on alertness, fatigue, cognitive functions, sleep, mood, homeostasis, as well as on exercise physiology and metabolism, and the biological mechanisms mediating the observed effects. There are substantial data on the effects of some energy drink ingredients, such as caffeine and sugars, on many of these outcomes; however, even for these ingredients many controversies and gaps remain, and data on other ingredients in caffeine-containing energy drinks, and on ingredient interactions, are sparse. This summary concludes with a discussion of critical gaps in the data and potential next steps. PMID:25293538

Invited Commentary on "Centers for Disease Control and Prevention Report to Congress: Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation".

PubMed

Flanagan, Steven R

2015-10-01

Traumatic brain injury (TBI) is a significant health problem, afflicting millions of people worldwide. Despite increasing awareness of its burden on patients, families, and society, much remains unknown regarding TBI incidence, how best to assess outcomes post-injury, and the most effective means of providing rehabilitation services. The Centers for Disease Control and Prevention recently published recommendations to Congress that address these critical knowledge gaps. The report is the end product of work completed by a notable panel of experts and stakeholders that makes overarching recommendations aimed at addressing knowledge gaps in TBI, with the ultimate goal of decreasing injury occurrence and improving outcomes. It is a succinct and powerful report that should serve as a call to action to fund innovative research and reverse a trend in health care that restricts access to rehabilitation services. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Farmers Extension Program Effects on Yield Gap in North China Plain

NASA Astrophysics Data System (ADS)

Sum, N.; Zhao, Y.

2015-12-01

Improving crop yield of the lowest yielding smallholder farmers in developing countries is essential to both food security of the country and the farmers' livelihood. Although wheat and maize production in most developed countries have reached 80% or greater of yield potential determined by simulated models, yield gap remains high in the developing world. One of these cases is the yield gap of maize in the North China Plain (NCP), where the average farmer's yield is 41% of his or her potential yield. This large yield gap indicates opportunity to raise yields substantially by improving agronomy, especially in nutrition management, irrigation facility, and mechanization issues such as technical services. Farmers' agronomic knowledge is essential to yield performance. In order to propagate such knowledge to farmers, agricultural extension programs, especially in-the-field guidance with training programs at targeted demonstration fields, have become prevalent in China. Although traditional analyses of the effects of the extension program are done through surveys, they are limited to only one to two years and to a small area. However, the spatial analysis tool Google Earth Engine (GEE) and its extensive satellite imagery data allow for unprecedented spatial temporal analysis of yield variation. We used GEE to analyze maize yield in Quzhou county in the North China Plain from 2007 to 2013. We based our analysis on the distance from a demonstration farm plot, the source of the farmers' agronomic knowledge. Our hypothesis was that the farther the farmers' fields were from the demonstration plot, the less access they would have to the knowledge, and the less increase in yield over time. Testing this hypothesis using GEE helps us determine the effectiveness of the demonstration plot in disseminating optimal agronomic practices in addition to evaluating yield performance of the demonstration field itself. Furthermore, we can easily extend this methodology to analyze the whole NCP and any other parts of the world for any type of crop.

The unrecognized burden of typhoid fever.

PubMed

Obaro, Stephen K; Iroh Tam, Pui-Ying; Mintz, Eric Daniel

2017-03-01

Typhoid fever (TF), caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, responsible for an estimated 129,000 deaths and more than 11 million cases annually. Although several reviews have provided global and regional TF disease burden estimates, major gaps in our understanding of TF epidemiology remain. Areas covered: We provide an overview of the gaps in current estimates of TF disease burden and offer suggestions for addressing them, so that affected communities can receive the full potential of disease prevention offered by vaccination and water, sanitation, and hygiene interventions. Expert commentary: Current disease burden estimates for TF do not capture cases from certain host populations, nor those with atypical presentations of TF, which may lead to substantial underestimation of TF cases and deaths. These knowledge gaps pose major obstacles to the informed use of current and new generation typhoid vaccines.

Understanding the digital divide in the clinical setting: the technology knowledge gap experienced by US safety net patients during teleretinal screening.

PubMed

George, Sheba; Moran, Erin; Fish, Allison; Ogunyemi, Lola

2013-01-01

Differential access to everyday technology and healthcare amongst safety net patients is associated with low technological and health literacies, respectively. These low rates of literacy produce a complex patient "knowledge gap" that influences the effectiveness of telehealth technologies. To understand this "knowledge gap", six focus groups (2 African-American and 4 Latino) were conducted with patients who received teleretinal screenings in U.S. urban safety-net settings. Findings indicate that patients' "knowledge gap" is primarily produced at three points: (1) when patients' preexisting personal barriers to care became exacerbated in the clinical setting; (2) through encounters with technology during screening; and (3) in doctor-patient follow-up. This "knowledge gap" can produce confusion and fear, potentially affecting patients' confidence in quality of care and limiting their disease management ability. In rethinking the digital divide to include the consequences of this knowledge gap faced by patients in the clinical setting, we suggest that patient education focus on both their disease and specific telehealth technologies deployed in care delivery.

Influenza-associated bacterial pneumonia; managing and controlling infection on two fronts.

PubMed

Campigotto, Aaron; Mubareka, Samira

2015-01-01

Bacterial pneumonia complicating influenza is well-recognized as a severe manifestation of influenza, accounting for a substantial number of deaths from the 1918 influenza pandemic. Influenza-associated bacterial pneumonia remains a major contributor to the burden of influenza, and poses new challenges as antibiotic-resistant organisms such as methicillin-resistant Staphylococcus aureus spread. We provide an overview of the current state of knowledge of the epidemiology and co-pathogenesis of influenza-associated bacterial pneumonia, and outline management approaches and their limitations. We review preventative measures and discuss implications for pandemic planning. Knowledge gaps are underscored and future research directions are proposed.

DCS: A Case Study of Identification of Knowledge and Disposition Gaps Using Principles of Continuous Risk Management

NASA Technical Reports Server (NTRS)

Norcross, Jason; Steinberg, Susan; Kundrot, Craig; Charles, John

2011-01-01

The Human Research Program (HRP) is formulated around the program architecture of Evidence-Risk-Gap-Task-Deliverable. Review of accumulated evidence forms the basis for identification of high priority risks to human health and performance in space exploration. Gaps in knowledge or disposition are identified for each risk, and a portfolio of research tasks is developed to fill them. Deliverables from the tasks inform the evidence base with the ultimate goal of defining the level of risk and reducing it to an acceptable level. A comprehensive framework for gap identification, focus, and metrics has been developed based on principles of continuous risk management and clinical care. Research towards knowledge gaps improves understanding of the likelihood, consequence or timeframe of the risk. Disposition gaps include development of standards or requirements for risk acceptance, development of countermeasures or technology to mitigate the risk, and yearly technology assessment related to watching developments related to the risk. Standard concepts from clinical care: prevention, diagnosis, treatment, monitoring, rehabilitation, and surveillance, can be used to focus gaps dealing with risk mitigation. The research plan for the new HRP Risk of Decompression Sickness (DCS) used the framework to identify one disposition gap related to establishment of a DCS standard for acceptable risk, two knowledge gaps related to DCS phenomenon and mission attributes, and three mitigation gaps focused on prediction, prevention, and new technology watch. These gaps were organized in this manner primarily based on target for closure and ease of organizing interim metrics so that gap status could be quantified. Additional considerations for the knowledge gaps were that one was highly design reference mission specific and the other gap was focused on DCS phenomenon.

Getting to the guts of the matter: the status and potential of 'omics' research of parasitic protists of the human gastrointestinal system.

PubMed

Jex, Aaron R; Koehler, Anson V; Ansell, Brendan R; Baker, Louise; Karunajeewa, Harin; Gasser, Robin B

2013-11-01

Parasitic protists are a major cause of diarrhoeal illnesses in humans globally. Collectively, enteric pathogens exceed all other forms of infectious disease, in terms of their estimated global prevalence and socioeconomic impact. They have a disproportionately high impact on children in impoverished communities, leading to acute (diarrhoea, vomiting, dehydration and death) and chronic disease (malabsorption, malnutrition, physical and cognitive stunting and predisposition to chronic, non-communicable disease) consequences. However, historically, investment in research and disease control measures has been disproportionately poor, leading to their current classification as neglected pathogens. A sound understanding of their biology is essential in underpinning detection, treatment and control efforts. One major tool in rapidly improving our knowledge of these parasites is the use of biological systems, including 'omic' technologies. In recent years, these tools have shown significant success when applied to enteric protists. This review summarises much of this knowledge and highlights the significant remaining knowledge gaps. A major focus of the present review was to provide a perspective on a way forward to address these gaps using advanced biotechnologies. Copyright © 2013 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

Evidence-based practice, research utilization, and knowledge translation in chiropractic: a scoping review.

PubMed

Bussières, André E; Al Zoubi, Fadi; Stuber, Kent; French, Simon D; Boruff, Jill; Corrigan, John; Thomas, Aliki

2016-07-13

Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for chiropractors to routinely apply evidence into clinical practice. Educational strategies aimed at practicing chiropractors can lead to more EBP and improved patient care. The chiropractic profession requires more robust dissemination and implementation research to improve guideline adherence and patient health outcomes.

Connexin-deficiency affects expression levels of glial glutamate transporters within the cerebrum.

PubMed

Unger, Tina; Bette, Stefanie; Zhang, Jiong; Theis, Martin; Engele, Jürgen

2012-01-06

The glial glutamate transporter subtypes, GLT-1/EAAT-2 and GLAST/EAAT-1 clear the bulk of extracellular glutamate and are severely dysregulated in various acute and chronic brain diseases. Despite the previous identification of several extracellular factors modulating glial glutamate transporter expression, our knowledge of the regulatory network controlling glial glutamate transport in health and disease still remains incomplete. In studies with cultured cortical astrocytes, we previously obtained evidence that glial glutamate transporter expression is also affected by gap junctions/connexins. To assess whether gap junctions would likewise control the in vivo expression of glial glutamate transporters, we have now assessed their expression levels in brains of conditional Cx43 knockout mice, total Cx30 knockouts, as well as Cx43/Cx30 double knockouts. We found that either knocking out Cx30, Cx43, or both increases GLT-1/EAAT-2 protein levels in the cerebral cortex to a similar extent. By contrast, GLAST/EAAT-1 protein levels maximally increased in cerebral cortices of Cx30/Cx43 double knockouts, implying that gap junctions differentially affect the expression of GLT-1/EAAT-2 and GLAST/EAAT-1. Quantitative PCR analysis further revealed that increases in glial glutamate transporter expression are brought about by transcriptional and translational/posttranslational processes. Moreover, GLT-1/EAAT-2- and GLAST/EAAT-1 protein levels remained unchanged in the hippocampi of Cx43/Cx30 double knockouts when compared to Cx43fl/fl controls, indicating brain region-specific effects of gap junctions on glial glutamate transport. Since astrocytic gap junction coupling is affected in various forms of brain injuries, our findings point to gap junctions/connexins as important regulators of glial glutamate turnover in the diseased cerebral cortex. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Mitigating the Mathematical Knowledge Gap between High School and First Year University Chemical Engineering Mathematics Course

ERIC Educational Resources Information Center

Basitere, Moses; Ivala, Eunice

2015-01-01

This paper reports on a study carried out at a University of Technology, South Africa, aimed at identifying the existence of the mathematical knowledge gap and evaluating the intervention designed to bridge the knowledge gap amongst students studying first year mathematics at the Chemical Engineering Extended Curriculum Program (ECP). In this…

Outcomes of a Clinic-Based Educational Intervention for Cardiovascular Disease Prevention by Race, Ethnicity, and Urban/Rural Status

PubMed Central

Slee, Christina; Lianov, Liana; Tancredi, Daniel

2016-01-01

Abstract Background and Purpose: Heart disease is the leading killer of women and remains poorly recognized in high-risk groups. We assessed baseline knowledge gaps and efficacy of a survey-based educational intervention. Methods: Four hundred seventy-two women in clinical settings completed pre-/post-surveys for knowledge of: heart disease as the leading killer, risk factors (general and personal levels), heart attack/stroke symptoms, and taking appropriate emergency action. They received a clinic-based educational intervention delivered by healthcare professionals in the course of their clinical care. Change score analyses tested pre-/post-differences in knowledge after the educational intervention, comparing proportions by race, ethnicity, and urban/nonurban status. Results: Knowledge and awareness was low in all groups, especially for American Indian women (p < 0.05). Awareness was overall highest for heart disease as the leading killer, but it was the lowest for taking appropriate action (13% of Hispanic, 13% of American Indian, 29% of African American, and 18% of nonurban women; p < 0.05). For all women, knowledge of the major risk factors was low (58%) as was knowledge of their personal levels for risk factors (73% awareness for hypertension, 54% for cholesterol, and 50% for diabetes). The intervention was effective (% knowledge gain) in all groups of women, particularly for raising awareness of: (1) heart disease as the leading killer in American Indian (25%), Hispanic (18%), and nonurban (15%) women; (2) taking appropriate action for American Indian (80%), African American (64%), non-Hispanic (55%), and urban (56%) women; (3) heart disease risk factors for Hispanic (56%) and American Indian (47%) women; and (4) heart disease and stroke symptoms in American Indian women (54% and 25%, respectively). Conclusions: Significant knowledge gaps persist for heart disease in high-risk women, suggesting that these gaps and groups should be targeted by educational programs. We specify areas of need, and we demonstrate efficacy of a clinic-based educational intervention that can be of utility to busy healthcare professionals. PMID:27356155

Clinical utility of EEG in diagnosing and monitoring epilepsy in adults.

PubMed

Tatum, W O; Rubboli, G; Kaplan, P W; Mirsatari, S M; Radhakrishnan, K; Gloss, D; Caboclo, L O; Drislane, F W; Koutroumanidis, M; Schomer, D L; Kasteleijn-Nolst Trenite, D; Cook, Mark; Beniczky, S

2018-05-01

Electroencephalography (EEG) remains an essential diagnostic tool for people with epilepsy (PWE). The International Federation of Clinical Neurophysiology produces new guidelines as an educational service for clinicians to address gaps in knowledge in clinical neurophysiology. The current guideline was prepared in response to gaps present in epilepsy-related neurophysiological assessment and is not intended to replace sound clinical judgement in the care of PWE. Furthermore, addressing specific pathophysiological conditions of the brain that produce epilepsy is of primary importance though is beyond the scope of this guideline. Instead, our goal is to summarize the scientific evidence for the utility of EEG when diagnosing and monitoring PWE. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

Media use and HIV/AIDS knowledge: a knowledge gap perspective.

PubMed

Bekalu, Mesfin Awoke; Eggermont, Steven

2014-12-01

Despite the widespread utilization of the mass media in HIV/AIDS prevention, little is known about the knowledge gap that results from disparities in mass media use. This study examined the relationship between HIV/AIDS-related mass media use and HIV/AIDS-related knowledge among urban and rural residents of northwestern Ethiopia. A hierarchical regression analysis indicated that HIV/AIDS-related mass media use has both sequestering and mainstreaming effects in certain segments of the study population, although it was not a significant predictor of HIV/AIDS-related knowledge in the total population. The knowledge gaps between individuals with high and low education and between individuals who experience high and low levels of interpersonal communication about HIV/AIDS narrowed as HIV/AIDS-related media use increased, but the gap between urban and rural residents widened. The widening gap could be explained by differences in perceptions of information salience and several theoretical assumptions. Current mass media information campaigns, which are often prepared and broadcast from urban centers, may not only fail to improve the HIV/AIDS knowledge of the rural populace but also put rural populations at a disadvantage relative to their urban counterparts. Communication interventions informed by socioecological models might be helpful to redress and/or narrow the widening knowledge gap between urban and rural residents. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Herbaceous species composition and richness of mesophytic cove forests in the southern Appalachians: synthesis and knowledge gaps

Treesearch

Katherine J. Elliott; James M. Vose; Duke Rankin

2014-01-01

We synthesized the current information on mesophytic cove forests in the southern Appalachians, assessed the range of variation in herb species composition and diversity in stands with different disturbance histories and environmental conditions, identified key knowledge gaps, and suggested approaches to fill these knowledge gaps. The purpose of this synthesis was to...

A Multirater Instrument for the Assessment of Simulated Pediatric Crises

PubMed Central

Calhoun, Aaron W; Boone, Megan; Miller, Karen H; Taulbee, Rebecca L; Montgomery, Vicki L; Boland, Kimberly

2011-01-01

Background Few validated instruments exist to measure pediatric code team skills. The goal of this study was to develop an instrument for the assessment of resuscitation competency and self-appraisal using multirater and gap analysis methodologies. Methods Multirater assessment with gap analysis is a robust methodology that enables the measurement of self-appraisal as well as competency, offering faculty the ability to provide enhanced feedback. The Team Performance during Simulated Crises Instrument (TPDSCI) was grounded in the Accreditation Council for Graduate Medical Education competencies. The instrument contains 5 competencies, each assessed by a series of descriptive rubrics. It was piloted during a series of simulation-based interdisciplinary pediatric crisis resource management education sessions. Course faculty assessed participants, who also did self-assessments. Internal consistency and interrater reliability were analyzed using Cronbach α and intraclass correlation (ICC) statistics. Gap analysis results were examined descriptively. Results Cronbach α for the instrument was between 0.72 and 0.69. The overall ICC was 0.82. ICC values for the medical knowledge, clinical skills, communication skills, and systems-based practice were between 0.87 and 0.72. The ICC for the professionalism domain was 0.22. Further examination of the professionalism competency revealed a positive skew, 43 simulated sessions (98%) had significant gaps for at least one of the competencies, 38 sessions (86%) had gaps indicating self-overappraisal, and 15 sessions (34%) had gaps indicating self-underappraisal. Conclusions The TPDSCI possesses good measures of internal consistency and interrater reliability with respect to medical knowledge, clinical skills, communication skills, systems-based practice, and overall competence in the context of simulated interdisciplinary pediatric medical crises. Professionalism remains difficult to assess. These results provide an encouraging first step toward instrument validation. Gap analysis reveals disparities between faculty and self-assessments that indicate inadequate participant self-reflection. Identifying self-overappraisal can facilitate focused interventions. PMID:22379528

Early Experience in Implementation of a Learning Assessment Toolkit in the AOTrauma Geriatric Fracture Course

PubMed Central

O’Malley, Natasha T.; Cunningham, Michael; Leung, Frankie; Blauth, Michael; Kates, Stephen L.

2011-01-01

Background: Surgical education is continually expanding to encompass new techniques and technologies. It is vital that educational activity is directed at gaps in knowledge and ability to improve the quality of learning. Aim: The aim of this study is to describe a published learning assessment toolkit when applied to participants attending AOTrauma Orthogeriatric Fracture courses. Methods: Precourse, participants received a questionnaire covering 10 competencies to assess knowledge gaps and a 20-question clinical knowledge test. The knowledge gap between perceived and desired knowledge was correlated with clinical knowledge test results to help course faculty focus the course curriculum to meet identified educational needs. A commitment to change survey was also administered. Results: Over 3 courses, 48% of registered attendees responded to the precourse survey, 44.5% responded postcourse. The precourse gap scores were generally highest for 2 competencies (“address secondary prevention,” “build a system of care”) indicating a higher level of motivation to learn in these topics and lowest for a variety of competencies (eg. “restore function early,” “co-manage patient care in the US surgeons group”) indicating lower motivation to learn in these competencies. These precourse gap scores guided adaptations in the course structure. Postcourse gaps were reduced in the 4 cohorts. Large improvements were seen in “Address secondary prevention” and “Build a system of care” in many of the cohorts. Competencies with the lowest precourse knowledge test scores were noted in each cohort. Where low pretest scores were noted, it highlighted the need for faculty to put appropriate emphasis on these topics in the delivery of the course content. Conclusion: The technique of evaluating and identifying gaps in knowledge and ability allows course designers to focus on areas of deficits. Measurable success was shown with a subjectively decreased gap score and objectively improved clinical knowledge, as demonstrated by improved test results after course completion. PMID:23569686

A square peg in a round hole: Theory-practice gap from the lens of Filipino student nurses.

PubMed

Factor, Elisa Monette R; Matienzo, Evangeline T; de Guzman, Allan B

2017-10-01

Previous studies suggest that theory-practice gap has remained to be a formidable task and a challenge to the nursing profession. While efforts to understand the nature and dynamics of theory-practice gap have been undertaken across the globe, a dearth in literature exists in the context of a developing country like the Philippines. Seemingly, no research has ventured yet to explore the theory-practice gap experiences of Filipino student nurses. Hence, the major intent of this qualitative investigation is to describe and capture how theory-practice gap is viewed by a select group of senior nursing students (n=10) in a comprehensive university in the Philippines. From the thickness and richness of the descriptions of the field text gathered in this study, an interesting conceptualization labeled as the Theory-Practice Gap Deficit Triad which consists of (a) structural, (b) pedagogical, and (c) relational deficits was emerged. Interestingly, the said model describes a clear intersection of the various concerns and dilemmas encountered by student nurses in their clinical exposures. Findings of this paper are valuable inputs to nursing educators, practitioners, and administrators in initiating realignment efforts geared toward developing nurses whose knowledge, skills and attitudes are responsive to the ever changing professional practice landscape. Copyright © 2017 Elsevier Ltd. All rights reserved.

Knowledge Management Assessment Trends

DTIC Science & Technology

2011-01-01

Recommendations for strategies and approaches to close the gaps An action plan with practical and operational solutions, along with a pilot and evaluation...access to a continuity book or a formal program to orient them to the organization. The BCKS assessment team has helped organizations close these gaps ...managers, and employees in the organization. The Knowledge Assessment identifies: • Knowledge and performance gaps • The causes or factors

Computational toxicology: Its essential role in reducing drug attrition.

PubMed

Naven, R T; Louise-May, S

2015-12-01

Predictive toxicology plays a critical role in reducing the failure rate of new drugs in pharmaceutical research and development. Despite recent gains in our understanding of drug-induced toxicity, however, it is urgent that the utility and limitations of our current predictive tools be determined in order to identify gaps in our understanding of mechanistic and chemical toxicology. Using recently published computational regression analyses of in vitro and in vivo toxicology data, it will be demonstrated that significant gaps remain in early safety screening paradigms. More strategic analyses of these data sets will allow for a better understanding of their domain of applicability and help identify those compounds that cause significant in vivo toxicity but which are currently mis-predicted by in silico and in vitro models. These 'outliers' and falsely predicted compounds are metaphorical lighthouses that shine light on existing toxicological knowledge gaps, and it is essential that these compounds are investigated if attrition is to be reduced significantly in the future. As such, the modern computational toxicologist is more productively engaged in understanding these gaps and driving investigative toxicology towards addressing them. © The Author(s) 2015.

Common Infrastructure for Neo Scientific and Planetary Defense Missions

NASA Technical Reports Server (NTRS)

Adams, Robert; Wilks, Rodney

2009-01-01

While defending the Earth against collisions with asteroids and comets has garnered increasing attention over the past few decades, our knowledge of the threats and methods of mitigation remain inadequate. There exists a considerable gap in knowledge regarding the size, composition, location, internal structure and formation of near earth asteroids and comets. Although estimates have been made, critical experiments have not yet been conducted on the effectiveness of various proposed mitigation techniques. Closing this knowledge gap is of interest to both the planetary defense and planetary science communities. Increased scientific knowledge of asteroid and comet composition and structure can confirm or advance current theories about the formation of the solar system. This proposal suggests a joint effort between these two communities to provide an economical architecture that supports multiple launches of characterization and mitigation payloads with minimal response time. The science community can use this architecture for characterization missions of opportunity when multiple scientific targets or targets of uncommon scientific value present themselves, while the planetary defense community would be able to fire characterization or mitigation payloads at targets that present a threat to the Earth. Both communities would benefit from testing potential mitigation techniques, which would reveal information on the internal structure of asteroids and comets. In return, the Earth would have the beginnings of a viable response system should an impact threat prove real in the near future.

Evidence-based decision-making within the context of globalization: A “Why–What–How” for leaders and managers of health care organizations

PubMed Central

Lapaige, Véronique

2009-01-01

In the globalized knowledge economy, the challenge of translating knowledge into policy and practice is universal. At the dawn of the 21st century, the clinicians, leaders, and managers of health care organizations are increasingly required to bridge the research-practice gap. A shift from moving evidence to solving problems is due. However, despite a vast literature on the burgeoning field of knowledge translation research, the “evidence-based” issue remains for many health care professionals a day-to-day debate leading to unresolved questions. On one hand, many clinicians still resist to the implementation of evidence-based clinical practice, asking themselves why their current practice should be changed or expanded. On the other hand, many leaders and managers of health care organizations are searching how to keep pace with the demand of actionable knowledge. For example, they are wondering: (a) if managerial and policy innovations are subjected to the same evidentiary standards as clinical innovations, and (b) how they can adapt the scope of evidence-based medicine to the culture, context, and content of health policy and management. This paper focuses on evidence-based health care management within the context of contemporary globalization. In this paper, our heuristic hypothesis is that decision-making process related changes within clinical/managerial/policy environments must be given a socio-historical backdrop. We argue that the relationship between research on the transfer of knowledge and its uptake by clinical, managerial and policy target audiences has undergone a shift, resulting in increasing pressures in health care for intense researcher-practitioner collaboration and the development of “integrative KT platforms” at the crossroads of different fields (the field of knowledge management and the field of knowledge translation). The objectives of this paper are: (a) to provide an answer to the questions that health professionals ask most frequently about “Why” and “How” to bridge the know-do gap, (b) to illustrate by a Canadian example how the PRO-ACTIVE program helps in closing the evidence-based practice gap. PMID:22312206

Executive summary of NIH workshop on the Use and Biology of Energy Drinks: Current Knowledge and Critical Gaps.

PubMed

Sorkin, Barbara C; Camp, Kathryn M; Haggans, Carol J; Deuster, Patricia A; Haverkos, Lynne; Maruvada, Padma; Witt, Ellen; Coates, Paul M

2014-10-01

Sales of energy drinks in the United States reached $12.5 billion in 2012. Emergency department visits related to consumption of these products have increased sharply, and while these numbers remain small relative to product sales, they raise important questions regarding biological and behavioral effects. Although some common ingredients of energy drinks have been extensively studied (e.g., caffeine, B vitamins, sugars, inositol), data on other ingredients (e.g., taurine) are limited. Summarized here are data presented elsewhere in this issue on the prevalence and patterns of caffeine-containing energy drink use, the effects of these products on alertness, fatigue, cognitive functions, sleep, mood, homeostasis, as well as on exercise physiology and metabolism, and the biological mechanisms mediating the observed effects. There are substantial data on the effects of some energy drink ingredients, such as caffeine and sugars, on many of these outcomes; however, even for these ingredients many controversies and gaps remain, and data on other ingredients in caffeine-containing energy drinks, and on ingredient interactions, are sparse. This summary concludes with a discussion of critical gaps in the data and potential next steps. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Acquisition of Simple and Complex Knowledge; A Knowledge Gap Perspective

ERIC Educational Resources Information Center

Le Heron, Judy; Sligo, Frank

2005-01-01

This paper assesses university students' acquisition of simple and complex knowledge, in exploring whether the knowledge gap hypothesis (KGH) with its origins in community-based research into people's informal learning from mass media, provides insights into students' acquisition and retention of information. The KGH posits that attempts to…

Extreme Glacial Legacies: A Synthesis of the Antarctic Springtail Phylogeographic Record

PubMed Central

McGaughran, Angela; Stevens, Mark I.; Hogg, Ian D.; Carapelli, Antonio

2011-01-01

We review current phylogeographic knowledge from across the Antarctic terrestrial landscape with a focus on springtail taxa. We describe consistent patterns of high genetic diversity and structure among populations which have persisted in glacial refugia across Antarctica over both short (<2 Mya) and long (>10 Mya) timescales. Despite a general concordance of results among species, we explain why location is important in determining population genetic patterns within bioregions. We complete our review by drawing attention to the main limitations in the field of Antarctic phylogeography, namely that the scope of geographic focus is often lacking within studies, and that large gaps remain in our phylogeographic knowledge for most terrestrial groups. PMID:26467614

Using the knowledge-to-action framework to guide the timing of dialysis initiation.

PubMed

Sood, Manish M; Manns, Braden; Nesrallah, Gihad

2014-05-01

The optimal time at which to initiate chronic dialysis remains unknown. Using a contemporary knowledge translation approach (the knowledge-to-action framework), a pan-Canadian collaboration (CANN-NET) set out to study the scope of the problem, then develop and disseminate evidence-based guidelines addressing the timing of dialysis initiation. The purpose of this review is to summarize the key findings and describe the planned Canadian knowledge translation strategy for improving knowledge and practices pertaining to the timing dialysis initiation. New research has provided considerable insights regarding the initiation of dialysis. A Canadian cohort study identified significant variation in the estimated glomerular filtration rate level at dialysis initiation, and a survey of providers identified related knowledge gaps that might be amenable to knowledge translation interventions. A recent knowledge synthesis/guideline concluded that early dialysis initiation is costly, and provides no measureable clinical benefits. A systematic knowledge translation intervention including a multifaceted approach may aid in reducing variation in practice and improving the quality of care. Utilizing the knowledge-to-action framework, we identified practice variation and key barriers to the optimal timing for dialysis initiation that may be amenable to knowledge translation strategies.

Closing the gap in travel medicine: reframing research questions for a new era.

PubMed

Chen, Lin H; Leder, Karin; Wilson, Mary E

2017-07-01

Travel medicine needs are changing. New patterns of travel, including greater travel by individuals from emerging economies with different values in costs, risks and benefits, must be considered. This review aims to (1) highlight selected studies that have been published that address previously identified gaps in knowledge; (2) propose possible ways to consider questions regarding travel medicine practice for travelers from emerging economies, underscoring priorities for research focusing on these important populations; (3) highlight potential deficiencies in relevance of current international guidelines as they pertain to travelers from emerging economies; (4) frame research questions for travelers from emerging economies and (5) consider roles for ISTM in closing the gap. We reviewed past travel medicine research priorities published in 2010 to identify publications that responded to some research questions posed. We also reviewed CDC and WHO recommendations and assessed their applicability to travelers from emerging economies. Recent publications have responded to some research questions, but gaps remain and new questions have emerged. Re-framing of several key research questions is needed for travelers from emerging economies. A new challenge looms for traditional travel medicine fields to identify and attend to knowledge and guideline gaps, particularly to rethink questions regarding travel medicine to make them relevant for travelers from emerging economies. The International Society of Travel Medicine is well positioned to assist emerging economies assess their resources and needs, formulate research priorities and tailor the development of travel medicine into a framework aligned to their requirements. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Selection of an Alternative Production Part Approval Process to Improve Weapon Systems Production Readiness

DTIC Science & Technology

2017-09-01

production outcomes: 1) knowledge gaps in technology, 2) design instability and 3) manufacturing knowledge gaps. Only manufacturing knowledge gaps...ability to produce at a desired production rate. Each item produced under this manufacturing development is to meet that item’s design requirements. The...represented with respect to assessing manufacturing design and development with a verification and demonstration. DOD acquisition waits to assess production

Predicting the Future Contribution of Himalayan Debris-covered Glaciers to River Discharge: Advances and Challenges

NASA Astrophysics Data System (ADS)

Quincey, D. J.; Hubbard, B. P.; Klaar, M. J.; Miles, E.; Miles, K.; Rowan, A. V.; King, O.; Watson, C. S.

2017-12-01

The glaciers and snowfields of the Himalaya are the ultimate source for the many rivers that flow across the Asian subcontinent, but they are diminishing rapidly in the face of sustained climatic change. Predictions of how future river discharge may vary through space and time are hampered by two major knowledge gaps. First, simulations of glacier mass loss in high Asia are severely limited by data availability and assumptions made in the parameterisation of glacier models. Consequently, projections of glacier change vary widely; in Nepal for example, recent estimates of volumetric ice loss by AD2100 have ranged between 8% and 99%. A second major gap in knowledge lies in the coupling between glaciers and downstream areas, and specifically in quantifying the relative contributions of different sources to river flow. Although it is clear that ice and snow melt dominates flow for considerable distances downstream, how this contribution interacts with groundwater supplies with increasing distance from its source remains poorly understood. This presentation will review recent work that closes some of the knowledge gaps in understanding debris-covered glacier behaviour including new results from drilling work on the Khumbu Glacier in Nepal. Additionally, it will report on the outputs from an interdisciplinary study in the Annapurna region of Nepal, which is focussing specifically on disaggregating the relative contributions to flow using isotope-based hydrograph separations. It will finish by exploring the most likely drivers of future changes to water supply, including an evaluation of the impact of glacial lake development, and by identifying the main challenges for future related research.

The humanistic and economic burden of Dravet syndrome on caregivers and families: Implications for future research.

PubMed

Jensen, Mark P; Brunklaus, Andreas; Dorris, Liam; Zuberi, Sameer M; Knupp, Kelly G; Galer, Bradley S; Gammaitoni, Arnold R

2017-05-01

We reviewed the current literature with respect to the humanistic and financial burdens of Dravet Syndrome (DS) on the caregivers of children with DS, in order to (1) identify key unanswered questions or gaps in knowledge that need to be addressed and then, based on these knowledge gaps, (2) propose a research agenda for the scientific community to address in the coming decade. The findings support the conclusion that caring for a child with DS is associated with significant humanistic burden and direct costs. However, due in part to the paucity of studies, as well as the lack of measures of specific burden domains, there remains much that is not known regarding the burden of caregiving for children with DS. To address the significant knowledge gaps in this area, research is needed that will: (1) identify the specific domains of caregivers' lives that are impacted by caring for a child with DS; (2) identify or, if needed, develop measures of caregiving impact in this area; (3) identify the factors that influence DS caregiving burden; (4) develop and evaluate the efficacy of treatments for reducing the negative impact of DS and its comorbidities on DS caregivers; (5) quantify the direct medical costs associated with DS and DS comorbidities and identify the factors that influence these costs; and (6) quantify and fully explore the indirect costs of DS. Research that addresses these goals will provide the empirical foundation needed for improving the quality of life of children with DS and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

Strategies for rehabilitation professionals to move evidence-based knowledge into practice: a systematic review.

PubMed

Menon, Anita; Korner-Bitensky, Nicol; Kastner, Monika; McKibbon, K Ann; Straus, Sharon

2009-11-01

Rehabilitation clinicians need to stay current regarding best practices, especially since adherence to clinical guidelines can significantly improve patient outcomes. However, little is known about the benefits of knowledge translation interventions for these professionals. To examine the effectiveness of single or multi-component knowledge translation interventions for improving knowledge, attitudes, and practice behaviors of rehabilitation clinicians. Systematic review of 7 databases conducted to identify studies evaluating knowledge translation interventions specific to occupational therapists and physical therapists. 12 studies met the eligibility criteria. For physical therapists, participation in an active multi-component knowledge translation intervention resulted in improved evidence-based knowledge and practice behaviors compared with passive dissemination strategies. These gains did not translate into change in clinicians' attitudes towards best practices. For occupational therapists, no studies have examined the use of multi-component interventions; studies of single interventions suggest limited evidence of effectiveness for all outcomes measured. While this review suggests the use of active, multi-component knowledge translation interventions to enhance knowledge and practice behaviors of physical therapists, additional research is needed to understand the impact of these strategies on occupational therapists. Serious research gaps remain regarding which knowledge translation strategies impact positively on patient outcomes.

Advancing biology through a deeper understanding of zebrafish ecology and evolution.

PubMed

Parichy, David M

2015-03-25

Over the last two decades, the zebrafish has joined the ranks of premier model organisms for biomedical research, with a full suite of tools and genomic resources. Yet we still know comparatively little about its natural history. Here I review what is known about the natural history of the zebrafish, where significant gaps in our knowledge remain, and how a fuller appreciation of this organism's ecology and behavior, population genetics, and phylogeny can inform a variety of research endeavors.

The Toxic Truth About Carbon Nanotubes in Water Purification: a Perspective View.

PubMed

Das, Rasel; Leo, Bey Fen; Murphy, Finbarr

2018-06-18

Without nanosafety guidelines, the long-term sustainability of carbon nanotubes (CNTs) for water purifications is questionable. Current risk measurements of CNTs are overshadowed by uncertainties. New risks associated with CNTs are evolving through different waste water purification routes, and there are knowledge gaps in the risk assessment of CNTs based on their physical properties. Although scientific efforts to design risk estimates are evolving, there remains a paucity of knowledge on the unknown health risks of CNTs. The absence of universal CNT safety guidelines is a specific hindrance. In this paper, we close these gaps and suggested several new risk analysis roots and framework extrapolations from CNT-based water purification technologies. We propose a CNT safety clock that will help assess risk appraisal and management. We suggest that this could form the basis of an acceptable CNT safety guideline. We pay particular emphasis on measuring risks based on CNT physico-chemical properties such as diameter, length, aspect ratio, type, charge, hydrophobicity, functionalities and so on which determine CNT behaviour in waste water treatment plants and subsequent release into the environment.

Impact of environmental exposures on ovarian function and role of xenobiotic metabolism during ovotoxicity

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

Bhattacharya, Poulomi; Keating, Aileen F., E-mail: akeating@iastate.edu

2012-06-15

The mammalian ovary is a heterogeneous organ and contains oocyte-containing follicles at varying stages of development. The most immature follicular stage, the primordial follicle, comprises the ovarian reserve and is a finite number, defined at the time of birth. Depletion of all follicles within the ovary leads to reproductive senescence, known as menopause. A number of chemical classes can destroy follicles, thus hastening entry into the menopausal state. The ovarian response to chemical exposure can determine the extent of ovotoxicity that occurs. Enzymes capable of bioactivating as well as detoxifying xenobiotics are expressed in the ovary and their impact onmore » ovotoxicity has been partially characterized for trichloroethylene, 7,12-dimethylbenz[a]anthracene, and 4-vinylcyclohexene. This review will discuss those studies, as well as illustrate where knowledge gaps remain for chemicals that have also been established as ovotoxicants. -- Highlights: ► Summary of ovotoxicant action during ovotoxicity. ► Discussion of impact of biotransformation on chemical toxicity. ► Identification of knowledge gaps in chemical metabolism.« less

Designing exercise clinical trials for older adults with cancer: Recommendations from 2015 Cancer and Aging Research Group NCI U13 Meeting

PubMed Central

Kilari, Deepak; Soto-Perez-de-Celis, Enrique; Mohile, Supriya Gupta; Alibhai, Shabbir M.H.; Presley, Carolyn J.; Wildes, Tanya M.; Klepin, Heidi D.; Demark-Wahnefried, Wendy; Jatoi, Amina; Harrison, Robert; Won, Elizabeth; Mustian, Karen M.

2016-01-01

Cancer and its treatment can lead to a myriad of adverse events and negatively impact quality of life of older cancer patients and survivors. Unmet physical activity needs vary across the cancer continuum and remain an important yet understudied area of research in this population. Exercise interventions have been shown to be effective in treating both the physical and psychological declines associated with cancer and its treatment, with a potential to improve cancer-related outcomes. Despite the current evidence, exercise is clearly underutilized due to several barriers and knowledge gaps in existing trials that include appropriate population identification, design, and outcome measures selection. The benefits of regular exercise in both the primary and secondary prevention of chronic conditions are well established in the non-cancer population. In older cancer patients and survivors, further research is needed before exercise gains widespread acceptance. The Cancer and Aging Research Group convened experts in exercise, aging and cancer to evaluate current scientific evidence and knowledge gaps in geriatric exercise oncology. This report summarizes these findings and provides future research directions. PMID:27197916

Environmental contaminants of health-care origin: Exposure and potential effects in wildlife

USGS Publications Warehouse

Bean, Thomas; Rattner, Barnett A.

2018-01-01

A diverse range of fauna could be exposed to active pharmaceutical ingredients (APIs) via diet, dermal absorption or bioconcentration. Low level exposures of free-ranging wildlife to APIs has only been demonstrated for a few pathways (e.g., ingestion of fish in estuaries by piscivorous birds), and many remain hypothetical (e.g., ingestion of invertebrates in sludge amended fields by terrestrial vertebrates). Our understanding of API dose-response relationships in wildlife have only been assessed for endocrine disrupting compounds and a few veterinary therapeutics. Drug specific responses at various levels of biological organization are poorly characterized for nearly all wildlife species, and thus our understanding of risk is limited. There is interest in using a read-across approach to fill knowledge gaps for risk. This approach, using data collected in laboratory mammals and humans, would enable predictions for likelihood of adverse effects in wildlife. Given the great diversities in physiologies among species, a combination of in vivo, in vitro and in silico approaches will be required to fill the knowledge gaps for exposure, hazard and risk.

Effect of Performance Feedback on Perceived Knowledge and Likelihood to Pursue Continuing Education

ERIC Educational Resources Information Center

Eberman, Lindsey E.; Tripp, Brady L.

2011-01-01

Context: For practicing health care professionals, waiting for a teachable moment to identify a gap in knowledge could prove critical. Other methods are needed to help health care professionals identify their knowledge gaps. Objective: To assess the effect of performance feedback on Athletic Trainers' (AT) perceived knowledge (PK) and likelihood…

Beyond the Academic Journal: Unfreezing Misconceptions About Mental Illness and Gun Violence Through Knowledge Translation to Decision-Makers.

PubMed

Horwitz, Joshua; Grilley, Anna; Kennedy, Orla

2015-06-01

In a policy arena characterized by polarized debate, such as the consideration of legal interventions to prevent gun violence, research evidence is an important tool to inform decision-making processes. However, unless the evidence is communicated to stakeholders who can influence policy decisions, the research will often remain an academic exercise with little practical impact. The Educational Fund to Stop Violence's process of "unfreezing" individual perceptions and conventional interpretations of the relationship between mental illness and gun violence, forming a consensus, and translating this knowledge to stakeholders through state discussion forums is one way to inform policy change. The recent passage of gun violence prevention legislation in California provides an example of successfully closing the knowledge translation gap between research and decision-making processes. Copyright © 2015 John Wiley & Sons, Ltd.

Commentary: Reconsidering the Role of Context in Diabetes Prevention

PubMed Central

Mezuk, Briana; Concha, Jeannie B.; Perrin, Paul; Green, Tiffany

2017-01-01

A substantial gap remains between what we know about type 2 diabetes prevention and our ability to apply that knowledge in socially disadvantaged populations at highest risk. This gap results, in part, from a lack of integration between epidemiologic science and social psychology theory, particularly regarding the intersections of stress, self-regulatory health behaviors, and the biological mechanisms underlying the development of diabetes. In this commentary, we describe the utility of a theoretical framework that focuses on the intersection of biological, psychosocial, and environmental contexts as they apply to diabetes disparities, and how such a framework could inform a translational research agenda to reorient prevention efforts to address these inequalities. Such reorientation is needed to ensure that the implementation of prevention efforts does not inadvertently widen diabetes disparities. PMID:28115823

Biochemistry of Mitochondrial Coenzyme Q Biosynthesis.

PubMed

Stefely, Jonathan A; Pagliarini, David J

2017-10-01

Coenzyme Q (CoQ, ubiquinone) is a redox-active lipid produced across all domains of life that functions in electron transport and oxidative phosphorylation and whose deficiency causes human diseases. Yet, CoQ biosynthesis has not been fully defined in any organism. Several proteins with unclear molecular functions facilitate CoQ biosynthesis through unknown means, and multiple steps in the pathway are catalyzed by currently unidentified enzymes. Here we highlight recent progress toward filling these knowledge gaps through both traditional biochemistry and cutting-edge 'omics' approaches. To help fill the remaining gaps, we present questions framed by the recently discovered CoQ biosynthetic complex and by putative biophysical barriers. Mapping CoQ biosynthesis, metabolism, and transport pathways has great potential to enhance treatment of numerous human diseases. Copyright © 2017 Elsevier Ltd. All rights reserved.

Metagenomics uncovers gaps in amplicon-based detection of microbial diversity

DOE PAGES

Eloe-Fadrosh, Emiley A.; Ivanova, Natalia N.; Woyke, Tanja; ...

2016-02-01

Our view of microbial diversity has expanded greatly over the past 40 years, primarily through the wide application of PCR-based surveys of the small-subunit ribosomal RNA (SSU rRNA) gene. Yet significant gaps in knowledge remain due to well-recognized limitations of this method. Here in this paper, we systematically survey primer fidelity in SSU rRNA gene sequences recovered from over 6,000 assembled metagenomes sampled globally. Our findings show that approximately 10% of environmental microbial sequences might be missed from classical PCR-based SSU rRNA gene surveys, mostly members of the Candidate Phyla Radiation (CPR) and as yet uncharacterized Archaea. In conclusion, thesemore » results underscore the extent of uncharacterized microbial diversity and provide fruitful avenues for describing additional phylogenetic lineages.« less

Research priorities on ending child marriage and supporting married girls.

PubMed

Svanemyr, Joar; Chandra-Mouli, Venkatraman; Raj, Anita; Travers, Ellen; Sundaram, Lakshmi

2015-09-03

Over the past few years the issue of child marriage has received growing political and programmatic attention. In spite of some progress in a number of countries, global rates have not declined over the past decade. Knowledge gaps remain in understanding trends, drivers and approaches to ending child marriage, especially to understand what is needed to achieve results on a large scale. This commentary summarizes the outcomes of an Expert Group Meeting organized by World Health Organization to discuss research priorities on Ending Child Marriage and Supporting Married Girls. It presents research gaps and recommends priorities for research in five key areas; (i) prevalence and trends of child marriage; (ii) causes of child marriage (iii) consequences of child marriage; (iv) efforts to prevent child marriage; (v) efforts to support married girls.

State of the Art in HIV Drug Resistance: Science and Technology Knowledge Gap.

PubMed

Boucher, Charles A; Bobkova, Marina R; Geretti, Anna Maria; Hung, Chien-Ching; Kaiser, Rolf; Marcelin, Anne-Geneviève; Streinu-Cercel, Adrian; van Wyk, Jean; Dorr, Pat; Vandamme, Anne-Mieke

2018-01-01

Resistance to antiretroviral therapy (ART) threatens the efficacy of human immunodeficiency virus type 1 (HIV-1) treatment. We present a review of knowledge gaps in the science and technologies of acquired HIV-1 drug resistance (HIVDR) in an effort to facilitate research, scientific exchange, and progress in clinical management. The expert authorship of this review convened to identify data gaps that exist in the field of HIVDR and discuss their clinical implications. A subsequent literature review of trials and current practices was carried out to provide supporting evidence. Several gaps were identified across HIVDR science and technology. A summary of the major gaps is presented, with an expert discussion of their implications within the context of the wider field. Crucial to optimizing the use of ART will be improved understanding of protease inhibitors and, in particular, integrase strand transfer inhibitors (INSTI) in the context of HIVDR. Limited experience with INSTI represents an important knowledge gap in HIV resistance science. Utilizing such knowledge in a clinical setting relies on accurate testing and analysis of resistance-associated mutations. As next-generation sequencing becomes more widely available, a gap in the interpretation of data is the lack of a defined, clinically relevant threshold of minority variants. Further research will provide evidence on where such thresholds lie and how they can be most effectively applied. Expert discussion identified a series of gaps in our knowledge of HIVDR. Addressing prefsuch gaps through further research and characterization will facilitate the optimal use of ART therapies and technologies.

Ovarian Cancer: Deaf and Hearing Women’s Knowledge Before and After an Educational Video

PubMed Central

Jensen, Lindsay G.; Nakaji, Melanie; Harry, Kadie M.; Gallegos, Nick; Malcarne, Vanessa L.; Sadler, Georgia Robins

2013-01-01

Members of the Deaf community report language and cultural barriers to accessing health information and care. This study evaluated whether an ovarian cancer education video in American Sign Language with English captioning and voiceover could close the anticipated knowledge gap between Deaf and hearing women’s cancer knowledge. Consented Deaf (n = 55) and hearing (n = 52) women’s General, Ovarian, and Total Cancer Knowledge were assessed before and after viewing the video. At baseline, hearing women demonstrated significantly higher General, Ovarian, and Total Cancer Knowledge scores than Deaf women. By the post-test, all of Deaf women’s knowledge scores had increased, closing the baseline gap. However, hearing women’s post-video knowledge had also increased, thereby creating a new knowledge gap. The ovarian cancer education video offers an effective method to increase ovarian and general cancer knowledge for Deaf and hearing women. PMID:23975658

A measure of knowledge flow between specific fields: Implications of interdisciplinarity for impact and funding

PubMed Central

Solomon, Gregg E. A.; Youtie, Jan; Porter, Alan L.

2017-01-01

Encouraging knowledge flow between mutually relevant disciplines is a worthy aim of research policy makers. Yet, it is less clear what types of research promote cross-disciplinary knowledge flow and whether such research generates particularly influential knowledge. Empirical questions remain as to how to identify knowledge-flow mediating research and how to provide support for this research. This study contributes to addressing these gaps by proposing a new way to identify knowledge-flow mediating research at the individual research article level, instead of at more aggregated levels. We identify journal articles that link two mutually relevant disciplines in three ways—aggregating, bridging, and diffusing. We then examine the likelihood that these papers receive subsequent citations or have funding acknowledgments. Our case study of cognitive science and educational research knowledge flow suggests that articles that aggregate knowledge from multiple disciplines are cited significantly more often than are those whose references are drawn primarily from a single discipline. Interestingly, the articles that meet the criteria for being considered knowledge-flow mediators are less likely to reflect funding, based on reported acknowledgements, than were those that did not meet these criteria. Based on these findings, we draw implications for research policymakers. PMID:29016631

Knowledge mapping as a technique to support knowledge translation.

PubMed Central

Ebener, S.; Khan, A.; Shademani, R.; Compernolle, L.; Beltran, M.; Lansang, Ma; Lippman, M.

2006-01-01

This paper explores the possibility of integrating knowledge mapping into a conceptual framework that could serve as a tool for understanding the many complex processes, resources and people involved in a health system, and for identifying potential gaps within knowledge translation processes in order to address them. After defining knowledge mapping, this paper presents various examples of the application of this process in health, before looking at the steps that need to be taken to identify potential gaps, to determine to what extent these gaps affect the knowledge translation process and to establish their cause. This is followed by proposals for interventions aimed at strengthening the overall process. Finally, potential limitations on the application of this framework at the country level are addressed. PMID:16917651

Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare.

PubMed

Park, Jason A; Safer, Joshua D

2018-01-01

Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported "high" comfort increased from 45% (9/20) to 80% (16/20) ( p =0.04), and students who reported "high" knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) ( p <0.001 ) . Conclusion: Although integrating evidence-based, transgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals.

Clinical Exposure to Transgender Medicine Improves Students' Preparedness Above Levels Seen with Didactic Teaching Alone: A Key Addition to the Boston University Model for Teaching Transgender Healthcare

PubMed Central

Park, Jason A.; Safer, Joshua D.

2018-01-01

Abstract Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients. We aimed to demonstrate that clinical exposure to care for transgender patients would help close this gap. Methods: At Boston University School of Medicine, we piloted a transgender medicine elective where students rotate on services that provide clinical care for transgender individuals. Pre- and postsurveys were administered to students who participated in the elective. Results: After completing the elective, students who reported “high” comfort increased from 45% (9/20) to 80% (16/20) (p=0.04), and students who reported “high” knowledge regarding management of transgender patients increased from 0% (0/20) to 85% (17/20) (p<0.001). Conclusion: Although integrating evidence-based, transgender-specific content into medical curricula improves student knowledge and comfort with transgender medical care, gaps remain. Clinical exposure to transgender medicine during clinical years can contribute to closing that gap and improving access to care for transgender individuals. PMID:29344576

Current status of pharmacokinetic and safety studies of multidrug-resistant tuberculosis treatment in children.

PubMed

Garcia-Prats, A J; Svensson, E M; Weld, E D; Schaaf, H S; Hesseling, A C

2018-05-01

After decades of neglect, data are finally becoming available on the appropriate, safe dosing of key second-line anti-tuberculosis drugs used for treating multidrug-resistant tuberculosis (MDR-TB) in children, including levofloxacin (LVX), moxifloxacin (MFX), linezolid (LZD) and delamanid (DLM). Much needed data on some novel and repurposed drugs are still lacking, including for bedaquiline (BDQ), pretomanid (PTM) and clofazimine (CFZ). We review the status of pharmacokinetic (PK) and safety studies of key anti-tuberculosis medications in children with MDR-TB, identify priority knowledge gaps and note ongoing work to address those gaps, in the context of planning for an efficacy trial in children with MDR-TB. There is international consensus that an efficacy trial of a novel, all-oral, shortened MDR-TB treatment trial in children is both needed and feasible. Key novel and repurposed second-line anti-tuberculosis drugs include BDQ, DLM, PTM, MFX, LVX, CFZ and LZD. The rapidly emerging PK and safety data on these medications in children with MDR-TB from studies that are underway, completed or planned, will be critical in supporting such an efficacy trial. Commitment to addressing the remaining knowledge gaps, developing child-friendly formulations of key medications, improving the design of paediatric PK and safety studies, and development of international trial capacity in children with MDR-TB are important priorities.

Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice.

PubMed

Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran

2017-09-01

To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. 
. Descriptive, cross-sectional study.
. Rambam Health Care Campus in northern Israel.
. A convenience sample of 434 hospital nurses with varied oncology experience.
. Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. 
. Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. 
. Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.

Two approaches to bridging the knowledge-practice gap in oncology nursing.

PubMed

Peek, Gloanna J

2015-01-01

The field of oncology nursing is continually changing. New drugs to aid in the fight against cancer are being developed, complementary therapies to ease symptoms are gaining prominence, and survivorship care is becoming a welcome yet challenging area of subspecialty. For oncology nurses to provide quality care and to develop improved care delivery systems, they must not only have access to the most current knowledge in the field, but also be equipped with the skills necessary to integrate that knowledge into practice for the benefit of patients and families (LoBiondo-Wood et al., 2014). The importance of nursing research and its relationship to the practice of oncology nursing cannot be minimized (Moore & Badger, 2014). Oncology nurse researchers advance knowledge and, consequently, improve the quality of care for patients with cancer and their families. For example, the Oncology Nursing Society (ONS) regularly surveys its membership to identify key areas of research focus that then guide the work of nurse investigators (LoBiondo-Wood et al., 2014; ONS Research Agenda Team, 2009). Unfortunately, the shortage of nurse scientists, particularly in oncology nursing, continues to increase as senior doctoral faculty reach retirement age and doctoral education program development remains stagnant (Glasgow & Dreher, 2010; LoBiondo-Wood et al., 2014). This shortage has and will continue to lead to gaps in the generation and implementation of new knowledge, negatively affecting the quality of patient care. As a result, an urgent need exists for innovative and quality doctoral educational programs to develop nurse scientists (Moore & Badger, 2014).

"Prince Charming Syndrome?" Gender gap in preferences for defined contribution pensions in Japan.

PubMed

Watanabe, Satoshi P

2017-01-01

Using survey data collected by the Japan Institute of Life Insurance in 2002, this study finds that a significant gender gap existed in defined contribution (DC) pension knowledge among workers employed at small- to medium-sized private firms in Japan. Even with similar DC knowledge, however, men and women reveal different preferences for DC pensions, indicating that their perceptional responses may widely differ from actual behaviors. Apart from the knowledge gap, the result shows evidence of the Prince Charming Syndrome among female employees as a significant source of the gender gap in DC participation rates. Among corporate pension-covered employees, the gender difference in the efficacy of DC portability is a more significant gap-generating factor. DC tax advantage is particularly favored by pension-covered female employees over male counterparts, reducing the DC preference gap. No similar evidence is found for employees with no corporate pension coverage.

Cybernetics: A Possible Solution for the "Knowledge Gap" between "External" and "Internal" in Evaluation Processes

ERIC Educational Resources Information Center

Levin-Rozalis, Miri

2010-01-01

This paper addresses the issue of the knowledge gap between evaluators and the entity being evaluated: the dilemma of the knowledge of professional evaluators vs. the in-depth knowledge of the evaluated subjects. In order to optimize evaluative outcomes, the author suggests an approach based on ideas borrowed from the science of cybernetics as a…

Test systems in drug discovery for hazard identification and risk assessment of human drug-induced liver injury.

PubMed

Weaver, Richard J; Betts, Catherine; Blomme, Eric A G; Gerets, Helga H J; Gjervig Jensen, Klaus; Hewitt, Philip G; Juhila, Satu; Labbe, Gilles; Liguori, Michael J; Mesens, Natalie; Ogese, Monday O; Persson, Mikael; Snoeys, Jan; Stevens, James L; Walker, Tracy; Park, B Kevin

2017-07-01

The liver is an important target for drug-induced toxicities. Early detection of hepatotoxic drugs requires use of well-characterized test systems, yet current knowledge, gaps and limitations of tests employed remains an important issue for drug development. Areas Covered: The current state of the science, understanding and application of test systems in use for the detection of drug-induced cytotoxicity, mitochondrial toxicity, cholestasis and inflammation is summarized. The test systems highlighted herein cover mostly in vitro and some in vivo models and endpoint measurements used in the assessment of small molecule toxic liabilities. Opportunities for research efforts in areas necessitating the development of specific tests and improved mechanistic understanding are highlighted. Expert Opinion: Use of in vitro test systems for safety optimization will remain a core activity in drug discovery. Substantial inroads have been made with a number of assays established for human Drug-induced Liver Injury. There nevertheless remain significant gaps with a need for improved in vitro tools and novel tests to address specific mechanisms of human Drug-Induced Liver Injury. Progress in these areas will necessitate not only models fit for application, but also mechanistic understanding of how chemical insult on the liver occurs in order to identify translational and quantifiable readouts for decision-making.

Clathrin-independent internalization and recycling

PubMed Central

Gong, Qiang; Huntsman, Christopher; Ma, Dzwokai

2008-01-01

Abstract The functionality of receptor and channel proteins depends directly upon their expression level on the plasma membrane. Therefore, the ability to selectively adjust the surface level of a particular receptor or channel protein is pivotal to many cellular signalling events. The internalization and recycling pathway plays a major role in the regulation of protein surface level, and thus has been a focus of research for many years. Although several endocytic pathways have been identified, most of our knowledge has come from the clathrin-dependent pathway, while the other pathways remain much less well defined. Considering that clathrin-independent internalization may account for as much as 50% of the total endocytic activity in the cell, the lack of such knowledge constitutes a major gap in our efforts to understand how different internalization pathways are utilized and co-ordinated. Recent studies have provided valuable insights into this area, yet many more questions still remain. In this review, we will give a panoramic introduction to the current knowledge of various internalization and recycling pathways, with an emphasis on the latest findings that have broadened our view of the clathrin-independent pathways. We will also dedicate one section to the emerging studies of the clathrin-independent internalization pathways in neuronal cells. PMID:18039352

A Twenty-Five-Year Review of Knowledge Gap Research.

ERIC Educational Resources Information Center

Gaziano, Cecilie

Evidence from 34 studies published since a 1983 review of 58 earlier studies underscores knowledge inequalities as an enduring phenomenon and emphasizes that interest in the knowledge gap phenomenon is accelerating. All 10 studies which varied "media publicity" supported the hypothesis. Eleven of 12 studies which varied some aspect of…

Uncertainty and Clinical Psychology: Therapists' Responses.

ERIC Educational Resources Information Center

Bienenfeld, Sheila

Three sources of professional uncertainty have been described: uncertainty about the practitioner's mastery of knowledge; uncertainty due to gaps in the knowledge base itself; and uncertainty about the source of the uncertainty, i.e., the practitioner does not know whether his uncertainty is due to gaps in the knowledge base or to personal…

The Integrated Skin Exam film: an educational intervention to promote early detection of melanoma by medical students.

PubMed

Garg, Amit; Wang, Joyce; Reddy, Shalini B; Powers, Jennifer; Jacob, Reza; Powers, Michael; Biello, Katie; Cayce, Rachael; Savory, Stephanie; Belazarian, Leah; Domingues, Erik; Korzenko, Adam; Wilson, Lindsay; Grant-Kels, Jane M; George, Paul; Robinson-Bostom, Leslie; Trotter, Shannon C; Geller, Alan C

2014-01-01

Knowledge of the skin cancer examination (SCE) and its practice remain relevant competency gaps among medical students. We elaborate on a method of SCE known as the Integrated Skin Exam and discuss the development of an instructional film that illustrates its principles. We assess the tool's effect on knowledge, attitudes, and perceptions related to the SCE. Second-year students among 8 randomized schools viewed the film and completed pre-post questionnaires. After viewing The Integrated Skin Exam film, students demonstrated improved melanoma knowledge, including identification of high-risk demographic groups (61% vs 42.9%, P < .001), high-risk anatomic sites in women (88.6% vs 46.5%, P < .001) and men (92.1% vs 34.8%, P < .001), and the ABCDEs of melanoma (98.4% vs 91.2%, P < .001). Students demonstrated increased confidence in the SCE (66.93% vs 16.40%, P < .001) and augmented intentions to practice it (99.05% vs 13.9%, P < .001). A greater proportion (70.4% vs 41.9%, P < .001) of students thought less than 3 minutes were required to integrate SCE into the routine examination. Longitudinal impact of the film was not assessed. The Integrated Skin Exam film introduces an integrated approach to the SCE that addresses knowledge gaps, mitigates perceived barriers, and augments intention related to practice of the SCE. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Closing the Gap: Addressing the Vocabulary Needs of English-Language Learners in Bilingual and Mainstream Classrooms

ERIC Educational Resources Information Center

Carlo, Mara S.; August, Diane; McLaughlin, Barry; Snow, Catherine E.; Dressler, Cheryl; Lippman, David N.; Lively, Teresa J.; White, Claire E.

2004-01-01

Gaps in reading performance between Anglo and Latino children are associated with gaps in vocabulary knowledge. An intervention was designed to enhance fifth graders' academic vocabulary. The meanings of academically useful words were taught together with strategies for using information from context, from morphology, from knowledge about multiple…

Level and determinants of diabetes knowledge in patients with diabetes in Zimbabwe: a cross-sectional study

PubMed Central

Mufunda, Esther; Wikby, Kerstin; Björn, Albin; Hjelm, Katarina

2012-01-01

Introduction A previous study of beliefs about health and illness in Zimbabweans with diabetes mellitus indicated limited knowledge about diabetes and the body, affecting self-care and health-care seeking behaviour. The aim of this study was to assess the level of diabetes knowledge in Zimbabwean adults with diabetes mellitus, to determine the main gaps in knowledge and identify the socio-demographic and diabetes-related determinants that predict diabetes awareness and self-care practices. Methods A cross-sectional descriptive study was performed using a standardized self-report Diabetes Knowledge Test questionnaire (DKT) of 58 respondents, 32 women and 26 men. Results were analysed with descriptive and analytic statistical methods. Results The majority of the respondents scored average knowledge on all three sub-scales: general knowledge, insulin use and total knowledge, with an overall score of 63.1± 14, 2%. Major knowledge gaps were in areas related to diet, insulin use and glycaemic control. No significant differences in mean scores were detected in the diabetes knowledge sub-scales when comparisons were made of mean knowledge scores in relation to socio-demographic and diabetes-related characteristics. However, diabetes-related complications were significantly associated with lower total and general diabetes knowledge, and female gender was an independent determinant of low general knowledge. Conclusion Knowledge gaps were evident in areas regarding insulin use, diet and glycaemic control. Low diabetes knowledge was associated with female gender and could be a risk factor for development of diabetes-related complications. Knowledge gaps need to be addressed in diabetes education to prevent development of diabetes-related complications. PMID:23396799

The Economic Importance of Financial Literacy: Theory and Evidence

PubMed Central

Lusardi, Annamaria; Mitchell, Olivia S.

2017-01-01

This paper undertakes an assessment of a rapidly growing body of economic research on financial literacy. We start with an overview of theoretical research which casts financial knowledge as a form of investment in human capital. Endogenizing financial knowledge has important implications for welfare as well as policies intended to enhance levels of financial knowledge in the larger population. Next, we draw on recent surveys to establish how much (or how little) people know and identify the least financially savvy population subgroups. This is followed by an examination of the impact of financial literacy on economic decision-making in the United States and elsewhere. While the literature is still young, conclusions may be drawn about the effects and consequences of financial illiteracy and what works to remedy these gaps. A final section offers thoughts on what remains to be learned if researchers are to better inform theoretical and empirical models as well as public policy. PMID:28579637

The Economic Importance of Financial Literacy: Theory and Evidence.

PubMed

Lusardi, Annamaria; Mitchell, Olivia S

2014-03-01

This paper undertakes an assessment of a rapidly growing body of economic research on financial literacy. We start with an overview of theoretical research which casts financial knowledge as a form of investment in human capital. Endogenizing financial knowledge has important implications for welfare as well as policies intended to enhance levels of financial knowledge in the larger population. Next, we draw on recent surveys to establish how much (or how little) people know and identify the least financially savvy population subgroups. This is followed by an examination of the impact of financial literacy on economic decision-making in the United States and elsewhere. While the literature is still young, conclusions may be drawn about the effects and consequences of financial illiteracy and what works to remedy these gaps. A final section offers thoughts on what remains to be learned if researchers are to better inform theoretical and empirical models as well as public policy.

Patient safety, quality of care, and knowledge translation in the intensive care unit.

PubMed

Needham, Dale M

2010-07-01

A large gap exists between the completion of clinical research demonstrating the benefit of new treatment interventions and improved patient outcomes resulting from implementation of these interventions as part of routine clinical practice. This gap clearly affects patient safety and quality of care. Knowledge translation is important for addressing this gap, but evaluation of the most appropriate and effective knowledge translation methods is still ongoing. Through describing one model for knowledge translation and an example of its implementation, insights can be gained into systematic methods for advancing the implementation of evidence-based interventions to improve safety, quality, and patient outcomes.

An Exploration of the Utility of a Knowledge Utilization Framework to Study the Gap between Reading Disabilities Research and Practice

ERIC Educational Resources Information Center

Davidson, Katherine; Nowicki, Elizabeth

2012-01-01

This pre-pilot study explored the usefulness of a knowledge utilization framework comprised of Knott and Wildavsky's (1980) seven stages of knowledge use and Stone's (2002) three routes to knowledge use to investigate the gap between reading disabilities research and teachers' self-reported use of that research. Semi-structured interviews of ten…

Prevention of cardiovascular diseases.

PubMed

Hobbs, F D Richard

2015-10-12

Cardiovascular disease (CVD) is the most important cause of premature death and disability globally. Much is known of the main aetiological risk factors, including elevated blood pressure, dyslipidaemia and smoking, with a raft of additional risks of increasing prevalence, such as obesity and diabetes. Furthermore, some of the most secure evidence-based management strategies in healthcare relate to interventions that modify risk. Yet major gaps remain in the implementation of such evidence, summarized in international guideline recommendations. Some of this gap relates to knowledge deficits amongst clinicians, but also to continued uncertainties over interpretation of the evidence base and areas where data are less available. This article collection in BMC Medicine seeks to offer reflections in each of these areas of uncertainty, spanning issues of better diagnosis, areas of controversy and glimpses of potentially potent future interventions in the prevention of CVD.

Native Americans: Where in Environmental Justice Research?

PubMed Central

Vickery, Jamie; Hunter, Lori M.

2016-01-01

While the last two decades have seen important theoretical, empirical, and policy advancements in environmental justice generally, much remains to be done regarding Native Americans. Unique political and cultural dynamics shape the study and pursuit of environmental justice (EJ) in Native American communities. This review summarizes Native American EJ issues based on a cross-disciplinary search of over 60 publications. In so doing, we discuss the unique nature of Native American EJ in terms of conducting research and working toward reducing the continuation of historical trauma associated with environmental ills, the types of strategies used in Native American EJ research, and issues of Native American climate justice. We conclude with discussion of remaining knowledge gaps and future research needs. PMID:27103758

Management of knowledge gaps: concept representation of things we don't know.

PubMed

Bleuer, Juerg P; Talerico, Daniele; Bösch, Kurt; Lampérière, Vincent; Ludwig, Christian A

2010-01-01

Suva (Swiss National Accident Insurance Fund) is the most important carrier of obligatory accident insurance in Switzerland. Its medical division supports doctors working in inpatient and outpatient care with comprehensive case management and with conciliar advice. The Suva hospitals provide inpatient rehabilitation. In 2002, Suva started the InWiM project. InWiM is an acronym and stands for "Integrierte Wissensbasen der Medizin", which can be translated as "Integrated Knowledge Bases in Medicine". Information retrieval within InWiM is achieved by means of the MeSH Index (Medical Subject Headings), the thesaurus of the United States National Library of Medicine (NLM). InWiM has now been extended towards the management not only of publications but also of areas where sound knowledge is missing, so called "knowledge gaps": Knowledge gaps are indexed with MeSH terms in a similar way to publications. This improves knowledge management: In particular it is possible to search and find knowledge gaps and solutions covering the same or a similar topic, thus allowing adequate collating and it prevents duplication of work. Furthermore, literature search strategies for the NML are predefined and do not need every time to be reinvented from scratch.

A Study of Gaps in Network Knowledge Synthesis

DTIC Science & Technology

2016-10-14

Lincoln Laboratory MASSACHUSETTS INSTITUTE OF TECHNOLOGY LEXINGTON, MASSACHUSETTS Technical Report 1195 A Study of Gaps in Network...unlimited. This report is the result of studies performed at Lincoln Laboratory, a federally funded research and development center operated...specifically authorized by the U.S. Government may violate any copyrights that exist in this work. A Study of Gaps in Network Knowledge Synthesis

Bordetella pertussis pathogenesis: current and future challenges.

PubMed

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

2014-04-01

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

Bordetella pertussis pathogenesis: current and future challenges

PubMed Central

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

2014-01-01

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

Advancing biology through a deeper understanding of zebrafish ecology and evolution

PubMed Central

Parichy, David M

2015-01-01

Over the last two decades, the zebrafish has joined the ranks of premier model organisms for biomedical research, with a full suite of tools and genomic resources. Yet we still know comparatively little about its natural history. Here I review what is known about the natural history of the zebrafish, where significant gaps in our knowledge remain, and how a fuller appreciation of this organism's ecology and behavior, population genetics, and phylogeny can inform a variety of research endeavors. DOI: http://dx.doi.org/10.7554/eLife.05635.001 PMID:25807087

Pharmaceutical R&D in the spotlight: why is there still unmet medical need?

PubMed

Schmid, Esther F; Smith, Dennis A

2007-12-01

Huge amounts of money and knowledge have been poured into biomedical research for decades. Yet, in some disease areas next to no progress has been made in providing medical treatment. Importantly, it is not only neglected diseases where unmet medical need remains, but many diseases of 'rich' countries are also affected. Occasionally, new therapies exacerbate the medical need gap, such as in cancer. Our paper discusses some of the reasons why this might be and why all of society needs to find solutions to address unmet medical need.

Contribution of Maternal Immunity to Decreased Rotavirus Vaccine Performance in Low- and Middle-Income Countries

PubMed Central

Mwila, Katayi; Simuyandi, Michelo; Permar, Sallie R.

2016-01-01

ABSTRACT The role of maternal immunity, received by infants either transplacentally or orally from breast milk, in rotavirus vaccine (RV) performance is evaluated here. Breastfeeding withholding has no effect on vaccine responses, but higher levels of transplacental rotavirus-specific IgG antibody contribute to reduced vaccine seroconversion. The gaps in knowledge on the factors associated with low RV efficacy in low- and middle-income countries (LMIC) remain, and further research is needed to shed more light on these issues. PMID:27847365

Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions: Workshop Report

NASA Technical Reports Server (NTRS)

Race, Margaret S. (Editor); Johnson, James E. (Editor); Spry, James A. (Editor); Siegel, Bette; Conley, Catharine A.

2015-01-01

This report on Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions summarizes the presentations, deliberations and findings of a workshop at NASA Ames Research Center, March 24-26, 2015, which was attended by more than 100 participants representing a diverse mix of science, engineering, technology, and policy areas. The main objective of the three-day workshop was to identify specific knowledge gaps that need to be addressed to make incremental progress towards the development of NASA Procedural Requirements (NPRs) for Planetary Protection during human missions to Mars.

A knowledge transfer scheme to bridge the gap between science and practice: an integration of existing research frameworks into a tool for practice.

PubMed

Verhagen, Evert; Voogt, Nelly; Bruinsma, Anja; Finch, Caroline F

2014-04-01

Evidence of effectiveness does not equal successful implementation. To progress the field, practical tools are needed to bridge the gap between research and practice and to truly unite effectiveness and implementation evidence. This paper describes the Knowledge Transfer Scheme integrating existing implementation research frameworks into a tool which has been developed specifically to bridge the gap between knowledge derived from research on the one side and evidence-based usable information and tools for practice on the other.

Understanding the Knowledge Gap Experienced by U.S. Safety Net Patients in Teleretinal Screening.

PubMed

George, Sheba M; Hayes, Erin Moran; Fish, Allison; Daskivich, Lauren Patty; Ogunyemi, Omolola I

2016-01-01

Safety-net patients' socioeconomic barriers interact with limited digital and health literacies to produce a "knowledge gap" that impacts the delivery of healthcare via telehealth technologies. Six focus groups (2 African- American and 4 Latino) were conducted with patients who received teleretinal screening in a U.S. urban safety-net setting. Focus groups were analyzed using a modified grounded theory methodology. Findings indicate that patients' knowledge gap is primarily produced at three points during the delivery of care: (1) exacerbation of patients' pre-existing personal barriers in the clinical setting; (2) encounters with technology during screening; and (3) lack of follow up after the visit. This knowledge gap produces confusion, potentially limiting patients' perceptions of care and their ability to manage their own care. It may be ameliorated through delivery of patient education focused on both disease pathology and specific role of telehealth technologies in disease management.

Motivation and the Knowledge Gap: Effects of a Campaign to Reduce Diet-Related Cancer Risk.

ERIC Educational Resources Information Center

Viswanath, K.; And Others

1993-01-01

Examines whether knowledge gaps decrease when motivation to acquire information is similar among more and less educated groups. Compares two groups with differing motivations to acquire cancer and diet information in a community that received a year-long health campaign. Finds evidence of education-based differences in knowledge even among members…

Phylogeny, extinction and conservation: embracing uncertainties in a time of urgency

PubMed Central

Forest, Félix; Crandall, Keith A.; Chase, Mark W.; Faith, Daniel P.

2015-01-01

Evolutionary studies have played a fundamental role in our understanding of life, but until recently, they had only a relatively modest involvement in addressing conservation issues. The main goal of the present discussion meeting issue is to offer a platform to present the available methods allowing the integration of phylogenetic and extinction risk data in conservation planning. Here, we identify the main knowledge gaps in biodiversity science, which include incomplete sampling, reconstruction biases in phylogenetic analyses, partly known species distribution ranges, and the difficulty in producing conservation assessments for all known species, not to mention that much of the effective biological diversity remains to be discovered. Given the impact that human activities have on biodiversity and the urgency with which we need to address these issues, imperfect assumptions need to be sanctioned and surrogates used in the race to salvage as much as possible of our natural and evolutionary heritage. We discuss some aspects of the uncertainties found in biodiversity science, such as the ideal surrogates for biodiversity, the gaps in our knowledge and the numerous available phylogenetic diversity-based methods. We also introduce a series of cases studies that demonstrate how evolutionary biology can effectively contribute to biodiversity conservation science. PMID:25561663

Designing exercise clinical trials for older adults with cancer: Recommendations from 2015 Cancer and Aging Research Group NCI U13 Meeting.

PubMed

Kilari, Deepak; Soto-Perez-de-Celis, Enrique; Mohile, Supriya Gupta; Alibhai, Shabbir M H; Presley, Carolyn J; Wildes, Tanya M; Klepin, Heidi D; Demark-Wahnefried, Wendy; Jatoi, Amina; Harrison, Robert; Won, Elizabeth; Mustian, Karen M

2016-07-01

Cancer and its treatment can lead to a myriad of adverse events and negatively impact quality of life of older cancer patients and survivors. Unmet physical activity needs vary across the cancer continuum and remain an important yet understudied area of research in this population. Exercise interventions have been shown to be effective in treating both the physical and psychological declines associated with cancer and its treatment, with a potential to improve cancer-related outcomes. Despite the current evidence, exercise is clearly underutilized due to several barriers and knowledge gaps in existing trials that include appropriate population identification, design, and outcome measures selection. The benefits of regular exercise in both the primary and secondary prevention of chronic conditions are well established in the non-cancer population. In older cancer patients and survivors, further research is needed before exercise gains widespread acceptance. The Cancer and Aging Research Group convened experts in exercise, aging and cancer to evaluate current scientific evidence and knowledge gaps in geriatric exercise oncology. This report summarizes these findings and provides future research directions. Published by Elsevier Ltd.

Patient or consumer? The colonization of the psychiatric clinic.

PubMed

Evans, Alicia M

2005-12-01

Information is given a privileged place in the psychiatric clinic, as illustrated by the prevalence and volume of data to be collected and forms to be completed by psychiatric nurses. Information though is different to knowledge. The present paper argues that information is part of a managerial discourse that implies commodification whereas knowledge is part of a clinical discourse that allows room for the suffering of the patient. Information belongs to the discourse of managerialism, one that positions the patient as customer/consumer and in doing so renders them unsuffering. The patient's suffering is silenced by their construction as a consumer. The discourse of managerialism seeks a complete data set of information. By way of contrast, another discourse, that of psychoanalysis offers the institution the idea that there are always holes, gaps, and uncertainty. The idea of uncertainty, gaps, things remaining unknown and a limit sits uncomfortably with the dominant discourse of managerialism; one that demands no limits, complete data sets, and many satisfied customers. This market model of managerialism denies the potential of the therapeutic relationship; that something curative might be produced via the transference. In addition, the managerialist discourse potentially positions the patient as both illegitimate and unsuffering.

A Systematic Review of Athletes’ and Coaches’ Nutrition Knowledge and Reflections on the Quality of Current Nutrition Knowledge Measures

PubMed Central

Trakman, Gina L.; Forsyth, Adrienne; Devlin, Brooke L.; Belski, Regina

2016-01-01

Context: Nutrition knowledge can influence dietary choices and impact on athletic performance. Valid and reliable measures are needed to assess the nutrition knowledge of athletes and coaches. Objectives: (1) To systematically review the published literature on nutrition knowledge of adult athletes and coaches and (2) to assess the quality of measures used to assess nutrition knowledge. Data Sources: MEDLINE, CINAHL, SPORTDiscuss, Web of Science, and SCOPUS. Study Selection: 36 studies that provided a quantitative measure of nutrition knowledge and described the measurement tool that was used were included. Data extraction: Participant description, questionnaire description, results (mean correct and responses to individual items), study quality, and questionnaire quality. Data synthesis: All studies were of neutral quality. Tools used to measure knowledge did not consider health literacy, were outdated with regards to consensus recommendations, and lacked appropriate and adequate validation. The current status of nutrition knowledge in athletes and coaches is difficult to ascertain. Gaps in knowledge also remain unclear, but it is likely that energy density, the need for supplementation, and the role of protein are frequently misunderstood. Conclusions: Previous reports of nutrition knowledge need to be interpreted with caution. A new, universal, up-to-date, validated measure of general and sports nutrition knowledge is required to allow for assessment of nutrition knowledge. PMID:27649242

Knowledge translation of research findings.

PubMed

Grimshaw, Jeremy M; Eccles, Martin P; Lavis, John N; Hill, Sophie J; Squires, Janet E

2012-05-31

One of the most consistent findings from clinical and health services research is the failure to translate research into practice and policy. As a result of these evidence-practice and policy gaps, patients fail to benefit optimally from advances in healthcare and are exposed to unnecessary risks of iatrogenic harms, and healthcare systems are exposed to unnecessary expenditure resulting in significant opportunity costs. Over the last decade, there has been increasing international policy and research attention on how to reduce the evidence-practice and policy gap. In this paper, we summarise the current concepts and evidence to guide knowledge translation activities, defined as T2 research (the translation of new clinical knowledge into improved health). We structure the article around five key questions: what should be transferred; to whom should research knowledge be transferred; by whom should research knowledge be transferred; how should research knowledge be transferred; and, with what effect should research knowledge be transferred? We suggest that the basic unit of knowledge translation should usually be up-to-date systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting), and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge translation strategy is informed by an assessment of the likely barriers and facilitators. Although our evidence on the likely effectiveness of different strategies to overcome specific barriers remains incomplete, there is a range of informative systematic reviews of interventions aimed at healthcare professionals and consumers (i.e., patients, family members, and informal carers) and of factors important to research use by policy makers. There is a substantial (if incomplete) evidence base to guide choice of knowledge translation activities targeting healthcare professionals and consumers. The evidence base on the effects of different knowledge translation approaches targeting healthcare policy makers and senior managers is much weaker but there are a profusion of innovative approaches that warrant further evaluation.

Relating Gap Analysis Results to Information Systems Program Attitudes: The Identification of Gap Priorities and Implications

ERIC Educational Resources Information Center

Van Auken, Stuart; Chrysler, Earl; Wells, Ludmilla Gricenko; Simkin, Mark

2011-01-01

The authors utilized a gap analysis approach to assess general IS knowledge and skill voids or overages in a specific program context. The authors asked alumni to reveal the emphasis that should have been given to 10 IS knowledge and skill areas and compared the results with the emphasis that was actually given. They proceed by relating the…

Results of the Lunar Exploration Analysis Group (LEAG) Gap Review: Specific Action Team (SAT), Examination of Strategic Knowledge Gaps (SKGs) for Human Exploration of the Moon

NASA Technical Reports Server (NTRS)

Shearer, C. K.; Eppler, D.; Farrell, W.; Gruener, J.; Lawrence, S.; Pellis, N.; Spudis, P. D.; Stopar, J.; Zeigler, R.; Neal, C;

The effect of EarthPulse on learning of declarative knowledge

NASA Astrophysics Data System (ADS)

McKinney, Heather E.

The purpose of this double-blind, bio-medical research study was to investigate the effect of EarthPulse, a brainwave entrainment and pulsed electromagnetic field (PEMF) device, on learning of declarative knowledge. Currently, PEMF research explores physiological and psychological effects but a gap exists in the potential effects of PEMF on learning. The study explored whether a relationship existed between receiving a thirty minute EarthPulse treatment on the "Entrain Up" setting and learning of declarative knowledge; whether the relationship remained over time; whether EarthPulse had an effect on sleep; and whether EarthPulse had an effect on attrition. Ninety-eight, randomly assigned, undergraduate students participated in this double-blind, experimental design study, of which 87 remained after attrition. After receiving a thirty minute EarthPulse or placebo treatment, experimental and control groups read identical passages and completed identical instruments to test learning and retention of declarative knowledge. Participants completed the same test in two intervals: an immediate (learning) and delayed (retention) posttest. Assumptions for normality and reliability were met. One-way ANOVA revealed no statistically significant effects on learning or retention at the 0.05 level. However, Chi square analysis revealed those who received the EarthPulse treatment were significantly less likely to fall asleep than those who received the control treatment (p=0.022) and very closely approached significance for attrition (p=0.051).

New graduate registered nurses' knowledge of patient safety and practice: A literature review.

PubMed

Murray, Melanie; Sundin, Deborah; Cope, Vicki

2018-01-01

To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.

Knowledge Translation for Cardiovascular Disease Research and Management in Japan

PubMed Central

Shommu, Nusrat S

2017-01-01

Knowledge translation is an essential and emerging arena in healthcare research. It is the process of aiding the application of research knowledge into clinical practice or policymaking. Individuals at all levels of the health care system, including patients, healthcare professionals, and policymakers, are affected by the gaps that exist between research evidence and practice; the process of knowledge translation plays a role in bridging these gaps and incorporating high-quality clinical research into decision-making. Cardiovascular disease (CVD) management is a crucial area of healthcare where information gaps are known to exist. Although Japan has one of the lowest risks and mortality rates from CVDs, an increasing trend of cardiovascular incidence and changes in the risk factor conditions have been observed in recent years. This article provides an overview of knowledge translation and its importance in the cardiovascular health of the Japanese population, and describes the key steps of a typical knowledge translation strategy. PMID:28757537

Knowledge Translation for Cardiovascular Disease Research and Management in Japan.

PubMed

Shommu, Nusrat S; Turin, Tanvir C

2017-09-01

Knowledge translation is an essential and emerging arena in healthcare research. It is the process of aiding the application of research knowledge into clinical practice or policymaking. Individuals at all levels of the health care system, including patients, healthcare professionals, and policymakers, are affected by the gaps that exist between research evidence and practice; the process of knowledge translation plays a role in bridging these gaps and incorporating high-quality clinical research into decision-making. Cardiovascular disease (CVD) management is a crucial area of healthcare where information gaps are known to exist. Although Japan has one of the lowest risks and mortality rates from CVDs, an increasing trend of cardiovascular incidence and changes in the risk factor conditions have been observed in recent years. This article provides an overview of knowledge translation and its importance in the cardiovascular health of the Japanese population, and describes the key steps of a typical knowledge translation strategy.

Eutrophication of freshwater and marine ecosystems

USGS Publications Warehouse

Smith, Val H.; Joye, Samantha B.; Howarth, Robert W.

2006-01-01

Initial understanding of the links between nutrients and aquatic productivity originated in Europe in the early 1900s, and our knowledge base has expanded greatly during the past 40 yr. This explosion of eutrophication-related research has made it unequivocally clear that a comprehensive strategy to prevent excessive amounts of nitrogen and phosphorus from entering our waterways is needed to protect our lakes, rivers, and coasts from water quality deterioration. However, despite these very significant advances, cultural eutrophication remains one of the foremost problems for protecting our valuable surface water resources. The papers in this special issue provide a valuable cross section and synthesis of our current understanding of both freshwater and marine eutrophication science. They also serve to identify gaps in our knowledge and will help to guide future research.

The experience of physicians in pharmacogenomic clinical decision support within eight German university hospitals.

PubMed

Hinderer, Marc; Boeker, Martin; Wagner, Sebastian A; Binder, Harald; Ückert, Frank; Newe, Stephanie; Hülsemann, Jan L; Neumaier, Michael; Schade-Brittinger, Carmen; Acker, Till; Prokosch, Hans-Ulrich; Sedlmayr, Brita

2017-06-01

The aim of this study was to assess the physicians' attitude, their knowledge and their experience in pharmacogenomic clinical decision support in German hospitals. We conducted an online survey to address physicians of 13 different medical specialties across eight German university hospitals. In total, 564 returned questionnaires were analyzed. The remaining knowledge gap, the uncertainty of test reimbursement and the physicians' lack of awareness of existing pharmacogenomic clinical decision support systems (CDSS) are the major barriers for implementing pharmacogenomic CDSS into German hospitals. Furthermore, pharmacogenomic CDSS are most effective in the form of real-time decision support for internists. Physicians in German hospitals require additional education of both genetics and pharmacogenomics. They need to be provided with access to relevant pharmacogenomic CDSS.

Youth Acquisition of Alcohol and Drinking Contexts: An In-Depth Look

PubMed Central

Friese, Bettina; Grube, Joel W.; Moore, Roland S.

2015-01-01

Despite efforts to limit underage access to alcohol, alcohol availability remains a challenge for youth drinking prevention. This paper fills a gap in our understanding of alcohol consumption among youths by systematically investigating how and under what circumstances they obtain alcohol and the context within which they consume it. Qualitative interviews (n=47) were conducted with teens to collect information about where and how they obtain alcohol and the contexts within which they drink. Respondents were knowledgeable about commercial and social sources and used this knowledge in their decision making regarding where to obtain alcohol. Teens used their social relationships to circumvent existing policies designed to limit underage access to alcohol. Findings indicate that the majority of teens’ drinking occasions occur in their own or someone else’s home. PMID:25445811

Non-operative management of appendicitis in children.

PubMed

Hall, Nigel J; Eaton, Simon

2018-05-01

While appendicectomy has been considered the mainstay of treatment for children with acute appendicitis for many decades, there has been a great deal of recent interest in non-operative treatment (NOT) with antibiotics alone. Initial results suggest that many children with appendicitis can indeed be safely treated with NOT and can be spared the surgeon's knife. Many as yet unanswered questions remain, however, before NOT can be considered a realistic and reliable alternative to surgery. This review summaries current knowledge and understanding of the role of NOT in children with appendicitis and outlines and discusses the outstanding knowledge gaps. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Use of designed sequences in protein structure recognition.

PubMed

Kumar, Gayatri; Mudgal, Richa; Srinivasan, Narayanaswamy; Sandhya, Sankaran

2018-05-09

Knowledge of the protein structure is a pre-requisite for improved understanding of molecular function. The gap in the sequence-structure space has increased in the post-genomic era. Grouping related protein sequences into families can aid in narrowing the gap. In the Pfam database, structure description is provided for part or full-length proteins of 7726 families. For the remaining 52% of the families, information on 3-D structure is not yet available. We use the computationally designed sequences that are intermediately related to two protein domain families, which are already known to share the same fold. These strategically designed sequences enable detection of distant relationships and here, we have employed them for the purpose of structure recognition of protein families of yet unknown structure. We first measured the success rate of our approach using a dataset of protein families of known fold and achieved a success rate of 88%. Next, for 1392 families of yet unknown structure, we made structural assignments for part/full length of the proteins. Fold association for 423 domains of unknown function (DUFs) are provided as a step towards functional annotation. The results indicate that knowledge-based filling of gaps in protein sequence space is a lucrative approach for structure recognition. Such sequences assist in traversal through protein sequence space and effectively function as 'linkers', where natural linkers between distant proteins are unavailable. This article was reviewed by Oliviero Carugo, Christine Orengo and Srikrishna Subramanian.

Education and Race.

ERIC Educational Resources Information Center

Lauter, Sylvia, Comp.

This report summarizes information, current in 1966, on the educational status of the nonwhite population. The study includes the following topics: (1) education and race: the racial gap in education closes, (2) education and employment: the racial unemployment income gap remains, (3) education and income: the racial income gap remains, (4)…

Optimizing the use of breed types in developing country livestock production systems: a neglected research area.

PubMed

Marshall, K

2014-10-01

Developing country livestock production systems are diverse and dynamic, and include those where existing indigenous breeds are currently optimal and likely to remain so, those where non-indigenous breed types are already in common use, and systems that are changing, such as by intensification, where the introduction of new breed types represents significant opportunities. These include opportunities to improve the livelihood of the world's poor, increase food and nutrition security and enhance environmental sustainability. At present, very little research has focused on this issue, such that significant knowledge gaps in relation to breed-change interventions remain. The purpose of this study is to raise awareness of this issue and suggests strategic research areas to begin filling these knowledge gaps. Such strategic research would include (i) assessing the impact of differing breed types in developing country livestock productions systems, from a range of viewpoints including intrahousehold livelihood benefit, food and nutrition security at different scales, and environmental sustainability; (ii) identification of specific livestock production systems within developing countries, and the type of livestock keepers within these system, that are most likely to benefit from new breed types; and (iii) identification of new breed types as candidates for in-situ testing within these systems, such as through the use of spatial analysis to identify similar production environments combined with community acceptance studies. Results of these studies would primarily assist stakeholders in agriculture, including both policy makers and livestock keepers, to make informed decisions on the potential use of new breed types. © 2014 Blackwell Verlag GmbH.

Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs.

PubMed

Lambdin, Barrot H; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C; Cattamanchi, Adithya; Geng, Elvin H; Volberding, Paul

2015-01-01

Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap.

Implementing Implementation Science: An Approach for HIV Prevention, Care and Treatment Programs

PubMed Central

Lambdin, Barrot H.; Cheng, Ben; Peter, Trevor; Mbwambo, Jessie; Apollo, Tsitsi; Dunbar, Megan; Udoh, Ifeoma C.; Cattamanchi, Adithya; Geng, Elvin H.; Volberding, Paul

2015-01-01

Though great progress has been realized over the last decade in extending HIV prevention, care and treatment in some of the least resourced settings of the world, a substantial gap remains between what we know works and what we are actually achieving in HIV programs. To address this, leaders have called for the adoption of an implementation science framework to improve the efficiency and effectiveness of HIV programs. Implementation science (IS) is a multidisciplinary scientific field that seeks generalizable knowledge about the magnitude of, determinants of and strategies to close the gap between evidence and routine practice for health in real-world settings. We propose an IS approach that is iterative in nature and composed of four major components: 1) Identifying Bottlenecks and Gaps, 2) Developing and Implementing Strategies, 3) Measuring Effectiveness and Efficiency, and 4) Utilizing Results. With this framework, IS initiatives draw from a variety of disciplines including qualitative and quantitative methodologies in order to develop new approaches responsive to the complexities of real world program delivery. In order to remain useful for the changing programmatic landscape, IS research should factor in relevant timeframes and engage the multi-sectoral community of stakeholders, including community members, health care teams, program managers, researchers and policy makers, to facilitate the development of programs, practices and polices that lead to a more effective and efficient global AIDS response. The approach presented here is a synthesis of approaches and is a useful model to address IS-related questions for HIV prevention, care and treatment programs. This approach, however, is not a panacea, and we will continue to learn new ways of thinking as we move forward to close the implementation gap. PMID:25986374

Hematology oncology practice in the Asia-Pacific APHCON survey results from the 6th international hematologic malignancies conference: bridging the gap 2015, Beijing, China.

PubMed

Huang, Xiao Jun; Liu, Kaiyan; Ritchie, David; Andersson, Borje; Lu, Jin; Hou, Jian; Burguera, Adolfo de la Fuente; Wang, JianXiang; Yeoh, Allen; Yan, Chenhua; Zhou, Daobin; Tan, Daryl; Kim, Dong Wook; Wu, Depei; Shpall, Elizabeth; Kornblau, Stephen; Neelapu, Sattava; Hongeng, Suradej; Li, Jianyong; Hu, Jiong; Zhang, Lian Sheng; Wang, Michael; Malhotra, Pankaj; Jiang, Qian; Qin, Yazhen; Wong, Raymond; Champlin, Richard; Hagemeister, Frederick; Westin, Jason; Iyer, Swaminathan; Mathews, Vikram; Wang, Yu; Hu, Yu; Xiao, Zhijian; Shao, Zonghong; Orlowski, Robert Z; Chim, Chor Sang; Mulligan, Stephen; Sanz, Miguel; Ozawa, Keiya; Parmar, Simrit; Issaragrisil, Surapol

2017-06-20

This report serves as a snapshot of the state-of-knowledge in the Asia Pacific (APAC) Hematology Oncology community, and establishes a baseline for longitudinal investigations to follow changes in best practices over time. The objective of this study was to understand the approach to hematologic diseases, common standards of care and best practices, issues that remain controversial or debated, and educational or resource gaps that warrant attention. We used mobile application to disseminate and distribute questionnaires to delegates during the 6th international hematologic malignancies conference hosted by the APAC Hematology Consortium at Beijing, China. User responses were collected in an anonymous fashion. We report survey results in two ways: the overall responses, and responses as stratified between Chinese physicians and "Other" represented nationalities. Overall geographical concordance in survey responses was positive and strong. Perhaps more interesting than instances of absolute agreement, these data provide a unique opportunity to identify topics in which physician knowledge or opinions diverge. We assigned questions from all modules to broad categories of: patient information; diagnosis; treatment preference; transplantation; and general knowledge/opinion. On average, we observed a geographic difference of 15% for any particular answer choice, and this was fairly constant across survey modules. These results reveal utility and need for widespread and ongoing initiatives to assess knowledge and provide evidence-based education in real time. The data will be made more valuable by longitudinal participation, such that we can monitor changes in the state of the art over time.

Knowledge, attitude and practice GAP in family planning usage: an analysis of selected cities of Uttar Pradesh.

PubMed

Singh, Anjali; Singh, K K; Verma, Prashant

2016-01-01

The GAP between the knowledge of contraception and its actual practice is well recognized in the literature of family welfare studies. The present study assessed the relation between the level of knowledge and practice of contraception among the women and sought to explore the reasons behind the Knowledge, Attitude, and Practice - GAP (KAP GAP) regarding contraceptive users in six cities of Uttar Pradesh. Present analysis based on 17,643 currently married women aged 15 to 49. A Bivariate analysis ( χ 2 test) and a multivariable logistic regression were performed for the study. The highest percentages of respondents (women) were in the age group 35-49 (40-45 %) in all the districts considered. Knowledge of contraceptives was almost universal; tubal ligation and pill were the commonly known methods. Information about the contraceptive methods was mostly obtained through the husband. In the present study, there was a highly significant association ( p  < 0.01) of age group, educational status of respondents, the number of living children, the wealth of the respondent, media exposure and husband's education with the variable KAP GAP for all six cities. Health concern issues in all the districts were the most prominent reason for not using contraception. There differences in the socioeconomic and demographic factors exist, which lead to KAP GAP in the family planning (FP) usages. Therefore, in designing effective family planning programme, there is a need to understand the various factors which influence the practice of contraception.

Discontinuities, cross-scale patterns, and the organization of ecosystems

USGS Publications Warehouse

Nash, Kirsty L.; Allen, Craig R.; Angeler, David G.; Barichievy, Chris; Eason, Tarsha; Garmestani, Ahjond S.; Graham, Nicholas A.J.; Granholm, Dean; Knutson, Melinda; Nelson, R. John; Nystrom, Magnus; Stow, Craig A.; Sandstrom, Shana M.

2014-01-01

Ecological structures and processes occur at specific spatiotemporal scales, and interactions that occur across multiple scales mediate scale-specific (e.g., individual, community, local, or regional) responses to disturbance. Despite the importance of scale, explicitly incorporating a multi-scale perspective into research and management actions remains a challenge. The discontinuity hypothesis provides a fertile avenue for addressing this problem by linking measureable proxies to inherent scales of structure within ecosystems. Here we outline the conceptual framework underlying discontinuities and review the evidence supporting the discontinuity hypothesis in ecological systems. Next we explore the utility of this approach for understanding cross-scale patterns and the organization of ecosystems by describing recent advances for examining nonlinear responses to disturbance and phenomena such as extinctions, invasions, and resilience. To stimulate new research, we present methods for performing discontinuity analysis, detail outstanding knowledge gaps, and discuss potential approaches for addressing these gaps.

Contraception in Japan: Current trends.

PubMed

Yoshida, Honami; Sakamoto, Haruka; Leslie, Asuka; Takahashi, Osamu; Tsuboi, Satoshi; Kitamura, Kunio

2016-06-01

High proportion of Japanese uses condoms; lower proportion uses oral contraceptive pills (OCPs). We examined the longitudinal patterns for contraceptive usage in Japan and evaluated differences before and after OCP government approval. We accessed nationally representative survey data for women aged 16-49years from 1950 to 2014. Usage of condoms and OCP was 83.4% and 3.0%, respectively in 2014. OCP use before (1.21%) and after (1.97%) government approval did not differ significantly (p=.58). The prevalence of OCP usage remains low in Japan. A wide gap in use between Japan and other developed countries exists. Through a wide gap in OCP use between Japan and other countries, we revealed how choices of contraceptive methods and their benefits could be openly available for women of reproductive age, and how health care professionals disseminate appropriate knowledge about contraception for women in need. Copyright © 2016 Elsevier Inc. All rights reserved.

Enhancing Diversity in Biomedical Data Science

PubMed Central

Canner, Judith E.; McEligot, Archana J.; Pérez, María-Eglée; Qian, Lei; Zhang, Xinzhi

2017-01-01

The gap in educational attainment separating underrepresented minorities from Whites and Asians remains wide. Such a gap has significant impact on workforce diversity and inclusion among cross-cutting Biomedical Data Science (BDS) research, which presents great opportunities as well as major challenges for addressing health disparities. This article provides a brief description of the newly established National Institutes of Health Big Data to Knowledge (BD2K) diversity initiatives at four universities: California State University, Monterey Bay; Fisk University; University of Puerto Rico, Río Piedras Campus; and California State University, Fullerton. We emphasize three main barriers to BDS careers (ie, preparation, exposure, and access to resources) experienced among those pioneer programs and recommendations for possible solutions (ie, early and proactive mentoring, enriched research experience, and data science curriculum development). The diversity disparities in BDS demonstrate the need for educators, researchers, and funding agencies to support evidence-based practices that will lead to the diversification of the BDS workforce PMID:28439180

Xerostomia and salivary hypofunction in vulnerable elders: prevalence and etiology.

PubMed

Liu, Bing; Dion, Michael R; Jurasic, M Marianne; Gibson, Gretchen; Jones, Judith A

2012-07-01

The goal of this article is to review existing research on the prevalence and etiology of dry mouth in the vulnerable elders and identify knowledge gaps. Vulnerable elders (VE) are persons aged >65 years who have any or all of the following: limited mobility, limited resources, or complex health status. A systematic search was conducted of PubMed sources from 1989 to May 2010. Evidence was evaluated on the prevalence and etiology of xerostomia and salivary gland hypofunction (SGH) in VE. The search identified 1,422 publications. The inclusion/exclusion criteria yielded 348 articles, 80 of which are cited herein. Research has showed a high prevalence of xerostomia and SGH in VE. Common etiologies include medications, poor general health, female gender, and age. Gaps still exist in the evaluation of dry mouth in VE. Nonetheless, oral dryness will remain an important health issue as life expectancy increases. Copyright © 2012 Elsevier Inc. All rights reserved.

Data from the German Chest Pain Unit Registry: The well known gap between knowledge and practice.

PubMed

Fernández-Bergés, Daniel

2017-11-01

In-hospital mortality of acute myocardial infarction with ST segment elevation remains high and is influenced by many factors, some of which are modifiable such as time to treatment initiation and modality of treatment. It is well established that reperfusion therapy is the gold-standard in the management of ST-elevation acute myocardial infarction. Despite recent developments and clear, comprehensible guidelines recommendations, it remains difficult to disseminate this knowledge to medical practitioners. The German Chest Pain Unit shows that the best door-to-balloon time is reached when patients contact the Emergency Medical Systems (EMS) directly, rather than when referred by the general practitioner (GP), or are transferred from another hospital, or present as a self-referral. In order to improve mortality in ST-elevation acute myocardial infarction, patients must be able to recognize symptoms and call the EMS as soon as possible, in addition to having an ECG within ten minutes and direct access to reperfusion therapy (PPCI preferred). The German Registry has highlighted the importance of training both patients and doctors. Copyright © 2017 Elsevier B.V. All rights reserved.

Giving what one should: explanations for the knowledge-behavior gap for altruistic giving.

PubMed

Blake, Peter R

2018-04-01

Several studies have shown that children struggle to give what they believe that they should: the so-called knowledge-behavior gap. Over a dozen recent Dictator Game studies find that, although young children believe that they should give half of a set of resources to a peer, they typically give less and often keep all of the resources for themselves. This article reviews recent evidence for five potential explanations for the gap and how children close it with age: self-regulation, social distance, theory of mind, moral knowledge and social learning. I conclude that self-regulation, social distance, and social learning show the most promising evidence for understanding the mechanisms that can close the gap. Copyright © 2017 Elsevier Ltd. All rights reserved.

Defaunation in the Anthropocene.

PubMed

Dirzo, Rodolfo; Young, Hillary S; Galetti, Mauro; Ceballos, Gerardo; Isaac, Nick J B; Collen, Ben

2014-07-25

We live amid a global wave of anthropogenically driven biodiversity loss: species and population extirpations and, critically, declines in local species abundance. Particularly, human impacts on animal biodiversity are an under-recognized form of global environmental change. Among terrestrial vertebrates, 322 species have become extinct since 1500, and populations of the remaining species show 25% average decline in abundance. Invertebrate patterns are equally dire: 67% of monitored populations show 45% mean abundance decline. Such animal declines will cascade onto ecosystem functioning and human well-being. Much remains unknown about this "Anthropocene defaunation"; these knowledge gaps hinder our capacity to predict and limit defaunation impacts. Clearly, however, defaunation is both a pervasive component of the planet's sixth mass extinction and also a major driver of global ecological change. Copyright © 2014, American Association for the Advancement of Science.

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm

PubMed Central

Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-01-01

Introduction: Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn’s theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. Methods: In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team’s four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn’s theory. Results: The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. Discussion: This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context. PMID:28435417

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm.

PubMed

Dogba, Maman Joyce; Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-07-19

Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn's theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team's four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn's theory. The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context.

Melanoma reporting to central cancer registries by US dermatologists: an analysis of the persistent knowledge and practice gap.

PubMed

Cartee, Todd V; Kini, Seema P; Chen, Suephy C

2011-11-01

Every state requires diagnosing physicians to report new cases of melanoma to its central cancer registry. Previous regional studies and anecdotal experience suggest that few dermatologists are cognizant of this obligation. This oversight could result in a large number of unreported melanomas annually and, in turn, US melanoma statistics that markedly underestimate the true incidence of the disease. We sought to quantify the percentage of dermatologists who are unaware of melanoma reporting requirements (the knowledge gap) and who are not reporting melanoma diagnoses (the practice gap). We also sought to delineate factors predictive of reporting knowledge and behavior. A survey was administered to attendees of the Cutaneous Oncology Symposium at the 2010 American Academy of Dermatology annual meeting. In all, 104 of 419 eligible attendees completed surveys (response rate 26%). Fifty percent of respondents do not believe they are required to report melanomas and 56% do not actively report their diagnoses to a registry. Practice duration of less than 10 years was significantly associated with both a knowledge gap (P = .047) and practice gap (P = .056). Similarly, dermatologists who diagnosed fewer than 10 melanomas per year were more likely to possess a knowledge gap (P = .096) and a practice gap (P = .087) than those who diagnosed more than 10. Limitations include small sample size and low response rate. A majority of dermatologists are not reporting melanomas they diagnose to a cancer registry, and half of those surveyed were not aware that diagnosing physicians are required to report melanoma. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Identification of knowledge gaps in neurosurgery using a validated self-assessment examination: differences between general and spinal neurosurgeons.

PubMed

Sheehan, Jason; Starke, Robert M; Pouratian, Nader; Litvack, Zachary

2013-11-01

The practice of neurosurgery requires fundamental knowledge base. Residency training programs and continuing medical education courses are designed to teach relevant neurosurgical principles. Nevertheless, knowledge gaps exist for neurosurgeons and may be different between cohorts of neurosurgeons. The Self-Assessment in Neurological Surgery (SANS) General Examination and Spine Examination are online educational tools for lifelong learning and maintenance of certification. This study examines the gaps in knowledge of spinal neurosurgeons and general neurosurgeons taking SANS. From 2008 to 2010, a total of 165 spinal neurosurgeons completed the 243 available questions of the SANS Spine Examination. Over that same time frame, 993 general neurosurgeons completed the SANS General Spine Examination. Mean scores were calculated and assessed according to 18 major neurosurgical knowledge disciplines. Statistical analysis was carried out to evaluate for significant knowledge gaps among all users and significant differences in performance between spinal neurosurgeons and their general neurosurgeon counterparts. The mean overall examination score was 87.4% ± 7.5% for spinal neurosurgeons and 71.5% ± 8.9% for general neurosurgeons (P < 0.001). Of the 18 major knowledge categories in SANS, spinal neurosurgeons (n = 165) answered questions incorrectly 15% or greater of the time in five of the categories. The categories of lower performance for spinal neurosurgeons were cerebrovascular, anesthesia and critical care, general clinical, tumor, and trauma. For general neurosurgeons (n = 993), the five knowledge categories with lowest performance were cerebrovascular, epilepsy, peripheral nerve, trauma, and radiosurgery. Although spinal neurosurgeons and general neurosurgeons shared some areas of decreased performance including trauma and cerebrovascular, spine neurosurgeons relatively underperformed in general clinical, anesthesia and critical care, and tumor. The SANS Spine Examination demonstrated knowledge gaps in specific categories for spinal surgeons. The knowledge areas of diminished performance differed between spinal and general neurosurgeons. Identification of specific areas of deficiency could prove useful in the design and implementation of educational programs and maintenance of certification. Copyright © 2013 Elsevier Inc. All rights reserved.

Gaps in Science Content Knowledge Encountered during Teaching Practice: A Study of Early-Career Middle-School Science Teachers

ERIC Educational Resources Information Center

Kinghorn, Brian Edward

2013-01-01

Subject-specific content knowledge is crucial for effective science teaching, yet many teachers are entering the field not fully equipped with all the science content knowledge they need to effectively teach the subject. Learning from practice is one approach to bridging the gap between what practicing teachers know and what they need to know.…

Minding the Gap: The Barriers and Facilitators of Getting Evidence into Policy When Using a Knowledge-Brokering Approach

ERIC Educational Resources Information Center

Reid, Garth; Connolly, John; Halliday, Wendy; Love, Anne-Marie; Higgins, Michael; MacGregor, Anita

2017-01-01

Transferring knowledge into action is challenging. Ward et al. (2009a) developed a framework for bridging this gap. This article describes what helps and hinders getting knowledge into action when using this approach in the field of mental health. Four areas of Scotland were selected which had used resources to inform local planning and…

A MSFD complementary approach for the assessment of pressures, knowledge and data gaps in Southern European Seas: The PERSEUS experience.

PubMed

Crise, A; Kaberi, H; Ruiz, J; Zatsepin, A; Arashkevich, E; Giani, M; Karageorgis, A P; Prieto, L; Pantazi, M; Gonzalez-Fernandez, D; Ribera d'Alcalà, M; Tornero, V; Vassilopoulou, V; Durrieu de Madron, X; Guieu, C; Puig, P; Zenetos, A; Andral, B; Angel, D; Altukhov, D; Ayata, S D; Aktan, Y; Balcıoğlu, E; Benedetti, F; Bouchoucha, M; Buia, M-C; Cadiou, J-F; Canals, M; Chakroun, M; Christou, E; Christidis, M G; Civitarese, G; Coatu, V; Corsini-Foka, M; Cozzi, S; Deidun, A; Dell'Aquila, A; Dogrammatzi, A; Dumitrache, C; Edelist, D; Ettahiri, O; Fonda-Umani, S; Gana, S; Galgani, F; Gasparini, S; Giannakourou, A; Gomoiu, M-T; Gubanova, A; Gücü, A-C; Gürses, Ö; Hanke, G; Hatzianestis, I; Herut, B; Hone, R; Huertas, E; Irisson, J-O; İşinibilir, M; Jimenez, J A; Kalogirou, S; Kapiris, K; Karamfilov, V; Kavadas, S; Keskin, Ç; Kideyş, A E; Kocak, M; Kondylatos, G; Kontogiannis, C; Kosyan, R; Koubbi, P; Kušpilić, G; La Ferla, R; Langone, L; Laroche, S; Lazar, L; Lefkaditou, E; Lemeshko, I E; Machias, A; Malej, A; Mazzocchi, M-G; Medinets, V; Mihalopoulos, N; Miserocchi, S; Moncheva, S; Mukhanov, V; Oaie, G; Oros, A; Öztürk, A A; Öztürk, B; Panayotova, M; Prospathopoulos, A; Radu, G; Raykov, V; Reglero, P; Reygondeau, G; Rougeron, N; Salihoglu, B; Sanchez-Vidal, A; Sannino, G; Santinelli, C; Secrieru, D; Shapiro, G; Simboura, N; Shiganova, T; Sprovieri, M; Stefanova, K; Streftaris, N; Tirelli, V; Tom, M; Topaloğlu, B; Topçu, N E; Tsagarakis, K; Tsangaris, C; Tserpes, G; Tuğrul, S; Uysal, Z; Vasile, D; Violaki, K; Xu, J; Yüksek, A; Papathanassiou, E

2015-06-15

PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional research themes targeting research topics that are requested to the achievement of GES. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Bridging the research-practice gap: breaking new ground in health care.

PubMed

Mulhall, A

2001-08-01

Many theorists have discussed the existence of a gap between nursing research and practice. Consequently much time and effort has been expended in trying to devise strategies to bridge this divide. This article explores what the research-practice gap is and discusses five important reasons for it. The issue is then raised as to whether or not there is a gap between evidence and practice, despite the existence of the gap between research and practice. This is explored in relation to the potential conflict between the 'know how' knowledge important in practice and the 'know that' knowledge important in academia. Finally, the concept of practitioner-centred research is described as one strategy that would effectively obliterate the research-practice gap as it is currently conceived.

An eHealth Approach to Reporting Allergic Reactions to Food and Closing the Knowledge Gap.

PubMed

Munro, Christopher; Semic-Jusufagic, Aida; Pyrz, Katarzyna; Couch, Philip; Dunn-Galvin, Audrey; Peek, Niels; Themis, Marina; Mills, Clare; Buchan, Iain; Hourihane, Jonathan; Simpson, Angela

2015-01-01

There is an important knowledge gap in food allergy management in understanding the factors that determine allergic reactions to food, in gathering objective reports of reactions in real time, and in accessing patients' reaction-histories during consultations. We investigate how eHealth methods can close this knowledge gap. We report experiences with an online tool for reporting allergic reactions that we have developed as a web application. This application has been successfully validated by participants from Ireland and the UK, and is currently being used in a pilot where participants report allergic reactions in near-real time.

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

Jordan, Amy B.; Boukhalfa, Hakim; Caporuscio, Florie Andre

To gain confidence in the predictive capability of numerical models, experimental validation must be performed to ensure that parameters and processes are correctly simulated. The laboratory investigations presented herein aim to address knowledge gaps for heat-generating nuclear waste (HGNW) disposal in bedded salt that remain after examination of prior field and laboratory test data. Primarily, we are interested in better constraining the thermal, hydrological, and physicochemical behavior of brine, water vapor, and salt when moist salt is heated. The target of this work is to use run-of-mine (RoM) salt; however during FY2015 progress was made using high-purity, granular sodium chloride.

Specialized metabolites from the microbiome in health and disease

PubMed Central

Sharon, Gil; Garg, Neha; Debelius, Justine; Knight, Rob; Dorrestein, Pieter C.; Mazmanian, Sarkis K.

2015-01-01

The microbiota, and the genes that comprise its microbiome, play key roles in human health. Host-microbe interactions affect immunity, metabolism, development, and behavior, and dysbiosis of gut bacteria contributes to disease. Despite advances in correlating changes in the microbiota with various conditions, specific mechanisms of host-microbiota signaling remain largely elusive. We discuss the synthesis of microbial metabolites, their absorption, and potential physiological effects on the host. We propose that the effects of specialized metabolites may explain present knowledge gaps linking the gut microbiota to biological host mechanisms during initial colonization, and in health and disease. PMID:25440054

[Hypothyroidism during pregnancy risks the child's neurocognitive development. New guidelines and remaining knowledge gaps].

PubMed

Skalkidou, Alkistis; Bixo, Marie; Sköldebrand Sparre, Ann-Charlotte; Strandell, Annika; Lindén Hirschberg, Angelica; Filipsson Nyström, Helena

2016-02-05

Thyroid abnormalities are common during pregnancy and can affect pregnancy outcome. In 2012, the working group for endocrinology was assigned by SFOG to develop evidence based guidelines for their management. There is high quality evidence that untreated clinical hypothyroidism increases the risk of pregnancy and fetal complications. Subclinical hypothyroidism is associated with pregnancy complications. The presence of TPO-antibodies is linked to miscarriage and premature birth. It is uncertain whether subclinical hypothyroidism/maternal TPO-antibodies adversely affect the child's neurocognitive development. Reference intervals for TSH among pregnant women in Sweden need to be established.

Automatic Road Gap Detection Using Fuzzy Inference System

NASA Astrophysics Data System (ADS)

Hashemi, S.; Valadan Zoej, M. J.; Mokhtarzadeh, M.

2011-09-01

Automatic feature extraction from aerial and satellite images is a high-level data processing which is still one of the most important research topics of the field. In this area, most of the researches are focused on the early step of road detection, where road tracking methods, morphological analysis, dynamic programming and snakes, multi-scale and multi-resolution methods, stereoscopic and multi-temporal analysis, hyper spectral experiments, are some of the mature methods in this field. Although most researches are focused on detection algorithms, none of them can extract road network perfectly. On the other hand, post processing algorithms accentuated on the refining of road detection results, are not developed as well. In this article, the main is to design an intelligent method to detect and compensate road gaps remained on the early result of road detection algorithms. The proposed algorithm consists of five main steps as follow: 1) Short gap coverage: In this step, a multi-scale morphological is designed that covers short gaps in a hierarchical scheme. 2) Long gap detection: In this step, the long gaps, could not be covered in the previous stage, are detected using a fuzzy inference system. for this reason, a knowledge base consisting of some expert rules are designed which are fired on some gap candidates of the road detection results. 3) Long gap coverage: In this stage, detected long gaps are compensated by two strategies of linear and polynomials for this reason, shorter gaps are filled by line fitting while longer ones are compensated by polynomials.4) Accuracy assessment: In order to evaluate the obtained results, some accuracy assessment criteria are proposed. These criteria are obtained by comparing the obtained results with truly compensated ones produced by a human expert. The complete evaluation of the obtained results whit their technical discussions are the materials of the full paper.

Therapeutic drug monitoring of antithyroid drugs in pregnancy: the knowledge gaps.

PubMed

Koren, Gideon; Soldin, Offie

2006-02-01

Despite being a common condition in pregnancy, and despite propylthiouracil (PTU) being perceived as safer than methimazole, there are virtually no epidemiological controlled studies on malformation rate an neurobehavioral outcomes with the former. This knowledge gap must be filled to ensure fetal safety.

Gaps in college biology students' understanding of photosynthesis: Implications for human constructivist learning theory and college classroom practice

NASA Astrophysics Data System (ADS)

Griffard, Phyllis Baudoin

1999-11-01

The main research question of this study was: What gaps in biochemical understanding are revealed by a range of university introductory biology students as they work through a critically acclaimed multimedia program on photosynthesis, and what are the corresponding implications for elaboration of the Ausubel-Novak-Gowin Learning Theory (ANG, now Human Constructivism)? Twelve students, mixed for ability, gender and ethnicity, were recruited from two sections of "Bio 101." Before and after instruction in photosynthesis, in-depth clinical interviews were conducted during which participants completed a range of cognitive tasks such as sorting, concept mapping, explaining and predicting. Some tasks involved interacting with a computer simulation of photosynthesis. This study primarily employed qualitative case study and verbal analysis methods. Verbal analysis of the clinical interviews revealed numerous gaps that were categorized into typologies. The two major categories were propositional gaps and processing gaps. Propositional gaps were evident in development of participants' concepts, links and constructs. Significant among these were conceptual distance gaps and continuity of matter gaps. Gaps such as convention gaps and relative significance gaps seem to be due to naivete in the discipline. Processing gaps included gaps in graphic decoding skills and relevant cognitive habits such as self-monitoring and consulting prior knowledge. Although the gaps were easier to detect and isolate with the above-average participants, all participants showed evidence of at least some of these gaps. Since some gaps are not unexpected at all but the highest literacy levels, not all the gaps identified are to be considered deficiencies. The gaps identified support the attention given by ANG theorists to the role of prior knowledge and metacognition as well as the value of graphic organizers in knowledge construction. In addition, this study revealed numerous gaps in graphic decoding, indicating that both direct experience and explicit instruction are needed if students are to "learn how to learn with graphics," especially those graphics central to understanding a computer simulation's representations of structures, inputs, processes and outputs. It is hypothesized that gaps similar to those revealed in this study may be at the root of some alternative conceptions documented in the literature.

Mujer Sana, Familia Fuerte: The Effects of a Culturally-Relevant, Community-Based, Promotores Program to Increase Cervical Cancer Screening among Latinas.

PubMed

McDonough, A Manuela; Vargas, Marcela; Nguyen-Rodriguez, Selena; Garcia, Melawhy; Galvez, Gino; Rios-Ellis, Britt

2016-01-01

Although cervical cancer can be prevented through screening and follow-up, Latinas' rate of Pap tests remains low due to knowledge gaps and cultural and attitudinal factors. This study used a single-group pre-/post-test design to evaluate the effectiveness of Mujer Sana, Familia Fuerte (Healthy Woman, Strong Family), an intervention intended to improve Latinas' cervical cancer prevention knowledge, attitudes, self-efficacy to obtain a Pap test, and intention to get tested. The intervention is delivered through a single session by promotores de salud, who use a culturally competent, linguistically appropriate toolkit. A total of 5,211 Latinas participated in the study. The evaluation indicated that participants had increases in knowledge, positive attitudes, self-efficacy, and intention to test. Latinas have a low rate of cervical cancer screening but a high rate of cervical cancer, and Mujer Sana, Familia Fuerte shows promise as a public health practice for use with this population.

Mujer Sana, Familia Fuerte: The Effects of a Culturally-Relevant, Community-Based, Promotores Program to Increase Cervical Cancer Screening among Latinas

PubMed Central

McDonough, A. Manuela; Vargas, Marcela; Nguyen-Rodriguez, Selena; Garcia, Melawhy; Galvez, Gino; Rios-Ellis, Britt

2018-01-01

Objective Although cervical cancer can be prevented through screening and follow-up, Latinas’ rate of Pap tests remains low due to knowledge gaps and cultural and attitudinal factors. Methods This study used a single-group pre-/post-test design to evaluate the effectiveness of Mujer Sana, Familia Fuerte (Healthy Woman, Strong Family), an intervention intended to improve Latinas’ cervical cancer prevention knowledge, attitudes, self-efficacy to obtain a Pap test, and intention to get tested. The intervention is delivered through a single session by promotores de salud, who use a culturally competent, linguistically appropriate toolkit. A total of 5,211 Latinas participated in the study. Results The evaluation indicated that participants had increases in knowledge, positive attitudes, self-efficacy, and intention to test. Conclusion Latinas have a low rate of cervical cancer screening but a high rate of cervical cancer, and Mujer Sana, Familia Fuerte shows promise as a public health practice for use with this population. PMID:27180696

Advancements in Hydrology and Erosion Process Understanding and Post-Fire Hydrologic and Erosion Model Development for Semi-Arid Landscapes

NASA Astrophysics Data System (ADS)

Williams, C. Jason; Pierson, Frederick B.; Al-Hamdan, Osama Z.; Robichaud, Peter R.; Nearing, Mark A.; Hernandez, Mariano; Weltz, Mark A.; Spaeth, Kenneth E.; Goodrich, David C.

2017-04-01

Fire activity continues to increase in semi-arid regions around the globe. Private and governmental land management entities are challenged with predicting and mitigating post-fire hydrologic and erosion responses on these landscapes. For more than a decade, a team of scientists with the US Department of Agriculture has collaborated on extensive post-fire hydrologic field research and the application of field research to development of post-fire hydrology and erosion predictive technologies. Experiments funded through this research investigated the impacts of fire on vegetation and soils and the effects of these fire-induced changes on infiltration, runoff generation, erodibility, and soil erosion processes. The distribution of study sites spans diverse topography across grassland, shrubland, and woodland landscapes throughout the western United States. Knowledge gleaned from the extensive field experiments was applied to develop and enhance physically-based models for hillslope- to watershed-scale runoff and erosion prediction. Our field research and subsequent data syntheses have identified key knowledge gaps and challenges regarding post-fire hydrology and erosion modeling. Our presentation details some consistent trends across a diverse domain and varying landscape conditions based on our extensive field campaigns. We demonstrate how field data have advanced our understanding of post-fire hydrology and erosion for semi-arid landscapes and highlight remaining key knowledge gaps. Lastly, we briefly show how our well-replicated experimental methodologies have contributed to advancements in hydrologic and erosion model development for the post-fire environment.

Key barriers to gout care: a systematic review and thematic synthesis of qualitative studies.

PubMed

Rai, Sharan K; Choi, Hyon K; Choi, Sally H J; Townsend, Anne F; Shojania, Kam; De Vera, Mary A

2018-04-17

Gout care remains highly suboptimal, contributing to an increased global disease burden. To understand barriers to gout care, our aim was to provide a systematic review and thematic synthesis of qualitative studies worldwide reporting provider and patient perspectives and experiences with management. We conducted a mapped search of MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Social Sciences Citation Index databases and selected qualitative studies of provider and patient perspectives on gout management. We used thematic synthesis to combine the included studies and identify key themes across studies. We included 20 studies that reported the experiences and perspectives of 480 gout patients and 120 providers spanning five different countries across three continents. We identified three predominant provider themes: knowledge gaps and management approaches; perceptions and beliefs about gout patients; and system barriers to optimal gout care (e.g. time constraints and a lack of incentives). We also identified four predominant themes among gout patients: limited gout knowledge; interactions with health-care providers; attitudes towards and experiences with taking medication; and practical barriers to long-term medication use. Our systematic review of worldwide literature consistently identified gaps in gout knowledge among providers, which is likely to contribute to patients' lack of appropriate education about the fundamental causes of and essential treatment approaches for gout. Furthermore, system barriers among providers and day-to-day challenges of taking long-term medications among patients are considerable. These factors provide key targets to improve the widespread suboptimal gout care.

Aerosol-Radiation-Cloud Interactions in the South-East Atlantic: Future Suborbital Activities to Address Knowledge Gaps in Satellite and Model Assessments

NASA Technical Reports Server (NTRS)

Redemann, Jens; Wood, R.; Zuidema, P.; Haywood, J.; Piketh, S.; Formenti, P.; L'Ecuyer, T.; Kacenelenbogen, M.; Segal-Rosenheimer, M.; Shinozuka, Y.;

Aerosol-Radiation-Cloud Interactions in the South-East Atlantic: Future Suborbital Activities to Address Knowledge Gaps in Satellite and Model Assessments

NASA Astrophysics Data System (ADS)

Redemann, J.; Wood, R.; Zuidema, P.; Haywood, J. M.; Piketh, S.; Formenti, P.; L'Ecuyer, T. S.; Kacenelenbogen, M. S.; Segal-Rosenhaimer, M.; Shinozuka, Y.; LeBlanc, S. E.; Vaughan, M. A.; Schmidt, S.; Flynn, C. J.; Song, S.; Schmid, B.; Luna, B.; Abel, S.

2015-12-01

Southern Africa produces almost a third of the Earth's biomass burning (BB) aerosol particles. Particles lofted into the mid-troposphere are transported westward over the South-East (SE) Atlantic, home to one of the three permanent subtropical stratocumulus (Sc) cloud decks in the world. The SE Atlantic stratocumulus deck interacts with the dense layers of BB aerosols that initially overlay the cloud deck, but later subside and may mix into the clouds. These interactions include adjustments to aerosol-induced solar heating and microphysical effects, and their global representation in climate models remains one of the largest uncertainties in estimates of future climate. Hence, new observations over the SE Atlantic have significant implications for global climate change scenarios. Our understanding of aerosol-cloud interactions in the SE Atlantic is hindered both by the lack of knowledge on aerosol and cloud properties, as well as the lack of knowledge about detailed physical processes involved. Most notably, we are missing knowledge on the absorptive and cloud nucleating properties of aerosols, including their vertical distribution relative to clouds, on the locations and degree of aerosol mixing into clouds, on the processes that govern cloud property adjustments, and on the importance of aerosol effects on clouds relative to co-varying synoptic scale meteorology. We discuss the current knowledge of aerosol and cloud property distributions based on satellite observations and sparse suborbital sampling. Recent efforts to make full use of A-Train aerosol sensor synergies will be highlighted. We describe planned field campaigns in the region to address the existing knowledge gaps. Specifically, we describe the scientific objectives and implementation of the five synergistic, international research activities aimed at providing some of the key aerosol and cloud properties and a process-level understanding of aerosol-cloud interactions over the SE Atlantic: NASA's ORACLES, the UK Met Office's CLARIFY-2016, the DoE's LASIC, NSF's ONFIRE, and CNRS' AEROCLO-SA.

Bedform development and morphodynamics in mixed cohesive sediment substrates: the importance of winnowing and flocculation

NASA Astrophysics Data System (ADS)

Ye, Leiping; Parsons, Daniel; Manning, Andrew

2016-04-01

There remains a lack of process-based knowledge of sediment dynamics within flows over bedforms generated in complex mixtures of cohesionless sand and biologically-active cohesive muds in natural estuarine flow systems. The work to be presented forms a part of the UK NERC "COHesive BEDforms (COHBED)" project which aims to fill this gap in knowledge. Herein results from a field survey in sub-tidal zone of Dee estuary (NW, England) and a set of large-scale laboratory experiments, conducted using mixtures of non-cohesive sands, cohesive muds and Xanthan gum (as a proxy for the biological stickiness of Extracellular Polymeric Substances (EPS)) will be presented. The results indicate the significance of biological-active cohesive sediments in controlling winnowing rates and flocculation dynamics, which contributes significantly to rates of bedform evolution.

Factors Associated with Adherence to Follow-up Colposcopy

ERIC Educational Resources Information Center

Fish, Laura J.; Moorman, Patricia G.; Wordlaw-Stintson, Lashawn; Vidal, Adriana; Smith, Jennifer S.; Hoyo, Cathrine

2013-01-01

Background: Understanding the gaps in knowledge about human papilloma virus (HPV) infection, transmission, and health consequences and factors associated with the knowledge gap is an essential first step for the development of interventions to improve adherence to follow-up among women with abnormal Pap smears. Purpose: To examine the relationship…

Educational Online Technologies in Blended Tertiary Environments: Experts' Perspectives

ERIC Educational Resources Information Center

Tuapawa, Kimberley

2017-01-01

Although educational online technologies (EOTs) present an extraordinary range of higher education opportunities, significant gaps in knowledge about their purpose and functionality may impede levels of adoption. As the demand for online learning grows, it is critical that tertiary education institutes (TEIs) address gaps in knowledge by…

Seahorses in focus: local ecological knowledge of seahorse-watching operators in a tropical estuary.

PubMed

Ternes, Maria L F; Gerhardinger, Leopoldo C; Schiavetti, Alexandre

2016-11-08

Seahorses are endangered teleost fishes under increasing human pressures worldwide. In Brazil, marine conservationists and policy-makers are thus often skeptical about the viability of sustainable human-seahorse interactions. This study focuses on local ecological knowledge on seahorses and the implications of their non-lethal touristic use by a coastal community in northeastern Brazil. Community-based seahorse-watching activities have been carried out in Maracaípe village since 1999, but remained uninvestigated until the present study. Our goal is to provide ethnoecological understanding on this non-extractive use to support seahorse conservation and management. We interviewed 32 informants through semi-structured questionnaires to assess their socioeconomic profile, their knowledge on seahorse natural history traits, human uses, threats and abundance trends. Seahorse-watching has high socioeconomic relevance, being the primary income source for all respondents. Interviewees elicited a body of knowledge on seahorse biology largely consistent with up-to-date research literature. Most informants (65.5 %) perceived no change in seahorse abundance. Their empirical knowledge often surpassed scientific reports, i.e. through remarks on trophic ecology; reproductive aspects, such as, behavior and breeding season; spatial and temporal distribution, suggesting seahorse migration related to environmental parameters. Seahorse-watching operators were aware of seahorse biological and ecological aspects. Despite the gaps remaining on biological data about certain seahorse traits, the respondents provided reliable information on all questions, adding ethnoecological remarks not yet assessed by conventional scientific surveys. We provide novel ethnobiological insight on non-extractive modes of human-seahorse interaction, eliciting environmental policies to integrate seahorse conservation with local ecological knowledge and innovative ideas for seahorse sustainable use. Our study resonates with calls for more active engagement with communities and their local ecologies if marine conservation and development are to be reconciled.

Knowledge, attitudes and practices on Schistosomiasis in sub-Saharan Africa: a systematic review.

PubMed

Sacolo, Hlengiwe; Chimbari, Moses; Kalinda, Chester

2018-01-18

Schistosomiasis remains a global health problem with an estimated 250 million people in 78 countries infected, of whom 85% live in Sub-Saharan Africa. Preventive chemotherapy remains the key public health strategy to combat schistosomiasis worldwide. Recently the WHO emphasized on the use of integrative approaches in the control and elimination of schistosomiasis. However, a detailed understanding of sociocultural factors that may influence the uptake of the intended health activities and services is vital. Thus, our study sought to understand the knowledge, attitudes, perceptions, beliefs and practices about schistosomiasis in various communities in Sub-Saharan Africa. A systematic search of literature for the period 2006-2016 was done on Medline, PubMed, CINAHL, Psych info and Google Scholar using the following key words "Schistosomiasis, S. mansoni, S. haematobium, knowledge, attitudes, perceptions, beliefs and practices in Sub-Saharan Africa" in combination with Bolean operators (OR, AND). In this context, we reviewed studies conducted among school children, community members and caregivers of preschool children. Thematic analysis was utilised for the overall synthesis of the selected studies. This was done after reading the articles in depth. Themes were identified and examined for similarities, differences and contradictions. Gaps in schistosomiasis related knowledge and sociocultural barriers towards the uptake of preventive and treatment services among communities in Sub-Saharan Africa were identified. In addition to limited knowledge and negative attitudes, risky water related practices among community members, school children and caregivers of preschool children were identified as key factors promoting transmission of the disease. The study concluded that a comprehensive health education programme using contextual and standardised training tools may improve peoples' knowledge, attitudes and practices in relation to schistosomiasis prevention and control. Findings also highlight the significance of including caregivers in the planning and implementation schistosomiasis control programs targeting pre-school children.

Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.

PubMed

Kiviniemi, Marc T; Orom, Heather; Waters, Erika A; McKillip, Megan; Hay, Jennifer L

2018-05-01

Risk perception is a key determinant of preventive health behaviour, but when asked, some individuals indicate they do not know their health risk. Low education is associated with both lack of knowledge about health risk and with the persistence and exacerbation of gaps in knowledge about health issues. This study uses the context of an emerging infectious disease threat to explore the hypothesis that the education-don't know risk relation results from differences in knowledge about the health issue of interest. Specifically, we examine whether patterns of change over time follow theoretical predictions that disparities in risk knowledge would increase over time in less educated sectors of the population (knowledge gap hypothesis). Secondary analysis of population-representative behavioural surveillance survey. We analysed data from the 1993 to 2000 Behavior Risk Factor Surveillance System surveys, which measured education and perceived HIV/AIDS risk in a population sample collected separately in each survey year; don't know responses were coded. In each year, individuals with higher education were less likely to respond don't know. The absolute prevalence of don't know responding dropped over time; nonetheless, there was an increase over time in the magnitude of the pattern of lower education being associated with greater don't know responding. We found support for the knowledge gap hypothesis. Over time, populations with greater education gained more knowledge about their HIV risk than populations with lower education. Results highlight the need to carefully consider health communication strategies to reach and address those individuals with low education and health knowledge. Statement of contribution What is already known on this subject? A meaningful potion of the population answers 'don't know' when asked to report their risk for health problems, indicating a lack of risk perception in the domain. Previous studies have shown that level of education is associated with don't know responding - those with lower educational attainment are more likely to respond don't know. The education-don't know responding relation suggests that lack of health information and health domain knowledge might be a factor in lacking risk perception, but this mechanism has not been previously tested. What does this study add? Patterns of changes in don't know responding over time as population-level knowledge of a health risk increase are consistent with the health information/health knowledge hypothesis outlined above. As population knowledge of HIV/AIDS risk in the United States increased over time (indicated by declining overall rates of don't know responses), the relation of education level to don't know responding actually became stronger. The pattern of change over time is the classic 'knowledge gap hypothesis' pattern, which has not been previously demonstrated for knowledge of personal health risk. The knowledge gap response pattern supports the health information/health knowledge hypothesis. © 2018 The British Psychological Society.

Designing Therapeutic Clinical Trials for Older and Frail Adults With Cancer: U13 Conference Recommendations

PubMed Central

Hurria, Arti; Dale, William; Mooney, Margaret; Rowland, Julia H.; Ballman, Karla V.; Cohen, Harvey J.; Muss, Hyman B.; Schilsky, Richard L.; Ferrell, Betty; Extermann, Martine; Schmader, Kenneth E.; Mohile, Supriya G.

2014-01-01

A majority of cancer diagnoses and deaths occur in patients age ≥ 65 years. With the aging of the US population, the number of older adults with cancer will grow. Although the coming wave of older patients with cancer was anticipated in the early 1980s, when the need for more research on the cancer-aging interface was recognized, many knowledge gaps remain when it comes to treating older and/or frailer patients with cancer. Relatively little is known about the best way to balance the risks and benefits of existing cancer therapies in older patients; however, these patients continue to be underrepresented in clinical trials. Furthermore, the available clinical trials often do not include end points pertinent to the older adult population, such as preservation of function, cognition, and independence. As part of its ongoing effort to advance research in the field of geriatric oncology, the Cancer and Aging Research Group held a conference in November 2012 in collaboration with the National Cancer Institute, the National Institute on Aging, and the Alliance for Clinical Trials in Oncology. The goal was to develop recommendations and establish research guidelines for the design and implementation of therapeutic clinical trials for older and/or frail adults. The conference sought to identify knowledge gaps in cancer clinical trials for older adults and propose clinical trial designs to fill these gaps. The ultimate goal of this conference series is to develop research that will lead to evidence-based care for older and/or frail adults with cancer. PMID:25071116

Knowledge translation of research findings

PubMed Central

2012-01-01

Background One of the most consistent findings from clinical and health services research is the failure to translate research into practice and policy. As a result of these evidence-practice and policy gaps, patients fail to benefit optimally from advances in healthcare and are exposed to unnecessary risks of iatrogenic harms, and healthcare systems are exposed to unnecessary expenditure resulting in significant opportunity costs. Over the last decade, there has been increasing international policy and research attention on how to reduce the evidence-practice and policy gap. In this paper, we summarise the current concepts and evidence to guide knowledge translation activities, defined as T2 research (the translation of new clinical knowledge into improved health). We structure the article around five key questions: what should be transferred; to whom should research knowledge be transferred; by whom should research knowledge be transferred; how should research knowledge be transferred; and, with what effect should research knowledge be transferred? Discussion We suggest that the basic unit of knowledge translation should usually be up-to-date systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting), and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge translation strategy is informed by an assessment of the likely barriers and facilitators. Although our evidence on the likely effectiveness of different strategies to overcome specific barriers remains incomplete, there is a range of informative systematic reviews of interventions aimed at healthcare professionals and consumers (i.e., patients, family members, and informal carers) and of factors important to research use by policy makers. Summary There is a substantial (if incomplete) evidence base to guide choice of knowledge translation activities targeting healthcare professionals and consumers. The evidence base on the effects of different knowledge translation approaches targeting healthcare policy makers and senior managers is much weaker but there are a profusion of innovative approaches that warrant further evaluation. PMID:22651257

Molecular Mechanotransduction: how forces trigger cytoskeletal dynamics

NASA Astrophysics Data System (ADS)

Ehrlicher, Allen

2012-02-01

Mechanical stresses elicit cellular reactions mediated by chemical signals. Defective responses to forces underlie human medical disorders, such as cardiac failure and pulmonary injury. Despite detailed knowledge of the cytoskeleton's structure, the specific molecular switches that convert mechanical stimuli into chemical signals have remained elusive. Here we identify the actin-binding protein, filamin A (FLNa) as a central mechanotransduction element of the cytoskeleton by using Fluorescence Loss After photoConversion (FLAC), a novel high-speed alternative to FRAP. We reconstituted a minimal system consisting of actin filaments, FLNa and two FLNa-binding partners: the cytoplasmic tail of ß-integrin, and FilGAP. Integrins form an essential mechanical linkage between extracellular and intracellular environments, with ß integrin tails connecting to the actin cytoskeleton by binding directly to filamin. FilGAP is a FLNa-binding GTPase-activating protein specific for Rac, which in vivo regulates cell spreading and bleb formation. We demonstrate that both externally-imposed bulk shear and myosin II driven forces differentially regulate the binding of integrin and FilGAP to FLNa. Consistent with structural predictions, strain increases ß-integrin binding to FLNa, whereas it causes FilGAP to dissociate from FLNa, providing a direct and specific molecular basis for cellular mechanotransduction. These results identify the first molecular mechanotransduction element within the actin cytoskeleton, revealing that mechanical strain of key proteins regulates the binding of signaling molecules. Moreover, GAP activity has been shown to switch cell movement from mesenchymal to amoeboid motility, suggesting that mechanical forces directly impact the invasiveness of cancer.

Impact of simple conventional and Telehealth solutions on improving mental health in Afghanistan.

PubMed

Khoja, Shariq; Scott, Richard; Husyin, Nida; Durrani, Hammad; Arif, Maria; Faqiri, Faqir; Hedayat, Ebadullah; Yousufzai, Wahab

2016-12-01

For more than a century Afghanistan has been unstable, facing decades of war, social problems, and intense poverty. As a result, many of the population suffer from a variety of mental health problems. The Government recognises the situation and has prioritised mental health, but progress is slow and services outside of Kabul remain poor. An international collaborative implemented a project in Badakshan province of Afghanistan using conventional and simple low-cost e-Health solutions to address the four most common issues: depression, psychosis, post-traumatic stress disorder, and substance abuse. Conventional town hall meetings informed community members to raise awareness and knowledge. In addition, an android-based mobile application used the World Health Organization's Mental Health Gap Action Programme guidelines and protocols to: collect information from community healthcare workers; provide referral services to patients; provide blended learning to improve providers' mental health knowledge, skills, and practice; and to provide store-and-forward and live consultations. Preliminary evaluation of the intervention shows enhanced access to care for remote communities, decreased stigma, and improved quality of health services. Primary care workers are also able to bridge the gap in consultations for rural and remote communities, connecting them with specialists and providing better access to care. © The Author(s) 2016.

Systematically evaluating read-across prediction and ...

EPA Pesticide Factsheets

Read-across is a popular data gap filling technique within category and analogue approaches for regulatory purposes. Acceptance of read-across remains an ongoing challenge with several efforts underway for identifying and addressing uncertainties. Here we demonstrate an algorithmic, automated approach to evaluate the utility of using in vitro bioactivity data (“bioactivity descriptors”, from EPA’s ToxCast program) in conjunction with chemical descriptor information to derive local validity domains (specific sets of nearest neighbors) to facilitate read-across for a number of in vivo repeated dose toxicity study types. Over 3400 different chemical structure descriptors were generated for a set of 976 chemicals and supplemented with the outcomes from 821 in vitro assays. The read-across prediction for a given chemical was based on the similarity weighted endpoint outcomes of its nearest neighbors. The approach enabled a performance baseline for read-across predictions of specific study outcomes to be established. Bioactivity descriptors were often found to be more predictive of in vivo toxicity outcomes than chemical descriptors or a combination of both. The approach shows promise as part of a screening assessment in the absence of prior knowledge. Future work will investigate to what extent encoding expert knowledge leads to an improvement in read-across prediction. Read-across is a popular data gap filling technique within category and analogue approaches

Domesticated animals as hosts of henipaviruses and filoviruses: A systematic review.

PubMed

Glennon, Emma E; Restif, Olivier; Sbarbaro, Silke Riesle; Garnier, Romain; Cunningham, Andrew A; Suu-Ire, Richard D; Osei-Amponsah, Richard; Wood, James L N; Peel, Alison J

2018-03-01

Bat-borne viruses carry undeniable risks to the health of human beings and animals, and there is growing recognition of the need for a 'One Health' approach to understand their frequently complex spill-over routes. While domesticated animals can play central roles in major spill-over events of zoonotic bat-borne viruses, for example during the pig-amplified Malaysian Nipah virus outbreak of 1998-1999, the extent of their potential to act as bridging or amplifying species for these viruses has not been characterised systematically. This review aims to compile current knowledge on the role of domesticated animals as hosts of two types of bat-borne viruses, henipaviruses and filoviruses. A systematic literature search of these virus-host interactions in domesticated animals identified 72 relevant studies, which were categorised by year, location, design and type of evidence generated. The review then focusses on Africa as a case study, comparing research efforts in domesticated animals and bats with the distributions of documented human cases. Major gaps remain in our knowledge of the potential ability of domesticated animals to contract or spread these zoonoses. Closing these gaps will be necessary to fully evaluate and mitigate spill-over risks of these viruses, especially with global agricultural intensification. Copyright © 2017 Elsevier Ltd. All rights reserved.

Locating relevant patient information in electronic health record data using representations of clinical concepts and database structures.

PubMed

Pan, Xuequn; Cimino, James J

2014-01-01

Clinicians and clinical researchers often seek information in electronic health records (EHRs) that are relevant to some concept of interest, such as a disease or finding. The heterogeneous nature of EHRs can complicate retrieval, risking incomplete results. We frame this problem as the presence of two gaps: 1) a gap between clinical concepts and their representations in EHR data and 2) a gap between data representations and their locations within EHR data structures. We bridge these gaps with a knowledge structure that comprises relationships among clinical concepts (including concepts of interest and concepts that may be instantiated in EHR data) and relationships between clinical concepts and the database structures. We make use of available knowledge resources to develop a reproducible, scalable process for creating a knowledge base that can support automated query expansion from a clinical concept to all relevant EHR data.

ROSS Skills, Knowledge, and Abilities Training Evaluation. Gaps and Recommendations

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

Ala, Maureen; Gruidl, Jeremiah; Buddemeier, Brooke

2015-09-30

This document describes the development of the ROSS SKAs, the cross-mapping of the SKAs to the available training, identifies gaps in the SKA and training, and provides recommendations to address those gaps.

Novel methodologies in marine fish larval nutrition.

PubMed

Conceição, Luis E C; Aragão, Cláudia; Richard, Nadège; Engrola, Sofia; Gavaia, Paulo; Mira, Sara; Dias, Jorge

2010-03-01

Major gaps in knowledge on fish larval nutritional requirements still remain. Small larval size, and difficulties in acceptance of inert microdiets, makes progress slow and cumbersome. This lack of knowledge in fish larval nutritional requirements is one of the causes of high mortalities and quality problems commonly observed in marine larviculture. In recent years, several novel methodologies have contributed to significant progress in fish larval nutrition. Others are emerging and are likely to bring further insight into larval nutritional physiology and requirements. This paper reviews a range of new tools and some examples of their present use, as well as potential future applications in the study of fish larvae nutrition. Tube-feeding and incorporation into Artemia of (14)C-amino acids and lipids allowed studying Artemia intake, digestion and absorption and utilisation of these nutrients. Diet selection by fish larvae has been studied with diets containing different natural stable isotope signatures or diets where different rare metal oxides were added. Mechanistic modelling has been used as a tool to integrate existing knowledge and reveal gaps, and also to better understand results obtained in tracer studies. Population genomics may assist in assessing genotype effects on nutritional requirements, by using progeny testing in fish reared in the same tanks, and also in identifying QTLs for larval stages. Functional genomics and proteomics enable the study of gene and protein expression under various dietary conditions, and thereby identify the metabolic pathways which are affected by a given nutrient. Promising results were obtained using the metabolic programming concept in early life to facilitate utilisation of certain nutrients at later stages. All together, these methodologies have made decisive contributions, and are expected to do even more in the near future, to build a knowledge basis for development of optimised diets and feeding regimes for different species of larval fish.

Review of key knowledge gaps in glucose-6-phosphate dehydrogenase deficiency detection with regard to the safe clinical deployment of 8-aminoquinoline treatment regimens: a workshop report.

PubMed

von Seidlein, Lorenz; Auburn, Sarah; Espino, Fe; Shanks, Dennis; Cheng, Qin; McCarthy, James; Baird, Kevin; Moyes, Catherine; Howes, Rosalind; Ménard, Didier; Bancone, Germana; Winasti-Satyahraha, Ari; Vestergaard, Lasse S; Green, Justin; Domingo, Gonzalo; Yeung, Shunmay; Price, Ric

2013-03-27

The diagnosis and management of glucose-6-phosphate dehydrogenase (G6PD) deficiency is a crucial aspect in the current phases of malaria control and elimination, which will require the wider use of 8-aminoquinolines for both reducing Plasmodium falciparum transmission and achieving the radical cure of Plasmodium vivax. 8-aminoquinolines, such as primaquine, can induce severe haemolysis in G6PD-deficient individuals, potentially creating significant morbidity and undermining confidence in 8-aminoquinoline prescription. On the other hand, erring on the side of safety and excluding large numbers of people with unconfirmed G6PD deficiency from treatment with 8-aminoquinolines will diminish the impact of these drugs. Estimating the remaining G6PD enzyme activity is the most direct, accessible, and reliable assessment of the phenotype and remains the gold standard for the diagnosis of patients who could be harmed by the administration of primaquine. Genotyping seems an unambiguous technique, but its use is limited by cost and the large range of recognized G6PD genotypes. A number of enzyme activity assays diagnose G6PD deficiency, but they require a cold chain, specialized equipment, and laboratory skills. These assays are impractical for care delivery where most patients with malaria live. Improvements to the diagnosis of G6PD deficiency are required for the broader and safer use of 8-aminoquinolines to kill hypnozoites, while lower doses of primaquine may be safely used to kill gametocytes without testing. The discussions and conclusions of a workshop conducted in Incheon, Korea in May 2012 to review key knowledge gaps in G6PD deficiency are reported here.

Review of key knowledge gaps in glucose-6-phosphate dehydrogenase deficiency detection with regard to the safe clinical deployment of 8-aminoquinoline treatment regimens: a workshop report

PubMed Central

2013-01-01

The diagnosis and management of glucose-6-phosphate dehydrogenase (G6PD) deficiency is a crucial aspect in the current phases of malaria control and elimination, which will require the wider use of 8-aminoquinolines for both reducing Plasmodium falciparum transmission and achieving the radical cure of Plasmodium vivax. 8-aminoquinolines, such as primaquine, can induce severe haemolysis in G6PD-deficient individuals, potentially creating significant morbidity and undermining confidence in 8-aminoquinoline prescription. On the other hand, erring on the side of safety and excluding large numbers of people with unconfirmed G6PD deficiency from treatment with 8-aminoquinolines will diminish the impact of these drugs. Estimating the remaining G6PD enzyme activity is the most direct, accessible, and reliable assessment of the phenotype and remains the gold standard for the diagnosis of patients who could be harmed by the administration of primaquine. Genotyping seems an unambiguous technique, but its use is limited by cost and the large range of recognized G6PD genotypes. A number of enzyme activity assays diagnose G6PD deficiency, but they require a cold chain, specialized equipment, and laboratory skills. These assays are impractical for care delivery where most patients with malaria live. Improvements to the diagnosis of G6PD deficiency are required for the broader and safer use of 8-aminoquinolines to kill hypnozoites, while lower doses of primaquine may be safely used to kill gametocytes without testing. The discussions and conclusions of a workshop conducted in Incheon, Korea in May 2012 to review key knowledge gaps in G6PD deficiency are reported here. PMID:23537118

Primary Health Care Providers' Knowledge Gaps on Parkinson's Disease

ERIC Educational Resources Information Center

Thompson, Megan R.; Stone, Ramona F.; Ochs, V. Dan; Litvan, Irene

2013-01-01

In order to determine primary health care providers' (PCPs) knowledge gaps on Parkinson's disease, data were collected before and after a one-hour continuing medical education (CME) lecture on early Parkinson's disease recognition and treatment from a sample of 104 PCPs participating at an annual meeting. The main outcome measure was the…

Knowledge Gained from Good Agricultural Practices Courses for Iowa Growers

ERIC Educational Resources Information Center

Shaw, Angela; Strohbehn, Catherine; Naeve, Linda; Domoto, Paul; Wilson, Lester

2015-01-01

Good Agricultural Practices (GAP) educational courses provide produce growers with the fundamental information for producing and processing safe produce. To determine the effectiveness of the current 7-hour GAP course provided in Iowa, growers were surveyed before and 7-14 days after the course to determine changes in knowledge and opinions.…

Knowledge Gaps Impacting the Development of Bovine Viral Diarrhea Virus Control Programs in the United States

USDA-ARS?s Scientific Manuscript database

This paper identifies knowledge gaps that impact on the design of programs to control and or eradicate bovine viral diarrhea viruses (BVDV) in the United States. Currently there are several voluntary regional BVDV control programs in place. These control programs are aimed at the removal of animals ...

Beyond Knowledge Gaps: Examining Socioeconomic Differences in Response to Cancer News

ERIC Educational Resources Information Center

Niederdeppe, Jeff

2008-01-01

This article tested a model, informed by the knowledge gap hypothesis, to predict information seeking about cancer immediately following news about the diagnosis or death from cancer of a national celebrity. I identified five celebrity news events and examined their impact using data from the 2005 Health Information National Trends Survey. News…

Mental Models Research to Inform Community Outreach for a Campus Recycling Program

ERIC Educational Resources Information Center

Olson, Lauren; Arvai, Joseph; Thorp, Laurie

2011-01-01

Purpose: The purpose of this paper is to develop a better understanding of the state of knowledge of students and faculty on the Michigan State University (MSU) campus; identify relevant gaps in knowledge and misconceptions about recycling; and provide recommendations regarding how these gaps and misconceptions may be addressed through education…

Knowledge Management Practices and Enablers in Public Universities: A Gap Analysis

ERIC Educational Resources Information Center

Ramachandran, Sharimllah Devi; Chong, Siong-Choy; Wong, Kuan-Yew

2013-01-01

Purpose: The purpose of this paper is to examine the gap between knowledge management (KM) practices and key strategic enablers in public universities. For this purpose, a 57-item survey on two dimensions--"use" and "importance"--was used as the instrument for this study. Design/methodology/approach: The questionnaire was…

Knowledge gaps among public librarians seeking vaccination information: A qualitative study

PubMed Central

Smith, Catherine Arnott; Hundal, Savreen; Keselman, Alla

2014-01-01

Public libraries have been called the “first responders” to the specialized health information needs of the general public. The challenges inherent in consumer health information (CHI) service are centered around the Patron, the Librarian, the Information Resources, and the Library itself. The pilot study involved interviews with nine individual library workers in eight public libraries in four library systems: the District of Columbia, Montgomery and Prince George’s Counties in Maryland, and Fairfax County in Virginia. Library workers were asked about common consumer health information requests, the nature of their collections, and the role of public libraries in meeting these information needs. The subjects were also presented with a hypothetical scenario, and their responses suggest knowledge gaps. The findings point to the increasing necessity and importance of training and support for public librarians, as well as the importance of understanding where the medical knowledge gaps exist. Public librarians need to commit to formal evaluation of their skill sets and knowledge gaps, in order to identify areas to which libraries can devote limited resources. PMID:26550002

Closing the Knowledge Gap on Effective Professional Development

ERIC Educational Resources Information Center

Guskey, Thomas R.

2009-01-01

Achievement gaps concern educators at all levels today. Educators recognize the threats these gaps pose to education quality and equity, and they are working hard to close them--but an equally threatening gap in education with consequences just as serious is largely ignored. It influences every educational-improvement effort and seriously…

AN EVALUATION OF HANFORD SITE TANK FARM SUBSURFACE CONTAMINATION FY2007

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

MANN, F.M.

2007-07-10

The Tank Farm Vadose Zone (TFVZ) Project conducts activities to characterize and analyze the long-term environmental and human health impacts from tank waste releases to the vadose zone. The project also implements interim measures to mitigate impacts, and plans the remediation of waste releases from tank farms and associated facilities. The scope of this document is to report data needs that are important to estimating long-term human health and environmental risks. The scope does not include technologies needed to remediate contaminated soils and facilities, technologies needed to close tank farms, or management and regulatory decisions that will impact remediation andmore » closure. This document is an update of ''A Summary and Evaluation of Hanford Site Tank Farm Subsurface Contamination''. That 1998 document summarized knowledge of subsurface contamination beneath the tank farms at the time. It included a preliminary conceptual model for migration of tank wastes through the vadose zone and an assessment of data and analysis gaps needed to update the conceptual model. This document provides a status of the data and analysis gaps previously defined and discussion of the gaps and needs that currently exist to support the stated mission of the TFVZ Project. The first data-gaps document provided the basis for TFVZ Project activities over the previous eight years. Fourteen of the nineteen knowledge gaps identified in the previous document have been investigated to the point that the project defines the current status as acceptable. In the process of filling these gaps, significant accomplishments were made in field work and characterization, laboratory investigations, modeling, and implementation of interim measures. The current data gaps are organized in groups that reflect Components of the tank farm vadose zone conceptual model: inventory, release, recharge, geohydrology, geochemistry, and modeling. The inventory and release components address residual wastes that will remain in the tanks and tank-farm infrastructure after closure and potential losses from leaks during waste retrieval. Recharge addresses the impacts of current conditions in the tank farms (i.e. gravel covers that affect infiltration and recharge) as well as the impacts of surface barriers. The geohydrology and geochemistry components address the extent of the existing subsurface contaminant inventory and drivers and pathways for contaminants to be transported through the vadose zone and groundwater. Geochemistry addresses the mobility of key reactive contaminants such as uranium. Modeling addresses conceptual models and how they are simulated in computers. The data gaps will be used to provide input to planning (including the upcoming C Farm Data Quality Objective meetings scheduled this year).« less

The developmental origins of fairness: the knowledge-behavior gap.

PubMed

Blake, Peter R; McAuliffe, Katherine; Warneken, Felix

2014-11-01

Recent research in developmental psychology shows that children understand several principles of fairness by 3 years of age, much earlier than previously believed. However, children's knowledge of fairness does not always align with their behavior, and immediate self-interest alone cannot explain this gap. In this forum paper, we consider two factors that influence the relation between fairness knowledge and behavior: relative advantage and how rewards are acquired. Copyright © 2014 Elsevier Ltd. All rights reserved.

Determining the ’Gap’

DTIC Science & Technology

2009-05-01

Army training doctrine, and by adjusting the curriculum of the officer core in order to close the knowledge gap . The author closes by concluding...fight. The research to find these gaps begins with a process trace of doctrine from 1976 to the present, starting with the advent of Active Defense...discovering the one gap , three were found. Upon further examination below, even these initially perceived gaps dissipate under close scrutiny. Gap

ExMC Technology Watch

NASA Technical Reports Server (NTRS)

Krihak, M.; Watkins, S.; Fung, Paul P.

2013-01-01

The Technology Watch (Tech Watch) project is a NASA project that is operated under the Human Research Programs (HRP) Exploration Medical Capability (ExMC) element, and focuses on ExMC technology gaps. The project coordinates the efforts of several NASA centers, including the Johnson Space Center (JSC), Glenn Research Center (GRC), Ames Research Center (ARC), and the Langley Research Center (LaRC). The objective of Tech Watch is to identify emerging, high-impact technologies that augment current NASA HRP technology development efforts. Identifying such technologies accelerates the development of medical care and research capabilities for the mitigation of potential health issues encountered during human space exploration missions. The aim of this process is to leverage technologies developed by academia, industry and other government agencies and to identify the effective utilization of NASA resources to maximize the HRP return on investment. The establishment of collaborations with these entities is beneficial to technology development, assessment and/or insertion and further NASAs goal to provide a safe and healthy environment for human exploration. In 2012, the Tech Watch project expanded the scope of activities to cultivate student projects targeted at specific ExMC gaps, generate gap reports for a majority of the ExMC gaps and maturate a gap report review process to optimize the technical and managerial aspects of ExMC gap status. Through numerous site visits and discussions with academia faculty, several student projects were initiated and/or completed this past year. A key element to these student projects was the ability of the project to align with a specific ExMC technology or knowledge gap. These projects were mentored and reviewed by Tech Watch leads at the various NASA centers. Another result of the past years efforts was the population of the ExMC wiki website that now contains more the three quarters of the ExMC gap reports. The remaining gap reports will be completed in FY13. Finally, the gap report review process for all ExMC gaps was initiated. This review process was instrumental in ensuring that each gap report was thoroughly reviewed for accuracy and relevant content prior to its public release. In the upcoming year, the gap report review process will be refined such that in addition to the gap report update, programmatic information related to gap closure will also be emphasized.

Which skills are associated with residents' sense of preparedness to manage chronic pain?

PubMed

Fox, Aaron D; Kunins, Hillary V; Starrels, Joanna L

2012-01-01

To identify gaps in residents' confidence and knowledge in managing chronic nonmalignant pain (CNMP) and to explore whether specific skills or pain knowledge was associated with global preparedness to manage CNMP. Cross-sectional web-based survey. Internal medicine residents in Bronx, NY. The authors assessed the following: 1) confidence in skills within the following four content areas: physical examination, diagnosis, treatment, and safer opioid prescribing; 2) pain-related knowledge on a 16-item scale; and 3) global preparedness to manage CNMP (agreement with, "I feel prepared to manage CNMP"). Gaps in confidence were skills in which fewer than 50 percent reported confidence. Gaps in knowledge were items in which fewer than 50 percent answered correctly. Using logistic regression, the authors examined whether skills or knowledge was associated with global preparedness. Of 145 residents, 92 (63 percent) responded. Gaps in confidence included diagnosing fibromyalgia, performing corticosteroid injections, and using pain medication agreements. Gaps in knowledge included pharmacotherapy for neuropathic pain and interpreting urine drug test results. Twenty-four residents (26 percent) felt globally prepared to manage CNMP. Confidence using pain medication agreements (adjusted odds ratio [AOR], 5.99; 95% confidence interval [CI], 2.02-17.75), prescribing long-acting opioids (AOR, 5.85; 95% CI, 2.00-17.18), and performing corticosteroid injection of the knee (AOR, 5.76; 95% CI, 1.16-28.60]) were strongly associated with global preparedness. Few internal medicine residents felt prepared to manage CNMP. Our findings suggest that educational interventions to improve residents' preparedness to manage CNMP should target complex pain syndromes (eg, fibromyalgia and neuropathic pain), safer opioid prescribing practices, and alternatives to opioid analgesics.

Which Skills are Associated with Residents’ Sense of Preparedness to Manage Chronic Pain?

PubMed Central

Fox, Aaron D.; Kunins, Hillary V.; Starrels, Joanna L.

2013-01-01

Objective To identify gaps in residents’ confidence and knowledge in managing chronic non-malignant pain (CNMP) and to explore whether specific skills or pain knowledge were associated with global preparedness to manage CNMP. Design Cross-sectional web-based survey Setting & Participants Internal medicine residents in Bronx, NY Main Outcome Measures We assessed: (1) confidence in skills within four content areas: physical examination, diagnosis, treatment, and safer opioid prescribing; (2) pain-related knowledge on a 16-item scale; and (3) global preparedness to manage CNMP (agreement with, “I feel prepared to manage CNMP”). Gaps in confidence were skills in which fewer than 50% reported confidence. Gaps in knowledge were items in which fewer than 50% answered correctly. Using logistic regression, we examined whether skills or knowledge were associated with global preparedness. Results Of 145 residents, 92 (63%) responded. Gaps in confidence included diagnosing fibromyalgia, performing corticosteroid injections, and using pain medication agreements. Gaps in knowledge included pharmacotherapy for neuropathic pain and interpreting urine drug test results. Twenty-four residents (26%) felt globally prepared to manage CNMP. Confidence using pain medication agreements (AOR 5.99, 95% CI: 2.02, 17.75), prescribing long-acting opioids (AOR 5.85, 95%CI: 2.00, 17.18), and performing corticosteroid injection of the knee (AOR 5.76, 95% CI: 1.16, 28.60]) were strongly associated with global preparedness. Conclusions Few internal medicine residents felt prepared to manage CNMP. Our findings suggest that educational interventions to improve residents’ preparedness to manage CNMP should target complex pain syndromes (e.g., fibromyalgia and neuropathic pain), safer opioid prescribing practices, and alternatives to opioid analgesics. PMID:23247909

Baseline knowledge survey of restaurant food handlers in suburban Chicago: do restaurant food handlers know what they need to know to keep consumers safe?

PubMed

Manes, Mindi R; Liu, Li C; Dworkin, Mark S

2013-01-01

In the U.S., foodborne disease causes millions of illnesses annually, resulting in thousands of deaths. To reduce food poisoning, restaurant food handlers need accurate knowledge of food safety principles as a starting point for the outcome of optimal food safety behavior. The study described in this article determined food safety knowledge gaps among suburban Chicago restaurant food handlers. A cross-sectional survey of 729 food handlers at 211 suburban Chicago restaurants was conducted from June 2009 through February 2010. A 50-question survey was administered by a trained interviewer in either English or Spanish. Mixed-effects regression analysis identified risk factors associated with an overall food safety knowledge score. The mean overall knowledge score was only 72% and substantial knowledge gaps related to cross contamination, cooking, and holding and storage of food were identified. Spanish-speaking food handlers scored significantly lower than English-speaking food handlers (p < .05). Although certified food managers scored significantly higher than noncertified food handlers, their score was only 79%. These data provide targets for educational interventions to remedy knowledge gaps in food handlers in order to prevent food poisoning from restaurants.

EVA Systems Technology Gaps and Priorities 2017

NASA Technical Reports Server (NTRS)

Johnson, Brian J.; Buffington, Jesse A.

2017-01-01

Performance of Extra-Vehicular Activities (EVA) has been and will continue to be a critical capability for human space flight. Human exploration missions beyond LEO will require EVA capability for either contingency or nominal activities to support mission objectives and reduce mission risk. EVA systems encompass a wide array of products across pressure suits, life support systems, EVA tools and unique spacecraft interface hardware (i.e. EVA Translation Paths and EVA Worksites). In a fiscally limited environment with evolving transportation and habitation options, it is paramount that the EVA community's strategic planning and architecture integration products be reviewed and vetted for traceability between the mission needs far into the future to the known technology and knowledge gaps to the current investments across EVA systems. To ascertain EVA technology and knowledge gaps many things need to be brought together, assessed and analyzed. This includes an understanding of the destination environments, various mission concept of operations, current state of the art of EVA systems, EVA operational lessons learned, and reference advanced capabilities. A combined assessment of these inputs should result in well-defined list of gaps. This list can then be prioritized depending on the mission need dates and time scale of the technology or knowledge gap closure plan. This paper will summarize the current state of EVA related technology and knowledge gaps derived from NASA's Exploration EVA Reference Architecture and Operations Concept products. By linking these products and articulating NASA's approach to strategic development for EVA across all credible destinations an EVA could be done in, the identification of these gaps is then used to illustrate the tactical and strategic planning for the EVA technology development portfolio. Finally, this paper illustrates the various "touch points" with other human exploration risk identification areas including human health and performance.

The Effects of Preliteracy Knowledge, Schooling, and Summer Vacation on Literacy Acquisition

ERIC Educational Resources Information Center

Tiruchittampalam, Shanthi; Nicholson, Tom; Levin, Joel R.; Ferron, John M.

2018-01-01

What causes the literacy gap and can schools compensate for it? The authors investigated 3 drivers of the gap: preliteracy knowledge, schooling, and the summer vacation. Longitudinal literacy data over 5 time points were collected on 126 five-year-olds attending higher or lower socioeconomic status (SES) schools during their first 15 months of…

Practice Patterns of School-Based Occupational Therapists Targeting Handwriting: A Knowledge-to-Practice Gap

ERIC Educational Resources Information Center

Cramm, Heidi; Egan, Mary

2015-01-01

Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus…

What College Students Do Not Know: Where Are the Gaps in Sexual Health Knowledge?

ERIC Educational Resources Information Center

Moore, Erin W.; Smith, William E.

2012-01-01

Objective: This study aimed to understand the gaps in college students' knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper…

Chapter 12: Gaps in scientific knowledge about fire and nonnative invasive plants

Treesearch

Kristin Zouhar; Gregory T. Munger; Jane Kapler Smith

2008-01-01

The potential for nonnative, invasive plants to alter an ecosystem depends on species traits, ecosystem characteristics, and the effects of disturbances, including fire. This study identifies gaps in science-based knowledge about the relationships between fire and nonnative invasive plants in the United States. The literature was searched for information on 60...

Evidence-Based Practice in Kinesiology: The Theory to Practice Gap Revisited

ERIC Educational Resources Information Center

Knudson, Duane

2005-01-01

As evidence-based practice sweeps the applied health professions, it is a good time to evaluate the generation of knowledge in Kinesiology and its transmission to professionals and the public. Knowledge transmission has been debated in the past from the perspectives of the theory-to-practice gap and the discipline versus profession emphasis.…

Pre-Service Teachers' Knowledge, Misconceptions and Gaps about Autism Spectrum Disorder

ERIC Educational Resources Information Center

Sanz-Cervera, Pilar; Fernández-Andrés, María-Inmaculada; Pastor-Cerezuela, Gemma; Tárraga-Mínguez, Raúl

2017-01-01

The inclusive education framework and the increase in autism diagnoses have led to an overwhelming challenge for pre-service teachers who need to be qualified to teach all children. To test the quality of their training, the main purpose of this study was to compare 866 pre-service teachers' knowledge, misconceptions, and gaps about autism in…

The Development of Children's Ability to Fill the Gaps in Their Knowledge by Consulting Experts

ERIC Educational Resources Information Center

Aguiar, Naomi R.; Stoess, Caryn J.; Taylor, Marjorie

2012-01-01

This research investigated children's ability to recognize gaps in their knowledge and seek missing information from appropriate informants. In Experiment 1, forty-five 4- and 5-year-olds were adept in assigning questions from 3 domains (medicine, firefighting, and farming) to corresponding experts (doctor, firefighter, or farmer). However, when…

The Role of Perceived Threat in Reducing Health Knowledge Gaps.

ERIC Educational Resources Information Center

Yows, Suzanne R.

A study tested the knowledge gap hypothesis, a promising framework for research in the field of mass communication devised by P. Tichenor, G. Donohue, and C. Olien in 1970. The study investigated the relative contribution of two types of factors--structural and motivational--in predicting the degree to which persons will attend to health messages,…

Gaps in agricultural climate adaptation research

NASA Astrophysics Data System (ADS)

Davidson, Debra

2016-05-01

The value of the social sciences to climate change research is well recognized, but notable gaps remain in the literature on adaptation in agriculture. Contributions focus on farmer behaviour, with important research regarding gender, social networks and institutions remaining under-represented.

Closing the gap between research and management

Treesearch

Deborah M. Finch; Marcia Patton-Mallory

1993-01-01

In this paper, we evaluate the reasons for gaps in communication between researchers and natural resource managers and identify methods to close these gaps. Gaps originate from differing patterns of language use, disparities in organizational culture and values, generation of knowledge that is too narrowly-focused to solve complex problems, failure by managers to relay...

Talk, trust and time: a longitudinal study evaluating knowledge translation and exchange processes for research on violence against women

PubMed Central

2011-01-01

Background Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies including two randomized trials, the McMaster University VAW Research Program studied one key research gap: evidence about the effectiveness of screening women for exposure to intimate partner violence. This project developed and evaluated KTE strategies to share research findings with policymakers, health and community service providers, and women's advocates. Methods A longitudinal cross-sectional design, applying concurrent mixed data collection methods (surveys, interviews, and focus groups), was used to evaluate the utility of specific KTE strategies, including a series of workshops and a day-long Family Violence Knowledge Exchange Forum, on research sharing, uptake, and use. Results Participants valued the opportunity to meet with researchers, provide feedback on key messages, and make personal connections with other stakeholders. A number of factors specific to the knowledge itself, stakeholders' contexts, and the nature of the knowledge gap being addressed influenced the uptake, sharing, and use of the research. The types of knowledge use changed across time, and were specifically related to both the types of decisions being made, and to stage of decision making; most reported use was conceptual or symbolic, with few examples of instrumental use. Participants did report actively sharing the research findings with their own networks. Further examination of these second-order knowledge-sharing processes is required, including development of appropriate methods and measures for its assessment. Some participants reported that they would not use the research evidence in their decision making when it contradicted professional experiences, while others used it to support apparently contradictory positions. The online wiki-based 'community of interest' requested by participants was not used. Conclusions Mobilizing knowledge in the area of VAW practice and policy is complex and resource-intensive, and must acknowledge and respect the values of identified knowledge users, while balancing the objectivity of the research and researchers. This paper provides important lessons learned about these processes, including attending to the potential unintended consequences of knowledge sharing. PMID:21896170

Talk, trust and time: a longitudinal study evaluating knowledge translation and exchange processes for research on violence against women.

PubMed

Wathen, C Nadine; Sibbald, Shannon L; Jack, Susan M; Macmillan, Harriet L

2011-09-06

Violence against women (VAW) is a major public health problem. Translation of VAW research to policy and practice is an area that remains understudied, but provides the opportunity to examine knowledge translation and exchange (KTE) processes in a complex, multi-stakeholder context. In a series of studies including two randomized trials, the McMaster University VAW Research Program studied one key research gap: evidence about the effectiveness of screening women for exposure to intimate partner violence. This project developed and evaluated KTE strategies to share research findings with policymakers, health and community service providers, and women's advocates. A longitudinal cross-sectional design, applying concurrent mixed data collection methods (surveys, interviews, and focus groups), was used to evaluate the utility of specific KTE strategies, including a series of workshops and a day-long Family Violence Knowledge Exchange Forum, on research sharing, uptake, and use. Participants valued the opportunity to meet with researchers, provide feedback on key messages, and make personal connections with other stakeholders. A number of factors specific to the knowledge itself, stakeholders' contexts, and the nature of the knowledge gap being addressed influenced the uptake, sharing, and use of the research. The types of knowledge use changed across time, and were specifically related to both the types of decisions being made, and to stage of decision making; most reported use was conceptual or symbolic, with few examples of instrumental use. Participants did report actively sharing the research findings with their own networks. Further examination of these second-order knowledge-sharing processes is required, including development of appropriate methods and measures for its assessment. Some participants reported that they would not use the research evidence in their decision making when it contradicted professional experiences, while others used it to support apparently contradictory positions. The online wiki-based 'community of interest' requested by participants was not used. Mobilizing knowledge in the area of VAW practice and policy is complex and resource-intensive, and must acknowledge and respect the values of identified knowledge users, while balancing the objectivity of the research and researchers. This paper provides important lessons learned about these processes, including attending to the potential unintended consequences of knowledge sharing.

Human Research Program Human Health Countermeasures Element Bone and Muscle Risk Standing Review Panel (SRP)

NASA Technical Reports Server (NTRS)

Glowacki, Julie; Gregor, Robert

2009-01-01

The Bone and Muscle Risk Standing Review Panel (SRP) met at the NASA Johnson Space Center (JSC) on October 4-6, 2009 to discuss the areas of current and future research targeted by the Human Health Countermeasures (HHC) Element of the Human Research Program (HRP). Using evidence-based knowledge as a background for identified risks to astronaut health and performance, NASA had identified gaps in knowledge to address those risks. Ongoing and proposed tasks were presented to address the gaps. The charge to the Bone and Muscle Risk SRP was to review the gaps, evaluate whether the tasks addressed these gaps and to make recommendations to NASA s HRP Science Management Office regarding the Panel's review. The Bone and Muscle Risk SRP consisted of scientists who are experts in muscle, bone, or both and could evaluate the existing evidence with sufficient knowledge of the potential effects of long duration exposure to microgravity. More important, although expertise in basic science is important, the SRP was requested to evaluate the practicality of the proposed efforts in light of the realistic demands placed on the HRP. In short, all tasks presented in the Integrated Research Plan (IRP) should address specific questions related to the challenges faced by the astronauts as a result of prolonged exposure to microgravity. All tasks proposed to fill the gaps in knowledge should provide applied, translational data necessary to answer the specific questions. Several presentations were made to the SRP during the site visit and the SRP spent sufficient time to address the panel charge, either as a group or in separate sessions for the Bone and Muscle Risk subgroups. The SRP made a final debriefing to the HRP Program Scientist, Dr. John B. Charles, on October 6, 2009. Taking the evidence and identified risks as givens, the SRP concluded that 1) integration of information should lead to a more comprehensive approach to identifying the gaps, 2) not all tasks addressed the gaps as stated in the IRP, 3) better access should be given to the SRP to existing data to include in its review, and 4) there were some missing gaps and tasks. As a result the SRP recommended 1) combining certain gaps, which in some cases were addressed with identical tasks, 2) additional gaps and tasks to address some of the gaps, 3) deleting some gaps and tasks to better focus the efforts of NASA s HRP in prioritizing their efforts, and 4) prioritizing gaps to address significant issues needing resolution in the short term while maintaining an awareness of long-term goals. The SRP commended the efforts by the HHC Element to integrate knowledge gaps and design tasks to address the higher order questions. This integration did not apply to the Bone and Muscle Risk alone, but the musculoskeletal system as its functions integrate with issues in

The Role of Internet Engagement in the Health-knowledge Gap

PubMed Central

Lee, Chul-joo

2014-01-01

The current research posits that education leads to differential levels of Internet engagement, which moderate the association between Internet use for health information and general health knowledge. Using a nationally representative survey that covers adults between the ages of 40 and 70 in the United States, it is found that education is positively related to Internet engagement. Also, Internet use has stronger associations with health knowledge for people exhibiting high Internet engagement than for people exhibiting low Internet engagement. The implications of these findings for research on both Internet use and knowledge gaps are discussed. PMID:25530667

Education Research: Neurology resident education

PubMed Central

Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

2016-01-01

Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

The placenta: the forgotten essential organ of iron transport

PubMed Central

Cao, Chang

2016-01-01

Optimal iron nutrition in utero is essential for development of the fetus and helps establish birth iron stores adequate to sustain growth in early infancy. In species with hemochorial placentas, such as humans and rodents, iron in the maternal circulation is transferred to the fetus by directly contacting placental syncytiotrophoblasts. Early kinetic studies provided valuable data on the initial uptake of maternal transferrin, an iron-binding protein, by the placenta. However, the remaining steps of iron trafficking across syncytiotrophoblasts and through the fetal endothelium into the fetal blood remain poorly characterized. Over the last 20 years, identification of transmembrane iron transporters and the iron regulatory hormone hepcidin has greatly expanded the knowledge of cellular iron transport and its regulation by systemic iron status. In addition, emerging human and animal data demonstrating comprised fetal iron stores in severe maternal iron deficiency challenge the classic dogma of exclusive fetal control over the transfer process and indicate that maternal and local signals may play a role in regulating this process. This review compiles current data on the kinetic, molecular, and regulatory aspects of placental iron transport and considers new questions and knowledge gaps raised by these advances. PMID:27261274

Pharmacologic studies in vulnerable populations: Using the pediatric experience.

PubMed

Zimmerman, Kanecia; Gonzalez, Daniel; Swamy, Geeta K; Cohen-Wolkowiez, Michael

2015-11-01

Historically, few data exist to guide dosing in children and pregnant women. Multiple barriers to inclusion of these vulnerable populations in clinical trials have led to this paucity of data. However, federal legislation targeted at pediatric therapeutics, innovative clinical trial design, use of quantitative clinical pharmacology methods, pediatric thought leadership, and collaboration have successfully overcome many existing barriers. This success has resulted in improved knowledge on pharmacokinetics, safety, and efficacy of therapeutics in children. To date, research in pregnant women has not been characterized by similar success. Wide gaps in knowledge remain despite the common use of therapeutics in pregnancy. Given the similar barriers to drug research and development in pediatric and pregnant populations, the route toward success in children may serve as a model for the advancement of drug development and appropriate drug administration in pregnant women. Copyright © 2015 Elsevier Inc. All rights reserved.

From Ice Sheets to Main Streets: Intermediaries Connect Climate Scientists to Coastal Adaptation

NASA Astrophysics Data System (ADS)

Ultee, Lizz; Arnott, James C.; Bassis, Jeremy; Lemos, Maria Carmen

2018-03-01

Despite the societal relevance of sea-level research, a knowledge-to-action gap remains between researchers and coastal communities. In the agricultural and water-management sectors, intermediaries such as consultants and extension agencies have a long and well-documented history of helping to facilitate the application of scientific knowledge on the ground. However, the role of such intermediaries in adaptation to sea-level rise, though potentially of vital importance, has been less thoroughly explored. In this commentary, we describe three styles of science intermediation that can connect researchers working on sea-level projections with decision-makers relying on those projections. We illustrate these styles with examples of recent and ongoing contexts for the application of sea-level research, at different spatial scales and political levels ranging from urban development projects to international organizations. Our examples highlight opportunities and drawbacks for the researchers involved and communities adapting to rising seas.

Pseudomonas aeruginosa infection in cystic fibrosis: pathophysiological mechanisms and therapeutic approaches.

PubMed

Lund-Palau, Helena; Turnbull, Andrew R; Bush, Andrew; Bardin, Emmanuelle; Cameron, Loren; Soren, Odel; Wierre-Gore, Natasha; Alton, Eric W F W; Bundy, Jacob G; Connett, Gary; Faust, Saul N; Filloux, Alain; Freemont, Paul; Jones, Andy; Khoo, Valerie; Morales, Sandra; Murphy, Ronan; Pabary, Rishi; Simbo, Ameze; Schelenz, Silke; Takats, Zoltan; Webb, Jeremy; Williams, Huw D; Davies, Jane C

2016-06-01

Pseudomonas aeruginosa is a remarkably versatile environmental bacterium with an extraordinary capacity to infect the cystic fibrosis (CF) lung. Infection with P. aeruginosa occurs early, and although eradication can be achieved following early detection, chronic infection occurs in over 60% of adults with CF. Chronic infection is associated with accelerated disease progression and increased mortality. Extensive research has revealed complex mechanisms by which P. aeruginosa adapts to and persists within the CF airway. Yet knowledge gaps remain, and prevention and treatment strategies are limited by the lack of sensitive detection methods and by a narrow armoury of antibiotics. Further developments in this field are urgently needed in order to improve morbidity and mortality in people with CF. Here, we summarize current knowledge of pathophysiological mechanisms underlying P. aeruginosa infection in CF. Established treatments are discussed, and an overview is offered of novel detection methods and therapeutic strategies in development.

Childhood leukemia and cancers near German nuclear reactors: significance, context, and ramifications of recent studies.

PubMed

Nussbaum, Rudi H

2009-01-01

A government-sponsored study of childhood cancer in the proximity of German nuclear power plants (German acronym KiKK) found that children < 5 years living < 5 km from plant exhaust stacks had twice the risk for contracting leukemia as those residing > 5 km. The researchers concluded that since "this result was not to be expected under current radiation-epidemiological knowledge" and confounders could not be identified, the observed association of leukemia incidence with residential proximity to nuclear plants "remains unexplained." This unjustified conclusion illustrates the dissonance between evidence and assumptions. There exist serious flaws and gaps in the knowledge on which accepted models for population exposure and radiation risk are based. Studies with results contradictory to those of KiKK lack statistical power to invalidate its findings. The KiKK study's ramifications add to the urgency for a public policy debate regarding the health impact of nuclear power generation.

Easing the transition between hospital and home: translating knowledge into action.

PubMed

Baumbusch, Jennifer; Semeniuk, Pat; McDonald, Heather; Khan, Koushambhi Basu; Reimer Kirkham, Sheryl; Tan, Elsie; Anderson, Joan M

2007-10-01

Knowledge translation is an interactive, dynamic approach to the uptake of evidence-based knowledge. In this article, the authors present a collaborative model for knowledge translation that grew out of a program of research focusing on the experiences of patients from ethnoculturally diverse groups as they were discharged home from hospital. Research findings highlight issues around gaps in the continuity of services and language and communication. The authors discuss a number of knowledge translation initiatives that were developed to address these gaps. Key to the success of this process has been a collaborative relationship between researchers and practitioners that is grounded in the shared goal of knowledge translation to support ethically sound decision-making in the delivery of health-care services.

Influenza-Omics and the Host Response: Recent Advances and Future Prospects

PubMed Central

Powell, Joshua D.; Waters, Katrina M.

2017-01-01

Influenza A viruses (IAV) continually evolve and have the capacity to cause global pandemics. Because IAV represents an ongoing threat, identifying novel therapies and host innate immune factors that contribute to IAV pathogenesis is of considerable interest. This review summarizes the relevant literature as it relates to global host responses to influenza infection at both the proteome and transcriptome level. The various-omics infection systems that include but are not limited to ferrets, mice, pigs, and even the controlled infection of humans are reviewed. Discussion focuses on recent advances, remaining challenges, and knowledge gaps as it relates to influenza-omics infection outcomes. PMID:28604586

Influenza-Omics and the Host Response: Recent Advances and Future Prospects

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

Powell, Joshua D.; Waters, Katrina M.

Influenza A viruses (IAV) continually evolve and have the capacity to cause global pandemics. Because IAV represents an ongoing threat, identifying novel therapies and host innate immune factors that contribute to IAV pathogenesis is of considerable interest. This review summarizes the relevant literature as it relates to global host responses to influenza infection at both the proteome and transcriptome level. Here, the various –omics infection systems that include but are not limited to ferrets, mice, pigs and even controlled infection of humans are reviewed. Discussion focuses on recent advances, remaining challenges, and knowledge gaps as it relates to influenza-omics infectionmore » outcomes.« less

Coagulant Recovery from Water Treatment Residuals: A Review of Applicable Technologies

PubMed Central

Keeley, J.; Jarvis, P.; Judd, S. J.

2014-01-01

Conventional water treatment consumes large quantities of coagulant and produces even greater volumes of sludge. Coagulant recovery (CR) presents an opportunity to reduce both the sludge quantities and the costs they incur, by regenerating and purifying coagulant before reuse. Recovery and purification must satisfy stringent potable regulations for harmful contaminants, while remaining competitive with commercial coagulants. These challenges have restricted uptake and lead research towards lower-gain, lower-risk alternatives. This review documents the context in which CR must be considered, before comparing the relative efficacies and bottlenecks of potential technologies, expediting identification of the major knowledge gaps and future research requirements. PMID:26064036

Supramolecular chemistry and chemical warfare agents: from fundamentals of recognition to catalysis and sensing.

PubMed

Sambrook, M R; Notman, S

2013-12-21

Supramolecular chemistry presents many possible avenues for the mitigation of the effects of chemical warfare agents (CWAs), including sensing, catalysis and sequestration. To-date, efforts in this field both to study fundamental interactions between CWAs and to design and exploit host systems remain sporadic. In this tutorial review the non-covalent recognition of CWAs is considered from first principles, including taking inspiration from enzymatic systems, and gaps in fundamental knowledge are indicated. Examples of synthetic systems developed for the recognition of CWAs are discussed with a focus on the supramolecular complexation behaviour and non-covalent approaches rather than on the proposed applications.

Chikungunya Virus: Pathophysiology, Mechanism, and Modeling

PubMed Central

Ganesan, Vaishnavi K.; Reid, St Patrick

2017-01-01

Chikungunya virus (CHIKV), a mosquito-transmitted alphavirus, is recurring in epidemic waves. In the past decade and a half, the disease has resurged in several countries around the globe, with outbreaks becoming increasingly severe. Though CHIKV was first isolated in 1952, there remain significant gaps in knowledge of CHIKV biology, pathogenesis, transmission, and mechanism. Diagnosis is largely simplified and based on symptoms, while treatment is supportive rather than curative. Here we present an overview of the disease, the challenges that lie ahead for future research, and what directions current studies are headed towards, with emphasis on improvement of current animal models and potential use of 3D models. PMID:29194359

The Role of PCR in the Diagnosis of Candida Vulvovaginitis-a New Gold Standard?

PubMed

Sobel, J D; Akins, Robert A

2015-06-01

PCR is recognized as a reliable technique for detection of all types of microorganisms. Being highly objective and reproducible also sensitive and specific, PCR is now widely used for sexually transmitted infection (STI) diagnosis. Potential, however, exists for detecting non-pathogens, and not identifying a pathogenic state decreases specificity or clinical significance. PCR Candida tests of vaginal specimens are now widely available and frequently used offering a modest to moderate increase in sensitivity and are likely to replace traditional culture and DNA homology testing. Nevertheless, there remain considerable gaps in our knowledge regarding the usefulness and applications of these expensive tests.

FOR LOVE OR REWARD? CHARACTERISING PREFERENCES FOR GIVING TO PARENTS IN AN EXPERIMENTAL SETTING*

PubMed Central

Porter, Maria; Adams, Abi

2017-01-01

Understanding the motivations behind intergenerational transfers is an important and active research area in economics. The existence and responsiveness of familial transfers have consequences for the design of intra and intergenerational redistributive programmes, particularly as such programmes may crowd out private transfers amongst altruistic family members. Yet, despite theoretical and empirical advances in this area, significant gaps in our knowledge remain. In this article, we advance the current literature by shedding light on both the motivation for providing intergenerational transfers, and on the nature of preferences for such giving behaviour, by using experimental techniques and revealed preference methods. PMID:29151611

Influenza-Omics and the Host Response: Recent Advances and Future Prospects

DOE PAGES

Powell, Joshua D.; Waters, Katrina M.

2017-06-10

Influenza A viruses (IAV) continually evolve and have the capacity to cause global pandemics. Because IAV represents an ongoing threat, identifying novel therapies and host innate immune factors that contribute to IAV pathogenesis is of considerable interest. This review summarizes the relevant literature as it relates to global host responses to influenza infection at both the proteome and transcriptome level. Here, the various –omics infection systems that include but are not limited to ferrets, mice, pigs and even controlled infection of humans are reviewed. Discussion focuses on recent advances, remaining challenges, and knowledge gaps as it relates to influenza-omics infectionmore » outcomes.« less

Bioinformatics for Exploration

NASA Technical Reports Server (NTRS)

Johnson, Kathy A.

2006-01-01

For the purpose of this paper, bioinformatics is defined as the application of computer technology to the management of biological information. It can be thought of as the science of developing computer databases and algorithms to facilitate and expedite biological research. This is a crosscutting capability that supports nearly all human health areas ranging from computational modeling, to pharmacodynamics research projects, to decision support systems within autonomous medical care. Bioinformatics serves to increase the efficiency and effectiveness of the life sciences research program. It provides data, information, and knowledge capture which further supports management of the bioastronautics research roadmap - identifying gaps that still remain and enabling the determination of which risks have been addressed.

Drug-induced liver injury: Do we know everything?

PubMed Central

Alempijevic, Tamara; Zec, Simon; Milosavljevic, Tomica

2017-01-01

Interest in drug-induced liver injury (DILI) has dramatically increased over the past decade, and it has become a hot topic for clinicians, academics, pharmaceutical companies and regulatory bodies. By investigating the current state of the art, the latest scientific findings, controversies, and guidelines, this review will attempt to answer the question: Do we know everything? Since the first descriptions of hepatotoxicity over 70 years ago, more than 1000 drugs have been identified to date, however, much of our knowledge of diagnostic and pathophysiologic principles remains unchanged. Clinically ranging from asymptomatic transaminitis and acute or chronic hepatitis, to acute liver failure, DILI remains a leading causes of emergent liver transplant. The consumption of unregulated herbal and dietary supplements has introduced new challenges in epidemiological assessment and clinician management. As such, numerous registries have been created, including the United States Drug-Induced Liver Injury Network, to further our understanding of all aspects of DILI. The launch of LiverTox and other online hepatotoxicity resources has increased our awareness of DILI. In 2013, the first guidelines for the diagnosis and management of DILI, were offered by the Practice Parameters Committee of the American College of Gastroenterology, and along with the identification of risk factors and predictors of injury, novel mechanisms of injury, refined causality assessment tools, and targeted treatment options have come to define the current state of the art, however, gaps in our knowledge still undoubtedly remain. PMID:28443154

Pain and symptom management in palliative care and at end of life.

PubMed

Wilkie, Diana J; Ezenwa, Miriam O

2012-01-01

The purpose of this review is to provide a literature update of the research published since 2004 on pain and symptom management in palliative care and at end of life. Findings suggest that pain and symptoms are inadequately assessed and managed, even at the end of life. Although not pervasive, there is evidence of racial/ethnic disparities in symptom management in palliative care and at end of life. There is a need for a broader conceptualization and measurement of pain and symptom management as multidimensional experiences. There is insufficient evidence about mechanisms underlying pain at end of life. Although there are advances in the knowledge of pain as a multidimensional experience and the many symptoms that occur sometimes with pain, gaps remain. One approach to addressing the gaps will involve assessment and management of pain and symptoms as multidimensional experiences in people receiving palliative care and at end of life. Copyright © 2012 Elsevier Inc. All rights reserved.

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

Sofu, Tanju; LaChance, Jeffrey L.; Bari, R.

This report proposes potential research priorities for the Department of Energy (DOE) with the intent of improving the licensability of the Sodium Fast Reactor (SFR). In support of this project, five panels were tasked with identifying potential safety-related gaps in available information, data, and models needed to support the licensing of a SFR. The areas examined were sodium technology, accident sequences and initiators, source term characterization, codes and methods, and fuels and materials. It is the intent of this report to utilize a structured and transparent process that incorporates feedback from all interested stakeholders to suggest future funding priorities formore » the SFR research and development. While numerous gaps were identified, two cross-cutting gaps related to knowledge preservation were agreed upon by all panels and should be addressed in the near future. The first gap is a need to re-evaluate the current procedures for removing the Applied Technology designation from old documents. The second cross-cutting gap is the need for a robust Knowledge Management and Preservation system in all SFR research areas. Closure of these and the other identified gaps will require both a reprioritization of funding within DOE as well as a re-evaluation of existing bureaucratic procedures within the DOE associated with Applied Technology and Knowledge Management.« less

Nursing as concrete philosophy, Part I: Risjord on nursing knowledge.

PubMed

Theodoridis, Kyriakos

2018-04-01

This essay addresses the problem of the essentiality of nursing knowledge and what kind of theory, if any, is essential to nursing practice. The overarching aim of the essay was to argue for the thesis that nursing may be described as a kind of philosophical activity, and, consequently, that philosophy is the kind of "theory" that is essential to nursing practice and to the nursing discipline at large. The essay consists of two papers. The present paper, Part I, is a critical examination of Mark Risjord's discussion of the problem of the theory-practice gap in his Nursing Knowledge: Practice, Science, Philosophy, from 2010. According to Risjord, the cause of the theory-practice gap originates in an erroneous conception of science (logical positivism) which had a decisive influence upon the way nursing scholars appropriated theoretical frameworks for the nursing discipline. This philosophical influence is considered in effect to have generated the theory-practice gap. In order to bridge the gap, Risjord suggests, the nursing discipline needs to adopt a standpoint epistemology conjoined with a postpositivist conception of scientific theory. In this way, a legitimate brand of nursing science may be developed and the theory-practice gap overcome. I will argue that neither Risjord's diagnosis of the problem, nor his recommended cure, may succeed in rescuing the nursing discipline from the theory-practice gap. Rather, the real cause of the theory-practice gap, I will claim, derives from an erroneous conception of nursing (not of science), namely the conception of nursing as a kind of science (roughly speaking). On my view, to overcome the gap, the nursing discipline needs to make salient the inherently philosophical character of nursing. In the second paper (Part II), I will continue the discussion of nursing knowledge and delineate the thesis of nursing as a kind of concrete philosophy. © 2017 John Wiley & Sons Ltd.

A call for action to establish a research agenda for building a future health workforce in Europe.

PubMed

Kuhlmann, Ellen; Batenburg, Ronald; Wismar, Matthias; Dussault, Gilles; Maier, Claudia B; Glinos, Irene A; Azzopardi-Muscat, Natasha; Bond, Christine; Burau, Viola; Correia, Tiago; Groenewegen, Peter P; Hansen, Johan; Hunter, David J; Khan, Usman; Kluge, Hans H; Kroezen, Marieke; Leone, Claudia; Santric-Milicevic, Milena; Sermeus, Walter; Ungureanu, Marius

2018-06-20

The importance of a sustainable health workforce is increasingly recognised. However, the building of a future health workforce that is responsive to diverse population needs and demographic and economic change remains insufficiently understood. There is a compelling argument to be made for a comprehensive research agenda to address the questions. With a focus on Europe and taking a health systems approach, we introduce an agenda linked to the 'Health Workforce Research' section of the European Public Health Association. Six major objectives for health workforce policy were identified: (1) to develop frameworks that align health systems/governance and health workforce policy/planning, (2) to explore the effects of changing skill mixes and competencies across sectors and occupational groups, (3) to map how education and health workforce governance can be better integrated, (4) to analyse the impact of health workforce mobility on health systems, (5) to optimise the use of international/EU, national and regional health workforce data and monitoring and (6) to build capacity for policy implementation. This article highlights critical knowledge gaps that currently hamper the opportunities of effectively responding to these challenges and advising policy-makers in different health systems. Closing these knowledge gaps is therefore an important step towards future health workforce governance and policy implementation. There is an urgent need for building health workforce research as an independent, interdisciplinary and multi-professional field. This requires dedicated research funding, new academic education programmes, comparative methodology and knowledge transfer and leadership that can help countries to build a people-centred health workforce.

Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial.

PubMed

Mathews, Ben; Yang, Chengwu; Lehman, Erik B; Mincemoyer, Claudia; Verdiglione, Nicole; Levi, Benjamin H

2017-01-01

Early childhood care and education providers (CCPs) work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control). Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93); large effect size 0.95, p < 0.001); the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22); negligible effect size 0.03, p = 0.684). Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05). Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior. US National Institutes of Health NCT02225301.

Exploration of Social Capital and Knowledge Sharing: An Empirical Study on Student Virtual Teams

ERIC Educational Resources Information Center

Liu, Ying Chieh; Li, FengChia

2012-01-01

Although research on virtual teams is becoming more popular, there is a gap in the understanding of how social capital affects knowledge sharing and creating, and their impacts on virtual team performance. To fill in this gap, this study establishes a framework by incorporating social capital with the SECI model and further examines it with an…

Detection capacity, information gaps and the design of surveillance programs for invasive forest pests

Treesearch

Denys Yemshanov; Frank Koch; Yakov Ben-Haim; William Smith

2010-01-01

Integrated pest risk maps and their underlying assessments provide broad guidance for establishing surveillance programs for invasive species, but they rarely account for knowledge gaps regarding the pest of interest or how these can be reduced. In this study we demonstrate how the somewhat competing notions of robustness to uncertainty and potential knowledge gains...

Transitioning Florida NPs to opioid prescribing.

PubMed

Craig-Rodriguez, Alicia; Gordon, Glenna; Kaplan, Louise; Grubbs, Laurie

2017-09-21

Prior to statutory changes in prescriptive authority for controlled substances, this study examined the knowledge gaps and prescribing limitations of Florida advanced registered nurse practitioners regarding opioids. Study results revealed statistically significant knowledge gaps in the areas of federal and state guidelines; opioid classes and proper doses; risk assessment skills; monitoring of treatment; and confidence in dealing with challenges of opioid prescribing.

Retirement financial planning and the RN: an integrative literature review.

PubMed

Keele, Shanna; Alpert, Patricia T

2013-11-01

This integrative literature review examined the current research on RN retirement. The review identified 3 critical gaps in knowledge: (a) minimal knowledge regarding the economic impact on RN retirement, (b) incomplete information regarding the demographics of RN retirement, and (c) a scarcity of prospective longitudinal RN workforce studies. Future research must address these gaps to better address RN workforce sustainability.

Retirement Financial Planning and the RN: An Integrative Literature Review.

PubMed

Keele, Shanna; Alpert, Patricia T

2015-10-01

This integrative literature review examined the current research on RN retirement. The review identified 3 critical gaps in knowledge: (a) minimal knowledge regarding the economic impact on RN retirement, (b) incomplete information regarding the demographics of RN retirement, and (c) a scarcity of prospective longitudinal RN workforce studies. Future research must address these gaps to better address RN workforce sustainability.

Education Outcomes and Poverty: A Reassessment. Education, Poverty and International Development

ERIC Educational Resources Information Center

Colclough, Christopher, Ed.

2012-01-01

What do we know about the outcomes of education in developing countries? Where are the gaps in our knowledge, and why are they important to fill? What are the policy challenges that underlie these knowledge gaps, and how can education best contribute to eliminating the problem of widespread poverty in the developing world? This book arises out of…

Robustness of risk maps and survey networks to knowledge gaps about a new invasive pest

Treesearch

Denys Yemshanov; Frank H. Koch; Yakov Ben-Haim; William D. Smith

2010-01-01

In pest risk assessment it is frequently necessary to make management decisions regarding emerging threats under severe uncertainty. Although risk maps provide useful decision support for invasive alien species, they rarely address knowledge gaps associated with the underlying risk model or how they may change the risk estimates. Failure to recognize uncertainty leads...

Review of the Transgender Literature: Where Do We Go from Here?

PubMed

Wanta, Jonathon W; Unger, Cecile A

2017-01-01

Purpose: The "transgender tipping point" has brought transgender social and health issues to the forefront of American culture. However, medical professionals have been lagging in academic research with a transgender-specific focus resulting in significant knowledge gaps in dealing with the care of our transgender patients. The aim of this article is to analyze all published Medline-available transgender-specific articles, identify these knowledge gaps, and direct future research to where it is most needed. Methods: We surveyed all Medline-available articles up to June 2016 using a combination of medical subject headings and keywords in titles and abstracts. Articles meeting inclusion criteria were reviewed, categorized, and analyzed for content and study design. Results: In our review of the literature, we identified 2405 articles published from January 1950 to June 2016 that focused on transgender health, primarily in the fields of surgery, mental health, and endocrinology. Conclusion: Significant knowledge gaps were found across the subspecialties, and there was a lack of prospective robust research and representation of transgender-specific data in the core medical journals. More data and research are needed to bridge the knowledge gaps that currently exist and improve the care of the transgender community.

Review of the Transgender Literature: Where Do We Go from Here?

PubMed Central

Wanta, Jonathon W.; Unger, Cecile A.

2017-01-01

Abstract Purpose: The “transgender tipping point” has brought transgender social and health issues to the forefront of American culture. However, medical professionals have been lagging in academic research with a transgender-specific focus resulting in significant knowledge gaps in dealing with the care of our transgender patients. The aim of this article is to analyze all published Medline-available transgender-specific articles, identify these knowledge gaps, and direct future research to where it is most needed. Methods: We surveyed all Medline-available articles up to June 2016 using a combination of medical subject headings and keywords in titles and abstracts. Articles meeting inclusion criteria were reviewed, categorized, and analyzed for content and study design. Results: In our review of the literature, we identified 2405 articles published from January 1950 to June 2016 that focused on transgender health, primarily in the fields of surgery, mental health, and endocrinology. Conclusion: Significant knowledge gaps were found across the subspecialties, and there was a lack of prospective robust research and representation of transgender-specific data in the core medical journals. More data and research are needed to bridge the knowledge gaps that currently exist and improve the care of the transgender community. PMID:29082332

Cross-disciplinary research in cancer: an opportunity to narrow the knowledge-practice gap.

PubMed

Urquhart, R; Grunfeld, E; Jackson, L; Sargeant, J; Porter, G A

2013-12-01

Health services researchers have consistently identified a gap between what is identified as "best practice" and what actually happens in clinical care. Despite nearly two decades of a growing evidence-based practice movement, narrowing the knowledge-practice gap continues to be a slow, complex, and poorly understood process. Here, we contend that cross-disciplinary research is increasingly relevant and important to reducing that gap, particularly research that encompasses the notion of transdisciplinarity, wherein multiple academic disciplines and non-academic individuals and groups are integrated into the research process. The assimilation of diverse perspectives, research approaches, and types of knowledge is potentially effective in helping research teams tackle real-world patient care issues, create more practice-based evidence, and translate the results to clinical and community care settings. The goals of this paper are to present and discuss cross-disciplinary approaches to health research and to provide two examples of how engaging in such research may optimize the use of research in cancer care.

DETERMINATION OF RELATIVE IMPORTANCE OF NONPROLIFERATION FACTORS

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

Richard Metcalf

2009-07-01

Methodologies to determine the proliferation resistance (PR) of nuclear facilities often rely on either expert elicitation, a resource-intensive approach without easily reproducible results, or numeric evaluations, which can fail to take into account the institutional knowledge and expert experience of the nonproliferation community. In an attempt to bridge the gap and bring the institutional knowledge into numeric evaluations of PR, a survey was conducted of 33 individuals to find the relative importance of a set of 62 nonproliferation factors, subsectioned into groups under the headings of Diversion, Transportation, Transformation, and Weaponization. One third of the respondents were self-described nonproliferation professionals,more » and the remaining two thirds were from secondary professions related to nonproliferation, such as industrial engineers or policy analysts. The factors were taken from previous work which used multi-attribute utility analysis with uniform weighting of attributes and did not include institutional knowledge. In both expert and non-expert groups, all four headings and the majority of factors had different relative importance at a confidence of 95% (p=0.05). This analysis and survey demonstrates that institutional knowledge can be brought into numeric evaluations of PR, if there is a sufficient investment of resources made prior to the evaluation.« less

If we only knew what we know: principles for knowledge sharing across people, practices, and platforms.

PubMed

Dearing, James W; Greene, Sarah M; Stewart, Walter F; Williams, Andrew E

2011-03-01

The improvement of health outcomes for both individual patients and entire populations requires improvement in the array of structures that support decisions and activities by healthcare practitioners. Yet, many gaps remain in how even sophisticated healthcare organizations manage knowledge. Here we describe the value of a trans-institutional network for identifying and capturing how-to knowledge that contributes to improved outcomes. Organizing and sharing on-the-job experience would concentrate and organize the activities of individual practitioners and subject their rapid cycle improvement testing and refinement to a form of collective intelligence for subsequent diffusion back through the network. We use the existing Cancer Research Network as an example of how a loosely structured consortium of healthcare delivery organizations could create and grow an implementation registry to foster innovation and implementation success by communicating what works, how, and which practitioners are using each innovation. We focus on the principles and parameters that could be used as a basis for infrastructure design. As experiential knowledge from across institutions builds within such a system, the system could ultimately motivate rapid learning and adoption of best practices. Implications for research about healthcare IT, invention, and organizational learning are discussed.

Nanoscale View of Dewetting and Coating on Partially Wetted Solids.

PubMed

Deng, Yajun; Chen, Lei; Liu, Qiao; Yu, Jiapeng; Wang, Hao

2016-05-19

There remain significant gaps in our ability to predict dewetting and wetting despite the extensive study over the past century. An important reason is the absence of nanoscopic knowledge about the processes near the moving contact line. This experimental study for the first time obtained the liquid morphology within 10 nm of the contact line, which was receding at low speed (U < 50 nm/s). The results put an end to long-standing debate about the microscopic contact angle, which turned out to be varying with the speed as opposed to the constant-angle assumption that has been frequently employed in modeling. Moreover, a residual film of nanometer thickness ubiquitously remained on the solid after the receding contact line passed. This microscopic residual film modified the solid surface and thus made dewetting far from a simple reverse of wetting. A complete scenario for dewetting and coating is provided.

Translating infection control guidelines into practice: implementation process within a health care institution.

PubMed

Raveis, Victoria H; Conway, Laurie J; Uchida, Mayuko; Pogorzelska-Maziarz, Monika; Larson, Elaine L; Stone, Patricia W

2014-04-01

Health-care-associated infections (HAIs) remain a major patient safety problem even as policy and programmatic efforts designed to reduce HAIs have increased. Although information on implementing effective infection control (IC) efforts has steadily grown, knowledge gaps remain regarding the organizational elements that improve bedside practice and accommodate variations in clinical care settings. We conducted in-depth, semistructured interviews in 11 hospitals across the United States with a range of hospital personnel involved in IC (n = 116). We examined the collective nature of IC and the organizational elements that can enable disparate groups to work together to prevent HAIs. Our content analysis of participants' narratives yielded a rich description of the organizational process of implementing adherence to IC. Findings document the dynamic, fluid, interactional, and reactive nature of this process. Three themes emerged: implementing adherence efforts institution-wide, promoting an institutional culture to sustain adherence, and contending with opposition to the IC mandate.

A knowledge integration approach to flood vulnerability

NASA Astrophysics Data System (ADS)

Mazzorana, Bruno; Fuchs, Sven

2014-05-01

Understanding, qualifying and quantifying vulnerability is an essential need for implementing effective and efficient flood risk mitigation strategies; in particular if possible synergies between different mitigation alternatives, such as active and passive measures, should be achieved. In order to combine different risk management options it is necessary to take an interdisciplinary approach to vulnerability reduction, and as a result the affected society may be willing to accept a certain degree of self-responsibility. However, due to differing mono-disciplinary approaches and regional foci undertaken until now, different aspects of vulnerability to natural hazards in general and to floods in particular remain uncovered and as a result the developed management options remain sub-optimal. Taking an even more fundamental viewpoint, the empirical vulnerability functions used in risk assessment specifically fail to capture physical principles of the damage-generating mechanisms to the build environment. The aim of this paper is to partially close this gap by discussing a balanced knowledge integration approach which can be used to resolve the multidisciplinary disorder in flood vulnerability research. Modelling techniques such as mathematical-physical modelling of the flood hazard impact to and response from the building envelope affected, and formative scenario analyses of possible consequences in terms of damage and loss are used in synergy to provide an enhanced understanding of vulnerability and to render the derived knowledge into interdisciplinary mitigation strategies. The outlined formal procedure allows for a convincing knowledge alignment of quantified, but partial, information about vulnerability as a result of the application of physical and engineering notions and valuable, but often underspecified, qualitative argumentation strings emerging from the adopted socio-economic viewpoint.

Human Research Program Human Health Countermeasures Element Sensorimotor Risk Standing Review Panel (SRP) Final Report

NASA Technical Reports Server (NTRS)

Peterson, Barry

2009-01-01

The Sensorimotor Risk Standing Review Panel (SRP) met at the NASA Johnson Space Center on October 4-6, 2009 to discuss the areas of future research targeted by the Human Health Countermeasures (HHC) Element of the Human Research Program (HRP). Using evidence-based knowledge as a background for risks, NASA had identified gaps in knowledge to address those risks. Ongoing and proposed tasks were presented to address the gaps. The charge to the Sensorimotor Risk SRP was to review the gaps, evaluate whether the tasks addressed these gaps and to make recommendations to NASA s HRP Science Management Office regarding the SRP's review. The SRP was requested to evaluate the practicality of the proposed efforts in light of the realistic demands placed on the HRP. In short, all tasks presented in the Integrated Research Plan (IRP) should address specific risks related to the challenges faced by the astronauts as a result of prolonged exposure to microgravity. All tasks proposed to fill the gaps in knowledge should provide applied, translational data necessary to address the specific risks. Several presentations were made to the SRP during the site visit and the SRP spent sufficient time to address the panel charge, either as a group or in separate sessions. The SRP made a final debriefing to the HRP Program Scientist. Taking the evidence and the risk as givens, the SRP reached the following conclusions: 1) the panel is very supportive of and endorses the present activities of the Sensorimotor Risk; and the panel is likewise supportive of the gaps and associated tasks in the IRP; 2) overall, the tasks addressed the gaps in the IRP; 3) there were some gaps and tasks that merit further enhancement and some new gaps/tasks that the SRP recommends.

Development of a Policy-Relevant Child Maltreatment Research Strategy

PubMed Central

MacMillan, Harriet L; Jamieson, Ellen; Wathen, C Nadine; Boyle, Michael H; Walsh, Christine A; Omura, John; Walker, Jason M; Lodenquai, Gregory

2007-01-01

Child maltreatment is associated with a huge burden of suffering, yet there are serious gaps in knowledge about its epidemiology and approaches to intervention. This article describes the development of a proposed national research framework in child maltreatment, as requested by the Department of Justice, Canada, based on (1) a review of the literature, (2) consultation with experts, and (3) application of evaluation criteria for considering research priorities. The article identifies gaps in knowledge about child maltreatment in Canada and proposes a research agenda to make evidence-based policy decisions more likely. Although this work was driven by gaps in Canada's knowledge about child maltreatment, the international scope of the review and consultation process could make the findings useful to broader research and policy audiences. PMID:17517119

Closing the clinical gap: translating best practice knowledge to performance with guidelines implementation.

PubMed

Ishii, Lisa E

2013-06-01

Unsustainable health care costs coupled with opportunity for improvement in health care outcomes in the United States are stimulating meaningful transformation in the way we deliver care. One approach in this transformation focuses on minimizing unnecessary variation in physician practices, instead focusing on evidence-based medicine in a more uniform manner. Clinical practice guidelines contain evidence-based recommendations, articulate goals of care, and can help to reduce unnecessary variation. While thousands of clinical practice guidelines are in existence, a clinical gap exists between knowledge and clinical performance. With thoughtful guidelines implementation strategies in place, organizations can begin to close the gap and translate best practice knowledge into care. Health systems that have done this effectively have seen improved clinical outcomes, improved patient satisfaction, and lower cost per patient.

Magnetic resonance imaging in multiple sclerosis--patients' experiences, information interests and responses to an education programme.

PubMed

Brand, Judith; Köpke, Sascha; Kasper, Jürgen; Rahn, Anne; Backhus, Imke; Poettgen, Jana; Stellmann, Jan-Patrick; Siemonsen, Susanne; Heesen, Christoph

2014-01-01

Magnetic resonance imaging (MRI) is a key diagnostic and monitoring tool in multiple sclerosis (MS) management. However, many scientific uncertainties, especially concerning correlates to impairment and prognosis remain. Little is known about MS patients' experiences, knowledge, attitudes, and unmet information needs concerning MRI. We performed qualitative interviews (n = 5) and a survey (n = 104) with MS patients regarding MRI patient information, and basic MRI knowledge. Based on these findings an interactive training program of 2 hours was developed and piloted in n = 26 patients. Interview analyses showed that patients often feel lost in the MRI scanner and left alone with MRI results and images while 90% of patients in the survey expressed a high interest in MRI education. Knowledge on MRI issues was fair with some important knowledge gaps. Major information interests were relevance of lesions as well as the prognostic and diagnostic value of MRI results. The education program was highly appreciated and resulted in a substantial knowledge increase. Patients reported that, based on the program, they felt more competent to engage in encounters with their physicians. This work strongly supports the further development of an evidence-based MRI education program for MS patients to enhance participation in health-care.

From Residency to Lifelong Learning.

PubMed

Brandt, Keith

2015-11-01

The residency training experience is the perfect environment for learning. The university/institution patient population provides a never-ending supply of patients with unique management challenges. Resources abound that allow the discovery of knowledge about similar situations. Senior teachers provide counseling and help direct appropriate care. Periodic testing and evaluations identify deficiencies, which can be corrected with future study. What happens, however, when the resident graduates? Do they possess all the knowledge they'll need for the rest of their career? Will medical discovery stand still limiting the need for future study? If initial certification establishes that the physician has the skills and knowledge to function as an independent physician and surgeon, how do we assure the public that plastic surgeons will practice lifelong learning and remain safe throughout their career? Enter Maintenance of Certification (MOC). In an ideal world, MOC would provide many of the same tools as residency training: identification of gaps in knowledge, resources to correct those deficiencies, overall assessment of knowledge, feedback about communication skills and professionalism, and methods to evaluate and improve one's practice. This article discusses the need; for education and self-assessment that extends beyond residency training and a commitment to lifelong learning. The American Board of Plastic Surgery MOC program is described to demonstrate how it helps the diplomate reach the goal of continuous practice improvement.

Empirical Research on Spatial Diffusion Process of Knowledge Spillovers

NASA Astrophysics Data System (ADS)

Jin, Xuehui

2018-02-01

Firstly, this paper gave a brief review of the core issues of previous studies on spatial distribution of knowledge spillovers. That laid the theoretical foundation for further research. Secondly, this paper roughly described the diffusion process of solar patents in Bejing-Tianjin-Hebei and the Pearl River Delta regions by means of correlation analysis based on patent information of the application date and address of patentee. After that, this paper introduced the variables of spatial distance, knowledge absorptive capacity, knowledge gap and pollution control and built the empirical model of patent, and then collecting data to test them. The results showed that knowledge absorptive capacity was the most significant factor than the other three, followed by the knowledge gap. The influence of spatial distance on knowledge spillovers was limited and the most weak influence factor was pollution control.

Cross-cultural differences in levels of knowledge about epilepsy.

PubMed

Doughty, Julie; Baker, Gus A; Jacoby, Ann; Lavaud, Virginie

2003-01-01

To study how much people with epilepsy in Europe know and understand about their condition and how this might affect their lives. Clinical, demographic, psychosocial details and information assessing knowledge were collected by using self-completion questionnaires mailed to members of epilepsy support groups. Data were collected from 6,156 people with epilepsy from ten European countries. There were significant between-country differences in all variables considered. Overall levels of knowledge were acceptable when measured by the epilepsy knowledge questionnaire (EKQ, medical items). However, there were some gaps in knowledge, particularly in issues relating to medication and cause of epilepsy. This is the largest study of its kind to date. Results clearly highlighted that levels of knowledge differed significantly between countries. Overall, people with epilepsy are reasonably well informed about epilepsy, although some gaps in knowledge were evident.

Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

PubMed

McKinnon-Howe, Leah; Dowdall, Jayme

2018-05-01

The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Ambiguity in knowledge transfer: The role of theory-practice gap.

PubMed

Cheraghi, Mohammad Ali; Salsali, Mahvash; Safari, Mahmoud

2010-01-01

In spite of much literature written about the theory-practice gap in the international nursing journals, there is evidence that indicates this subject has not been probed comprehensively since nursing education was transferred to universities in Iran. In the recent years, the public and the government have criticized Iranian nurses because of poor quality of patient care. Although this subject has been lamented by some researchers, there is no comprehensive work on how this gap resulted. In the process of a larger study on "nursing knowledge translation to practice", of one PhD thesis, this process was explored. Using grounded theory analysis, indepth interviews were undertaken with a purposive sample of 29 nurses, with different levels of experience, from the school of nursing in Tehran University of Medical Sciences in 2006 from January to August. Data were analyzed using the constant comparative method. Three main themes emerging from this study included clinical behavior structure, paradoxical knowledge and practice, and divergent nursing organization. It seems that nursing education with some praxis and paradoxes in the realm of nursing knowledge and practice, along with divergent organizational structure have decreased nurses' ability in applying their professional knowledge and skills in order to bridge the gap between theory and practice. Moreover, in spite of increased academic input into nursing education, clinical behaviors of both education and practice settings was perceived as "traditional routine-based".

EVA Suit Studies: Human Forward Contamination Project

NASA Technical Reports Server (NTRS)

Rucker, Michelle

2017-01-01

Background: NASA Strategic Knowledge Gap B5: Forward Contamination for Mars. Issue: we have knowledge gaps!: Whether / how microbes are released from crewed pressure systems. Why do we care?: Informs Mars operational concepts - How to protect the science; Informs architecture decisions - How “open” Environmental Control and Life Support (ECLS) systems are; Informs landing site selection decisions - How close we can land / operate to where life may be present. Project goal: get some data to fill in these gaps: Data will help determine whether we’re ready to go to Mars, or if we need to change our systems or operational designs.

A quantitative systems physiology model of renal function and blood pressure regulation: Model description.

PubMed

Hallow, K M; Gebremichael, Y

2017-06-01

Renal function plays a central role in cardiovascular, kidney, and multiple other diseases, and many existing and novel therapies act through renal mechanisms. Even with decades of accumulated knowledge of renal physiology, pathophysiology, and pharmacology, the dynamics of renal function remain difficult to understand and predict, often resulting in unexpected or counterintuitive therapy responses. Quantitative systems pharmacology modeling of renal function integrates this accumulated knowledge into a quantitative framework, allowing evaluation of competing hypotheses, identification of knowledge gaps, and generation of new experimentally testable hypotheses. Here we present a model of renal physiology and control mechanisms involved in maintaining sodium and water homeostasis. This model represents the core renal physiological processes involved in many research questions in drug development. The model runs in R and the code is made available. In a companion article, we present a case study using the model to explore mechanisms and pharmacology of salt-sensitive hypertension. © 2017 The Authors CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

Understanding information and education gaps among people with type 1 diabetes: a qualitative investigation.

PubMed

Rankin, David; Heller, Simon; Lawton, Julia

2011-04-01

Many patients with type 1 diabetes struggle to self-manage this chronic disease, often because they have a poor knowledge and understanding of the condition. However, little attention has been paid to examining the reasons for this poor knowledge/understanding. To inform future educational interventions, we explored patients' accounts of the education and information they had received since diagnosis, and the reasons behind gaps in their diabetes knowledge. Semi-structured interviews were conducted with 30 type 1 diabetes patients enrolled on a structured education programme in the UK. Data were analysed using an inductive, thematic approach. Patients' accounts illustrated a number of knowledge deficits which were influenced by various lifecourse events. Reasons for deficits included: diagnosis at a young age and assumption of decision-making responsibility by parents; lack of engagement with information when feeling well; transitions in care; inconsistency in information provision; and, lack of awareness that knowledge was poor or incomplete. Patients' knowledge deficits can arise for different reasons, at different points in the lifecourse, and may change over time. The delivery of individualised education should take account of the origins of patients' knowledge gaps and be provided on a regular and on-going basis. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports

PubMed Central

Newquist, Deborah D.; DeLiema, Marguerite; Wilber, Kathleen H.

2016-01-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. PMID:26062611

Mind the Gap: Privileging Epistemic Access to Knowledge in the Transition from Leaving Certificate Music to Higher Education

ERIC Educational Resources Information Center

Moore, Gwen

2014-01-01

In recent years, music at Leaving Certificate level has come under increasing focus in media and higher education discourse as an easy option. In particular, scant attention has been paid to the musical knowledge and skills needed in the transition to higher music education within the Irish context. This paper addresses the perceived gap in…

First-Time Knowledge Brokers in Health Care: The Experiences of Nurses and Allied Health Professionals of Bridging the Research-Practice Gap

ERIC Educational Resources Information Center

Wright, Nicola

2013-01-01

This study describes the experiences of nurses and allied health professionals as first-time knowledge brokers, attempting to bridge the research-practice gap within health care. A qualitative study using in-depth interviews and documentary analysis was conducted. The data was analysed using a thematic analysis strategy. Participants were 17…

Tranexamic Acid and Trauma: Current Status and Knowledge Gaps with Recommended Research Priorities

DTIC Science & Technology

2013-01-01

Review Article TRANEXAMIC ACID AND TRAUMA: CURRENT STATUS AND KNOWLEDGE GAPS WITH RECOMMENDED RESEARCH PRIORITIES Anthony E. Pusateri,* Richard B...on the use of tranexamic acid (TXA) for trauma reported important survival benefits. Subsequently, successful use of TXA for combat casualties in...refinement of practice guidelines over time. KEYWORDS— Tranexamic acid , trauma, efficacy, safety, research requirements INTRODUCTION Tranexamic acid (TXA

Knowledge translation in Africa for 21st century integrative biology: the "know-do gap" in family planning with contraceptive use among Somali women.

PubMed

Ahmed, Ahmed A; Mohamed, Abdullahi A; Guled, Ibrahim A; Elamin, Hayfa M; Abou-Zeid, Alaa H

2014-11-01

An emerging dimension of 21(st) century integrative biology is knowledge translation in global health. The maternal mortality rate in Somalia is amongst the highest in the world. We set out to study the "know-do" gap in family planning measures in Somalia, with a view to inform future interventions for knowledge integration between theory and practice. We interviewed 360 Somali females of reproductive age and compared university-educated females to women with less or no education, using structured interviews, with a validated questionnaire. The mean age of marriage was 18 years, with 4.5 pregnancies per marriage. The mean for the desired family size was 9.3 and 10.5 children for the university-educated group and the less-educated group, respectively. Importantly, nearly 90% of the university-educated group knew about family planning, compared to 45.6% of the less-educated group. All of the less-educated group indicated that they would never use contraceptives, as compared to 43.5% of the university-educated group. Prevalence of contraceptive use among ever-married women was 4.3%. In the less-educated group, 80.6% indicated that they would not recommend contraceptives to other women as compared to 66.0% of the university-educated group. There is a huge gap between knowledge and practice regarding family planning in Somalia. The attendant reasons for this gap, such as level of education, expressed personal religious beliefs and others, are examined here. For primary health care to gain traction in Africa, we need to address the existing "know-do" gaps that are endemic and adversely impacting on global health. This is the first independent research study examining the knowledge gaps for family planning in Somalia in the last 20 years, with a view to understanding knowledge integration in a global world. The results shall guide policy makers, donors, and implementers to develop a sound family planning policy and program to improve maternal and child health in 21(st) century primary healthcare.

A review of quantitative structure-property relationships for the fate of ionizable organic chemicals in water matrices and identification of knowledge gaps.

PubMed

Nolte, Tom M; Ragas, Ad M J

2017-03-22

Many organic chemicals are ionizable by nature. After use and release into the environment, various fate processes determine their concentrations, and hence exposure to aquatic organisms. In the absence of suitable data, such fate processes can be estimated using Quantitative Structure-Property Relationships (QSPRs). In this review we compiled available QSPRs from the open literature and assessed their applicability towards ionizable organic chemicals. Using quantitative and qualitative criteria we selected the 'best' QSPRs for sorption, (a)biotic degradation, and bioconcentration. The results indicate that many suitable QSPRs exist, but some critical knowledge gaps remain. Specifically, future focus should be directed towards the development of QSPR models for biodegradation in wastewater and sediment systems, direct photolysis and reaction with singlet oxygen, as well as additional reactive intermediates. Adequate QSPRs for bioconcentration in fish exist, but more accurate assessments can be achieved using pharmacologically based toxicokinetic (PBTK) models. No adequate QSPRs exist for bioconcentration in non-fish species. Due to the high variability of chemical and biological species as well as environmental conditions in QSPR datasets, accurate predictions for specific systems and inter-dataset conversions are problematic, for which standardization is needed. For all QSPR endpoints, additional data requirements involve supplementing the current chemical space covered and accurately characterizing the test systems used.

A review on alum sludge reuse with special reference to agricultural applications and future challenges.

PubMed

Dassanayake, K B; Jayasinghe, G Y; Surapaneni, A; Hetherington, C

2015-04-01

Alum salts are commonly used in the water industry to promote coagulation in the production of clean drinking water, which results in the generation and accumulation of 'waste' by-product 'alum sludge' in large volumes. Effective and efficient management of alum sludge in an economically and environmentally sustainable manner remains a significant social and environmental concern with ever increasing demand for potable water as a result of rapidly escalating world population and urban expansion. Various intensive practices have been employed to reuse the alum sludge in an attempt to figure out how to fill the gap between successful drinking water treatment process and environmentally friendly alum sludge management for over the years. This paper primarily aimed at comprehensive review of the existing literature on alum sludge characteristics, its environmental concerns and their potential utilization, especially in agricultural and horticultural sectors leading to update our recent state of knowledge and formulate a compendium of present and past developments. Different types of alum sludge utilizations in various fields were recognized and examined. The strengths, weaknesses, opportunities and potential risks of alum sludge reuse options with particular reference to agriculture were highlighted and knowledge gaps were identified. Research priorities and future challenges that will support in the development of effective alumsludgemanagement practices in agriculture with multi-prong strategies were discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Carbon-water Cycling in the Critical Zone: Understanding Ecosystem Process Variability Across Complex Terrain

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

Barnard, Holly; Brooks, Paul

2016-06-16

One of the largest knowledge gaps in environmental science is the ability to understand and predict how ecosystems will respond to future climate variability. The links between vegetation, hydrology, and climate that control carbon sequestration in plant biomass and soils remain poorly understood. Soil respiration is the second largest carbon flux of terrestrial ecosystems, yet there is no consensus on how respiration will change as water availability and temperature co-vary. To address this knowledge gap, we use the variation in soil development and topography across an elevation and climate gradient on the Front Range of Colorado to conduct a naturalmore » experiment that enables us to examine the co-evolution of soil carbon, vegetation, hydrology, and climate in an accessible field laboratory. The goal of this project is to further our ability to combine plant water availability, carbon flux and storage, and topographically driven hydrometrics into a watershed scale predictive model of carbon balance. We hypothesize: (i) landscape structure and hydrology are important controls on soil respiration as a result of spatial variability in both physical and biological drivers: (ii) variation in rates of soil respiration during the growing season is due to corresponding shifts in belowground carbon inputs from vegetation; and (iii) aboveground carbon storage (biomass) and species composition are directly correlated with soil moisture and therefore, can be directly related to subsurface drainage patterns.« less

Athletic Trainers' Knowledge Regarding Airway Adjuncts

ERIC Educational Resources Information Center

Edler, Jessica R.; Eberman, Lindsey E.; Kahanov, Leamor; Roman, Christopher; Mata, Heather Lynne

2015-01-01

Context: Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective: To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the…

Health literacy and knowledge in a cohort of Australian patients taking warfarin.

PubMed

Yiu, Angela W; Bajorek, Beata V

2018-01-01

To 1) characterise older patients taking warfarin, 2) assess these patients' level of warfarin knowledge, and 3) describe their strengths and limitations in health literacy, and 4) explore relationships between participants' characteristics, warfarin knowledge and health literacy. A warfarin knowledge questionnaire and Health Literacy Questionnaire (HLQ) were administered to older patients (aged >65 years, N=34) taking warfarin in an Australian general practice setting. Key gaps in participant knowledge pertained to the consequences of an international normalized ratio (INR) being below the target INR range and safety issues such as when to seek medical attention. A limitation for participants with a lower level of health literacy was the ability to appraise health information. Patients who needed assistance in completing the HLQs had significantly lower warfarin knowledge scores (p=0.03). Overseas-born participants and those taking 5 or more long-term medications had lower HLQ scores for specific scales (p<0.05). In this study warfarin knowledge gaps and a limitation of health literacy amongst a small sample of older patients were identified. The findings suggest that education and resources may need to be tailored to the needs of older patients taking warfarin and their carers to address these knowledge gaps and limitations in health literacy. Patients who may need greater support include those that need assistance in completing the HLQ, are overseas-born, or are taking 5 or more long-term medications.

The dynamics of team cognition: A process-oriented theory of knowledge emergence in teams.

PubMed

Grand, James A; Braun, Michael T; Kuljanin, Goran; Kozlowski, Steve W J; Chao, Georgia T

2016-10-01

Team cognition has been identified as a critical component of team performance and decision-making. However, theory and research in this domain continues to remain largely static; articulation and examination of the dynamic processes through which collectively held knowledge emerges from the individual- to the team-level is lacking. To address this gap, we advance and systematically evaluate a process-oriented theory of team knowledge emergence. First, we summarize the core concepts and dynamic mechanisms that underlie team knowledge-building and represent our theory of team knowledge emergence (Step 1). We then translate this narrative theory into a formal computational model that provides an explicit specification of how these core concepts and mechanisms interact to produce emergent team knowledge (Step 2). The computational model is next instantiated into an agent-based simulation to explore how the key generative process mechanisms described in our theory contribute to improved knowledge emergence in teams (Step 3). Results from the simulations demonstrate that agent teams generate collectively shared knowledge more effectively when members are capable of processing information more efficiently and when teams follow communication strategies that promote equal rates of information sharing across members. Lastly, we conduct an empirical experiment with real teams participating in a collective knowledge-building task to verify that promoting these processes in human teams also leads to improved team knowledge emergence (Step 4). Discussion focuses on implications of the theory for examining team cognition processes and dynamics as well as directions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Internet-based learning programme to increase nurses' knowledge level about venous leg ulcer care in home health care.

PubMed

Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

2017-11-01

To test the effectiveness of an Internet-based education programme about venous leg ulcer nursing care on perceived and theoretical knowledge levels and attitudes among nurses working in home health care. Nurses have been shown to have knowledge gaps in venous leg ulcer nursing care. Internet-based learning could offer a means for flexible continuing education for home healthcare environment. Quasi-experimental study with pre- and postmeasurements and nonequivalent intervention and comparison groups. Nurses (n = 946) in home health care in two Finnish municipalities were invited to participate in the study and divided into intervention and comparison groups. The intervention group received education programme about venous leg ulcer nursing care, while the comparison group did not. Data were collected at baseline, at six weeks and at 10 weeks to test the hypotheses: nurses using education programme about venous leg ulcer nursing care will have higher level of knowledge and more positive attitudes than those not using education programme about venous leg ulcer nursing care. An analysis of variance and mixed models with repeated measures were used to test differences in knowledge and attitudes between and within the groups. There were statistically significant increases in knowledge levels in the intervention group from baseline to the first and second follow-up measurements. In the comparison group, the knowledge levels remained unchanged during the study. Attitude levels remained unchanged in both groups. Nurses' perceived and theoretical knowledge levels of venous leg ulcer nursing care can be increased with Internet-based education. However, this increase in knowledge levels is short-lived, which emphasises the need for continuous education. Internet-based education about venous leg ulcer nursing care is recommended for home healthcare nurses. Education programme about venous leg ulcer nursing care provides flexible method for nurses' learning with feasible and cost-effective access to evidence-based education. Education programme about venous leg ulcer nursing care material can be used in all nursing environments where Internet is available. © 2017 John Wiley & Sons Ltd.

New horizons in the implementation and research of comprehensive geriatric assessment: knowing, doing and the 'know-do' gap.

PubMed

Gladman, John R F; Conroy, Simon Paul; Ranhoff, Anette Hylen; Gordon, Adam Lee

2016-03-01

In this paper, we outline the relationship between the need to put existing applied health research knowledge into practice (the 'know-do gap') and the need to improve the evidence base (the 'know gap') with respect to the healthcare process used for older people with frailty known as comprehensive geriatric assessment (CGA). We explore the reasons for the know-do gap and the principles of how these barriers to implementation might be overcome. We explore how these principles should affect the conduct of applied health research to close the know gap. We propose that impaired flow of knowledge is an important contributory factor in the failure to implement evidence-based practice in CGA; this could be addressed through specific knowledge mobilisation techniques. We describe that implementation failures are also produced by an inadequate evidence base that requires the co-production of research, addressing not only effectiveness but also the feasibility and acceptability of new services, the educational needs of practitioners, the organisational requirements of services, and the contribution made by policy. Only by tackling these issues in concert and appropriate proportion, will the know and know-do gaps for CGA be closed. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A cross sectional study of knowledge and attitudes towards tuberculosis amongst front-line tuberculosis personnel in high burden areas of Lima, Peru.

PubMed

Minnery, Mark; Contreras, Carmen; Pérez, Rosa; Solórzano, Ninfa; Tintaya, Karen; Jimenez, Judith; Soto, Silvia; Lecca, Leonid

2013-01-01

Tuberculosis, reported as the second most common infectious cause of death worldwide, is a key mortality contributor in developing countries and globally. The disease is endemic in Peru and while relative success was achieved during the 1990s in its control, this slowed as new complications, such as multi drug resistant TB arose. Health centre workers participating in the national DOTS program, create the front-line TB work-force in Peru meaning their knowledge and attitudes about the disease are key in its control. A Spanish language, multiple choice knowledge and attitudes survey was designed based on previous successful studies and the national Peruvian TB control guidelines. It was applied to two health networks in Lima, Peru amongst 301 health workers participating in the national TB control program from 66 different health centres. The study results were analysed to test mean knowledge scores amongst different groups, overall gaps in key areas of TB treatment and control knowledge, and attitudes towards the disease and the national TB control program. A mean knowledge score of 10.1 (+/- 1.7) out of 15 or 67.3% correct was shown. Demographics shown to have an effect on knowledge score were age and level of education. Major knowledge gaps were noted primarily in themes relating to treatment and diagnostics. Greater community involvement including better patient education about TB was seen as important in implementing the national TB control program. Participants were in disagreement about the current distribution of health resources throughout the study area. Discussion Serious knowledge gaps were identified from the survey; these reflect findings from a previous study in Lima and other studies from TB endemic areas throughout the world. Understanding these gaps and observations made by front-line TB workers in Lima may help to improve the national TB control program and other control efforts globally.

Sexual Knowledge among Norwegian Adolescents.

ERIC Educational Resources Information Center

Kraft, Pal

1993-01-01

Studied sexual knowledge among Norwegian adolescents (n=1,855) aged 17-19 years. Found knowledge gaps among adolescents on sexual physiology and anatomy, sexually transmitted diseases, and fecundation/contraception. Level of sexual knowledge was higher among girls than boys and increased with increasing age. Sexual knowledge did not predict…

Research Networks, Mentorship and Sustainability Knowledge

NASA Astrophysics Data System (ADS)

Kafle, A.; Mukhopadhyay, P.; Nepal, M.; Shyamsundar, P.

2015-12-01

In South Asia, a majority of institutions are ill-equipped to undertake research on multi-disciplinary environmental problems, though these problems are increasing at a fast rate and connected to the region's poverty and growth objectives. In this context, the South Asian Network for Development and Environmental Economics (SANDEE) tries to fill a research, training and knowledge gap by building skills in the area of Environment and Development Economics. In this paper, the authors argue that research networks contribute to the growth of sustainability knowledge through (a) knowledge creation, (b) knowledge transfer and (c) knowledge deepening. The paper tries to show the relationship between capacity building, mentorship and research scholarship. It demonstrates that researchers, by associating with the network and its multiple training and mentoring processes, are able to build skills, change curricula and deliver useful knowledge products. The paper discusses the need for interdisciplinary research and the challenges of bridging the gap between research outputs and policy reforms.

Agriculture and nutrition in India: mapping evidence to pathways.

PubMed

Kadiyala, Suneetha; Harris, Jody; Headey, Derek; Yosef, Sivan; Gillespie, Stuart

2014-12-01

In India, progress against undernutrition has been slow. Given its importance for income generation, improving diets, care practices, and maternal health, the agriculture sector is widely regarded as playing an important role in accelerating the reduction in undernutrition. This paper comprehensively maps existing evidence along agriculture-nutrition pathways in India and assesses both the quality and coverage of the existing literature. We present a conceptual framework delineating six key pathways between agriculture and nutrition. Three pathways pertain to the nutritional impacts of farm production, farm incomes, and food prices. The other three pertain to agriculture-gender linkages. After an extensive search, we found 78 research papers that provided evidence to populate these pathways. The literature suggests that Indian agriculture has a range of important influences on nutrition. Agriculture seems to influence diets even when controlling for income, and relative food prices could partly explain observed dietary changes in recent decades. The evidence on agriculture-gender linkages to nutrition is relatively weak. Sizeable knowledge gaps remain. The root causes of these gaps include an interdisciplinary disconnect between nutrition and economics/agriculture, a related problem of inadequate survey data, and limited policy-driven experimentation. Closing these gaps is essential to strengthening the agriculture sector's contribution to reducing undernutrition. © 2014 New York Academy of Sciences.

Acculturative family distancing (AFD) and depression in Chinese American families.

PubMed

Hwang, Wei-Chin; Wood, Jeffrey J; Fujimoto, Ken

2010-10-01

Knowledge of acculturative processes and their impact on immigrant families remains quite limited. Acculturative family distancing (AFD) is the distancing that occurs between immigrant parents and their children and is caused by breakdowns in communication and cultural value differences. It is a more proximal and problem-focused formulation of the acculturation gap and is hypothesized to increase depression via family conflict. Data were collected from 105 Chinese American high school students and their mothers. Rasch modeling was used to refine the AFD measure, and structural equation modeling was used to determine the effects of AFD on youth and maternal depression. Findings indicate that greater AFD was associated with higher depressive symptoms and risk for clinical depression. Family conflict partially mediated this relation for youths, whereas for mothers, AFD directly increased risk for depression. Greater mother-child heritage enculturation discrepancies were associated with greater mother and child AFD. Mainstream acculturation discrepancies and language gaps between mothers and youths were not significantly associated with any of the primary outcome variables. Results highlight the need for better understanding of how AFD and other acculturation-gap phenomena affect immigrant mental health. They also underscore the need for prevention and intervention programs that target communication difficulties and intergenerational cultural value differences. Copyright 2010 APA, all rights reserved.

Reactor Safety Gap Evaluation of Accident Tolerant Components and Severe Accident Analysis

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

Farmer, Mitchell T.; Bunt, R.; Corradini, M.

The overall objective of this study was to conduct a technology gap evaluation on accident tolerant components and severe accident analysis methodologies with the goal of identifying any data and/or knowledge gaps that may exist, given the current state of light water reactor (LWR) severe accident research, and additionally augmented by insights obtained from the Fukushima accident. The ultimate benefit of this activity is that the results can be used to refine the Department of Energy’s (DOE) Reactor Safety Technology (RST) research and development (R&D) program plan to address key knowledge gaps in severe accident phenomena and analyses that affectmore » reactor safety and that are not currently being addressed by the industry or the Nuclear Regulatory Commission (NRC).« less

Effect of point defects on the electronic density states of SnC nanosheets: First-principles calculations

NASA Astrophysics Data System (ADS)

Majidi, Soleyman; Achour, Amine; Rai, D. P.; Nayebi, Payman; Solaymani, Shahram; Beryani Nezafat, Negin; Elahi, Seyed Mohammad

In this work, we investigated the electronic and structural properties of various defects including single Sn and C vacancies, double vacancy of the Sn and C atoms, anti-sites, position exchange and the Stone-Wales (SW) defects in SnC nanosheets by using density-functional theory (DFT). We found that various vacancy defects in the SnC monolayer can change the electronic and structural properties. Our results show that the SnC is an indirect band gap compound, with the band gap of 2.10 eV. The system turns into metal for both structure of the single Sn and C vacancies. However, for the double vacancy contained Sn and C atoms, the structure remains semiconductor with the direct band gap of 0.37 eV at the G point. We also found that for anti-site defects, the structure remains semiconductor and for the exchange defect, the structure becomes indirect semiconductor with the K-G point and the band gap of 0.74 eV. Finally, the structure of SW defect remains semiconductor with the direct band gap at K point with band gap of 0.54 eV.

Expanding Knowledge Gaps: The Function of Fictions in Teaching Materials after the 2011 Swedish High School Reform

ERIC Educational Resources Information Center

Graeske, Caroline

2016-01-01

The aim in the study is to analyze how work with fiction is organized in six textbooks for senior high school in Sweden after the school reform 2011. Research into Swedish teaching materials has been neglected in recent years and there is a knowledge gap about how the work with fictions is affected by the reform in 2011. In the study quantitative…

Conceptual Model-Based Systems Biology: Mapping Knowledge and Discovering Gaps in the mRNA Transcription Cycle

PubMed Central

Somekh, Judith; Choder, Mordechai; Dori, Dov

2012-01-01

We propose a Conceptual Model-based Systems Biology framework for qualitative modeling, executing, and eliciting knowledge gaps in molecular biology systems. The framework is an adaptation of Object-Process Methodology (OPM), a graphical and textual executable modeling language. OPM enables concurrent representation of the system's structure—the objects that comprise the system, and behavior—how processes transform objects over time. Applying a top-down approach of recursively zooming into processes, we model a case in point—the mRNA transcription cycle. Starting with this high level cell function, we model increasingly detailed processes along with participating objects. Our modeling approach is capable of modeling molecular processes such as complex formation, localization and trafficking, molecular binding, enzymatic stimulation, and environmental intervention. At the lowest level, similar to the Gene Ontology, all biological processes boil down to three basic molecular functions: catalysis, binding/dissociation, and transporting. During modeling and execution of the mRNA transcription model, we discovered knowledge gaps, which we present and classify into various types. We also show how model execution enhances a coherent model construction. Identification and pinpointing knowledge gaps is an important feature of the framework, as it suggests where research should focus and whether conjectures about uncertain mechanisms fit into the already verified model. PMID:23308089

A qualitative study of how patients with type 2 diabetes use an electronic stand-alone personal health record.

PubMed

Fuji, Kevin T; Abbott, Amy A; Galt, Kimberly A

2015-04-01

Patient use of personal health records (PHRs) to manage their health information has been proposed to enhance patient knowledge and empower patients to make changes in their self-care behaviors. However, there remains a gap in understanding about patients' actual PHR use behaviors. The purpose of this qualitative study was to explore how patients with type 2 diabetes used a PHR to manage their diabetes-related health information for self-care. Fifty-nine patients with type 2 diabetes were interviewed 3-6 months after receiving initial training on a free-of-charge, Web-based PHR. Interviews were audio-recorded, transcribed, and analyzed using an iterative process of in vivo coding, categorization, and theme development. Nine themes emerged, three of which expressed positive experiences: complete and accessible record; increased awareness; and behavioral changes. The remaining six themes expressed negative experiences: out of sight, out of mind; I would have used it if I were sicker; economic, infrastructure, and computer literacy barriers; lack of patient-provider engagement; double tracking; and privacy and security concerns. Despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. Provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.

Connecting the coronaries: How the coronary plexus develops and is functionalized

PubMed Central

Dyer, Laura; Pi, Xinchun; Patterson, Cam

2015-01-01

The establishment of the coronary circulation is one of the final critical steps during heart development. Despite decades of research, our understanding of how the coronary vasculature develops and connects to the aorta remains limited. This review serves two specific purposes: it addresses recent advances in understanding the origin of the coronary endothelium, and it then focuses on the last crucial step of coronary vasculature development, the connection of the coronary plexus to the aorta. The chick and quail animal models have yielded most of the information for how these connections form, starting with a fine network of vessels that penetrate the aorta and coalesce to form two distinct ostia. Studies in mouse and rat confirm that at least some of these steps are conserved in mammals, but gaps still exist in our understanding of mammalian coronary ostia formation. The signaling cues necessary to guide the coronary plexus to the aorta are also incompletely understood. Hypoxia-inducible transcription factor-1 and its downstream targets are among the few identified genes that promote the formation of the coronary stems. Together, this review summarizes our current knowledge of coronary vascular formation and highlights the significant gaps that remain. In addition, it highlights some of the coronary artery anomalies known to affect human health, demonstrating that even seemingly subtle defects arising from incorrect coronary plexus formation can result in significant health crises. PMID:25173872

Device-independent point estimation from finite data and its application to device-independent property estimation

NASA Astrophysics Data System (ADS)

Lin, Pei-Sheng; Rosset, Denis; Zhang, Yanbao; Bancal, Jean-Daniel; Liang, Yeong-Cherng

2018-03-01

The device-independent approach to physics is one where conclusions are drawn directly from the observed correlations between measurement outcomes. In quantum information, this approach allows one to make strong statements about the properties of the underlying systems or devices solely via the observation of Bell-inequality-violating correlations. However, since one can only perform a finite number of experimental trials, statistical fluctuations necessarily accompany any estimation of these correlations. Consequently, an important gap remains between the many theoretical tools developed for the asymptotic scenario and the experimentally obtained raw data. In particular, a physical and concurrently practical way to estimate the underlying quantum distribution has so far remained elusive. Here, we show that the natural analogs of the maximum-likelihood estimation technique and the least-square-error estimation technique in the device-independent context result in point estimates of the true distribution that are physical, unique, computationally tractable, and consistent. They thus serve as sound algorithmic tools allowing one to bridge the aforementioned gap. As an application, we demonstrate how such estimates of the underlying quantum distribution can be used to provide, in certain cases, trustworthy estimates of the amount of entanglement present in the measured system. In stark contrast to existing approaches to device-independent parameter estimations, our estimation does not require the prior knowledge of any Bell inequality tailored for the specific property and the specific distribution of interest.

The Trilogy of Science: Filling the Knowledge Management Gap with Knowledge Science and Theory

ERIC Educational Resources Information Center

Bates, Anthony Shawn

2017-01-01

The international knowledge management field has different ways of investigating, developing, believing, and studying knowledge management. Knowledge management (KM) is distinguished deductively by know-how, and its intangible nature establishes different approaches to KM concepts, practices, and developments. Exploratory research and theoretical…

Reply to: Mounting evidence indicates that escalating doses of allopurinol are unnecessary for cardiovascular protection.

PubMed

Coburn, Brian W; Michaud, Kaleb; Bergman, Debra A; Mikuls, Ted R

2018-05-08

We thank Dr. Bredemeier for his comments regarding our manuscript on allopurinol dose escalation and mortality. He raises important evidence to consider in support of an interesting hypothesis that dose escalation may be unnecessary for allopurinol's cardiovascular (CV) protection and may actually be related to adverse CV outcomes. While we agree that evidence exists suggesting that low doses of allopurinol may be sufficient for CV protection, we believe that the studies cited highlight a number of areas where knowledge gaps remain which preclude any definitive conclusions about the effect of dose escalation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Reorienting Esthetic Knowing as an Appropriate "Object" of Scientific Inquiry to Advance Understanding of a Critical Pattern of Nursing Knowledge in Practice.

PubMed

Bender, Miriam; Elias, Dina

The esthetic pattern of knowing is critical for nursing practice, yet remains weakly defined and understood. This gap has arguably relegated esthetic knowing to an "ineffable" creativity that resists transparency and understanding, which is a barrier to articulating its value for nursing and its importance in producing beneficial health outcomes. Current philosophy of science developments are synthesized to argue that esthetic knowing is an appropriate "object" of scientific inquiry. Examples of empirical scholarship that can be conceived as scientific inquiry into manifestations of esthetic knowing are highlighted. A program of research is outlined to advance a science of esthetic knowing.

Polio vaccination: past, present and future.

PubMed

Bandyopadhyay, Ananda S; Garon, Julie; Seib, Katherine; Orenstein, Walter A

2015-01-01

Live attenuated oral polio vaccine (OPV) and inactivated polio vaccine (IPV) are the tools being used to achieve eradication of wild polio virus. Because OPV can rarely cause paralysis and generate revertant polio strains, IPV will have to replace OPV after eradication of wild polio virus is certified to sustain eradication of all polioviruses. However, uncertainties remain related to IPV's ability to induce intestinal immunity in populations where fecal-oral transmission is predominant. Although substantial effectiveness and safety data exist on the use and delivery of OPV and IPV, several new research initiatives are currently underway to fill specific knowledge gaps to inform future vaccination policies that would assure polio is eradicated and eradication is maintained.

A systematic evaluation of websites offering information on chronic kidney disease.

PubMed

Lutz, Erin R; Costello, Kaitlin L; Jo, Minjeong; Gilet, Constance A; Hawley, Jennifer M; Bridgman, Jessica C; Song, Mi-Kyung

2014-01-01

In this study, we described the content and characteristics of 40 non-proprietary websites offering information about chronic kidney disease (CKD) and evaluated their information quality using the DISCERN scale and readability using Flesch Reading Ease and Flesch-Kincaid grade level. The areas in which the websites scored the lowest on the DISCERN scale were whether the website discussed knowledge gaps, presented balanced information, and was clear about the information source. Websites that rated higher quality on the DISCERN scale were more difficult to read. The quality and readability of many websites about CKD to be used as meaningful educational resources for patients who desire to learn more about CKD and treatment options remain inadequate.

AMYGDALA MICROCIRCUITS CONTROLLING LEARNED FEAR

PubMed Central

Duvarci, Sevil; Pare, Denis

2014-01-01

We review recent work on the role of intrinsic amygdala networks in the regulation of classically conditioned defensive behaviors, commonly known as conditioned fear. These new developments highlight how conditioned fear depends on far more complex networks than initially envisioned. Indeed, multiple parallel inhibitory and excitatory circuits are differentially recruited during the expression versus extinction of conditioned fear. Moreover, shifts between expression and extinction circuits involve coordinated interactions with different regions of the medial prefrontal cortex. However, key areas of uncertainty remain, particularly with respect to the connectivity of the different cell types. Filling these gaps in our knowledge is important because much evidence indicates that human anxiety disorders results from an abnormal regulation of the networks supporting fear learning. PMID:24908482

Improving Surface Mass Balance Over Ice Sheets and Snow Depth on Sea Ice

NASA Technical Reports Server (NTRS)

Koenig, Lora Suzanne; Box, Jason; Kurtz, Nathan

2013-01-01

Surface mass balance (SMB) over ice sheets and snow on sea ice (SOSI) are important components of the cryosphere. Large knowledge gaps remain in scientists' abilities to monitor SMB and SOSI, including insufficient measurements and difficulties with satellite retrievals. On ice sheets, snow accumulation is the sole mass gain to SMB, and meltwater runoff can be the dominant single loss factor in extremely warm years such as 2012. SOSI affects the growth and melt cycle of the Earth's polar sea ice cover. The summer of 2012 saw the largest satellite-recorded melt area over the Greenland ice sheet and the smallest satellite-recorded Arctic sea ice extent, making this meeting both timely and relevant.

Bridging the gap: simulations meet knowledge bases

NASA Astrophysics Data System (ADS)

King, Gary W.; Morrison, Clayton T.; Westbrook, David L.; Cohen, Paul R.

2003-09-01

Tapir and Krill are declarative languages for specifying actions and agents, respectively, that can be executed in simulation. As such, they bridge the gap between strictly declarative knowledge bases and strictly executable code. Tapir and Krill components can be combined to produce models of activity which can answer questions about mechanisms and processes using conventional inference methods and simulation. Tapir was used in DARPA's Rapid Knowledge Formation (RKF) project to construct models of military tactics from the Army Field Manual FM3-90. These were then used to build Courses of Actions (COAs) which could be critiqued by declarative reasoning or via Monte Carlo simulation. Tapir and Krill can be read and written by non-knowledge engineers making it an excellent vehicle for Subject Matter Experts to build and critique knowledge bases.

Identifying knowledge-attitude-practice gaps to enhance HPV vaccine diffusion.

PubMed

Cohen, Elisia L; Head, Katharine J

2013-01-01

To examine differences in knowledge, attitudes, and related practices among adopters and nonadopters of the human papillomavirus (HPV) vaccine, the researchers conducted 83 in-depth interviews with 18- to 26-year-old women. The study identified knowledge-attitude-practice gaps in the context of the HPV vaccine to explain why diffusion of a preventive innovation (such as the HPV vaccine) requires targeted risk communication strategies in order to increase demand. Salient findings included similarities between vaccinated and unvaccinated women's lack of knowledge and uncertainties about HPV and cervical cancer. Vaccinated women who had no knowledge of HPV or no-risk/low-risk perceptions of HPV reported receiving vaccination, indicating HPV risk protection behavior could precede knowledge acquisition for vaccinated women. These vaccinated women identified an interpersonal network supportive of vaccination and reported supportive social influences. Among unvaccinated women, unsupportive vaccination attitudes included low perceived personal risk of HPV. In contrast, unvaccinated women often cited erroneous beliefs that HPV could be avoided by abstinence, monogamy, and knowledge of their partners' sexual history as reasons that the vaccine was not personally relevant. Unvaccinated women cited interpersonal influences that activated short- and long-term vaccination safety and efficacy concerns. Different levels of fear regarding the HPV vaccine may underlie (a) attitudinal differences between vaccinated and unvaccinated women in perceived vaccination value and (b) attitude-practice gaps.

A quantitative analysis of the mass media coverage of genomics medicine in China: a call for science journalism in the developing world.

PubMed

Zhao, Feifei; Chen, Yan; Ge, Siqi; Yu, Xinwei; Shao, Shuang; Black, Michael; Wang, Youxin; Zhang, Jie; Song, Manshu; Wang, Wei

2014-04-01

Science journalism is a previously neglected but rapidly growing area of scholarship in postgenomics medicine and socio-technical studies of knowledge-based innovations. Science journalism can help evaluate the quantity and quality of information flux between traditional scientific expert communities and the broader public, for example, in personalized medicine education. Newspapers can play a crucial role in science and health communication, and more importantly, in framing public engagement. However, research on the role of newspaper coverage of genomics-related articles has not been readily available in resource-limited settings. As genomics is rapidly expanding worldwide, this gap in newspaper reportage in China is therefore an important issue. In order to bridge this gap, we investigated the coverage of genomics medicine in eight major Chinese national newspapers, using the China Core Newspapers Full-text Database (CCND) and articles in scientific journals in PubMed from 2000 to 2011. Coverage of genomics medicine in these eight official government Chinese newspapers has remained low, with only 12 articles published per newspaper per year between 2000 and 2011. Between 2000 and 2011, over a 40-fold difference was observed in the number of genomics medicine-related articles in PubMed, as compared to that in newspapers. The numbers of genomics-related articles among the eight major newspapers from 2000 to 2011 were significantly different (p=0.001). Commentary/mini reviews and articles about gene therapy for specific diseases were most frequently published in 2006 and 2011. In parallel, we observed that "cancer gene therapy," "new susceptibility gene locus," and "gene technology revolution" were the top three thematic strands addressed in the newspapers, even though their volume remained low. This study reports on the under-representation of newspaper coverage of genomics medicine in China, despite the vast growth of scientific articles in journals in this knowledge domain. This underscores the need to enhance collaboration between scientists, medical professionals, and journalists as an important strand of overall communications efforts in disseminating genomic medicine knowledge to larger audiences. Yet a substantive question remains to be examined: would traditional journalism, alone, be adequate to address the advances and challenges in genomics medicine in the media? Conversely, should we invest in science journalism programs as a subspecialty in biomedicine so scientists and clinicians acquire the twin scholarship of science/clinical medicine and journalism in their formative education?

A Quantitative Analysis of the Mass Media Coverage of Genomics Medicine in China: A Call for Science Journalism in the Developing World

PubMed Central

Zhao, Feifei; Chen, Yan; Ge, Siqi; Yu, Xinwei; Shao, Shuang; Black, Michael; Wang, Youxin; Zhang, Jie; Wang, Wei

2014-01-01

Abstract Science journalism is a previously neglected but rapidly growing area of scholarship in postgenomics medicine and socio-technical studies of knowledge-based innovations. Science journalism can help evaluate the quantity and quality of information flux between traditional scientific expert communities and the broader public, for example, in personalized medicine education. Newspapers can play a crucial role in science and health communication, and more importantly, in framing public engagement. However, research on the role of newspaper coverage of genomics-related articles has not been readily available in resource-limited settings. As genomics is rapidly expanding worldwide, this gap in newspaper reportage in China is therefore an important issue. In order to bridge this gap, we investigated the coverage of genomics medicine in eight major Chinese national newspapers, using the China Core Newspapers Full-text Database (CCND) and articles in scientific journals in PubMed from 2000 to 2011. Coverage of genomics medicine in these eight official government Chinese newspapers has remained low, with only 12 articles published per newspaper per year between 2000 and 2011. Between 2000 and 2011, over a 40-fold difference was observed in the number of genomics medicine-related articles in PubMed, as compared to that in newspapers. The numbers of genomics-related articles among the eight major newspapers from 2000 to 2011 were significantly different (p=0.001). Commentary/mini reviews and articles about gene therapy for specific diseases were most frequently published in 2006 and 2011. In parallel, we observed that “cancer gene therapy,” “new susceptibility gene locus,” and “gene technology revolution” were the top three thematic strands addressed in the newspapers, even though their volume remained low. This study reports on the under-representation of newspaper coverage of genomics medicine in China, despite the vast growth of scientific articles in journals in this knowledge domain. This underscores the need to enhance collaboration between scientists, medical professionals, and journalists as an important strand of overall communications efforts in disseminating genomic medicine knowledge to larger audiences. Yet a substantive question remains to be examined: would traditional journalism, alone, be adequate to address the advances and challenges in genomics medicine in the media? Conversely, should we invest in science journalism programs as a subspecialty in biomedicine so scientists and clinicians acquire the twin scholarship of science/clinical medicine and journalism in their formative education? PMID:24512309

Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future.

PubMed

Rossignol, Patrick; Legrand, Matthieu; Kosiborod, Mikhail; Hollenberg, Steven M; Peacock, W Frank; Emmett, Michael; Epstein, Murray; Kovesdy, Csaba P; Yilmaz, Mehmet Birhan; Stough, Wendy Gattis; Gayat, Etienne; Pitt, Bertram; Zannad, Faiez; Mebazaa, Alexandre

2016-11-01

Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment. The Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT) aimed to evaluate the current knowledge pertaining to the emergency treatment of hyperkalemia. The INI-CRCT developed a treatment algorithm reflecting expert opinion of best practices in the context of current evidence, identified gaps in knowledge, and set priorities for future research. We searched PubMed (to August 4, 2015) for consensus guidelines, reviews, randomized clinical trials, and observational studies, limited to English language but not by publication date. Treatment approaches are based on small studies, anecdotal experience, and traditional practice patterns. The safety and real-world effectiveness of standard therapies remain unproven. Prospective research is needed and should include studies to better characterize the population, define the serum potassium thresholds where life-threatening arrhythmias are imminent, assess the potassium and electrocardiogram response to standard interventions. Randomized, controlled trials are needed to test the safety and efficacy of new potassium binders for the emergency treatment of severe hyperkalemia in hemodynamically stable patients. Existing emergency treatments for severe hyperkalemia are not supported by a compelling body of evidence, and they are used inconsistently across institutions, with potentially significant associated side effects. Further research is needed to fill knowledge gaps, and definitive clinical trials are needed to better define optimal management strategies, and ultimately to improve outcomes in these patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Practices of depression care in home health care: Home health clinician perspectives

PubMed Central

Bao, Yuhua; Eggman, Ashley A.; Richardson, Joshua E.; Sheeran, Thomas; Bruce, Martha L.

2015-01-01

Objective To assess any gaps between published best practices and real-world practices of treating depression in home health care (HHC), and barriers to closing any gaps. Methods A qualitative study based on semi-structured interviews with HHC nurses and administrators from five home health agencies in five states (n=20). Audio-recorded interviews were transcribed and analyzed by a multi-disciplinary team using grounded theory method to identify themes. Results Routine home health nursing care overlapped with all functional areas of depression care. However, there were reported gaps between best practices and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care. Conclusions Strategies to close gaps between typical and best practices need to enhance HHC clinician knowledge and self-efficacy with depression treatment and improve the quality of antidepressant management and communication with primary care. PMID:26423098

Education Research: Neurology resident education: Trending skills, confidence, and professional preparation.

PubMed

Jordan, Justin T; Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M; Engstrom, John

2016-03-15

To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. © 2016 American Academy of Neurology.

The Civic Engagement Gap(s): Youth Participation and Inequality from 1976 to 2009

ERIC Educational Resources Information Center

Gaby, Sarah

2017-01-01

Civic participation in the United States is highly unequal, resulting in a "civic engagement gap" between socioeconomic, racial, and gender groups. Variation in civic participation and the civic engagement gap remain contested, primarily as a result of inconsistent definitions and measurement issues in previous work. Using consistent…

A long-term study of tree seedling recruitment in Southern Appalachian forests: the effects of canopy gaps and shrub understories

Treesearch

Brian Beckage; James S. Clark; Barton D. Clinton; Bruce L. Haines

2000-01-01

We examined the importance of intermediate-sized gaps and a dense shrub layer on tree seedling recruitment in a Southern Appalachian deciduous forest. We created 12 canopy gaps under two contrasting understory conditions: 6 gaps were dominated by the dense, shade-producing shrub, Rhododendron maximum L., while the remaining gaps were relatively open...

Power relations and reciprocity: dialectics of knowledge construction.

PubMed

Ben-Ari, Adital; Enosh, Guy

2013-03-01

In this article we suggest a theoretical framework of knowledge construction by employing the concept of dialectics to power relationships between researcher and participants. Power distribution in research is perceived as dichotomous and asymmetrical in favor of the researcher, creating unequal power relations that make exploitation possible. Acknowledging such exploitation has led to a critical stance and attempts to bridge gaps through egalitarianism and empowerment of participants. Some scholars have focused on shifting expert knowledge differentials between researcher and participants throughout the research project. Others have evaluated such gaps as a source of knowledge construction. In the present work we applied a dialectical approach to understanding research relationships, suggesting reciprocity as their defining attribute, regardless of symmetry or asymmetry and as a source of knowledge construction. In this article we recommend avoiding a taken-for-granted attitude, because we see it as a direct obstacle to the construction of knowledge.

Cybernetics: a possible solution for the "knowledge gap" between "external" and "internal" in evaluation processes.

PubMed

Levin-Rozalis, Miri

2010-11-01

This paper addresses the issue of the knowledge gap between evaluators and the entity being evaluated: the dilemma of the knowledge of professional evaluators vs. the in-depth knowledge of the evaluated subjects. In order to optimize evaluative outcomes, the author suggests an approach based on ideas borrowed from the science of cybernetics as a method of evaluation--one that enables in-depth perception of the evaluated field without jeopardizing a rigorous study or the evaluator's professionalism. The paper focuses on the main concepts that deal with this dilemma--showing how cybernetics combines the different bodies of knowledge of the different stakeholders, including the professional evaluator, resulting in a coherent body of knowledge created mainly by those internal to the process, owned by them, and relevant to all--those who are internal and those who are external and their different purposes. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Assessing Exposure and Health Consequences of Chemicals in Drinking Water: Current State of Knowledge and Research Needs

PubMed Central

Kogevinas, Manolis; Cordier, Sylvaine; Templeton, Michael R.; Vermeulen, Roel; Nuckols, John R.; Nieuwenhuijsen, Mark J.; Levallois, Patrick

2014-01-01

Background: Safe drinking water is essential for well-being. Although microbiological contamination remains the largest cause of water-related morbidity and mortality globally, chemicals in water supplies may also cause disease, and evidence of the human health consequences is limited or lacking for many of them. Objectives: We aimed to summarize the state of knowledge, identify gaps in understanding, and provide recommendations for epidemiological research relating to chemicals occurring in drinking water. Discussion: Assessing exposure and the health consequences of chemicals in drinking water is challenging. Exposures are typically at low concentrations, measurements in water are frequently insufficient, chemicals are present in mixtures, exposure periods are usually long, multiple exposure routes may be involved, and valid biomarkers reflecting the relevant exposure period are scarce. In addition, the magnitude of the relative risks tends to be small. Conclusions: Research should include well-designed epidemiological studies covering regions with contrasting contaminant levels and sufficient sample size; comprehensive evaluation of contaminant occurrence in combination with bioassays integrating the effect of complex mixtures; sufficient numbers of measurements in water to evaluate geographical and temporal variability; detailed information on personal habits resulting in exposure (e.g., ingestion, showering, swimming, diet); collection of biological samples to measure relevant biomarkers; and advanced statistical models to estimate exposure and relative risks, considering methods to address measurement error. Last, the incorporation of molecular markers of early biological effects and genetic susceptibility is essential to understand the mechanisms of action. There is a particular knowledge gap and need to evaluate human exposure and the risks of a wide range of emerging contaminants. Citation: Villanueva CM, Kogevinas M, Cordier S, Templeton MR, Vermeulen R, Nuckols JR, Nieuwenhuijsen MJ, Levallois P. 2014. Assessing exposure and health consequences of chemicals in drinking water: current state of knowledge and research needs. Environ Health Perspect 122:213–221; http://dx.doi.org/10.1289/ehp.1206229 PMID:24380896

Principled Practical Knowledge: Not a Bridge but a Ladder

ERIC Educational Resources Information Center

Bereiter, Carl

2014-01-01

The much-lamented gap between theory and practice in education cannot be filled by practical knowledge alone or by explanatory knowledge alone. Principled practical knowledge (PPK) is a type of knowledge that has characteristics of both practical know-how and scientific theory. Like basic scientific theory, PPK meets standards of explanatory…

Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps.

PubMed

Dvorak, Marcel F; Cheng, Christiana L; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S; White, Barry A B; Ho, Chester; Ahn, Henry; Kwon, Brian K; Christie, Sean; Noonan, Vanessa K

2017-10-15

Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds.

Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps

PubMed Central

Cheng, Christiana L.; Fallah, Nader; Santos, Argelio; Atkins, Derek; Humphreys, Suzanne; Rivers, Carly S.; White, Barry A.B.; Ho, Chester; Ahn, Henry; Kwon, Brian K.; Christie, Sean; Noonan, Vanessa K.

2017-01-01

Abstract Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds. PMID:28745934

Gaps in exposure to essential competencies in hand surgery fellowship training: a national survey of program directors.

PubMed

Sears, Erika Davis; Larson, Bradley P; Chung, Kevin C

2013-03-01

Graduate medical education has moved towards competency-based training. The aim of this study was to assess hand surgery program directors' opinions of exposure gaps in core competencies rated as essential for hand surgery training. We surveyed the 74 ACGME hand surgery fellowship program directors. Respondents rated their opinion of 9 general areas of practice, 97 knowledge topics, and 172 procedures into one of three categories: essential, exposure needed, or unnecessary. Program directors also rated trainee exposure of each component at their respective program. Moderate and large exposure gaps were respectively defined as presence of at least 25 and 50 % of programs rating trainees as not having proficiency in the component at the end of training. Sixty-two of 74 program directors (84 %) responded to the survey. For the 76 knowledge topics and 98 procedures rated as essential, a majority of the knowledge topics (61 %; n = 46) and procedures (72 %; n = 71) had at least a moderate exposure gap. In addition, 22 % (n = 17) of the essential knowledge topics and 26 % (n = 25) of the essential procedures had a large exposure gap. This study illuminates the discrepancies between what is believed to be important for practicing hand surgeons and graduates' proficiency as perceived by program directors. The field of hand surgery must work to determine if program directors have unrealistic expectations for what is essential for practicing hand surgeons or if reforms are needed to improve exposure to essential skills in hand surgery training.

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports.

PubMed

Newquist, Deborah D; DeLiema, Marguerite; Wilber, Kathleen H

2015-10-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. © The Author(s) 2015.

The utilization of knowledge of and interest in research and development among primary care staff by means of strategic communication - a staff cohort study.

PubMed

Morténius, Helena; Marklund, Bertil; Palm, Lars; Fridlund, Bengt; Baigi, Amir

2012-08-01

The obvious gap between evidence and practice in health care is unfavourable for patient care and requires the promotion of a scientific attitude among health care professionals. The aim of the present study was to determine the utilization of knowledge of and interest in research and development among primary care staff by means of a strategic communication process. A cohort consisting of primary care staff (n = 1276) was designed and strategic communication was utilized as a platform over a 7-year period. Quantitative and qualitative methods were taken in account. We found that 97% of the staff had gained knowledge of research and development, 60% of whom remained interested in the subject. The oral communication channel was the most powerful for creating research interest. Organizational culture was a barrier to interest in science. The study demonstrates a significant increase in knowledge and interest among primary care staff as a result of a strategic communication process. Strategic communication should lead to a more evenly distributed research commitment among all health care professionals, thus facilitating communication between them and patients in order to clarify, for example, the causes of disease. © 2011 Blackwell Publishing Ltd.

An analysis of learning in an online biology course for teachers and teacher candidates: A mixed methods approach

NASA Astrophysics Data System (ADS)

Lebec, Michael Thomas

Due to discipline specific shortages, web-based learning has been proposed as a convenient way to upgrade the content knowledge of instructors interested in learning to teach science. Despite quantitative evidence that web-based instruction is equivalent to traditional methods, questions remain regarding its use. The efficiency and practicality of this approach with teachers in particular has not been extensively studied. This investigation examines learning in an online biology course designed to help teachers prepare for science certification exams. Research questions concern flow teachers learn biology in the online environment and how this setting influences the learning process. Quantitative and qualitative methodologies are employed in an attempt to provide a more complete perspective than typical studies of online learning. Concept maps, tests, and online discussion transcripts are compared as measures of assimilated knowledge, while interviews reflect participants' views on the course. Findings indicate that participants experienced gains in declarative knowledge, but little improvement with respect to conditional knowledge. Qualitative examination of concept maps demonstrates gaps in participants' understandings of key course ideas. Engagement in the use of online resources varied according to participants' attitudes towards online learning. Subjects also reported a lack of motivation to fully engage in the course due to busy teaching schedules and the absence of accountability.

Insular ecosystems of the southeastern United States—A regional synthesis to support biodiversity conservation in a changing climate

USGS Publications Warehouse

Cartwright, Jennifer M.; Wolfe, William J.

2016-08-11

In the southeastern United States, insular ecosystems—such as rock outcrops, depression wetlands, high-elevation balds, flood-scoured riparian corridors, and insular prairies and barrens—occupy a small fraction of land area but constitute an important source of regional and global biodiversity, including concentrations of rare and endemic plant taxa. Maintenance of this biodiversity depends upon regimes of abiotic stress and disturbance, incorporating factors such as soil surface temperature, widely fluctuating hydrologic conditions, fires, flood scouring, and episodic droughts that may be subject to alteration by climate change. Over several decades, numerous localized, site-level investigations have yielded important information about the floristics, physical environments, and ecological dynamics of these insular ecosystems; however, the literature from these investigations has generally remained fragmented. This report consists of literature syntheses for eight categories of insular ecosystems of the southeastern United States, concerning (1) physical geography, (2) ecological determinants of community structures including vegetation dynamics and regimes of abiotic stress and disturbance, (3) contributions to regional and global biodiversity, (4) historical and current anthropogenic threats and conservation approaches, and (5) key knowledge gaps relevant to conservation, particularly in terms of climate-change effects on biodiversity. This regional synthesis was undertaken to discern patterns across ecosystems, identify knowledge gaps, and lay the groundwork for future analyses of climate-change vulnerability. Findings from this synthesis indicate that, despite their importance to regional and global biodiversity, insular ecosystems of the southeastern United States have been subjected to a variety of direct and indirect human alterations. In many cases, important questions remain concerning key determinants of ecosystem function. In particular, few empirical investigations in these ecosystems have focused on possible climate-change effects, despite the well-documented ecological effects of climate change at a global level. Long-term management of these ecosystems could benefit from increased scientific effort to characterize and quantify the linkages between changing environmental conditions and the ecological processes that sustain biodiversity.

Global Foot-and-Mouth Disease Research Update and Gap Analysis: 7 - Pathogenesis and Molecular Biology.

PubMed

Robinson, L; Knight-Jones, T J D; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

2016-06-01

We assessed research knowledge gaps in the fields of FMDV (foot-and-mouth disease virus) pathogenesis and molecular biology by performing a literature review (2011-15) and collecting research updates (2014) from 33 institutes from across the world. Findings were used to identify priority areas for future research. There have been important advances in FMDV pathogenesis; FMDV remains in lymph nodes of many recovered animals that otherwise do not appear persistently infected, even in species previously not associated with the carrier state. Whether virus retention helps maintain host immunity and/or virus survival is not known. Studies of FMDV pathogenesis in wildlife have provided insights into disease epidemiology, in endemic and epidemic settings. Many aspects of FMDV infection and virus entry remain unknown; however, at the cellular level, we know that expression level and availability of integrins (that permit viral entry), rate of clearance of infected cells and strength of anti-viral type I IFN (interferon) response are key determinants of tissue tropism. Extending findings to improved understanding of transmission requires a standardized approach and adoption of natural routes of infection during experimental study. There has been recognition of the importance of autophagosomes for FMDV entry into the cytoplasm following cell surface receptor binding, and that distinct internal cellular membranes are exploited for viral replication and immune evasion. New roles for viral proteins in blocking type I IFN production and downstream signalling have been identified facilitating research in anti-viral therapeutics. We know more about how infection affects cell protein expression, and research into molecular determinants of capsid stability has aided the development of stable vaccines. We have an expanding knowledge of viral and host molecular determinates of virulence and infectiousness, and of how phylogenetics may be used to estimate vaccine match and strain distribution. With ongoing advances, these areas could translate into significantly improved disease control. © 2016 Blackwell Verlag GmbH.

Teachers' Perceptions of Instructional Practices for Yup'ik Students with Special Education Needs: A Case Study

ERIC Educational Resources Information Center

Jacobson, Elisabeth

2017-01-01

As classrooms across America become more increasingly diverse, culturally and linguistically and students with special needs, the achievement gap remains evident. One population that remains behind their Caucasian peers is that of Alaska Natives. While many instructional practices have been identified for addressing the gap for many populations,…

Tackling the Remaining Attainment Gap between Students with and without Immigrant Background: An Investigation into the Equivalence of SES Constructs

ERIC Educational Resources Information Center

Lenkeit, Jenny; Caro, Daniel H.; Strand, Steve

2015-01-01

In England, students with immigrant background exhibit lower educational attainment than those without immigrant background. Family socioeconomic status (SES) helps explain differences in educational attainment, but a gap remains that differs in size for students with different immigrant backgrounds. While the explanatory repertoire for the…

Interactive case-based learning improves resident knowledge and confidence in reproductive endocrinology and infertility.

PubMed

Goldman, Kara N; Tiegs, Ashley W; Uquillas, Kristen; Nachtigall, Margaret; Fino, M Elizabeth; Winkel, Abigail F; Lerner, Veronica

2017-06-01

Resident physicians' scores on the REI section of the CREOG exam are traditionally low, and nearly 40% of house staff nation-wide perceive their REI knowledge to be poor. We aimed to assess whether an interactive case-based group-learning curriculum would narrow the REI knowledge gap by improving understanding and retention of core REI concepts under the time constraints affecting residents. A three-hour case-based workshop was developed to address four primary CREOG objectives. A multiple-choice test was administered immediately before and after the intervention and 7 weeks post-workshop, to evaluate both knowledge and confidence. Following the intervention, residents self-reported increased confidence with counseling and treatment of PCOS, ovulation induction cycle monitoring, counseling and treatment of POI, and breaking bad news related to infertility (p < 0.05). The multiple-choice exam was re-administered 7 weeks post-intervention, and scores remained significantly improved compared to pre-workshop scores (p < 0.05). At that time, all residents either strongly agreed (91.7%) or agreed (8.3%) that the case-based interactive format was preferable to traditional lecture-based teaching. In conclusion, a nontraditional curriculum aimed at teaching core REI concepts to residents through interactive case-based learning can be successfully integrated into a residency curriculum, and significantly improves knowledge and confidence of critical concepts in REI.

Discrimination and the health of immigrants and refugees: exploring Canada's evidence base and directions for future research in newcomer receiving countries.

PubMed

Edge, Sara; Newbold, Bruce

2013-02-01

Research and practice increasingly suggests discrimination compromises health. Yet the unique experiences and effects facing immigrant and refugee populations remain poorly understood in Canada and abroad. We review current knowledge on discrimination against newcomers in Canada, emphasizing impacts upon health status and service access to identify gaps and research needs. Existing knowledge centers around experiences within health-care settings, differences in perception and coping, mental health impacts, and debates about "non-discriminatory" health-care. There is need for comparative analyses within and across ethno-cultural groups and newcomer classes to better understand factors shaping how discrimination and its health effects are differentially experienced. Women receive greater attention in the literature given their compounded vulnerability. While this must continue, little is known about the experiences of youth and men. Governance and policy discourse analyses would elucidate how norms, institutions and practices shape discriminatory attitudes and responses. Finally, "non-discriminatory health-care" interventions require critical evaluation to determine their effectiveness.

Reducing empiricism in malaria vaccine design.

PubMed

Moorthy, Vasee S; Kieny, Marie Paule

2010-03-01

Gains in the control of malaria and the promising progress of a malaria vaccine that is partly efficacious do not reduce the need for a high-efficacy vaccine in the longer term. Evidence supports the feasibility of developing a highly efficacious malaria vaccine. However, design of candidate malaria vaccines remains empirical and is necessarily based on many unproven assumptions because much of the knowledge needed to design vaccines and to predict efficacy is not available. Data to inform key questions of vaccine science might allow the design of vaccines to progress to a less empirical stage, for example through availability of assay results associated with vaccine efficacy. We discuss six strategic gaps in knowledge that contribute to empiricism in the design of vaccines. Comparative evaluation, assay and model standardisation, greater sharing of information, collaboration and coordination between groups, and rigorous evaluation of existing datasets are steps that can be taken to enable reductions in empiricism over time. 2010 Elsevier Ltd. All rights reserved.

Multimodel inference to quantify the relative importance of abiotic factors in the population dynamics of marine zooplankton

NASA Astrophysics Data System (ADS)

Everaert, Gert; Deschutter, Yana; De Troch, Marleen; Janssen, Colin R.; De Schamphelaere, Karel

2018-05-01

The effect of multiple stressors on marine ecosystems remains poorly understood and most of the knowledge available is related to phytoplankton. To partly address this knowledge gap, we tested if combining multimodel inference with generalized additive modelling could quantify the relative contribution of environmental variables on the population dynamics of a zooplankton species in the Belgian part of the North Sea. Hence, we have quantified the relative contribution of oceanographic variables (e.g. water temperature, salinity, nutrient concentrations, and chlorophyll a concentrations) and anthropogenic chemicals (i.e. polychlorinated biphenyls) to the density of Acartia clausi. We found that models with water temperature and chlorophyll a concentration explained ca. 73% of the population density of the marine copepod. Multimodel inference in combination with regression-based models are a generic way to disentangle and quantify multiple stressor-induced changes in marine ecosystems. Future-oriented simulations of copepod densities suggested increased copepod densities under predicted environmental changes.

Neuropharmacology of brain-stimulation-evoked aggression.

PubMed

Siegel, A; Roeling, T A; Gregg, T R; Kruk, M R

1999-01-01

Evidence is reviewed concerning the brain areas and neurotransmitters involved in aggressive behavior in the cat and rodent. In the cat, two distinct neural circuits involving the hypothalamus and PAG subserve two different kinds of aggression: defensive rage and predatory (quiet-biting) attack. The roles played by the neurotransmitters serotonin, GABA, glutamate, opioids, cholecystokinin, substance P, norepinephrine, dopamine, and acetylcholine in the modulation and expression of aggression are discussed. For the rat, a single area, largely coincident with the intermediate hypothalamic area, is crucial for the expression of attack; variations in the rat attack response in natural settings are due largely to environmental variables. Experimental evidence emphasizing the roles of serotonin and GABA in modulating hypothalamically evoked attack in the rat is discussed. It is concluded that significant progress has been made concerning our knowledge of the circuitry underlying the neural basis of aggression. Although new and important insights have been made concerning neurotransmitter regulation of aggressive behavior, wide gaps in our knowledge remain.

A framework for designing hand hygiene educational interventions in schools.

PubMed

Appiah-Brempong, Emmanuel; Harris, Muriel J; Newton, Samuel; Gulis, Gabriel

2018-03-01

Hygiene education appears to be the commonest school-based intervention for preventing infectious diseases, especially in the developing world. Nevertheless, there remains a gap in literature regarding a school-specific theory-based framework for designing a hand hygiene educational intervention in schools. We sought to suggest a framework underpinned by psychosocial theories towards bridging this knowledge gap. Furthermore, we sought to propound a more comprehensive definition of hand hygiene which could guide the conceptualisation of hand hygiene interventions in varied settings. Literature search was guided by a standardized tool and literature was retrieved on the basis of a predetermined inclusion criteria. Databases consulted include PubMed, ERIC, and EBSCO host (Medline, CINAHL, PsycINFO, etc.). Evidence bordering on a theoretical framework to aid the design of school-based hand hygiene educational interventions is summarized narratively. School-based hand hygiene educational interventions seeking to positively influence behavioural outcomes could consider enhancing psychosocial variables including behavioural capacity, attitudes and subjective norms (normative beliefs and motivation to comply). A framework underpinned by formalized psychosocial theories has relevance and could enhance the design of hand hygiene educational interventions, especially in schools.

Assessing Students' Accounting Knowledge: A Structural Approach.

ERIC Educational Resources Information Center

Boldt, Margaret N.

2001-01-01

Comparisons of students' representations of financial accounting concepts with the knowledge structures of experts were depicted using Pathfinder networks. This structural approach identified the level of students' understanding of concepts and knowledge gaps that need to be addressed. (SK)

The Use of Gap Analysis to Increase Student Completion Rates at Travelor Adult School

ERIC Educational Resources Information Center

Gil, Blanca Estela

2013-01-01

This project applied the gap analysis problem-solving framework (Clark & Estes, 2008) in order to help develop strategies to increase completion rates at Travelor Adult School. The purpose of the study was to identify whether the knowledge, motivation and organization barriers were contributing to the identified gap. A mixed method approached…

The Zika Virus Outbreak in Brazil: Knowledge Gaps and Challenges for Risk Reduction.

PubMed

Garcia Serpa Osorio-de-Castro, Claudia; Silva Miranda, Elaine; Machado de Freitas, Carlos; Rochel de Camargo, Kenneth; Cranmer, Hilarie Hartel

2017-06-01

We analyzed uncertainties and complexities of the Zika virus outbreak in Brazil, and we discuss risk reduction for future emergencies. We present the public health situation in Brazil and concurrent determinants of the epidemic and the knowledge gaps that persist despite building evidence from research, making public health decisions difficult. Brazil has adopted active measures, but producing desired outcomes may be uncertain because of partial or unavailable information. Reducing population group vulnerabilities and acting on environmental issues are medium- to long-term measures. Simultaneously dealing with information gaps, uncontrolled disease spread, and vulnerabilities is a new risk scenario and must be approached decisively to face emerging biothreats.

Investigating Information System Development, Behavior and Business Knowledge Impact on Project Success: Quantitative Analysis

ERIC Educational Resources Information Center

Skinner, Ann

2018-01-01

Resource-based theory provided the theoretical foundation to investigate the extent that developer knowledge correlated to success of information technology (IT) development projects. Literature indicated there was a knowledge gap in understanding whether developer information system development, behavior and business knowledge contributed to IT…

Activation of Background Knowledge for Inference Making: Effects on Reading Comprehension

ERIC Educational Resources Information Center

Elbro, Carsten; Buch-Iversen, Ida

2013-01-01

Failure to "activate" relevant, existing background knowledge may be a cause of poor reading comprehension. This failure may cause particular problems with inferences that depend heavily on prior knowledge. Conversely, teaching how to use background knowledge in the context of gap-filling inferences could improve reading comprehension in…

Research to practice in The Journal of Continuing Education in the Health Professions: a thematic analysis of volumes 1 through 24.

PubMed

MacIntosh-Murray, Anu; Perrier, Laure; Davis, David

2006-01-01

Authors have stressed the importance of the broader contextual influences on practice improvement and learning and have expressed concern about gaps between research and practice. This implies a potential expansion of the knowledge base for continuing education in the health professions (CEHP) and an increased emphasis on research evidence for that knowledge. How has the content of The Journal of Continuing Education in the Health Professions (JCEHP) reflected those changes? What are the implications for CEHP practitioners? Based on all abstracts, tables of contents, and editorials, a thematic analysis was completed for volumes 1 through 24 of JCEHP. All texts were downloaded into qualitative analysis software and coded. Main code categories included demographics of articles, concepts relating to CEHP as a discipline, knowledge translation and outcomes-oriented continuing education, and theories and frameworks. Key themes were identified. Key themes include categories of topics included in JCEHP over the years, the increased prominence of research in JCEHP, a dual research evidence-to-practice gap, the professionalization of continuing education providers, and interdisciplinarity and the links with broader frameworks that have been proposed for CEHP. Two sets of research-to-practice gaps are portrayed in the journal: the gap between clinical research and practice and the gap between research and practice in CEHP. To close the first gap, authors have asserted that the second gap must be addressed, ensuring that CEHP practices themselves are evidence based, driven by theory-based research. This is a variation on prior debates regarding the need to define CEHP as a discipline, which uses the language of professionalization. The increased focus of continuing education on the contexts of health care providers' practices has multiplied the topics that are potentially relevant to CEHP practice.

Assessing the level of healthcare information technology adoption in the United States: a snapshot

PubMed Central

Poon, Eric G; Jha, Ashish K; Christino, Melissa; Honour, Melissa M; Fernandopulle, Rushika; Middleton, Blackford; Newhouse, Joseph; Leape, Lucian; Bates, David W; Blumenthal, David; Kaushal, Rainu

2006-01-01

Background Comprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap. Methods We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each, focusing on applications most likely to improve patient safety, quality of care and organizational efficiency. We then conducted a multi-site qualitative study in Boston and Denver by interviewing key informants from each stakeholder group. Interview transcripts were analyzed to assess the level of adoption and to document the major barriers to further adoption. Findings for Boston and Denver were then presented to an expert panel, which was then asked to estimate the national level of adoption using the modified Delphi approach. We measured adoption level in Boston and Denver was graded on Rogers' technology adoption curve by co-investigators. National estimates from our expert panel were expressed as percentages. Results Adoption of functionalities with financial benefits far exceeds adoption of those with safety and quality benefits. Despite growing interest to adopt HIT to improve safety and quality, adoption remains limited, especially in the area of ambulatory electronic health records and physician-patient communication. Organizations, particularly physicians' practices, face enormous financial challenges in adopting HIT, and concerns remain about its impact on productivity. Conclusion Adoption of HIT is limited and will likely remain slow unless significant financial resources are made available. Policy changes, such as financial incentivesto clinicians to use HIT or pay-for-performance reimbursement, may help health care providers defray upfront investment costs and initial productivity loss. PMID:16396679

Concussion assessment and management knowledge among chiropractic fourth year interns and residents

PubMed Central

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-01-01

Objectives: To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. Methods: A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Results: Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator’s reports on medical students and residents. Several knowledge gaps were identified in the sample population. Conclusion: The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents. PMID:28065987

Concussion assessment and management knowledge among chiropractic fourth year interns and residents.

PubMed

Kazemi, Mohsen; Pichini, Alessandro; Scappaticci, Steven; Savic, Mitchell

2016-12-01

To investigate the degree of knowledge chiropractic fourth year interns and post-graduate chiropractic residents have in regard to concussion diagnosis and management. A survey modified from a study conducted by Boggild and Tator (2012), was administered to fourth year chiropractic interns and post-graduate residents via SurveyMonkey.com. Chiropractic fourth year interns and postgraduate chiropractic specialty college residents scored 5.2 and 5.25 out of 9 respectively, which compares well with Bogglid and Tator's reports on medical students and residents. Several knowledge gaps were identified in the sample population. The results from this survey show that the concussion knowledge among Canadian fourth year chiropractic interns and specialty college residents compares favorably with the knowledge of fourth year medical students and residents in diagnosing and managing concussions. Chiropractors appear to possess the skills and knowledge to diagnose and manage concussion equal to their medical counterparts. However, knowledge gaps regarding concussion diagnosis and management were found among chiropractic students and residents.

Practice gaps in the care of mitral valve regurgitation: Insights from the American College of Cardiology mitral regurgitation gap analysis and advisory panel.

PubMed

Wang, Andrew; Grayburn, Paul; Foster, Jill A; McCulloch, Marti L; Badhwar, Vinay; Gammie, James S; Costa, Salvatore P; Benitez, Robert Michael; Rinaldi, Michael J; Thourani, Vinod H; Martin, Randolph P

2016-02-01

The revised 2014 American College of Cardiology (ACC)/American Heart Association valvular heart disease guidelines provide evidenced-based recommendations for the management of mitral regurgitation (MR). However, knowledge gaps related to our evolving understanding of critical MR concepts may impede their implementation. The ACC conducted a multifaceted needs assessment to characterize gaps, practice patterns, and perceptions related to the diagnosis and treatment of MR. A key project element was a set of surveys distributed to primary care and cardiovascular physicians (cardiologists and cardiothoracic surgeons). Survey and other gap analysis findings were presented to a panel of 10 expert advisors from specialties of general cardiology, cardiac imaging, interventional cardiology, and cardiac surgeons with expertise in valvular heart disease, especially MR, and cardiovascular education. The panel was charged with assessing the relative importance and potential means of remedying identified gaps to improve care for patients with MR. The survey results identified several knowledge and practice gaps that may limit implementation of evidence-based recommendations for MR care. Specifically, half of primary care physicians reported uncertainty regarding timing of intervention for patients with severe primary or functional MR. Physicians in all groups reported that quantitative indices of MR severity were frequently not reported in clinical echocardiographic interpretations, and that these measurements were not consistently reviewed when provided in reports. In the treatment of MR, nearly 30% of primary care physician and general cardiologists did not know the volume of mitral valve repair surgeries by their reference cardiac surgeons and did not have a standard source to obtain this information. After review of the survey results, the expert panel summarized practice gaps into 4 thematic areas and offered proposals to address deficiencies and promote better alignment with the 2014 ACC/American Heart Association valvular disease guidelines. Important knowledge and skill gaps exist that may impede optimal care of the patient with MR. Focused educational and practice interventions should be developed to reduce these gaps. Copyright © 2015 Elsevier Inc. All rights reserved.

Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review.

PubMed

Gettelfinger, John D; Paulk, P Barrett; Schmalbach, Cecelia E

2017-06-01

Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."

Effect of ethanol on psychomotor performance and on risk taking behaviour.

PubMed

Farquhar, K; Lambert, K; Drummond, G B; Tiplady, B; Wright, P

2002-12-01

Ethanol may increase the willingness to take risks, but this issue remains controversial. We used a risk-taking paradigm in which volunteers answered a series of general knowledge questions with numerical answers and were asked to judge the length of a line that would just fit into a given gap. A maximum score was given for an exactly correct answer. For answers that were less than the correct value, the score was reduced gradually to zero, while answers even slightly over the correct value were penalized considerably. Total points were rewarded by cash payments, so volunteers were taking real risks when making their responses. Performance was assessed in a two-period, double-blind crossover study, comparing ethanol (0.7 g/kg) with placebo in 20 female volunteers aged 19-20 years. Tests were carried out before and at 45 min after dosing. Mean (SD) ethanol blood alcohol concentrations were 65 (10.5) mg/100 ml. Ethanol impaired the skill/ability measure of the length estimation test (SD of difference between length of line and gap), which increased from 5.9 to 6.6 (p < 0.05), indicating a reduced accuracy of estimation. The risk measures in both tasks were not significantly affected. The skill/ability measure in the general knowledge task was not significantly affected. Other performance tests showed that ethanol produced the expected impairment of both speed and accuracy. These results suggest that risk-taking is not increased by ethanol at doses approaching the UK legal limit for driving.

Climate Change and Human Health Impacts in the United States: An Update on the Results of the U.S. National Assessment

PubMed Central

Ebi, Kristie L.; Mills, David M.; Smith, Joel B.; Grambsch, Anne

2006-01-01

The health sector component of the first U.S. National Assessment, published in 2000, synthesized the anticipated health impacts of climate variability and change for five categories of health outcomes: impacts attributable to temperature, extreme weather events (e.g., storms and floods), air pollution, water- and food-borne diseases, and vector- and rodent-borne diseases. The Health Sector Assessment (HSA) concluded that climate variability and change are likely to increase morbidity and mortality risks for several climate-sensitive health outcomes, with the net impact uncertain. The objective of this study was to update the first HSA based on recent publications that address the potential impacts of climate variability and change in the United States for the five health outcome categories. The literature published since the first HSA supports the initial conclusions, with new data refining quantitative exposure–response relationships for several health end points, particularly for extreme heat events and air pollution. The United States continues to have a very high capacity to plan for and respond to climate change, although relatively little progress has been noted in the literature on implementing adaptive strategies and measures. Large knowledge gaps remain, resulting in a substantial need for additional research to improve our understanding of how weather and climate, both directly and indirectly, can influence human health. Filling these knowledge gaps will help better define the potential health impacts of climate change and identify specific public health adaptations to increase resilience. PMID:16966082

Biology and impacts of Pacific Islands invasive species. 14. Sus scrofa the feral pig (Artiodactyla: Suidae)

USGS Publications Warehouse

Wehr, Nathaniel H.; Hess, Steven C.; Litton, Creighton M.

2018-01-01

Feral pigs (Sus scrofa L.) are perhaps the most abundant, widespread, and economically significant large introduced vertebrate across the Pacific island region. Unlike many other nonnative invasive species, feral pigs have both cultural and recreational importance in the region, complicating their management. Today, Pacific island feral pigs are a mixture of several strains of domestic swine, Asiatic wild boar, and European wild boar. Due to their generalist diet and rooting behavior, feral pigs alter soils and watersheds and negatively impact native and nonnative flora and fauna. As a result, feral pigs have played a role in the extinction of several species of plants and animals on Pacific islands and have negative effects on both ecotourism and agricultural industries in the region. Despite numerous published studies on feral pigs in the Pacific island region, of which the majority include systematic analyses of original empirical data, some fundamental aspects of feral pig ecology remain poorly characterized, at least partly due to the remote and inaccessible environments that they often inhabit. To address these knowledge gaps, effort should be made to integrate research conducted outside the Pacific island region into local management strategies. This review summarizes the origins, history, ecology, environmental effects, and current management of feral pigs in the Pacific island region; integrates regional scientific findings with those of other insular and continental systems; and identifies current knowledge gaps requiring further research to inform the ecology and management of this impactful invasive species.

Shared Care of Childhood Cancer Survivors: A Telemedicine Feasibility Study.

PubMed

Costello, Aimee G; Nugent, Bethany D; Conover, Noelle; Moore, Amanda; Dempsey, Kathleen; Tersak, Jean M

2017-12-01

With an increasing number of childhood cancer survivors (CCSs), determining the best model of survivorship transition care is becoming a growing priority. Shared care between pediatric oncology and adult primary care is often necessary, making survivorship a time of transition, but effective standard models are lacking. We sought to provide a more integrated approach to transition using telemedicine. Recruited primary care provider/CCS dyads were instructed to log-in to a password-protected virtual meeting room using telemedicine equipment at the time or a regularly scheduled office visit. Dyads were joined by a pediatric survivorship clinic team member who conducted the telemedicine portion of the transition visit, which consisted of the review of an individualized treatment summary and care plan. Postquestionnaires were developed to evaluate key points such as fund of knowledge, satisfaction with the visit, and effectiveness of this electronic tool. There were 19 transition visits conducted, 13 of which used the telemedicine equipment as planned. Those that did not use the equipment were primarily unable to due to technical difficulties. Postquestionnaires were overall positive, confirming increased knowledge, comfort and abilities, and patient satisfaction in survivorship care. Negative comments were primarily related to equipment difficulties. A gap still remains in helping CCSs transition from oncology to primary care and this pilot study offered insights into how we might better bridge that gap through the use of telemedicine. Further research is needed to refine the transition process for CCSs, including evaluation and testing models for standard of care.

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

Allison, Steven D.

The role of specific micro-organisms in the carbon cycle, and their responses to environmental change, are unknown in most ecosystems. This knowledge gap limits scientists’ ability to predict how important ecosystem processes, like soil carbon storage and loss, will change with climate and other environmental factors. The investigators addressed this knowledge gap by transplanting microbial communities from different environments into new environments and measuring the response of community composition and carbon cycling over time. Using state-of-the-art sequencing techniques, computational tools, and nanotechnology, the investigators showed that microbial communities on decomposing plant material shift dramatically with natural and experimentally-imposed drought. Microbialmore » communities also shifted in response to added nitrogen, but the effects were smaller. These changes had implications for carbon cycling, with lower rates of carbon loss under drought conditions, and changes in the efficiency of decomposition with nitrogen addition. Even when transplanted into the same conditions, microbial communities from different environments remained distinct in composition and functioning for up to one year. Changes in functioning were related to differences in enzyme gene content across different microbial groups. Computational approaches developed for this project allowed the conclusions to be tested more broadly in other ecosystems, and new computer models will facilitate the prediction of microbial traits and functioning across environments. The data and models resulting from this project benefit the public by improving the ability to predict how microbial communities and carbon cycling functions respond to climate change, nutrient enrichment, and other large-scale environmental changes.« less

Specificity of learning: why infants fall over a veritable cliff.

PubMed

Adolph, K E

2000-07-01

Nine-month-old infants were tested at the precipice of safe and risky gaps in the surface of support. Their reaching and avoidance responses were compared in two postures, an experienced sitting posture and a less familiar crawling posture. The babies avoided reaching over risky gaps in the sitting posture but fell into risky gaps while attempting to reach in the crawling posture. This dissociation between developmental changes in posture suggests that (a) each postural milestone represents a different, modularly organized control system and (b) infants' adaptive avoidance responses are based on information about their postural stability relative to the gap size. Moreover, the results belie previous accounts suggesting that avoidance of a disparity in depth of the ground surface depends on general knowledge such as fear of heights, associations between depth information and falling, or knowledge that the body cannot be supported in empty space.

Biogeochemical cycles and biodiversity as key drivers of ecosystem services provided by soils

NASA Astrophysics Data System (ADS)

Smith, P.; Cotrufo, M. F.; Rumpel, C.; Paustian, K.; Kuikman, P. J.; Elliott, J. A.; McDowell, R.; Griffiths, R. I.; Asakawa, S.; Bustamante, M.; House, J. I.; Sobocká, J.; Harper, R.; Pan, G.; West, P. C.; Gerber, J. S.; Clark, J. M.; Adhya, T.; Scholes, R. J.; Scholes, M. C.

2015-11-01

Soils play a pivotal role in major global biogeochemical cycles (carbon, nutrient, and water), while hosting the largest diversity of organisms on land. Because of this, soils deliver fundamental ecosystem services, and management to change a soil process in support of one ecosystem service can either provide co-benefits to other services or result in trade-offs. In this critical review, we report the state-of-the-art understanding concerning the biogeochemical cycles and biodiversity in soil, and relate these to the provisioning, regulating, supporting, and cultural ecosystem services which they underpin. We then outline key knowledge gaps and research challenges, before providing recommendations for management activities to support the continued delivery of ecosystem services from soils. We conclude that, although soils are complex, there are still knowledge gaps, and fundamental research is still needed to better understand the relationships between different facets of soils and the array of ecosystem services they underpin, enough is known to implement best practices now. There is a tendency among soil scientists to dwell on the complexity and knowledge gaps rather than to focus on what we do know and how this knowledge can be put to use to improve the delivery of ecosystem services. A significant challenge is to find effective ways to share knowledge with soil managers and policy makers so that best management can be implemented. A key element of this knowledge exchange must be to raise awareness of the ecosystems services underpinned by soils and thus the natural capital they provide. We know enough to start moving in the right direction while we conduct research to fill in our knowledge gaps. The lasting legacy of the International Year of Soils in 2015 should be for soil scientists to work together with policy makers and land managers to put soils at the centre of environmental policy making and land management decisions.

A controlled investigation of continuing pain education for long-term care staff.

PubMed

Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Dal Bello-Haas, Vanina; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra M G; Carleton, R N; Hunter, Paulette V; Lix, Lisa M

2013-01-01

The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. To investigate the effectiveness of an expert-based continuing education program in pain assessment⁄management for LTC staff. Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes⁄beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers.

Obesity and drug pharmacology: a review of the influence of obesity on pharmacokinetic and pharmacodynamic parameters.

PubMed

Smit, Cornelis; De Hoogd, Sjoerd; Brüggemann, Roger J M; Knibbe, Catherijne A J

2018-03-01

The rising prevalence of obesity confronts clinicians with dosing problems in the (extreme) overweight population. Obesity has a great impact on key organs that play a role in the pharmacokinetics (PK) and pharmacodynamics (PD) of drugs, however the ultimate impact of these changes on how to adapt the dose may not always be known. Areas covered: In this review, physiological changes associated with obesity are discussed. An overview is provided on the alterations in absorption, distribution, drug metabolism and clearance in (morbid) obesity focusing on general principles that can be extracted from pharmacokinetic studies. Also, relevant pharmacodynamic considerations in obesity are discussed. Expert opinion: Over the last two decades, increased knowledge is generated on PK and PD in obesity. Future research should focus on filling in the knowledge gaps that remain, especially in connecting obesity-related physiological changes with changes in PK and/or PD and vice versa. Ultimately, this knowledge can be used to develop physiologically based PK and PD models on the basis of quantitative systems pharmacology principles. Moreover, efforts should focus on thorough prospective evaluation of developed model-based doses with subsequent implementation of these dosing recommendations in clinical practice.

U.S. view of human problems to be addressed for long duration space flights. [physiological and psychological effects

NASA Technical Reports Server (NTRS)

Berry, C. A.

1973-01-01

The Russian and American space programs have consisted of several thousands of hours of exposure of man to the space environment. In spite of numerous biological phenomena of adaptation observed, the space travellers have displayed, after their return, no enduring pathological effect. Although the usable data remain too limited to reflect fully the effects of space flight, it is possible to sketch the biological responses in the absence of gravity and to define the work bases for the future. Beyond its basic physiological effects, weightlessness has operational consequences in the daily life of the astronauts. These consequences will be still more evident during missions of long duration. The conclusions drawn in flight as well as on the ground are reviewed, and future requirements concerning prolonged flights are outlined. The gaps in actual knowledge are discussed and solutions are suggested. The problems of habitability are considered, particularly those which remain at present without satisfactory solutions: psychological responses to a confined life, cleaning, hygiene, and used material.

Nutrition for synchronized swimming: a review.

PubMed

Lundy, Bronwen

2011-10-01

Synchronized swimming enjoys worldwide popularity and has been part of the formal Olympic program since 1984. Despite this, relatively little research has been conducted on participant nutrition practices and requirements, and there are significant gaps in the knowledge base despite the numerous areas in which nutrition could affect performance and safety. This review aimed to summarize current findings and identify areas requiring further research. Uniform physique in team or duet events may be more important than absolute values for muscularity or body fat, but a lean and athletic appearance remains key. Synchronized swimmers appear to have an increased risk of developing eating disorders, and there is evidence of delayed menarche, menstrual dysfunction, and lower bone density relative to population norms. Dietary practices remain relatively unknown, but micronutrient status for iron and magnesium may be compromised. More research is required across all aspects of nutrition status, anthropometry, and physiology, and both sports nutrition and sports medicine support may be required to reduce risks for participants.

Collective intelligence for translational medicine: Crowdsourcing insights and innovation from an interdisciplinary biomedical research community.

PubMed

Budge, Eleanor Jane; Tsoti, Sandra Maria; Howgate, Daniel James; Sivakumar, Shivan; Jalali, Morteza

2015-01-01

Translational medicine bridges the gap between discoveries in biomedical science and their safe and effective clinical application. Despite the gross opportunity afforded by modern research for unparalleled advances in this field, the process of translation remains protracted. Efforts to expedite science translation have included the facilitation of interdisciplinary collaboration within both academic and clinical environments in order to generate integrated working platforms fuelling the sharing of knowledge, expertise, and tools to align biomedical research with clinical need. However, barriers to scientific translation remain, and further progress is urgently required. Collective intelligence and crowdsourcing applications offer the potential for global online networks, allowing connection and collaboration between a wide variety of fields. This would drive the alignment of biomedical science with biotechnology, clinical need, and patient experience, in order to deliver evidence-based innovation which can revolutionize medical care worldwide. Here we discuss the critical steps towards implementing collective intelligence in translational medicine using the experience of those in other fields of science and public health.

Genetic Causes of Recurrent Pregnancy Loss.

PubMed

Page, Jessica M; Silver, Robert M

2016-09-01

Pregnancy loss is one of the most common obstetric complications, affecting over 30% of conceptions. A considerable proportion of losses are due to genetic abnormalities. Indeed, over 50% of early pregnancy losses have been associated with chromosomal abnormalities. Most are due to de novo nondisjunctional events but balanced parental translocations are responsible for a small but important percentage of genetic abnormalities in couples with recurrent pregnancy loss. In the past, assessment of genetic abnormalities was limited to karyotype performed on placental or fetal tissue. However, advances in molecular genetic technology now provide rich genetic information about additional genetic causes of and risk factors for pregnancy loss. In addition, the use of preimplantation genetic testing in couples undergoing in vitro fertilization has the potential to decrease the risk of pregnancy loss from genetic abnormalities. To date, efficacy is uncertain but considerable potential remains. This chapter will review what is known about genetic causes of recurrent pregnancy loss with a focus on novel causes and potential treatments. Remaining knowledge gaps will be highlighted.

Kindergarten Black-White Test Score Gaps: Replicating and Updating Previous Findings with New National Data

ERIC Educational Resources Information Center

Quinn, David

2014-01-01

A substantial body of evidence has shown large academic test score gaps between black and white students in early childhood. These gaps remain, and probably grow, as students progress through school. Many researchers have sought to explain these persistent test score gaps, and particularly, to understand the role of students' socio-economic status…

Contextualized analysis of a needs assessment using the Theoretical Domains Framework: a case example in endocrinology

PubMed Central

2014-01-01

Background The Theoretical Domains Framework (TDF) is a set of 14 domains of behavior change that provide a framework for the critical issues and factors influencing optimal knowledge translation. Considering that a previous study has identified optimal knowledge translation techniques for each TDF domain, it was hypothesized that the TDF could be used to contextualize and interpret findings from a behavioral and educational needs assessment. To illustrate this hypothesis, findings and recommendations drawn from a 2012 national behavioral and educational needs assessment conducted with healthcare providers who treat and manage Growth and Growth Hormone Disorders, will be discussed using the TDF. Methods This needs assessment utilized a mixed-methods research approach that included a combination of: [a] data sources (Endocrinologists (n:120), Pediatric Endocrinologists (n:53), Pediatricians (n:52)), [b] data collection methods (focus groups, interviews, online survey), [c] analysis methodologies (qualitative - analyzed through thematic analysis, quantitative - analyzed using frequencies, cross-tabulations, and gap analysis). Triangulation was used to generate trustworthy findings on the clinical practice gaps of endocrinologists, pediatric endocrinologists, and general pediatricians in their provision of care to adult patients with adult growth hormone deficiency or acromegaly, or children/teenagers with pediatric growth disorders. The identified gaps were then broken into key underlying determinants, categorized according to the TDF domains, and linked to optimal behavioral change techniques. Results The needs assessment identified 13 gaps, each with one or more underlying determinant(s). Overall, these determinants were mapped to 9 of the 14 TDF domains. The Beliefs about Consequences domain was identified as a contributing determinant to 7 of the 13 challenges. Five of the gaps could be related to the Skills domain, while three were linked to the Knowledge domain. Conclusions The TDF categorization of the needs assessment findings allowed recommendation of appropriate behavior change techniques for each underlying determinant, and facilitated communication and understanding of the identified issues to a broader audience. This approach provides a means for health education researchers to categorize gaps and challenges identified through educational needs assessments, and facilitates the application of these findings by educators and knowledge translators, by linking the gaps to recommended behavioral change techniques. PMID:25060235

Contextualized analysis of a needs assessment using the Theoretical Domains Framework: a case example in endocrinology.

PubMed

Lazure, Patrice; Bartel, Robert C; Biller, Beverly M K; Molitch, Mark E; Rosenthal, Stephen M; Ross, Judith L; Bernsten, Brock D; Hayes, Sean M

2014-07-24

The Theoretical Domains Framework (TDF) is a set of 14 domains of behavior change that provide a framework for the critical issues and factors influencing optimal knowledge translation. Considering that a previous study has identified optimal knowledge translation techniques for each TDF domain, it was hypothesized that the TDF could be used to contextualize and interpret findings from a behavioral and educational needs assessment. To illustrate this hypothesis, findings and recommendations drawn from a 2012 national behavioral and educational needs assessment conducted with healthcare providers who treat and manage Growth and Growth Hormone Disorders, will be discussed using the TDF. This needs assessment utilized a mixed-methods research approach that included a combination of: [a] data sources (Endocrinologists (n:120), Pediatric Endocrinologists (n:53), Pediatricians (n:52)), [b] data collection methods (focus groups, interviews, online survey), [c] analysis methodologies (qualitative - analyzed through thematic analysis, quantitative - analyzed using frequencies, cross-tabulations, and gap analysis). Triangulation was used to generate trustworthy findings on the clinical practice gaps of endocrinologists, pediatric endocrinologists, and general pediatricians in their provision of care to adult patients with adult growth hormone deficiency or acromegaly, or children/teenagers with pediatric growth disorders. The identified gaps were then broken into key underlying determinants, categorized according to the TDF domains, and linked to optimal behavioral change techniques. The needs assessment identified 13 gaps, each with one or more underlying determinant(s). Overall, these determinants were mapped to 9 of the 14 TDF domains. The Beliefs about Consequences domain was identified as a contributing determinant to 7 of the 13 challenges. Five of the gaps could be related to the Skills domain, while three were linked to the Knowledge domain. The TDF categorization of the needs assessment findings allowed recommendation of appropriate behavior change techniques for each underlying determinant, and facilitated communication and understanding of the identified issues to a broader audience. This approach provides a means for health education researchers to categorize gaps and challenges identified through educational needs assessments, and facilitates the application of these findings by educators and knowledge translators, by linking the gaps to recommended behavioral change techniques.

Status of scientific knowledge, recovery progress, and future research directions for the Gulf Sturgeon, Acipenser oxyrinchus desotoi Vladykov, 1955

USGS Publications Warehouse

Sulak, Kenneth J.; Parauka, F; Slack, W. Todd; Ruth, T; Randall, Michael T.; Luke, K; Mette, M. F; Price, M. E

2016-01-01

The Gulf Sturgeon, Acipenser oxyrinchus desotoi, is an anadromous species of Acipenseridae and native to North America. It currently inhabits and spawns in the upper reaches of seven natal rivers along the northern coast of the Gulf of Mexico from the Suwannee River, Florida, to the Pearl River, Louisiana, during spring to autumn. Next to the Alligator Gar (Atractosteus spatula), the Gulf Sturgeon is currently the largest fish species occurring in U.S. Gulf Coast rivers, attaining a length of 2.35 m and weights exceeding 135 kg, but historically attained a substantially larger size. Historically, the spawning populations existed in additional rivers from which the species has been wholly or nearly extirpated, such as the Mobile and Ochlockonee rivers, and possibly the Rio Grande River. Most Gulf Sturgeon populations were decimated by unrestricted commercial fishing between 1895–1910. Subsequently most populations remained unrecovered or extirpated due to continued harvest until the 1970s–1980s, and the construction of dams blocking access to ancestral upriver spawning grounds. Late 20th Century harvest bans and net bans enacted by the several Gulf Coast states have stabilized several populations and enabled the Suwannee River population to rebound substantially and naturally. Hatchery supplementation has not been necessary in this regard to date. Sturgeon are resilient and adaptable fishes with a geological history of 150 million years. Research undertaken since the 1970s has addressed many aspects of Gulf Sturgeon life history, reproduction, migration, population biology, habitat requirements, and other aspects of species biology. However, many knowledge gaps remain, prominently including the life history of early developmental stages in the first year of life. Natural population recovery is evident for the Suwannee River population, but seems promising as well for at least four other populations. The Pascagoula and Pearl River populations face a challenging future due a combination of natural and anthropogenic factors. These two populations, and perhaps the Escambia River population, are particularly vulnerable to periodic mass mortality due to major stochastic events including hurricanes, flooding, hypoxia, and toxic spills. The present manuscript provides a comprehensive synthesis of knowledge regarding the Gulf Sturgeon at the organismal and population levels, identifying knowledge gaps as priorities for future research. Topics not treated in the present synthesis include morphology, internal biology, physiology, and endocrinology. Topics only briefly treated include parasites and diseases, contaminants, and sturgeon aquaculture.

Kernel Tuning and Nonuniform Influence on Optical and Electrochemical Gaps of Bimetal Nanoclusters.

PubMed

He, Lizhong; Yuan, Jinyun; Xia, Nan; Liao, Lingwen; Liu, Xu; Gan, Zibao; Wang, Chengming; Yang, Jinlong; Wu, Zhikun

2018-03-14

Fine tuning nanoparticles with atomic precision is exciting and challenging and is critical for tuning the properties, understanding the structure-property correlation and determining the practical applications of nanoparticles. Some ultrasmall thiolated metal nanoparticles (metal nanoclusters) have been shown to be precisely doped, and even the protecting staple metal atom could be precisely reduced. However, the precise addition or reduction of the kernel atom while the other metal atoms in the nanocluster remain the same has not been successful until now, to the best of our knowledge. Here, by carefully selecting the protecting ligand with adequate steric hindrance, we synthesized a novel nanocluster in which the kernel can be regarded as that formed by the addition of two silver atoms to both ends of the Pt@Ag 12 icosohedral kernel of the Ag 24 Pt(SR) 18 (SR: thiolate) nanocluster, as revealed by single crystal X-ray crystallography. Interestingly, compared with the previously reported Ag 24 Pt(SR) 18 nanocluster, the as-obtained novel bimetal nanocluster exhibits a similar absorption but a different electrochemical gap. One possible explanation for this result is that the kernel tuning does not essentially change the electronic structure, but obviously influences the charge on the Pt@Ag 12 kernel, as demonstrated by natural population analysis, thus possibly resulting in the large electrochemical gap difference between the two nanoclusters. This work not only provides a novel strategy to tune metal nanoclusters but also reveals that the kernel change does not necessarily alter the optical and electrochemical gaps in a uniform manner, which has important implications for the structure-property correlation of nanoparticles.

Increasing Student Performance on the Independent School Entrance Exam (ISEE) Using the Gap Analysis Approach

ERIC Educational Resources Information Center

Sarshar, Shanon Etty

2013-01-01

Using the Gap Analysis problem-solving framework (Clark & Estes, 2008), this study examined the performance gap experienced by 6th grade students on the math sections of the ISEE (Independent School Entrance Exam). The purpose of the study was to identify and validate the knowledge, motivation, and organization causes of the students' low…

Information Literacy: Instrument Development to Measure Competencies and Knowledge Among Nursing Educators, Nursing Administrators, and Nursing Clinicians: A Pilot Study

PubMed Central

Pierce, Susan; Pravikoff, Diane; Tanner, Annelle

2003-01-01

This poster describes a pilot study conducted to establish validity and reliability of an instrument that will be used in a nationwide needs assessment, implemented to identify gaps in Information Literacy skills, competencies, and knowledge among key nursing groups nationally. Data and information gathered using the tool will guide the profession in developing appropriate education and continuing education programs to close identified gaps and enhance nurses’ readiness for Evidence-Based Practice (EBP). PMID:14728475

There are big gaps in our knowledge, and thus approach, to zoo animal welfare: a case for evidence-based zoo animal management.

PubMed

Melfi, V A

2009-11-01

There are gaps in knowledge that hinder our ability within zoos to provide good animal welfare. This does not mean that zoos cannot or do not provide good welfare, only that currently this goal is hindered. Three reasons for these gaps are identified as: (1) there is an emphasis on the identification and monitoring of indicators that represent poor welfare and it is assumed that an absence of poor welfare equates to good welfare. This assumption is overly simplistic and potentially erroneous; (2) our understanding of how housing and husbandry (H&H) affects animals is limited to a small set of variables determined mostly by our anthropogenic sensitivities. Thus, we place more value on captive environmental variables like space and companionship, ignoring other factors that may have a greater impact on welfare, like climate; (3) finally, whether intentional or not, our knowledge and efforts to improve zoo animal welfare are biased to very few taxa. Most attention has been focused on mammals, notably primates, large cats, bears, and elephants, to the exclusion of the other numerous species about which very little is known. Unfortunately, the extent to which these gaps limit our ability to provide zoo animals with good welfare is exacerbated by our over reliance on using myth and tradition to determine zoo animal management. I suggest that we can fill these gaps in our knowledge and improve our ability to provide zoo animals with good welfare through the adoption of an evidence-based zoo animal management framework. This approach uses evidence gathered from different sources as a basis for making any management decisions, as good quality evidence increases the likelihood that these decisions result in good zoo animal welfare.

Epigenetics in focus: pathogenesis of myelodysplastic syndromes and the role of hypomethylating agents.

PubMed

Santini, Valeria; Melnick, Ari; Maciejewski, Jaroslaw P; Duprez, Estelle; Nervi, Clara; Cocco, Lucio; Ford, Kevin G; Mufti, Ghulam

2013-11-01

Dysregulation of cellular epigenetic machinery is considered a major pathogenetic determinant in many malignancies, including myelodysplastic syndromes (MDS). The importance of epigenetic dysfunction in MDS is reflected by the success of hypomethylating agents as standard of care for their treatment. Although these agents improve both survival and quality of life, knowledge gaps remain regarding the precise role of epigenetics in the pathogenesis of MDS and mechanisms by which hypomethylating agents exert their clinical effects. This article reviews the pathogenic role of epigenetic alterations in MDS, including the relationship between genetic and epigenetic abnormalities, and highlights emerging evidence that hypomethylating agents may reprogram the "methylome" while re-establishing hematopoiesis. Copyright © 2013. Published by Elsevier Ireland Ltd.

Pertussis and influenza immunisation during pregnancy: a landscape review.

PubMed

Abu Raya, Bahaa; Edwards, Kathryn M; Scheifele, David W; Halperin, Scott A

2017-07-01

Immunisation during pregnancy is a relatively new strategy, and is currently limited to tetanus, pertussis, and influenza vaccines. None of these vaccines were developed specifically for use in pregnancy, but they provide an effective method of protecting mothers and young infants. In response to increases in pertussis morbidity and mortality among young infants, several countries have recommended universal tetanus, diphtheria, and acellular pertussis immunisation during pregnancy. Similarly, many countries recommend influenza immunisation during pregnancy to reduce the risk of disease for mother and infant. Although scientific evidence to support maternal immunisation against pertussis and influenza is rapidly accumulating, important knowledge gaps remain that need to be addressed by future research, which we have highlighted in this Series paper. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multifaceted Roles of Connexin 43 in Stem Cell Niches.

PubMed

Genet, Nafiisha; Bhatt, Neha; Bourdieu, Antonin; Hirschi, Karen K

2018-01-01

Considerable progress has been made in the field of stem cell research; nonetheless, the use of stem cells for regenerative medicine therapies, for either endogenous tissue repair or cellular grafts post injury, remains a challenge. To better understand how to maintain stem cell potential in vivo and promote differentiation ex vivo, it is fundamentally important to elucidate the interactions between stem cells and their surrounding partners within their distinct niches. Among the vast array of proteins depicted as mediators for cell-to-cell interactions, connexin-comprised gap junctions play pivotal roles in the regulation of stem cell fate both in vivo and in vitro. This review summarizes and illustrates the current knowledge regarding the multifaceted roles of Cx43, specifically, in various stem cell niches.

Forensic medical evaluations of child maltreatment: a proposed research agenda.

PubMed

Dubowitz, Howard; Christian, Cindy W; Hymel, Kent; Kellogg, Nancy D

2014-11-01

Physicians play an important role in the forensic evaluation of suspected child abuse and neglect. There has been considerable progress in the medical field, helping distinguish findings related to maltreatment from other conditions or circumstances. Nevertheless, important questions remain. This article covers several of these questions and proposes a research agenda concerning five main topics: sexual abuse, neglect, fractures, abusive head trauma, and physicians work in interdisciplinary settings. The suggestions are hardly inclusive, but offer suggestions the authors think are priorities, and ones that research could reasonably address. By providing some background to gaps in our knowledge, this paper should be of interest to a broader audience than just medical professionals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Human Gut Microbiome: Function Matters.

PubMed

Heintz-Buschart, Anna; Wilmes, Paul

2017-11-22

The human gut microbiome represents a complex ecosystem contributing essential functions to its host. Recent large-scale metagenomic studies have provided insights into its structure and functional potential. However, the functional repertoire which is actually contributed to human physiology remains largely unexplored. Here, by leveraging recent omics datasets, we challenge current assumptions regarding key attributes of the functional gut microbiome, in particular with respect to its variability. We further argue that the closing of existing gaps in functional knowledge should be addressed by a most-wanted gene list, the development and application of molecular and cellular high-throughput measurements, the development and sensible use of experimental models, as well as the direct study of observable molecular effects in the human host. Copyright © 2017 Elsevier Ltd. All rights reserved.

Behavioral addictions in addiction medicine: from mechanisms to practical considerations.

PubMed

Banz, Barbara C; Yip, Sarah W; Yau, Yvonne H C; Potenza, Marc N

2016-01-01

Recent progress has been made in our understanding of nonsubstance or "behavioral" addictions, although these conditions and their most appropriate classification remain debated and the knowledge basis for understanding the pathophysiology of and treatments for these conditions includes important gaps. Recent developments include the classification of gambling disorder as a "Substance-Related and Addictive Disorder" in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and proposed diagnostic criteria for Internet Gaming Disorder in Section 3 of DSM-5. This chapter reviews current neuroscientific understandings of behavioral addictions and the potential of neurobiological data to assist in the development of improved policy, prevention, and treatment efforts. © 2016 Elsevier B.V. All rights reserved.

A Systematic Evaluation of Websites Offering Information on Chronic Kidney Disease

PubMed Central

Lutz, Erin R.; Costello, Kaitlin L.; Jo, Minjeong; Gilet, Constance A.; Hawley, Jennifer M.; Bridgman, Jessica C.; Song, Mi-Kyung

2014-01-01

In this study, we described the content and characteristics of 40 non-proprietary websites offering information about chronic kidney disease (CKD) and evaluated their information quality using the DISCERN scale and readability using Flesch Reading Ease and Flesch-Kincaid grade level. The areas in which the websites scored the lowest on the DISCERN scale were whether the website discussed knowledge gaps, presented balanced information, and was clear about the information source. Websites that rated higher quality on the DISCERN scale were more difficult to read. The quality and readability of many websites about CKD to be used as meaningful educational resources for patients who desire to learn more about CKD and treatment options remain inadequate. PMID:25244890

Summary: The natural history and immunobiology of Chlamydia trachomatis genital infection and implications for Chlamydia control.

PubMed

Gottlieb, Sami L; Martin, David H; Xu, Fujie; Byrne, Gerald I; Brunham, Robert C

2010-06-15

In 2008, the US Centers for Disease Control and Prevention held the Chlamydia Immunology and Control Expert Advisory Meeting to foster a dialogue among basic scientists, clinical researchers, and epidemiologists studying genital Chlamydia trachomatis infection. The objectives of the meeting were to determine key questions related to C. trachomatis natural history and immunobiology, with implications for control programs;to review existing data on these key questions; and to delineate research needs to address remaining gaps in knowledge. The 9 articles in this supplement to The Journal of Infectious Diseases describe salient findings presented at the 2008 meeting, and this commentary summarizes and synthesizes these articles and discusses implications for chlamydia control efforts and future research priorities.

Word and World Knowledge among Deaf Learners with and without Cochlear Implants

ERIC Educational Resources Information Center

Convertino, Carol; Borgna, Georgianna; Marschark, Marc; Durkin, Andreana

2014-01-01

Deaf learners frequently demonstrate significantly less vocabulary knowledge than hearing age-mates. Studies involving other domains of knowledge, and perhaps deaf learners' academic performance, indicate similar lags with regard to world knowledge. Such gaps often are attributed to limitations on deaf children's incidental learning by…

Building and Activating Students' Background Knowledge: It's What They Already Know That Counts

ERIC Educational Resources Information Center

Fisher, Douglas; Frey, Nancy; Lapp, Diane

2012-01-01

Students enter the middle grades with varying amounts of background knowledge. Teachers must assess student background knowledge for gaps or misconceptions and then provide instruction to build on that base. This article discusses effective strategies for assessing and developing students' background knowledge so they can become independent…

Analysis of Knowledge-Sharing Evolutionary Game in University Teacher Team

ERIC Educational Resources Information Center

Huo, Mingkui

2013-01-01

The knowledge-sharing activity is a major drive force behind the progress and innovation of university teacher team. Based on the evolutionary game theory, this article analyzes the knowledge-sharing process model of this team, studies the influencing mechanism of various factors such as knowledge aggregate gap, incentive coefficient and risk…

Evidence for consistency of the glycation gap in diabetes.

PubMed

Nayak, Ananth U; Holland, Martin R; Macdonald, David R; Nevill, Alan; Singh, Baldev M

2011-08-01

Discordance between HbA(1c) and fructosamine estimations in the assessment of glycemia is often encountered. A number of mechanisms might explain such discordance, but whether it is consistent is uncertain. This study aims to coanalyze paired glycosylated hemoglobin (HbA(1c))-fructosamine estimations by using fructosamine to determine a predicted HbA(1c), to calculate a glycation gap (G-gap) and to determine whether the G-gap is consistent over time. We included 2,263 individuals with diabetes who had at least two paired HbA(1c)-fructosamine estimations that were separated by 10 ± 8 months. Of these, 1,217 individuals had a third pair. The G-gap was calculated as G-gap = HbA(1c) minus the standardized fructosamine-derived HbA(1c) equivalent (FHbA(1c)). The hypothesis that the G-gap would remain consistent in individuals over time was tested. The G-gaps were similar in the first, second, and third paired samples (0.0 ± 1.2, 0.0 ± 1.3, and 0.0 ± 1.3, respectively). Despite significant changes in the HbA(1c) and fructosamine, the G-gap did not differ in absolute or relative terms and showed no significant within-subject variability. The direction of the G-gap remained consistent. The G-gap appears consistent over time; thus, by inference any key underlying mechanisms are likely to be consistent. G-gap calculation may be a method of exploring and evaluating any such underlying mechanisms.

Electronic patient records in action: Transforming information into professionally relevant knowledge.

PubMed

Winman, Thomas; Rystedt, Hans

2011-03-01

The implementation of generic models for organizing information in complex institutions like those in healthcare creates a gap between standardization and the need for locally relevant knowledge. The present study addresses how this gap can be bridged by focusing on the practical work of healthcare staff in transforming information in EPRs into knowledge that is useful for everyday work. Video recording of shift handovers on a rehabilitation ward serves as the empirical case. The results show how extensive selections and reorganizations of information in EPRs are carried out in order to transform information into professionally relevant accounts. We argue that knowledge about the institutional obligations and professional ways of construing information are fundamental for these transitions. The findings point to the need to consider the role of professional knowledge inherent in unpacking information in efforts to develop information systems intended to bridge between institutional and professional boundaries in healthcare. © The Author(s) 2011.

Safeguards Knowledge Management & Retention at U.S. National Laboratories.

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

Haddal, Risa; Jones, Rebecca; Bersell, Bridget

In 2017, four U.S. National Laboratories collaborated on behalf of DOE/NNSA to explore the safeguards knowledge retention problem, identify possible approaches, and develop a strategy to address it. The one-year effort consisted of four primary tasks. First, the project sought to identify critical safeguards information at risk of loss. Second, a survey and workshop were conducted to assess nine U.S. National Laboratories' efforts to determine current safeguards knowledge retention practices and challenges, and identify best practices. Third, specific tools were developed to identify and predict critical safeguards knowledge gaps and how best to recruit in order to fill those gaps.more » Finally, based on findings from the first three tasks and research on other organizational approaches to address similar issues, a strategy was developed on potential knowledge retention methods, customized HR policies, and best practices that could be implemented across the National Laboratory Complex.« less

Overcoming gaps and bottlenecks to advance precision agriculture

USDA-ARS?s Scientific Manuscript database

Maintaining a clear understanding of the technology gaps, knowledge needs, and training bottlenecks is required for improving adoption of precision agriculture. As an industry, precision agriculture embraces tools, methods, and practices that are constantly changing, requiring industry, education, a...

Positive Community Norm Survey 2011 : Methodology and Results

DOT National Transportation Integrated Search

2012-09-01

This survey established a baseline understanding of the positive norms that exist in Idaho, plus reveal the gaps in knowledge and perceived norms with regard to impaired driving. These gaps will indicate the most effective opportunities for future co...

Positive Community Norm Survey 2011: Methodology and Results

DOT National Transportation Integrated Search

2012-09-01

This survey established a baseline understanding of the positive norms that exist in Idaho, plus reveal the gaps in knowledge and perceived norms with regard to impaired driving. These gaps will indicate the most effective opportunities for future co...

A review of child stunting determinants in Indonesia.

PubMed

Beal, Ty; Tumilowicz, Alison; Sutrisna, Aang; Izwardy, Doddy; Neufeld, Lynnette M

2018-05-17

Child stunting reduction is the first of 6 goals in the Global Nutrition Targets for 2025 and a key indicator in the second Sustainable Development Goal of Zero Hunger. The prevalence of child stunting in Indonesia has remained high over the past decade, and at the national level is approximately 37%. It is unclear whether current approaches to reduce child stunting align with the scientific evidence in Indonesia. We use the World Health Organization conceptual framework on child stunting to review the available literature and identify what has been studied and can be concluded about the determinants of child stunting in Indonesia and where data gaps remain. Consistent evidence suggests nonexclusive breastfeeding for the first 6 months, low household socio-economic status, premature birth, short birth length, and low maternal height and education are particularly important child stunting determinants in Indonesia. Children from households with both unimproved latrines and untreated drinking water are also at increased risk. Community and societal factors-particularly, poor access to health care and living in rural areas-have been repeatedly associated with child stunting. Published studies are lacking on how education; society and culture; agriculture and food systems; and water, sanitation, and the environment contribute to child stunting. This comprehensive synthesis of the available evidence on child stunting determinants in Indonesia outlines who are the most vulnerable to stunting, which interventions have been most successful, and what new research is needed to fill knowledge gaps. © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Cancer Pain Management in Developing Countries.

PubMed

Saini, Shalini; Bhatnagar, Sushma

2016-01-01

The World Health Organization estimated that more than 60% of the 14 million new cancer cases worldwide in 2012 were reported in the developing part of the world, including Asia, Africa, Central and South America. Cancer survival rate is poorer in developing countries due to diagnosis at late stage and limited access to timely treatment. Since the disease per se cannot be treated even with the best available treatment modalities, what remains important is symptom management and providing comfort care to these patients. The incidence of pain in advanced stages of cancer approaches 70-80%. Lack of preventive strategies, poverty, illiteracy, and social stigma are the biggest cause of pain suffering and patient presenting in advance stage of their disease. The need for palliative care is expanding due to aging of world's population and increase in the rate of cancer in developed and developing countries. A huge gap remains between demand and current palliative care services. Overcoming barriers to palliative care is a major global health agenda that need immediate attention. Main causes of inadequate pain relief remain lack of knowledge among physician and patients, lack of adequate supply of opioids and other drugs for pain relief, strong bureaucracy involved in terms of procurement, and dispensing of opioids. Beside this, poverty and illiteracy remain the most important factors of increased suffering.

ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement.

PubMed

Kleinman, Monica E; Perkins, Gavin D; Bhanji, Farhan; Billi, John E; Bray, Janet E; Callaway, Clifton W; de Caen, Allan; Finn, Judith C; Hazinski, Mary Fran; Lim, Swee Han; Maconochie, Ian; Morley, Peter; Nadkarni, Vinay; Neumar, Robert W; Nikolaou, Nikolaos; Nolan, Jerry P; Reis, Amelia; Sierra, Alfredo F; Singletary, Eunice M; Soar, Jasmeet; Stanton, David; Travers, Andrew; Welsford, Michelle; Zideman, David

2018-04-26

Despite significant advances in the field of resuscitation science, important knowledge gaps persist. Current guidelines for resuscitation are based on the International Liaison Committee on Resuscitation 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, which includes treatment recommendations supported by the available evidence. The writing group developed this consensus statement with the goal of focusing future research by addressing the knowledge gaps identified during and after the 2015 International Liaison Committee on Resuscitation evidence evaluation process. Key publications since the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations are referenced, along with known ongoing clinical trials that are likely to affect future guidelines. © 2018 European Resuscitation Council and American Heart Association, Inc. Published by Elsevier B.V. All rights reserved. Copyright © 2018 European Resuscitation Council and American Heart Association, Inc. Published by Elsevier B.V. All rights reserved.

Towards a Consensus View on Understanding Nanomaterials Hazards and Managing Exposure: Knowledge Gaps and Recommendations

PubMed Central

Hunt, Geoffrey; Lynch, Iseult; Cassee, Flemming; Handy, Richard D.; Fernandes, Teresa F.; Berges, Markus; Kuhlbusch, Thomas A. J.; Dusinska, Maria; Riediker, Michael

2013-01-01

The aim of this article is to present an overview of salient issues of exposure, characterisation and hazard assessment of nanomaterials as they emerged from the consensus-building of experts undertaken within the four year European Commission coordination project NanoImpactNet. The approach adopted is to consolidate and condense the findings and problem-identification in such a way as to identify knowledge-gaps and generate a set of interim recommendations of use to industry, regulators, research bodies and funders. The categories of recommendation arising from the consensual view address: significant gaps in vital factual knowledge of exposure, characterisation and hazards; the development, dissemination and standardisation of appropriate laboratory protocols; address a wide range of technical issues in establishing an adequate risk assessment platform; the more efficient and coordinated gathering of basic data; greater inter-organisational cooperation; regulatory harmonization; the wider use of the life-cycle approaches; and the wider involvement of all stakeholders in the discussion and solution-finding efforts for nanosafety. PMID:28809359

Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system

PubMed Central

Anand, Sonia S.; Hawkes, Corinna; de Souza, Russell J.; Mente, Andrew; Dehghan, Mahshid; Nugent, Rachel; Zulyniak, Michael A.; Weis, Tony; Bernstein, Adam M.; Krauss, Ronald; Kromhout, Daan; Jenkins, David J.A.; Malik, Vasanti; Martinez-Gonzalez, Miguel A.; Mozafarrian, Dariush; Yusuf, Salim; Willett, Walter C.; Popkin, Barry M

2015-01-01

Major scholars in the field, based on a 3-day consensus, created an in-depth review of current knowledge on the role of diet in CVD, the changing global food system and global dietary patterns, and potential policy solutions. Evidence from different countries, age/race/ethnicity/socioeconomic groups suggest the health effects studies of foods, macronutrients, and dietary patterns on CVD appear to be far more consistent though regional knowledge gaps are highlighted. There are large gaps in knowledge about the association of macronutrients to CVD in low- and middle-income countries (LMIC), particularly linked with dietary patterns are reviewed. Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however major gaps exist both in dietary pattern research and ways to change diets and food systems. Based on the current evidence, the traditional Mediterranean-type diet, including plant foods/emphasizing plant protein sources, provides a well-tested healthy dietary pattern to reduce CVD. PMID:26429085

Sixty-five years since the New York heat wave: advances in sweat testing for cystic fibrosis.

PubMed

Collie, Jake T B; Massie, R John; Jones, Oliver A H; LeGrys, Vicky A; Greaves, Ronda F

2014-02-01

The sweat test remains important as a diagnostic test for cystic fibrosis (CF) and has contributed greatly to our understanding of CF as a disease of epithelial electrolyte transport. The standardization of the sweat test, by Gibson and Cooke [Gibson and Cooke (1959) Pediatrics 1959;23:5], followed observations of excessive dehydration amongst patients with CF and confirmed the utility as a diagnostic test. Quantitative pilocarpine iontophoresis remains the gold standard for sweat induction, but there are a number of collection and analytical methods. The pathophysiology of electrolyte transport in sweat was described by Quinton [Quinton (1983) Nature 1983;301:421-422], and this complemented the developments in genetics that discovered the cystic fibrosis transmembrane conductance regulator (CFTR), an epithelial-based electrolyte transport protein. Knowledge of CF has since increased rapidly and further developments in sweat testing include: new collection methods, further standardization of the technique with international recommendations and age related reference intervals. More recently, sweat chloride values have been used as proof of effect for the new drugs that activate CFTR. However, there remain issues with adherence to sweat test guidelines in many countries and there are gaps in our knowledge, including reference intervals for some age groups and stability of sweat samples in transport. Furthermore, modern methods of elemental quantification need to be explored as alternatives to the original analytical methods for sweat electrolyte measurement. The purpose of this review is therefore to describe the development of the sweat test and consider future directions. © 2013 Wiley Periodicals, Inc.

Consolidating the State of Knowledge: A Synoptical Review of Wind Energy's Wildlife Effects.

PubMed

Schuster, Eva; Bulling, Lea; Köppel, Johann

2015-08-01

Wind energy development contributes substantially to achieve climate protection goals. Unintended side effects, especially on wildlife, have long been discussed and substantial research has evolved over the last decade. At this stage, it is important to identify what we have learnt so far, as well as which predominant uncertainties and gaps remain. This review article aims to consolidate the state of knowledge, providing a qualitative analysis of the main effects of wind energy development on- and offshore, focusing on frequently studied species groups (bats, breeding and resting birds, raptors, migratory birds, marine mammals). We reviewed over 220 publications from which we identified predominant hypotheses that were summarized and displayed in tables. Journal publications, conference contributions, and further studies have been considered. We found that research focusing on offshore wind energy within the last couple of years has increased significantly as well, catching up with the vast amount of onshore studies. Some hypotheses have been verified by numerous publications and a consensus has been reached (e.g., correlation between bat activity and weather factors), while others are still being debated more (e.g., determination of migratory corridors) or remain unknown (e.g., effect on population level). Factors influencing potential effects were mainly related to species characteristics (morphology, phenology, abundance, behavior, and response to turbines) or site characteristics (landscape features, weather, and habitat quality). Consolidating the state of research provides the groundwork for the identification of mitigation measures and advanced planning approaches. However, the quantification of effects remains challenging and uncertainties will always persist.

Consolidating the State of Knowledge: A Synoptical Review of Wind Energy's Wildlife Effects

NASA Astrophysics Data System (ADS)

Schuster, Eva; Bulling, Lea; Köppel, Johann

2015-08-01

Wind energy development contributes substantially to achieve climate protection goals. Unintended side effects, especially on wildlife, have long been discussed and substantial research has evolved over the last decade. At this stage, it is important to identify what we have learnt so far, as well as which predominant uncertainties and gaps remain. This review article aims to consolidate the state of knowledge, providing a qualitative analysis of the main effects of wind energy development on- and offshore, focusing on frequently studied species groups (bats, breeding and resting birds, raptors, migratory birds, marine mammals). We reviewed over 220 publications from which we identified predominant hypotheses that were summarized and displayed in tables. Journal publications, conference contributions, and further studies have been considered. We found that research focusing on offshore wind energy within the last couple of years has increased significantly as well, catching up with the vast amount of onshore studies. Some hypotheses have been verified by numerous publications and a consensus has been reached (e.g., correlation between bat activity and weather factors), while others are still being debated more (e.g., determination of migratory corridors) or remain unknown (e.g., effect on population level). Factors influencing potential effects were mainly related to species characteristics (morphology, phenology, abundance, behavior, and response to turbines) or site characteristics (landscape features, weather, and habitat quality). Consolidating the state of research provides the groundwork for the identification of mitigation measures and advanced planning approaches. However, the quantification of effects remains challenging and uncertainties will always persist.

Ecological research and environmental management: We need different interfaces based on different knowledge types.

PubMed

Gosselin, Frédéric; Cordonnier, Thomas; Bilger, Isabelle; Jappiot, Marielle; Chauvin, Christophe; Gosselin, Marion

2018-04-25

The role of ecological science in environmental management has been discussed by many authors who recognize that there is a persistent gap between ecological science and environmental management. Here we develop theory through different perspectives based on knowledge types, research categories and research-management interface types, which we combine into a common framework. To draw out insights for bridging this gap, we build our case by:We point out the complementarities as well as the specificities and limitations of the different types of ecological research, ecological knowledge and research-management interfaces, which is of major importance for environmental management and research policies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Arizona Registered Dietitians Show Gaps in Knowledge of Bean Health Benefits

PubMed Central

Thompson, Sharon V.; Dougherty, Mariah K.

2018-01-01

Registered Dietitians (RDs) promote nutrition practices and policies and can influence food consumption patterns to include nutrient dense foods such as beans. Although many evidence-based health benefits of bean consumption (e.g., cholesterol reduction, glycemic control) have been demonstrated, there is limited research on the knowledge, attitudes, and perceptions of RDs regarding the inclusion of beans in a healthy diet. To fill this existing research gap, this cross-sectional survey explored the perceptions, knowledge, and attitudes of 296 RDs in Arizona, USA, toward beans. The RDs largely held positive attitudes toward the healthfulness of beans and were aware of many health benefits. Some gaps in awareness were evident, including effect on cancer risk, intestinal health benefits, folate content, and application with celiac disease patients. RDs with greater personal bean consumption had significantly higher bean health benefit knowledge. Twenty-nine percent of the RDs did not know the meaning of ‘legume’, and over two-thirds could not define the term ‘pulse’. It is essential that RDs have up-to-date, evidence-based information regarding bean benefits to provide appropriate education to patients, clients, and the public. PMID:29316699

Laxity Profiles in the Native and Replaced Knee-Application to Robotic-Assisted Gap-Balancing Total Knee Arthroplasty.

PubMed

Shalhoub, Sami; Moschetti, Wayne E; Dabuzhsky, Leonid; Jevsevar, David S; Keggi, John M; Plaskos, Christopher

2018-05-14

The traditional goal of the gap-balancing method in total knee arthroplasty is to create equal and symmetric knee laxity throughout the arc of flexion. The purpose of this study was to (1) quantify the laxity in the native and the replaced knee throughout the range of flexion in gap-balancing total knee arthroplasty (TKA) and (2) quantify the precision in achieving a targeted gap profile throughout flexion using a robotic-assisted technique with active ligament tensioning. Robotic-assisted, gap-balancing TKA was performed in 14 cadaver specimens. The proximal tibia was resected, and the native tibiofemoral gaps were measured using a robotic tensioner that dynamically tensioned the soft-tissue envelope throughout the arc of flexion. The femoral implant was then aligned to balance the gaps at 0° and 90° of flexion. The postoperative gaps were then measured during final trialing with the robotic tensioner and compared with the planned gaps. The native gaps increased by 3.4 ± 1.7 mm medially and 3.7 ± 2.1 mm laterally from full extension to 20° of flexion (P < .001) and then remained consistent through the remaining arc of flexion. Gap balancing after TKA produced equal gaps at 0° and 90° of flexion, but the gap laxity in midflexion was 2-4 mm greater than at 0° and 90° (P < .001). The root mean square error between the planned gaps and actual measured postoperative gaps was 1.6 mm medially and 1.7 mm laterally throughout the range of motion. Aiming for equal gaps at 0° and 90° of flexion produced equal gaps in extension and flexion with larger gaps in midflexion. Consistent soft-tissue balance to a planned gap profile could be achieved by using controlled ligament tensioning in robotic-assisted TKA. Copyright © 2018 Elsevier Inc. All rights reserved.

Stochastic Estimation of Cost Frontier: Evidence from Bangladesh

ERIC Educational Resources Information Center

Mamun, Shamsul Arifeen Khan

2012-01-01

In the literature of higher education cost function study, enough knowledge is created in the area of economy scale in the context of developed countries but the knowledge of input demand is lacking. On the other hand, empirical knowledge in the context of developing countries is very meagre. The paper fills up the knowledge gap, estimating a…

Finding Platinum-Coating Gaps On Titanium Anodes

NASA Technical Reports Server (NTRS)

Bodemeijer, Ronnald; Flowers, Cecil E.

1990-01-01

Simple procedure makes gaps visible to eye. New gap-detection method consists of plating thin layer of non-silver-colored metal like copper or gold on anode. Contrast in color between plated metal and bare anode material makes gaps stand out. If anode passes inspection, copper or gold plate removable by reversal of test-plating current. Remains to be determined whether test plating and removal damages anode. New method simpler and more economical than previous attempts to identify gaps in platinum.

1H, 15N, 13C resonance assignment of human GAP-43.

PubMed

Flamm, Andrea Gabriele; Żerko, Szymon; Zawadzka-Kazimierczuk, Anna; Koźmiński, Wiktor; Konrat, Robert; Coudevylle, Nicolas

2016-04-01

GAP-43 is a 25 kDa neuronal intrinsically disordered protein, highly abundant in the neuronal growth cone during development and regeneration. The exact molecular function(s) of GAP-43 remains unclear but it appears to be involved in growth cone guidance and actin cytoskeleton organization. Therefore, GAP-43 seems to play an important role in neurotransmitter vesicle fusion and recycling, long-term potentiation, spatial memory formation and learning. Here we report the nearly complete assignment of recombinant human GAP-43.

Gaps and opportunities in refractory status epilepticus research in children: a multi-center approach by the Pediatric Status Epilepticus Research Group (pSERG).

PubMed

Sánchez Fernández, Iván; Abend, Nicholas S; Agadi, Satish; An, Sookee; Arya, Ravindra; Carpenter, Jessica L; Chapman, Kevin E; Gaillard, William D; Glauser, Tracy A; Goldstein, David B; Goldstein, Joshua L; Goodkin, Howard P; Hahn, Cecil D; Heinzen, Erin L; Mikati, Mohamad A; Peariso, Katrina; Pestian, John P; Ream, Margie; Riviello, James J; Tasker, Robert C; Williams, Korwyn; Loddenkemper, Tobias

2014-02-01

Status epilepticus (SE) is a life-threatening condition that can be refractory to initial treatment. Randomized controlled studies to guide treatment choices, especially beyond first-line drugs, are not available. This report summarizes the evidence that guides the management of refractory convulsive SE (RCSE) in children, defines gaps in our clinical knowledge and describes the development and works of the 'pediatric Status Epilepticus Research Group' (pSERG). A literature review was performed to evaluate current gaps in the pediatric SE and RCSE literature. In person and online meetings helped to develop and expand the pSERG network. The care of pediatric RCSE is largely based on extrapolations of limited evidence derived from adult literature and supplemented with case reports and case series in children. No comparative effectiveness trials have been performed in the pediatric population. Gaps in knowledge include risk factors for SE, biomarkers of SE and RCSE, second- and third-line treatment options, and long-term outcome. The care of children with RCSE is based on limited evidence. In order to address these knowledge gaps, the multicenter pSERG was established to facilitate prospective collection, analysis, and sharing of de-identified data and biological specimens from children with RCSE. These data will allow identification of treatment strategies associated with better outcomes and delineate evidence-based interventions to improve the care of children with SE. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cross-National Gender Gaps in Political Knowledge

PubMed Central

Fortin-Rittberger, Jessica

2016-01-01

Although the majority of studies on political knowledge document lingering gender-based differences in advanced industrial democracies, most contributors have drawn such conclusions from a single or a handful of countries, using limited batteries of political information items. Exploiting a pooled data set of the Comparative Study of Electoral Systems encompassing 106 post-election surveys in forty-seven countries between 1996 and 2011, this article demonstrates that survey instrument–related factors, such as question format and content, as well as the overall difficulty of questions, are more consequential in shaping the size of gender gaps in political knowledge than institutional factors, such as electoral rules or opportunity structures. The research design of this article draws from almost three hundred different items measuring factual political knowledge using the broadest country coverage and most comprehensive approach to measurement to date. PMID:27524874

A controlled investigation of continuing pain education for long-term care staff

PubMed Central

Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Bello-Haas, Vanina Dal; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra MG; Carleton, R Nicholas; Hunter, Paulette V; Lix, Lisa M

2013-01-01

BACKGROUND: The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff. METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers. PMID:23457681

Constant voltage electro-slag remelting control

DOEpatents

Schlienger, Max E.

1996-01-01

A system for controlling electrode gap in an electro-slag remelt furnace has a constant regulated voltage and an eletrode which is fed into the slag pool at a constant rate. The impedance of the circuit through the slag pool is directly proportional to the gap distance. Because of the constant voltage, the system current changes are inversely proportional to changes in gap. This negative feedback causes the gap to remain stable.

Understanding the Gender Gap.

ERIC Educational Resources Information Center

Goldin, Claudia

1985-01-01

Despite the great influx of women into the labor market, the gap between men's and women's wages has remained stable at 40 percent since 1950. Analysis of labor data suggests that this has occurred because women's educational attainment compared to men has declined. Recently, however, the wage gap has begun to narrow, and this will probably become…

Two Models of Learning and Achievement: An Explanation for the Achievement Gap?

ERIC Educational Resources Information Center

Yeh, Stuart S.

2015-01-01

Background/Context: Despite decades of research, the persistence of the gap in student achievement between disadvantaged minority students and their middle-class peers remains unexplained. Purpose/Objective: The purpose of the current article is to propose a new model of the achievement gap. Research Design: Data were analyzed from three…

GAP-43 Gene Expression Regulates Information Storage

ERIC Educational Resources Information Center

Holahan, Matthew R.; Honegger, Kyle S.; Tabatadze, Nino; Routtenberg, Aryeh

2007-01-01

Previous reports have shown that overexpression of the growth- and plasticity-associated protein GAP-43 improves memory. However, the relation between the levels of this protein to memory enhancement remains unknown. Here, we studied this issue in transgenic mice (G-Phos) overexpressing native, chick GAP-43. These G-Phos mice could be divided at…

Gaps in health insurance: why so many Americans experience breaks in coverage and how the Affordable Care Act will help: findings from the Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults, 2011.

PubMed

Collins, Sara R; Robertson, Ruth; Garber, Tracy; Doty, Michelle M

2012-04-01

The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults finds that one-quarter of adults ages 19 to 64 experienced a gap in their health insurance in 2011, with a majority remaining uninsured for one year or more. Losing or changing jobs was the primary reason people experienced a gap. Compared with adults who had continuous coverage, those who experienced gaps were less likely to have a regular doctor and less likely to be up to date with recommended preventive care tests, with rates declining as the length of the coverage gap increases. Early provisions of the Affordable Care Act are already helping bridge gaps in coverage among young adults and people with preexisting conditions. Beginning in 2014, new affordable health insurance options through Medicaid and state insurance exchanges will enable adults and their families to remain insured even in the face of job changes and other life disruptions.

Innovation strategy management survey of the Chilean biomedical industry. Assessment of windows of opportunities to reduce technological gaps.

PubMed

Bas, Tomas Gabriel; Oliu, Carolina Alejandra

2018-04-01

The convergence of different theories (ie, catch-up effect and windows of opportunities) allows for the interpretation of different "technological innovation gaps" in Chile's biomedical industry. It is common knowledge that Chile has always had an economy almost exclusively based on services, commodities, and mainly in the exploitation of natural resources with low value added. The literature confirms that countries that concentrate their economies on the knowledge, research, development, and commercialization of technology and innovation have a better and more stable growth rate in the medium and long run. The "Asian Tigers" are a good example of this. Analyzing the technological gaps that affect the Chilean biomedical industry, it is possible to find windows of opportunities to catch up. This could allow the country to take its knowledge, skills, and capabilities further, thus enabling Chile to not just depend on its unpredictable natural resources. For the first time, a quantitative diagnosis of the Chilean biomedical industry was made. This study considered the Chilean biomedical industry and its innovation and entrepreneurship environment, taking into account its productive capacities and its potential to make progress in technological innovation and, as a result, dramatically reducing technological gaps through windows of opportunities. Copyright © 2018 John Wiley & Sons, Ltd.

Coffee as an Antidote to Knowledge Stickiness

ERIC Educational Resources Information Center

Blackman, Deborah; Phillips, Diane

2011-01-01

This paper considers the concept of space and its role in both knowledge creation and overcoming knowledge stickiness. Aristotelian concepts of "freedom to" and "freedom from" are used to reconceptualise space. Informal and formal spaces, concepts and places are discussed as both specific locations and as gaps providing space for knowledge…

Useful Knowledge? Concepts, Values, and Access in American Education, 1776-1840.

ERIC Educational Resources Information Center

Watkinson, James D.

1990-01-01

Traces changing concepts of what constituted useful knowledge, especially as revealed in journals, in the United States from 1776 to 1840. Identifies a widening knowledge gap--corresponding with industrialization--between increasingly elitist, specialized learned societies and mechanics/farmers. Argues that as science grew more professionalized,…

Family Communication, Risk Perception and Cancer Knowledge of Young Adults from BRCA1/2 Families: a Systematic Review.

PubMed

Young, Alison L; Butow, Phyllis N; Vetsch, Janine; Quinn, Veronica F; Patenaude, Andrea F; Tucker, Katherine M; Wakefield, Claire E

2017-12-01

Understanding challenges in familial communication of cancer risk has informed genetic service delivery. Parent-child interactions have received considerable attention, but few studies focus on young adulthood experiences within BRCA1/2 families. Young adults are approaching, or at a life stage where awareness of hereditary cancer risk is vital for informed choice of risk management options. This review assesses family communication, risk perception and cancer knowledge held by 18-40 year old individuals who have a parent with a BRCA1/2 gene mutation or carry the gene mutation themselves. Thirteen papers met the inclusion criteria. One utilized a 'mixed methods' methodology and the remaining used a qualitative approach. Findings were synthesized into themes and reported narratively. In general, parents are communicating openly about genetic risk with young adult offspring, but there is evidence that some young adults are withholding information from their parents about their own test results. Risk perception is influenced by a family history of cancer, childbearing plans and health providers' advice. Misconceptions about genetic risk appear to be common and gaps in hereditary cancer knowledge are evident. It is unclear whether incorrect knowledge was passed from parents to offspring. Health providers need to provide developmentally appropriate services for emerging adults (18-25 years old), with particular support in navigating through risk management options.

Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public.

PubMed

Richards, W; Filipponi, T; Roberts-Burt, V

2014-02-01

The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.

Summary of: Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public.

PubMed

Levine, R S

2014-02-01

The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.

Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice.

PubMed

Henderson, Saras

2002-12-01

Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.

Medical education and law: withholding/withdrawing treatment from adults without capacity.

PubMed

Parker, M; Willmott, L; White, B; Williams, G; Cartwright, C

2015-06-01

Law is increasingly involved in clinical practice, particularly at the end of life, but undergraduate and postgraduate education in this area remains unsystematic. We hypothesised that attitudes to and knowledge of the law governing withholding/withdrawing life-sustaining treatment from adults without capacity (the WWLST law) would vary and demonstrate deficiencies among medical specialists. We investigated perspectives, knowledge and training of medical specialists in the three largest (populations and medical workforces) Australian states, concerning the WWLST law. Following expert legal review, specialist focus groups, pre-testing and piloting in each state, seven specialties involved with end-of-life care were surveyed, with a variety of statistical analyses applied to the responses. Respondents supported the need to know and follow the law. There were mixed views about its helpfulness in medical decision-making. Over half the respondents conceded poor knowledge of the law; this was mirrored by critical gaps in knowledge that varied by specialty. There were relatively low but increasing rates of education from the undergraduate to continuing professional development (CPD) stages. Mean knowledge score did not vary significantly according to undergraduate or immediate postgraduate training, but CPD training, particularly if recent, resulted in greater knowledge. Case-based workshops were the preferred CPD instruction method. Teaching of current and evolving law should be strengthened across all stages of medical education. This should improve understanding of the role of law, ameliorate ambivalence towards the law and contribute to more informed deliberation about end-of-life issues with patients and families. © 2015 Royal Australasian College of Physicians.

Knowledge of the law about withholding or withdrawing life-sustaining treatment by intensivists and other specialists.

PubMed

White, Ben; Willmott, Lindy; Cartwright, Colleen; Parker, Malcolm H; Williams, Gail

2016-06-01

Decisions about withholding or withdrawing life-sustaining treatment (WWLST) from adults who lack capacity are an integral part of intensive care (IC) practice. We compare the knowledge, attitudes and practice of intensivists in relation to the law about WWLST with six other specialties most often involved in end-of-life care. We used a cross-sectional postal survey of medical specialists in the three most populous Australian states, and analysed responses from 867 medical specialists from the seven specialties most likely to be involved in WWLST decisions in the acute-care setting (emergency, geriatric, palliative, renal and respiratory medicine, medical oncology and IC). Attitudes to, and knowledge and practice of, the law relating to end-of-life care. Of 2702 surveys sent to eligible practitioners, 867 completed questionnaires were returned. There was an overall response rate of 32% and an IC response rate also of 32% (125/388). Intensivists performed better than average in legal knowledge but important knowledge gaps remain. Intensivists had a more negative attitude to the role of law in this area than other specialty groups but reported being seen as a leading source of information about legal issues by other medical specialists and nurses. Intensivists also reported being the specialists most frequently making decisions about end-of-life treatment. Improved legal knowledge and open engagement with the law can help manage the risk of harm to patients and protect intensivists from liability. IC guidelines and continuing professional development are important strategies to address these issues.

Knowledge, attitudes, beliefs, and practices about HIV/AIDS in Kuwait.

PubMed

al-Owaish, R; Moussa, M A; Anwar, S; al-Shoumer, H; Sharma, P

1999-04-01

This survey is aimed at assessing knowledge, attitudes, beliefs and practices in Kuwait regarding AIDS/HIV. Structured face-to-face interviews were conducted during the year 1995 on a sample of 2,219 subjects, aged 18 to 60, health professionals were excluded. The survey instrument included 26 questions on AIDS/HIV knowledge, 6 about attitudes and beliefs, and 6 about behavior and practice. The remaining 22 items dealt with sociodemographic characteristics, role of religion, source of information, and satisfaction about AIDS control programs. Two thirds of subjects had good knowledge about the main modes of HIV/AIDS transmission. Using a multiple regression model, the knowledge score was positively associated with level of education, age, years of hearing about AIDS, and socioeconomic status. The multiple logistic regression showed that subjects tend not to change their behavior related to AIDS if they were less than 40 years old, had low education, were females, single, had a lower socioeconomic status, had heard about AIDS for less than 3 years, and had a low level of knowledge about AIDS. More than half of the participants were satisfied with the government's action for AIDS prevention. The majority of subjects thought that religion was important in dealing with daily life problems. In conclusion, while most of the people in Kuwait were aware of the main modes of AIDS transmission, a gap existed about modes that did not transmit the disease. This was reflected in their attitudes and practice toward AIDS patients. The study calls for a greater role for medical professionals, mass media, and religion in AIDS prevention and control.

Moving Evolution Education Forward: A Systematic Analysis of Literature to Identify Gaps in Collective Knowledge for Teaching

ERIC Educational Resources Information Center

Ziadie, M. A.; Andrews, T. C.

2018-01-01

Evolution is a unifying theory in biology and is challenging for undergraduates to learn. An instructor's ability to help students learn is influenced by pedagogical content knowledge (PCK), which is topic-specific knowledge of teaching and learning. Instructors need PCK for every topic they teach, which is a tremendous body of knowledge to…

Knowledge and Beliefs about Developmental Dyslexia: A Comparison between Pre-Service and In-Service Peruvian Teachers

ERIC Educational Resources Information Center

Echegaray-Bengoa, Joyce; Soriano-Ferrer, Manuel; Joshi, R. Malatesha

2017-01-01

The purpose of this study was to investigate the knowledge, misconceptions, and knowledge gaps of Peruvian pre-service teachers (PSTs) and in-service teachers (ISTs). To do so, 112 PSTs and 113 ISTs completed the Knowledge and Beliefs About Developmental Dyslexia Scale (KBDDS). Results show that ISTs scored significantly higher than PSTs.…

Big data analytics in immunology: a knowledge-based approach.

PubMed

Zhang, Guang Lan; Sun, Jing; Chitkushev, Lou; Brusic, Vladimir

2014-01-01

With the vast amount of immunological data available, immunology research is entering the big data era. These data vary in granularity, quality, and complexity and are stored in various formats, including publications, technical reports, and databases. The challenge is to make the transition from data to actionable knowledge and wisdom and bridge the knowledge gap and application gap. We report a knowledge-based approach based on a framework called KB-builder that facilitates data mining by enabling fast development and deployment of web-accessible immunological data knowledge warehouses. Immunological knowledge discovery relies heavily on both the availability of accurate, up-to-date, and well-organized data and the proper analytics tools. We propose the use of knowledge-based approaches by developing knowledgebases combining well-annotated data with specialized analytical tools and integrating them into analytical workflow. A set of well-defined workflow types with rich summarization and visualization capacity facilitates the transformation from data to critical information and knowledge. By using KB-builder, we enabled streamlining of normally time-consuming processes of database development. The knowledgebases built using KB-builder will speed up rational vaccine design by providing accurate and well-annotated data coupled with tailored computational analysis tools and workflow.

Understanding and living with glaucoma and non-communicable diseases like hypertension and diabetes in the Jhaukhel-Duwakot Health Demographic Surveillance Site: a qualitative study from Nepal

PubMed Central

Shakya-Vaidya, Suraj; Povlsen, Lene; Shrestha, Binjwala; Grjibovski, Andrej M.; Krettek, Alexandra

2014-01-01

Background Primary open-angle glaucoma (POAG) is one of the most common causes of irreversible blindness. A possible association between POAG and non-communicable diseases such as hypertension and diabetes suggests that the incidence of POAG may increase. People with POAG in Nepal usually present late to hospital and have poor knowledge of glaucoma. Objectives Anticipating a knowledge gap regarding these diseases, this study aimed to explore the knowledge of POAG, hypertension, and diabetes in the community and barriers to health care. Design We conducted this qualitative study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), a peri-urban community near Kathmandu, a capital city of Nepal. To study how disease influences knowledge, we conducted focus group discussions separately for men and women with and without pre-existing POAG, hypertension, and diabetes. Data were analyzed using the framework analysis approach. Results Although people suffering from POAG, hypertension, and/or diabetes exhibited adequate knowledge of hypertension and diabetes, they lacked in-depth knowledge of POAG. People believed mostly in internal health locus of control. Perception of disease consequences and impact of disease on daily life was influenced by pre-existing POAG, hypertension, and/or diabetes but only in men. Gender disparity was observed regarding health literacy, health perception, and health barriers, which put women in a more difficult situation to tackle their health. We also revealed a gap between knowledge, attitude, and practice of health among women and healthy men. Conclusion Although people in JD-HDSS exhibited adequate knowledge regarding hypertension and diabetes, they lacked in-depth knowledge about POAG. This study demonstrated gender difference in health literacy and access to health care, making women more vulnerable towards disease. We also demonstrated a gap between knowledge, attitude, and practice of health. However, tailored health literacy programs may bring changes in the health status in the community. PMID:25361727

Gap Size Uncertainty Quantification in Advanced Gas Reactor TRISO Fuel Irradiation Experiments

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

Pham, Binh T.; Einerson, Jeffrey J.; Hawkes, Grant L.

The Advanced Gas Reactor (AGR)-3/4 experiment is the combination of the third and fourth tests conducted within the tristructural isotropic fuel development and qualification research program. The AGR-3/4 test consists of twelve independent capsules containing a fuel stack in the center surrounded by three graphite cylinders and shrouded by a stainless steel shell. This capsule design enables temperature control of both the fuel and the graphite rings by varying the neon/helium gas mixture flowing through the four resulting gaps. Knowledge of fuel and graphite temperatures is crucial for establishing the functional relationship between fission product release and irradiation thermal conditions.more » These temperatures are predicted for each capsule using the commercial finite-element heat transfer code ABAQUS. Uncertainty quantification reveals that the gap size uncertainties are among the dominant factors contributing to predicted temperature uncertainty due to high input sensitivity and uncertainty. Gap size uncertainty originates from the fact that all gap sizes vary with time due to dimensional changes of the fuel compacts and three graphite rings caused by extended exposure to high temperatures and fast neutron irradiation. Gap sizes are estimated using as-fabricated dimensional measurements at the start of irradiation and post irradiation examination dimensional measurements at the end of irradiation. Uncertainties in these measurements provide a basis for quantifying gap size uncertainty. However, lack of gap size measurements during irradiation and lack of knowledge about the dimension change rates lead to gap size modeling assumptions, which could increase gap size uncertainty. In addition, the dimensional measurements are performed at room temperature, and must be corrected to account for thermal expansion of the materials at high irradiation temperatures. Uncertainty in the thermal expansion coefficients for the graphite materials used in the AGR-3/4 capsules also increases gap size uncertainty. This study focuses on analysis of modeling assumptions and uncertainty sources to evaluate their impacts on the gap size uncertainty.« less

Constant voltage electro-slag remelting control

DOEpatents

Schlienger, M.E.

1996-10-22

A system for controlling electrode gap in an electro-slag remelt furnace has a constant regulated voltage and an electrode which is fed into the slag pool at a constant rate. The impedance of the circuit through the slag pool is directly proportional to the gap distance. Because of the constant voltage, the system current changes are inversely proportional to changes in gap. This negative feedback causes the gap to remain stable. 1 fig.

Phononic Band Gaps in 2D Quadratic and 3D Cubic Cellular Structures

PubMed Central

Warmuth, Franziska; Körner, Carolin

2015-01-01

The static and dynamic mechanical behaviour of cellular materials can be designed by the architecture of the underlying unit cell. In this paper, the phononic band structure of 2D and 3D cellular structures is investigated. It is shown how the geometry of the unit cell influences the band structure and eventually leads to full band gaps. The mechanism leading to full band gaps is elucidated. Based on this knowledge, a 3D cellular structure with a broad full band gap is identified. Furthermore, the dependence of the width of the gap on the geometry parameters of the unit cell is presented. PMID:28793713

Phononic Band Gaps in 2D Quadratic and 3D Cubic Cellular Structures.

PubMed

Warmuth, Franziska; Körner, Carolin

2015-12-02

The static and dynamic mechanical behaviour of cellular materials can be designed by the architecture of the underlying unit cell. In this paper, the phononic band structure of 2D and 3D cellular structures is investigated. It is shown how the geometry of the unit cell influences the band structure and eventually leads to full band gaps. The mechanism leading to full band gaps is elucidated. Based on this knowledge, a 3D cellular structure with a broad full band gap is identified. Furthermore, the dependence of the width of the gap on the geometry parameters of the unit cell is presented.

We’re only in it for the knowledge? A problem solving turn in environment and health expert elicitation

PubMed Central

2012-01-01

Background The FP6 EU HENVINET project aimed at synthesizing the scientific information available on a number of topics of high relevance to policy makers in environment and health. The goal of the current paper is to reflect on the methodology that was used in the project, in view of exploring the usefulness of this and similar methodologies to the policy process. The topics investigated included health impacts of the brominated flame retardants decabrominated diphenylether (decaBDE) and hexabromocyclododecane (HBCD), phthalates highlighting di(2-ethylhexyl)phthalate (DEHP), the pesticide chlorpyrifos (CPF), nanoparticles, the impacts of climate change on asthma and other respiratory disorders, and the influence of environment health stressors on cancer induction. Methods Initially the focus was on identifying knowledge gaps in the state of the art in scientific knowledge. Literature reviews covered all elements that compose the causal chain of the different environmental health issues from emissions to exposures, to effects and to health impacts. Through expert elicitation, knowledge gaps were highlighted by assessing expert confidence using calibrated confidence scales. During this work a complementary focus to that on knowledge gaps was developed through interdisciplinary reflections. By extending the scope of the endeavour from only a scientific perspective, to also include the more problem solving oriented policy perspective, the question of which kind of policy action experts consider justifiable was addressed. This was addressed by means of a questionnaire. In an expert workshop the results of both questionnaires were discussed as a basis for policy briefs. Results The expert elicitation, the application of the calibrated confidence levels and the problem solving approach were all experienced as being quite challenging for the experts involved, as these approaches did not easily relate to mainstream environment and health scientific practices. Even so, most experts were quite positive about it. In particular, the opportunity to widen one’s own horizon and to interactively exchange knowledge and debate with a diversity of experts seemed to be well appreciated in this approach. Different parts of the approach also helped in focussing on specific relevant aspects of scientific knowledge, and as such can be considered of reflective value. Conclusions The approach developed by HENVINET was part of a practice of learning by doing and of interdisciplinary cooperation and negotiation. Ambitions were challenged by unforeseen complexities and difference of opinion and as no Holy Grail approach was at hand to copy or follow, it was quite an interesting but also complicated endeavour. Perfection, if this could be defined, seemed out of reach all the time. Nevertheless, many involved were quite positive about it. It seems that many felt that it fitted some important needs in current science when addressing the needs of policy making on such important issues, without anyone really having a clue on how to actually do this. Challenging questions remain on the quality of such approach and its product. Practice tells us that there probably is no best method and that the best we can do is dependent on contextual negotiation and learning from experiences that we think are relevant. PMID:22759503

The Gars Programme And The Integrated Global Observing Strategy For Geohazards

NASA Astrophysics Data System (ADS)

Marsh, S.; Paganini, M.; Missotten, R.; Palazzo, F.

UNESCO and the IUGS have funded the Geological Applications of Remote Sensing Programme (GARS) since 1984. Its aim is to assess the value and utility of remotely sensed data for geoscience, whilst at the same time building capacity in developing countries. It has run projects in Africa on geological mapping, in Latin America on landslide hazards and in Asia on volcanic hazards. It is a main sponsor of the Integrated Global Observing Strategy (IGOS) for Geohazards. The societal impact of geological and related geophysical hazards is enormous. Every year volcanoes, earthquakes, landslides and subsidence claim thousands of lives, injure thousands more, devastate homes and destroy livelihoods. Damaged infrastructure and insurance premiums increase these costs. As population increases, more people live in hazardous areas and the impact grows. The World Summit on Sustainable Development recognised that systematic, joint international observations under initiatives like the Integrated Global Observing Strategy form the basis for an integrated approach to hazard mitigation and preparedness. In this context, the IGOS Partners developed this geohazards theme. Its goal is to integrate disparate, multidisciplinary, applied research into global, operational systems by filling gaps in organisation, observation and knowledge. It has four strategic objectives; building global capacity to mitigate geohazards; improving mapping, monitoring and forecasting, based on satellite and ground-based observations; increasing preparedness, using integrated geohazards information products and improved geohazards models; and promoting global take-up of local best practice in geohazards management. Gaps remain between what is known and the knowledge required to answer citizen's questions, what is observed and what must be observed to provide the necessary information for hazard mitigation and current data integration and the integration needed to make useful geohazard information products. An action plan is proposed that is designed to close these gaps. Priority actions are to: begin networking within the geohazards community; improve topographic data provision using existing observations and secure continuity of C- and L-Band radar interferometry with the space agencies; assess the potential for existing data to be integrated into geohazard products and services; evaluate ways to improve databases with their managing agencies; and initiate research that increases geohazards knowledge. This paper presents the strategy and describes the action plan that will implement it over the next decade, as a key part of the GARS Programme.

Implementing and evaluating early intervention for children with autism: Where are the gaps and what should we do?

PubMed

Vivanti, Giacomo; Kasari, Connie; Green, Jonathan; Mandell, David; Maye, Melissa; Hudry, Kristelle

2018-01-01

Despite recent advances, the evidence base supporting early intervention for young children with autism spectrum disorder (ASD) remains relatively sparse. The International Society for Autism Research (INSAR) recently sponsored a Special Interest Group (SIG) on Implementing and Evaluating Community-Based Early Intervention. Across three meetings, in 2015, 2016, and 2017, conveners of this SIG engaged >200 members to identify knowledge gaps and research priorities for moving the field forward. Here, we summarize the perspectives that emerged from group discussion at the SIG meetings as represented by scholars working actively in the field. Despite encouraging progress, critical gaps and research priorities were identified across all the stages of intervention development and testing from conceptualization to community implementation. Key issues include the need for (a) formal theories to guide early intervention development, evaluation, and implementation; and alignment of intervention goals with scientific knowledge and societal changes that have occurred in the decades since interventions were originally developed; (b) increased focus on feasibility of treatment procedures and alignment with stakeholder values during pilot evaluations; (c) use of research designs that allow for comparisons of different interventions and formats, analyses of active ingredients of treatment, and identification of moderators and mediators of outcome; (d) use of community-partnered participatory research to guide adaptation of intervention models to community settings; (e) inclusion of constructs related to implementation processes and outcomes in treatment trials and; (f) an iterative approach to the progression of knowledge from intervention development to implementation. Autism Res 2018, 11: 16-23. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. In this article, we summarize the themes discussed at the INSAR Special Interest Group (SIG) on Implementing and Evaluating Community-Based Early Intervention. Priorities for moving the field forward identified in the SIG included the need for (a) formal theories to guide the development and evaluation of interventions, (b) pilot evaluations that investigate feasibility and acceptability of interventions, (c) methodologies that allow us to determine for whom different interventions bring most benefit and why this is so, (d) strategies to include community members and other stakeholders in the process of developing and evaluating interventions, and (e) understanding of factors that make interventions more likely to be adopted and successfully implemented in the real world. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Barriers to Primary Care Clinician Adherence to Clinical Guidelines for the Management of Low Back Pain: A Systematic Review and Metasynthesis of Qualitative Studies.

PubMed

Slade, Susan C; Kent, Peter; Patel, Shilpa; Bucknall, Tracey; Buchbinder, Rachelle

2016-09-01

Despite the availability of evidence-based guidelines for the management of low back pain (LBP) that contain consistent messages, large evidence-practice gaps in primary care remain. To perform a systematic review and metasynthesis of qualitative studies that have explored primary care clinicians' perceptions and beliefs about guidelines for LBP, including perceived enablers and barriers to guideline adherence. Studies investigating perceptions and beliefs about LBP guidelines were included if participants were primary care clinicians and qualitative methods had been used for both data collection and analysis. We searched major databases up to July 2014. Pairs of reviewers independently screened titles and abstracts, extracted data, appraised method quality using the CASP checklist, conducted thematic analysis, and synthesized the results in narrative format. Seventeen studies, with a total of 705 participants, were included. We identified 3 key emergent themes and 8 subthemes: (1) guideline implementation and adherence beliefs and perceptions; (2) maintaining the patient-clinician relationship with imaging referrals; and (3) barriers to guideline implementation. Clinicians believed that guidelines were categorical, prescriptive, and constrained professional practice; however, popular clinical practices superseded the guidelines. Imaging referrals were used to manage consultations and to obtain definitive diagnoses. Clinicians' perceptions reflected a lack of content knowledge and understanding of how guidelines are developed. Addressing misconceptions and other barriers to uptake of evidence-based guidelines for managing LBP is needed to improve knowledge transfer and close the evidence-practice gap in the treatment of this common condition.

Ten-year assessment of the 100 priority questions for global biodiversity conservation.

PubMed

Jucker, Tommaso; Wintle, Bonnie; Shackelford, Gorm; Bocquillon, Pierre; Geffert, Jan Laurens; Kasoar, Tim; Kovacs, Eszter; Mumby, Hannah S; Orland, Chloé; Schleicher, Judith; Tew, Eleanor R; Zabala, Aiora; Amano, Tatsuya; Bell, Alexandra; Bongalov, Boris; Chambers, Josephine M; Corrigan, Colleen; Durán, América P; Duvic-Paoli, Leslie-Anne; Emilson, Caroline; da Silva, Jéssica Fonseca; Garnett, Emma E; Green, Elizabeth J; Guth, Miriam K; Hacket-Pain, Andrew; Hinsley, Amy; Igea, Javier; Kunz, Martina; Luke, Sarah H; Lynam, William; Martin, Philip A; Nunes, Matheus H; Ockendon, Nancy; Pavitt, Aly; Payne, Charlotte L R; Plutshack, Victoria; Rademacher, Tim T; Robertson, Rebecca J; Rose, David C; Serban, Anca; Simmons, Benno I; Emilson, Erik J S; Tayleur, Catherine; Wordley, Claire F R; Mukherjee, Nibedita

2018-06-20

In 2008, a group of conservation scientists compiled a list of 100 priority questions for the conservation of the world's biodiversity [Sutherland et al. (2009) Conservation Biology, 23, 557-567]. However, now almost a decade later, no one has yet published a study gauging how much progress has been made in addressing these 100 high-priority questions in the peer-reviewed literature. Here we take a first step toward re-examining the 100 questions and identify key knowledge gaps that still remain. Through a combination of a questionnaire and a literature review, we evaluated each of the 100 questions on the basis of two criteria: relevance and effort. We defined highly-relevant questions as those which - if answered - would have the greatest impact on global biodiversity conservation, while effort was quantified based on the number of review publications addressing a particular question, which we used as a proxy for research effort. Using this approach we identified a set of questions that, despite being perceived as highly relevant, have been the focus of relatively few review publications over the past ten years. These questions covered a broad range of topics but predominantly tackled three major themes: the conservation and management of freshwater ecosystems, the role of societal structures in shaping interactions between people and the environment, and the impacts of conservation interventions. We see these questions as important knowledge gaps that have so far received insufficient attention and may need to be prioritised in future research. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Terrestrial "Islands" in a Changing Climate

NASA Astrophysics Data System (ADS)

Cartwright, J. M.; Wolfe, W. J.

2016-12-01

Terrestrial insular ecosystems—such as rock outcrops, depression wetlands, high-elevation balds, flood-scoured riparian corridors, and insular prairies—occupy a small fraction of land area but constitute an important source of regional and global biodiversity, including concentrations of rare and endemic plant taxa. Maintenance of this biodiversity depends upon regimes of abiotic stress and disturbance, such as soil-surface temperature, extreme hydrologic conditions, fires, flood-scouring, and episodic droughts, all of which may be subject to alteration by climate change. Over several decades, numerous site-specific investigations have yielded important information on the floristics, physical environments, and ecological dynamics of these insular ecosystems, but this literature has generally remained fragmented. Regional and cross-system syntheses are needed to discern larger patterns in the drivers of plant biodiversity in these ecosystems, identify knowledge gaps, and lay the groundwork for climate-change vulnerability analysis. For eight categories of insular ecosystems of the southeastern United States, a synthetic literature review was completed to assess the state-of-the-science concerning (1) physical geography including geologic, topographic, edaphic, hydrologic, and geomorphic context; (2) ecological determinants of community structures including factors regulating successional dynamics and spatial vegetation patterns; (3) contributions of the insular ecosystem to regional and global biodiversity; (4) historic and current anthropogenic threats as well as conservation approaches to mitigate these threats; and (5) key knowledge gaps relevant to conservation, particularly in terms of climate-change effects on biodiversity. From this synthesis, new conceptual models were developed to assess ecosystem-level exposure, sensitivity, and adaptive capacity to climate change and other anthropogenic influences.

Toward production from gas hydrates: Current status, assessment of resources, and simulation-based evaluation of technology and potential

USGS Publications Warehouse

Moridis, G.J.; Collett, T.S.; Boswell, R.; Kurihara, M.; Reagan, M.T.; Koh, C.; Sloan, E.D.

2009-01-01

Gas hydrates (GHs) are a vast energy resource with global distribution in the permafrost and in the oceans. Even if conservative estimates are considered and only a small fraction is recoverable, the sheer size of the resource is so large that it demands evaluation as a potential energy source. In this review paper, we discuss the distribution of natural GH accumulations, the status of the primary international research and development (R&D) programs, and the remaining science and technological challenges facing the commercialization of production. After a brief examination of GH accumulations that are well characterized and appear to be models for future development and gas production, we analyze the role of numerical simulation in the assessment of the hydrate-production potential, identify the data needs for reliable predictions, evaluate the status of knowledge with regard to these needs, discuss knowledge gaps and their impact, and reach the conclusion that the numerical-simulation capabilities are quite advanced and that the related gaps either are not significant or are being addressed. We review the current body of literature relevant to potential productivity from different types of GH deposits and determine that there are consistent indications of a large production potential at high rates across long periods from a wide variety of hydrate deposits. Finally, we identify (a) features, conditions, geology and techniques that are desirable in potential production targets; (b) methods to maximize production; and (c) some of the conditions and characteristics that render certain GH deposits undesirable for production. Copyright ?? 2009 Society of Petroleum Engineers.

Toward production from gas hydrates: Current status, assessment of resources, and simulation-based evaluation of technology and potential

USGS Publications Warehouse

Moridis, G.J.; Collett, T.S.; Boswell, R.; Kurihara, M.; Reagan, M.T.; Koh, C.; Sloan, E.D.

2008-01-01

Gas hydrates are a vast energy resource with global distribution in the permafrost and in the oceans. Even if conservative estimates are considered and only a small fraction is recoverable, the sheer size of the resource is so large that it demands evaluation as a potential energy source. In this review paper, we discuss the distribution of natural gas hydrate accumulations, the status of the primary international R&D programs, and the remaining science and technological challenges facing commercialization of production. After a brief examination of gas hydrate accumulations that are well characterized and appear to be models for future development and gas production, we analyze the role of numerical simulation in the assessment of the hydrate production potential, identify the data needs for reliable predictions, evaluate the status of knowledge with regard to these needs, discuss knowledge gaps and their impact, and reach the conclusion that the numerical simulation capabilities are quite advanced and that the related gaps are either not significant or are being addressed. We review the current body of literature relevant to potential productivity from different types of gas hydrate deposits, and determine that there are consistent indications of a large production potential at high rates over long periods from a wide variety of hydrate deposits. Finally, we identify (a) features, conditions, geology and techniques that are desirable in potential production targets, (b) methods to maximize production, and (c) some of the conditions and characteristics that render certain gas hydrate deposits undesirable for production. Copyright 2008, Society of Petroleum Engineers.

How does lower urinary tract dysfunction (LUTD) affect sexual function in men and women? ICI-RS 2015-Part 2.

PubMed

Apostolidis, Apostolos; Rantell, Angie; Anding, Ralf; Kirschner-Hermanns, Ruth; Cardozo, Linda

2017-04-01

To discuss available data on the links between LUTD and sexual dysfunction, what is still unknown about the causative effect of disease processes on sexual function (SF), and to suggest proposals for further research. At the 2015 International Consultation on Incontinence-Research Society (ICI-RS), a multi-disciplinary group presented a literature search of what is known about the effect of LUTD on SF in men and women. Wider discussions regarding knowledge gaps, and ideal research methodology ensued and are presented. The underlying mechanisms of the impact of LUTD on SF remain largely unknown. Risk factors for the metabolic syndrome may cause both LUTS and ED in men, and their improvement may improve both conditions. In women, neurovascular changes may be common in LUTD and FSD. Successful LUTS management results in FSD improvement, but the mechanisms are ill understood. Gaps in standardization of sexual dysfunction terminology, variations of assessment, and treatment in clinical practice and research make most studies not comparable. The sensitive knowledge and subjective nature of the problem present challenges and often result in neglecting it. Neurovascular and hormonal factors, but also indirect effects may link LUTD to SD in both sexes, but the evidence is not robust and the mechanisms unclear. There is a need for defining the terminology and standardizing outcomes assessed in clinical trials. The multifactorial nature of SF in both sexes makes trial design challenging and "real world" studies may prove more beneficial for patients' outcomes and clinicians' understanding. © 2017 Wiley Periodicals, Inc.

Paracetamol in Older People: Towards Evidence-Based Dosing?

PubMed

Mian, Paola; Allegaert, Karel; Spriet, Isabel; Tibboel, Dick; Petrovic, Mirko

2018-06-19

Paracetamol is the most commonly used analgesic in older people, and is mainly dosed according to empirical dosing guidelines. However, the pharmacokinetics and thereby the effects of paracetamol can be influenced by physiological changes occurring with ageing. To investigate the steps needed to reach more evidence-based paracetamol dosing regimens in older people, we applied the concepts used in the paediatric study decision tree. A search was performed to retrieve studies on paracetamol pharmacokinetics and safety in older people (> 60 years) or studies that performed a (sub) analysis of pharmacokinetics and/or safety in older people. Of 6088 articles identified, 259 articles were retained after title and abstract screening. Further abstract and full-text screening identified 27 studies, of which 20 described pharmacokinetics and seven safety. These studies revealed no changes in absorption with ageing. A decreased (3.9-22.9%) volume of distribution (V d ) in robust older subjects and a further decreased V d (20.3%) in frail older compared with younger subjects was apparent. Like V d , age and frailty decreased paracetamol clearance (29-45.7 and 37.5%) compared with younger subjects. Due to limited and heterogeneous evidence, it was difficult to draw firm and meaningful conclusions on changed risk for paracetamol safety in older people. This review is a first step towards bridging knowledge gaps to move to evidence-based paracetamol dosing in older subjects. Remaining knowledge gaps are safety when using therapeutic dosages, pharmacokinetics changes in frail older people, and to what extent changes in paracetamol pharmacokinetics should lead to a change in dosage in frail and robust older people.

Why We Don't Collaborate in Response to Climate Change: The Knowledge Deficit, Co-Production, and the Future of the IPCC.

NASA Astrophysics Data System (ADS)

Cook, B. R.; Overpeck, J. T.

2014-12-01

Scientific knowledge production is based on recognizing and filling knowledge deficits or 'gaps' in understanding, but for climate adaptation and mitigation, the applicability of this approach is questionable. The Intergovernmental Panel on Climate Change (IPCC) mandate is an example of this type of 'gap filling,' in which the elimination of uncertainties is presumed to enable rational decision making for individuals and rational governance for societies. Presumed knowledge deficits, though, are unsuited to controversial problems with social, cultural, and economic dimensions; likewise, communication to educate is an ineffective means of inciting behavioural change. An alternative is needed, particularly given the economic, social, and political scale that action on climate change requires. We review the 'deficit-education framing' and show how it maintains a wedge between those affected and those whose knowledge is required. We then review co-production to show how natural and social scientists, as well as the IPCC, might more effectively proceed.

Patient perceptions of antibiotic use and resistance at a single university dermatology clinic.

PubMed

Goettsche, Lainee S; Weig, Emily A; Chung, Jina; Hoff, Brian M; Ince, Dilek; Wanat, Karolyn A

2018-05-21

Antibiotic resistance is an important problem that requires continued patient education and important prescribing stewardship. Dermatologists prescribe the most antibiotics per provider in comparison to other specialties and have an important role to play in the campaign of mindful prescribing. Data on the dermatology patients' knowledge and perception regarding antibiotic resistance is lacking and could play a role in providers' continuation of medications. We conducted a single institution survey of 512 dermatology clinic patients to understand patient's knowledge and potential gaps. Overall, our results demonstrated an overall higher level of knowledge than expected, there were still several knowledge gaps identified. Ninety-one percent of respondents were aware of the term 'antibiotic resistance'. However, 65% of participants believed that a short course of antibiotics could not cause resistance. While our patients have awareness of antibiotic resistance, it is imperative to continue to assess patients' knowledge about antibiotic resistance and provide education whenever possible in order to continue to practice antibiotic stewardship.

STEMMING the Gap

ERIC Educational Resources Information Center

Kahler, Jim; Valentine, Nancy

2011-01-01

America has a gap when it comes to youth pursuing science and technology careers. In an effort to improve the knowledge and application of science, technology, engineering, and math (STEM), after-school programs can work in conjunction with formal in-school curriculum to improve science education. One organization that actively addresses this…

Initial Low-Reynolds Number Iced Aerodynamic Performance for CRM Wing

NASA Technical Reports Server (NTRS)

Woodard, Brian; Diebold, Jeff; Broeren, Andy; Potapczuk, Mark; Lee, Sam; Bragg, Michael

2015-01-01

NASA, FAA, ONERA, and other partner organizations have embarked on a significant, collaborative research effort to address the technical challenges associated with icing on large scale, three-dimensional swept wings. These are extremely complex phenomena important to the design, certification and safe operation of small and large transport aircraft. There is increasing demand to balance trade-offs in aircraft efficiency, cost and noise that tend to compete directly with allowable performance degradations over an increasing range of icing conditions. Computational fluid dynamics codes have reached a level of maturity that they are being proposed by manufacturers for use in certification of aircraft for flight in icing. However, sufficient high-quality data to evaluate their performance on iced swept wings are not currently available in the public domain and significant knowledge gaps remain.

The intersection between asthma and acute chest syndrome in children with sickle-cell anaemia

PubMed Central

DeBaun, Michael R; Strunk, Robert C

2016-01-01

Acute chest syndrome is a frequent cause of acute lung disease in children with sickle-cell disease. Asthma is common in children with sickle-cell disease and is associated with increased incidence of vaso-occlusive pain events, acute chest syndrome episodes, and earlier death. Risk factors for asthma exacerbation and an acute chest syndrome episode are similar, and both can present with shortness of breath, chest pain, cough, and wheezing. Despite overlapping risk factors and symptoms, an acute exacerbation of asthma or an episode of acute chest syndrome are two distinct entities that need disease-specific management strategies. Although understanding has increased about asthma as a comorbidity in sickle-cell disease and its effects on morbidity, substantial gaps remain in knowledge about best management. PMID:27353685

Proteomics reveals novel components of the Anopheles gambiae eggshell

PubMed Central

Amenya, Dolphine A.; Chou, Wayne; Li, Jianyong; Yan, Guiyun; Gershon, Paul D.; James, Anthony A.; Marinotti, Osvaldo

2010-01-01

While genome and transcriptome sequencing has revealed a large number and diversity of Anopheles gambiae predicted proteins, identifying their functions and biosynthetic pathways remains challenging. Applied mass spectrometry based proteomics in conjunction with mosquito genome and transcriptome databases were used to identify 44 proteins as putative components of the eggshell. Among the identified molecules are two vitelline membrane proteins and a group of seven putative chorion proteins. Enzymes with peroxidase, laccase and phenoloxidase activities, likely involved in cross-linking reactions that stabilize the eggshell structure, also were identified. Seven odorant binding proteins were found in association with the mosquito eggshell, although their role has yet to be demonstrated. This analysis fills a considerable gap of knowledge about proteins that build the eggshell of anopheline mosquitoes. PMID:20433845

Needs assessment for business strategies of anesthesiology groups' practices.

PubMed

Scurlock, Corey; Dexter, Franklin; Reich, David L; Galati, Maria

2011-07-01

Progress has been made in understanding strategic decision making influencing anesthesia groups' operating room business practices. However, there has been little analysis of the remaining gaps in our knowledge. We performed a needs assessment to identify unsolved problems in anesthesia business strategy based on Porter's Five Forces Analysis. The methodology was a narrative literature review. We found little previous investigation for 2 of the 5 forces (threat of new entrants and bargaining power of suppliers), modest understanding for 1 force (threat of substitute products or services), and substantial understanding for 2 forces (bargaining power of customers and jockeying for position among current competitors). Additional research in strategic decisions influencing anesthesia groups should focus on the threat of new entrants, bargaining power of suppliers, and the threat of substitute products or services.

Malnutrition and vaccination in developing countries

PubMed Central

Prendergast, Andrew J.

2015-01-01

Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge. PMID:25964453

The role of plant hormones during grafting.

PubMed

Nanda, Amrit K; Melnyk, Charles W

2018-01-01

For millennia, people have cut and joined different plant tissues together through a process known as grafting. By creating a chimeric organism, desirable properties from two plants combine to enhance disease resistance, abiotic stress tolerance, vigour or facilitate the asexual propagation of plants. In addition, grafting has been extremely informative in science for studying and identifying the long-distance movement of molecules. Despite its increasing use in horticulture and science, how plants undertake the process of grafting remains elusive. Here, we discuss specifically the role of eight major plant hormones during the wound healing and vascular formation process, two phenomena involved in grafting. We furthermore present the roles of these hormones during graft formation and highlight knowledge gaps and future areas of interest for the field of grafting biology.

Microplastic Exposure Assessment in Aquatic Environments: Learning from Similarities and Differences to Engineered Nanoparticles.

PubMed

Hüffer, Thorsten; Praetorius, Antonia; Wagner, Stephan; von der Kammer, Frank; Hofmann, Thilo

2017-03-07

Microplastics (MPs) have been identified as contaminants of emerging concern in aquatic environments and research into their behavior and fate has been sharply increasing in recent years. Nevertheless, significant gaps remain in our understanding of several crucial aspects of MP exposure and risk assessment, including the quantification of emissions, dominant fate processes, types of analytical tools required for characterization and monitoring, and adequate laboratory protocols for analysis and hazard testing. This Feature aims at identifying transferrable knowledge and experience from engineered nanoparticle (ENP) exposure assessment. This is achieved by comparing ENP and MPs based on their similarities as particulate contaminants, whereas critically discussing specific differences. We also highlight the most pressing research priorities to support an efficient development of tools and methods for MPs environmental risk assessment.

On the psychology of poverty.

PubMed

Haushofer, Johannes; Fehr, Ernst

2014-05-23

Poverty remains one of the most pressing problems facing the world; the mechanisms through which poverty arises and perpetuates itself, however, are not well understood. Here, we examine the evidence for the hypothesis that poverty may have particular psychological consequences that can lead to economic behaviors that make it difficult to escape poverty. The evidence indicates that poverty causes stress and negative affective states which in turn may lead to short-sighted and risk-averse decision-making, possibly by limiting attention and favoring habitual behaviors at the expense of goal-directed ones. Together, these relationships may constitute a feedback loop that contributes to the perpetuation of poverty. We conclude by pointing toward specific gaps in our knowledge and outlining poverty alleviation programs that this mechanism suggests. Copyright © 2014, American Association for the Advancement of Science.

Modelling and enhanced molecular dynamics to steer structure-based drug discovery.

PubMed

Kalyaanamoorthy, Subha; Chen, Yi-Ping Phoebe

2014-05-01

The ever-increasing gap between the availabilities of the genome sequences and the crystal structures of proteins remains one of the significant challenges to the modern drug discovery efforts. The knowledge of structure-dynamics-functionalities of proteins is important in order to understand several key aspects of structure-based drug discovery, such as drug-protein interactions, drug binding and unbinding mechanisms and protein-protein interactions. This review presents a brief overview on the different state of the art computational approaches that are applied for protein structure modelling and molecular dynamics simulations of biological systems. We give an essence of how different enhanced sampling molecular dynamics approaches, together with regular molecular dynamics methods, assist in steering the structure based drug discovery processes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Forests and Their Canopies: Achievements and Horizons in Canopy Science.

PubMed

Nakamura, Akihiro; Kitching, Roger L; Cao, Min; Creedy, Thomas J; Fayle, Tom M; Freiberg, Martin; Hewitt, C N; Itioka, Takao; Koh, Lian Pin; Ma, Keping; Malhi, Yadvinder; Mitchell, Andrew; Novotny, Vojtech; Ozanne, Claire M P; Song, Liang; Wang, Han; Ashton, Louise A

2017-06-01

Forest canopies are dynamic interfaces between organisms and atmosphere, providing buffered microclimates and complex microhabitats. Canopies form vertically stratified ecosystems interconnected with other strata. Some forest biodiversity patterns and food webs have been documented and measurements of ecophysiology and biogeochemical cycling have allowed analyses of large-scale transfer of CO 2 , water, and trace gases between forests and the atmosphere. However, many knowledge gaps remain. With global research networks and databases, and new technologies and infrastructure, we envisage rapid advances in our understanding of the mechanisms that drive the spatial and temporal dynamics of forests and their canopies. Such understanding is vital for the successful management and conservation of global forests and the ecosystem services they provide to the world. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Ammonia oxidation: Ecology, physiology, biochemistry and why they must all come together.

PubMed

Lehtovirta-Morley, Laura E

2018-05-01

Ammonia oxidation is a fundamental core process in the global biogeochemical nitrogen cycle. Oxidation of ammonia (NH3) to nitrite (NO2 -) is the first and rate-limiting step in nitrification and is carried out by distinct groups of microorganisms. Ammonia oxidation is essential for nutrient turnover in most terrestrial, aquatic and engineered ecosystems and plays a major role, both directly and indirectly, in greenhouse gas production and environmental damage. Although ammonia oxidation has been studied for over a century, this research field has been galvanised in the past decade by the surprising discoveries of novel ammonia oxidising microorganisms. This review reflects on the ammonia oxidation research to date and discusses the major gaps remaining in our knowledge of the biology of ammonia oxidation.

ACOG Committee Opinion No. 646: Ethical Considerations for Including Women as Research Participants.

PubMed

2015-11-01

Inclusion of women in research studies is necessary for valid inferences about health and disease in women. The generalization of results from trials conducted in men may yield erroneous conclusions that fail to account for the biologic differences between men and women. Although significant changes in research design and practice have led to an increase in the proportion of women included in research trials, knowledge gaps remain because of a continued lack of inclusion of women, especially those who are pregnant, in premarketing research trials. This document provides a historical overview of issues surrounding women as participants in research trials, followed by an ethical framework and discussion of the issues of informed consent, contraception requirements, intimate partner consent, and the appropriate inclusion of pregnant women in research studies.

Closing the Gap: The Maturing of Quality Assurance in Australian University Libraries

ERIC Educational Resources Information Center

Tang, Karen

2012-01-01

A benchmarking review of the quality assurance practices of the libraries of the Australian Technology Network conducted in 2006 revealed exemplars of best practice, but also sector-wide gaps. A follow-up review in 2010 indicated the best practices that remain relevant. While some gaps persist, there has been improvement across the libraries and…

Connecting Social Disorganization Theory to African-American Outcomes to Explain the Achievement Gap

ERIC Educational Resources Information Center

Madyun, Na'im H.

2011-01-01

African-American student achievement outcomes have been and continue to be a critical concern for education researchers. Much of the framing of African-American student outcomes centers on what is known as achievement gaps that exist between African-American and White students. Unfortunately, these gaps have remained roughly the same since the…

Gender and Racial Gaps in Earnings among Recent College Graduates

ERIC Educational Resources Information Center

Zhang, Liang

2008-01-01

Using a nationally representative sample of baccalaureate graduates from 1993 (B&B 93/97/03), I explore factors that contribute to the gender and racial gap in earnings among recent college graduate. Results indicate that college major remains the most significant factor in accounting for the gender gap in pay. Female graduates are still left…

Sticking to the story: outstanding challenges in gecko-inspired adhesives.

PubMed

Niewiarowski, Peter H; Stark, Alyssa Y; Dhinojwala, Ali

2016-04-01

The natural clinging ability of geckos has inspired hundreds of studies seeking design principles that could be applied to creating synthetic adhesives with the same performance capabilities as the gecko: adhesives that use no glue, are self-cleaning and reusable, and are insensitive to a wide range of surface chemistries and roughness. Important progress has been made, and the basic mechanics of how 'hairy' adhesives work have been faithfully reproduced, advancing theory in surface science and portending diverse practical applications. However, after 15 years, no synthetic mimic can yet perform as well as a gecko and simultaneously meet of all the criteria listed above. Moreover, processes for the production of inexpensive and scalable products are still not clearly in view. Here, we discuss our perspective on some of the gaps in understanding that still remain; these gaps in our knowledge should stimulate us to turn to deeper study of the way in which free-ranging geckos stick to the variety of surfaces found in their natural environments and to a more complete analysis of the materials composing the gecko toe pads. © 2016. Published by The Company of Biologists Ltd.

The effectiveness of a community-based breast cancer education intervention in the New York State Capital Region.

PubMed

Zeinomar, Nur; Moslehi, Roxana

2013-09-01

We determined the effectiveness of a community-based breast cancer education intervention among understudied populations in the New York State (NYS) Capital Region by assessing and comparing baseline and post-education breast cancer knowledge. Participants included 417 students recruited from five colleges/universities and 67 women from four community group organizations. Baseline and post-education knowledge was assessed via self-administered mostly multiple-choice questionnaires. An open-ended question soliciting opinions about public health prevention strategies against breast cancer was included on college/university students' questionnaires. Effectiveness of education intervention was estimated through a paired t test. Stratified analysis was done using demographic and descriptive variables. Answers to the open-ended questions were analyzed qualitatively. The mean percentage of correct answers increased from 39.9% at baseline to 80.8% post-education (P < 0.0001) among college/university students and from 43.5% to 77.8% (P < 0.0001) among community group members. Effectiveness remained statistically significant in all stratified analyses with similarly high percentage of correct answers achieved post-education irrespective of knowledge level at baseline. Stratified analysis also revealed similar patterns of improvement in overall knowledge and narrowing of the gap in post-education knowledge. Primary prevention emerged as the dominant theme post-education in students' responses to the open-ended question, signifying the effectiveness of our education in raising awareness about modifiable risk factors and inspiring proactive thinking about public health prevention strategies. This community-based education intervention was effective in increasing breast cancer knowledge among demographically diverse groups with low levels of baseline knowledge in the NYS Capital Region. Our findings provide leads for future public health prevention strategies.

Reactive Nitrogen Monitoring Gaps: Issues, Activities and Needs

EPA Science Inventory

In this article we demonstrate the importance of ammonia and organic nitrogen to total N deposition budgets and review the current activities to close these monitoring gaps. Finally, remaining monitoring needs and issues are discussed.

The Bridge of Knowledge

ERIC Educational Resources Information Center

Dong, Yu Ren

2014-01-01

Although many English language learners (ELLs) in the United States have knowledge gaps that make it hard for them to master high-level content and skills, ELLs also often have background knowledge relevant to school learning that teachers neglect to access, this author argues. In the Common Core era, with ELLs being the fastest growing population…

The Knowing-Doing Gap in Advance Directives in Asian Americans: The Role of Education and Acculturation.

PubMed

Jang, Yuri; Park, Nan Sook; Chiriboga, David A; Radhakrishnan, Kavita; Kim, Miyong T

2017-11-01

The purposes of the present study were (1) to explore the completion rate of advance directives (ADs) in a sample of Asian Americans and (2) to examine the direct and moderating effects of knowledge of AD, education, and acculturation in predicting AD completion. Education and acculturation were conceptualized as moderators in the link between knowledge and completion of ADs. Using data from 2609 participants in the 2015 Asian American Quality of Life survey (aged 18-98), logistic regression analyses on AD completion were conducted, testing both direct and moderating effects. The overall AD completion rate in sample was about 12%. The AD knowledge and acculturation independently predicted AD completion. No direct effect of education was found; however, it interacted with AD knowledge. The AD knowledge was more likely to be translated into completion in the group with higher education. The AD completion rate observed in the present sample of Asian Americans was much lower than that of the US general population (26%-36%). The interactive role of education helps to explain the gap between AD knowledge and completion and suggests intervention strategies.

An International Study of the Propensity of Students to Limit Their Use of Private Transport in Light of Their Understanding of the Causes of Global Warming

ERIC Educational Resources Information Center

Boyes, Eddie; Stanisstreet, Martin; Skamp, Keith; Rodriguez, Manuel; Malandrakis, Georgios; Fortner, Rosanne W.; Kilinc, Ahmet; Taylor, Neil; Chhokar, Kiran; Dua, Shweta; Ambusaidi, Abdullah; Cheong, Irene Poh-Ai; Kim, Mijung; Yoon, Hye-Gyoung

2014-01-01

Previous studies have shown that there is what has been called a "gap" between environmental knowledge and a willingness to act in a pro-environmental manner. For the individual, this gap is probably the result of the huge complexity of factors that affect behaviour. The way in which this "gap" is sometimes identified in the…

Degradation of connexins and gap junctions

PubMed Central

Falk, Matthias M.; Kells, Rachael M.; Berthoud, Viviana M.

2014-01-01

Connexin proteins are short-lived within the cell, whether present in the secretory pathway or in gap junction plaques. Their levels can be modulated by their rate of degradation. Connexins, at different stages of assembly, are degraded through the proteasomal, endo-/lysosomal, and phago-/lysosomal pathways. In this review, we summarize the current knowledge about connexin and gap junction degradation including the signals and protein-protein interactions that participate in their targeting for degradation. PMID:24486527

Dietary traces of neonicotinoid pesticides as a cause of population declines in honey bees: an evaluation by Hill's epidemiological criteria.

PubMed

Cresswell, James E; Desneux, Nicolas; vanEngelsdorp, Dennis

2012-06-01

Honey bees are important pollinators of both crops and wild plants. Pesticide regimes that threaten their sustainability should therefore be assessed. As an example, evidence that the agricultural use of neonicotinoid pesticides is a cause of the recently observed declines in honey bees is examined. The aim is to define exacting demographic conditions for a detrimental factor to precipitate a population decline, and Hill's epidemiological 'causality criteria' are employed as a structured process for making an expert judgement about the proposition that trace dietary neonicotinoids in nectar and pollen cause population declines in honey bees. In spite of the absence of decisive experimental results, the analysis shows that, while the proposition is a substantially justified conjecture in the context of current knowledge, it is also substantially contraindicated by a wide variety of circumstantial epidemiological evidence. It is concluded that dietary neonicotinoids cannot be implicated in honey bee declines, but this position is provisional because important gaps remain in current knowledge. Avenues for further investigations to resolve this longstanding uncertainty are therefore identified. Copyright © 2012 Society of Chemical Industry.

Microplastics in the environment: What can we learn from a decade of engineered nanoparticle fate and risk assessment?

NASA Astrophysics Data System (ADS)

Hüffer, T.; Praetorius, A.; Wagner, S.; von der Kammer, F.; Hofmann, T.

2016-12-01

The field of environmental fate and risk assessment is frequently dominated by "hot topics" of emerging contaminants; in recent years for example pharmaceuticals, nanomaterials or, most recently, microplastics. Since no emerging pollutant is entirely new, a careful assessment of existing knowledge on related substances can help us direct our research efforts and employ the limited resources in a more efficient way. Crucial questions on the environmental implications of microplastics, for example the need for analytical tools, adequate protocols to study their fate, or the effects of aging and a risk assessment based thereon remain largely unanswered. Over the last decade, the field of environmental implications of engineered nanoparticles (ENPs) has been facing similar challenges. The goal of this contribution is to suggest a road-map to pursue the risk assessment of microplastics based on our experience in one decade in ENPs research. We highlight how to avoid potential dead-ends in microplastics research. We also illustrate that cross-linking other research fields, especially polymer chemistry and material sciences, may facilitate filling the urgent knowledge gaps.

Introduction to biological complexity as a missing link in drug discovery.

PubMed

Gintant, Gary A; George, Christopher H

2018-06-06

Despite a burgeoning knowledge of the intricacies and mechanisms responsible for human disease, technological advances in medicinal chemistry, and more efficient assays used for drug screening, it remains difficult to discover novel and effective pharmacologic therapies. Areas covered: By reference to the primary literature and concepts emerging from academic and industrial drug screening landscapes, the authors propose that this disconnect arises from the inability to scale and integrate responses from simpler model systems to outcomes from more complex and human-based biological systems. Expert opinion: Further collaborative efforts combining target-based and phenotypic-based screening along with systems-based pharmacology and informatics will be necessary to harness the technological breakthroughs of today to derive the novel drug candidates of tomorrow. New questions must be asked of enabling technologies-while recognizing inherent limitations-in a way that moves drug development forward. Attempts to integrate mechanistic and observational information acquired across multiple scales frequently expose the gap between our knowledge and our understanding as the level of complexity increases. We hope that the thoughts and actionable items highlighted will help to inform the directed evolution of the drug discovery process.

Emergency contraception in Honduras: knowledge, attitudes, and practice among urban family planning clients.

PubMed

García, Sandra G; Lara, Diana; Landis, Sarah H; Yam, Eileen A; Pavón, Suyapa

2006-09-01

Emergency contraception (EC) has the potential to improve women's reproductive health significantly. In Honduras, where nearly one-fourth of pregnancies are unplanned, the need for EC is substantial. To increase awareness of this option, nongovernmental organizations launched countrywide EC outreach activities in 2001-03. We conducted pre- and postintervention cross-sectional surveys among a total of 2,693 family planning clinic clients to assess EC knowledge, attitudes, and practice at baseline and at two years postintroduction. EC awareness increased over time, but remained at just 20 percent at follow-up. Respondents generally demonstrated a positive attitude and low rates of concern about EC. Awareness of and willingness to use EC were strongly associated with age, educational status, and city of residence. Public-sector acceptance of the method is essential to increase awareness of and access to EC. This study is intended to fill an information gap regarding EC in Latin America and the Caribbean and to be useful in determining educational messages and target audiences for future awareness campaigns in Honduras.

The Multifold Relationship Between Memory and Decision Making: An Individual-differences Study

PubMed Central

Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M.; Nilsson, Lars-Göran

2014-01-01

Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 to 80 years, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory, and semantic memory, respectively, and six main components of decision-making competence. In line with the hypotheses, working memory was positively related with the more cognitively-demanding tasks (Resistance to Framing, Applying Decision Rules, and Under/Overconfidence), whereas episodic memory was positively associated with a more experience-based judgment task (Recognizing Social Norms). Furthermore, semantic memory was positively related with two more knowledge-based decision-making tasks (Consistency in Risk Perception and Resistance to Sunk Costs). Finally, the age-related decline observed in some of the decision-making tasks was (partially or totally) mediated by the age-related decline in working memory or episodic memory. These findings are discussed in relation to the functional roles fulfilled by different memory processes in judgment and decision-making tasks. PMID:23565790

Evaluation of Possible Consequences of Zika Virus Infection in the Developing Nervous System.

PubMed

Walter, Lais Takata; Higa, Guilherme Shigueto Vilar; Ikebara, Juliane Midori; Vedovello, Danila; Salvador, Felipe Scassi; Takada, Silvia Honda; Kinjo, Erika Reime; Whalley, Benjamin J; Sperança, Márcia Aparecida; Kihara, Alexandre Hiroaki

2018-02-01

The Zika virus (ZIKV) outbreak that occurred in the northeast of Brazil in 2015 led to alarming numbers of babies born with microcephaly in this region. Since then, several studies have evaluated the relationship between ZIKV infection and development of the malformation although the specific mechanistic interaction between ZIKV and human physiological processes that ultimately manifest as microcephaly remains debated. Importantly, most current studies did not consider the specificities of the biology and life cycle of ZIKV. As a consequence, specificities of the infection on the developing central nervous system (CNS) were frequently disregarded. In order to begin to address this important gap in our knowledge, we have collated and critically reviewed the existing evidence in this area to identify any emerging consensus on this topic and thereafter describe possible mechanisms by which ZIKV infection could interfere with specific processes of CNS development, such as neuronal proliferation, and the complex interactions of immature neurons with radial glial cells. With this, we were able to present the current knowledge on this important topic in the neurobiology field.

OpenBiodiv-O: ontology of the OpenBiodiv knowledge management system.

PubMed

Senderov, Viktor; Simov, Kiril; Franz, Nico; Stoev, Pavel; Catapano, Terry; Agosti, Donat; Sautter, Guido; Morris, Robert A; Penev, Lyubomir

2018-01-18

The biodiversity domain, and in particular biological taxonomy, is moving in the direction of semantization of its research outputs. The present work introduces OpenBiodiv-O, the ontology that serves as the basis of the OpenBiodiv Knowledge Management System. Our intent is to provide an ontology that fills the gaps between ontologies for biodiversity resources, such as DarwinCore-based ontologies, and semantic publishing ontologies, such as the SPAR Ontologies. We bridge this gap by providing an ontology focusing on biological taxonomy. OpenBiodiv-O introduces classes, properties, and axioms in the domains of scholarly biodiversity publishing and biological taxonomy and aligns them with several important domain ontologies (FaBiO, DoCO, DwC, Darwin-SW, NOMEN, ENVO). By doing so, it bridges the ontological gap across scholarly biodiversity publishing and biological taxonomy and allows for the creation of a Linked Open Dataset (LOD) of biodiversity information (a biodiversity knowledge graph) and enables the creation of the OpenBiodiv Knowledge Management System. A key feature of the ontology is that it is an ontology of the scientific process of biological taxonomy and not of any particular state of knowledge. This feature allows it to express a multiplicity of scientific opinions. The resulting OpenBiodiv knowledge system may gain a high level of trust in the scientific community as it does not force a scientific opinion on its users (e.g. practicing taxonomists, library researchers, etc.), but rather provides the tools for experts to encode different views as science progresses. OpenBiodiv-O provides a conceptual model of the structure of a biodiversity publication and the development of related taxonomic concepts. It also serves as the basis for the OpenBiodiv Knowledge Management System.

Results of a novel screening tool measuring dietary sodium knowledge in patients with chronic kidney disease.

PubMed

Wright Nunes, Julie A; Anderson, Cheryl A M; Greene, Jane H; Ikizler, Talat Alp; Cavanaugh, Kerri L

2015-03-31

Reducing dietary sodium has potential to benefit patients with chronic kidney disease (CKD). Little research is available defining dietary sodium knowledge gaps in patients with pre-dialysis CKD. We designed a brief screening tool to rapidly identify patient knowledge gaps related to dietary sodium for patients with CKD not yet on dialysis. A Short Sodium Knowledge Survey (SSKS) was developed and administered to patients with pre-dialysis CKD. We also asked patients if they received counseling on dietary sodium reduction and about recommended intake limits. We performed logistic regression to examine the association between sodium knowledge and patient characteristics. Characteristics of patients who answered all SSKS questions correctly were compared to those who did not. One-hundred fifty-five patients were surveyed. The mean (SD) age was 56.6 (15.1) years, 84 (54%) were men, and 119 (77%) were white. Sixty-seven patients (43.2%) correctly identified their daily intake sodium limit. Fifty-eight (37.4%) were unable to answer all survey questions correctly. In analysis adjusted for age, sex, race, education, health literacy, CKD stage, self-reported hypertension and attendance in a kidney education class, women and patients of non-white race had lower odds of correctly answering survey questions (0.36 [0.16,0.81]; p = 0.01 women versus men and 0.33 [0.14,0.76]; p = 0.01 non-white versus white, respectively). Our survey provides a mechanism to quickly identify dietary sodium knowledge gaps in patients with CKD. Women and patients of non-white race may have knowledge barriers impeding adherence to sodium reduction advice.

Identifying knowledge gaps between practice and research for implementation components of sustainable interventions to improve the working environment - A rapid review.

PubMed

Rasmussen, Charlotte Diana Nørregaard; Højberg, Helene; Bengtsen, Elizabeth; Jørgensen, Marie Birk

2018-02-01

In a recent study, we involved all relevant stakeholders to identify practice-based implementation components for successful implementation and sustainability in work environment interventions. To understand possible knowledge gaps between evidence and practice, the aim of this paper is to investigate if effectiveness studies of the 11 practice-based implementation components can be identified in existing scientific literature. PubMed/MEDLINE, PsycINFO, and Web of Science were searched for relevant studies. After screening, 38 articles met the inclusion criteria. Since some of the studies describe more than one practice-based implementation concept a total of 125 quality criteria assessments were made. The overall result is that 10 of the 11 practice-based implementation components can be found in the scientific literature, but the evaluation of them is poor. From this review it is clear that there are knowledge gaps between evidence and practice with respect to the effectiveness of implementation concepts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Closing the mycetoma knowledge gap.

PubMed

van de Sande, Wendy; Fahal, Ahmed; Ahmed, Sarah Abdalla; Serrano, Julian Alberto; Bonifaz, Alexandro; Zijlstra, Ed

2018-04-01

On 28th May 2016, mycetoma was recognized as a neglected tropical disease by the World Health Organization. This was the result of a 4-year journey starting in February 2013 with a meeting of global mycetoma experts. Knowledge gaps were identified and included the incidence, prevalence, and mapping of mycetoma; the mode of transmission; the development of methods for early diagnosis; and better treatment. In this review, we review the road to recognition, the ISHAM working group meeting in Argentina, and we address the progress made in closing the knowledge gaps since 2013. Progress included adding another 9000 patients to the literature, which allowed us to update the prevalence map on mycetoma. Furthermore, based on molecular phylogeny, species names were corrected and four novel mycetoma causative agents were identified. By mapping mycetoma causative agents an association with Acacia trees was found. For early diagnosis, three different isothermal amplification techniques were developed, and novel antigens were discovered. To develop better treatment strategies for mycetoma patients, in vitro susceptibility tests for the coelomycete agents of black grain mycetoma were developed, and the first randomized clinical trial for eumycetoma started early 2017.

Research Priorities in Mental Health, Justice, and Safety: A Multidisciplinary Stakeholder Report

PubMed Central

Crocker, Anne G.; Nicholls, Tonia L.; Seto, Michael C.; Roy, Laurence; Leclair, Marichelle C.; Brink, Johann; Simpson, Alexander I. F.; Côté, Gilles

2015-01-01

This paper is based on the report following the National Research Agenda Meeting on Mental Health, Justice, and Safety held in Montreal on November 19, 2014, which convened academics; health, social, and legal professionals; and people with lived experience of mental illness from across Canada. The goal was to identify research priorities addressing relevant knowledge gaps and research strategies that can translate into public policy action and improvements in evidence-based services. Participants identified key challenges: (1) inadequate identification and response to needs by civil mental health services and frontline law enforcement, (2) limited specialized resources in forensic and correctional settings, (3) fragmented care and gaps between systems, (4) limited resources for adequate community reintegration, and (5) poor knowledge transfer strategies as obstacles to evidence-based policies. Knowledge gaps were identified in epidemiology and risk reduction, frontline training and programs, forensic and correctional practices, organizations and institutions, knowledge transfer, and rehabilitation. Finally, participants identified potential sources of support to conduct real time research with regard to data collection and sharing. The findings represent a roadmap for how forensic mental health systems can best proceed to address current challenges through research and practice initiatives, drawing from lived, clinical and research experiences of a multidisciplinary group of experts. PMID:26681928

Addressing the Common Pathway Underlying Hypertension and Diabetes in People Who Are Obese by Maximizing Health: The Ultimate Knowledge Translation Gap

PubMed Central

Dean, Elizabeth; Lomi, Constantina; Bruno, Selma; Awad, Hamzeh; O'Donoghue, Grainne

2011-01-01

In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM), and obesity and the low profile of noninvasive (nondrug) compared with invasive (drug) interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance. PMID:21423684

Wave Coupling in the Atmosphere-Ionosphere System

NASA Astrophysics Data System (ADS)

Forbes, J. M.

2016-12-01

Vertically-propagating solar and lunar tides, Kelvin waves, gravity waves (GW) and planetary waves (PW) constitute the primary mechanism for transmitting lower atmosphere variability to the upper atmosphere and ionosphere. Vertically propagating waves grow exponentially with height into the more rarified atmosphere where they dissipate, deposit net momentum and heat, and induce net constituent transport. Some waves penetrate to the base of the exosphere (ca. 500-600 km). Over the past decade, a mature knowledge of the tidal part of the spectrum has emerged, in an average or climatological sense, up to about 110 km. This knowledge has largely accrued as a result of remote sensing observations made from the TIMED satellite. These observations have also enabled limited studies on day-to-day variability of atmospheric tides, the PW and Kelvin wave spectra up to 110 km, and PW-tide coupling. Complementary ionospheric observations made by GPS receivers, COSMIC, CHAMP, and ROCSAT contain signatures of plasma redistributions induced by these waves, and ionosphere-thermosphere (IT) general circulation models have been developed that provide a corroborating theoretical foundation. Pioneering theoretical and modeling work also demonstrate the importance of the GW part of the spectrum on thermosphere circulation and thermal structure. While significant strides have been made, critical shortcomings in our understanding of atmosphere-IT coupling remain. In particular, we are practically absent any observations of the vertical evolution and dissipation of the wave spectrum between 100 and 200 km, which is also the region where electric fields and currents are generated by dynamo action. Moreover, the day-to-day variability of the wave spectrum and secondary wave generation remain to be quantified in this critical region. In this talk, the above progress and knowledge gaps will be examined in light of imminent and potential future missions.

Expanding the use of empiricism in nursing: can we bridge the gap between knowledge and clinical practice?

PubMed

Giuliano, Karen K

2003-04-01

The philosophy of Aristotle and its impact on the process of empirical scientific inquiry has been substantial. The influence of the clarity and orderliness of his thinking, when applied to the acquisition of knowledge in nursing, can not be overstated. Traditional empirical approaches have and will continue to have an important influence on the development of nursing knowledge through nursing research. However, as nursing is primarily a practice discipline, the transition from empirical and syllogistic reasoning is problematic. Other types of inquiry are essential in the application of nursing knowledge obtained by empirical scientific approaches and to understand how that knowledge can best be used in the care of patients. This paper reviews the strengths and limitations of syllogistic reasoning by applying it to a recently published study on temperature measurement in nursing. It then discusses possible ways that the empirical knowledge gained from that study and confirmed in its reasoning by logical analysis could be used in the daily care of critically ill patients. It concludes by highlighting the utility of broader approaches to knowledge development, including interpretative approaches and contemporary empiricism, as a way to bridge the gap between factual empirical knowledge and the practical application of that knowledge in everyday clinical nursing practice.

Caste- and ethnicity-based inequalities in HIV/AIDS-related knowledge gap: a case of Nepal.

PubMed

Atteraya, Madhu; Kimm, HeeJin; Song, In Han

2015-05-01

Caste- and ethnicity-based inequalities are major obstacles to achieving health equity. The authors investigated whether there is any association between caste- and ethnicity-based inequalities and HIV-related knowledge within caste and ethnic populations. They used the 2011 Nepal Demographic and Health Survey, a nationally represented cross-sectional study data set. The study sample consisted of 11,273 women between 15 and 49 years of age. Univariate and logistic regression models were used to examine the relationship between caste- and ethnicity-based inequalities and HIV-related knowledge. The study sample was divided into high Hindu caste (47.9 percent), "untouchable" caste (18.4 percent), and indigenous populations (33.7 percent). Within the study sample, the high-caste population was found to have the greatest knowledge of the means by which HIV is prevented and transmitted. After controlling for socioeconomic and demographic characteristics, untouchables were the least knowledgeable. The odds ratio for incomplete knowledge about transmission among indigenous populations was 1.27 times higher than that for high Hindu castes, but there was no significant difference in knowledge of preventive measures. The findings suggest the existence of a prevailing HIV knowledge gap. This in turn suggests that appropriate steps need to be implemented to convey complete knowledge to underprivileged populations.

Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates.

PubMed

Wozney, Lori; Newton, Amanda S; Gehring, Nicole D; Bennett, Kathryn; Huguet, Anna; Hartling, Lisa; Dyson, Michele P; McGrath, Patrick

2017-06-02

The use of technology such as computers, tablets, and smartphones to improve access to and the delivery of mental health care (eMental Health care) is growing worldwide. However, despite the rapidly expanding evidence base demonstrating the efficacy of eMental Health care, its implementation in clinical practice and health care systems remains fragmented. To date, no peer-reviewed, key-informant studies have reported on the perspectives of decision-makers concerned with whether and how to implement eMental Health care. From September to November 2015, we conducted 31 interviews with key informants responsible for leadership, policy, research, and/ or information technology in organizations influential in the adoption of technology for eMental Health care. Deductive and inductive thematic analyses of transcripts were conducted using the Behavior Change Wheel as an organizing framework. Frequency and intensity effect sizes were calculated for emerging themes to further explore patterns within the data. Key informant responses (n = 31) representing 6 developed countries and multiple organizations showed consensus on common factors impacting implementation: individual and organizational capacities (e.g., computer literacy skills [patients and providers], knowledge gaps about cyber security, limited knowledge of available services); motivational drivers of technology-based care (e.g., extending care, data analytics); and opportunities for health systems to advance eMental Health care implementation (e.g., intersectoral research, rapid testing cycles, sustainable funding). Frequency effect sizes showed strong associations between implementation and credibility, knowledge, workflow, patient empowerment, electronic medical record (EMR) integration, sustained funding and intersectoral networks. Intensity effect sizes showed the highest concentration of statements (>10% of all comments) related to funding, credibility, knowledge gaps, and patient empowerment. This study provides previously unavailable information about key informant perspectives on eMental Health care implementation. The themes that emerged, namely the need to intensify intersectoral research, measure/monitor readiness to implement, define cost-utility benchmarks, raise awareness about available technologies, and test assumptions that 'proven' technologies will be easily integrated can inform the design and evaluation of eMental Health care implementation models.

Healthcare professionals' behavior, skills, knowledge and attitudes on evidence-based health practice: a protocol of cross-sectional study.

PubMed

Mariano, Arielly Souza; Souza, Nathan Mendes; Cavaco, Afonso; Lopes, Luciane Cruz

2018-06-04

In Brazil, as in most countries nowadays, there is a pursuit for healthcare quality improvement and sustainability in public and private systems. Healthcare professionals' perceptions, knowledge and attitudes determine evidence-based practice (EBP), which remain uncertain among Brazilian practitioners. A standardised national instrument whose wide use will identify gaps and flaws in establishing an EBP could contribute to an effective resources allocation from health professionals willing to use an EBP. To present a study protocol on the development and validation of an instrument to measure Brazilian healthcare professionals' behaviour, skills, self-efficacy, knowledge and attitudes towards EBP. This is a validation study with Brazilian healthcare professionals to develop a valid and reliable questionnaire, including selection of domains and formulation of questions. Construct and content validity will be assess by a panel of experts, with data collection and analysis following a Delphi-like methodology. Further, a pilot survey will be accomplished with a representative sample of different healthcare professionals from all main Brazilian regions. An exploratory factor analysis and a confirmatory factor analysis will be conducted afterwards. The ratio of χ 2 and df (χ 2 /df), comparative fit index, goodness of fit index and root mean square error of approximation will be used for assessing the model fit. In addition, the reliability of the instrument will be estimated by test-retest reproducibility and Cronbach's alpha coefficient (α). This study has received ethical approval from the Pharmaceutical Sciences Faculty of the São Paulo State University (1.425.808). The use among a wide national sample is expected to promote an extensive view of evidence-based decision-making, identifying the knowledge gaps in this area. Study findings will be circulated to healthcare professionals and scientists in the field through the publication in peer-reviewed journals and conference presentations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Co-Operative Advances in Behavioral Health and Performance Research and Operations

NASA Technical Reports Server (NTRS)

VanderArk, Stephen T.; Leveton, Lauren B.

2011-01-01

In organizations that engage in both operations and applied research, with operational needs guiding research questions and research informing improved operations, the ideal goal is a synergy of ideas and information. In reality, this ideal synergy is often lacking. Real-time operational needs driving day-to-day decisions, lack of communication, lag time in getting research advances plugged into operations can cause both areas to suffer from this gap between operations and research. At Johnson Space Center, the Behavior Health and Performance group (BHP) strives to bridge this gap by following a Human Research Program framework: Expectations of future operational needs identify the knowledge gaps; the gaps in turn guide research leading to a product that is transitioned into operations. Thus, the direction those of us in research take is in direct response to current and future needs of operations. Likewise, those of us in operations actively seek knowledge that is supported by evidence-based research. We make an ongoing effort to communicate across the research and operations gap by working closely with each other and making a conscious effort to keep each other informed. The objective of the proposed panel discussion is to demonstrate through the following presentations the results of a successful collaboration between research and operations and to provide ASMA members with more practical knowledge and strategies for building these bridges to serve our field of practice well. The panel will consist of six presenters from BHP operations, internal BHP research, and external research instigated by BHP who together represent the entire BHP Research Transition to Operations Framework

Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: challenges to optimal care in Crohn's Disease.

PubMed

Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

2009-12-01

A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn's disease (CD). A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice context.

Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: Challenges to optimal care in Crohn’s disease

PubMed Central

Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

2009-01-01

OBJECTIVE: A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn’s disease (CD). METHODS: A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. RESULTS: Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. CONCLUSIONS: Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice context. PMID:20011732