Methodological Considerations for Research With Black Male Victims of Violent Injury in an Urban Trauma Unit.

PubMed

St Vil, Christopher; Richardson, Joseph; Cooper, Carnell

2018-04-01

There is a body of research over the last three decades that has focused on the etiology of violence among victims of violent injury. This body of literature indicates that Black men are disproportionately represented among victims of violent injury seen in emergency departments and trauma centers across the country. Despite the disproportionate number of low-income young Black men treated for violent injury in urban trauma units and the growing body of literature accompanying it, little is known about the unique methodological challenges violent injury researchers face when conducting research on this vulnerable population in a clinical setting. This article describes the unique and often nuanced methodological difficulties a research team encountered while conducting a longitudinal qualitative study on risk factors for repeat violent injury among low-income young Black male victims of violent injury treated at a Level II trauma center in the Eastern United States. Four methodological challenges are identified: (a) the identification and screening of participants, (b) recruitment and interviewing, (c) understanding hospital culture, policies, and procedures, and (d) retention and attrition of sample. Recommendations to overcome these challenges are offered.

Navigating political minefields: partnerships in organizational case study research.

PubMed

Moll, Sandra

2012-01-01

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

Methodological issues in medical workforce analysis: implications for regional Australia.

PubMed

Hays, R B; Veitch, P C; Franklin, L; Crossland, L

1998-02-01

Medical workforce data have a profound impact on health policy formulation, but derived doctor population ratios (DPR) are often more relevant to plotting national trends than providing a detailed regional or local workforce perspective. Regional workforce data may be more useful if national approaches are augmented by local information. In developing a detailed workforce analysis for one region of Australia, the authors encountered several challenging methodological issues, including the accuracy of medical workforce databases, clarity of definition of community boundaries, interpretation of workforce definitions and the difficulty accounting for local community needs. This paper discusses the implications for regional workforce research.

Methodological and Ethical Issues in Pediatric Medication Safety Research.

PubMed

Carpenter, Delesha; Gonzalez, Daniel; Retsch-Bogart, George; Sleath, Betsy; Wilfond, Benjamin

2017-09-01

In May 2016, the Eshelman School of Pharmacy at The University of North Carolina at Chapel Hill convened the PharmSci conference to address the topic of "methodological and ethical issues in pediatric medication safety research." A multidisciplinary group of experts representing a diverse array of perspectives, including those of the US Food and Drug Administration, children's hospitals, and academia, identified important considerations for pediatric medication safety research and opportunities to advance the field. This executive summary describes current challenges that clinicians and researchers encounter related to pediatric medication safety research and identifies innovative and ethically sound methodologies to address these challenges to improve children's health. This article addresses 5 areas: (1) pediatric drug development and drug trials; (2) conducting comparative effectiveness research in pediatric populations; (3) child and parent engagement on study teams; (4) improving communication with children and parents; and (5) assessing child-reported outcomes and adverse drug events. Copyright © 2017 by the American Academy of Pediatrics.

Postmodern feminist perspectives and nursing research: a passionately interested form of inquiry.

PubMed

Aranda, Kay

2006-06-01

The challenges posed by postmodern and poststructural theories profoundly disrupt the certainties of feminist and nursing research, yet at the same time offer possibilities for developing new epistemologies. While there are an increasing number of accounts discussing the theoretical implications of these ideas for nursing research, I wish to discuss the practical and the methodological implications of using postmodern feminist theories within empirical research. In particular, I identify the challenges I encountered through an examination of specific aspects of the research process and through examples drawn from empirical research. I conclude that using postmodern feminist theories requires a continuous engagement with, and interrogation of, the modern epistemological and ontological assumptions of qualitative, feminist nursing research and, in so doing, presents the possibility for nurse scholars to begin to develop a 'passionately interested' methodological approach to nursing inquiry.

An innovative method to involve community health workers as partners in evaluation research.

PubMed

Peacock, Nadine; Issel, L Michele; Townsell, Stephanie J; Chapple-McGruder, Theresa; Handler, Arden

2011-12-01

We developed a process through which community outreach workers, whose role is not typically that of a trained researcher, could actively participate in collection of qualitative evaluation data. Outreach workers for a community-based intervention project received training in qualitative research methodology and certification in research ethics. They used a Voice over Internet Protocol phone-in system to provide narrative reports about challenges faced by women they encountered in their outreach activities as well as their own experiences as outreach workers. Qualitative data contributed by outreach workers provided insights not otherwise available to the evaluation team, including details about the complex lives of underserved women at risk for poor pregnancy outcomes and the challenges and rewards of the outreach worker role. Lay health workers can be a valuable asset as part of a research team. Training in research ethics and methods can be tailored to their educational level and preferences, and their insights provide important information and perspectives that may not be accessible via other data collection methods. Challenges encountered in the dual roles of researcher and lay health worker can be addressed in training.

Conducting a meta-ethnography of qualitative literature: lessons learnt.

PubMed

Atkins, Salla; Lewin, Simon; Smith, Helen; Engel, Mark; Fretheim, Atle; Volmink, Jimmy

2008-04-16

Qualitative synthesis has become more commonplace in recent years. Meta-ethnography is one of several methods for synthesising qualitative research and is being used increasingly within health care research. However, many aspects of the steps in the process remain ill-defined. We utilized the seven stages of the synthesis process to synthesise qualitative research on adherence to tuberculosis treatment. In this paper we discuss the methodological and practical challenges faced; of particular note are the methods used in our synthesis, the additional steps that we found useful in clarifying the process, and the key methodological challenges encountered in implementing the meta-ethnographic approach. The challenges included shaping an appropriate question for the synthesis; identifying relevant studies; assessing the quality of the studies; and synthesising findings across a very large number of primary studies from different contexts and research traditions. We offer suggestions that may assist in undertaking meta-ethnographies in the future. Meta-ethnography is a useful method for synthesising qualitative research and for developing models that interpret findings across multiple studies. Despite its growing use in health research, further research is needed to address the wide range of methodological and epistemological questions raised by the approach.

Conducting a meta-ethnography of qualitative literature: Lessons learnt

PubMed Central

Atkins, Salla; Lewin, Simon; Smith, Helen; Engel, Mark; Fretheim, Atle; Volmink, Jimmy

2008-01-01

Background Qualitative synthesis has become more commonplace in recent years. Meta-ethnography is one of several methods for synthesising qualitative research and is being used increasingly within health care research. However, many aspects of the steps in the process remain ill-defined. Discussion We utilized the seven stages of the synthesis process to synthesise qualitative research on adherence to tuberculosis treatment. In this paper we discuss the methodological and practical challenges faced; of particular note are the methods used in our synthesis, the additional steps that we found useful in clarifying the process, and the key methodological challenges encountered in implementing the meta-ethnographic approach. The challenges included shaping an appropriate question for the synthesis; identifying relevant studies; assessing the quality of the studies; and synthesising findings across a very large number of primary studies from different contexts and research traditions. We offer suggestions that may assist in undertaking meta-ethnographies in the future. Summary Meta-ethnography is a useful method for synthesising qualitative research and for developing models that interpret findings across multiple studies. Despite its growing use in health research, further research is needed to address the wide range of methodological and epistemological questions raised by the approach. PMID:18416812

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion.

PubMed

Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra

2015-08-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. © 2015 Associated Professional Sleep Societies, LLC.

What guidance is available for researchers conducting overviews of reviews of healthcare interventions? A scoping review and qualitative metasummary.

PubMed

Pollock, Michelle; Fernandes, Ricardo M; Becker, Lorne A; Featherstone, Robin; Hartling, Lisa

2016-11-14

Overviews of reviews (overviews) compile data from multiple systematic reviews to provide a single synthesis of relevant evidence for decision-making. Despite their increasing popularity, there is limited methodological guidance available for researchers wishing to conduct overviews. The objective of this scoping review is to identify and collate all published and unpublished documents containing guidance for conducting overviews examining the efficacy, effectiveness, and/or safety of healthcare interventions. Our aims were to provide a map of existing guidance documents; identify similarities, differences, and gaps in the guidance contained within these documents; and identify common challenges involved in conducting overviews. We conducted an iterative and extensive search to ensure breadth and comprehensiveness of coverage. The search involved reference tracking, database and web searches (MEDLINE, EMBASE, DARE, Scopus, Cochrane Methods Studies Database, Google Scholar), handsearching of websites and conference proceedings, and contacting overview producers. Relevant guidance statements and challenges encountered were extracted, edited, grouped, abstracted, and presented using a qualitative metasummary approach. We identified 52 guidance documents produced by 19 research groups. Relatively consistent guidance was available for the first stages of the overview process (deciding when and why to conduct an overview, specifying the scope, and searching for and including systematic reviews). In contrast, there was limited or conflicting guidance for the latter stages of the overview process (quality assessment of systematic reviews and their primary studies, collecting and analyzing data, and assessing quality of evidence), and many of the challenges identified were also related to these stages. An additional, overarching challenge identified was that overviews are limited by the methods, reporting, and coverage of their included systematic reviews. This compilation of methodological guidance for conducting overviews of healthcare interventions will facilitate the production of future overviews and can help authors address key challenges they are likely to encounter. The results of this project have been used to identify areas where future methodological research is required to generate empirical evidence for overview methods. Additionally, these results have been used to update the chapter on overviews in the next edition of the Cochrane Handbook for Systematic Reviews of Interventions.

Automatic indexing and retrieval of encounter-specific evidence for point-of-care support.

PubMed

O'Sullivan, Dympna M; Wilk, Szymon A; Michalowski, Wojtek J; Farion, Ken J

2010-08-01

Evidence-based medicine relies on repositories of empirical research evidence that can be used to support clinical decision making for improved patient care. However, retrieving evidence from such repositories at local sites presents many challenges. This paper describes a methodological framework for automatically indexing and retrieving empirical research evidence in the form of the systematic reviews and associated studies from The Cochrane Library, where retrieved documents are specific to a patient-physician encounter and thus can be used to support evidence-based decision making at the point of care. Such an encounter is defined by three pertinent groups of concepts - diagnosis, treatment, and patient, and the framework relies on these three groups to steer indexing and retrieval of reviews and associated studies. An evaluation of the indexing and retrieval components of the proposed framework was performed using documents relevant for the pediatric asthma domain. Precision and recall values for automatic indexing of systematic reviews and associated studies were 0.93 and 0.87, and 0.81 and 0.56, respectively. Moreover, precision and recall for the retrieval of relevant systematic reviews and associated studies were 0.89 and 0.81, and 0.92 and 0.89, respectively. With minor modifications, the proposed methodological framework can be customized for other evidence repositories. Copyright 2010 Elsevier Inc. All rights reserved.

Employing an ethnographic approach: key characteristics.

PubMed

Lambert, Veronica; Glacken, Michele; McCarron, Mary

2011-01-01

Nurses are increasingly embracing ethnography as a useful research methodology. This paper presents an overview of some of the main characteristics we considered and the challenges encountered when using ethnography to explore the nature of communication between children and health professionals in a children's hospital. There is no consensual definition or single procedure to follow when using ethnography. This is largely attributable to the re-contextualisation of ethnography over time through diversification in and across many disciplines. Thus, it is imperative to consider some of ethnography's trademark features. To identify core trademark features of ethnography, we collated data following a scoping review of pertinent ethnographic textbooks, journal articles, attendance at ethnographic workshops and discussions with principle ethnographers. This is a methodological paper. Essentially, ethnography is a field-orientated activity that has cultural interpretations at its core, although the levels of those interpretations vary. We identified six trademark features to be considered when embracing an ethnographic approach: naturalism; context; multiple data sources; small case numbers; 'emic' and 'etic' perspectives, and ethical considerations. Ethnography has an assortment of meanings, so it is not often used in a wholly orthodox way and does not fall under the auspices of one epistemological belief. Yet, there are core criteria and trademark features that researchers should take into account alongside their particular epistemological beliefs when embracing an ethnographic inquiry. We hope this paper promotes a clearer vision of the methodological processes to consider when embarking on ethnography and creates an avenue for others to disseminate their experiences of and challenges encountered when applying ethnography's trademark features in different healthcare contexts.

Climbing the ladder: capability maturity model integration level 3

NASA Astrophysics Data System (ADS)

Day, Bryce; Lutteroth, Christof

2011-02-01

This article details the attempt to form a complete workflow model for an information and communication technologies (ICT) company in order to achieve a capability maturity model integration (CMMI) maturity rating of 3. During this project, business processes across the company's core and auxiliary sectors were documented and extended using modern enterprise modelling tools and a The Open Group Architectural Framework (TOGAF) methodology. Different challenges were encountered with regard to process customisation and tool support for enterprise modelling. In particular, there were problems with the reuse of process models, the integration of different project management methodologies and the integration of the Rational Unified Process development process framework that had to be solved. We report on these challenges and the perceived effects of the project on the company. Finally, we point out research directions that could help to improve the situation in the future.

Applying a contemporary grounded theory methodology.

PubMed

Licqurish, Sharon; Seibold, Carmel

2011-01-01

The aim of this paper is to discuss the application of a contemporary grounded theory methodology to a research project exploring the experiences of students studying for a degree in midwifery. Grounded theory is a qualitative research approach developed by Glaser and Strauss in the 1950s but the methodology for this study was modelled on Clarke's (2005) approach and was underpinned by a symbolic interactionist theoretical perspective, post-structuralist theories of Michel Foucault and a constructionist epistemology. The study participants were 19 midwifery students completing their final placement. Data were collected through individual in-depth interviews and participant observation, and analysed using the grounded theory analysis techniques of coding, constant comparative analysis and theoretical sampling, as well as situational maps. The analysis focused on social action and interaction and the operation of power in the students' environment. The social process in which the students were involved, as well as the actors and discourses that affected the students' competency development, were highlighted. The methodology allowed a thorough exploration of the students' experiences of achieving competency. However, some difficulties were encountered. One of the major issues related to the understanding and application of complex sociological theories that challenged positivist notions of truth and power. Furthermore, the mapping processes were complex. Despite these minor challenges, the authors recommend applying this methodology to other similar research projects.

An Innovative Method to Involve Community Health Workers as Partners in Evaluation Research

PubMed Central

Issel, L. Michele; Townsell, Stephanie J.; Chapple-McGruder, Theresa; Handler, Arden

2011-01-01

Objectives. We developed a process through which community outreach workers, whose role is not typically that of a trained researcher, could actively participate in collection of qualitative evaluation data. Methods. Outreach workers for a community-based intervention project received training in qualitative research methodology and certification in research ethics. They used a Voice over Internet Protocol phone-in system to provide narrative reports about challenges faced by women they encountered in their outreach activities as well as their own experiences as outreach workers. Results. Qualitative data contributed by outreach workers provided insights not otherwise available to the evaluation team, including details about the complex lives of underserved women at risk for poor pregnancy outcomes and the challenges and rewards of the outreach worker role. Conclusions. Lay health workers can be a valuable asset as part of a research team. Training in research ethics and methods can be tailored to their educational level and preferences, and their insights provide important information and perspectives that may not be accessible via other data collection methods. Challenges encountered in the dual roles of researcher and lay health worker can be addressed in training. PMID:22021290

Complex self-management interventions in chronic disease unravelled: a review of lessons learned from an individual patient data meta-analysis.

PubMed

Jonkman, Nini H; Groenwold, Rolf H H; Trappenburg, Jaap C A; Hoes, Arno W; Schuurmans, Marieke J

2017-03-01

Meta-analyses using individual patient data (IPD) rather than aggregated data are increasingly applied to analyze sources of heterogeneity between trials and have only recently been applied to unravel multicomponent, complex interventions. This study reflects on methodological challenges encountered in two IPD meta-analyses on self-management interventions in patients with heart failure or chronic obstructive pulmonary disease. Critical reflection on prior IPD meta-analyses and discussion of literature. Experience from two IPD meta-analyses illustrates methodological challenges. Despite close collaboration with principal investigators, assessing the effect of characteristics of complex interventions on the outcomes of trials is compromised by lack of sufficient details on intervention characteristics and limited data on fidelity and adherence. Furthermore, trials collected baseline variables in a highly diverse way, limiting the possibilities to study subgroups of patients in a consistent manner. Possible solutions are proposed based on lessons learnt from the methodological challenges. Future researchers of complex interventions should pay considerable attention to the causal mechanism underlying the intervention and conducting process evaluations. Future researchers on IPD meta-analyses of complex interventions should carefully consider their own causal assumptions and availability of required data in eligible trials before undertaking such resource-intensive IPD meta-analysis. Copyright © 2017 Elsevier Inc. All rights reserved.

Toward the Long-Term Scientific Study of Encounter Group Phenomena: I. Methodological Considerations.

ERIC Educational Resources Information Center

Diamond, Michael Jay; Shapiro, Jerrold Lee

This paper proposes a model for the long-term scientific study of encounter, T-, and sensitivity groups. The authors see the need for overcoming major methodological and design inadequacies of such research. They discuss major methodological flaws in group outcome research as including: (1) lack of adequate base rate or pretraining measures; (2)…

Celebrating methodological challenges and changes: reflecting on the emergence and importance of the role of qualitative evidence in Cochrane reviews

PubMed Central

2013-01-01

Cochrane systematic reviews have proven to be beneficial for decision making processes, both on a practitioner and a policy level, and there are current initiatives to extend the types of evidence used by them, including qualitative research. In this article we outline the major achievements of the Cochrane Qualitative and Implementation Methods Group. Although the Group has encountered numerous challenges in dealing with the evolution of qualitative evidence synthesis, both outside and within the Cochrane Collaboration, it has successfully responded to the challenges posed in terms of incorporating qualitative evidence in systematic reviews. The Methods Group will continue to advocate for more flexible and inclusive approaches to evidence synthesis in order to meet the exciting challenges and opportunities presented by mixed methods systematic reviews and reviews of complex interventions. PMID:24135194

Issues encountered in a qualitative secondary analysis of help-seeking in the prodrome to psychosis.

PubMed

Gladstone, Brenda M; Volpe, Tiziana; Boydell, Katherine M

2007-10-01

Primary data are rarely used explicitly as a source of data outside of the original research purpose for which they were collected. As a result, qualitative secondary analysis (QSA) has been described as an "invisible enterprise" for which there is a "notable silence" amongst the qualitative research community. In this paper, we report on the methodological implications of conducting a secondary analysis of qualitative data focusing on parents' narratives of help-seeking activities in the prodrome to psychosis. We review the literature on QSA, highlighting the main characteristics of the approach, and discuss issues and challenges encountered in conducting a secondary analysis. We conclude with some thoughts on the implications for conducting a QSA in children's mental health services and research.

Pediatric microdose and microtracer studies using 14C in Europe.

PubMed

Turner, M A; Mooij, M G; Vaes, W H J; Windhorst, A D; Hendrikse, N H; Knibbe, C A J; Kõrgvee, L T; Maruszak, W; Grynkiewicz, G; Garner, R C; Tibboel, D; Park, B K; de Wildt, S N

2015-09-01

Important information gaps remain on the efficacy and safety of drugs in children. Pediatric drug development encounters several ethical, practical, and scientific challenges. One barrier to the evaluation of medicines for children is a lack of innovative methodologies that have been adapted to the needs of children. This article presents our successful experience of pediatric microdose and microtracer studies using (14) C-labeled probes in Europe to illustrate the strengths and limitations of these approaches. © 2015 ASCPT.

Identifying the challenges and facilitators of implementing a COPD care bundle.

PubMed

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges.

The systematic review team: contributions of the health sciences librarian.

PubMed

Dudden, Rosalind F; Protzko, Shandra L

2011-01-01

While the role of the librarian as an expert searcher in the systematic review process is widely recognized, librarians also can be enlisted to help systematic review teams with other challenges. This article reviews the contributions of librarians to systematic reviews, including communicating methods of the review process, collaboratively formulating the research question and exclusion criteria, formulating the search strategy on a variety of databases, documenting the searches, record keeping, and writing the search methodology. It also discusses challenges encountered such as irregular timelines, providing education, communication, and learning new technologies for record keeping. Rewards include building relationships with researchers, expanding professional expertise, and receiving recognition for contributions to health care outcomes.

Unsolicited written narratives as a methodological genre in terminal illness: challenges and limitations.

PubMed

O'Brien, Mary R; Clark, David

2012-02-01

Stories about illness have proven invaluable in helping health professionals understand illness experiences. Such narratives have traditionally been solicited by researchers through interviews and the collection of personal writings, including diaries. These approaches are, however, researcher driven; the impetus for the creation of the story comes from the researcher and not the narrator. In recent years there has been exponential growth in illness narratives created by individuals, of their own volition, and made available for others to read in print or as Internet accounts. We sought to determine whether it was possible to identify such material for use as research data to explore the subject of living with the terminal illness amyotrophic lateral sclerosis/motor neuron disease--the contention being that these accounts are narrator driven and therefore focus on issues of greatest importance to the affected person. We encountered and sought to overcome a number of methodological and ethical challenges, which is our focus here.

Probing the Proteome on Earth and Beyond

NASA Astrophysics Data System (ADS)

Ostrom, P.

2008-12-01

Less than a decade ago, protein sequencing was the bane of paleobiology. Since that time researchers have completely sequenced proteins in >50 Ka fossils, been dazzled by reports of collagen peptides in dinosaur bones, and witnessed the development of phylogenetic trees from ancient protein sequences. Enlisting proteomics as biosignature is now in our grasp. In this talk the pitfalls and challenges of mass spectrometric approaches to protein sequencing will be illustrated and phylogenetic applications will be discussed. Work on extinct organisms at Michigan State University, University of Michigan and York University will provide a vantage point to assess methodologies, explore diagenetic alterations, evaluate mass spectra and illustrate issues associated with data base searching. Challenges encountered in the study of paleoproteomics, such as the absence of sequences for extinct organisms in commercially available databases, protein diagenesis and low concentrations of target are parallel to those that will be encountered when protein sequencing is extended to extreme and extraterrestrial environments. Thus, lessons learned from interrogating the ancient proteome are important and necessary step in developing proteomics as a biosignature tools.

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

PubMed

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

2009-01-01

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

Implementation of heaters on thermally actuated spacecraft mechanisms

NASA Technical Reports Server (NTRS)

Busch, John D.; Bokaie, Michael D.

1994-01-01

This paper presents general insight into the design and implementation of heaters as used in actuating mechanisms for spacecraft. Problems and considerations that were encountered during development of the Deep Space Probe and Science Experiment (DSPSE) solar array release mechanism are discussed. Obstacles included large expected fluctuations in ambient temperature, variations in voltage supply levels outgassing concerns, heater circuit design, materials selection, and power control options. Successful resolution of these issues helped to establish a methodology which can be applied to many of the heater design challenges found in thermally actuated mechanisms.

Conceiving "personality": Psychologist's challenges and basic fundamentals of the Transdisciplinary Philosophy-of-Science Paradigm for Research on Individuals.

PubMed

Uher, Jana

2015-09-01

Scientists exploring individuals, as such scientists are individuals themselves and thus not independent from their objects of research, encounter profound challenges; in particular, high risks for anthropo-, ethno- and ego-centric biases and various fallacies in reasoning. The Transdisciplinary Philosophy-of-Science Paradigm for Research on Individuals (TPS-Paradigm) aims to tackle these challenges by exploring and making explicit the philosophical presuppositions that are being made and the metatheories and methodologies that are used in the field. This article introduces basic fundamentals of the TPS-Paradigm including the epistemological principle of complementarity and metatheoretical concepts for exploring individuals as living organisms. Centrally, the TPS-Paradigm considers three metatheoretical properties (spatial location in relation to individuals' bodies, temporal extension, and physicality versus "non-physicality") that can be conceived in different forms for various kinds of phenomena explored in individuals (morphology, physiology, behaviour, the psyche, semiotic representations, artificially modified outer appearances and contexts). These properties, as they determine the phenomena's accessibility in everyday life and research, are used to elaborate philosophy-of-science foundations and to derive general methodological implications for the elementary problem of phenomenon-methodology matching and for scientific quantification of the various kinds of phenomena studied. On the basis of these foundations, the article explores the metatheories and methodologies that are used or needed to empirically study each given kind of phenomenon in individuals in general. Building on these general implications, the article derives special implications for exploring individuals' "personality", which the TPS-Paradigm conceives of as individual-specificity in all of the various kinds of phenomena studied in individuals.

The Mother-Infant Study Cohort (MISC): Methodology, challenges, and baseline characteristics

PubMed Central

Hashim, Mona; Shaker Obaid, Reyad; Hasan, Hayder; Naja, Farah; Al Ghazal, Hessa; Jan Jan Mohamed, Hamid; Al Hilali, Marwa; Rayess, Rana; Izzaldin, Ghamra

2018-01-01

Background The United Arab Emirates (UAE) exhibits alarming high prevalence of Non-Communicable Diseases (NCDs) and their risk factors. Emerging evidence highlighted the role of maternal and early child nutrition in preventing later-onset NCDs. The objectives of this article are to describe the design and methodology of the first Mother and Infant Study Cohort (MISC) in UAE; present the baseline demographic characteristics of the study participants; and discuss the challenges of the cohort and their respective responding strategies. Methods The MISC is an ongoing two-year prospective cohort study which recruited Arab pregnant women in their third trimester from prenatal clinics in Dubai, Sharjah and Ajman. Participants will be interviewed six times (once during pregnancy, at delivery, and at 2, 6, 12 and 24months postpartum). Perinatal information is obtained from hospital records. Collected data include socio-demographic characteristics, lifestyle, dietary intake and anthropometry; infant feeding practices, cognitive development; along with maternal and infant blood profile and breast milk profile. Results The preliminary results reported that 256 completed baseline assessment (mean age: 30.5±6.0 years; 76.6% multiparous; about 60% were either overweight or obese before pregnancy). The prevalence of gestational diabetes was 19.2%. Upon delivery, 208 women-infant pairs were retained (mean gestational age: 38.5±1.5 weeks; 33.3% caesarean section delivery; 5.3% low birthweight; 5.7% macrosomic deliveries). Besides participant retention, the main encountered challenges pertained to cultural complexity, underestimation the necessary start-up time, staff, and costs, and biochemical data collection. Conclusions Despite numerous methodological, logistical and sociocultural challenges, satisfactory follow-up rates are recorded. Strategies addressing challenges are documented, providing information for planning and implementing future birth cohort studies locally and internationally. PMID:29851999

Communicative Language Teaching: A Practical Scenario in the Context of Bangladesh

ERIC Educational Resources Information Center

Ahmed, Md. Kawser

2016-01-01

Communicative Language Teaching, popularly known as CLT, has become a newly adopted methodology in the teaching and learning context of Bangladesh. This methodology, since the initiation, has encountered and is still encountering a number of hurdles that need to be dealt with best care and feasible strategy. Of all methods, most of the educational…

Bridging the gap in complementary and alternative medicine research: manualization as a means of promoting standardization and flexibility of treatment in clinical trials of acupuncture.

PubMed

Schnyer, Rosa N; Allen, John J B

2002-10-01

An important methodological challenge encountered in acupuncture clinical research involves the design of treatment protocols that help ensure standardization and replicability while allowing for the necessary flexibility to tailor treatments to each individual. Manualization of protocols used in clinical trials of acupuncture and other traditionally-based complementary and alternative medicine (CAM) systems facilitates the systematic delivery of replicable and standardized, yet individually-tailored treatments. To facilitate high-quality CAM acupuncture research by outlining a method for the systematic design and implementation of protocols used in CAM clinical trials based on the concept of treatment manualization. A series of treatment manuals was developed to systematically articulate the Chinese medical theoretical and clinical framework for a given Western-defined illness, to increase the quality and consistency of treatment, and to standardize the technical aspects of the protocol. In all, three manuals were developed for National Institutes of Health (NIH)-funded clinical trials of acupuncture for depression, spasticity in cerebral palsy, and repetitive stress injury. In Part I, the rationale underlying these manuals and the challenges encountered in creating them are discussed, and qualitative assessments of their utility are provided. In Part II, a methodology to develop treatment manuals for use in clinical trials is detailed, and examples are given. A treatment manual provides a precise way to train and supervise practitioners, enable evaluation of conformity and competence, facilitate the training process, and increase the ability to identify the active therapeutic ingredients in clinical trials of acupuncture.

Clinical workflow for spinal curvature measurement with portable ultrasound

NASA Astrophysics Data System (ADS)

Tabanfar, Reza; Yan, Christina; Kempston, Michael; Borschneck, Daniel; Ungi, Tamas; Fichtinger, Gabor

2016-03-01

PURPOSE: Spinal curvature monitoring is essential in making treatment decisions in scoliosis. Monitoring entails radiographic examinations, however repeated ionizing radiation exposure has been shown to increase cancer risk. Ultrasound does not emit ionizing radiation and is safer for spinal curvature monitoring. We investigated a clinical sonography protocol and challenges associated with position-tracked ultrasound in spinal curvature measurement in scoliosis. METHODS: Transverse processes were landmarked along each vertebra using tracked ultrasound snapshots. The transverse process angle was used to determine the orientation of each vertebra. We tested our methodology on five patients in a local pediatric scoliosis clinic, comparing ultrasound to radiographic curvature measurements. RESULTS: Despite strong correlation between radiographic and ultrasound curvature angles in phantom studies, we encountered new challenges in the clinical setting. Our main challenge was differentiating transverse processes from ribs and other structures during landmarking. We observed up to 13° angle variability for a single vertebra and a 9.85° +/- 10.81° difference between ultrasound and radiographic Cobb angles for thoracic curvatures. Additionally, we were unable to visualize anatomical landmarks in the lumbar region where soft tissue depth was 25-35mm. In volunteers with large Cobb angles (greater than 40° thoracic and 60° lumbar), we observed spinal protrusions resulting in incomplete probe-skin contact and partial ultrasound images not suitable for landmarking. CONCLUSION: Spinal curvature measurement using tracked ultrasound is viable on phantom spine models. In the clinic, new challenges were encountered which must be resolved before a universal sonography protocol can be developed.

Beyond Compliance Checking: A Situated Approach to Visual Research Ethics.

PubMed

Lenette, Caroline; Botfield, Jessica R; Boydell, Katherine; Haire, Bridget; Newman, Christy E; Zwi, Anthony B

2018-03-19

Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of individual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous.

The origin of life and its methodological challenge.

PubMed

Wächtershäuser, G

1997-08-21

The problem of the origin of life is discussed from a methodological point of view as an encounter between the teleological thinking of the historian and the mechanistic thinking of the chemist; and as the Kantian task of replacing teleology by mechanism. It is shown how the Popperian situational logic of historic understanding and the Popperian principle of explanatory power of scientific theories, when jointly applied to biochemistry, lead to a methodology of biochemical retrodiction, whereby common precursor functions are constructed for disparate successor functions. This methodology is exemplified by central tenets of the theory of the chemo-autotrophic origin of life: the proposal of a surface metabolism with a two-dimensional order; the basic polarity of life with negatively charged constituents on positively charged mineral surfaces; the surface-metabolic origin of phosphorylated sugar metabolism and nucleic acids; the origin of membrane lipids and of chemi-osmosis on pyrite surfaces; and the principles of the origin of the genetic machinery. The theory presents the early evolution of life as a process that begins with chemical necessity and winds up in genetic chance.

Bridging the knowledge-resuscitation gap for children: Still a long way to go

PubMed Central

Goldman, Ran D; Ho, Kendall; Peterson, Robert; Kissoon, Niranjan

2007-01-01

The American Heart Association, along with the International Liaison Committee on Resuscitation, recently made changes to the paediatric resuscitation guidelines. Knowledge translation (KT) is imperative, but there is a lack of sufficient evidence for appropriate methodologies for implementation of these guidelines. Paediatric resuscitation presents many challenges; cases happen infrequently, affording few opportunities for implementation of the new guidelines, and are highly stressful and filled with uncertainty. Some KT strategies have shown some success in causing a notable degree of change in behaviour, but none have shown a striking difference when used alone. Previous efforts to disseminate current guidelines centred on development of courses for health care providers and preparing paediatric residents and paediatricians for circumstances they could encounter with paediatric acute illness. None of the studies assessing these techniques measured direct patient outcomes, and only a few demonstrated some long-term knowledge acquisition among trainees. The purpose of the present review was to illuminate the challenges, offer future directions for KT and outline potentially more effective methodologies and strategies to overcome current barriers. PMID:19030414

Implementing HIPAA security in a membership organization.

PubMed

Hillabrant, L P; Gaignard, K E

2000-01-01

The upcoming HIPAA security regulations are forcing a change in business and operating procedures that many, if not most, healthcare organizations are ill-prepared to tackle. Of all healthcare organizational structures, membership organizations will most likely face the greatest number of obstacles in preparing for and implementing the HIPAA security regulations. This is because the membership organization as a whole must find a way to accommodate the disparate technologies, business and operating methodologies and processes, and available, limited resources of its individual member organizations, and integrate these into a uniform implementation plan. Compounding these obvious difficulties is the unique challenge of enforcement authority. The individual member organizations are autonomous business entities, whereas the membership organization as a whole merely acts as an advisor or consultant, and has only limited enforcement authority over any individual member organization. This article explores this unique situation in depth. We focus on PROMINA Health System, a nonprofit healthcare membership organization that consists of five disparate member healthcare organizations. We examine the challenges PROMINA has encountered in its quest to institute an organization-wide HIPAA security program and its methodology for accomplishing program implementation.

Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions.

PubMed

Pollock, Michelle; Fernandes, Ricardo M; Hartling, Lisa

2017-03-23

Overviews of reviews (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. It is recommended that authors assess and report the methodological quality of SRs in overviews-for example, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Currently, there is variation in whether and how overview authors assess and report SR quality, and limited guidance is available. Our objectives were to: examine methodological considerations involved in using AMSTAR to assess the quality of Cochrane and non-Cochrane SRs in overviews of healthcare interventions; identify challenges (and develop potential decision rules) when using AMSTAR in overviews; and examine the potential impact of considering methodological quality when making inclusion decisions in overviews. We selected seven overviews of healthcare interventions and included all SRs meeting each overview's inclusion criteria. For each SR, two reviewers independently conducted AMSTAR assessments with consensus and discussed challenges encountered. We also examined the correlation between AMSTAR assessments and SR results/conclusions. Ninety-five SRs were included (30 Cochrane, 65 non-Cochrane). Mean AMSTAR assessments (9.6/11 vs. 5.5/11; p < 0.001) and inter-rater reliability (AC1 statistic: 0.84 vs. 0.69; "almost perfect" vs. "substantial" using the Landis & Koch criteria) were higher for Cochrane compared to non-Cochrane SRs. Four challenges were identified when applying AMSTAR in overviews: the scope of the SRs and overviews often differed; SRs examining similar topics sometimes made different methodological decisions; reporting of non-Cochrane SRs was sometimes poor; and some non-Cochrane SRs included other SRs as well as primary studies. Decision rules were developed to address each challenge. We found no evidence that AMSTAR assessments were correlated with SR results/conclusions. Results indicate that the AMSTAR tool can be used successfully in overviews that include Cochrane and non-Cochrane SRs, though decision rules may be useful to circumvent common challenges. Findings support existing recommendations that quality assessments of SRs in overviews be conducted independently, in duplicate, with a process for consensus. Results also suggest that using methodological quality to guide inclusion decisions (e.g., to exclude poorly conducted and reported SRs) may not introduce bias into the overview process.

Identifying the challenges and facilitators of implementing a COPD care bundle

PubMed Central

Lennox, Laura; Green, Stuart; Howe, Cathy; Musgrave, Hannah; Bell, Derek; Elkin, Sarah

2014-01-01

Background Care bundles have been shown to improve outcomes, reduce hospital readmissions and reduce length of hospital stay; therefore increasing the speed of uptake and delivery of care bundles should be a priority in order to deliver more timely improvements and consistent high-quality care. Previous studies have detailed the difficulties of obtaining full compliance to bundle elements but few have described the underlying reasons for this. In order to improve future implementation this paper investigates the challenges encountered by clinical teams implementing a chronic obstructive pulmonary disease (COPD) care bundle and describes actions taken to overcome these challenges. Methods An initial retrospective documentary analysis of data from seven clinical implementation teams was undertaken to review the challenges faced by the clinical teams. Three focus groups with healthcare professionals and managers explored solutions to these challenges developed during the project. Results Documentary analysis identified 28 challenges which directly impacted implementation of the COPD care bundle within five themes; staffing, infrastructure, process, use of improvement methodology and patient and public involvement. Focus groups revealed that the five most significant challenges for all groups were: staff too busy, staff shortages, lack of staff engagement, added workload of the bundle and patient coding issues. The participants shared facilitating factors used to overcome issues including: shifting perceptions to improve engagement, further education sessions to increase staff participation and gaining buy-in from managers through payment frameworks. Conclusions Maximising the impact of a care bundle relies on its successful and timely implementation. Teams implementing the COPD care bundle encountered challenges that were common to all teams and sites. Understanding and learning from the challenges faced by previous endeavours and identifying the facilitators to overcoming these barriers provides an opportunity to mitigate issues that waste time and resources, and ensures that training can be tailored to the anticipated challenges. PMID:25478183

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

PubMed Central

Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

2015-01-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med 2015;11(8):931–952. PMID:26235159

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

PubMed Central

Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

2015-01-01

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. SLEEP 2015;38(8):1161–1183. PMID:26194576

Ethical challenges in mental health research among internally displaced people: ethical theory and research implementation

PubMed Central

2013-01-01

Millions of people undergo displacement in the world. Internally displaced people (IDP) are especially vulnerable as they are not protected by special legislation in contrast to other migrants. Research conducted among IDPs must be correspondingly sensitive in dealing with ethical issues that may arise. Muslim IDPs in Puttalam district in the North-Western province of Sri Lanka were initially displaced from Northern Sri Lanka due to the conflict in 1991. In the backdrop of a study exploring the prevalence of common mental disorders among the IDPs, researchers encountered various ethical challenges. These included inter-related issues of autonomy, non-maleficence, beneficence, confidentiality and informed consent, and how these were tailored in a culture-specific way to a population that has increased vulnerability. This paper analyses how these ethical issues were perceived, detected and managed by the researchers, and the role of ethics review committees in mental health research concerning IDPs. The relevance of guidelines and methodologies in the context of an atypical study population and the benefit versus risk potential of research for IDPs are also discussed. The limitations that were encountered while dealing with ethical challenges during the study are discussed. The concept of post-research ethical conduct audit is suggested to be considered as a potential step to minimize the exploitation of vulnerable populations such as IDPs in mental health research. PMID:23497333

Ethical challenges in mental health research among internally displaced people: ethical theory and research implementation.

PubMed

Siriwardhana, Chesmal; Adikari, Anushka; Jayaweera, Kaushalya; Sumathipala, Athula

2013-03-12

Millions of people undergo displacement in the world. Internally displaced people (IDP) are especially vulnerable as they are not protected by special legislation in contrast to other migrants. Research conducted among IDPs must be correspondingly sensitive in dealing with ethical issues that may arise. Muslim IDPs in Puttalam district in the North-Western province of Sri Lanka were initially displaced from Northern Sri Lanka due to the conflict in 1991. In the backdrop of a study exploring the prevalence of common mental disorders among the IDPs, researchers encountered various ethical challenges. These included inter-related issues of autonomy, non-maleficence, beneficence, confidentiality and informed consent, and how these were tailored in a culture-specific way to a population that has increased vulnerability. This paper analyses how these ethical issues were perceived, detected and managed by the researchers, and the role of ethics review committees in mental health research concerning IDPs. The relevance of guidelines and methodologies in the context of an atypical study population and the benefit versus risk potential of research for IDPs are also discussed. The limitations that were encountered while dealing with ethical challenges during the study are discussed. The concept of post-research ethical conduct audit is suggested to be considered as a potential step to minimize the exploitation of vulnerable populations such as IDPs in mental health research.

The Role of Formative Evaluation in Implementation Research and the QUERI Experience

PubMed Central

Stetler, Cheryl B; Legro, Marcia W; Wallace, Carolyn M; Bowman, Candice; Guihan, Marylou; Hagedorn, Hildi; Kimmel, Barbara; Sharp, Nancy D; Smith, Jeffrey L

2006-01-01

This article describes the importance and role of 4 stages of formative evaluation in our growing understanding of how to implement research findings into practice in order to improve the quality of clinical care. It reviews limitations of traditional approaches to implementation research and presents a rationale for new thinking and use of new methods. Developmental, implementation-focused, progress-focused, and interpretive evaluations are then defined and illustrated with examples from Veterans Health Administration Quality Enhancement Research Initiative projects. This article also provides methodologic details and highlights challenges encountered in actualizing formative evaluation within implementation research. PMID:16637954

Performance improvement CME for quality: challenges inherent to the process.

PubMed

Vakani, Farhan Saeed; O'Beirne, Ronan

2015-01-01

The purpose of this paper is to discuss the perspective debates upon the real-time challenges for a three-staged Performance Improvement Continuing Medical Education (PI-CME) model, an innovative and potential approach for future CME, to inform providers to think, prepare and to act proactively. In this discussion, the challenges associated for adopting the American Medical Association's three-staged PI-CME model are reported. Not many institutions in USA are using a three-staged performance improvement model and then customizing it to their own healthcare context for the specific targeted audience. They integrate traditional CME methods with performance and quality initiatives, and linking with CME credits. Overall the US health system is interested in a structured PI-CME model with the potential to improve physicians practicing behaviors. Knowing the dearth of evidence for applying this structured performance improvement methodology into the design of CME activities, and the lack of clarity on challenges inherent to the process that learners and providers encounter. This paper establishes all-important first step to render the set of challenges for a three-staged PI-CME model.

Reduction of Complications of Local Anaesthesia in Dental Healthcare Setups by Application of the Six Sigma Methodology: A Statistical Quality Improvement Technique.

PubMed

Akifuddin, Syed; Khatoon, Farheen

2015-12-01

Health care faces challenges due to complications, inefficiencies and other concerns that threaten the safety of patients. The purpose of his study was to identify causes of complications encountered after administration of local anaesthesia for dental and oral surgical procedures and to reduce the incidence of complications by introduction of six sigma methodology. DMAIC (Define, Measure, Analyse, Improve and Control) process of Six Sigma was taken into consideration to reduce the incidence of complications encountered after administration of local anaesthesia injections for dental and oral surgical procedures using failure mode and effect analysis. Pareto analysis was taken into consideration to analyse the most recurring complications. Paired z-sample test using Minitab Statistical Inference and Fisher's exact test was used to statistically analyse the obtained data. The p-value <0.05 was considered as significant value. Total 54 systemic and 62 local complications occurred during three months of analyse and measure phase. Syncope, failure of anaesthesia, trismus, auto mordeduras and pain at injection site was found to be most recurring complications. Cumulative defective percentage was 7.99 in case of pre-improved data and decreased to 4.58 in the control phase. Estimate for difference was 0.0341228 and 95% lower bound for difference was 0.0193966. p-value was found to be highly significant with p= 0.000. The application of six sigma improvement methodology in healthcare tends to deliver consistently better results to the patients as well as hospitals and results in better patient compliance as well as satisfaction.

Setting research priorities by applying the combined approach matrix.

PubMed

Ghaffar, Abdul

2009-04-01

Priority setting in health research is a dynamic process. Different organizations and institutes have been working in the field of research priority setting for many years. In 1999 the Global Forum for Health Research presented a research priority setting tool called the Combined Approach Matrix or CAM. Since its development, the CAM has been successfully applied to set research priorities for diseases, conditions and programmes at global, regional and national levels. This paper briefly explains the CAM methodology and how it could be applied in different settings, giving examples and describing challenges encountered in the process of setting research priorities and providing recommendations for further work in this field. The construct and design of the CAM is explained along with different steps needed, including planning and organization of a priority-setting exercise and how it could be applied in different settings. The application of the CAM are described by using three examples. The first concerns setting research priorities for a global programme, the second describes application at the country level and the third setting research priorities for diseases. Effective application of the CAM in different and diverse environments proves its utility as a tool for setting research priorities. Potential challenges encountered in the process of research priority setting are discussed and some recommendations for further work in this field are provided.

Revisiting Rossion and Pourtois with new ratings for automated complexity, familiarity, beauty, and encounter.

PubMed

Forsythe, Alex; Street, Nichola; Helmy, Mai

2017-08-01

Differences between norm ratings collected when participants are asked to consider more than one picture characteristic are contrasted with the traditional methodological approaches of collecting ratings separately for image constructs. We present data that suggest that reporting normative data, based on methodological procedures that ask participants to consider multiple image constructs simultaneously, could potentially confounded norm data. We provide data for two new image constructs, beauty and the extent to which participants encountered the stimuli in their everyday lives. Analysis of this data suggests that familiarity and encounter are tapping different image constructs. The extent to which an observer encounters an object predicts human judgments of visual complexity. Encountering an image was also found to be an important predictor of beauty, but familiarity with that image was not. Taken together, these results suggest that continuing to collect complexity measures from human judgments is a pointless exercise. Automated measures are more reliable and valid measures, which are demonstrated here as predicting human preferences.

A novel neural network based image reconstruction model with scale and rotation invariance for target identification and classification for Active millimetre wave imaging

NASA Astrophysics Data System (ADS)

Agarwal, Smriti; Bisht, Amit Singh; Singh, Dharmendra; Pathak, Nagendra Prasad

2014-12-01

Millimetre wave imaging (MMW) is gaining tremendous interest among researchers, which has potential applications for security check, standoff personal screening, automotive collision-avoidance, and lot more. Current state-of-art imaging techniques viz. microwave and X-ray imaging suffers from lower resolution and harmful ionizing radiation, respectively. In contrast, MMW imaging operates at lower power and is non-ionizing, hence, medically safe. Despite these favourable attributes, MMW imaging encounters various challenges as; still it is very less explored area and lacks suitable imaging methodology for extracting complete target information. Keeping in view of these challenges, a MMW active imaging radar system at 60 GHz was designed for standoff imaging application. A C-scan (horizontal and vertical scanning) methodology was developed that provides cross-range resolution of 8.59 mm. The paper further details a suitable target identification and classification methodology. For identification of regular shape targets: mean-standard deviation based segmentation technique was formulated and further validated using a different target shape. For classification: probability density function based target material discrimination methodology was proposed and further validated on different dataset. Lastly, a novel artificial neural network based scale and rotation invariant, image reconstruction methodology has been proposed to counter the distortions in the image caused due to noise, rotation or scale variations. The designed neural network once trained with sample images, automatically takes care of these deformations and successfully reconstructs the corrected image for the test targets. Techniques developed in this paper are tested and validated using four different regular shapes viz. rectangle, square, triangle and circle.

A methodology for successfully producing global translations of patient reported outcome measures for use in multiple countries.

PubMed

Two, Rebecca; Verjee-Lorenz, Aneesa; Clayson, Darren; Dalal, Mehul; Grotzinger, Kelly; Younossi, Zobair M

2010-01-01

The production of accurate and culturally relevant translations of patient reported outcome (PRO) measures is essential for the success of international clinical trials. Although there are many reports in publication regarding the translation of PRO measures, the techniques used to produce single translations for use in multiple countries (global translations) are not well documented. This article addresses this apparent lack of documentation and presents the methodology used to create global translations of the Chronic Liver Disease Questionnaire-Hepatitis C Virus (CLDQ-HCV). The challenges of creating a translation for use in multiple countries are discussed, and the criteria for a global translation project explained. Based on a thorough translation and linguistic validation methodology including a concept elaboration, multiple forward translations, two back translations, reviews by in-country clinicians and the instrument developer, pilot testing in each target country and multiple sets of proofreading, the key concept of the global translation methodology is consistent international harmonization, achieved through the involvement of linguists from each target country at every stage of the process. This methodology enabled the successful resolution of the translation issues encountered, and resulted in consistent translations of the CLDQ-HCV that were linguistically and culturally appropriate for all target countries.

Challenges in assessing food environments in northern and remote communities in Canada.

PubMed

Skinner, Kelly; Burnett, Kristin; Williams, Patricia; Martin, Debbie; Stothart, Christopher; LeBlanc, Joseph; Veeraraghavan, Gigi; Sheedy, Amanda

2016-06-09

Effective tools for retail food environments in northern and remote communities are lacking. This paper examines the challenges of conducting food environment assessments in northern and remote communities in Canada encountered during our experience with a food costing project. One of the goals of the Paying for Nutrition in the North project is to develop guidelines to improve current food costing tools for northern Canada. Paying for Nutrition illustrates the complex context of measuring food environments in northern and remote communities. Through the development of a food costing methodology guide to assess northern food environments, several contextual issues emerged, including retail store oligopolies in communities; the importance of assessing food quality; informal social food economies; and the challenge of costing the acquisition and consumption of land- and water-based foods. Food environment measures designed for northern and remote communities need to reflect the geographic context in which they are being employed and must include input from local residents.

Operational challenges in delivering CD4 diagnostics in sub-Saharan Africa.

PubMed

Thairu, L; Katzenstein, D; Israelski, D

2011-07-01

Access to reliable and low cost CD4 T-cell enumeration to stage illness and monitor anti-retroviral therapy remains elusive in resource-limited settings. We report challenges in delivering CD4 testing using the microcapillary Fluorescence-Activated Cell Sorter (FACS) methodology (Guava EasyCD4 instrument Guava Technologies, Hayward) in Burkina Faso and Zimbabwe. Resources, instruments, reagents, and training were provided to local laboratories within the existing infrastructure and data on CD4 were collected from routine laboratory testing. Challenges encountered included frequent instrument breakdown; poor manufacturer maintenance; difficulties in managing reagent stocks; high technician turnover; reliance on antiquated data management systems; redundant service provision; and lack of repeat testing in male HIV+ patients and in patients with higher CD4 counts after initial staging. While adopting newer, less expensive technologies such as fluorescent platforms and point of care tests can facilitate access to lower cost CD4 testing, our experience suggests that supply chain, corporate commitment to implementation, and community factors also require consideration.

The reporting characteristics and methodological quality of Cochrane reviews about health policy research.

PubMed

Xiu-xia, Li; Ya, Zheng; Yao-long, Chen; Ke-hu, Yang; Zong-jiu, Zhang

2015-04-01

The systematic review has increasingly become a popular tool for researching health policy. However, due to the complexity and diversity in the health policy research, it has also encountered more challenges. We set out the Cochrane reviews on health policy research as a representative to provide the first examination of epidemiological and descriptive characteristics as well as the compliance of methodological quality with the AMSTAR. 99 reviews were included by inclusion criteria, 73% of which were Implementation Strategies, 15% were Financial Arrangements and 12% were Governance Arrangements; involved Public Health (34%), Theoretical Exploration (18%), Hospital Management (17%), Medical Insurance (12%), Pharmaceutical Policy (9%), Community Health (7%) and Rural Health (2%). Only 39% conducted meta-analysis, and 49% reported being updates, and none was rated low methodological quality. Our research reveals that the quantity and quality of the evidence should be improved, especially Financial Arrangements and Governance Arrangements involved Rural Health, Health Care Reform and Health Equity, etc. And the reliability of AMSTAR needs to be tested in larger range in this field. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Methodological challenges in a study on falls in an older population of Cape Town, South Africa.

PubMed

Kalula, Sebastiana Z; Ferreira, Monica; Swingler, George H; Badri, Motasim; Sayer, Avan A

2017-09-01

Falls are a major cause of disability, morbidity and mortality in older persons, but have been under researched in developing countries. To describe challenges encountered in a community-based study on falls in a multi-ethnic population aged ≥65 years in a low-income setting. The study was conducted in four stages: A pilot study (n=105) to establish a sample size for the survey. An equipment validation study (n=118) to use for fall risk determination. A cross-sectional baseline (n=837) and a 12-month follow-up survey (n=632) to establish prevalence and risk factors for falls. Prevalence rate of 26.4% (95% CI 23.5-29.5%) and risk factors for recurrent falls: previous falls, self-reported poor mobility and dizziness were established. Adaptations to the gold standard prospective fall research study design were employed: 1) to gain access to the study population in three selected suburbs, 2) to perform assessments in a non-standardised setting, 3) to address subjects' poverty and low literacy levels, and high attrition of subjects and field workers. Studies on falls in the older population of low- to middle-income countries have methodological challenges. Adaptive strategies used in the Cape Town study and the research experience reported may be instructive for investigators planning similar studies in such settings.

The Challenges of Practitioner Research: A Comparative Study of Singapore and NSW

ERIC Educational Resources Information Center

Ellis, Neville; Loughland, Tony

2016-01-01

Practitioner research is considered an integral form of professional learning for teachers but in its implementation it will often encounter significant challenges. This qualitative comparative case-study of teachers in Singapore and NSW investigated the range of challenges they encountered during their work as practitioner researchers. The study…

Monitoring inter-group encounters in wilderness

Treesearch

Alan E. Watson; Rich Cronn; Neal A. Christensen

1998-01-01

Many managers face the challenge of monitoring rates of visitor encounters in wilderness. This study (1) provides estimates of encounter rates through use of several monitoring methods, (2) determines the relationship between the various measures of encounter rates, and (3) determines the relationship between various indirect predictors of encounter rates and actual...

Smartphone app design for the wireless control of a neuromuscular electrical stimulator device with integrated randomization allocation process for RCT applications.

PubMed

Sweeney, Dean; Quinlan, Leo R; OLaighin, Gearoid

2015-08-01

The use of NMES has evolved over the last five decades. Technological advancements have transformed these once complex systems into user-friendly devices with enhanced control functions, leading to new applications of NMES being investigated. The use of Randomized Control Trial (RCT) methodology in evaluating the effectiveness of new and existing applications of NMES is a demanding process adding time and cost to a translation into clinical practice. Poor quality trials may result in poor evidence of NMES effectiveness. In this paper some of the key challenges encountered in NMES clinical trials are identified with the aim of purposing a solution to address these challenges through the adoption of Smartphone technology. The design and evaluation of a smartphone application to provide automatic blind randomization control and facilitating the wireless temporal control of a portable Bluetooth enabled NMES is presented.

Promoting Conditional Use of Communication Skills for Learners With Complex Communication Needs: A Tutorial.

PubMed

Simacek, Jessica; Reichle, Joe; Byiers, Breanne J; Parker-McGowan, Quannah; Dimian, Adele F; Elmquist, Marianne

2018-05-03

Conditional use of communication skills refers to the ability of a learner to appropriately generalize and discriminate when, where, and how to communicate based on constant variation and shifts in environmental cues. We describe discrimination and generalization challenges encountered by learners with complex communication needs and ways in which these challenges are fostered through traditional communication intervention programming. We address arrangements in instruction that maximize the probability of learners acquiring the conditional use of new vocabulary and the modest instructional technology implemented when planning for generalization. We propose establishing well-discriminated and generalized use of new vocabulary items through the application of a general case instruction framework to communication intervention programming. We provide intervention methodology, including intervention steps for general case instruction, a plethora of functional examples, and graphic displays to assess and intervene to promote conditional use of communication skills for learners with complex communication needs.

Difficult medical encounters and job satisfaction - results of a cross sectional study with general practitioners in Germany.

PubMed

Goetz, Katja; Mahnkopf, Janis; Kornitzky, Anna; Steinhäuser, Jost

2018-05-09

In primary care 15% of patient encounters are perceived as challenging by general practitioners (GP). However it is unknown what impact these encounters have regarding job satisfaction. The aim of this study was to evaluate which encounters are perceived as challenging by German GPs and whether they were associated with job satisfaction. A total of 1538 questionnaires were sent to GPs in the federal state of Schleswig-Holstein, Germany. GPs should rate 14 medical conditions and 8 traits of patients on the perceived challenge using a Likert scale (1: 'not challenging at all' to 10: 'extremely challenging'). Job satisfaction was measured with the Warr-Cook-Wall job satisfaction scale. A linear regression analyses were used to explore potential associations between for the primary outcome variable 'overall job satisfaction'. Total response was 578 (38%). GPs perceived 16% of their patients as challenging. Psychiatric disorders such as somatization disorder (mean = 7.42), schizophrenia (mean = 6.83) and anxiety disorder (mean = 6.57) were ranked as high challenging while diabetes mellitus type 2 (mean = 4.87) and high blood pressure (mean = 3.22) were ranked as a rather low challenging condition. GPs were mostly satisfied with 'colleagues' (mean = 5.80) and mostly dissatisfied with their 'hours of work' (mean = 4.20). The linear regression analysis showed no association with challenging medical conditions and traits of patients but only with different aspects of job satisfaction concerning the outcome variable 'overall job satisfaction'. Especially psychiatric conditions are perceived as challenging the question arises, in what amount psychiatric competences are gained during the postgraduate specialty training in general practice and if GPs with a mandatory rotation in psychiatry perceive these conditions as less challenging. Interestingly this study indicates that challenging encounter in terms of challenging medical conditions and traits of patients do not affect GP's job satisfaction.

Role of Enhancing Visual Effects Education Delivery to Encounter Career Challenges in Malaysia

ERIC Educational Resources Information Center

Ng, Lynn-Sze

2017-01-01

Problem-based Learning (PBL) is one of the most effective methods of instruction that helps Visual Effects (VFX) students to be more adaptable at encountering career challenges in Malaysia. These challenges are; lack of several important requirements such as, the basic and fundamental knowledge of VFX concepts, the ability to understand real-world…

Reduction of Complications of Local Anaesthesia in Dental Healthcare Setups by Application of the Six Sigma Methodology: A Statistical Quality Improvement Technique

PubMed Central

Khatoon, Farheen

2015-01-01

Background Health care faces challenges due to complications, inefficiencies and other concerns that threaten the safety of patients. Aim The purpose of his study was to identify causes of complications encountered after administration of local anaesthesia for dental and oral surgical procedures and to reduce the incidence of complications by introduction of six sigma methodology. Materials and Methods DMAIC (Define, Measure, Analyse, Improve and Control) process of Six Sigma was taken into consideration to reduce the incidence of complications encountered after administration of local anaesthesia injections for dental and oral surgical procedures using failure mode and effect analysis. Pareto analysis was taken into consideration to analyse the most recurring complications. Paired z-sample test using Minitab Statistical Inference and Fisher’s exact test was used to statistically analyse the obtained data. The p-value <0.05 was considered as significant value. Results Total 54 systemic and 62 local complications occurred during three months of analyse and measure phase. Syncope, failure of anaesthesia, trismus, auto mordeduras and pain at injection site was found to be most recurring complications. Cumulative defective percentage was 7.99 in case of pre-improved data and decreased to 4.58 in the control phase. Estimate for difference was 0.0341228 and 95% lower bound for difference was 0.0193966. p-value was found to be highly significant with p= 0.000. Conclusion The application of six sigma improvement methodology in healthcare tends to deliver consistently better results to the patients as well as hospitals and results in better patient compliance as well as satisfaction. PMID:26816989

Outcomes of planetary close encounters - A systematic comparison of methodologies

NASA Technical Reports Server (NTRS)

Greenberg, Richard; Carusi, Andrea; Valsecchi, G. B.

1988-01-01

Several methods for estimating the outcomes of close planetary encounters are compared on the basis of the numerical integration of a range of encounter types. An attempt is made to lay the foundation for the development of predictive rules concerning the encounter outcomes applicable to the refinement of the statistical mechanics that apply to planet-formation and similar problems concerning planetary swarms. Attention is given to Oepik's (1976) formulation of the two-body approximation, whose predicted motion differs from the correct three-body behavior.

ASRS Reports on Wake Vortex Encounters

NASA Technical Reports Server (NTRS)

Connell, Linda J.; Taube, Elisa Ann; Drew, Charles Robert; Barclay, Tommy Earl

2010-01-01

ASRS is conducting a structured callback research project of wake vortex incidents reported to the ASRS at all US airports, as well as wake encounters in the enroute environment. This study has three objectives: (1) Utilize the established ASRS supplemental data collection methodology and provide ongoing analysis of wake vortex encounter reports; (2) Document event dynamics and contributing factors underlying wake vortex encounter events; and (3) Support ongoing FAA efforts to address pre-emptive wake vortex risk reduction by utilizing ASRS reporting contributions.

Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome: diagnostic and methodological challenges.

PubMed

Jeanes, Yvonne M; Reeves, Sue

2017-06-01

Women with polycystic ovary syndrome (PCOS) have a considerable risk of metabolic dysfunction. This review aims to present contemporary knowledge on obesity, insulin resistance and PCOS with emphasis on the diagnostic and methodological challenges encountered in research and clinical practice. Variable diagnostic criteria for PCOS and associated phenotypes are frequently published. Targeted searches were conducted to identify all available data concerning the association of obesity and insulin resistance with PCOS up to September 2016. Articles were considered if they were peer reviewed, in English and included women with PCOS. Obesity is more prevalent in women with PCOS, but studies rarely reported accurate assessments of adiposity, nor split the study population by PCOS phenotypes. Many women with PCOS have insulin resistance, though there is considerable variation reported in part due to not distinguishing subgroups known to have an impact on insulin resistance as well as limited methodology to measure insulin resistance. Inflammatory markers are positively correlated with androgen levels, but detailed interactions need to be identified. Weight management is the primary therapy; specific advice to reduce the glycaemic load of the diet and reduce the intake of pro-inflammatory SFA and advanced glycation endproducts have provided promising results. It is important that women with PCOS are educated about their increased risk of metabolic complications in order to make timely and appropriate lifestyle modifications. Furthermore, well-designed robust studies are needed to evaluate the mechanisms behind the improvements observed with dietary interventions.

Transdisciplinary translational behavioral (TDTB) research: opportunities, barriers, and innovations.

PubMed

Czajkowski, Susan M; Lynch, Minda R; Hall, Kara L; Stipelman, Brooke A; Haverkos, Lynne; Perl, Harold; Scott, Marcia S; Shirley, Mariela C

2016-03-01

The translation of basic behavioral science discoveries into practical strategies represents a promising approach to developing more effective preventive interventions to improve health. Since translational research inevitably involves making use of diverse perspectives from multiple disciplines, it is best conducted as a transdisciplinary enterprise. In this paper, we discuss current strategies used by NIH to support transdisciplinary translational behavioral (TDTB) research, summarize successful efforts, and highlight challenges encountered in conducting such work (ranging from conceptual to organizational to methodological). Using examples from NIH-funded projects we illustrate the potential benefits of, and barriers to, pursuing this type of research and discuss next steps and potential future directions for NIH-supported TDTB research.

The Challenges Faced by Eastern European Students within a 16-19 Education Setting in the United Kingdom

ERIC Educational Resources Information Center

Babalola, Shade

2015-01-01

To examine the challenges encountered by Eastern European students within a sixth form college in the United Kingdom. This paper aims to consider the difficulties encountered by this particular ethnic group examining the impact the challenges may have on their performance, success and achievement. This paper will also highlight equality and…

Fortuitous phenomena: on complexity, pragmatic randomised controlled trials, and knowledge for evidence-based practice.

PubMed

Thompson, Carl

2004-01-01

Many of the interventions that nurses develop and implement are in themselves complex and have to operate in situations of irreducible complexity and uncertainty. This article argues that the primary means of generating knowledge for the evidence-based deployment of complex interventions should be the pragmatic randomised controlled trial. Randomised controlled trials represent the only research design to adequately deal with that which we know and (far more importantly) that which we do not. Using the example of practice development as an exemplar for complexity, and drawing on the objections often voiced as a response to calls to make use of randomised controlled trials in nursing and nursing research, the article presents a developmental framework and some methodological solutions to problems often encountered. Randomised controlled trials, whilst undoubtedly methodologically and strategically challenging, offer the most robust basis for developing primary research knowledge on the effects of complex interventions in nursing and their active components.

Bioinspired Methodology for Artificial Olfaction

PubMed Central

Raman, Baranidharan; Hertz, Joshua L.; Benkstein, Kurt D.; Semancik, Steve

2008-01-01

Artificial olfaction is a potential tool for noninvasive chemical monitoring. Application of “electronic noses” typically involves recognition of “pretrained” chemicals, while long-term operation and generalization of training to allow chemical classification of “unknown” analytes remain challenges. The latter analytical capability is critically important, as it is unfeasible to pre-expose the sensor to every analyte it might encounter. Here, we demonstrate a biologically inspired approach where the recognition and generalization problems are decoupled and resolved in a hierarchical fashion. Analyte composition is refined in a progression from general (e.g., target is a hydrocarbon) to precise (e.g., target is ethane), using highly optimized response features for each step. We validate this approach using a MEMS-based chemiresistive microsensor array. We show that this approach, a unique departure from existing methodologies in artificial olfaction, allows the recognition module to better mitigate sensor-aging effects and to better classify unknowns, enhancing the utility of chemical sensors for real-world applications. PMID:18855409

The Double Flybys of the Cassini Mission: Navigation Challenges and Lessons Learned

NASA Technical Reports Server (NTRS)

Wagner, Sean; Buffington, Brent

2014-01-01

Since 2004, the Cassini spacecraft has flown by Titan and other Saturn moons numerous times, successfully accomplishing its 100th targeted encounter of Titan in March 2014. The navigation of Cassini is challenging, even more so with "double flybys," two encounters separated by at most a few days. Because of this tight spacing, there is not enough time for a maneuver in between. Additionally, maneuvers prior to a double flyby only target one of the two encounters. This paper discusses the challenges faced by the Cassini Navigation Team with each double flyby, as well as lessons learned during operational support of each dual encounter. The strengths and weaknesses of the targeting strategies considered for each double flyby are also detailed, by comparing downstream ?V costs and changes to the non-targeted flyby conditions.

Neuropsychological assessment of refugees: Methodological and cross-cultural barriers.

PubMed

Veliu, Bahrie; Leathem, Janet

2017-01-01

Cross-cultural research in neuropsychological assessment has primarily focused on Hispanic and African American populations. Less is known about the impact of language, culture, education, socioeconomic factors, and life experiences on assessment for other cultural groups. We highlight the methodological and cross-cultural barriers encountered at each stage of the neuropsychological assessment of Arabic- and Burmese-speaking refugees, who were culturally and linguistically diverse (CALD). A total of 18 refugees (13 men/five women; in their 20-50s) who were victims of torture in their countries of origin, some with post-traumatic stress disorder (PTSD) and now residents in New Zealand, were seen for neuropsychological assessment. Measures were officially translated, back translated, and administered with the assistance of professional interpreters. Multiple challenges arose in terms of administration (e.g., use of interpreters, interactions with the tester, assessment environment, assessment experience, and motivation), scoring, and interpretation (e.g., age appropriate scoring, estimation of prior function, estimation of brain injury severity, obtaining collateral information), the tests themselves, and ecological validity. There are more challenges in the neuropsychological assessment of people who are CALD than can be managed by adhering to current guidelines. The best approach is to find a balance between maintaining assessment integrity and working creatively and sensitively with this group.

Overcoming the Challenges of Unstructured Data in Multisite, Electronic Medical Record-based Abstraction.

PubMed

Polnaszek, Brock; Gilmore-Bykovskyi, Andrea; Hovanes, Melissa; Roiland, Rachel; Ferguson, Patrick; Brown, Roger; Kind, Amy J H

2016-10-01

Unstructured data encountered during retrospective electronic medical record (EMR) abstraction has routinely been identified as challenging to reliably abstract, as these data are often recorded as free text, without limitations to format or structure. There is increased interest in reliably abstracting this type of data given its prominent role in care coordination and communication, yet limited methodological guidance exists. As standard abstraction approaches resulted in substandard data reliability for unstructured data elements collected as part of a multisite, retrospective EMR study of hospital discharge communication quality, our goal was to develop, apply and examine the utility of a phase-based approach to reliably abstract unstructured data. This approach is examined using the specific example of discharge communication for warfarin management. We adopted a "fit-for-use" framework to guide the development and evaluation of abstraction methods using a 4-step, phase-based approach including (1) team building; (2) identification of challenges; (3) adaptation of abstraction methods; and (4) systematic data quality monitoring. Unstructured data elements were the focus of this study, including elements communicating steps in warfarin management (eg, warfarin initiation) and medical follow-up (eg, timeframe for follow-up). After implementation of the phase-based approach, interrater reliability for all unstructured data elements demonstrated κ's of ≥0.89-an average increase of +0.25 for each unstructured data element. As compared with standard abstraction methodologies, this phase-based approach was more time intensive, but did markedly increase abstraction reliability for unstructured data elements within multisite EMR documentation.

The Challenges Faced by New Science Teachers in Saudi Arabia

NASA Astrophysics Data System (ADS)

Alsharari, Salman

Growing demand for science teachers in the Kingdom of Saudi Arabia, fed by increasing numbers of public school students, is forcing the Saudi government to attract, recruit and retain well-qualified science teachers. Beginning science teachers enter the educational profession with a massive fullfilment and satisfaction in their roles and positions as teachers to educating children in a science classroom. Nevertheless, teachers, over their early years of practice, encounter numerous challenges to provide the most effective science instruction. Therefore, the current study was aimed to identify academic and behavioral classroom challenges faced by science teachers in their first three years of teaching in the Kingdom of Saudi Arabia. In addition, new science teacher gender, school level and years of teaching experience differences in perceptions of the challenges that they encountered at work were analyzed. The present study also investigated various types of support that new science teachers may need to overcome academic and behavioral classroom challenges. In order to gain insights about ways to adequately support novice science teachers, it was important to examine new science teachers' beliefs, ideas and perceptions about effective science teaching. Three survey questionnaires were developed and distributed to teachers of both sexes who have been teaching science subjects, for less than three years, to elementary, middle and high school students in Al Jouf public schools. A total of 49 novice science teachers responded to the survey and 9 of them agreed to participate voluntarily in a face-to-face interview. Different statistical procedures and multiple qualitative methodologies were used to analyze the collected data. Findings suggested that the top three academic challenges faced by new science teachers were: poor quality of teacher preparation programs, absence of appropriate school equipment and facilities and lack of classroom materials and instructional supplies. Moreover, excessive student absenteeism, student readiness to learn science and student lack of interest in science were the three most behavioral challenges encountered by beginning science teachers in the Kingdom of Saudi Arabia. Results also indicated that the perceptions of academic and behavioral classroom challenges may vary according to new science teacher gender, school level and years of teaching experience. More importantly, to become more effective science teachers, novice science teachers are expecting to receive more and better support from their schools. School principals and administrators should provide opportunities for beginning science teachers to attend effective new teacher orientation programs, use complete and well-developed curriculum materials with detailed sequence of teaching procedures, help in dealing with classroom management, and opportunities to participate in successful mentoring programs, coherent in-service training programs and regular professional development programs. Implications for Saudi Arabia government and policy makers, school principals and administrators, students and their parents were discussed and recommendations were made.

Cleaning and Disinfection of Bacillus cereus Biofilm.

PubMed

Deal, Amanda; Klein, Dan; Lopolito, Paul; Schwarz, John Spencer

2016-01-01

Methodology has been evolving for the testing of disinfectants against bacterial single-species biofilms, as the difficulty of biofilm remediation continues to gain much-needed attention. Bacterial single-species biofilm contamination presents a real risk to good manufacturing practice-regulated industries. However, mixed-species biofilms and biofilms containing bacterial spores remain an even greater challenge for cleaning and disinfection. Among spore-forming microorganisms frequently encountered in pharmaceutical manufacturing areas, the spores of Bacillus cereus are often determined to be the hardest to disinfect and eradicate. One of the reasons for the low degree of susceptibility to disinfection is the ability of these spores to be encapsulated within an exopolysachharide biofilm matrix. In this series of experiments, we evaluated the disinfectant susceptibility of B. cereus biofilms relative to disassociated B. cereus spores and biofilm from a non-spore-forming species. Further, we assessed the impact that pre-cleaning has on increasing that susceptibility. Methodology has been evolving for the testing of disinfectants against bacterial single-species biofilms, as the difficulty of biofilm remediation continues to gain much-needed attention. Bacterial single-species biofilm contamination presents a real risk to good manufacturing practice-regulated industries. However, mixed-species biofilms and biofilms containing bacterial spores remain an even greater challenge for cleaning and disinfection. Among spore-forming microorganisms frequently encountered in pharmaceutical manufacturing areas, the spores of Bacillus cereus are often determined to be the hardest to disinfect and eradicate. One of the reasons for the low degree of susceptibility to disinfection is the ability of these spores to be encapsulated within an exopolysachharide biofilm matrix. In this series of experiments, we evaluated the disinfectant susceptibility of B. cereus biofilms relative to disassociated B. cereus spores and biofilm from a non-spore-forming species. Further, we assessed the impact that pre-cleaning has on increasing that susceptibility. © PDA, Inc. 2016.

Methodological Problems Encountered in the Review of Research in Science Teaching

ERIC Educational Resources Information Center

Lawlor, E. P.; Lawlor, F. X.

1972-01-01

Describes the difficulties encountered in selecting material to be included in the reviews of science education research in the Curtis Series'' published by the Columbia Teachers' College Press. Presents evidence outlining the weaknesses of using a jury'' to determine so-called superior research. (AL)

Challenges and Ideas from a Research Program on High Quality, Evidence-Based Practice in School Mental Health

PubMed Central

Weist, Mark D.; Youngstrom, Eric A.; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

2013-01-01

Objective Reviews the progression of a research program designed to develop, implement and study the implementation of “achievable” evidence-based practices (EBPs) in schools. Reviews challenges encountered and ideas to overcome them to enhance this avenue of research. Method Presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on Personal Wellness. In both studies primary aims focused on changes in clinician attitudes and behavior, including the delivery of high quality, evidence-based practices and secondary aims focused on student level impacts. Results A number of challenges, many not reported in the literature are reviewed, and ideas for overcoming them are presented. Conclusions Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health (SMH) services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians. PMID:24063310

Challenges and ideas from a research program on high-quality, evidence-based practice in school mental health.

PubMed

Weist, Mark D; Youngstrom, Eric A; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly

2014-01-01

This article reviews the progression of a research program designed to develop, implement, and study the implementation of "achievable" evidence-based practices (EBPs) in schools. We review challenges encountered and ideas to overcome them to enhance this avenue of research. The article presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on personal wellness. In both studies, primary aims focused on changes in clinician attitudes and behavior, including the delivery of high-quality EBPs and secondary aims focused on student-level impacts. A number of challenges, many not reported in the literature, are reviewed, and ideas for overcoming them are presented. Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians.

Enhancing Collaborative and Meaningful Language Learning Through Concept Mapping

NASA Astrophysics Data System (ADS)

Marriott, Rita De Cássia Veiga; Torres, Patrícia Lupion

This chapter aims to investigate new ways of foreign-language teaching/learning via a study of how concept mapping can help develop a student's reading, writing and oral skills as part of a blended methodology for language teaching known as LAPLI (Laboratorio de Aprendizagem de LInguas: The Language Learning Lab). LAPLI is a student-centred and collaborative methodology which encourages students to challenge their limitations and expand their current knowledge whilst developing their linguistic and interpersonal skills. We explore the theories that underpin LAPLI and detail the 12 activities comprising its programme with specify reference to the use of "concept mapping". An innovative table enabling a formative and summative assessment of the concept maps is formulated. Also presented are some of the qualitative and quantitative results achieved when this methodology was first implemented with a group of pre-service students studying for a degree in English and Portuguese languages at the Catholic University of Parana (PUCPR) in Brazil. The contribution of concept mapping and LAPLI to an under standing of language learning along with a consideration of the difficulties encountered in its implementation with student groups is discussed and suggestions made for future research.

Enhancing Collaborative and Meaningful Language Learning through Concept Mapping

NASA Astrophysics Data System (ADS)

de Cássia Veiga Marriott, Rita; Torres, Patrícia Lupion

This chapter aims to investigate new ways of foreign-language teaching/learning via a study of how concept mapping can help develop a student's reading, writing and oral skills as part of a blended methodology for language teaching known as LAPLI (Laboratorio de Aprendizagem de LInguas: The Language Learning Lab). LAPLI is a student-centred and collaborative methodology which encourages students to challenge their limitations and expand their current knowledge whilst developing their linguistic and interpersonal skills. We explore the theories that underpin LAPLI and detail the 12 activities comprising its programme with specify reference to the use of “concept mapping”. An innovative table enabling a formative and summative assessment of the concept maps is formulated. Also presented are some of the qualitative and quantitative results achieved when this methodology was first implemented with a group of pre-service students studying for a degree in English and Portuguese languages at the Catholic University of Parana (PUCPR) in Brazil. The contribution of concept mapping and LAPLI to an understanding of language learning along with a consideration of the difficulties encountered in its implementation with student groups is discussed and suggestions made for future research.

Challenges Encountered by 17 Autistic Young Adults in Hong Kong

ERIC Educational Resources Information Center

Wong, Shui-wai

2017-01-01

The self-portrayals of 17 young persons with autism spectrum disorder reveal the challenges encountered by them, including study problems, inter-personal relationships, being bullied by classmates at school, discrimination by the public in general and teachers, social workers, and peers in particular, obstacles to post-secondary education,…

Supervision Challenges Encountered during Kenyan University Students' Practicum Attachment

ERIC Educational Resources Information Center

Kathuri-Ogola, Lucy; VanLeeuwen, Charlene; Kabaria-Muriithi, Joan; Weeks, Lori E.; Kieru, Jane; Ndayala, Phoebe

2015-01-01

There is little published research that examines the supervision experience of field attachment supervisors in Kenya. In this study, we identify the challenges encountered by field supervisors during student field attachments with community organizations. Fifteen organizations that had hosted third year students from the Department of Community…

Planning strategies for the avoidance of pitfalls in intervention research.

PubMed

Pruitt, R H; Privette, A B

2001-08-01

With the exception of large clinical trials, few studies in nursing and other social sciences test interventions. The discipline of nursing needs to maintain a full range of research designs for continued knowledge development. Intervention research presents unique opportunities and challenges for the novice as well as the seasoned researcher. Some of these methodological challenges include the complex nature of human subjects and interventions, including many factors that interfere with the study variables. Preliminary studies often reveal challenges that may not always be predicted or reflected in research texts. These challenges may be as important as the study results for success in future research efforts. Difficulties encountered in intervention research and suggested strategies for maintaining the integrity of the study are addressed. These challenges include maintaining an adequate sample size, intervention demands, measuring variables, timing issues, and experiencing unexpected events. Strategies presented include the importance of extensive planning, minimizing subject expectations and rewarding efforts, attention to control group members, incorporating retention strategies, expanding knowledge of variables and the study population, preliminary studies as well as anticipating unexpected events. The need for enhanced communication among nurse researchers, educators and clinicians is addressed. In the current health care arena, nurse researchers must understand organizational dynamics and marketing strategies. Collaborative research efforts can increase the visibility of nursing research as well as funding opportunities.

Helping Students Navigate Faith Challenges in the Biblical Studies Classroom

ERIC Educational Resources Information Center

Sharp, Carolyn J.; Clark-Soles, Jaime

2012-01-01

What happens when students encounter the academic study of the Bible in the seminary or undergraduate classroom? Does a teacher have a responsibility to help students navigate challenges to Christian faith that might arise? What pedagogical problems and opportunities does this encounter present? How does this issue manifest differently in…

Identifying the Ethical Challenges Encountered by Information Technology Professionals Working within the Nevada Casino Industry

ERIC Educational Resources Information Center

Essig, Michael R.

2014-01-01

A thematic analysis qualitative study was used to identify the unethical challenges encountered by Information Technology (IT) professionals working within the Nevada casino industry. Fourteen current and former IT leaders working or who worked in the Nevada casino industry were interviewed. Using thematic analysis, nine themes regarding ethical…

Acoustics outreach program for the deaf

NASA Astrophysics Data System (ADS)

Vongsawad, Cameron T.; Berardi, Mark L.; Whiting, Jennifer K.; Lawler, M. Jeannette; Gee, Kent L.; Neilsen, Tracianne B.

2016-03-01

The Hear and See methodology has often been used as a means of enhancing pedagogy by focusing on the two strongest learning senses, but this naturally does not apply to deaf or hard of hearing students. Because deaf students' prior nonaural experiences with sound will vary significantly from those of students with typical hearing, different methods must be used to build understanding. However, the sensory-focused pedagogical principle can be applied in a different way for the Deaf by utilizing the senses of touch and sight, called here the ``See and Feel'' method. This presentation will provide several examples of how acoustics demonstrations have been adapted to create an outreach program for a group of junior high students from a school for the Deaf and discuss challenges encountered.

Confronting Challenges in Intervention Research with Ethnically Diverse Older Adults: The USC Well Elderly II Trial

PubMed Central

Jackson, Jeanne; Mandel, Deborah; Blanchard, Jeanine; Carlson, Mike; Cherry, Barbara; Azen, Stanley; Chou, Chih-Ping; Jordan-Marsh, Maryalice; Forman, Todd; White, Brett; Granger, Douglas; Knight, Bob; Clark, Florence

2011-01-01

Background Community-dwelling older adults are at risk for declines in physical health, cognition, and psychosocial well-being. However, their enactment of active and health-promoting lifestyles can reduce such declines. Purpose The purpose of this article is to describe the USC Well Elderly II study, a randomized clinical trial designed to test the effectiveness of a healthy lifestyle program for elders, and document how various methodological challenges were addressed during the course of the trial. Methods In the study, 460 ethnically diverse elders recruited from a variety of sites in the urban Los Angeles area were enrolled in a randomized experiment involving a crossover design component. Within either the first or second six month phase of their study involvement, each elder received a lifestyle intervention designed to improve a variety of aging outcomes. At 4–5 time points over an 18–24 month interval, the research participants were assessed on measures of healthy activity, coping, social support, perceived control, stress-related biomarkers, perceived physical health, psychosocial well-being, and cognitive functioning to test the effectiveness of the intervention and document the process mechanisms responsible for its effects. Results The study protocol was successfully implemented, including the enrollment of study sites, the recruitment of 460 older adults, administration of the intervention, adherence to the plan for assessment, and establishment of a large computerized data base. Limitations Methodological challenges were encountered in the areas of site recruitment, participant recruitment, testing, and intervention delivery. Conclusions The completion of clinical trials involving elders from numerous local sites requires careful oversight and anticipation of threats to the study design that stem from: (a) social situations that are particular to specific study sites; and (b) physical, functional, and social challenges pertaining to the elder population. PMID:19254939

Confronting challenges in intervention research with ethnically diverse older adults: the USC Well Elderly II Trial.

PubMed

Jackson, Jeanne; Mandel, Deborah; Blanchard, Jeanine; Carlson, Mike; Cherry, Barbara; Azen, Stanley; Chou, Chih-Ping; Jordan-Marsh, Maryalice; Forman, Todd; White, Brett; Granger, Douglas; Knight, Bob; Clark, Florence

2009-02-01

Community-dwelling older adults are at risk for declines in physical health, cognition, and psychosocial well-being. However, their enactment of active and health-promoting lifestyles can reduce such declines. The purpose of this article is to describe the USC Well Elderly II study, a randomized clinical trial designed to test the effectiveness of a healthy lifestyle program for elders, and document how various methodological challenges were addressed during the course of the trial. In the study, 460 ethnically diverse elders recruited from a variety of sites in the urban Los Angeles area were enrolled in a randomized experiment involving a crossover design component. Within either the first or second 6-month phase of their study involvement, each elder received a lifestyle intervention designed to improve a variety of aging outcomes. At 4-5 time points over an 18-24 month interval, the research participants were assessed on measures of healthy activity, coping, social support, perceived control, stress-related biomarkers, perceived physical health, psychosocial well-being, and cognitive functioning to test the effectiveness of the intervention and document the process mechanisms responsible for its effects. The study protocol was successfully implemented, including the enrollment of study sites, the recruitment of 460 older adults, administration of the intervention, adherence to the plan for assessment, and establishment of a large computerized data base. Methodological challenges were encountered in the areas of site recruitment, participant recruitment, testing, and intervention delivery. The completion of clinical trials involving elders from numerous local sites requires careful oversight and anticipation of threats to the study design that stem from: (a) social situations that are particular to specific study sites; and (b) physical, functional, and social challenges pertaining to the elder population.

Systematic review of factors affecting driving and motor vehicle transportation among people with autism spectrum disorder.

PubMed

Lindsay, Sally

2017-05-01

This systematic review is to critically appraise the literature on factors affecting driving and motor vehicle transportation experiences of people with autism spectrum disorders (ASD) and to provide insight into future directions for research. Systematic searches of eight databases identified 22 studies meeting our inclusion criteria. These studies were analysed in terms of the characteristics of the participants, methodology, results of the study and quality of the evidence. Among the 22 studies, 2919 participants (364 individuals with ASD; 2555 parents of youth with ASD; mean age of person with ASD = 17.3) were represented, across six countries. Studies (n = 13) focused on factors affecting driving, including challenges in obtaining a licence, driving confidence, driving behaviours and strategies to improve driving skills. In regards to factors related to public and/or school transportation, nine studies explored rates of transportation use, access, cost and safety. Our findings highlight several gaps in the research and an urgent need for further transportation-related training and supports for people with ASD. Implications for rehabilitation Many people with ASD encounter challenges in obtaining a driver's licence, driving confidence and driving performance compared to those without ASD. Several strategies can be useful when teaching people with ASD to drive including direct communication, encouraging coping mechanisms, breaking down tasks and providing regular and consistent driving lessons. Clinicians and educators should advocate for further transportation-related training and supports for people with ASD. More research is needed from the perspective of people with ASD to understand their experiences and the particular challenges that they encounter in obtaining a licence and navigating public transportation.

Researching Children's Rights in Education: Sociology of Childhood Encountering Educational Theory

ERIC Educational Resources Information Center

Quennerstedt, Ann; Quennerstedt, Mikael

2014-01-01

This paper aims to explore and develop a theoretical approach for children's rights research in education formed through an encounter between the sociology of childhood and John Dewey's educational theory. The interest is mainly methodological, in the sense that the primary ambition of the investigation is to suggest a fruitful and useful…

Entering a Crack: An Encounter with Gossip

ERIC Educational Resources Information Center

Henderson, Linda

2014-01-01

In this paper, I enter a crack to think otherwise about the concept "gossip". Drawing on previous scholarship engaging with Deleuzian concepts to inform research methodologies, this paper builds on this body of work. Following Deleuze and Guattari, the paper undertakes a mapping of gossip, subsequent to an encounter with a crack.…

The Methodological Benefits of Social Media: "Studying Up" in Brazil in the Facebook Age

ERIC Educational Resources Information Center

Straubhaar, Rolf

2015-01-01

While conducting research on the organizational cultures of elite nonprofit organizations in Rio de Janeiro, the author encountered many access issues identified in the current literature: in particular, difficulty in encountering research subjects due to the transitional nature of educational nonprofits and the role of secretaries and…

Pooling Data from Multiple Longitudinal Studies: The Role of Item Response Theory in Integrative Data Analysis

PubMed Central

Curran, Patrick J.; Hussong, Andrea M.; Cai, Li; Huang, Wenjing; Chassin, Laurie; Sher, Kenneth J.; Zucker, Robert A.

2010-01-01

There are a number of significant challenges encountered when studying development over an extended period of time including subject attrition, changing measurement structures across group and developmental period, and the need to invest substantial time and money. Integrative data analysis is an emerging set of methodologies that overcomes many of the challenges of single sample designs through the pooling of data drawn from multiple existing developmental studies. This approach is characterized by a host of advantages, but this also introduces several new complexities that must be addressed prior to broad adoption by developmental researchers. In this paper we focus on methods for fitting measurement models and creating scale scores using data drawn from multiple longitudinal studies. We present findings from the analysis of repeated measures of internalizing symptomatology that were pooled from three existing developmental studies. We describe and demonstrate each step in the analysis and we conclude with a discussion of potential limitations and directions for future research. PMID:18331129

Diffuse-Interface Modelling of Flow in Porous Media

NASA Astrophysics Data System (ADS)

Addy, Doug; Pradas, Marc; Schmuck, Marcus; Kalliadasis, Serafim

2016-11-01

Multiphase flows are ubiquitous in a wide spectrum of scientific and engineering applications, and their computational modelling often poses many challenges associated with the presence of free boundaries and interfaces. Interfacial flows in porous media encounter additional challenges and complexities due to their inherently multiscale behaviour. Here we investigate the dynamics of interfaces in porous media using an effective convective Cahn-Hilliard (CH) equation recently developed in from a Stokes-CH equation for microscopic heterogeneous domains by means of a homogenization methodology, where the microscopic details are taken into account as effective tensor coefficients which are given by a Poisson equation. The equations are decoupled under appropriate assumptions and solved in series using a classic finite-element formulation with the open-source software FEniCS. We investigate the effects of different microscopic geometries, including periodic and non-periodic, at the bulk fluid flow, and find that our model is able to describe the effective macroscopic behaviour without the need to resolve the microscopic details.

Multiscale Phenomena in the Solid-Liquid Transition State of a Granular Material: Analysis and Modelling of Dense Granular Materials

DTIC Science & Technology

2011-09-26

most challenging to characterize and model of the gamut of granular behaviour encountered in practice. In particular, it exhibits self-organized...is intrinsically multiscale and is arguably one of, if not, the most challenging to characterize and model of the gamut of granular behaviour...the most challenging to characterize and model of the gamut of granular behaviour encountered in practice. In particular, it exhibits self-organized

Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

PubMed

Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

2016-11-01

Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

Web-based versus face-to-face interprofessional team encounters with standardized patients.

PubMed

Lempicki, Kelly A; Holland, Christine S

2018-03-01

Challenges exist in developing interprofessional education (IPE) activities including coordinating schedules and obtaining appropriate space for teams to work. Virtual worlds have been explored as a means to overcome some of these challenges. We sought to develop a web-based interprofessional team interaction with a standardized patient (SP), as compared to a face-to-face SP interaction, focusing on the competency area of interprofessional communication. Interprofessional teams of students were randomized to complete a web-based or face-to-face SP encounter. The web-based encounter was conducted via video conference that students accessed using their own electronic device. Interprofessional communication was evaluated by faculty observers and the SPs. Participants of the web-based encounter also completed a perceptions questionnaire. Interprofessional communication was rated as average/above average by the authors and SPs. Perceptions of the web-based encounter were mixed with not all students willing to complete such an encounter again despite finding it enjoyable and a positive learning experience. The need for adequate preparation was identified, including the opportunity to review the patient case before the encounter. The web-based SP encounter afforded students the opportunity to utilize communication technology to provide patient-centered care while collaborating as an interprofessional team. Video conferencing presents an opportunity to bypass some logistical challenges in scheduling IPE experiences and can be implemented as a co-curricular activity, avoiding course revisions. Additional studies are needed to further explore student and patient perspectives and clarify when, and with what level of trainees, the experiences are most valuable. Copyright © 2017 Elsevier Inc. All rights reserved.

Users and uses of Landsat 8 satellite imagery—2014 survey results

USGS Publications Warehouse

Miller, Holly M.

2016-04-18

To explore the effect of the availability of Landsat 8 imagery on Landsat imagery use in general, established users (those who had consistently used Landsat imagery both before and after Landsat 8 imagery became available) using Landsat 8 imagery were asked about changes in the amount of Landsat imagery they used. The majority of established users using Landsat 8 imagery (60 percent) reported an average increase of 51 percent in the number of scenes obtained after Landsat 8 imagery became available. Landsat 8 users were asked if they had encountered challenges in using Landsat 8 whereas non-Landsat 8 users were asked if such challenges had played a role in why they were not using Landsat 8 imagery. Although many users did not encounter challenges when using or trying to use Landsat 8 data, slightly less than 30 percent did encounter issues with processing the data to a usable point. The most common issue reported was not being able to create or have access to a surface reflectance corrected product. Other challenges were related to the file sizes of images being too large to download, store, or analyze. There were no statistically significant differences between Landsat 8 and non-Landsat 8 users in terms of challenges encountered when using or trying to use the imagery, which indicates that users were not unduly discouraged by the challenges they may have encountered. When asked about potential consequences of not using Landsat 8, more than half of the non-Landsat 8 users did not report detrimental effects on their work from not using the imagery. Of those who did report detrimental effects, decreased quality of work, decreased scope of work, and increased time spent on work were the most common.   

Development of a meta-algorithm for guiding primary care encounters for patients with multimorbidity using evidence-based and case-based guideline development methodology.

PubMed

Muche-Borowski, Cathleen; Lühmann, Dagmar; Schäfer, Ingmar; Mundt, Rebekka; Wagner, Hans-Otto; Scherer, Martin

2017-06-22

The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures. Primary care. The meta-algorithm was developed in six steps:1. Designing 10 case vignettes of patients with multimorbidity (common, epidemiologically confirmed disease patterns and/or particularly challenging health care needs) in a multidisciplinary workshop.2. Based on the main diagnoses, a systematic guideline synopsis of evidence-based and consensus-based clinical practice guidelines was prepared. The recommendations were prioritised according to the clinical and psychosocial characteristics of the case vignettes.3. Case vignettes along with the respective guideline recommendations were validated and specifically commented on by an external panel of practicing general practitioners (GPs).4. Guideline recommendations and experts' opinions were summarised as case specific management recommendations (N-of-one guidelines).5. Healthcare preferences of patients with multimorbidity were elicited from a systematic literature review and supplemented with information from qualitative interviews.6. All N-of-one guidelines were analysed using pattern recognition to identify common decision nodes and care elements. These elements were put together to form a generic meta-algorithm. The resulting meta-algorithm reflects the logic of a GP's encounter of a patient with multimorbidity regarding decision-making situations, communication needs and priorities. It can be filled with the complex problems of individual patients and hereby offer guidance to the practitioner. Contrary to simple, symptom-oriented algorithms, the meta-algorithm illustrates a superordinate process that permanently keeps the entire patient in view. The meta-algorithm represents the back bone of the multimorbidity guideline of the German College of General Practitioners and Family Physicians. This article presents solely the development phase; the meta-algorithm needs to be piloted before it can be implemented. © 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.

Cross-cultural adaptation and translation of a quality of life tool for new mothers: a methodological and experiential account from six countries.

PubMed

Symon, Andrew; Nagpal, Jitender; Maniecka-Bryła, Irena; Nowakowska-Głąb, Agata; Rashidian, Arash; Khabiri, Roghayeh; Mendes, Isabel; Pinheiro, Ana Karina Bezerra; de Oliveira, Mirna Fontenele; Wu, Liping

2013-04-01

To examine the challenges and solutions encountered in the translation and cross-cultural adaptation of an English language quality of life tool in India, China, Iran, Portugal, Brazil, and Poland. Those embarking on research involving translation and cross-cultural adaptation must address certain practical and conceptual issues. These include instrument choice, linguistic factors, and cultural or philosophical differences, which may render an instrument inappropriate, even when expertly translated. Publication bias arises when studies encountering difficulties do not admit to these, or are not published at all. As an educative guide to the potential pitfalls involved in the cross-cultural adaptation process, this article reports the conceptual, linguistic, and methodological experiences of researchers in six countries, who translated and adapted the Mother-Generated Index, a quality of life tool originally developed in English. Principal investigator experience from six stand-alone studies (two published) ranging from postgraduate research to citywide surveys. DISCUSSION/IMPLICATIONS FOR NURSING: This analysis of a series of stand-alone cross-cultural studies provides lessons about how conceptual issues, such as the uniqueness of perceived quality of life and the experience of new motherhood, can be addressed. This original international approach highlights practical lessons relating to instrument choice, and the resources available to researchers with different levels of experience. Although researchers may be confident of effective translation, conceptual and practical difficulties may be more problematic. Instrument choice is crucial. Researchers must negotiate adequate resources for cross-cultural research, including time, translation facilities, and expert advice about conceptual issues. © 2012 Blackwell Publishing Ltd.

Methodology for a trial of brain-centered versus anticholinergic therapy in women with urgency urinary incontinence.

PubMed

Komesu, Yuko M; Rogers, Rebecca G; Sapien, Robert E; Schrader, Ronald M; Simmerman-Sierra, Timothy; Mayer, Andrew R; Ketai, Loren H

2017-06-01

We describe the rationale and methodology for a study comparing mind-body treatment and pharmacotherapy in women with urgency urinary incontinence (UUI). To explore brain associations in UUI, a subset of patients will also undergo functional magnetic resonance imaging (fMRI). We hypothesize that hypnotherapy, a mind-body intervention, will be at least as effective as pharmacotherapy in treating UUI. We also hypothesize that fMRI findings will change following treatment, with changes potentially differing between groups. We describe the development and design challenges of a study comparing the efficacy of hypnotherapy and conventional pharmacotherapy in the treatment of UUI. The study randomizes women to either of these treatments, and outcome measures include bladder diaries and validated questionnaires. Sample size estimates, based on a noninferiority test (alpha = 0.025, beta = 0.20), after considering dropout subjects and subjects lost to follow-up, indicated that approximately 150 woman would be required to test the hypothesis that hypnotherapy is not inferior to pharmacotherapy within a 5 % noninferiority margin. The study will also evaluate fMRI changes in a subset of participants before and after therapy. Challenges included designing a study with a mind-body therapy and a comparison treatment equally acceptable to participants, standardizing the interventions, and confronting the reality that trials are time-consuming for participants who have to make appropriate accommodations in their schedule. Study enrollment began in March 2013 and is ongoing. We describe the design of a randomized controlled trial comparing mind-body therapy and pharmacotherapy in the treatment of UUI and the challenges encountered in its implementation.

Overcoming the Challenges of Unstructured Data in Multi-site, Electronic Medical Record-based Abstraction

PubMed Central

Polnaszek, Brock; Gilmore-Bykovskyi, Andrea; Hovanes, Melissa; Roiland, Rachel; Ferguson, Patrick; Brown, Roger; Kind, Amy JH

2014-01-01

Background Unstructured data encountered during retrospective electronic medical record (EMR) abstraction has routinely been identified as challenging to reliably abstract, as this data is often recorded as free text, without limitations to format or structure. There is increased interest in reliably abstracting this type of data given its prominent role in care coordination and communication, yet limited methodological guidance exists. Objective As standard abstraction approaches resulted in sub-standard data reliability for unstructured data elements collected as part of a multi-site, retrospective EMR study of hospital discharge communication quality, our goal was to develop, apply and examine the utility of a phase-based approach to reliably abstract unstructured data. This approach is examined using the specific example of discharge communication for warfarin management. Research Design We adopted a “fit-for-use” framework to guide the development and evaluation of abstraction methods using a four step, phase-based approach including (1) team building, (2) identification of challenges, (3) adaptation of abstraction methods, and (4) systematic data quality monitoring. Measures Unstructured data elements were the focus of this study, including elements communicating steps in warfarin management (e.g., warfarin initiation) and medical follow-up (e.g., timeframe for follow-up). Results After implementation of the phase-based approach, inter-rater reliability for all unstructured data elements demonstrated kappas of ≥ 0.89 -- an average increase of + 0.25 for each unstructured data element. Conclusions As compared to standard abstraction methodologies, this phase-based approach was more time intensive, but did markedly increase abstraction reliability for unstructured data elements within multi-site EMR documentation. PMID:27624585

Challenges of implementing intervention research in persons with dementia: example of a glider swing intervention.

PubMed

Snyder, M; Tseng, Y H; Brandt, C; Croghan, C; Hanson, S; Constantine, R; Kirby, L

2001-01-01

Intervention studies for persons with dementia present many challenges. This article describes challenges encountered in conducting a glider swing intervention study for persons with dementia and the strategies used to manage the problems encountered. The overall purpose of a quasi-experimental study was to explore the effects of a glider swing intervention on emotions, relaxation, and aggressive behaviors in nursing home residents with dementia. Suggestions for investigators conducting intervention studies for persons with dementia are provided.

Learning Clinical Skills during Bedside Teaching Encounters in General Practice: A Video-Observational Study with Insights from Activity Theory

ERIC Educational Resources Information Center

Ajjawi, Rola; Rees, Charlotte; Monrouxe, Lynn V.

2015-01-01

Purpose: This paper aims to explore how opportunities for learning clinical skills are negotiated within bedside teaching encounters (BTEs). Bedside teaching, within the medical workplace, is considered essential for helping students develop their clinical skills. Design/methodology/approach: An audio and/or video observational study examining…

Adopting a Blended Learning Approach: Challenges Encountered and Lessons Learned in an Action Research Study

ERIC Educational Resources Information Center

Kenney, Jane; Newcombe, Ellen

2011-01-01

Adopting a new teaching approach is often a daunting task especially if one is an early adopter in a limited-resource environment. This article describes the challenges encountered and the strategies used in pilot testing a blended instructional method in a large size class within the college of education at a medium-sized university. The main…

Conceptual and Preliminary Design of a Low-Cost Precision Aerial Delivery System

DTIC Science & Technology

2016-06-01

test results. It includes an analysis of the failure modes encountered during flight experimentation , methodology used for conducting coordinate...and experimentation . Additionally, the current and desired end state of the research is addressed. Finally, this chapter outlines the methodology ...preliminary design phases are utilized to investigate and develop a potentially low-cost alternative to existing systems. Using an Agile methodology

Use of evidence-based practice in an aid organisation: a proposal to deal with the variety in terminology and methodology.

PubMed

De Buck, Emmy; Pauwels, Nele S; Dieltjens, Tessa; Vandekerckhove, Philippe

2014-03-01

As part of its strategy Belgian Red Cross-Flanders underpins all its activities with evidence-based guidelines and systematic reviews. The aim of this publication is to describe in detail the methodology used to achieve this goal within an action-oriented organisation, in a timely and cost-effective way. To demonstrate transparency in our methods, we wrote a methodological charter describing the way in which we develop evidence-based materials to support our activities. Criteria were drawn up for deciding on project priority and the choice of different types of projects (scoping reviews, systematic reviews and evidence-based guidelines). While searching for rigorous and realistically attainable methodological standards, we encountered a wide variety in terminology and methodology used in the field of evidence-based practice. Terminologies currently being used by different organisations and institutions include systematic reviews, systematic literature searches, evidence-based guidelines, rapid reviews, pragmatic systematic reviews, and rapid response service. It is not always clear what the definition and methodology is behind these terms and whether they are used consistently. We therefore describe the terminology and methodology used by Belgian Red Cross-Flanders; criteria for making methodological choices and details on the methodology we use are given. In our search for an appropriate methodology, taking into account time and resource constraints, we encountered an enormous variety of methodological approaches and terminology used for evidence-based materials. In light of this, we recommend that authors of evidence-based guidelines and reviews are transparent and clear about the methodology used. To be transparent about our approach, we developed a methodological charter. This charter may inspire other organisations that want to use evidence-based methodology to support their activities.

Technology-enhanced focus groups as a component of instrument development.

PubMed

Strout, Tania D; DiFazio, Rachel L; Vessey, Judith A

2017-06-22

Background Bullying is a critical public health problem and a screening tool for use in healthcare is needed. Focus groups are a common tool for generating qualitative data when developing an instrument and evidence suggests that technology-enhanced focus groups can be effective in simultaneously engaging participants from diverse settings. Aim To examine the use of technology-enhanced focus groups in generating an item pool to develop a youth-bullying screening tool. Discussion The authors explore methodological and ethical issues related to conducting technology-enhanced focus groups, drawing on their experience in developing a youth-bullying measure. They conducted qualitative focus groups with professionals from the front lines of bullying response and intervention. They describe the experience of conducting technology-enhanced focus group sessions, focusing on the methodological and ethical issues that researchers engaging in similar work may encounter. Challenges associated with this methodology include establishing rapport among participants, privacy concerns and limited non-verbal communication. Conclusion The use of technology-enhanced focus groups can be valuable in obtaining rich data from a wide variety of disciplines and contexts. Organising these focus groups was inexpensive and preferred by the study's participants. Implications for practice Researchers should consider using technology-enhanced focus groups to generate data to develop health-related measurement tools.

Transmission line relay mis-operation detection based on time-synchronized field data

DOE PAGES

Esmaeilian, Ahad; Popovic, Tomo; Kezunovic, Mladen

2015-05-04

In this paper, a real-time tool to detect transmission line relay mis-operation is implemented. The tool uses time-synchronized measurements obtained from both ends of the line during disturbances. The proposed fault analysis tool comes into the picture only after the protective device has operated and tripped the line. The proposed methodology is able not only to detect, classify, and locate transmission line faults, but also to accurately confirm whether the line was tripped due to a mis-operation of protective relays. The analysis report includes either detailed description of the fault type and location or detection of relay mis-operation. As such,more » it can be a source of very useful information to support the system restoration. The focus of the paper is on the implementation requirements that allow practical application of the methodology, which is illustrated using the field data obtained the real power system. Testing and validation is done using the field data recorded by digital fault recorders and protective relays. The test data included several hundreds of event records corresponding to both relay mis-operations and actual faults. The discussion of results addresses various challenges encountered during the implementation and validation of the presented methodology.« less

Medical anthropology and the physician assistant profession.

PubMed

Henry, Lisa R

2015-01-01

Medical anthropology is a subfield of anthropology that investigates how culture influences people's ideas and behaviors regarding health and illness. Medical anthropology contributes to the understanding of how and why health systems operate the way they do, how different people understand and interact with these systems and cultural practices, and what assets people use and challenges they may encounter when constructing perceptions of their own health conditions. The goal of this article is to highlight the methodological tools and analytical insights that medical anthropology offers to the study of physician assistants (PAs). The article discusses the field of medical anthropology; the advantages of ethnographic and qualitative research; and how medical anthropology can explain how PAs fit into improved health delivery services by exploring three studies of PAs by medical anthropologists.

The Multi-Country Evaluation of the Integrated Management of Childhood Illness Strategy: Lessons for the Evaluation of Public Health Interventions

PubMed Central

Bryce, Jennifer; Victora, Cesar G.; Habicht, Jean-Pierre; Vaughan, J. Patrick; Black, Robert E.

2004-01-01

The Multi-Country Evaluation of the Integrated Management of Childhood Illness (IMCI) includes studies of the effectiveness, cost, and impact of the IMCI strategy in Bangladesh, Brazil, Peru, Tanzania, and Uganda. Seven questions were addressed when the evaluation was designed: who would be in charge, through what mechanisms IMCI could affect child health, whether the focus would be efficacy or effectiveness, what indicators would be measured, what types of inference would be made, how costs would be incorporated, and what elements would constitute the plan of analysis. We describe how these questions were answered, the challenges encountered in implementing the evaluation, and the 5 study designs. The methodological insights gained can improve future evaluations of public health programs. PMID:14998804

Metrics for Evaluating the Accuracy of Solar Power Forecasting: Preprint

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

Zhang, J.; Hodge, B. M.; Florita, A.

2013-10-01

Forecasting solar energy generation is a challenging task due to the variety of solar power systems and weather regimes encountered. Forecast inaccuracies can result in substantial economic losses and power system reliability issues. This paper presents a suite of generally applicable and value-based metrics for solar forecasting for a comprehensive set of scenarios (i.e., different time horizons, geographic locations, applications, etc.). In addition, a comprehensive framework is developed to analyze the sensitivity of the proposed metrics to three types of solar forecasting improvements using a design of experiments methodology, in conjunction with response surface and sensitivity analysis methods. The resultsmore » show that the developed metrics can efficiently evaluate the quality of solar forecasts, and assess the economic and reliability impact of improved solar forecasting.« less

Methodological and Ethical Considerations in a Life History Study of Teacher Thinking.

ERIC Educational Resources Information Center

Muchmore, James A.

This paper discusses some of the methodological and ethical issues that one educational researcher encountered throughout his work, focusing on the importance of understanding teachers' thinking from their perspective (an insider looking out rather than an outsider looking in). It highlights a collaborative research relationship that the…

Patterns of antibiotic use in the community and challenges of antibiotic surveillance in a lower-middle-income country setting: a repeated cross-sectional study in Vellore, South India.

PubMed

Chandy, Sujith J; Thomas, Kurien; Mathai, Elizabeth; Antonisamy, Belavendra; Holloway, Kathleen A; Stalsby Lundborg, Cecilia

2013-01-01

There is considerable evidence linking antibiotic usage to bacterial resistance. Intervention strategies are needed to contain antibiotic use and thereby resistance. To plan appropriate strategies, it is imperative to undertake surveillance in the community to monitor antibiotic encounters and drivers of specific antibiotic misuse. Such surveillance is rarely in place in lower-middle-income countries (LMICs). This study describes antibiotic patterns and challenges faced while developing such surveillance systems in an LMIC. Surveillance of antibiotic encounters (prescriptions and dispensations) was carried out using a repeated cross-sectional design for 2 years in Vellore, south India. Every month, patients attending 30 health facilities (small hospitals, general practitioner clinics and pharmacy shops) were observed until 30 antibiotic encounters were attained in each. Antibiotic use was expressed as the percentage of encounters containing specific antibiotics and defined daily doses (DDDs)/100 patients. Bulk antibiotic sales data were also collected. Over 2 years, a total of 52,788 patients were observed and 21,600 antibiotic encounters (40.9%) were accrued. Fluoroquinolones and penicillins were widely used. Rural hospitals used co-trimoxazole more often and urban private hospitals used cephalosporins more often; 41.1% of antibiotic prescriptions were for respiratory infections. The main challenges in surveillance included issues regarding sampling, data collection, denominator calculation and sustainability. Patterns of antibiotic use varied across health facilities, suggesting that interventions should involve all types of health facilities. Although challenges were encountered, our study shows that it is possible to develop surveillance systems in LMICs and the data generated may be used to plan feasible interventions, assess impact and thereby contain resistance.

Interpreting "Personality" Taxonomies: Why Previous Models Cannot Capture Individual-Specific Experiencing, Behaviour, Functioning and Development. Major Taxonomic Tasks Still Lay Ahead.

PubMed

Uher, Jana

2015-12-01

As science seeks to make generalisations, a science of individual peculiarities encounters intricate challenges. This article explores these challenges by applying the Transdisciplinary Philosophy-of-Science Paradigm for Research on Individuals (TPS-Paradigm) and by exploring taxonomic "personality" research as an example. Analyses of researchers' interpretations of the taxonomic "personality" models, constructs and data that have been generated in the field reveal widespread erroneous assumptions about the abilities of previous methodologies to appropriately represent individual-specificity in the targeted phenomena. These assumptions, rooted in everyday thinking, fail to consider that individual-specificity and others' minds cannot be directly perceived, that abstract descriptions cannot serve as causal explanations, that between-individual structures cannot be isomorphic to within-individual structures, and that knowledge of compositional structures cannot explain the process structures of their functioning and development. These erroneous assumptions and serious methodological deficiencies in widely used standardised questionnaires have effectively prevented psychologists from establishing taxonomies that can comprehensively model individual-specificity in most of the kinds of phenomena explored as "personality", especially in experiencing and behaviour and in individuals' functioning and development. Contrary to previous assumptions, it is not universal models but rather different kinds of taxonomic models that are required for each of the different kinds of phenomena, variations and structures that are commonly conceived of as "personality". Consequently, to comprehensively explore individual-specificity, researchers have to apply a portfolio of complementary methodologies and develop different kinds of taxonomies, most of which have yet to be developed. Closing, the article derives some meta-desiderata for future research on individuals' "personality".

A researcher's journey: Exploring a sensitive topic with vulnerable women.

PubMed

Marsh, Christine A; Browne, Jenny; Taylor, Jan; Davis, Deborah

2017-02-01

The conduct of research regardless of the subject or methods employed brings responsibilities and challenges. These are greater when dealing with sensitive topics and vulnerable groups and therefore researchers must navigate a range of complex issues and make choices in relation to practical, ethical and philosophical concerns. While literature dealing with research methodologies and research design may assist to some degree, it cannot provide a clear pathway or template as each research project must respond to a unique set of circumstances. We can however, also learn from sharing our stories and critical reflections on our research processes. The purpose of this article is to highlight the practical and methodological issues arising from researching a sensitive topic with vulnerable women experiencing an Assumption of Care. Research involving topics that are deeply personal and private combined with a vulnerable population can be complex and challenging for the researcher. Although some issues were anticipated from the literature, others encountered in this study were unexpected. Special considerations and prerequisites were necessary to build mutual trust and share power with women who had experienced an Assumption of Care at birth. Narrative Inquiry was a good methodological fit for this study as it privileged the voices of women and insisted that their experiences be considered within the context of their lives. Although Narrative Inquiry is a suitable choice for researching sensitive topics with vulnerable women specific considerations are still required to ensure the benefits of this research for both participants and researchers. Family and Community Service (FACS) have now replaced the formerly known Department of Community Services (DoCS) and in consideration of the timing of this study this article uses the terminology as DoCS. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Recruitment using mobile telephones in an Irish general population sexual health survey: challenges and practical solutions

PubMed Central

2012-01-01

Background Non-coverage of households without a landline telephone is a major concern of telephone survey researchers. Sampling mobile telephone users in national surveys is vital in order to gain access to the growing proportion of households that use mobile telephones extensively or exclusively. The complex logistics of conducting surveys with mobile telephones have been discussed in the literature. This paper outlines the actual challenges encountered during a recent national sexual health survey in Ireland, which utilized a mobile telephone sampling frame to recruit approximately half of the sample. Method The 2010 Irish Contraception and Crisis Pregnancy Survey (ICCP-2010) is a nationally representative sample of adults aged 18-45 years living in Ireland (n = 3002; 1416 recruited by landline telephone and 1586 recruited by mobile telephone). The overall response rate for the survey was 69% (79% for the landline telephone strand; 61% for the mobile telephone strand). All interviews were conducted using computer-assisting telephone interviewing. Results During the 18-week fieldwork period, five main challenges relating to the use of mobile telephones were encountered: (1) explaining to respondents how random digit dialling works in relation to mobile telephones; (2) establishing the respondent's eligibility; (3) calling the respondent with the Caller ID blocked or withheld; (4) calling the respondent when they are in any number of locations or situations; and (5) explaining to respondents the importance of refusal conversion calls for the response rate calculation. Details of how the survey protocols and procedures were monitored and adapted throughout the study to ensure a high response rate are outlined. Conclusion It is undeniably more challenging to recruit respondents using mobile telephones as opposed to landline telephones. Respondents are generally not familiar with being contacted on their personal mobile telephone for the purposes of being recruited for a research study. The main challenge for survey methodologists and interviewers is to devise simple protocols to explain to respondents why they are being contacted on a mobile telephone. Recommendations for survey researchers interested in using this methodological approach in the future are discussed. PMID:22475155

NEW DIRECTIONS AND CHALLENGES FOR THE COMMUNITY EARTH SYSTEM MODELIn this talk, we will discuss the upcoming release of CESM2 and the challenges encountered in the process. We will then discuss upcoming new opportunities in development and applications of Earth System Models

NASA Astrophysics Data System (ADS)

Lamarque, J. F.

2016-12-01

In this talk, we will discuss the upcoming release of CESM2 and the computational and scientific challenges encountered in the process. We will then discuss upcoming new opportunities in development and applications of Earth System Models; in particular, we will discuss additional ways in which the university community can contribute to CESM.

Decision-problem state analysis methodology

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A methodology for analyzing a decision-problem state is presented. The methodology is based on the analysis of an incident in terms of the set of decision-problem conditions encountered. By decomposing the events that preceded an unwanted outcome, such as an accident, into the set of decision-problem conditions that were resolved, a more comprehensive understanding is possible. All human-error accidents are not caused by faulty decision-problem resolutions, but it appears to be one of the major areas of accidents cited in the literature. A three-phase methodology is presented which accommodates a wide spectrum of events. It allows for a systems content analysis of the available data to establish: (1) the resolutions made, (2) alternatives not considered, (3) resolutions missed, and (4) possible conditions not considered. The product is a map of the decision-problem conditions that were encountered as well as a projected, assumed set of conditions that should have been considered. The application of this methodology introduces a systematic approach to decomposing the events that transpired prior to the accident. The initial emphasis is on decision and problem resolution. The technique allows for a standardized method of accident into a scenario which may used for review or the development of a training simulation.

Studying Physician-Patient Communication in the Acute Care Setting: The Hospitalist Rapport Study

PubMed Central

Anderson, Wendy G.; Winters, Kathryn; Arnold, Robert M.; Puntillo, Kathleen A.; White, Douglas B.; Auerbach, Andrew D.

2010-01-01

Objective To assess the feasibility of studying physician-patient communication in the acute care setting. Methods We recruited hospitalist physicians and patients from two hospitals within a university system and audio-recorded their first encounter. Recruitment, data collection, and challenges encountered were tracked. Results Thirty-two physicians consented (rate 91%). Between August 2008 and March 2009, 441 patients were referred, 210 (48%) were screened, and 119 (66% of 179 eligible) consented. We audio-recorded encounters of 80 patients with 27 physicians. Physicians’ primary concern about participation was interference with their workflow. Addressing their concerns and building the protocol around their schedules facilitated participation. Challenges unique to the acute care setting were: 1) extremely limited time for patient identification, screening, and enrollment during which patients were ill and busy with clinical care activities, and 2) little advance knowledge of when physician-patient encounters would occur. Employing a full-time study coordinator mitigated these challenges. Conclusion Physician concerns for participating in communication studies are similar in ambulatory and acute care settings. The acute care setting presents novel challenges for patient recruitment and data collection. Practice Implications These methods should be used to study provider-patient communication in acute care settings. Future work should test strategies to increase patient enrollment. PMID:20444569

An intelligent listening framework for capturing encounter notes from a doctor-patient dialog

PubMed Central

Klann, Jeffrey G; Szolovits, Peter

2009-01-01

Background Capturing accurate and machine-interpretable primary data from clinical encounters is a challenging task, yet critical to the integrity of the practice of medicine. We explore the intriguing possibility that technology can help accurately capture structured data from the clinical encounter using a combination of automated speech recognition (ASR) systems and tools for extraction of clinical meaning from narrative medical text. Our goal is to produce a displayed evolving encounter note, visible and editable (using speech) during the encounter. Results This is very ambitious, and so far we have taken only the most preliminary steps. We report a simple proof-of-concept system and the design of the more comprehensive one we are building, discussing both the engineering design and challenges encountered. Without a formal evaluation, we were encouraged by our initial results. The proof-of-concept, despite a few false positives, correctly recognized the proper category of single-and multi-word phrases in uncorrected ASR output. The more comprehensive system captures and transcribes speech and stores alternative phrase interpretations in an XML-based format used by a text-engineering framework. It does not yet use the framework to perform the language processing present in the proof-of-concept. Conclusion The work here encouraged us that the goal is reachable, so we conclude with proposed next steps. Some challenging steps include acquiring a corpus of doctor-patient conversations, exploring a workable microphone setup, performing user interface research, and developing a multi-speaker version of our tools. PMID:19891797

Methodological Complications of Matching Designs under Real World Constraints: Lessons from a Study of Deeper Learning

ERIC Educational Resources Information Center

Zeiser, Kristina; Rickles, Jordan; Garet, Michael S.

2014-01-01

To help researchers understand potential issues one can encounter when conducting propensity matching studies in complex settings, this paper describes methodological complications faced when studying schools using deeper learning practices to improve college and career readiness. The study uses data from high schools located in six districts…

Contextual Determination of Human Thinking: About Some Conceptual and Methodological Obstacles in Psychology Studies

ERIC Educational Resources Information Center

Sorsana, Christine; Trognon, Alain

2011-01-01

This theoretical paper discusses some conceptual and methodological obstacles that one encounters when analyzing the contextual determination of thinking in psychology. First, we comment upon the various representations of the "cognitive" individual that have been formed over the years--from the epistemic subject to the psychological subject, and…

Media Literacy, Education & (Civic) Capability: A Transferable Methodology

ERIC Educational Resources Information Center

McDougall, Julian; Berger, Richard; Fraser, Pete; Zezulkova, Marketa

2015-01-01

This article explores the relationship between a formal media educational encounter in the UK and the broad objectives for media and information literacy education circulating in mainland Europe and the US. A pilot study, developed with a special interest group of the United Kingdom Literacy Association, applied a three-part methodology for…

Educational Strategies for Teaching Basic Family Dynamics to Non-Family Therapists.

ERIC Educational Resources Information Center

Merkel, William T.; Rudisill, John R.

1985-01-01

Presents six-part methodology for teaching basic concepts of family systems to non-family therapists and describes application of methodology to teach primary care physicians. Explains use of simulated encounters in which a physically symptomatic adolescent is interviewed alone, then with his mother, then with his whole family. (Author/NRB)

Methodology for a Trial of Brain-Centered versus Anti-cholinergic Therapy for Women with Urgency Urinary Incontinence

PubMed Central

Komesu, Yuko M.; Ketai, Loren H.; Sapien, Robert E.; Rogers, Rebecca G.; Schrader, Ronald M.; Simmerman-Sierra, Timothy; Mayer, Andrew R.

2016-01-01

Introduction This paper describes the rationale and methodology a study which investigates mind-body treatment versus pharmacotherapy for women with urgency urinary incontinence (UUI). To explore brain associations in UUI, a subset of patients will also undergo functional magnetic resonance imaging (fMRI). We hypothesize that hypnotherapy a mind-body intervention, will be at least as effective pharmacotherapy in treating UUI. We also hypothesize that fMRI findings will change following treatment, with changes potentially differing between groups. Methods The purpose of this manuscript is to recount the development and design challenges of a study evaluating the efficacy of hypnotherapy compared to conventional pharmacotherapy in UUI treatment. The study randomizes women to either of these treatments and outcome measures include bladder diaries and validated questionnaires. Sample size estimates, based on a non-inferiority test (alpha=.025, beta=0.20), after considering drop-out/loss to follow-up, indicated approximately 150 woman would be required to test the hypothesis that hypnotherapy is non-inferior to pharmacotherapy within a 5% non-inferiority margin. The study will also evaluate fMRI change in a subset of participants before and after therapy. Study challenges included designing a study with a mind-body therapy and a comparison treatment equally acceptable to participants, standardizing the interventions, confronting the reality that trials are time-consuming for participants and making appropriate accommodations. Results Study enrollment began March 2013 and is ongoing. Conclusions This manuscript details the design a of randomized controlled trial (RCT) comparing mind-body therapy to medications in treatment of UUI and describes the challenges encountered in its planning. PMID:27752750

Qualitative Analysis of the Interdisciplinary Interaction between Data Analysis Specialists and Novice Clinical Researchers

PubMed Central

Zammar, Guilherme Roberto; Shah, Jatin; Bonilauri Ferreira, Ana Paula; Cofiel, Luciana; Lyles, Kenneth W.; Pietrobon, Ricardo

2010-01-01

Background The inherent complexity of statistical methods and clinical phenomena compel researchers with diverse domains of expertise to work in interdisciplinary teams, where none of them have a complete knowledge in their counterpart's field. As a result, knowledge exchange may often be characterized by miscommunication leading to misinterpretation, ultimately resulting in errors in research and even clinical practice. Though communication has a central role in interdisciplinary collaboration and since miscommunication can have a negative impact on research processes, to the best of our knowledge, no study has yet explored how data analysis specialists and clinical researchers communicate over time. Methods/Principal Findings We conducted qualitative analysis of encounters between clinical researchers and data analysis specialists (epidemiologist, clinical epidemiologist, and data mining specialist). These encounters were recorded and systematically analyzed using a grounded theory methodology for extraction of emerging themes, followed by data triangulation and analysis of negative cases for validation. A policy analysis was then performed using a system dynamics methodology looking for potential interventions to improve this process. Four major emerging themes were found. Definitions using lay language were frequently employed as a way to bridge the language gap between the specialties. Thought experiments presented a series of “what if” situations that helped clarify how the method or information from the other field would behave, if exposed to alternative situations, ultimately aiding in explaining their main objective. Metaphors and analogies were used to translate concepts across fields, from the unfamiliar to the familiar. Prolepsis was used to anticipate study outcomes, thus helping specialists understand the current context based on an understanding of their final goal. Conclusion/Significance The communication between clinical researchers and data analysis specialists presents multiple challenges that can lead to errors. PMID:20195374

Risk factors for bladder cancer: challenges of conducting a literature search using PubMed.

PubMed

Joshi, Ashish; Preslan, Elicia

2011-04-01

The objective of this study was to assess the risk factors for bladder cancer using PubMed articles from January 2000 to December 2009. The study also aimed to describe the challenges encountered in the methodology of a literature search for bladder cancer risk factors using PubMed. Twenty-six categories of risk factors for bladder cancer were identified using the National Cancer Institute Web site and the Medical Subject Headings (MeSH) Web site. A total of 1,338 PubMed searches were run using the term "urinary bladder cancer" and a risk factor term (e.g., "cigarette smoking") and were screened to identify 260 articles for final analysis. The search strategy had an overall precision of 3.42 percent, relative recall of 12.64 percent, and an F-measure of 5.39 percent. Although search terms derived from MeSH had the highest overall precision and recall, the differences did not reach significance, which indicates that for generalized, free-text searches of the PubMed database, the searchers' own terms are generally as effective as MeSH terms.

Focused Metabolite Profiling for Dissecting Cellular and Molecular Processes of Living Organisms in Space Environments

NASA Technical Reports Server (NTRS)

2008-01-01

Regulatory control in biological systems is exerted at all levels within the central dogma of biology. Metabolites are the end products of all cellular regulatory processes and reflect the ultimate outcome of potential changes suggested by genomics and proteomics caused by an environmental stimulus or genetic modification. Following on the heels of genomics, transcriptomics, and proteomics, metabolomics has become an inevitable part of complete-system biology because none of the lower "-omics" alone provide direct information about how changes in mRNA or protein are coupled to changes in biological function. The challenges are much greater than those encountered in genomics because of the greater number of metabolites and the greater diversity of their chemical structures and properties. To meet these challenges, much developmental work is needed, including (1) methodologies for unbiased extraction of metabolites and subsequent quantification, (2) algorithms for systematic identification of metabolites, (3) expertise and competency in handling a large amount of information (data set), and (4) integration of metabolomics with other "omics" and data mining (implication of the information). This article reviews the project accomplishments.

Simulation Modeling for Off-Nominal Conditions - Where Are We Today?

NASA Technical Reports Server (NTRS)

Shah, Gautam H.; Foster, John V.; Cunningham, Kevin

2010-01-01

The modeling of aircraft flight characteris4cs in off-nominal or otherwise adverse conditions has become increasingly important for simulation in the loss-of-control arena. Adverse conditions include environmentally-induced upsets such as wind shear or wake vortex encounters; off-nominal flight conditions, such as stall or departure; on-board systems failures; and structural failures or aircraft damage. Spirited discussions in the research community are taking place as to the fidelity and data requirements for adequate representation of vehicle dynamics under such conditions for a host of research areas, including recovery training, flight controls development, trajectory guidance/planning, and envelope limiting. The increasing need for multiple sources of data (empirical, computational, experimental) for modeling across a larger flight envelope leads to challenges in developing methods of appropriately applying or combining such data, particularly in a dynamic flight environment with a physically and/or aerodynamically asymmetric vehicle. Traditional simplifications and symmetry assumptions in current modeling methodology may no longer be valid. Furthermore, once modeled, challenges abound in the validation of flight dynamics characteristics in adverse flight regimes

Parkes radio science system design and testing for Voyager Neptune encounter

NASA Technical Reports Server (NTRS)

Rebold, T. A.; Weese, J. F.

1989-01-01

The Radio Science System installed at Parkes, Australia for the Voyager Neptune encounter was specified to meet the same stringent requirements that were imposed upon the Deep Space Network Radio Science System. The system design and test methodology employed to meet these requirements at Parkes are described, and data showing the measured performance of the system are presented. The results indicate that the system operates with a comfortable margin on the requirements. There was a minor problem with frequency-dependent spurious signals which could not be fixed before the encounter. Test results characterizing these spurious signals are included.

Evaluation of Fast-Time Wake Vortex Models using Wake Encounter Flight Test Data

NASA Technical Reports Server (NTRS)

Ahmad, Nashat N.; VanValkenburg, Randal L.; Bowles, Roland L.; Limon Duparcmeur, Fanny M.; Gloudesman, Thijs; van Lochem, Sander; Ras, Eelco

2014-01-01

This paper describes a methodology for the integration and evaluation of fast-time wake models with flight data. The National Aeronautics and Space Administration conducted detailed flight tests in 1995 and 1997 under the Aircraft Vortex Spacing System Program to characterize wake vortex decay and wake encounter dynamics. In this study, data collected during Flight 705 were used to evaluate NASA's fast-time wake transport and decay models. Deterministic and Monte-Carlo simulations were conducted to define wake hazard bounds behind the wake generator. The methodology described in this paper can be used for further validation of fast-time wake models using en-route flight data, and for determining wake turbulence constraints in the design of air traffic management concepts.

Review of calcium methodologies.

PubMed

Zak, B; Epstein, E; Baginski, E S

1975-01-01

A review of calcium methodologies for serum has been described. The analytical systems developed over the past century have been classified as to type beginning with gravimetry and extending to isotope dilution-mass spectrometry by covering all of the commonly used technics which have evolved during that period. Screening and referee procedures are discussed along with comparative sensitivities encountered between atomic absorption spectrophotometry and molecular absorption spectrophotometry. A procedure involving a simple direct reaction for serum calcium using cresolphthalein complexone is recommended in which high blanks are minimized by repressing the ionization of the color reagent on lowering the dielectric constant characteristics of the mixture with dimethylsulfoxide. Reaction characteristics, errors which can be encountered, normal ranges and an interpretative resume are included in its discussion.

Functional connectomics from a "big data" perspective.

PubMed

Xia, Mingrui; He, Yong

2017-10-15

In the last decade, explosive growth regarding functional connectome studies has been observed. Accumulating knowledge has significantly contributed to our understanding of the brain's functional network architectures in health and disease. With the development of innovative neuroimaging techniques, the establishment of large brain datasets and the increasing accumulation of published findings, functional connectomic research has begun to move into the era of "big data", which generates unprecedented opportunities for discovery in brain science and simultaneously encounters various challenging issues, such as data acquisition, management and analyses. Big data on the functional connectome exhibits several critical features: high spatial and/or temporal precision, large sample sizes, long-term recording of brain activity, multidimensional biological variables (e.g., imaging, genetic, demographic, cognitive and clinic) and/or vast quantities of existing findings. We review studies regarding functional connectomics from a big data perspective, with a focus on recent methodological advances in state-of-the-art image acquisition (e.g., multiband imaging), analysis approaches and statistical strategies (e.g., graph theoretical analysis, dynamic network analysis, independent component analysis, multivariate pattern analysis and machine learning), as well as reliability and reproducibility validations. We highlight the novel findings in the application of functional connectomic big data to the exploration of the biological mechanisms of cognitive functions, normal development and aging and of neurological and psychiatric disorders. We advocate the urgent need to expand efforts directed at the methodological challenges and discuss the direction of applications in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

Text-in-context: a method for extracting findings in mixed-methods mixed research synthesis studies.

PubMed

Sandelowski, Margarete; Leeman, Jennifer; Knafl, Kathleen; Crandell, Jamie L

2013-06-01

Our purpose in this paper is to propose a new method for extracting findings from research reports included in mixed-methods mixed research synthesis studies. International initiatives in the domains of systematic review and evidence synthesis have been focused on broadening the conceptualization of evidence, increased methodological inclusiveness and the production of evidence syntheses that will be accessible to and usable by a wider range of consumers. Initiatives in the general mixed-methods research field have been focused on developing truly integrative approaches to data analysis and interpretation. The data extraction challenges described here were encountered, and the method proposed for addressing these challenges was developed, in the first year of the ongoing (2011-2016) study: Mixed-Methods Synthesis of Research on Childhood Chronic Conditions and Family. To preserve the text-in-context of findings in research reports, we describe a method whereby findings are transformed into portable statements that anchor results to relevant information about sample, source of information, time, comparative reference point, magnitude and significance and study-specific conceptions of phenomena. The data extraction method featured here was developed specifically to accommodate mixed-methods mixed research synthesis studies conducted in nursing and other health sciences, but reviewers might find it useful in other kinds of research synthesis studies. This data extraction method itself constitutes a type of integration to preserve the methodological context of findings when statements are read individually and in comparison to each other. © 2012 Blackwell Publishing Ltd.

An overview of Quality Management System implementation in a research laboratory

NASA Astrophysics Data System (ADS)

Molinéro-Demilly, Valérie; Charki, Abdérafi; Jeoffrion, Christine; Lyonnet, Barbara; O'Brien, Steve; Martin, Luc

2018-02-01

The aim of this paper is to show the advantages of implementing a Quality Management System (QMS) in a research laboratory in order to improve the management of risks specific to research programmes and to increase the reliability of results. This paper also presents experience gained from feedback following the implementation of the Quality process in a research laboratory at INRA, the French National Institute for Agronomic Research and details the various challenges encountered and solutions proposed to help achieve smoother adoption of a QMS process. The 7Ms (Management, Measurement, Manpower, Methods, Materials, Machinery, Mother-nature) methodology based on the Ishikawa `Fishbone' diagram is used to show the effectiveness of the actions considered by a QMS, which involve both the organization and the activities of the laboratory. Practical examples illustrate the benefits and improvements observed in the laboratory.

Mass-Gathering Medical Care in Electronic Dance Music Festivals.

PubMed

FitzGibbon, Kathleen M; Nable, Jose V; Ayd, Benjamin; Lawner, Benjamin J; Comer, Angela C; Lichenstein, Richard; Levy, Matthew J; Seaman, Kevin G; Bussey, Ian

2017-10-01

Introduction Electronic dance music (EDM) festivals represent a unique subset of mass-gathering events with limited guidance through literature or legislation to guide mass-gathering medical care at these events. Hypothesis/Problem Electronic dance music festivals pose unique challenges with increased patient encounters and heightened patient acuity under-estimated by current validated casualty predication models. This was a retrospective review of three separate EDM festivals with analysis of patient encounters and patient transport rates. Data obtained were inserted into the predictive Arbon and Hartman models to determine estimated patient presentation rate and patient transport rates. The Arbon model under-predicted the number of patient encounters and the number of patient transports for all three festivals, while the Hartman model under-predicted the number of patient encounters at one festival and over-predicted the number of encounters at the other two festivals. The Hartman model over-predicted patient transport rates for two of the three festivals. Electronic dance music festivals often involve distinct challenges and current predictive models are inaccurate for planning these events. The formation of a cohesive incident action plan will assist in addressing these challenges and lead to the collection of more uniform data metrics. FitzGibbon KM , Nable JV , Ayd B , Lawner BJ , Comer AC , Lichenstein R , Levy MJ , Seaman KG , Bussey I . Mass-gathering medical care in electronic dance music festivals. Prehosp Disaster Med. 2017;32(5):563-567.

Barriers and facilitators to recruitment of physicians and practices for primary care health services research at one centre.

PubMed

Johnston, Sharon; Liddy, Clare; Hogg, William; Donskov, Melissa; Russell, Grant; Gyorfi-Dyke, Elizabeth

2010-12-13

While some research has been conducted examining recruitment methods to engage physicians and practices in primary care research, further research is needed on recruitment methodology as it remains a recurrent challenge and plays a crucial role in primary care research. This paper reviews recruitment strategies, common challenges, and innovative practices from five recent primary care health services research studies in Ontario, Canada. We used mixed qualitative and quantitative methods to gather data from investigators and/or project staff from five research teams. Team members were interviewed and asked to fill out a brief survey on recruitment methods, results, and challenges encountered during a recent or ongoing project involving primary care practices or physicians. Data analysis included qualitative analysis of interview notes and descriptive statistics generated for each study. Recruitment rates varied markedly across the projects despite similar initial strategies. Common challenges and creative solutions were reported by many of the research teams, including building a sampling frame, developing front-office rapport, adapting recruitment strategies, promoting buy-in and interest in the research question, and training a staff recruiter. Investigators must continue to find effective ways of reaching and involving diverse and representative samples of primary care providers and practices by building personal connections with, and buy-in from, potential participants. Flexible recruitment strategies and an understanding of the needs and interests of potential participants may also facilitate recruitment.

Neurophenomenology revisited: second-person methods for the study of human consciousness

PubMed Central

Olivares, Francisco A.; Vargas, Esteban; Fuentes, Claudio; Martínez-Pernía, David; Canales-Johnson, Andrés

2015-01-01

In the study of consciousness, neurophenomenology was originally established as a novel research program attempting to reconcile two apparently irreconcilable methodologies in psychology: qualitative and quantitative methods. Its potential relies on Francisco Varela’s idea of reciprocal constraints, in which first-person accounts and neurophysiological data mutually inform each other. However, since its first conceptualization, neurophenomenology has encountered methodological problems. These problems have emerged mainly because of the difficulty of obtaining and analyzing subjective reports in a systematic manner. However, more recently, several interview techniques for describing subjective accounts have been developed, collectively known as “second-person methods.” Second-person methods refer to interview techniques that solicit both verbal and non-verbal information from participants in order to obtain systematic and detailed subjective reports. Here, we examine the potential for employing second-person methodologies in the neurophenomenological study of consciousness and we propose three practical ideas for developing a second-person neurophenomenological method. Thus, we first describe second-person methodologies available in the literature for analyzing subjective reports, identifying specific constraints on the status of the first-, second- and third- person methods. Second, we analyze two experimental studies that explicitly incorporate second-person methods for traversing the “gap” between phenomenology and neuroscience. Third, we analyze the challenges that second-person accounts face in establishing an objective methodology for comparing results across different participants and interviewers: this is the “validation” problem. Finally, we synthesize the common aspects of the interview methods described above. In conclusion, our arguments emphasize that second-person methods represent a powerful approach for closing the gap between the experiential and the neurobiological levels of description in the study of human consciousness. PMID:26074839

Challenges in the development of very high resolution Earth System Models for climate science

NASA Astrophysics Data System (ADS)

Rasch, Philip J.; Xie, Shaocheng; Ma, Po-Lun; Lin, Wuyin; Wan, Hui; Qian, Yun

2017-04-01

The authors represent the 20+ members of the ACME atmosphere development team. The US Department of Energy (DOE) has, like many other organizations around the world, identified the need for an Earth System Model capable of rapid completion of decade to century length simulations at very high (vertical and horizontal) resolution with good climate fidelity. Two years ago DOE initiated a multi-institution effort called ACME (Accelerated Climate Modeling for Energy) to meet this an extraordinary challenge, targeting a model eventually capable of running at 10-25km horizontal and 20-400m vertical resolution through the troposphere on exascale computational platforms at speeds sufficient to complete 5+ simulated years per day. I will outline the challenges our team has encountered in development of the atmosphere component of this model, and the strategies we have been using for tuning and debugging a model that we can barely afford to run on today's computational platforms. These strategies include: 1) evaluation at lower resolutions; 2) ensembles of short simulations to explore parameter space, and perform rough tuning and evaluation; 3) use of regionally refined versions of the model for probing high resolution model behavior at less expense; 4) use of "auto-tuning" methodologies for model tuning; and 5) brute force long climate simulations.

Outcomes assessment of dental hygiene clinical teaching workshops.

PubMed

Wallace, Juanita S; Infante, Taline D

2008-10-01

Faculty development courses related to acquiring clinical teaching skills in the health professions are limited. Consequently, the Department of Dental Hygiene at the University of Texas Health Science Center at San Antonio conducted a series of clinical teaching workshops to address clinical teaching methodology. The goal of these workshops was to promote a problem-solving learning atmosphere for dental hygiene faculty to acquire and share sound clinical teaching strategies. To determine the value of the annual workshops on clinical teaching and evaluation, a web-based qualitative program assessment was developed using software by Survey Tracker. Four open-ended questions were designed to elicit perceptions regarding what significant changes in teaching strategies were achieved, what barriers or challenges were encountered in making these changes, and what strategies were used to overcome the barriers. The assessment was sent to dental hygiene educators representing thirty-eight dental hygiene programs who had participated in two or more of these workshops. Twenty-eight programs provided collective responses to the questions, and the narrative data were analyzed, using a qualitative methodology. Responses revealed that programs had made productive changes to their clinical education curricula and the information gained from the workshops had a positive effect on clinical teaching.

Computational assessment of hemodynamics-based diagnostic tools using a database of virtual subjects: Application to three case studies.

PubMed

Willemet, Marie; Vennin, Samuel; Alastruey, Jordi

2016-12-08

Many physiological indexes and algorithms based on pulse wave analysis have been suggested in order to better assess cardiovascular function. Because these tools are often computed from in-vivo hemodynamic measurements, their validation is time-consuming, challenging, and biased by measurement errors. Recently, a new methodology has been suggested to assess theoretically these computed tools: a database of virtual subjects generated using numerical 1D-0D modeling of arterial hemodynamics. The generated set of simulations encloses a wide selection of healthy cases that could be encountered in a clinical study. We applied this new methodology to three different case studies that demonstrate the potential of our new tool, and illustrated each of them with a clinically relevant example: (i) we assessed the accuracy of indexes estimating pulse wave velocity; (ii) we validated and refined an algorithm that computes central blood pressure; and (iii) we investigated theoretical mechanisms behind the augmentation index. Our database of virtual subjects is a new tool to assist the clinician: it provides insight into the physical mechanisms underlying the correlations observed in clinical practice. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

On uncertainty quantification in hydrogeology and hydrogeophysics

NASA Astrophysics Data System (ADS)

Linde, Niklas; Ginsbourger, David; Irving, James; Nobile, Fabio; Doucet, Arnaud

2017-12-01

Recent advances in sensor technologies, field methodologies, numerical modeling, and inversion approaches have contributed to unprecedented imaging of hydrogeological properties and detailed predictions at multiple temporal and spatial scales. Nevertheless, imaging results and predictions will always remain imprecise, which calls for appropriate uncertainty quantification (UQ). In this paper, we outline selected methodological developments together with pioneering UQ applications in hydrogeology and hydrogeophysics. The applied mathematics and statistics literature is not easy to penetrate and this review aims at helping hydrogeologists and hydrogeophysicists to identify suitable approaches for UQ that can be applied and further developed to their specific needs. To bypass the tremendous computational costs associated with forward UQ based on full-physics simulations, we discuss proxy-modeling strategies and multi-resolution (Multi-level Monte Carlo) methods. We consider Bayesian inversion for non-linear and non-Gaussian state-space problems and discuss how Sequential Monte Carlo may become a practical alternative. We also describe strategies to account for forward modeling errors in Bayesian inversion. Finally, we consider hydrogeophysical inversion, where petrophysical uncertainty is often ignored leading to overconfident parameter estimation. The high parameter and data dimensions encountered in hydrogeological and geophysical problems make UQ a complicated and important challenge that has only been partially addressed to date.

Methodological, technical, and ethical issues of a computerized data system.

PubMed

Rice, C A; Godkin, M A; Catlin, R J

1980-06-01

This report examines some methodological, technical, and ethical issues which need to be addressed in designing and implementing a valid and reliable computerized clinical data base. The report focuses on the data collection system used by four residency based family health centers, affiliated with the University of Massachusetts Medical Center. It is suggested that data reliability and validity can be maximized by: (1) standardizing encounter forms at affiliated health centers to eliminate recording biases and ensure data comparability; (2) using forms with a diagnosis checklist to reduce coding errors and increase the number of diagnoses recorded per encounter; (3) developing uniform diagnostic criteria; (4) identifying sources of error, including discrepancies of clinical data as recorded in medical records, encounter forms, and the computer; and (5) improving provider cooperation in recording data by distributing data summaries which reinforce the data's applicability to service provision. Potential applications of the data for research purposes are restricted by personnel and computer costs, confidentiality considerations, programming related issues, and, most importantly, health center priorities, largely focused on patient care, not research.

The Challenges Encountered by Immigrant-Serving Agencies in Addressing the Health of Temporary Foreign Workers.

PubMed

Salami, Bukola; Kirova, Anna; Hegadoren, Kathleen; Meherali, Salima; Chiu, Yvonne; Nsaliwa, Christina

2016-01-01

This study sought to examine the challenges encountered by immigrant-serving agencies in meeting the health needs of temporary foreign workers and their families in one Canadian province. The authors interviewed 11 representatives of immigrant-serving agencies and two policy makers. Some of the challenges that agencies face in delivering programs and services for temporary foreign workers and their families include the time required to build trust with this population, temporary foreign workers' reluctance to use services due to fear that it will affect their immigration status, and the emotional labor associated with working with temporary foreign workers.

Using Machine Learning for Behavior-Based Access Control: Scalable Anomaly Detection on TCP Connections and HTTP Requests

DTIC Science & Technology

2013-11-01

machine learning techniques used in BBAC to make predictions about the intent of actors establishing TCP connections and issuing HTTP requests. We discuss pragmatic challenges and solutions we encountered in implementing and evaluating BBAC, discussing (a) the general concepts underlying BBAC, (b) challenges we have encountered in identifying suitable datasets, (c) mitigation strategies to cope...and describe current plans for transitioning BBAC capabilities into the Department of Defense together with lessons learned for the machine learning

Challenges Encountered Using Ophthalmic Anesthetics in Space Medicine

NASA Technical Reports Server (NTRS)

Bayuse, T.; Law, J.; Alexander, D.; Moynihan, S.; LeBlanc, C.; Langford, K.; Magalhaes, L.

2015-01-01

On orbit, ophthalmic anesthetics are used for tonometry and off-nominal corneal examinations. Proparacaine has been flown traditionally. However, the manufacturers recently changed its storage requirements from room temperature storage to refrigerated storage to preserve stability and prolong the shelf-life. Since refrigeration on orbit is not readily available and there were stability concerns about flying proparacaine unrefrigerated, tetracaine was selected as an alternative ophthalmic anesthetic in 2013. We will discuss the challenges encountered flying and using these anesthetics on the International Space Station.

Envisioning invertebrates and other aquatic encounters

NASA Astrophysics Data System (ADS)

Hayward, Eva

2007-12-01

To "envision" animals is to visualize, to experience, to figure, to image, kinds of species, discourses, representations, institutions, histories, epistemologies; and, to "imagine possible" a set of material and ethical relationships between species. This dissertation explores the "envisioning of animals" that takes place through/across/between the interfaces of seawater/visuality/experience/biology/technology/phyla---as illustrated in the documentary works of Jean Painleve (scientist and filmmaker), Genevieve Hamon (filmmaker and set-designer), Leni Riefenstahl (filmmaker and photographer), and David Powell (scientist and aquarist). In each case, aesthetic conceptions of beauty and/or ambiguity coupled with biological epistemology and phenomenology of the organisms themselves compete over "what gets to count as culture and nature," and in doing so, construct a host of hybridized and enmeshed "encounters." In the process the following questions are raised: What is the role of the ocean---it's ecosystems and semiotics---in the production of "envisioning"? How are animals used---and in turn shape and reshape the users---to construct tropes of encounter? What theories can be used to understand the phenomenological, semiotic, material, and rhetorical use/miss-use of animals in the articulation of history, economy, biology, narrativity, and representation? How does this motley crew of documentarians answer differently "the animal question," and challenge and/or reinforce anthropocentrism? Divided into two parts, the dissertation first develops a set of methodological questions derived from critical appraisal of "envisioning," encountering, and embodying through science studies, as well as an account of the use and misuse of animals as only "stand ins" for human intentionality; secondly, the dissertation analyses the work of the documentarians in question. Jean Painleve and Genevieve Hamon are shown to critique traditions of representation in nature/science films, particularly through challenging anthropocentrism with a "toolkit" of surrealist strategies and a biological knowledge of octopuses. Soft and hard corals (anthrozoans) are shown to enact a "biosemiotics" or "zoosemiotics" that "presses against" Leni Riefenstahl's "fascist (and humanist) aesthetic," which desires to memorialize "beautiful and unpolluted" coral communities. "The Drifter's Gallery," the primary designer being David Powell, at the Monterey Bay Aquarium, is shown to install a promise of immediate and luminous experience of "jellyfish otherness," but delivers an account of jellyfish as historically situated "actors" with in biocapitalism. The work of these documentarians is particularly prescient, considering the growing international concern about coral bleaching, anthropogenic pollution, over-harvesting, and commercialization of the oceans' resources. As a form of "situated knowledge," this dissertation expands the boundaries of "who/what gets to count?" to encompass an ethical concern about systems of power that constitutively produce animal and human actors. If we are to be committed to understanding the encounters and formations of encounters between non-human animals and human animals, then projects that bridge---rather than divide---disciplines are necessary endeavors for more inhabitable futures; this project attempts such a bridge.

Critical challenges in ERP implementation: A qualitative case study in the Canadian oil and gas industry

NASA Astrophysics Data System (ADS)

Menon, Sreekumar A.

This exploratory qualitative single-case study examines critical challenges encountered during ERP implementation based on individual perspectives in four project roles: senior leaders, project managers, project team members, and business users, all specifically in Canadian oil and gas industry. Data was collected by interviewing participants belonging to these categories, and by analyzing project documentation about ERP implementation. The organization for the case study was a leading multinational oil and gas company having a substantial presence in the energy sector in Canada. The study results were aligned with the six management questions regarding critical challenges in ERP: (a) circumstances to implement ERP, (b) benefits and process improvements achieved, (c) best practices implemented, (d) critical challenges encountered, (e) strategies and mitigating actions used, and (f) recommendations to improve future ERP implementations. The study results highlight six key findings. First, the study provided valid circumstances for implementing ERP systems. Second, the study underscored the importance of benefits and process improvements in ERP implementation. Third, the study highlighted that adoption of best practices is crucial for ERP Implementation. Fourth, the study found that critical challenges are encountered in ERP Implementation and are significant during ERP implementation. Fifth, the study found that strategies and mitigating actions can overcome challenges in ERP implementation. Finally, the study provided ten major recommendations on how to improve future ERP implementations.

Roadmap to the multidisciplinary design analysis and optimisation of wind energy systems

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

Perez-Moreno, S. Sanchez; Zaaijer, M. B.; Bottasso, C. L.

Here, a research agenda is described to further encourage the application of Multidisciplinary Design Analysis and Optimisation (MDAO) methodologies to wind energy systems. As a group of researchers closely collaborating within the International Energy Agency (IEA) Wind Task 37 for Wind Energy Systems Engineering: Integrated Research, Design and Development, we have identified challenges that will be encountered by users building an MDAO framework. This roadmap comprises 17 research questions and activities recognised to belong to three research directions: model fidelity, system scope and workflow architecture. It is foreseen that sensible answers to all these questions will enable to more easilymore » apply MDAO in the wind energy domain. Beyond the agenda, this work also promotes the use of systems engineering to design, analyse and optimise wind turbines and wind farms, to complement existing compartmentalised research and design paradigms.« less

Practical approaches to the ESI-MS analysis of catalytic reactions.

PubMed

Yunker, Lars P E; Stoddard, Rhonda L; McIndoe, J Scott

2014-01-01

Electrospray ionization mass spectrometry (ESI-MS) is a soft ionization technique commonly coupled with liquid or gas chromatography for the identification of compounds in a one-time view of a mixture (for example, the resulting mixture generated by a synthesis). Over the past decade, Scott McIndoe and his research group at the University of Victoria have developed various methodologies to enhance the ability of ESI-MS to continuously monitor catalytic reactions as they proceed. The power, sensitivity and large dynamic range of ESI-MS have allowed for the refinement of several homogenous catalytic mechanisms and could potentially be applied to a wide range of reactions (catalytic or otherwise) for the determination of their mechanistic pathways. In this special feature article, some of the key challenges encountered and the adaptations employed to counter them are briefly reviewed. Copyright © 2014 John Wiley & Sons, Ltd.

Community resources support adherence to treatment for childhood cancer in El Salvador.

PubMed

Rossell, Nuria; Salaverria, Carmen; Hernandez, Angelica; Alabi, Soad; Vasquez, Roberto; Bonilla, Miguel; Lam, Catherine G; Ribeiro, Raul; Reis, Ria

2018-01-01

In order to reduce nonadherence and treatment abandonment of children with cancer in El Salvador, institutions located nearby the patients' homes were involved to provide support. Methodological approach: Health clinics and municipality offices in the patients' communities were asked to assist families who were not promptly located after missing hospital appointments, or those whose financial limitations were likely to impede continuation of treatment. Data was collected about the number of contacted institutions, the nature of help provided, staff's time investments, and parents' perceptions about the intervention. Local institutions (133 from 206 contacts) conducted home visits (83), and/or provided parents with money (55) or transportation (60). Parents found this support essential for continuing the treatment but they also encountered challenges regarding local institutions' inconsistencies. Nonadherence and abandonment decreased. Economic burden was reduced on both the families and the hospital. Involvement of external institutions might become regular practice to support families of children with cancer.

Development of a Clinical Data Warehouse for Hospital Infection Control

PubMed Central

Wisniewski, Mary F.; Kieszkowski, Piotr; Zagorski, Brandon M.; Trick, William E.; Sommers, Michael; Weinstein, Robert A.

2003-01-01

Existing data stored in a hospital's transactional servers have enormous potential to improve performance measurement and health care quality. Accessing, organizing, and using these data to support research and quality improvement projects are evolving challenges for hospital systems. The authors report development of a clinical data warehouse that they created by importing data from the information systems of three affiliated public hospitals. They describe their methodology; difficulties encountered; responses from administrators, computer specialists, and clinicians; and the steps taken to capture and store patient-level data. The authors provide examples of their use of the clinical data warehouse to monitor antimicrobial resistance, to measure antimicrobial use, to detect hospital-acquired bloodstream infections, to measure the cost of infections, and to detect antimicrobial prescribing errors. In addition, they estimate the amount of time and money saved and the increased precision achieved through the practical application of the data warehouse. PMID:12807807

Roadmap to the multidisciplinary design analysis and optimisation of wind energy systems

DOE PAGES

Perez-Moreno, S. Sanchez; Zaaijer, M. B.; Bottasso, C. L.; ...

2016-10-03

Here, a research agenda is described to further encourage the application of Multidisciplinary Design Analysis and Optimisation (MDAO) methodologies to wind energy systems. As a group of researchers closely collaborating within the International Energy Agency (IEA) Wind Task 37 for Wind Energy Systems Engineering: Integrated Research, Design and Development, we have identified challenges that will be encountered by users building an MDAO framework. This roadmap comprises 17 research questions and activities recognised to belong to three research directions: model fidelity, system scope and workflow architecture. It is foreseen that sensible answers to all these questions will enable to more easilymore » apply MDAO in the wind energy domain. Beyond the agenda, this work also promotes the use of systems engineering to design, analyse and optimise wind turbines and wind farms, to complement existing compartmentalised research and design paradigms.« less

Guilty by dissociation-development of gas chromatography-mass spectrometry (GC-MS) and other rapid screening methods for the analysis of 13 diphenidine-derived new psychoactive substances (NPSs).

PubMed

Geyer, Pierre M; Hulme, Matthew C; Irving, Joseph P B; Thompson, Paul D; Ashton, Ryan N; Lee, Robert J; Johnson, Lucy; Marron, Jack; Banks, Craig E; Sutcliffe, Oliver B

2016-11-01

The prevalence of new psychoactive substances (NPSs) in forensic casework has increased prominently in recent years. This has given rise to significant legal and analytical challenges in the identification of these substances. The requirement for validated, robust and rapid testing methodologies for these compounds is obvious. This study details the analysis of 13 synthesised diphenidine derivatives encountered in casework using presumptive testing, thin layer chromatography and gas chromatography-mass spectrometry (GC-MS). Specifically, the validated GC-MS method provides, for the first time, both a general screening method and quantification of the active components for seized solid samples, both in their pure form and in the presence of common adulterants. Graphical Abstract Chemical synthesis and forensic analysis of 13 diphenidine-derived new psychoactive substance(s).

Development of Microencapsulation Delivery System for Long-Term Preservation of Probiotics as Biotherapeutics Agent

PubMed Central

Solanki, Himanshu K.; Pawar, Dipak D.; Shah, Dushyant A.; Prajapati, Vipul D.; Jani, Girish K.; Mulla, Akil M.; Thakar, Prachi M.

2013-01-01

The administration of probiotic bacteria for health benefit has rapidly expanded in recent years, with a global market worth $32.6 billion predicted by 2014. The oral administration of most of the probiotics results in the lack of ability to survive in a high proportion of the harsh conditions of acidity and bile concentration commonly encountered in the gastrointestinal tract of humans. Providing probiotic living cells with a physical barrier against adverse environmental conditions is therefore an approach currently receiving considerable interest. Probiotic encapsulation technology has the potential to protect microorganisms and to deliver them into the gut. However, there are still many challenges to overcome with respect to the microencapsulation process and the conditions prevailing in the gut. This review focuses mainly on the methodological approach of probiotic encapsulation including biomaterials selection and choice of appropriate technology in detailed manner. PMID:24027760

The Impact of New Technologic and Molecular Advances in the Daily Practice of Gastrointestinal and Hepatobiliary Pathology.

PubMed

Xue, Yue; Farris, Alton Brad; Quigley, Brian; Krasinskas, Alyssa

2017-04-01

The practice of anatomic pathology, and of gastrointestinal pathology in particular, has been dramatically transformed in the past decade. In addition to the multitude of diseases, syndromes, and clinical entities encountered in daily clinical practice, the increasing integration of new technologic and molecular advances into the field of gastroenterology is occurring at a fast pace. Application of these advances has challenged pathologists to correlate newer methodologies with existing morphologic criteria, which in many instances still provide the gold standard for diagnosis. This review describes the impact of new technologic and molecular advances on the daily practice of gastrointestinal and hepatobiliary pathology. We discuss new drugs that can affect the gastrointestinal tract and liver, new endoluminal techniques, new molecular tests that are often performed reflexively, new imaging techniques for evaluating hepatocellular carcinoma, and modified approaches to the gross and histologic assessment of tissues that have been exposed to neoadjuvant therapies.

Challenges in making a seismic hazard map for Alaska and the Aleutians

USGS Publications Warehouse

Wesson, R.L.; Boyd, O.S.; Mueller, C.S.; Frankel, A.D.; Freymueller, J.T.

2008-01-01

We present a summary of the data and analyses leading to the revision of the time-independent probabilistic seismic hazard maps of Alaska and the Aleutians. These maps represent a revision of existing maps based on newly obtained data, and reflect best current judgments about methodology and approach. They have been prepared following the procedures and assumptions made in the preparation of the 2002 National Seismic Hazard Maps for the lower 48 States, and will be proposed for adoption in future revisions to the International Building Code. We present example maps for peak ground acceleration, 0.2 s spectral amplitude (SA), and 1.0 s SA at a probability level of 2% in 50 years (annual probability of 0.000404). In this summary, we emphasize issues encountered in preparation of the maps that motivate or require future investigation and research.

Methodological and Ethical Dilemmas Encountered during Field Research of Family Violence Experienced by Adolescent Women in Buenos Aires

ERIC Educational Resources Information Center

Luxardo, Natalia; Colombo, Graciela; Iglesias, Gabriela

2011-01-01

The purpose of this article is to examine some obstacles and dilemmas related to methodological strategies and ethical considerations that arose during the fieldwork of research focused on family violence during the stages of pregnancy and childbirth in adolescent females in Buenos Aires during 2007. From this study, we are able to contribute some…

Defending against pathogens – immunological priming and its molecular basis in a sea anemone, cnidarian

PubMed Central

Brown, Tanya; Rodriguez-Lanetty, Mauricio

2015-01-01

Cnidarians, in general, are long-lived organisms and hence may repeatedly encounter common pathogens during their lifespans. It remains unknown whether these early diverging animals possess some type of immunological reaction that strengthens the defense response upon repeated infections, such as that described in more evolutionary derived organisms. Here we show results that sea anemones that had previously encountered a pathogen under sub-lethal conditions had a higher survivorship during a subsequently lethal challenge than naïve anemones that encountered the pathogen for the first time. Anemones subjected to the lethal challenge two and four weeks after the sub-lethal exposure presented seven- and five-fold increases in survival, respectively, compared to the naïve anemones. However, anemones challenged six weeks after the sub-lethal exposure showed no increase in survivorship. We argue that this short-lasting priming of the defense response could be ecologically relevant if pathogen encounters are restricted to short seasons characterized by high stress. Furthermore, we discovered significant changes in proteomic profiles between naïve sea anemones and those primed after pathogen exposure suggesting a clear molecular signature associated with immunological priming in cnidarians. Our findings reveal that immunological priming may have evolved much earlier in the tree of life than previously thought. PMID:26628080

A qualitative description of service providers' experiences of ethical issues in HIV care.

PubMed

Sabone, Motshedisi B; Mogobe, Keitshokile Dintle; Matshediso, Ellah; Shaibu, Sheila; Ntsayagae, Esther I; Corless, Inge B; Cuca, Yvette P; Holzemer, William L; Dawson-Rose, Carol; Baez, Solymar S Soliz; Rivero-Mendz, Marta; Webel, Allison R; Eller, Lucille Sanzero; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Wantland, Dean; Nicholas, Patrice K; Lingren, Teri; Portillo, Carmen J; Sefcik, Elizabeth; Long-Middleton, Ellen

2018-01-01

Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care.

Challenges in conducting research in pediatric long-term care facilities.

PubMed

Larson, Elaine L; Cohen, Bevin; Murray, Meghan; Saiman, Lisa

2014-10-01

Children residing in long-term care facilities (LTCFs) have complex medical problems and unique care needs, yet research in this setting is rare. As part of an intervention study to improve patient safety (Keep It Clean for Kids [KICK]), we describe the challenges encountered and recommend approaches to build a successful and sustained collaborative relationship between pediatric LTCFs and the research team. We implemented a program with 5 components: leadership commitment, active staff participation by the creation of KICK teams, workflow assessments, staff training in the World Health Organization's "5 Moments for Hand Hygiene," and electronic monitoring and feedback to staff regarding hand hygiene practices. Major challenges encountered were establishing trust, building research teams, enhancing staff participation, and engaging families and visitors. Approaches to deal with these challenges are discussed. Conducting research in pediatric LTCFs requires sustained commitment to dealing with challenges and establishing collaborative relationships with administrative and frontline staff. © The Author(s) 2014.

Distributed Prognostic Health Management with Gaussian Process Regression

NASA Technical Reports Server (NTRS)

Saha, Sankalita; Saha, Bhaskar; Saxena, Abhinav; Goebel, Kai Frank

2010-01-01

Distributed prognostics architecture design is an enabling step for efficient implementation of health management systems. A major challenge encountered in such design is formulation of optimal distributed prognostics algorithms. In this paper. we present a distributed GPR based prognostics algorithm whose target platform is a wireless sensor network. In addition to challenges encountered in a distributed implementation, a wireless network poses constraints on communication patterns, thereby making the problem more challenging. The prognostics application that was used to demonstrate our new algorithms is battery prognostics. In order to present trade-offs within different prognostic approaches, we present comparison with the distributed implementation of a particle filter based prognostics for the same battery data.

Pathways to Teacher Education for Intercultural Communicative Competence: Teachers' Perceptions

ERIC Educational Resources Information Center

Bastos, Mónica; Araújo e Sá, Helena

2015-01-01

Intercultural and plurilingual encounters have become increasingly frequent due to Information and Communication Technologies (ICT) developments, mobility (real/virtual) and migration. To face the challenges inherent in such encounters, the development of intercultural communicative competence (ICC) is crucial. ICC development may start in the…

The space of togetherness--a caring encounter.

PubMed

Holopainen, Gunilla; Kasén, Anne; Nyström, Lisbet

2014-03-01

Encounters in relation to the nurse-patient relationship are often discussed within nursing and caring literature without a reflection on the actual meaning of the concept. Assuming that an encounter is essential for nursing care, this article seeks to create a deeper understanding of the concept through a hermeneutic approach to texts by the philosophers Buber and Marcel. Presence, recognition, availability and mutuality seem to be essential prerequisites for an encounter. As these prerequisites are fulfilled within and between human beings who encounter each other, it is possible to speak of a space of togetherness, a mutual existence, where life's mystery shines forth and caring is realized. The challenge lies in creating these encounters within nursing care. © 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

Text-in-Context: A Method for Extracting Findings in Mixed-Methods Mixed Research Synthesis Studies

PubMed Central

Leeman, Jennifer; Knafl, Kathleen; Crandell, Jamie L.

2012-01-01

Aim Our purpose in this paper is to propose a new method for extracting findings from research reports included in mixed-methods mixed research synthesis studies. Background International initiatives in the domains of systematic review and evidence synthesis have been focused on broadening the conceptualization of evidence, increased methodological inclusiveness and the production of evidence syntheses that will be accessible to and usable by a wider range of consumers. Initiatives in the general mixed-methods research field have been focused on developing truly integrative approaches to data analysis and interpretation. Data source The data extraction challenges described here were encountered and the method proposed for addressing these challenges was developed, in the first year of the ongoing (2011–2016) study: Mixed-Methods Synthesis of Research on Childhood Chronic Conditions and Family. Discussion To preserve the text-in-context of findings in research reports, we describe a method whereby findings are transformed into portable statements that anchor results to relevant information about sample, source of information, time, comparative reference point, magnitude and significance and study-specific conceptions of phenomena. Implications for nursing The data extraction method featured here was developed specifically to accommodate mixed-methods mixed research synthesis studies conducted in nursing and other health sciences, but reviewers might find it useful in other kinds of research synthesis studies. Conclusion This data extraction method itself constitutes a type of integration to preserve the methodological context of findings when statements are read individually and in comparison to each other. PMID:22924808

Early assessment of the 10-step patient engagement framework for patient-centred outcomes research studies: the first three steps.

PubMed

Sofolahan-Oladeinde, Yewande; Newhouse, Robin P; Lavallee, Danielle C; Huang, Jennifer C; Mullins, C Daniel

2017-06-01

A key principle of patient-centred outcomes research (PCOR) is the engagement of patients and other stakeholders in the research process, but the evidence is still emerging on the impact patient engagement has on the research process. A 10-step framework has been developed to provide methodological guidance for patient engagement throughout the research process. However, the utility of the framework for patient engagement has not been tested in actual research studies. To describe researcher's overall experiences with engaging patients at the beginning of their PCOR research process. Twelve in-depth interviews were conducted face-to-face and by telephone with PCOR researchers between November 2014 and January 2015 at an Academic Health Center in the eastern USA. All data were audiotaped and transcribed, and NVivo 10 software was used for data analysis. Four major themes emerged (i) the importance of patient engagement and how it provides 'a perspective you can't get unless you talk to the patient'; (ii) the impact of patient engagement; (iii) challenges and barriers of engagement; and (iv) the realities of patient engagement. Researchers' views illustrate the need to re-evaluate patient engagement in PCOR based on current realities. Given the many challenges to engagement that researchers encounter, it may be more productive to redefine the process of patient engagement so that the issues researchers now face are taken into account in future funding announcements, engagement rubrics and methodology frameworks developed. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Beyond human subjects: risk, ethics, and clinical development of nanomedicines.

PubMed

Kimmelman, Jonathan

2012-01-01

Clinical testing of nanomedicines presents two challenges to prevailing, human subject-centered frameworks governing research ethics. First, some nanomedical applications may present risk to persons other than research subjects. Second, pressures encountered in testing nanomedicines may present threats to the kinds of collaborations and collective activities needed for supporting clinical translation and redeeming research risk. In this article, I describe how similar challenges were encountered and addressed in gene transfer, and sketch policy options that might be explored in the nanomedicine translation arena. © 2012 American Society of Law, Medicine & Ethics, Inc.

Racialized Aggressions and Social Media on Campus

ERIC Educational Resources Information Center

Gin, Kevin J.; Martínez-Alemán, Ana M.; Rowan-Kenyon, Heather T.; Hottell, Derek

2017-01-01

Using a phenomenological approach, rooted in critical theory's desire to challenge systemic structures of inequality, we explored the impact of racialized hate encountered on social media by students of color at a predominately White institution. The encounters of racialized hostility manifested as anti-Black sentiments and produced racial battle…

Intercultural Simulation Games: A Review (of the United States and beyond)

ERIC Educational Resources Information Center

Fowler, Sandra M.; Pusch, Margaret D.

2010-01-01

Intercultural simulations are instructional activities that engage and challenge participants with experiences integral to encounters between people of more than one cultural group. Simulations designed specifically to support intercultural encounters have been in use since the 1970s. This article examines the conceptual bases for intercultural…

Insurance-related and financial challenges reported by managed care enrollees with breast cancer.

PubMed

Klimmek, Rachel; Snow, Denise; Wenzel, Jennifer

2010-10-01

Cancer survivors in the United States often encounter significant challenges in obtaining and paying for medical care. Multiple research studies have examined these issues in Medicare and Medicaid populations and the underinsured, but very little is known about insurance-related challenges encountered by cancer survivors enrolled in private insurance programs such as managed care. This secondary analysis of data explored the insurance-related and financial challenges reported by women enrolled in a managed care organization during cancer treatment and early follow-up. The researchers reviewed semistructured interviews with 14 women with breast cancer near the time of diagnosis, midway through treatment, and after treatment completion. Most women reported considerable stress related to performance of insurance-related tasks during or immediately after treatment, which resulted in negative emotional and psychological experiences. This article presents recommendations for how oncology nurses can intervene to assess and address these challenges and their effects. Future research should examine best practices related to nursing management of insurance-related and financial challenges during cancer.

Ergonomic and organizational analysis of an association of collectors of recyclable waste.

PubMed

Maria, R; Chagas, T; Silva, V

2012-01-01

The managerial difficulties encountered by an Association of Recyclable Materials Collectors to organize and ensure the perpetuation of his work gave rise to this research. In order to overcome the difficulties encountered with regard to accounting, organizational and ergonomic work, we used a methodology capable of providing a greater interaction between researchers and collectors, facilitating the exchange of knowledge and the perpetuation of the techniques used. Improvements were seen in relation to screening, storage and organization of work.

The Johns Hopkins Hospital: identifying and addressing risks and safety issues.

PubMed

Paine, Lori A; Baker, David R; Rosenstein, Beryl; Pronovost, Peter J

2004-10-01

At The Johns Hopkins Hospital (JHH), a culture of safety refers to the presence of characteristics such as the belief that harm is untenable and the use of a systems approach to analyzing safety issues. The leadership of JHH provides strategic planning guidance for safety and improvement initiatives, involves the patient safety committee in capital investment allocation decisions and in designing and planning new hospital facilities, and ensures that safety and quality head the agenda of board-of-trustees meetings. Although JHH takes a systems approach, structures such as monitoring staff behavior trends are used to hold people accountable for job performance. JHH encountered three major hurdles in implementing and sustaining a culture of safety. First, JHH's decentralized organizational structure contributes to a silo effect that limits the spread of ideas, practices, and culture. JHH intends to create an internal collaborative of departmental safety initiatives to foster opportunities for units to share ideas and results. Second, in response to the challenge of encouraging teams to think and act in an interdisciplinary fashion, communication and teamwork training are being used to enhance the effectiveness of interdisciplinary teams. Further development of valid and meaningful safety-related measurement and data collection methodologies is JHH's largest remaining challenge.

Stresses and Challenges for New Graduates in Hospitals.

ERIC Educational Resources Information Center

Oermann, Marilyn H.; Garvin, Michael F.

2002-01-01

Recent nursing graduates (n=46) rated stresses and challenges in clinical practice. Stressors included not feeling competent/confident, making mistakes due to increased workload, and encountering new situations. Challenges included applying knowledge to practice and acquiring new skills. Most emotions were positive but anxiety was frequent. Ways…

The Experiences and Challenges in Drilling into Semi molten or Molten Intrusive in Menengai Geothermal Field

NASA Astrophysics Data System (ADS)

Mortensen, A. K.; Mibei, G. K.

2017-12-01

Drilling in Menengai has experienced various challenges related to drilling operations and the resource itself i.e. quality discharge fluids vis a vis gas content. The main reason for these challenges is related to the nature of rocks encountered at depths. Intrusives encountered within Menengai geothermal field have been group into three based on their geological characteristics i.e. S1, S2 and S3.Detailed geology and mineralogical characterization have not been done on these intrusive types. However, based on physical appearances, S1 is considered as a diorite dike, S2 is syenite while S3 is molten rock material. This paper summarizes the experiences in drilling into semi molten or molten intrusive (S3).

Burkholderia pseudomallei: Challenges for the Clinical Microbiology Laboratory.

PubMed

Hemarajata, Peera; Baghdadi, Jonathan D; Hoffman, Risa; Humphries, Romney M

2016-12-01

Melioidosis is a potentially fatal infection caused by the bacterium Burkholderia pseudomallei Clinical diagnosis of melioidosis can be challenging since there is no pathognomonic clinical syndrome, and the organism is often misidentified by methods used routinely in clinical laboratories. Although the disease is more prevalent in Thailand and northern Australia, sporadic cases may be encountered in areas where it is not endemic, including the United States. Since the organism is considered a tier 1 select agent according to the Centers for Disease Control and Prevention and the U.S. Department of Agriculture Animal and Plant Health Inspection Service, clinical laboratories must be proficient at rapidly recognizing isolates suspicious for B. pseudomallei, be able to safely perform necessary rule-out tests, and to refer suspect isolates to Laboratory Response Network reference laboratories. In this minireview, we report a case of melioidosis encountered at our institution and discuss the laboratory challenges encountered when dealing with clinical isolates suspicious for B. pseudomallei or clinical specimens from suspected melioidosis cases. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Creating learning momentum through overt teaching interactions during real acute care episodes.

PubMed

Piquette, Dominique; Moulton, Carol-Anne; LeBlanc, Vicki R

2015-10-01

Clinical supervisors fulfill a dual responsibility towards patient care and learning during clinical activities. Assuming such roles in today's clinical environments may be challenging. Acute care environments present unique learning opportunities for medical trainees, as well as specific challenges. The goal of this paper was to better understand the specific contexts in which overt teaching interactions occurred in acute care environments. We conducted a naturalistic observational study based on constructivist grounded theory methodology. Using participant observation, we collected data on the teaching interactions occurring between clinical supervisors and medical trainees during 74 acute care episodes in the critical care unit of two academic centers, in Toronto, Canada. Three themes contributed to a better understanding of the conditions in which overt teaching interactions among trainees and clinical supervisors occurred during acute care episodes: seizing emergent learning opportunities, coming up against challenging conditions, and creating learning momentum. Our findings illustrate how overt learning opportunities emerged from certain clinical situations and how clinical supervisors and trainees could purposefully modify unfavorable learning conditions. None of the acute care episodes encountered in the critical care environment represented ideal conditions for learning. Yet, clinical supervisors and trainees succeeded in engaging in overt teaching interactions during many episodes. The educational value of these overt teaching interactions should be further explored, as well as the impact of interventions aimed at increasing their use in acute care environments.

Cost-Effectiveness Analysis (CEA) of Four Interventions for Adolescents with a Substance Use Disorder

PubMed Central

French, Michael T.; Zavala, Silvana K.; McCollister, Kathryn E.; Waldron, Holly B.; Turner, Charles W.; Ozechowski, Timothy J.

2008-01-01

Alcohol, tobacco, and illicit drug use among adolescents in the U.S. continues to be a serious public health challenge. A variety of outpatient treatments for adolescent substance use disorders have been developed and evaluated. Although no specific treatment modality is effective in all settings, a number of promising adolescent interventions have emerged. As policy makers try to prioritize which programs to fund with limited public resources, the need for systematic economic evaluations of these programs is critical. The present study attempted a cost-effectiveness analysis (CEA) of four interventions, including family-based, individual, and group cognitive behavioral approaches, for adolescents with a substance use disorder. The results indicated that treatment costs varied substantially across the four interventions. Moreover, family therapy showed significantly better substance use outcome compared to group treatment at the 4-month assessment, but group treatment was similar to the other interventions for substance use outcome at the 7-month assessment and for delinquency outcome at both the 4-month and 7-month assessments. These findings over a relatively short follow-up period suggest that the least expensive intervention (group) was the most cost effective. However, this study encountered numerous data and methodological challenges in trying to supplement a completed clinical trial with an economic evaluation. These challenges are explained and recommendations are proposed to guide future economic evaluations in this area. PMID:17600651

Hand's Academy Challenge: Some Starter Questions

ERIC Educational Resources Information Center

Gardner, Peter

2014-01-01

Michael Hand has recently challenged certain religious organisations that run Academies in the United Kingdom to devise and pursue their own faith-based curricula in their schools. In this short article I examine some of the problems Hand's challenge might encounter, including whether religious conceptions of worthwhile activities and of human…

Navigating the Challenges Arising from University-School Collaborative Action Research

ERIC Educational Resources Information Center

Yuan, Rui; Mak, Pauline

2016-01-01

Despite increasing evidence showing the benefits language teachers can reap from university-school collaborative action research (CAR), scant attention has been given to how university researchers collaborate with language teachers, what challenges they might encounter, and how they navigate such challenges in CAR. To fill the gap, this study…

Ethical Challenges in the Teaching of Multicultural Course Work

ERIC Educational Resources Information Center

Fier, Elizabeth Boyer; Ramsey, MaryLou

2005-01-01

The authors explore the ethical issues and challenges frequently encountered by counselor educators of multicultural course work. Existing ethics codes are examined, and the need for greater specificity with regard to teaching courses of multicultural content is addressed. Options for revising existing codes to better address the challenges of…

Being a Mathematics Teacher Educator in China: Challenges and Strategic Responses

ERIC Educational Resources Information Center

Wu, Yingkang; Hwang, Stephen; Cai, Jinfa

2017-01-01

In this exploratory study, we developed a portrait of the challenges and strategic responses of secondary mathematics teacher educators (MTEs) in Chinese universities. The MTEs reported encountering more challenges when teaching pedagogical courses and supervising student teachers than when teaching college mathematics courses and teaching…

Shark Interactions With Directed and Incidental Fisheries in the Northeast Pacific Ocean: Historic and Current Encounters, and Challenges for Shark Conservation.

PubMed

King, Jackie; McFarlane, Gordon A; Gertseva, Vladlena; Gasper, Jason; Matson, Sean; Tribuzio, Cindy A

For over 100 years, sharks have been encountered, as either directed catch or incidental catch, in commercial fisheries throughout the Northeast Pacific Ocean. A long-standing directed fishery for North Pacific Spiny Dogfish (Squalus suckleyi) has occurred and dominated shark landings and discards. Other fisheries, mainly for shark livers, have historically targeted species including Bluntnose Sixgill Shark (Hexanchus griseus) and Tope Shark (Galeorhinus galeus). While incidental catches of numerous species have occurred historically, only recently have these encounters been reliably enumerated in commercial and recreational fisheries. In this chapter we present shark catch statistics (directed and incidental) for commercial and recreational fisheries from Canadian waters (off British Columbia), southern US waters (off California, Oregon, and Washington), and northern US waters (off Alaska). In total, 17 species of sharks have collectively been encountered in these waters. Fishery encounters present conservation challenges for shark management, namely, the need for accurate catch statistics, stock delineation, life history parameter estimates, and improved assessments methods for population status and trends. Improvements in management and conservation of shark populations will only come with the further development of sound science-based fishery management practices for both targeted and incidental shark fisheries. © 2017 Elsevier Ltd All rights reserved.

[Development of New Mathematical Methodology in Air Traffic Control for the Analysis of Hybrid Systems

NASA Technical Reports Server (NTRS)

Hermann, Robert

1997-01-01

The aim of this research is to develop new mathematical methodology for the analysis of hybrid systems of the type involved in Air Traffic Control (ATC) problems. Two directions of investigation were initiated. The first used the methodology of nonlinear generalized functions, whose mathematical foundations were initiated by Colombeau and developed further by Oberguggenberger; it has been extended to apply to ordinary differential. Systems of the type encountered in control in joint work with the PI and M. Oberguggenberger. This involved a 'mixture' of 'continuous' and 'discrete' methodology. ATC clearly involves mixtures of two sorts of mathematical problems: (1) The 'continuous' dynamics of a standard control type described by ordinary differential equations (ODE) of the form: {dx/dt = f(x, u)} and (2) the discrete lattice dynamics involved of cellular automata. Most of the CA literature involves a discretization of a partial differential equation system of the type encountered in physics problems (e.g. fluid and gas problems). Both of these directions requires much thinking and new development of mathematical fundamentals before they may be utilized in the ATC work. Rather than consider CA as 'discretization' of PDE systems, I believe that the ATC applications will require a completely different and new mathematical methodology, a sort of discrete analogue of jet bundles and/or the sheaf-theoretic techniques to topologists. Here too, I have begun work on virtually 'virgin' mathematical ground (at least from an 'applied' point of view) which will require considerable preliminary work.

Updated methodology for nuclear magnetic resonance characterization of shales

NASA Astrophysics Data System (ADS)

Washburn, Kathryn E.; Birdwell, Justin E.

2013-08-01

Unconventional petroleum resources, particularly in shales, are expected to play an increasingly important role in the world's energy portfolio in the coming years. Nuclear magnetic resonance (NMR), particularly at low-field, provides important information in the evaluation of shale resources. Most of the low-field NMR analyses performed on shale samples rely heavily on standard T1 and T2 measurements. We present a new approach using solid echoes in the measurement of T1 and T1-T2 correlations that addresses some of the challenges encountered when making NMR measurements on shale samples compared to conventional reservoir rocks. Combining these techniques with standard T1 and T2 measurements provides a more complete assessment of the hydrogen-bearing constituents (e.g., bitumen, kerogen, clay-bound water) in shale samples. These methods are applied to immature and pyrolyzed oil shale samples to examine the solid and highly viscous organic phases present during the petroleum generation process. The solid echo measurements produce additional signal in the oil shale samples compared to the standard methodologies, indicating the presence of components undergoing homonuclear dipolar coupling. The results presented here include the first low-field NMR measurements performed on kerogen as well as detailed NMR analysis of highly viscous thermally generated bitumen present in pyrolyzed oil shale.

Updated methodology for nuclear magnetic resonance characterization of shales

USGS Publications Warehouse

Washburn, Kathryn E.; Birdwell, Justin E.

2013-01-01

Unconventional petroleum resources, particularly in shales, are expected to play an increasingly important role in the world’s energy portfolio in the coming years. Nuclear magnetic resonance (NMR), particularly at low-field, provides important information in the evaluation of shale resources. Most of the low-field NMR analyses performed on shale samples rely heavily on standard T1 and T2 measurements. We present a new approach using solid echoes in the measurement of T1 and T1–T2 correlations that addresses some of the challenges encountered when making NMR measurements on shale samples compared to conventional reservoir rocks. Combining these techniques with standard T1 and T2 measurements provides a more complete assessment of the hydrogen-bearing constituents (e.g., bitumen, kerogen, clay-bound water) in shale samples. These methods are applied to immature and pyrolyzed oil shale samples to examine the solid and highly viscous organic phases present during the petroleum generation process. The solid echo measurements produce additional signal in the oil shale samples compared to the standard methodologies, indicating the presence of components undergoing homonuclear dipolar coupling. The results presented here include the first low-field NMR measurements performed on kerogen as well as detailed NMR analysis of highly viscous thermally generated bitumen present in pyrolyzed oil shale.

The challenge of designing a database for auditing surgical in-patients.

PubMed

Branday, J M; Crandon, I; Carpenter, R; Rhoden, A; Meeks-Aitken, N

1999-12-01

Surgical audit is imperative in modern practice, particularly in the developing world where resources are limited and efficient allocation important. The structure, process and outcome of surgical care can be determined for quality assurance or for research. Improved efficiency and reduction of morbidity and mortality are additional goals which may be accomplished. However, computerization, medical staff cooperation and the availability of dedicated staff are among the hurdles which may be encountered. We report the challenge of designing and establishing a database for auditing surgical inpatients in a developing country and the difficulties which were encountered.

Speed Accuracy Tradeoffs in Human Speech Production

DTIC Science & Technology

2017-05-01

for considering Fitts’ law in the domain of speech production is elucidated. Methodological challenges in applying Fitts-style analysis are addressed...order to assess whether articulatory kinematics conform to Fitts’ law. A second, associated goal is to address the methodological challenges inherent in...performing Fitts-style analysis on rtMRI data of speech production. Methodological challenges include segmenting continuous speech into specific motor

Demanding Patient or Demanding Encounter?: A Case Study of a Cancer Clinic

PubMed Central

Stacey, Clare Louise; Henderson, Stuart; MacArthur, Kelly R; Dohan, Daniel

2009-01-01

This paper explores the sociological relevance of demanding encounters between doctors and patients. Borrowing from Potter and McKinlay's (2005) reconceptualization of the doctor-patient relationship, we suggest an analytic shift away from `demanding patients' toward `demanding encounters'. Such a shift places provider-patient conflict within a broader sociocultural context, emphasizing constraints facing both doctor and patient as they interact in a clinical setting. Specifically, through an ethnographic study of doctor-patient interactions at the oncology clinic of a US University Hospital, we examine the respective influences of new information technologies and patient consumerism in the production of demanding encounters in oncology. Findings suggest that these interconnected socio-cultural realities, in tandem with patient tendencies to challenge physician judgment or expertise, play a role in demanding encounters. We conclude by considering the implications of demanding encounters for doctors, patients and healthcare organizations. PMID:19619924

Managing the Challenges of Leadership in ERP Implementations: An Exploratory Study of the Leadership Challenges Encountered by Project Managers Involved in ERP Implementation Projects

ERIC Educational Resources Information Center

Wanjagi, James K.

2013-01-01

Increasingly, organizations are conducting more Enterprise Resource Planning (ERP) projects in order to promote organizational efficiencies. Meanwhile, minimal research has been conducted on the leadership challenges faced by project managers during the ERP project implementations and how these challenges are managed. The existing project…

Methodological challenges to human medical study.

PubMed

Zhong, Yixin; Liu, Baoyan; Qu, Hua; Xie, Qi

2014-09-01

With the transformation of modern medicinal pattern, medical studies are confronted with methodological challenges. By analyzing two methodologies existing in the study of physical matter system and information system, the article points out that traditional Chinese medicine (TCM), especially the treatment based on syndrome differentiation, embodies information conception of methodological positions, while western medicine represents matter conception of methodological positions. It proposes a new way of thinking about combination of TCM and western medicine by combinating two kinds of methodological methods.

Faith and feminism: how African American women from a storefront church resist oppression in healthcare.

PubMed

Abrums, Mary

2004-01-01

It is well documented that racism in the US healthcare system, including the objectification and disparagement of women of color, contributes to disparities in health status. However, it is a mistaken notion to characterize women of color as unknowing victims. In this study, black feminist standpoint epistemology is used in methodological approach and analysis to understand how a small group of African American church-going women use religious beliefs to help them cope with and resist the racism and discriminatory objectification they encounter in healthcare encounters.

DSN radio science system design and testing for Voyager-Neptune encounter

NASA Technical Reports Server (NTRS)

Ham, N. C.; Rebold, T. A.; Weese, J. F.

1989-01-01

The Deep Space Network (DSN) Radio Science System presently implemented within the Deep Space Network was designed to meet stringent requirements imposed by the demands of the Voyager-Neptune encounter and future missions. One of the initial parameters related to frequency stability is discussed. The requirement, specification, design, and methodology for measuring this parameter are described. A description of special instrumentation that was developed for the test measurements and initial test data resulting from the system tests performed at Canberra, Australia and Usuda, Japan are given.

An Inquiry into Action Research: Teaching and Doing Action Research for the First-Time

ERIC Educational Resources Information Center

Palak, Deniz

2013-01-01

I undertook this inquiry into action research while teaching research methods within a graduate degree teacher education program. This inquiry represents my initial encounter with action research and describes the tools, challenges, and uncertainties that I encountered while teaching and doing action research for the first-time. The main purpose…

Understanding the Conceptual and Language Challenges Encountered by Grade 4 Students When Writing Scientific Explanations

ERIC Educational Resources Information Center

Seah, Lay Hoon

2016-01-01

This study is an attempt to examine the use of linguistic resources by primary science students so as to understand the conceptual and language demands encountered by them when constructing written explanations. The students' written explanations and the instructional language (whole-class discussion and textbook) employed over the topic, the life…

Freight transportation : strategies needed to address planning and financing limitations

DOT National Transportation Integrated Search

2003-12-01

The General Accounting Office (GAO) was asked to address (1) the challenges to freight mobility, (2) the limitations key stakeholders have encountered in addressing these challenges, and (3) strategies that may aid decision makers in enhancing freigh...

Showing Your Students You Care: Seeing the Individual Trees in the Classroom Forest

ERIC Educational Resources Information Center

Philipp, Randolph A.; Thanheiser, Eva

2010-01-01

Teaching is a complex profession, and although every context is unique, teachers face common challenges. The authors have identified two challenges that nearly every teacher encounters: (1) managing a classroom of students; and (2) addressing the needs of individual students. Although these are not teachers' only challenges, the authors highlight…

Leading Schools Facing Challenging Circumstances: Some Insights from Western Australia

ERIC Educational Resources Information Center

Gillett, Jonathan; Clarke, Simon; O'Donoghue, Tom

2016-01-01

This paper examines leadership strategies that are most likely to engender success in schools that may be defined as facing challenging circumstances. First, it presents an overview of the relevant literature in order to illustrate distinctive challenges that tend to be encountered in these environments, as well as strategies that are adopted for…

Educational Challenges of Internal Migrant Girls: A Case Study among Primary School Children in Turkey

ERIC Educational Resources Information Center

Altinyelken, Hulya Kosar

2009-01-01

This article seeks to investigate education-related challenges encountered by internal migrant girls studying at primary schools in Turkey. From the perspectives of participants, the emerging themes included adaptation, language, low socio-economic status, peer relations, discrimination and bullying. These challenges seem to have direct or…

Challenges Social Work Students Encounter in International Field Placements and Recommendations for Responsible Management

ERIC Educational Resources Information Center

Matthew, Lenore E.; Lough, Benjamin J.

2017-01-01

Social work students often face personal and institutional challenges prior to, during, and after international field placements. If not managed, these challenges may compromise students' professional development and hinder their meaningful contribution to placements abroad, which is of particular concern when students from the Global North are…

Recruitment Challenges: Lessons from Senior Centers and Older African-American Participants in a Literacy Study

ERIC Educational Resources Information Center

Ntiri, Daphne W.; Stewart, Merry

2010-01-01

This article reviews the challenges encountered in the recruitment of urban older African-Americans in a study to explore the effects of interactive educational intervention on functional health literacy and diabetes knowledge. Our methods included identification of challenges related to the individual characteristics of seniors' centers that…

Methodology for Generating Conflict Scenarios by Time Shifting Recorded Traffic Data

NASA Technical Reports Server (NTRS)

Paglione, Mike; Oaks, Robert; Bilimoria, Karl D.

2003-01-01

A methodology is presented for generating conflict scenarios that can be used as test cases to estimate the operational performance of a conflict probe. Recorded air traffic data is time shifted to create traffic scenarios featuring conflicts with characteristic properties similar to those encountered in typical air traffic operations. First, a reference set of conflicts is obtained from trajectories that are computed using birth points and nominal flight plans extracted from recorded traffic data. Distributions are obtained for several primary properties (e.g., encounter angle) that are most likely to affect the performance of a conflict probe. A genetic algorithm is then utilized to determine the values of time shifts for the recorded track data so that the primary properties of conflicts generated by the time shifted data match those of the reference set. This methodology is successfully demonstrated using recorded traffic data for the Memphis Air Route Traffic Control Center; a key result is that the required time shifts are less than 5 min for 99% of the tracks. It is also observed that close matching of the primary properties used in this study additionally provides a good match for some other secondary properties.

Quantifying tobacco related health care expenditures in the Republic of the Marshall Islands: a case study in determining health costs in a developing US associated island nation.

PubMed

Palafox, N A; Ou, A C; Haberle, H; Chen, T H

2001-01-01

This case study examines the advantages, disadvantages, and utility of three research methods to measure the medical costs of tobacco use in the Republic of the Marshall Islands (RMI). The authors used the morbidity-based models, models based on the difference in utilization of medical facilities between smokers and non-smokers, and models of inter-country comparisons. In the RMI, morbidity models would have a propensity to grossly under-estimate the medical costs of tobacco use. Models that measure the difference in medical service utilization between smokers and non-smokers can be confounded by cultural factors and by the level of health care that is provided. The RMI population structure affected the sampling methods. The external validity of the survey instrument may be increased through measuring more parameters with greater precision. Inter-country comparisons may be used to approximate and set upper and lower limits of costs for past medical costs, and may be the only method to determine future health care costs from tobacco use. Determining medical costs of tobacco use in an US Associated island nation with an under-developed health care infrastructure has not been previously attempted. There were significant methodological challenges that were encountered. Health, economic, cultural, and research environments in the RMI are unique and require innovative methods to determine medical costs associated with tobacco use. Direct application of the methodologies utilized in the United States to determine medical costs of tobacco use may grossly under-estimate the medical cost of tobacco use in the RMI. The research challenges can be addressed.

Multi-rater feedback with gap analysis: an innovative means to assess communication skill and self-insight.

PubMed

Calhoun, Aaron W; Rider, Elizabeth A; Peterson, Eleanor; Meyer, Elaine C

2010-09-01

Multi-rater assessment with gap analysis is a powerful method for assessing communication skills and self-insight, and enhancing self-reflection. We demonstrate the use of this methodology. The Program for the Approach to Complex Encounters (PACE) is an interdisciplinary simulation-based communication skills program. Encounters are assessed using an expanded Kalamazoo Consensus Statement Essential Elements Checklist adapted for multi-rater feedback and gap analysis. Data from a representative conversation were analyzed. Likert and forced-choice data with gap analysis are used to assess performance. Participants were strong in Demonstrating Empathy and Providing Closure, and needed to improve Relationship Building, Gathering Information, and understanding the Patient's/Family's Perspective. Participants under-appraised their abilities in Relationship Building, Providing Closure, and Demonstrating Empathy, as well as their overall performance. The conversion of these results into verbal feedback is discussed. We describe an evaluation methodology using multi-rater assessment with gap analysis to assess communication skills and self-insight. This methodology enables faculty to identify undervalued skills and perceptual blind spots, provide comprehensive, data driven, feedback, and encourage reflection. Implementation of graphical feedback forms coupled with one-on-one discussion using the above methodology has the potential to enhance trainee self-awareness and reflection, improving the impact of educational programs. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Reflecting on the methodological challenges of recruiting to a United Kingdom-wide, multi-centre, randomised controlled trial in gynaecology outpatient settings.

PubMed

Dickson, Sylvia; Logan, Janet; Hagen, Suzanne; Stark, Diane; Glazener, Cathryn; McDonald, Alison M; McPherson, Gladys

2013-11-15

Successful recruitment of participants to any trial is central to its success. Trial results are routinely published, and recruitment is often cited to be slower and more difficult than anticipated. This article reflects on the methodological challenges of recruiting women with prolapse attending United Kingdom (UK) gynaecology outpatient clinics to a multi-centre randomised controlled trial (RCT) of physiotherapy, and the systems put in place in an attempt to address them. Gynaecology outpatients with symptomatic prolapse were to be recruited over a 16-month period from 14 UK hospitals and one New Zealand hospital. Eligible women were informed about the trial by their gynaecologist and informed consent was obtained by the central trial office. Recruitment difficulties were encountered early on, and a number of strategies were employed to try to improve recruitment. Some strategies were more successful than others and they differed in the resources required. Actions that facilitated recruitment included increasing recruiting centres to 23 UK and two international hospitals, good centre support, using processes embedded in clinical practice, and good communication between the trial office, collaborators and participants. Collaborator incentives, whereby staff involved received the benefit immediately, were more successful than a nominal monetary payment per woman randomised. Barriers to recruitment included fewer eligible women than anticipated, patient's preference to receive active treatment rather than allocation to the control group, lack of support staff and high staff turnover. Geographical variations in Primary Care Trust Research Management and Governance approval systems and general practitioner (GP) referral procedures also impacted negatively on recruitment. Our article reflects on the methodological challenges of recruiting to a multi-centre RCT in a UK gynaecology setting. Effective interventions included increasing the number of recruiting centres and providing collaborator incentives. Barriers to recruitment included fewer eligible women than anticipated, patient's preference to be allocated to the treatment group, lack of support staff, and variations in approval systems and GP referral procedures. To improve the evidence base on clinical trial recruitment, trialists need to publish their experiences and lessons learned. Future RCTs should evaluate, where possible, the effect of strategies designed to improve recruitment and retention. Current Controlled Trials ISRCTN35911035.

Reflecting on the methodological challenges of recruiting to a United Kingdom-wide, multi-centre, randomised controlled trial in gynaecology outpatient settings

PubMed Central

2013-01-01

Background Successful recruitment of participants to any trial is central to its success. Trial results are routinely published, and recruitment is often cited to be slower and more difficult than anticipated. This article reflects on the methodological challenges of recruiting women with prolapse attending United Kingdom (UK) gynaecology outpatient clinics to a multi-centre randomised controlled trial (RCT) of physiotherapy, and the systems put in place in an attempt to address them. Methods Gynaecology outpatients with symptomatic prolapse were to be recruited over a 16-month period from 14 UK hospitals and one New Zealand hospital. Eligible women were informed about the trial by their gynaecologist and informed consent was obtained by the central trial office. Recruitment difficulties were encountered early on, and a number of strategies were employed to try to improve recruitment. Results Some strategies were more successful than others and they differed in the resources required. Actions that facilitated recruitment included increasing recruiting centres to 23 UK and two international hospitals, good centre support, using processes embedded in clinical practice, and good communication between the trial office, collaborators and participants. Collaborator incentives, whereby staff involved received the benefit immediately, were more successful than a nominal monetary payment per woman randomised. Barriers to recruitment included fewer eligible women than anticipated, patient’s preference to receive active treatment rather than allocation to the control group, lack of support staff and high staff turnover. Geographical variations in Primary Care Trust Research Management and Governance approval systems and general practitioner (GP) referral procedures also impacted negatively on recruitment. Conclusions Our article reflects on the methodological challenges of recruiting to a multi-centre RCT in a UK gynaecology setting. Effective interventions included increasing the number of recruiting centres and providing collaborator incentives. Barriers to recruitment included fewer eligible women than anticipated, patient’s preference to be allocated to the treatment group, lack of support staff, and variations in approval systems and GP referral procedures. To improve the evidence base on clinical trial recruitment, trialists need to publish their experiences and lessons learned. Future RCTs should evaluate, where possible, the effect of strategies designed to improve recruitment and retention. Trial registration Current Controlled Trials ISRCTN35911035 PMID:24228935

The Reference Encounter Model.

ERIC Educational Resources Information Center

White, Marilyn Domas

1983-01-01

Develops model of the reference interview which explicitly incorporates human information processing, particularly schema ideas presented by Marvin Minsky and other theorists in cognitive processing and artificial intelligence. Questions are raised concerning use of content analysis of transcribed verbal protocols as methodology for studying…

eLearning to enhance physician patient communication: a pilot test of "doc.com" and "WebEncounter" in teaching bad news delivery.

PubMed

Daetwyler, Christof J; Cohen, Diane G; Gracely, Edward; Novack, Dennis H

2010-01-01

Physician-patient communication skills help determine the nature and quality of diagnostic information elicited from patients, the quality of the physician's counseling, and the patient's adherence to treatment. In spite of their importance, surveys have demonstrated a wide variability and deficiencies in the teaching of these skills. Describe two specific methodologies for teaching physician-patient communication skills developed at our institution and pilot test them for effectiveness. Between 2004 and 2009 we developed "doc.com," a series of 41 media-rich online modules on all aspects of healthcare communication jointly with the American Academy on Communication in Healthcare. Starting in 2006, we expanded our pre-existing experience with the videoconferencing system "WebOSCE" into the online application "WebEncounter." This new methodology combines practice of communication skills on standardized patients with structured assessment and constructive feedback. We had three randomized groups: controls who did only the assessment parts of a WebOSCE on two occasions, a doc.com group who had doc.com in between the assessment occasions, and a combined group that had both doc.com and a WebEncounter between assessments. We found significant improvement in skills as components were added, and the training program was well received.

Collecting and validating experiential expertise is doable but poses methodological challenges.

PubMed

Burda, Marika H F; van den Akker, Marjan; van der Horst, Frans; Lemmens, Paul; Knottnerus, J André

2016-04-01

To give an overview of important methodological challenges in collecting, validating, and further processing experiential expertise and how to address these challenges. Based on our own experiences in studying the concept, operationalization, and contents of experiential expertise, we have formulated methodological issues regarding the inventory and application of experiential expertise. The methodological challenges can be categorized in six developmental research stages, comprising the conceptualization of experiential expertise, methods to harvest experiential expertise, the validation of experiential expertise, evaluation of the effectiveness, how to translate experiential expertise into acceptable guidelines, and how to implement these. The description of methodological challenges and ways to handle those are illustrated using diabetes mellitus as an example. Experiential expertise can be defined and operationalized in terms of successful illness-related behaviors and translated into recommendations regarding life domains. Pathways have been identified to bridge the gaps between the world of patients' daily lives and the medical world. Copyright © 2016 Elsevier Inc. All rights reserved.

Exploration of the Trade Space Between Unmanned Aircraft Systems Descent Maneuver Performance and Sense-and-Avoid System Performance Requirements

NASA Technical Reports Server (NTRS)

Jack, Devin P.; Hoffler, Keith D.; Johnson, Sally C.

2014-01-01

A need exists to safely integrate Unmanned Aircraft Systems (UAS) into the United States' National Airspace System. Replacing manned aircraft's see-and-avoid capability in the absence of an onboard pilot is one of the key challenges associated with safe integration. Sense-and-avoid (SAA) systems will have to achieve yet-to-be-determined required separation distances for a wide range of encounters. They will also need to account for the maneuver performance of the UAS they are paired with. The work described in this paper is aimed at developing an understanding of the trade space between UAS maneuver performance and SAA system performance requirements, focusing on a descent avoidance maneuver. An assessment of current manned and unmanned aircraft performance was used to establish potential UAS performance test matrix bounds. Then, near-term UAS integration work was used to narrow down the scope. A simulator was developed with sufficient fidelity to assess SAA system performance requirements. The simulator generates closest-point-of-approach (CPA) data from the wide range of UAS performance models maneuvering against a single intruder with various encounter geometries. Initial attempts to model the results made it clear that developing maneuver performance groups is required. Discussion of the performance groups developed and how to know in which group an aircraft belongs for a given flight condition and encounter is included. The groups are airplane, flight condition, and encounter specific, rather than airplane-only specific. Results and methodology for developing UAS maneuver performance requirements are presented for a descent avoidance maneuver. Results for the descent maneuver indicate that a minimum specific excess power magnitude can assure a minimum CPA for a given time-to-go prediction. However, smaller amounts of specific excess power may achieve or exceed the same CPA if the UAS has sufficient speed to trade for altitude. The results of this study will support UAS maneuver performance requirements development for integrating UAS in the NAS. The methods described are being used to help RTCA Special Committee 228 develop requirements.

Challenges of Combining Perspectives.

PubMed

Sundvall, Maria; Titelman, David; Bäärnhielm, Sofie

2018-02-23

Asylum seekers have increased risk of suicide and suicidal behavior, with differences related to origin, gender, and age. There are barriers to communication in clinical encounters between asylum seekers and clinicians. There is insufficient knowledge about how communication in the clinical encounter affects the suicide risk in female asylum seekers. To explore the documented communication between female asylum-seeking suicide attempters and clinicians and how it affects treatment. The medical records of 18 asylum-seeking women who had attempted suicide were analyzed with content analysis. Communication between patients and clinicians was affected by: the unbearable realities of the women; difficulties for clinicians in decoding languages of distress, and understanding trauma and subjective meanings of suicide; challenges of combining patients' and clinicians' perspectives; and a sense of shared powerlessness. The medical records did not give direct access to the patient's experience, only to the patient as documented by the clinician. The results suggest that clinicians working with asylum seekers who have attempted suicide need to develop an understanding of social and cultural factors and of trauma issues. A question for further study is how an enhanced integration of context and subjectivity in psychiatric practice would equip clinicians for the specific challenges encountered.

78 FR 13874 - Watershed Modeling To Assess the Sensitivity of Streamflow, Nutrient, and Sediment Loads to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-01

... an improved understanding of methodological challenges associated with integrating existing tools and... methodological challenges associated with integrating existing tools (e.g., climate models, downscaling... sensitivity to methodological choices such as different approaches for downscaling global climate change...

Motivational Strategies and the Reframing of English: Activity Design and Challenges for Teachers in Contexts of Extensive Extramural Encounters

ERIC Educational Resources Information Center

Henry, Alastair; Korp, Helena; Sundqvist, Pia; Thorsen, Cecilia

2018-01-01

Motivational strategies are underresearched, and studies so far conducted have been in sociolinguistic contexts where English is not extensively encountered outside the classroom. Given also that little is known about strategies relating to the design and content of classroom activities, the purpose of this study is to identify and critically…

Challenges Facing Chinese Academic Staff in a UK University in Terms of Language, Relationships and Culture

ERIC Educational Resources Information Center

Hsieh, Hui-hua

2012-01-01

The recruitment of international academic staff is viewed as one of the strategies to internationalise the universities. International academic staff, however, usually encounter many challenges when in a foreign context. This study aims to investigate the challenges of Chinese academic staff teaching in the UK in terms of language, relationships…

The Development of Questioning as a Means of Framing Problems and Posing Challenges.

ERIC Educational Resources Information Center

Feigenbaum, Peter

When a person encounters a problem, the character, form, and content of his or her response provides psychologists with useful and interesting information about processes of challenge and their relationship to intellectual development. In essence, challenge is a developing relationship that is defined on the one hand by objective factors (a person…

Art-technology Collaboration and Motivation Sources in Technologically Supported Artwork Buildup Project

NASA Astrophysics Data System (ADS)

Happonen, Ari; Stepanov, Alexander; Hirvimäki, Marika; Manninen, Matti; Dennisuk, William; Piili, Heidi; Salminen, Antti

This study is based on observed outcomes of motivation sources and collaboration elements from a living lab style co-operation project. In this project, researchers of engineering science and an individual artist co-operated closely. The goal was to create an artwork made from corrugated board by utilizing laser cutting technology. In the context of this study, the scientist and the artist participated in the whole process and the research was done in living lab style arrangement. The research process integrated multiple experts from different scientific fields and experts from practical contexts to develop a new art design and art forming process with utilization of laser cutting technology. The purpose of this study was to find out and discuss about the key elements for high motivation to work together and then reveal the best practice findings in this co-operative development process. Elements were studied from three different points of view: artists view, collaboration motivation view and practical cutting point of view. The elements were analysed by utilizing an active documentation collection methodology, during the whole process, and by using story-telling methodology. The documents were used to reflect facts and feelings from the co-operation, the work process and the challenges encountered within collaboration. This article contributes to research methodology and best practice context by revealing the key elements, which build the motivation compelling (as personal inner motivation) the participant to work out of office hours as well as on weekends. Furthermore, as the artist-engineer co-operation is not frequently reported in scientific literature, this study reveals valuable information for practitioners and co-operation researchers.

Effects of Soundscapes on Perceived Crowding and Encounter Norms

NASA Astrophysics Data System (ADS)

Kim, Sang-Oh; Shelby, Bo

2011-07-01

Soundscapes in recreation settings are becoming an important issue, but there are few studies of the effects of sounds on recreation experiences, especially crowding perceptions and encounter norms. This study compared effects of six types of sounds (an airplane, a truck engine, children playing, birds, water, and a control) on perceived crowding (PC) and encounter norms for hikers. Data were collected from 47 college students through lab experiments using simulated images, with moving hikers inserted in the original photo taken in the Jungmeori area of Mudeungsan Provincial Park in Korea. Overall, the motor-made sounds of the airplane and truck engine increased PC and decreased acceptability ratings, and the natural sounds of birds and water decreased PC and increased acceptability ratings. Ratings of the sound of children playing were similar to those in the control (i.e., no sound). In addition, as numbers of hikers increased, the overall effects of sounds decreased, and there were few significant differences in PC or acceptability ratings at the highest encounter levels. Theoretical and methodological implications are discussed.

Effects of soundscapes on perceived crowding and encounter norms.

PubMed

Kim, Sang-Oh; Shelby, Bo

2011-07-01

Soundscapes in recreation settings are becoming an important issue, but there are few studies of the effects of sounds on recreation experiences, especially crowding perceptions and encounter norms. This study compared effects of six types of sounds (an airplane, a truck engine, children playing, birds, water, and a control) on perceived crowding (PC) and encounter norms for hikers. Data were collected from 47 college students through lab experiments using simulated images, with moving hikers inserted in the original photo taken in the Jungmeori area of Mudeungsan Provincial Park in Korea. Overall, the motor-made sounds of the airplane and truck engine increased PC and decreased acceptability ratings, and the natural sounds of birds and water decreased PC and increased acceptability ratings. Ratings of the sound of children playing were similar to those in the control (i.e., no sound). In addition, as numbers of hikers increased, the overall effects of sounds decreased, and there were few significant differences in PC or acceptability ratings at the highest encounter levels. Theoretical and methodological implications are discussed.

The pitfalls of container production

Treesearch

Wayne Bell

2013-01-01

This paper summarizes ten of the biggest “pitfalls” or challenges I have encountered in my experience growing southern pine seedlings in containers over the past 30 years. Learning from challenges is an important part of growing successful nursery operations.

Design and application of gas-gap heat switches

NASA Technical Reports Server (NTRS)

Chan, C. K.; Ross, R. G., Jr.

1990-01-01

Gas-gap heat switches can serve as an effective means of thermally disconnecting a standby cryocooler when the primary (operating) cooler is connected and vice versa. The final phase of the development and test of a cryogenic heat switch designed for loads ranging from 2 watts at 8 K, to 100 watts at 80 K are described. Achieved heat-switch on/off conductance ratio ranged from 11,000 at 8 K to 2200 at 80 K. A particularly challenging element of heat-switch design is achieving satisfactory operation when large temperatures differentials exist across the switch. A special series of tests and analyses was conducted and used in this Phase-2 activity to evaluate the developed switches for temperature differentials ranging up to 200 K. Problems encountered at the maximum levels are described and analyzed, and means of avoiding the problems in the future are presented. A comprehensive summary of the overall heat-switch design methodology is also presented with special emphasis on lessons learned over the course of the 4-year development effort.

Meeting patient expectations: healthcare professionals and service re-engineering.

PubMed

Laing, Angus

2002-08-01

A central theme underpinning the reform of healthcare systems in western economies since the 1980s has been the emphasis on reorienting service provision around the patient. Healthcare organizations have been forced to re-appraise the design of the service delivery process, specifically the service encounter, to take account of these changing patient expectations. This reorientation of healthcare services around the patient has fundamental implications for healthcare professionals, specifically challenging the dominance of service professionals in the design and delivery of health services. Utilizing a qualitative methodological framework, this paper explores the responses of healthcare professionals to service redesign initiatives implemented in acute NHS hospitals in Scotland and considers the implications of such professional responses for the development of patient-focused service delivery. Within this, it specifically examines evolving professional perspectives on the place of a service user focus in a publicly funded healthcare system, professional attitudes towards private sector managerial practices, and the dynamics of changing professional behaviour.

Lessons learned from translators and interpreters from the Dinka tribe of southern Sudan.

PubMed

Baird, Martha B

2011-04-01

This article discusses the methodological challenges associated with working with translators and interpreters from the Dinka tribe of southern Sudan during an ethnographic study with refugee Dinka women who were resettled with their children in the United States. Navigating the cultural differences between the researcher, the translator, and the interpreters provided a deeper understanding about the culture of the study population. The lessons learned included the importance of cultural congruence between the interpreters and participants; the education, training, and experience of the interpreters; and the difficulties encountered in preparing interpreters according to university institutional review board requirements. Cultural differences such as time perception and communication and literacy styles were negotiated throughout each phase of the study. The most valuable lesson learned from this experience was the importance of the relationship between the researcher, the translator, and the interpreters as well as between the interpreters and participants to achieve credibility and trustworthiness of the study results.

Identifying and Overcoming Obstacles to Point-of-Care Data Collection for Eye Care Professionals

PubMed Central

Lobach, David F.; Silvey, Garry M.; Macri, Jennifer M.; Hunt, Megan; Kacmaz, Roje O.; Lee, Paul P.

2005-01-01

Supporting data entry by clinicians is considered one of the greatest challenges in implementing electronic health records. In this paper we describe a formative evaluation study using three different methodologies through which we identified obstacles to point-of-care data entry for eye care and then used the formative process to develop and test solutions to overcome these obstacles. The greatest obstacles were supporting free text annotation of clinical observations and accommodating the creation of detailed diagrams in multiple colors. To support free text entry, we arrived at an approach that captures an image of a free text note and associates this image with related data elements in an encounter note. The detailed diagrams included a color pallet that allowed changing pen color with a single stroke and also captured the diagrams as an image associated with related data elements. During observed sessions with simulated patients, these approaches satisfied the clinicians’ documentation needs by capturing the full range of clinical complexity that arises in practice. PMID:16779083

Anthropological Contributions to the Search for Extraterrestrial Intelligence

NASA Astrophysics Data System (ADS)

Vakoch, D. A.

2009-12-01

Three recent annual conferences of the American Anthropological Association (AAA) have included symposia on the Search for Extraterrestrial Intelligence (SETI). This paper reviews these symposia, which dealt with themes associated with the overarching AAA conference themes for each year: in 2004, the SETI session addressed Anthropology, Archaeology, and Interstellar Communication: Science and the Knowledge of Distant Worlds; in 2005, it dealt with Historical Perspectives on Anthropology and SETI; and in 2006, the session examined Culture, Anthropology, and SETI. Among the topics considered in these symposia were analogues for contact with extraterrestrial intelligence (ETI), examining anthropologists’ experience in the field encountering other cultures-past and present. Similarly, the methodologies of archaeologists provide analogies for making contact with temporally distant civilizations, based on reconstructions from fragmentary information. Case studies helped make such analogies concrete in the symposia. The challenges of comprehending intelligences with different mental worlds was explored through a study of the meetings of Neanderthals and Homo sapiens, for example, while the decryption of Mayan hieroglyphics provided lessons on understanding others of own species.

RF control at SSCL — an object oriented design approach

NASA Astrophysics Data System (ADS)

Dohan, D. A.; Osberg, E.; Biggs, R.; Bossom, J.; Chillara, K.; Richter, R.; Wade, D.

1994-12-01

The Superconducting Super Collider (SSC) in Texas, the construction of which was stopped in 1994, would have represented a major challenge in accelerator research and development. This paper addresses the issues encountered in the parallel design and construction of the control systems for the RF equipment for the five accelerators comprising the SSC. An extensive analysis of the components of the RF control systems has been undertaken, based upon the Schlaer-Mellor object-oriented analysis and design (OOA/OOD) methodology. The RF subsystem components such as amplifiers, tubes, power supplies, PID loops, etc. were analyzed to produce OOA information, behavior and process models. Using these models, OOD was iteratively applied to develop a generic RF control system design. This paper describes the results of this analysis and the development of 'bridges' between the analysis objects, and the EPICS-based software and underlying VME-based hardware architectures. The application of this approach to several of the SSCL RF control systems is discussed.

African American grandfamilies' attitudes and feelings about sexual communication: focus group results.

PubMed

Cornelius, Judith B; LeGrand, Sara; Jemmott, Loretta Sweet

2009-01-01

Little attention has been given to the responsibilities that African American grandparent caregivers face when they assume the role of raising their grandchildren. One particularly challenging task of grandparent caregivers is communicating with their grandchildren about sexuality issues. This study therefore examined the sexual communications and attitudes and feelings toward these communications between African American grandparent caregivers and their adolescent grandchildren (11-13 years of age). Focus group methodology was used to generate data about the grandparent/grandchild sexuality communication process and attitudes and feelings toward that process. The sample included 40 dyads of African American grandparents/grandchildren, for a total of 80 participants. Grandparents as well as their adolescent grandchildren desired open communication about sexuality issues, said that societal pressure makes sexual encounters hard to resist, and felt that they needed assistance with the sexuality communication process. Nurses can build upon the study's results to assist African American grandparents and their adolescent grandchildren with sexual communication.

SURVIAC Bulletin: RPG Encounter Modeling, Vol 27, Issue 1, 2012

DTIC Science & Technology

2012-01-01

return a probability of hit ( PHIT ) for the scenario. In the model, PHIT depends on the presented area of the targeted system and a set of errors infl...simplifying assumptions, is data-driven, and uses simple yet proven methodologies to determine PHIT . Th e inputs to THREAT describe the target, the RPG, and...Point on 2-D Representation of a CH-47 Th e determination of PHIT by THREAT is performed using one of two possible methodologies. Th e fi rst is a

Analytical Methodology Used To Assess/Refine Observatory Thermal Vacuum Test Conditions For the Landsat 8 Data Continuity Mission

NASA Technical Reports Server (NTRS)

Fantano, Louis

2015-01-01

Thermal and Fluids Analysis Workshop Silver Spring, MD NCTS 21070-15 The Landsat 8 Data Continuity Mission, which is part of the United States Geologic Survey (USGS), launched February 11, 2013. A Landsat environmental test requirement mandated that test conditions bound worst-case flight thermal environments. This paper describes a rigorous analytical methodology applied to assess refine proposed thermal vacuum test conditions and the issues encountered attempting to satisfy this requirement.

Lost and misplaced items and assistive devices in nursing homes: Identifying problems and technological opportunities through participatory design research

PubMed Central

Oude Weernink, C.E.; Sweegers, L.; Relou, L.; van der Zijpp, T.J.; van Hoof, J.

2018-01-01

INTRODUCTION: Modern healthcare, including nursing home care, goes together with the use of technologies to support treatment, the provision of care and daily activities. The challenges concerning the implementation of such technologies are numerous. One of these emerging technologies are location technologies (RTLS or Real-Time Location Systems). that can be utilized in the nursing home for monitoring the use and location of assets. METHODOLOGY: This paper describes a participatory design study of RTLS based on context mapping, conducted in two nursing home organizations. Rather than investigating the technological possibilities, this study investigates the needs and wishes from the perspective of the care professional. RESULTS: The study identified semantic themes that relate to the practicalities of lost and misplaced items in the nursing home, as well as latent themes that cover the wishes regarding technology in the nursing homes. The organizational culture and building typology may play a role in losing items. CONCLUSION: The participants in this study indicated that RTLS can provide a solution to some of the challenges that they encounter in the workplace. However, the implementation of new technologies should be done with care and should be integrated into existing ICT systems in order to minimize additional training and posing a burden on the workload. PMID:29527110

Integrated Simulation Design Challenges to Support TPS Repair Operations

NASA Technical Reports Server (NTRS)

Quiocho, Leslie J.; Crues, Edwin Z.; Huynh, An; Nguyen, Hung T.; MacLean, John

2005-01-01

During the Orbiter Repair Maneuver (ORM) operations planned for Return to Flight (RTF), the Shuttle Remote Manipulator System (SRMS) must grapple the International Space Station (ISS), undock the Orbiter, maneuver it through a long duration trajectory, and orient it to an EVA crewman poised at the end of the Space Station Remote Manipulator System (SSRMS) to facilitate the repair of the Thermal Protection System (TPS). Once repair has been completed and confirmed, then the SRMS proceeds back through the trajectory to dock the Orbiter to the Orbiter Docking System. In order to support analysis of the complex dynamic interactions of the integrated system formed by the Orbiter, ISS, SRMS, and SSRMS during the ORM, simulation tools used for previous 'nominal' mission support required substantial enhancements. These upgrades were necessary to provide analysts with the capabilities needed to study integrated system performance. This paper discusses the simulation design challenges encountered while developing simulation capabilities to mirror the ORM operations. The paper also describes the incremental build approach that was utilized, starting with the subsystem simulation elements and integration into increasing more complex simulations until the resulting ORM worksite dynamics simulation had been assembled. Furthermore, the paper presents an overall integrated simulation V&V methodology based upon a subsystem level testing, integrated comparisons, and phased checkout.

Test Driven Development of a Parameterized Ice Sheet Component

NASA Astrophysics Data System (ADS)

Clune, T.

2011-12-01

Test driven development (TDD) is a software development methodology that offers many advantages over traditional approaches including reduced development and maintenance costs, improved reliability, and superior design quality. Although TDD is widely accepted in many software communities, the suitability to scientific software is largely undemonstrated and warrants a degree of skepticism. Indeed, numerical algorithms pose several challenges to unit testing in general, and TDD in particular. Among these challenges are the need to have simple, non-redundant closed-form expressions to compare against the results obtained from the implementation as well as realistic error estimates. The necessity for serial and parallel performance raises additional concerns for many scientific applicaitons. In previous work I demonstrated that TDD performed well for the development of a relatively simple numerical model that simulates the growth of snowflakes, but the results were anecdotal and of limited relevance to far more complex software components typical of climate models. This investigation has now been extended by successfully applying TDD to the implementation of a substantial portion of a new parameterized ice sheet component within a full climate model. After a brief introduction to TDD, I will present techniques that address some of the obstacles encountered with numerical algorithms. I will conclude with some quantitative and qualitative comparisons against climate components developed in a more traditional manner.

Asset - An application in mission automation for science planning

NASA Technical Reports Server (NTRS)

Finnerty, D. F.; Martin, J.; Doms, P. E.

1987-01-01

Recent advances in computer technology were used to great advantage in planning science observation sequences for the Voyager 2 encounter with Uranus in 1986. Despite a loss of experienced personnel, a challenging schedule, workforce limitations, and the complex nature of the Uranus encounter itself, the resultant science observation timelines were the most highly optimized of the five Voyager encounters with the outer planets. In part, this was due to the development of a microcomputer-based system, called ASSET (Automated Science Sequence Encounter Timelines generator), which was used to design those science observation timelines. This paper details the development of that system. ASSET demonstrates several features essential to the design of the first expert systems for science planning which will be applied for future missions.

Conducting Research with LGB People of Color: Methodological Challenges and Strategies

ERIC Educational Resources Information Center

DeBlaere, Cirleen; Brewster, Melanie E.; Sarkees, Anthony; Moradi, Bonnie

2010-01-01

Methodological barriers have been highlighted as a primary reason for the limited research with lesbian, gay, and bisexual (LGB) people of color. Thus, strategies for anticipating and addressing potential methodological barriers are needed. To address this need, this article discusses potential challenges associated with conducting research with…

An Exploratory Study of Pharmacists Professional Learning

ERIC Educational Resources Information Center

Wittstrom, Kristina M.

2012-01-01

Today's healthcare professional is challenged to stay current with increasingly complex therapeutic challenges, greater societal needs and expectations, and a public demand for the best possible care. Professional learning opportunities are needed to develop new knowledge, skills, or abilities to address specific matters encountered during…

Orff Ensembles: Benefits, Challenges, and Solutions

ERIC Educational Resources Information Center

Taylor, Donald M.

2012-01-01

Playing Orff instruments provides students with a wide variety of opportunities to explore creative musicianship. This article examines the benefits of classroom instrument study, common challenges encountered, and viable teaching strategies to promote student success. The ability to remove notes from barred instruments makes note accuracy more…

Resources and Recommendations for Using Transcriptomics to Address Grand Challenges in Comparative Biology

PubMed Central

Mykles, Donald L.; Burnett, Karen G.; Durica, David S.; Joyce, Blake L.; McCarthy, Fiona M.; Schmidt, Carl J.; Stillman, Jonathon H.

2016-01-01

High-throughput RNA sequencing (RNA-seq) technology has become an important tool for studying physiological responses of organisms to changes in their environment. De novo assembly of RNA-seq data has allowed researchers to create a comprehensive catalog of genes expressed in a tissue and to quantify their expression without a complete genome sequence. The contributions from the “Tapping the Power of Crustacean Transcriptomics to Address Grand Challenges in Comparative Biology” symposium in this issue show the successes and limitations of using RNA-seq in the study of crustaceans. In conjunction with the symposium, the Animal Genome to Phenome Research Coordination Network collated comments from participants at the meeting regarding the challenges encountered when using transcriptomics in their research. Input came from novices and experts ranging from graduate students to principal investigators. Many were unaware of the bioinformatics analysis resources currently available on the CyVerse platform. Our analysis of community responses led to three recommendations for advancing the field: (1) integration of genomic and RNA-seq sequence assemblies for crustacean gene annotation and comparative expression; (2) development of methodologies for the functional analysis of genes; and (3) information and training exchange among laboratories for transmission of best practices. The field lacks the methods for manipulating tissue-specific gene expression. The decapod crustacean research community should consider the cherry shrimp, Neocaridina denticulata, as a decapod model for the application of transgenic tools for functional genomics. This would require a multi-investigator effort. PMID:27639274

Challenges encountered in providing integrated HIV, antenatal and postnatal care services: a case study of Katakwi and Mubende districts in Uganda.

PubMed

Ahumuza, Sharon Eva; Rujumba, Joseph; Nkoyooyo, Abdallah; Byaruhanga, Raymond; Wanyenze, Rhoda K

2016-04-18

Integration of sexual and reproductive health (SRH), HIV/AIDS and maternal health (MH) services is a critical strategy to confront the HIV/AIDS epidemic, high maternal mortality and the unmet need for contraception. In 2011 the AIDS Information Centre (AIC) in partnership with the Ministry of Health implemented SRH, HIV/AIDS and MH integration services in the districts of Katakwi and Mubende in Uganda. This paper documents challenges encountered in providing these integrated services in the two districts. This was a cross-sectional qualitative study conducted in Mubende and Katakwi districts in Uganda. Data were collected using 10 focus group discussions with 89 women attending ANC and postnatal care and 21 key informant interviews with district managers and health workers who were involved in the integrated service delivery. Content thematic approach was used for data analysis. The study findings indicate that various challenges were encountered in integrating HIV, ANC and PNC services. Major challenges included inadequate staff, gaps in knowledge of service providers especially with regard to provision of long-term family planning, limited space, shortage of critical supplies such as HIV test kits, drugs and gloves. These findings indicate that the delivery of integrated HIV, SRH and MH services is hampered greatly by health system challenges and depict the need for additional staffing in health facilities, capacity building of health workers and health managers as well as ensuring sufficient supplies to health facilities for smooth implementation of integrated SRH, HIV and MH services.

Developing a Simulated-Person Methodology Workshop: An Experiential Education Initiative for Educators and Simulators

ERIC Educational Resources Information Center

Peisachovich, Eva Hava; Nelles, L. J.; Johnson, Samantha; Nicholson, Laura; Gal, Raya; Kerr, Barbara; Celia, Popovic; Epstein, Iris; Da Silva, Celina

2017-01-01

Numerous forecasts suggest that professional-competence development depends on human encounters. Interaction between organizations, tasks, and individual providers influence human behaviour, affect organizations' or systems' performance, and are a key component of professional-competence development. Further, insufficient or ineffective…

The Future of Psychology. A Reply to Buss

ERIC Educational Resources Information Center

Abrahams, J. P.; And Others

1975-01-01

This paper describes the observations and experiences of a graduate student employed as a nurse's aide in a home for the aged. The difficulties encountered in attempting to apply traditional psychological methodology are discussed, and detailed anecdotal reports on individual cases are presented. (GO)

Globalization and its methodological discontents: Contextualizing globalization through the study of HIV/AIDS

PubMed Central

2011-01-01

There remains considerable discontent between globalization scholars about how to conceptualize its meaning and in regards to epistemological and methodological questions concerning how we can come to understand how these processes ultimately operate, intersect and transform our lives. This article argues that to better understand what globalization is and how it affects issues such as global health, we must take a differentiating approach, which focuses on how the multiple processes of globalization are encountered and informed by different social groups and with how these encounters are experienced within particular contexts. The article examines the heuristic properties of qualitative field research as a means to help better understand how the intersections of globalization are manifested within particular locations. To do so, the article focuses on three recent case studies conducted on globalization and HIV/AIDS and explores how these cases can help us to understand the contextual permutations involved within the processes of globalization. PMID:21861895

Women's Experiences of the Tenure Process: A Case Study at a Small Public Southeastern University

ERIC Educational Resources Information Center

Cody, Debra Jennings

2012-01-01

The purpose of this study was to describe women's experiences and challenges encountered during the tenure process at one institution, if and how they overcame those challenges, and if the challenges are consistent with those that appear in the literature. Higher education is comprised of a majority of male faculty members and administrators, but…

Documenting Sociolinguistic Variation in Lesser-Studied Indigenous Communities: Challenges and Practical Solutions

ERIC Educational Resources Information Center

Mansfield, John; Stanford, James

2017-01-01

Documenting sociolinguistic variation in lesser-studied languages presents methodological challenges, but also offers important research opportunities. In this paper we examine three key methodological challenges commonly faced by researchers who are outsiders to the community. We then present practical solutions for successful variationist…

78 FR 68449 - Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

... RFA-HS14-002, Addressing Methodological Challenges in Research for Patients With Multiple Chronic... applications for the ``AHRQ RFA-HS14-002, Addressing Methodological Challenges in Research for Patients With...

Learning as discourse change: A sociocultural mechanism

NASA Astrophysics Data System (ADS)

Wickman, Per-Olof; Östman, Leif

2002-09-01

This paper deals with a theoretical mechanism for learning and a methodological approach for analyzing meaning making in classroom talk and action. It examines the potential of the approach for illuminating learning on a discursive level, i.e., how discourses change and how individuals become participants of new practices. Our approach involves a high-resolution analysis of how meaningful relations are built in encounters between individuals and between individuals and the world. The approach is based mainly on the work of the later Wittgenstein, but also on pragmatism and sociocultural research. To demonstrate how our approach can be used, we analyze what university students learn during a practical on insects. We specifically demonstrate how the encounters with physical pinned insects contribute to the meaning students make and how these encounters interact with other experiences during laboratory work.

Contrasting diets reveal the metabolic plasticity of the tree-killing beetle, Anoplophora glabripennis (Cerambycidae: Lamiinae)

USDA-ARS?s Scientific Manuscript database

Wood-feeding insects encounter challenging diets with low quantities of protein, recalcitrant sources of carbohydrates, and high levels of defensive compounds. These insects have multiple, complementary mechanisms to contend with these digestive challenges. The Asian longhorned beetle (Anoplophora g...

Challenges of Field Testing The Traffic Monitoring Advisor in an Operational Air Traffic Control Facility

DOT National Transportation Integrated Search

1997-01-01

The Traffic Management Advisor (TMA), the sequence and schedule tool of the : Center/TRACON Automation System (CTAS), was evaluated at the Fort Worth Center : (ZFW) in the summer of 1996. This paper describes the challenges encountered : during the v...

Implementation Challenges to TADS Cognitive-Behavioral Therapy

ERIC Educational Resources Information Center

Kennard, Betsy D.; Ginsburg, Golda S.; Feeny, Norah C.; Sweeney, Michael; Zagurski, Robin

2005-01-01

This article discusses treatment obstacles that were frequently encountered by CBT therapists in the Treatment for Adolescents With Depression Study (TADS) trial. The most common or challenging treatment obstacles and their respective solutions were distilled from the minutes of national conference calls attended by TADS CBT supervisors and…

Critical reflections on methodological challenge in arts and dementia evaluation and research.

PubMed

Gray, Karen; Evans, Simon Chester; Griffiths, Amanda; Schneider, Justine

2017-01-01

Methodological rigour, or its absence, is often a focus of concern for the emerging field of evaluation and research around arts and dementia. However, this paper suggests that critical attention should also be paid to the way in which individual perceptions, hidden assumptions and underlying social and political structures influence methodological work in the field. Such attention will be particularly important for addressing methodological challenges relating to contextual variability, ethics, value judgement and signification identified through a literature review on this topic. Understanding how, where and when evaluators and researchers experience such challenges may help to identify fruitful approaches for future evaluation.

Practical Issues of Conducting a Q Methodology Study: Lessons Learned From a Cross-cultural Study.

PubMed

Stone, Teresa Elizabeth; Maguire, Jane; Kang, Sook Jung; Cha, Chiyoung

This article advances nursing research by presenting the methodological challenges experienced in conducting a multination Q-methodology study. This article critically analyzes the relevance of the methodology for cross-cultural and nursing research and the challenges that led to specific responses by the investigators. The use of focus groups with key stakeholders supplemented the Q-analysis results. The authors discuss practical issues and shared innovative approaches and provide best-practice suggestions on the use of this flexible methodology. Q methodology has the versatility to explore complexities of contemporary nursing practice and cross-cultural health research.

Tests for informative cluster size using a novel balanced bootstrap scheme.

PubMed

Nevalainen, Jaakko; Oja, Hannu; Datta, Somnath

2017-07-20

Clustered data are often encountered in biomedical studies, and to date, a number of approaches have been proposed to analyze such data. However, the phenomenon of informative cluster size (ICS) is a challenging problem, and its presence has an impact on the choice of a correct analysis methodology. For example, Dutta and Datta (2015, Biometrics) presented a number of marginal distributions that could be tested. Depending on the nature and degree of informativeness of the cluster size, these marginal distributions may differ, as do the choices of the appropriate test. In particular, they applied their new test to a periodontal data set where the plausibility of the informativeness was mentioned, but no formal test for the same was conducted. We propose bootstrap tests for testing the presence of ICS. A balanced bootstrap method is developed to successfully estimate the null distribution by merging the re-sampled observations with closely matching counterparts. Relying on the assumption of exchangeability within clusters, the proposed procedure performs well in simulations even with a small number of clusters, at different distributions and against different alternative hypotheses, thus making it an omnibus test. We also explain how to extend the ICS test to a regression setting and thereby enhancing its practical utility. The methodologies are illustrated using the periodontal data set mentioned earlier. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Methodologies for Verification and Validation of Space Launch System (SLS) Structural Dynamic Models

NASA Technical Reports Server (NTRS)

Coppolino, Robert N.

2018-01-01

Responses to challenges associated with verification and validation (V&V) of Space Launch System (SLS) structural dynamics models are presented in this paper. Four methodologies addressing specific requirements for V&V are discussed. (1) Residual Mode Augmentation (RMA), which has gained acceptance by various principals in the NASA community, defines efficient and accurate FEM modal sensitivity models that are useful in test-analysis correlation and reconciliation and parametric uncertainty studies. (2) Modified Guyan Reduction (MGR) and Harmonic Reduction (HR, introduced in 1976), developed to remedy difficulties encountered with the widely used Classical Guyan Reduction (CGR) method, are presented. MGR and HR are particularly relevant for estimation of "body dominant" target modes of shell-type SLS assemblies that have numerous "body", "breathing" and local component constituents. Realities associated with configuration features and "imperfections" cause "body" and "breathing" mode characteristics to mix resulting in a lack of clarity in the understanding and correlation of FEM- and test-derived modal data. (3) Mode Consolidation (MC) is a newly introduced procedure designed to effectively "de-feature" FEM and experimental modes of detailed structural shell assemblies for unambiguous estimation of "body" dominant target modes. Finally, (4) Experimental Mode Verification (EMV) is a procedure that addresses ambiguities associated with experimental modal analysis of complex structural systems. Specifically, EMV directly separates well-defined modal data from spurious and poorly excited modal data employing newly introduced graphical and coherence metrics.

A methodology of SiP testing based on boundary scan

NASA Astrophysics Data System (ADS)

Qin, He; Quan, Haiyang; Han, Yifei; Zhu, Tianrui; Zheng, Tuo

2017-10-01

System in Package (SiP) play an important role in portable, aerospace and military electronic with the microminiaturization, light weight, high density, and high reliability. At present, SiP system test has encountered the problem on system complexity and malfunction location with the system scale exponentially increase. For SiP system, this paper proposed a testing methodology and testing process based on the boundary scan technology. Combining the character of SiP system and referencing the boundary scan theory of PCB circuit and embedded core test, the specific testing methodology and process has been proposed. The hardware requirement of the under test SiP system has been provided, and the hardware platform of the testing has been constructed. The testing methodology has the character of high test efficiency and accurate malfunction location.

Encounters and Places: Project Negotiations in Galessa, Ethiopia

ERIC Educational Resources Information Center

Habermann, Birgit; Felt, Ulrike; Vogl, Christian R.; Bekele, Kassahun; Mekonnen, Kindu

2012-01-01

Purpose: Reflections on negotiation processes between farmers and scientists in research projects provide insights into issues of participation, power and equity. The purpose of this paper is to illustrate how actors chose places to meet, negotiate and represent technologies. Design/methodology/approach: The research involved semi-structured…

Burn Survivors' Perceptions regarding Relevant Sexual Education Strategies

ERIC Educational Resources Information Center

Parrott, Yolan; Esmail, Shaniff

2010-01-01

Purpose: This paper aims to investigate the unique issues childhood burn survivors experience in relation to sex education and sexual development. Design/methodology/approach: Using a phenomenological approach, participants described their lived experiences with regards to sex education and the sexuality issues they encountered as child burn…

Analysis and Reduction of Complex Networks Under Uncertainty.

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

Ghanem, Roger G

2014-07-31

This effort was a collaboration with Youssef Marzouk of MIT, Omar Knio of Duke University (at the time at Johns Hopkins University) and Habib Najm of Sandia National Laboratories. The objective of this effort was to develop the mathematical and algorithmic capacity to analyze complex networks under uncertainty. Of interest were chemical reaction networks and smart grid networks. The statements of work for USC focused on the development of stochastic reduced models for uncertain networks. The USC team was led by Professor Roger Ghanem and consisted of one graduate student and a postdoc. The contributions completed by the USC teammore » consisted of 1) methodology and algorithms to address the eigenvalue problem, a problem of significance in the stability of networks under stochastic perturbations, 2) methodology and algorithms to characterize probability measures on graph structures with random flows. This is an important problem in characterizing random demand (encountered in smart grid) and random degradation (encountered in infrastructure systems), as well as modeling errors in Markov Chains (with ubiquitous relevance !). 3) methodology and algorithms for treating inequalities in uncertain systems. This is an important problem in the context of models for material failure and network flows under uncertainty where conditions of failure or flow are described in the form of inequalities between the state variables.« less

Shared decision-making in medical encounters regarding breast cancer treatment: the contribution of methodological triangulation.

PubMed

Durif-Bruckert, C; Roux, P; Morelle, M; Mignotte, H; Faure, C; Moumjid-Ferdjaoui, N

2015-07-01

The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires (n = 132), longitudinal interviews (n = 47) and observations of consultations (n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available. © 2014 John Wiley & Sons Ltd.

Talking about history: discussions in a middle school inclusive classroom.

PubMed

Okolo, Cynthia M; Ferretti, Ralph P; MacArthur, Charles A

2007-01-01

In this study, we examined the nature of whole-class discussion and teachers' instruction during discussion about historical topics in one inclusive, middle-grade classroom. We videotaped and analyzed 4 lessons to determine the nature of discussion sequences, rates of participation, and instructional challenges encountered by the teacher and students. We triangulated our analysis of observational data with teacher interviews. The results showed high rates of student participation, with no differences between students with and without disabilities. The teacher initiated and controlled the discussion, and nearly all student responses were from teacher to student rather than from student to student. The teacher encountered three challenges in developing students' understanding, and we identify specific practices she used to address these challenges. Based on students' response to measures administered by project staff and on their scores on statewide tests, this teacher's practices seemed to be highly effective.

Survey of Applications of Active Control Technology for Gust Alleviation and New Challenges for Lighter-weight Aircraft

NASA Technical Reports Server (NTRS)

Regan, Christopher D.; Jutte, Christine V.

2012-01-01

This report provides a historical survey and assessment of the state of the art in the modeling and application of active control to aircraft encountering atmospheric disturbances in flight. Particular emphasis is placed on applications of active control technologies that enable weight reduction in aircraft by mitigating the effects of atmospheric disturbances. Based on what has been learned to date, recommendations are made for addressing gust alleviation on as the trend for more structurally efficient aircraft yields both lighter and more flexible aircraft. These lighter more flexible aircraft face two significant challenges reduced separation between rigid body and flexible modes, and increased sensitivity to gust encounters due to increased wing loading and improved lift to drag ratios. The primary audience of this paper is engineering professionals new to the area of gust load alleviation and interested in tackling the multifaceted challenges that lie ahead for lighter-weight aircraft.

Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations with staff during clinical placement: A qualitative study.

PubMed

McCloughen, Andrea; Foster, Kim

2018-07-01

To identify challenging interpersonal interactions experienced by nursing and pharmacy students during clinical placement, and strategies used to manage those situations. Healthcare students and staff experience elevated stress when exposed to dynamic clinical environments, complex care and challenging professional relationships. Emotionally intelligent behaviours are associated with appropriate recognition and management of emotions evoked by stressful experiences and development of effective relationships. Nursing and pharmacy students' use of emotionally intelligent behaviours to manage challenging interpersonal situations is not well known. A qualitative design, using semi-structured interviews to explore experiences of challenging interpersonal situations during clinical placement (Phase two of a larger mixed-methods study). Final-year Australian university nursing and pharmacy students (n = 20) were purposefully recruited using a range of Emotional Intelligence scores (derived in Phase one), measured using the GENOS Emotional intelligence Inventory (concise version). Challenging interpersonal situations involving student-staff and intrastaff conflict, discourteous behaviour and criticism occurred during clinical placement. Students used personal and relational strategies, incorporating emotionally intelligent behaviours, to manage these encounters. Strategies included reflecting and reframing, being calm, controlling discomfort and expressing emotions appropriately. Emotionally intelligent behaviours are effective to manage stressful interpersonal interactions. Methods for strengthening these behaviours should be integrated into education of nursing and pharmacy students and qualified professionals. Education within the clinical/workplace environment can incorporate key interpersonal skills of collaboration, social interaction and reflection, while also attending to sociocultural contexts of the healthcare setting. Students and staff are frequently exposed to stressful clinical environments and challenging interpersonal encounters within healthcare settings. Use of emotionally intelligent behaviours to recognise and effectively manage these encounters may contribute to greater stress tolerance and enhanced professional relationships. Nursing and pharmacy students, and their qualified counterparts, need to be educated to strengthen their emotional intelligence skills. © 2017 John Wiley & Sons Ltd.

Summative assessment of undergraduates' communication competence in challenging doctor-patient encounters. Evaluation of the Düsseldorf CoMeD-OSCE.

PubMed

Mortsiefer, Achim; Immecke, Janine; Rotthoff, Thomas; Karger, André; Schmelzer, Regine; Raski, Bianca; Schmitten, Jürgen In der; Altiner, Attila; Pentzek, Michael

2014-06-01

To evaluate the summative assessment (OSCE) of a communication training programme for dealing with challenging doctor-patient encounters in the 4th study year. Our OSCE consists of 4 stations (breaking bad news, guilt and shame, aggressive patients, shared decision making), using a 4-item global rating (GR) instrument. We calculated reliability coefficients for different levels, discriminability of single items and interrater reliability. Validity was estimated by gender differences and accordance between GR and a checklist. In a pooled sample of 456 students in 3 OSCEs over 3 terms, total reliability was α=0.64, reliability coefficients for single stations were >0.80, and discriminability in 3 of 4 stations was within the range of 0.4-0.7. Except for one station, interrater reliability was moderate to strong. Reliability on item level was poor and pointed to some problems with the use of the GR. The application of the GR on regular undergraduate medical education shows moderate reliability in need of improvement and some traits of validity. Ongoing development and evaluation is needed with particular regard to the training of the examiners. Our CoMeD-OSCE proved suitable for the summative assessment of communication skills in challenging doctor-patient encounters. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Imagined Community of Education: Voices from Refugees and Immigrants

ERIC Educational Resources Information Center

He, Ye; Bettez, Silvia Cristina; Levin, Barbara B.

2017-01-01

To challenge deficit thinking concerning immigrants and refugees in urban schools, we engaged members of local immigrant and refugee communities from China, Mexico, Liberia, and Sudan in focus group discussions about their prior educational experiences, their hopes and aspirations for education, and the supports and challenges they encountered in…

Promoting Social and Emotional Growth of Students with Disabilities

ERIC Educational Resources Information Center

Darrow, Alice-Ann

2014-01-01

Students with disabilities are often faced with numerous challenges as they progress through their school years. In addition to disability-related challenges, they may encounter additional difficulties such as bullying in school and lack of social acceptance by their peers. It is important that students with disabilities develop competence in…

Pluralism and Particularism: Friends or Foes?

ERIC Educational Resources Information Center

Menninger, Rich

2007-01-01

A major challenge facing Christian higher education is how to interact with a pluralistic society. This challenge is encountered in many venues such as community involvement, accountability to churches at large, and the various activities within a particular school (college or university) itself as it conducts business, including teaching. A…

Understanding the Coping Strategies of International Students: A Qualitative Approach

ERIC Educational Resources Information Center

Khawaja, Nigar G.; Stallman, Helen M.

2011-01-01

International students encounter a range of additional challenges as a part of their tertiary study experience. A qualitative approach was used to understand the challenges faced by international students, coping strategies that promoted their personal resilience and advice they have for future international students. Twenty-two international…

Impact of Military Deployment and Distance Learning on Soldier-Students

ERIC Educational Resources Information Center

Murray, August T.

2013-01-01

Soldiers face complex challenges, issues, and decisions when pursuing distance learning while deployed. These challenges are encountered frequently while completing undergraduate and graduate degree programs on active duty overseas. Many learning programs and benefits are available and utilized by military online learners in a war zone. Education…

Faculty Perceptions of Common Challenges Encountered by Novice Doctoral Writers

ERIC Educational Resources Information Center

Maher, Michelle A.; Feldon, David F.; Timmerman, Briana E.; Chao, Jie

2014-01-01

Although learning to write for publication is an important outcome of doctoral education, it has received surprisingly little scholarly attention. Within a socialization and supervisor pedagogy framework, this study uses narratives of faculty who regularly write with their doctoral students for publication to expose challenges students commonly…

Don't Give Up! Practical Strategies for Challenging Collaborations

ERIC Educational Resources Information Center

Cramer, Sharon; Stivers, Jan

2007-01-01

People faced with collaboration challenges are often reluctant to be honest about problems because in many schools collaboration is a norm. But whereas most special educators are intuitively skilled at working with others, "problematic professional encounters are inevitable barriers that will appear occasionally in the life of every special…

Challenges Experienced by Japanese Students with Oral Communication Skills in Australian Universities

ERIC Educational Resources Information Center

Yanagi, Miho; Baker, Amanda A.

2016-01-01

Due to ever-increasing demands to acquire effective communicative abilities in the English language, increasing numbers of international students choose to study in Western tertiary institutions; however, they frequently encounter difficulties in performing satisfactorily in English. This study aims to identify specific challenges that Japanese…

Online Tools to Support the Delivery of Evidence-Based Practices for Students with ASD

ERIC Educational Resources Information Center

Sam, Ann M.; Kucharczyk, Suzanne; Waters, Victoria

2018-01-01

Educators continually encounter new challenges that require different tools or ways to utilize current tools in novel ways. Common challenges when working with students with autism spectrum disorder (ASD) may include addressing interfering behavior, developing communication systems, increasing social opportunities for students, and addressing…

Cultural and Cognitive Development in Short-Term Study Abroad: Illuminating the 360 Experience

ERIC Educational Resources Information Center

Burton, Susan

2012-01-01

The three articles in this dissertation investigate leading others through developmental opportunities by facilitating their engagement in intercultural challenges. Specifically the research explores the meaning followers make of developmental challenges during short-term study abroad experiences and encounters with diversity. Data in the form of…

Career Advancement of Women Senior Academic Administrators in Indonesia: Supports and Challenges

ERIC Educational Resources Information Center

Murniati, Cecilia Titiek

2012-01-01

Increasing numbers of women have gained access to college and the college teaching profession worldwide. However, women continue to be underrepresented in academic, research, and leadership positions. Women who have aspirations for top leadership positions still encounter numerous internal and external challenges. Existent literature on women…

Choosing High-Yield Tasks for the Mathematical Development of Practicing Secondary Teachers

ERIC Educational Resources Information Center

Epperson, James A. Mendoza; Rhoads, Kathryn

2015-01-01

Many mathematics teacher educators encounter the challenge of creating or choosing mathematical tasks that evoke important mathematical insights and connections yet remain firmly grounded in school mathematics. This challenge increases substantially when trying to meet the needs of practicing secondary mathematics teachers pursuing graduate work…

Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016.

PubMed

Farrer, Louise M; Walker, Jennie; Harrison, Christopher; Banfield, Michelle

2018-01-01

General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.

Inclusive Education for Students with Hearing Impairment in the Regular Secondary Schools in the North-West Region of Cameroon: Initiatives and Challenges

ERIC Educational Resources Information Center

Bamu, Beryl Ndongwa; De Schauwer, Elisabeth; Verstraete, Sara; Van Hove, Geert

2017-01-01

Although some initiatives are implemented in the education of students with hearing impairments in the regular school, challenges are still encountered in their education. This article which is part of the results from an ongoing qualitative study in the North-West region of Cameroon addresses the different initiatives and challenges involved with…

Lubrication of space systems: Challenges and potential solutions

NASA Technical Reports Server (NTRS)

Fusaro, Robert L.

1992-01-01

Future space missions will all require advanced mechanical moving components which will require wear protection and lubrication. The tribology practices used today are primarily based upon a technology base that is more than 20 years old. This paper will discuss NASA's future space missions and some of the mechanism tribology challenges that will be encountered. Potential solutions to these challenges using coatings technology will be assessed.

Applications of decision analysis and related techniques to industrial engineering problems at KSC

NASA Technical Reports Server (NTRS)

Evans, Gerald W.

1995-01-01

This report provides: (1) a discussion of the origination of decision analysis problems (well-structured problems) from ill-structured problems; (2) a review of the various methodologies and software packages for decision analysis and related problem areas; (3) a discussion of how the characteristics of a decision analysis problem affect the choice of modeling methodologies, thus providing a guide as to when to choose a particular methodology; and (4) examples of applications of decision analysis to particular problems encountered by the IE Group at KSC. With respect to the specific applications at KSC, particular emphasis is placed on the use of the Demos software package (Lumina Decision Systems, 1993).

Evaluation of the Trade Space Between UAS Maneuver Performance and SAA System Performance Requirements

NASA Technical Reports Server (NTRS)

Jack, Devin P.; Hoffler, Keith D.; Johnson, Sally C.

2014-01-01

A need exists to safely integrate Unmanned Aircraft Systems (UAS) into the National Airspace System. Replacing manned aircraft's see-and-avoid capability in the absence of an onboard pilot is one of the key challenges associated with safe integration. Sense-and-avoid (SAA) systems will have to achieve yet-to-be-determined required separation distances for a wide range of encounters. They will also need to account for the maneuver performance of the UAS they are paired with. The work described in this paper is aimed at developing an understanding of the trade space between UAS maneuver performance and SAA system performance requirements. An assessment of current manned and unmanned aircraft performance was used to establish potential UAS performance test matrix bounds. Then, nearterm UAS integration work was used to narrow down the scope. A simulator was developed with sufficient fidelity to assess SAA system performance requirements for a wide range of encounters. The simulator generates closest-point-of-approach (CPA) data from the wide range of UAS performance models maneuvering against a single intruder with various encounter geometries. The simulator is described herein and has both a graphical user interface and batch interface to support detailed analysis of individual UAS encounters and macro analysis of a very large set of UAS and encounter models, respectively. Results from the simulator using approximate performance data from a well-known manned aircraft is presented to provide insight into the problem and as verification and validation of the simulator. Analysis of climb, descent, and level turn maneuvers to avoid a collision is presented. Noting the diversity of backgrounds in the UAS community, a description of the UAS aerodynamic and propulsive design and performance parameters is included. Initial attempts to model the results made it clear that developing maneuver performance groups is required. Discussion of the performance groups developed and how to know in which group an aircraft belongs for a given flight condition and encounter is included. The groups are specific to airplane, flight condition, and encounter, rather than airplane-only specific. Results and methodology for developing UAS maneuver performance requirements are presented for each maneuver as well. Results for the vertical maneuver indicate that a minimum specific excess power value can assure a minimum CPA for a given time-to-go prediction. However, smaller values of specific excess power may achieve or exceed the same CPA if the UAS has sufficient speed to trade for altitude. Level turn results are less impacted by specific excess power and are presented as a function of turn rate. The effect of altitude is also discussed for the turns. Next steps and future work are discussed. Future studies will lead to better quantification of the preliminary results and cover the remainder of the proposed test matrix. It is anticipated that this will be done in conjunction with RTCA SC-228 over the next few months.

Troubling the Boundaries: Overcoming Methodological Challenges in a Multi-Sectoral and Multi-Jurisdictional HIV/HCV Policy Scoping Review

ERIC Educational Resources Information Center

Hare, Kathleen A.; Dubé, Anik; Marshall, Zack; Gahagan, Jacqueline; Harris, Gregory E.; Tucker, Maryanne; Dykeman, Margaret; MacDonald, Jo-Ann

2016-01-01

Policy scoping reviews are an effective method for generating evidence-informed policies. However, when applying guiding methodological frameworks to complex policy evidence, numerous, unexpected challenges can emerge. This paper details five challenges experienced and addressed by a policy trainee-led, multi-disciplinary research team, while…

Challenges of the management of mass casualty: lessons learned from the Jos crisis of 2001

PubMed Central

2013-01-01

Background Jos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis. Methodology We reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods. Results Communication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies. Conclusion Mass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response. PMID:24164778

Observational studies of the association between glucose-lowering medications and cardiovascular outcomes: addressing methodological limitations.

PubMed

Patorno, Elisabetta; Patrick, Amanda R; Garry, Elizabeth M; Schneeweiss, Sebastian; Gillet, Victoria G; Bartels, Dorothee B; Masso-Gonzalez, Elvira; Seeger, John D

2014-11-01

Recent years have witnessed a growing body of observational literature on the association between glucose-lowering treatments and cardiovascular disease. However, many of the studies are based on designs or analyses that inadequately address the methodological challenges involved. We reviewed recent observational literature on the association between glucose-lowering medications and cardiovascular outcomes and assessed the design and analysis methods used, with a focus on their ability to address specific methodological challenges. We describe and illustrate these methodological issues and their impact on observed associations, providing examples from the reviewed literature. We suggest approaches that may be employed to manage these methodological challenges. From the evaluation of 81 publications of observational investigations assessing the association between glucose-lowering treatments and cardiovascular outcomes, we identified the following methodological challenges: 1) handling of temporality in administrative databases; 2) handling of risks that vary with time and treatment duration; 3) definitions of the exposure risk window; 4) handling of exposures that change over time; and 5) handling of confounding by indication. Most of these methodological challenges may be suitably addressed through application of appropriate methods. Observational research plays an increasingly important role in the evaluation of the clinical effects of diabetes treatment. Implementation of appropriate research methods holds the promise of reducing the potential for spurious findings and the risk that the spurious findings will mislead the medical community about risks and benefits of diabetes medications.

Rethinking What Is Entrepreneurship Education: A Macro Integrative Perspective

ERIC Educational Resources Information Center

Wu, Hongyun; Gu, Jibao

2017-01-01

Research on entrepreneurship education (EE) has encountered confusing ontological and methodological issues, such as definitional controversy, gaps between research and practice, and lack of theoretical foundations. These are factors holding back the further development of the research and practice in this field. This paper presents a whole…

76 FR 47301 - Medicare Program; Hospice Wage Index for Fiscal Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... aggregate cap calculation methodology. This final rule will also revise the hospice requirement for a face-to-face encounter for recertification of a patient's terminal illness. Finally, this final rule will..., (410) 786-2120 for questions regarding hospice wage index and hospice face-to-face requirement. Katie...

Teacher Education With an Inquiry Emphasis.

ERIC Educational Resources Information Center

Wright, David P.

A program for prospective elementary and secondary teachers emphasizing inquiry and problem solving techniques for use in the classroom is described. In the conceptual framework of this program, a situation is defined as a set of circumstances that teachers commonly encounter, and an issue is a theoretical, ethical, or methodological question. A…

Cultural Diversity Online: Student Engagement with Learning Technologies

ERIC Educational Resources Information Center

Hannon, John; D'Netto, Brian

2007-01-01

Purpose: The purpose of this research is to focus on how students from different cultural and linguistic backgrounds encounter online learning environments, and to assess the extent to which cultural factors impact on learners' engagement with online learning. Design/methodology/approach: The study explores how a culturally diverse cohort of…

Using Phatic Expressions in Introductions in Intercultural Online Discussions

ERIC Educational Resources Information Center

Zimmerman, Lynn W.

2011-01-01

This study examines the use of formulaic language in an intercultural communication encounter. It focuses particularly on phatic expressions used in an online discussion about gender stereotypes in English among 167 undergraduate university students in Taiwan, Israel, and the US. Content analysis methodology was used to examine whether there are…

Festival of Pacific Arts: Education in Multi-Cultural Encounters

ERIC Educational Resources Information Center

d'Hauteserre, Anne-Marie

2011-01-01

Can acts of support and/or revival of Pacific cultures serve to educate international tourists about Indigenous cultures? This paper examines, from a postcolonial perspective and using a qualitative methodology, whether the Festivals of Pacific Arts, to which all nations send delegations, can educate visitors about Indigenous cultures of the…

Introduction: Qualitative Approaches to Research on Plurilingual Education

ERIC Educational Resources Information Center

Dooly, Melinda; Moore, Emilee

2017-01-01

This handbook has been conceived as a guide for young researchers embarking on the exciting journey of investigating different aspects of plurilingual education. The text can also serve to review ideas previously encountered, and perhaps as a means of interrogating research methodologies in plurilingual contexts for those who already have ample…

A statistical framework for multiparameter analysis at the single-cell level.

PubMed

Torres-García, Wandaliz; Ashili, Shashanka; Kelbauskas, Laimonas; Johnson, Roger H; Zhang, Weiwen; Runger, George C; Meldrum, Deirdre R

2012-03-01

Phenotypic characterization of individual cells provides crucial insights into intercellular heterogeneity and enables access to information that is unavailable from ensemble averaged, bulk cell analyses. Single-cell studies have attracted significant interest in recent years and spurred the development of a variety of commercially available and research-grade technologies. To quantify cell-to-cell variability of cell populations, we have developed an experimental platform for real-time measurements of oxygen consumption (OC) kinetics at the single-cell level. Unique challenges inherent to these single-cell measurements arise, and no existing data analysis methodology is available to address them. Here we present a data processing and analysis method that addresses challenges encountered with this unique type of data in order to extract biologically relevant information. We applied the method to analyze OC profiles obtained with single cells of two different cell lines derived from metaplastic and dysplastic human Barrett's esophageal epithelium. In terms of method development, three main challenges were considered for this heterogeneous dynamic system: (i) high levels of noise, (ii) the lack of a priori knowledge of single-cell dynamics, and (iii) the role of intercellular variability within and across cell types. Several strategies and solutions to address each of these three challenges are presented. The features such as slopes, intercepts, breakpoint or change-point were extracted for every OC profile and compared across individual cells and cell types. The results demonstrated that the extracted features facilitated exposition of subtle differences between individual cells and their responses to cell-cell interactions. With minor modifications, this method can be used to process and analyze data from other acquisition and experimental modalities at the single-cell level, providing a valuable statistical framework for single-cell analysis.

A question of style: method, integrity and the meaning of proper science.

PubMed

Penders, Bart; Vos, Rein; Horstman, Klasien

2009-09-01

Controversies in science often centre on methodology and integrity; these are the gatekeepers of proper science. But what exactly defines proper science as proper is not universal, especially in collaborative fields of enquiry where different perspectives meet. These encounters often result in friction, yet may equally give rise to new perspectives on proper science. A tour of collaborative endeavours like structural biology and nutrigenomics highlights some of those frictions and the controversies that can result from the encounter of 'wet' and 'dry' science. Attuning scientists to the plurality of proper science may safeguard many a scientist's integrity from being questioned unjustly.

Speed-Accuracy Tradeoffs in Speech Production

DTIC Science & Technology

2017-06-01

imaging data of speech production. A theoretical framework for considering Fitts’ law in the domain of speech production is elucidated. Methodological ...articulatory kinematics conform to Fitts’ law. A second, associated goal is to address the methodological challenges inherent in performing Fitts-style...analysis on rtMRI data of speech production. Methodological challenges include segmenting continuous speech into specific motor tasks, defining key

Synthesising quantitative and qualitative research in evidence-based patient information.

PubMed

Goldsmith, Megan R; Bankhead, Clare R; Austoker, Joan

2007-03-01

Systematic reviews have, in the past, focused on quantitative studies and clinical effectiveness, while excluding qualitative evidence. Qualitative research can inform evidence-based practice independently of other research methodologies but methods for the synthesis of such data are currently evolving. Synthesising quantitative and qualitative research in a single review is an important methodological challenge. This paper describes the review methods developed and the difficulties encountered during the process of updating a systematic review of evidence to inform guidelines for the content of patient information related to cervical screening. Systematic searches of 12 electronic databases (January 1996 to July 2004) were conducted. Studies that evaluated the content of information provided to women about cervical screening or that addressed women's information needs were assessed for inclusion. A data extraction form and quality assessment criteria were developed from published resources. A non-quantitative synthesis was conducted and a tabular evidence profile for each important outcome (eg "explain what the test involves") was prepared. The overall quality of evidence for each outcome was then assessed using an approach published by the GRADE working group, which was adapted to suit the review questions and modified to include qualitative research evidence. Quantitative and qualitative studies were considered separately for every outcome. 32 papers were included in the systematic review following data extraction and assessment of methodological quality. The review questions were best answered by evidence from a range of data sources. The inclusion of qualitative research, which was often highly relevant and specific to many components of the screening information materials, enabled the production of a set of recommendations that will directly affect policy within the NHS Cervical Screening Programme. A practical example is provided of how quantitative and qualitative data sources might successfully be brought together and considered in one review.

Chilled to the bone: embodied countertransference and unspoken traumatic memories.

PubMed

Zoppi, Luisa

2017-11-01

Starting from a deeply challenging experience of early embodied countertransference in a first encounter with a new patient, the author explores the issues it raised. Such moments highlight projective identification as well as what Stone (2006) has described as 'embodied resonance in the countertransference'. In these powerful experiences linear time and subject boundaries are altered, and this leads to central questions about analytic work. As well as discussing the uncanny experience at the very beginning of an analytic encounter and its challenges for the analytic field, the author considers 'the time horizon of analytic process' (Hogenson ), the relationship between 'moments of complexity and analytic boundaries' (Cambray ) and the role of mirror neurons in intersubjective experience. © 2017, The Society of Analytical Psychology.

Atmospheric Propagation and Combining of High-Power Lasers

DTIC Science & Technology

2015-09-08

Brightness-scaling potential of actively phase- locked solid state laser arrays,” IEEE J. Sel. Topics Quantum Electron., vol. 13, no. 3, pp. 460–472, May...attempting to phase- lock high-power lasers, which is not encountered when phase- locking low-power lasers, for example mW power levels. Regardless, we...technology does not currently exist. This presents a challenging problem when attempting to phase- lock high-power lasers, which is not encountered when

Factors Influencing Provision of Play and Learning Materials among Children with Physical Challenges. A Case Study of Joytown Special School, Kiambu County

ERIC Educational Resources Information Center

Muthoni, Kamau Joyce

2016-01-01

In Kenya there is still a high population of children either born with or who develop physical challenges. These children are often neglected and most do not join school at the expected age. In joining school they encounter several difficulties in their play and learning activities. These children with physical challenges have developmental needs…

Faith and the Literary Imagination: The Educational Challenge

ERIC Educational Resources Information Center

Williams, Kevin

2013-01-01

Divided into four parts, the article explores the relationship between literature and faith. The first part examines the connection between literature and the pursuit of truth and the second shows that literature can offer a challenging encounter with different beliefs. Part three examines some examples of the imagination at work in illuminating…

Coping Strategies among Internal Migrant Students in Turkey

ERIC Educational Resources Information Center

Altinyelken, Hulya Kosar

2009-01-01

This article is based on a qualitative study that explored educational challenges and coping mechanisms of internal migrant girls whose families moved from the rural areas in the east to the western parts of Turkey. The study revealed that internal migrant girls have encountered a number of challenges that influence their educational achievement…

Adult English Language Learners with Limited Literacy

ERIC Educational Resources Information Center

Bigelow, Martha; Schwarz, Robin Lovrien

2010-01-01

Adult English language learners who lack print literacy or experience with formal education encounter a unique set of challenges in their lives and their efforts to learn English. Educators and policymakers are similarly challenged by how best to help these adults acquire English literacy. This paper reviews a variety of research, including that…

Creating Critical Conversations: Investigating the Utility of Socratic Dialogues in Elementary Social Studies Methods

ERIC Educational Resources Information Center

Buchanan, Lisa Brown

2012-01-01

This article explores the utility of Socratic dialogues in the elementary social studies methods course. Findings include preservice teachers' behaviors during dialogues, perceived strengths and challenges of using Socratic dialogues in teacher education, and the impact on student learning. Challenges and apprehensions encountered by the teacher…

Dealing with the Challenges of Teaching Molecular Biophysics to Biochemistry Majors through an Heuristics-Based Approach

ERIC Educational Resources Information Center

Castanho, Miguel A. R. B.

2002-01-01

The main distinction between the overlapping fields of molecular biophysics and biochemistry resides in their different approaches to the same problems. Molecular biophysics makes more use of physical techniques and focuses on quantitative data. This difference encounters two difficult pedagogical challenges when teaching molecular biophysics to…

Reflection and Reflexivity in Practice versus in Theory: Challenges of Conceptualization, Complexity, and Competence

ERIC Educational Resources Information Center

Alexander, Patricia A.

2017-01-01

In this commentary, theoretical principles pertaining to the role of epistemic cognition in teaching and professional development, synthesized from the content of this special issue on reflection and reflexivity, are proffered. These theoretical notions are then followed with a critical analysis of specific challenges encountered in enacting these…

"Victims of History": Challenging Students' Perceptions of Women in History

ERIC Educational Resources Information Center

Lockyer, Bridget; Tazzymant, Abigail

2016-01-01

As postgraduate historians with teaching responsibilities at the University of York, Bridget Lockyer and Abigail Tazzyman were concerned to tackle some of the challenges reported by their students who had generally only encountered women's history in a disconnected way through stand-alone topics or modules. Their response was to create a series of…

Foundation Officers, Evaluation, and Ethical Problems: A Pilot Investigation

ERIC Educational Resources Information Center

Morris, Michael

2007-01-01

Ethical problems encountered by foundation officers in their evaluation-related work were identified via an email survey of a sample of Council on Foundations member organizations. Of the respondents who had worked with evaluators, one-third indicated that they had faced ethical challenges. Most challenges fell into one of four categories:…

A Critical Reflection: Foster Care Youth Experiences at a Four Year Postsecondary Institution

ERIC Educational Resources Information Center

Greer, Renada D.

2016-01-01

Foster care youth face significant challenges to postsecondary educational success, especially while enrolled at four-year institutions. Foster care youth are absent of family support that their non-foster peers receive throughout the college experience. Without family support, foster care youth encounter greater challenges to persevere through…

Evaluating the Learning Outcomes of An International Field Trip in Postgraduate Lighting Design Courses

ERIC Educational Resources Information Center

Isoardi, Gillian

2010-01-01

Lighting industry professionals work in an international marketplace and encounter a range of social, geographical and cultural challenges associated with this. Education in lighting should introduce students to aspects of these challenges. To achieve this, an international field trip was recently undertaken that sought to provide an authentic…

Lived Experiences of Parents of Children with Disabilities in Swaziland

ERIC Educational Resources Information Center

Thwala, S'lungile K.; Ntinda, Kayi; Hlanze, Buyisile

2015-01-01

Raising a child with disability is a challenge to most parents. The study explored the lived experiences of parents of children with disabilities in Swaziland. The specific objective was to determine the challenges which parents of children with disability encounter at home, school and community, which may hinder them to work collaboratively with…

Educators' Challenges of Including Children with Autism Spectrum Disorder in Mainstream Classrooms

ERIC Educational Resources Information Center

Lindsay, Sally; Proulx, Meghann; Thomson, Nicole; Scott, Helen

2013-01-01

Although children with autism spectrum disorder (ASD) are increasingly being placed within mainstream classes, little is known about the challenges that teachers encounter with including them as full participants in the class. This qualitative study draws on a purposive sample of 13 educators who have experience teaching children with ASD within…

Implementing Small Scale ICT Projects in Developing Countries--How Challenging Is It?

ERIC Educational Resources Information Center

Karunaratne, Thashmee; Peiris, Colombage; Hansson, Henrik

2018-01-01

This paper summarises experiences of efforts made by twenty individuals when implementing small-scale ICT development projects in their organizations located in seven developing countries. The main focus of these projects was the use of ICT in educational settings. Challenges encountered and the contributing factors for implementation success of…

When Students Say "I Just Couldn't Think": Challenges in Teaching Skilful Thinking

ERIC Educational Resources Information Center

Row, Bavani Nageswana; Subramaniam, Selvaranee; Sathasivam, Renuka V.

2016-01-01

This paper discusses challenges encountered by selected Year Four science teachers regarding their knowledge and implementation of skilful thinking (ST) in their classrooms. ST is a complex concept comprising three elements; specific thinking strategies, habits of mind and metacognitive thinking. Due of the complexity of ST, the implementation of…

Regional assessments of stream ecological condition: Scientific challenges associated with the USA's national Wadeable Stream Assessment

EPA Science Inventory

In this special issue of J-NABS, we have compiled a series of papers that describe some of the major scientific challenges that were encountered during the national Wadeable Streams Assessment (WSA) and some of the lessons learned subsequent to the assessment. Our goal in produc...

Engineering Encounters: The Tightrope Challenge

ERIC Educational Resources Information Center

Burton, Bill

2014-01-01

In order to prepare students to become the next innovators, teachers need to provide real-world challenges that allow children to exercise their innovation muscles. Innovation starts with a problem and innovators work to solve a problem by planning, creating, and testing. The real-world innovation process does not happen on a worksheet, and it…

Curricular Integration and Measurement of Cultural Competence Development in a Group of Physical Therapy Students

ERIC Educational Resources Information Center

Palombaro, Kerstin M.; Dole, Robin L.; Black, Jill D.

2015-01-01

Introduction and Background: The link between cultural competence and effective physical therapy encounters is established. Physical therapist educational programs face the challenge of fostering the cultural competence of students in effective and meaningful ways within the curriculum. They also face the challenge of measuring the development of…

Big Class Size Challenges: Teaching Reading in Primary Classes in Kampala, Uganda's Central Municipality

ERIC Educational Resources Information Center

Kewaza, Samuel; Welch, Myrtle I.

2013-01-01

Research on reading has established that reading is a pivotal discipline and early literacy development dictates later reading success. Therefore, the purpose of this study is to investigate challenges encountered with reading pedagogy, teaching materials, and teachers' attitudes towards teaching reading in crowded primary classes in Kampala,…

Leading Remotely: Exploring the Experiences of Principals in Rural and Remote School Communities in Jamaica

ERIC Educational Resources Information Center

Miller, Paul

2015-01-01

School leadership is an exciting although challenging job. Principals of schools located in rural and remote communities, particular small schools, experience and encounter many challenges that their counterparts in suburban and urban areas do not experience. Concerns over staffing, the quality and availability of materials, facilities,…

Administrative Challenges and Response Strategies to the Job Performance of Marketing Department Chairs.

ERIC Educational Resources Information Center

Dyer, Beverly G.; Miller, Michael T.

This study reports on the job challenges and corresponding response strategies that department chairs at graduate and undergraduate colleges and universities encounter and rely upon. Literature and research related to marketing department chairs, marketing education, and marketing majors indicates that business schools have come under attack by…

Novice Teachers' Opinions on Students' Disruptive Behaviours: A Case Study

ERIC Educational Resources Information Center

Sezer, Senol

2017-01-01

Purpose: It is recognised worldwide that novice teachers encounter various disruptive behaviours and face many challenges that stem from problematic students. Disruptive behaviours are seen as some of the most pervasive challenges widely affecting the teaching experience of novice teachers. In this study, the aim was to determine novice teachers'…

Stakeholder Perceptions of the Positive Benefits and Critical Challenges Involved in Student Service-Learning Experiences

ERIC Educational Resources Information Center

Hohenthal, K. Darcy

2010-01-01

The Bolman and Deal (2003) Four-Frame Model was adapted in this qualitative phenomenological research study to describe how stakeholders experience student service-learning. The study presents how students perceive the positive benefits and critical challenges encountered in their service-learning experience; how professors perceive the positive…

Identifying the Challenging Factors in the Transition from Colleges of Engineering to Employment

ERIC Educational Resources Information Center

Baytiyeh, Hoda; Naja, Mohamad

2012-01-01

The transition from university to a career in engineering is a challenging process. This study examined the perceptions of engineering graduates regarding the difficulties they encountered in their transition from the university to the workplace. Lebanese practising engineers (n=217), living around the world, were surveyed to identify their…

Reinvention: The Promise and Challenge of Transforming a Community College System

ERIC Educational Resources Information Center

Hyman, Cheryl L.

2018-01-01

"Reinvention" chronicles an unprecedentedly comprehensive approach to community college reform and the leadership challenges encountered along the way. The book addresses cultural clashes over the role and purpose of community colleges and argues for an emphasis on success and access. As chancellor of the City Colleges of Chicago, Cheryl…

Valuable yet Vulnerable-A review of the challenges encountered by older nurses in the workplace.

PubMed

Ryan, C; Bergin, M; Wells, J S

2017-07-01

As the global nursing workforce ages, developing a comprehensive understanding of the experiences, needs and values specific to older nurses is increasingly significant. This paper reviews the evidence with regard to the specific challenges encountered by older nurses in the workplace. A scoping review of the published literature was conducted using the electronic databases Medline, CINAHL, PsycINFO, Science Direct and Google Scholar. A total of 20 papers were included in this review, most of which were qualitative (n=14). Three quantitative studies were identified (including one study which combined a physical exam with survey methods) as well as three mixed method studies. The challenges faced by older nurses in their practice are synthesised across three primary domains: Nursing and the ageing body; Recognition and support of the older nurse and Demands associated with middle-age. As older nurses form a substantial proportion of the healthcare workforce in many countries, the development and implementation of strategies to address these challenges is of utmost importance. Copyright © 2017 Elsevier Ltd. All rights reserved.

A method for communication analysis in prosthodontics.

PubMed

Sondell, K; Söderfeldt, B; Palmqvist, S

1998-02-01

Particularly in prosthodontics, in which the issues of esthetic preferences and possibilities are abundant, improved knowledge about dentist patient communication during clinical encounters is important. Because previous studies on communication used different methods and patient materials, the results are difficult to evaluate. There is, therefore, a need for methodologic development. One method that makes it possible to quantitatively describe different interaction behaviors during clinical encounters is the Roter Method of Interaction Process Analysis (RIAS). Since the method was developed in the USA for use in the medical context, a translation of the method into Swedish and a modification of the categories for use in prosthodontics were necessary. The revised manual was used to code 10 audio recordings of dentist patient encounters at a specialist clinic for prosthodontics. No major alterations of the RIAS manual were made during the translation and modification. The study shows that it is possible to distinguish patterns of communication in audio-recorded dentist patient encounters. The method also made the identification of different interaction profiles possible. These profiles distinguished well among the audio-recorded encounters. The coding procedures were tested for intra-rater reliability and found to be 97% for utterance classification and lambda = 0.76 for categorization definition. It was concluded that the revised RIAS method is applicable in communication studies in prosthodontics.

Therapists' Perspectives on Suicide: A Conceptual Model of Connectedness.

PubMed

Aherne, Cian; Coughlan, Barry; Surgenor, Paul

2017-08-03

A sense of disconnection for people who are suicidal seems to be a key construct of previous literature. Therapists' ways of encountering and understanding people who are suicidal have not been previously researched in depth using qualitative methodologies. The current study aims to develop a theoretical framework for the role played by connectedness in relation to suicide based on the perspectives of psychotherapists working in the field of suicide intervention. Psychotherapists (N = 12) from a suicide intervention service in Ireland were interviewed in relation to connectedness and suicide. The interviews were analysed using Constructivist Grounded Theory. A tentative theoretical model for connectedness in relation to suicide was developed. Therapists view self-disconnect as at the core of suicidality and note that toxic relationships also play a critical role. Therapeutic connection can present as a life-saving paradox for people who are suicidal. Risk of death and therapeutic endeavour may present as challenging dynamics for working with people who are suicidal. Some discussion points include the worth of self-compassion development for people who are suicidal, the rephrasing of "psychotherapy" when trying to save someone's life and the emphasis on relationship skills for all healthcare professionals who encounter people who are suicidal. Clinical or methodological significance of this article: This article is one of the first in which therapists are interviewed about their understandings of suicide and the processes of suicide in the therapeutic space. It offers novel insights about how people who are suicidal present in therapy and what may be contributing to this presentation. The research also gives insights on the struggles for therapists working with people who are suicidal and who may be ambiguous about the prospect of therapy and connecting. The study also offers important direction for future studies in relation to what requires further discussion and exploration regarding engaging in therapy with people who are suicidal. In addition, the current study can offer previously unexplored insights regarding suicide and therapy that may have the potential to assist in future intervention for people who are risk of killing themselves.

Q methodology in health economics.

PubMed

Baker, Rachel; Thompson, Carl; Mannion, Russell

2006-01-01

The recognition that health economists need to understand the meaning of data if they are to adequately understand research findings which challenge conventional economic theory has led to the growth of qualitative modes of enquiry in health economics. The use of qualitative methods of exploration and description alongside quantitative techniques gives rise to a number of epistemological, ontological and methodological challenges: difficulties in accounting for subjectivity in choices, the need for rigour and transparency in method, and problems of disciplinary acceptability to health economists. Q methodology is introduced as a means of overcoming some of these challenges. We argue that Q offers a means of exploring subjectivity, beliefs and values while retaining the transparency, rigour and mathematical underpinnings of quantitative techniques. The various stages of Q methodological enquiry are outlined alongside potential areas of application in health economics, before discussing the strengths and limitations of the approach. We conclude that Q methodology is a useful addition to economists' methodological armoury and one that merits further consideration and evaluation in the study of health services.

Data Visualization Challenges and Opportunities in User-Oriented Application Development

NASA Astrophysics Data System (ADS)

Pilone, D.; Quinn, P.; Mitchell, A. E.; Baynes, K.; Shum, D.

2015-12-01

This talk introduces the audience to some of the very real challenges associated with visualizing data from disparate data sources as encountered during the development of real world applications. In addition to the fundamental challenges of dealing with the data and imagery, this talk discusses usability problems encountered while trying to provide interactive and user-friendly visualization tools. At the end of this talk the audience will be aware of some of the pitfalls of data visualization along with tools and techniques to help mitigate them. There are many sources of variable resolution visualizations of science data available to application developers including NASA's Global Imagery Browse Services (GIBS), however integrating and leveraging visualizations in modern applications faces a number of challenges, including: - Varying visualized Earth "tile sizes" resulting in challenges merging disparate sources - Multiple visualization frameworks and toolkits with varying strengths and weaknesses - Global composite imagery vs. imagery matching EOSDIS granule distribution - Challenges visualizing geographically overlapping data with different temporal bounds - User interaction with overlapping or collocated data - Complex data boundaries and shapes combined with multi-orbit data and polar projections - Discovering the availability of visualizations and the specific parameters, color palettes, and configurations used to produce them In addition to discussing the challenges and approaches involved in visualizing disparate data, we will discuss solutions and components we'll be making available as open source to encourage reuse and accelerate application development.

Methodological Challenges in Studies Examining the Effects of Breakfast on Cognitive Performance and Appetite in Children and Adolescents.

PubMed

Adolphus, Katie; Bellissimo, Nick; Lawton, Clare L; Ford, Nikki A; Rains, Tia M; Totosy de Zepetnek, Julia; Dye, Louise

2017-01-01

Breakfast is purported to confer a number of benefits on diet quality, health, appetite regulation, and cognitive performance. However, new evidence has challenged the long-held belief that breakfast is the most important meal of the day. This review aims to provide a comprehensive discussion of the key methodological challenges and considerations in studies assessing the effect of breakfast on cognitive performance and appetite control, along with recommendations for future research. This review focuses on the myriad challenges involved in studying children and adolescents specifically. Key methodological challenges and considerations include study design and location, sampling and sample section, choice of objective cognitive tests, choice of objective and subjective appetite measures, merits of providing a fixed breakfast compared with ad libitum, assessment and definition of habitual breakfast consumption, transparency of treatment condition, difficulty of isolating the direct effects of breakfast consumption, untangling acute and chronic effects, and influence of confounding variables. These methodological challenges have hampered a clear substantiation of the potential positive effects of breakfast on cognition and appetite control and contributed to the debate questioning the notion that breakfast is the most important meal of the day. © 2017 American Society for Nutrition.

Methodological Challenges in Studies Examining the Effects of Breakfast on Cognitive Performance and Appetite in Children and Adolescents123

PubMed Central

Bellissimo, Nick; Ford, Nikki A; Rains, Tia M

2017-01-01

Breakfast is purported to confer a number of benefits on diet quality, health, appetite regulation, and cognitive performance. However, new evidence has challenged the long-held belief that breakfast is the most important meal of the day. This review aims to provide a comprehensive discussion of the key methodological challenges and considerations in studies assessing the effect of breakfast on cognitive performance and appetite control, along with recommendations for future research. This review focuses on the myriad challenges involved in studying children and adolescents specifically. Key methodological challenges and considerations include study design and location, sampling and sample section, choice of objective cognitive tests, choice of objective and subjective appetite measures, merits of providing a fixed breakfast compared with ad libitum, assessment and definition of habitual breakfast consumption, transparency of treatment condition, difficulty of isolating the direct effects of breakfast consumption, untangling acute and chronic effects, and influence of confounding variables. These methodological challenges have hampered a clear substantiation of the potential positive effects of breakfast on cognition and appetite control and contributed to the debate questioning the notion that breakfast is the most important meal of the day. PMID:28096143

Methods for a multicenter randomized trial for mixed urinary incontinence: rationale and patient-centeredness of the ESTEEM trial.

PubMed

Sung, Vivian W; Borello-France, Diane; Dunivan, Gena; Gantz, Marie; Lukacz, Emily S; Moalli, Pamela; Newman, Diane K; Richter, Holly E; Ridgeway, Beri; Smith, Ariana L; Weidner, Alison C; Meikle, Susan

2016-10-01

Mixed urinary incontinence (MUI) can be a challenging condition to manage. We describe the protocol design and rationale for the Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM) trial, designed to compare a combined conservative and surgical treatment approach versus surgery alone for improving patient-centered MUI outcomes at 12 months. ESTEEM is a multisite, prospective, randomized trial of female participants with MUI randomized to a standardized perioperative behavioral/pelvic floor exercise intervention plus midurethral sling versus midurethral sling alone. We describe our methods and four challenges encountered during the design phase: defining the study population, selecting relevant patient-centered outcomes, determining sample size estimates using a patient-reported outcome measure, and designing an analysis plan that accommodates MUI failure rates. A central theme in the design was patient centeredness, which guided many key decisions. Our primary outcome is patient-reported MUI symptoms measured using the Urogenital Distress Inventory (UDI) score at 12 months. Secondary outcomes include quality of life, sexual function, cost-effectiveness, time to failure, and need for additional treatment. The final study design was implemented in November 2013 across eight clinical sites in the Pelvic Floor Disorders Network. As of 27 February 2016, 433 total/472 targeted participants had been randomized. We describe the ESTEEM protocol and our methods for reaching consensus for methodological challenges in designing a trial for MUI by maintaining the patient perspective at the core of key decisions. This trial will provide information that can directly impact patient care and clinical decision making.

'Changing climate, changing health, changing stories' profile: using an EcoHealth approach to explore impacts of climate change on inuit health.

PubMed

Harper, S L; Edge, V L; Cunsolo Willox, A

2012-03-01

Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.

Development of a conceptually equivalent Chinese-language translation of the US Household Food Security Survey Module for Chinese immigrants to the USA.

PubMed

Kwan, Christine Ml; Napoles, Anna M; Chou, Jeyling; Seligman, Hilary K

2015-02-01

To develop a conceptually equivalent Chinese-language translation of the eighteen-item US Household Food Security Survey Module. In the current qualitative study, we (i) highlight methodological challenges which arise in developing survey instruments that will be used to make comparisons across language groups and (ii) describe the development of a Chinese-language translation of the US Household Food Security Survey Module, called the San Francisco Chinese Food Security Module. Community sites in San Francisco, CA, USA. We conducted cognitive interviews with twenty-two community members recruited from community sites hosting food pantries and with five professionals recruited from clinical settings. Development of conceptually equivalent surveys can be difficult. We highlight challenges related to dialect, education, literacy (e.g. preferences for more or less formal phrasing), English words and phrases for which there is no Chinese language equivalent (e.g. 'balanced meals' and 'eat less than you felt you should') and response formats. We selected final translations to maximize: (i) consistency of the Chinese translation with the intent of the English version; (ii) clarity; and (iii) similarities in understanding across dialects and literacy levels. Survey translation is essential for conducting research in many communities. The challenges encountered illustrate how literal translations can affect the conceptual equivalence of survey items across languages. Cognitive interview methods should be routinely used for survey translation when such non-equivalence is suspected, such as in surveys addressing highly culturally bound behaviours such as diet and eating behaviours. Literally translated surveys lacking conceptual equivalence may magnify or obscure important health inequalities.

Beliefs, attitudes and perceived practice among newly enrolled students at the Jordanian Ministry of Health nursing colleges and institutes in 2003.

PubMed

Jrasat, Manal; Samawi, Osama; Wilson, Calvin

2005-07-01

This study investigates beginning Jordanian nursing students' level of awareness and attitudes toward the nursing profession, their expected future practices and their anticipated reactions when faced with challenging hypothetical situations, together with any correlation between these variables and the students' sex, age and social status. The cross-sectional, descriptive methodology was applied to a population of 330 male and female students enrolled at the first year level of associate nursing at two Ministry of Health (MOH) training institutions in November 2003. A student's personal desire to become a nurse accounted for only 31.0% of the total, while 69.0% began a nursing career because of other reasons, such as family or economic pressures. There was no correlation between the student's gender, high-school public certificate average, or socio-economic condition and the decision to become a nurse. Upon graduation, 30.0% of students would prefer to work at hospitals, 19.0% at emergency rooms, 21.0% at an ambulatory health center and 26.0% in administrative positions. Females favoured working at health centres over males (24.8% vs. 12.1%, respectively), while more males favoured working in administrative positions than females (30.8% and 23.5%, respectively). Analysis of students' expected reactions to various challenging encounters with a patient showed that approximately 50% would react in a less than professional manner. Curricular emphasis should be placed on expanding and raising nursing students' awareness of their responsibilities toward patients, especially in challenging or difficult situations, and on improving their concept of nursing as a profession.

A Systematic Comparison of Teaching Hospital and Remote-Site Clinical Education

ERIC Educational Resources Information Center

And Others; Friedman, Charles P.

1978-01-01

A methodology is presented for examining activities of medical students on multisite clinical clerkships in obstetrics and gynecology. Five variables are explored: distribution of student activities, type or class of clinical conditions encountered, degree of "esoterism" of those conditions, type of student role, and flexibility of student role.…

Facilitating Small-Scale Implementation of Inquiry-Based Teaching: Encounters and Experiences of Experimento Multipliers in One South African Province

ERIC Educational Resources Information Center

Dudu, Washington Takawira

2017-01-01

This paper explores the experiences of 37 physical science high school teachers who participated in a professional development (PD) programme coordinated by three Experimento multipliers. The Experimento programme is a Siemens Stiftung international educational programme aimed at providing didactic and methodological approaches to classroom…

Co-Researching School Spaces of Dispossession: A Story of Survival

ERIC Educational Resources Information Center

Krueger-Henney, Patricia

2013-01-01

Through combining the methodology of portraiture with the epistemological stance of youth participatory action research, this article positions Latino/a youth as experts with their encounters with the school-to-prison pipeline. This article examines what it's like to live within the tight and probational spaces of criminal justice-based school…

Transition to Science Teacher Educator: Tensions Experienced While Learning to Teach Lesson Sequencing

ERIC Educational Resources Information Center

Wiebke, Heidi; Park Rogers, Meredith

2014-01-01

This self-study investigated the tensions that I (Heidi) encountered when teaching elementary preservice teachers how to develop a coherent sequence of five science lessons. Four lesson planning components guided me in developing a series of lessons to support the preservice teachers with this exercise. Employing self-study methodology, data…

Shifting Priorities: Reflections on Teaching Qualitative Research Methods

ERIC Educational Resources Information Center

Booker, Keonya C.

2009-01-01

The purpose of this paper is to describe pedagogical approaches to qualitative methodology by an instructor of educational psychology at a large research university. The essay begins with an overview of how my graduate training influenced my orientation to empirical study. Next, I will focus on the obstacles encountered when instructing graduate…

Education and Employment. Indicators of Education Systems = Formation et Emploi. Indicateurs des Systemes d'Enseignement.

ERIC Educational Resources Information Center

Bucht, Bertil; Harnqvist, Kjell

This book contains 11 reports describing the conceptual, methodological, and policy problems encountered during development of the international indicators known as Network B, which were developed as part of the Organisation for Economic Cooperation and Development's Project on International Indicators of Education Systems to serve as…

Video Analysis in Cross-Cultural Environments and Methodological Issues

ERIC Educational Resources Information Center

Montandon, Christiane

2015-01-01

This paper addresses the use of videography combined with group interviews, as a way to better understand the informal learnings of 11-12 year old children in cross-cultural encounters during French-German school exchanges. The complete, consistent video data required the researchers to choose the most significant sequences to highlight the…

Authenticity in Learning--Nursing Students' Experiences at a Clinical Education Ward

ERIC Educational Resources Information Center

Manninen, Katri; Henriksson, Elisabet Welin; Scheja, Max; Silen, Charlotte

2013-01-01

Purpose: This study aims to explore and understand first year nursing students' experiences of learning at a clinical education ward. Design/methodology/approach: The setting is a clinical education ward for nursing students at a department of infectious diseases. A qualitative study was carried out exploring students' encounters with patients,…

Digital London: Creating a Searchable Web of Interlinked Sources on Eighteenth Century London

ERIC Educational Resources Information Center

Shoemaker, Robert

2005-01-01

Purpose: To outline the conceptual and technical difficulties encountered, as well as the opportunities created, when developing an interlinked collection of web-based digitised primary sources on eighteenth century London. Design/methodology/approach: As a pilot study for a larger project, a variety of primary sources, including the "Old…

California Women and the Strategies Utilized on the Path to the Superintendency

ERIC Educational Resources Information Center

Guzman, Anna-Maria

2012-01-01

Purpose: The purpose of this study was to identify leadership strategies utilized and the barriers encountered by females in pursuit of the role of superintendent. This study also intended to identify the strategies women used to overcome these barriers. Methodology: This study utilized descriptive research. Descriptive research involves gathering…

Knowledge and Transformative Social Action: The Encounter of Selected Traditions of Participatory (Action) Research

ERIC Educational Resources Information Center

Streck, Danilo Romeu

2014-01-01

The argument in this paper is that action and participatory research developed within the context of social and political movements aimed at promoting democratic relationships and institutions represents a methodological strategy for deconstructing and reconstructing the hegemonic perspective of knowledge and knowledge production. After a brief…

A personal encounter with psychology (1937-2002).

PubMed

Kendler, H H

2002-02-01

An undergraduate assistantship with Abraham Maslow, research with Solomon Asch, and an indirect exposure to Ernest Nagel's philosophy of science encouraged Howard H. Kendler to become involved with methodological issues in psychology. Graduate training with Kenneth Spence led to an active research career that was initially immersed in the latent learning controversy and later, with the collaboration of his wife Tracy Kendler, in the extension of the Hull-Spence model of cognitive development. Methodological concerns from a variety of sources encouraged Kendler to express his ideas on the methodology and history of psychology as well as its role in ethical and social policy issues. A productive symbiotic relationship is created from the interaction of democracy, natural-science psychology, and moral pluralism.

Challenges and Opportunities of US and Arab Collaborations in Health Services Research: A Case Study from Qatar

PubMed Central

Hammoud, Maya M.; Elnashar, Maha; Abdelrahim, Huda; Khidir, Amal; Elliott, Heather A.K.; Killawi, Amal; Padela, Aasim I.; Khal, Abdul Latif Al; Bener, Abdulbari; Fetters, Michael D.

2012-01-01

Economic globalization and advances in technology have made it more feasible and even necessary to develop international research collaborations in global public health. Historically, collaborations in global research described in the literature have been mostly “North-South” collaborations in which the more developed “North” country works together with a developing “South” country to conduct research in the latter. This type of collaboration has for the most part, represented unequal partnership and rarely left behind a lasting impact. Recently, the opportunity for a new kind of international research partnership has emerged in which the host country has significant financial resources, but relatively limited expertise in research methodology or techniques and research implementation. This type of collaboration features a relative equalization of power between the international partners. The purpose of this paper is to describe the process of building a successful research collaboration between a team in the United States and a team in Qatar, a rich Arabic nation in Gulf. We present a case study that provides an overview of our own project focused on the development of a culturally and linguistically adapted health care quality instrument for Qatar, discussing many of the benefits and challenges we encountered during each phase of instrument development. We present recommendations for researchers seeking sustainable and equitable partnerships with the Arab World. PMID:23121751

Challenges and opportunities of US and Arab collaborations in health services research: a case study from Qatar.

PubMed

Hammoud, Maya M; Elnashar, Maha; Abdelrahim, Huda; Khidir, Amal; Elliott, Heather A K; Killawi, Amal; Padela, Aasim I; Al Khal, Abdul Latif; Bener, Abdulbari; Fetters, Michael D

2012-09-25

Economic globalization and advances in technology have made it more feasible and even necessary to develop international research collaborations in global public health. Historically, collaborations in global research described in the literature have been mostly "North-South" collaborations in which the more developed "North" country works together with a developing "South" country to conduct research in the latter. This type of collaboration has for the most part, represented unequal partnership and rarely left behind a lasting impact. Recently, the opportunity for a new kind of international research partnership has emerged in which the host country has significant financial resources, but relatively limited expertise in research Methodology or techniques and research implementation.  This type of collaboration features a relative equalization of power between the international partners. The purpose of this paper is to describe the process of building a successful research collaboration between a team in the United States and a team in Qatar, a rich Arabic nation in Gulf. We present a case study that provides an overview of our own project focused on the development of a culturally and linguistically adapted health care quality instrument for Qatar, discussing many of the benefits and challenges we encountered during each phase of instrument development. We present recommendations for researchers seeking sustainable and equitable partnerships with the Arab World.

Military deployment toxicology: a program manager's perspective.

PubMed

Knechtges, P L

2000-02-01

The Persian Gulf War drew attention to the potential hazards of chemicals that personnel may encounter during military operations and deployments overseas. During the War, the oil well fires of Kuwait highlighted the military threat of industrial chemicals in the area of operations. Following the War, the occurrence of Gulf War Illnesses brought home concerns and suspicions regarding "low level" and "mixed" exposures to chemicals. The public's concern and attention resulted in numerous institutional responses to the real and perceived problems of health risks during military deployments. These institutional responses ranged in scope from a Presidential Review Directive to the initiative known as the Deployment Toxicology Research, Development, Testing and Evaluation (RDT&E) Program. Most institutions, however, seem to agree that additional research is needed to assess the health risks from chemical exposures during military deployments. Establishing and managing an effective RDT&E program in risk assessment for deployed forces is a challenging enterprise. The Deployment Toxicology RDT&E Program was conceived utilizing the military's acquisition framework, an effective methodology with a proven record of fielding of new technologies. Based on a series of structured meetings with military representatives that would utilize new risk assessment tools, a hierarchical set of plans was developed to identify and prioritize end products. The challenge ahead for the Deployment Toxicology RDT&E Program is to execute these plans, provide the necessary oversight, and transition the results into successful product development.

Emergency management of blunt chest trauma in children: an evidence-based approach.

PubMed

Pauzé, Denis R; Pauzé, Daniel K

2013-11-01

Pediatric trauma is commonly encountered in the emergency department, and trauma to the head, chest, and abdomen may be a source of significant morbidity and mortality. As children have unique thoracic anatomical and physiological properties, they may present with diagnostic challenges that the emergency clinician must be aware of. This review examines the effects of blunt trauma to the pediatric chest, as well as its relevant etiologies and associated mortality. Diagnostic and treatment options for commonly encountered injuries such as pulmonary contusions, rib fractures, and pneumothoraces are examined. Additionally, this review discusses rarely encountered--yet highly lethal--chest wall injuries such as blunt cardiac injuries, commotio cordis, nonaccidental trauma, and aortic injuries.

Design and challenges of a randomized controlled trial for reducing risk factors of metabolic syndrome in Mexican women through water intake

PubMed Central

Hernández-Cordero, Sonia; González-Castell, Dinorah; Rodríguez-Ramírez, Sonia; Villanueva-Borbolla, María Ángeles; Unar, Mishel; Barquera, Simón; de Cossío, Teresita González; Rivera-Dommarco, Juan; Popkin, Barry M

2014-01-01

Objective To describe the design, methods, and challenges encountered during a randomized clinical trial aimed to promote water intake for reducing risks of metabolic syndrome in Mexican women. Materials and methods In a randomized clinical trial in Cuernavaca, Mexico, overweight and obese (body mass index [BMI] ≥ 25 < 39) women, 18 – < 45 years old with an intake of sugar-sweetened beverages ≥ 250 kilocalories per day (kcal/day) were randomly allocated to the water and education provision group (n = 120) or the education provision only group (n = 120). Results We screened 1 756 women. The main difficulties encountered were identifying participants with the recruitment criteria, delivering water to participants, and the time demanded from the study participants. Conclusions The trial’s main challenges were difficulties surrounding recruitment, delivery of the intervention, and the time demanded from the study participants. Modifications were effectively implemented without jeopardizing the original protocol. PMID:24715012

From development to success: the European surveillance scheme for travel associated Legionnaires' disease.

PubMed

Joseph, Carol A; Ricketts, Katherine D

2007-12-01

EWGLINET, the European surveillance scheme for travel associated Legionnaires' disease, was established in 1987 following the identification of the disease in 1976. In 1998, the European Commission's Decision 2119/98/EC provided a legal framework for EWGLINET's operation, and its aims and objectives were formalised. Since its inception, the scheme has encountered a number of challenges which have influenced its development as a Disease Specific Network. The solutions to these challenges, and their successes, may be of interest to similar schemes. This article traces the development of the scheme and its responses to the challenges it has encountered. One especially significant document developed by the scheme is the European Guidelines for Control and Prevention of Travel Associated Legionnaires' Disease;(1) its history is explored. In addition, EWGLINET's relationship with collaborating centres and other groups such as tour operators is highlighted. Despite changing over time, the collaborations and partnerships have been maintained and continue to ensure a close cooperation, maximizing public health effects.

A Study of the EFL Writing of Chinese Learners: A Critical Narrative

ERIC Educational Resources Information Center

Ai, Bin

2015-01-01

Writing is often a massive challenge for the learners who study English as a Foreign Language (EFL). Many EFL practitioners are searching for solutions to help learners improve the level of their writing. In this auto-ethnographic study, two narratives are discussed. In the first narrative, the primary challenges of EFL writing encountered by a…

Challenges in Postgraduate Studies: Assessments by Doctoral Students in a Swedish University

ERIC Educational Resources Information Center

Ezebilo, Eugene E.

2012-01-01

The success of research students largely depends on their relationship with supervisors. If the students encounter lot of problems it may impinge on their academic potentials. This study examines the challenges facing doctoral students and how they have coped over time. How supervisor-student relationship could be improved is discussed. The data…

Studying Challenges in Integrating Technology in Secondary Mathematics with Technological Pedagogical and Content Knowledge (TPACK)

ERIC Educational Resources Information Center

Stoilescu, Dorian

2014-01-01

This paper describes challenges encountered by two secondary mathematics teachers when they try to integrate ICT devices in their classes. These findings are based on using the Technological Pedagogical and Content Knowledge (TPACK) context, the four dimension framework developed by Niess: 1) overarching conceptions of integrating ICT, 2)…

Recurring Issues Encountered by Distance Educators in Developing and Emerging Nations

ERIC Educational Resources Information Center

Wright, Clayton R.; Dhanarajan, Gajaraj; Reju, Sunday A.

2009-01-01

This article explores a number of challenges faced by e-learning or distance educators in developing and emerging countries, provides a context for many of the challenges, and outlines some measures devised to overcome them. These educators must determine a sound rationale for employing online learning, recognize that technology is only part of…

Challenges Inherent in the Design and Implementation of After-School Intervention Programs for Middle Grade Underachieving Readers

ERIC Educational Resources Information Center

Velten, Justin; Mokhtari, Kouider

2016-01-01

In this brief report, we share three challenges we encountered when designing and implementing an after school intervention program for an ethnically diverse group of middle grade underachieving readers. We also offer practical solutions to help guide middle school teams in anticipating and addressing potential problems when putting in place…

Quality of Life of Higher Education Students with Learning Disability Studying Online

ERIC Educational Resources Information Center

Lambert, David C.; Dryer, Rachel

2018-01-01

This study examined how learning challenges encountered within online learning environments affected the quality of life of students with learning disability. A qualitative content analysis of semi-structured interviews conducted with eight students (mean[subscript age] = 33.75 years; SD = 8.15), revealed that learning challenges had consequences…

Conformity and Resistance in Self-Management Strategies of "Good Girls"

ERIC Educational Resources Information Center

Sanders, Jackie; Munford, Robyn

2008-01-01

This article examines how girls manage challenging encounters with non-familial adults. Drawing on a subset of qualitative data collected as part of a larger ethnographic study, it examines the ways girls maintain a strong sense of self as a good person in the face of interpersonal challenge from these non-familial adults. The discourse of the…

Students' Perceptions of Undertaking Workplace Tasks within a Foundation Degree--Health and Social Care

ERIC Educational Resources Information Center

Thurgate, Claire; MacGregor, Janet

2009-01-01

Foundation degrees (FDs) involve the fusion of academic and vocational paths in higher education (HE) qualifications; the challenge for academics and employers is the credible assessment of the student's workplace learning. Focusing to the workplace enables participants to learn from their daily routines encountered at work. The challenge is to…

Legal Challenges to Teacher Evaluation: Pitfalls and Possibilities in the States

ERIC Educational Resources Information Center

Hazi, Helen M.

2014-01-01

This article forecasts potential legal problems emerging from the use of new teacher evaluation systems in the states. This research was a policy analysis that combined three types of data to forecast the states and the legal challenges they might encounter: state policy data, selected case law, and problems from the literature of teacher…

Roles, Duties and Challenges of Special/Support Teachers at Secondary Education: Implications for Promoting Inclusive Practices

ERIC Educational Resources Information Center

Vlachou, Anastasia; Didaskalou, Eleni; Kontofryou, Maria

2015-01-01

Recent inclusive policy directives and advice offered to schools strongly recommend special/support teachers to expand their role and extend their duties. In light of this, we investigated how Greek secondary special/support teachers perceive and experience their role, work profile and the challenges they encounter. Qualitative analysis revealed…

When Districts Encounter Teacher Shortages: The Challenges of Recruiting and Retaining Mathematics Teachers in Urban Districts

ERIC Educational Resources Information Center

Liu, Edward; Rosenstein, Joseph G.; Swan, Aubrie E.; Khalil, Deena

2008-01-01

Administrators in six urban districts were interviewed to understand the nature and extent of their problems with recruiting and retaining high quality mathematics teachers. Findings suggest that the math staffing challenge is quite complex, and administrators have had to make difficult compromises because of deficiencies in the quantity and…

Virtual Academic Community: Online Education Instructors' Social Presence in Association with Freshman Composition Students' Critical Thinking and Argumentation

ERIC Educational Resources Information Center

Paquette, Paige Fuller

2009-01-01

There is much literature addressing challenges face-to-face freshman composition instructors encounter in developing college courses that foster critical thinking skills crucial to developing written argument. Composition instructors may face challenges in teaching students that writing is a means of making meaning, there are many different…

Using Support Mechanisms to Balance Work and Family Life: How Mid and Senior Level Student Affairs Administrators Overcome Challenges

ERIC Educational Resources Information Center

Cassell, Aba DeLynda

2012-01-01

Female student affairs leaders who also have family responsibilities find that a primary challenge they encounter is society's expectations concerning their roles and responsibilities in both realms. Research discovers that women experience internal and external barriers that hinder their advancement opportunities however; women's…

Surprise and Awe: Learning from Indigenous Managers and Implications for Management Education

ERIC Educational Resources Information Center

Schwabenland, Christina

2011-01-01

This article describes a self-reflexive exploration of five instances of encounters with indigenous managers that challenged my preconceptions about management. My focus is on the praxis of the moments in which these challenges occurred. I analyze these experiences to answer four questions: How did learning occur? What was that learning? How did…

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

ERIC Educational Resources Information Center

Ditto, Peter H

2006-01-01

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

Rethinking the Practice of Inclusion: Challenges Middle School Teachers Encounter in Inclusion Classrooms

ERIC Educational Resources Information Center

Brown, Hannah

2017-01-01

The inclusion of students with special needs in the general education classroom is challenging. Adherence to federal laws that advocate for equality in the classroom means that most contact hours for teachers working in such setting will be in classrooms consisting of both students with disabilities and their nondisabled peers. Oftentimes, these…

Beyond Right or Wrong: Challenges of Including Creative Design Activities in the Classroom

ERIC Educational Resources Information Center

Brennan, Karen

2015-01-01

In this article, we explore challenges encountered by K-12 educators in establishing classroom cultures that support creative learning activities with the Scratch programming language. Providing opportunities for students to understand and to build capacities for creative work was described by many of the teachers that we interviewed as a central…

Exploring Challenges Encountered by EFL Libyan Learners in Research Teaching and Writing

ERIC Educational Resources Information Center

Alsied, Safia Mujtaba; Ibrahim, Noura Winis

2017-01-01

Research is conducted all over the world to solve problems or to answer questions of significance to humanity. Academic writing or writing to report research is not easy because it requires adequate background knowledge, interest, motivation and hard work. This study investigates the major challenges in research writing faced by Libyan EFL…

Exploring the Relationship among International Students' English Self-Efficacy, Using English to Learn Self-Efficacy, and Academic Self-Efficacy

ERIC Educational Resources Information Center

Wang, Chih-hsuan; Harrison, Jamie; Cardullo, Victoria; Lin, Xi

2018-01-01

One of the major challenges for international students to pursue academic goals in the United States is English language proficiency, which often negatively affects academic success. Even students with confidence in their English language proficiency encounter challenges using English in class. Previous research indicates self-efficacy positively…

The Tale of One Children's Choir Educator within a Not-for-Profit Agency

ERIC Educational Resources Information Center

Parker, Elizabeth

2011-01-01

This narrative is an attempt to examine the conflicting expectations and mission confusion of one children's choir director. It details the challenges music educators may encounter at the nexus between educational and institutional goals or between ethical and professional challenges. The author has chosen to use narrative not only to tell her own…

Challenges in Mentoring Software Development Projects in the High School: Analysis According to Shulman's Teacher Knowledge Base Model

ERIC Educational Resources Information Center

Meerbaum-Salant, Orni; Hazzan, Orit

2009-01-01

This paper focuses on challenges in mentoring software development projects in the high school and analyzes difficulties encountered by Computer Science teachers in the mentoring process according to Shulman's Teacher Knowledge Base Model. The main difficulties that emerged from the data analysis belong to the following knowledge sources of…

Early Childhood Education in Pakistan--Progress and Challenges

ERIC Educational Resources Information Center

Shami, Pervez A.

2009-01-01

This paper is on Early Childhood Education (ECE)--a goal of Education For All (EFA), assesses the progress of Pakistan's efforts and strategies mainly during post Dakar period 2001-02 to 2005-06 and the major challenges being encountered. The information includes analysis of National Educational Data on ECE in the light of policies and plans, EFA…

Dental Hygiene Entry-Level Program Administrators' Strategies for Overcoming Challenges of Distance Education

ERIC Educational Resources Information Center

Buchanan, Bette A.

2009-01-01

The use of distance education by entry-level dental hygiene programs is increasing. The focus of this study was to determine the number of entry-level dental hygiene program administrators with experience developing and/or maintaining dental hygiene education by distance, the challenges encountered, and the strategies used to overcome the…

Factors Influencing Teacher Career Satisfaction, Teacher Collaboration and Everyday Challenges: An Exploratory Factor Analysis

ERIC Educational Resources Information Center

Narayan, Nilesh Anish

2016-01-01

The main purpose of this study is to assess the construct validity of Australian eighth grade mathematics teachers' perceptions towards their career satisfaction, their teaching practice and the everyday challenges encountered in schools. The data were utilised from the Trends in International Mathematics and Science Study where a total of 802…

Content-Based Instruction in Primary and Secondary School Settings. Case Studies in TESOL Practice Series

ERIC Educational Resources Information Center

Kaufman, Dorit, Ed.; Crandall, JoAnn, Ed.

2005-01-01

Content-based instruction (CBI) challenges English language educators to teach English using materials that learners encounter in their regular subject-area classes. This volume helps ESL and EFL teachers meet that challenge by providing them with creative ways to integrate English language learning with the content that students study at primary…

"We Are Like Orphans": Exploring Narratives of Lao Doctoral Alumni Educated in Sweden

ERIC Educational Resources Information Center

Silfver, Ann-Louise; Berge, Britt-Marie

2016-01-01

In this article, we explore the narratives of 10 doctoral alumni from Lao People's Democratic Republic (PDR) who underwent graduate training in Sweden. The narratives identify challenges encountered by the alumni but more importantly reveal the agency by which these challenges were overcome. The most important strategy was that of collaborative…

Application of LC/MS/MS Techniques to Development of US ...

EPA Pesticide Factsheets

This presentation will describe the U.S. EPA’s drinking water and ambient water method development program in relation to the process employed and the typical challenges encountered in developing standardized LC/MS/MS methods for chemicals of emerging concern. The EPA’s Drinking Water Contaminant Candidate List and Unregulated Contaminant Monitoring Regulations, which are the driving forces behind drinking water method development, will be introduced. Three drinking water LC/MS/MS methods (Methods 537, 544 and a new method for nonylphenol) and two ambient water LC/MS/MS methods for cyanotoxins will be described that highlight some of the challenges encountered during development of these methods. This presentation will provide the audience with basic understanding of EPA's drinking water method development program and an introduction to two new ambient water EPA methods.

Community health assessment using self-organizing maps and geographic information systems

PubMed Central

Basara, Heather G; Yuan, May

2008-01-01

Background From a public health perspective, a healthier community environment correlates with fewer occurrences of chronic or infectious diseases. Our premise is that community health is a non-linear function of environmental and socioeconomic effects that are not normally distributed among communities. The objective was to integrate multivariate data sets representing social, economic, and physical environmental factors to evaluate the hypothesis that communities with similar environmental characteristics exhibit similar distributions of disease. Results The SOM algorithm used the intrinsic distributions of 92 environmental variables to classify 511 communities into five clusters. SOM determined clusters were reprojected to geographic space and compared with the distributions of several health outcomes. ANOVA results indicated that the variability between community clusters was significant with respect to the spatial distribution of disease occurrence. Conclusion Our study demonstrated a positive relationship between environmental conditions and health outcomes in communities using the SOM-GIS method to overcome data and methodological challenges traditionally encountered in public health research. Results demonstrated that community health can be classified using environmental variables and that the SOM-GIS method may be applied to multivariate environmental health studies. PMID:19116020

Estimation of the latent mediated effect with ordinal data using the limited-information and Bayesian full-information approaches.

PubMed

Chen, Jinsong; Zhang, Dake; Choi, Jaehwa

2015-12-01

It is common to encounter latent variables with ordinal data in social or behavioral research. Although a mediated effect of latent variables (latent mediated effect, or LME) with ordinal data may appear to be a straightforward combination of LME with continuous data and latent variables with ordinal data, the methodological challenges to combine the two are not trivial. This research covers model structures as complex as LME and formulates both point and interval estimates of LME for ordinal data using the Bayesian full-information approach. We also combine weighted least squares (WLS) estimation with the bias-corrected bootstrapping (BCB; Efron Journal of the American Statistical Association, 82, 171-185, 1987) method or the traditional delta method as the limited-information approach. We evaluated the viability of these different approaches across various conditions through simulation studies, and provide an empirical example to illustrate the approaches. We found that the Bayesian approach with reasonably informative priors is preferred when both point and interval estimates are of interest and the sample size is 200 or above.

DengueME: A Tool for the Modeling and Simulation of Dengue Spatiotemporal Dynamics †

PubMed Central

de Lima, Tiago França Melo; Lana, Raquel Martins; de Senna Carneiro, Tiago Garcia; Codeço, Cláudia Torres; Machado, Gabriel Souza; Ferreira, Lucas Saraiva; de Castro Medeiros, Líliam César; Davis Junior, Clodoveu Augusto

2016-01-01

The prevention and control of dengue are great public health challenges for many countries, particularly since 2015, as other arboviruses have been observed to interact significantly with dengue virus. Different approaches and methodologies have been proposed and discussed by the research community. An important tool widely used is modeling and simulation, which help us to understand epidemic dynamics and create scenarios to support planning and decision making processes. With this aim, we proposed and developed DengueME, a collaborative open source platform to simulate dengue disease and its vector’s dynamics. It supports compartmental and individual-based models, implemented over a GIS database, that represent Aedes aegypti population dynamics, human demography, human mobility, urban landscape and dengue transmission mediated by human and mosquito encounters. A user-friendly graphical interface was developed to facilitate model configuration and data input, and a library of models was developed to support teaching-learning activities. DengueME was applied in study cases and evaluated by specialists. Other improvements will be made in future work, to enhance its extensibility and usability. PMID:27649226

A Comparative Study of Three Methodologies for Modeling Dynamic Stall

NASA Technical Reports Server (NTRS)

Sankar, L.; Rhee, M.; Tung, C.; ZibiBailly, J.; LeBalleur, J. C.; Blaise, D.; Rouzaud, O.

2002-01-01

During the past two decades, there has been an increased reliance on the use of computational fluid dynamics methods for modeling rotors in high speed forward flight. Computational methods are being developed for modeling the shock induced loads on the advancing side, first-principles based modeling of the trailing wake evolution, and for retreating blade stall. The retreating blade dynamic stall problem has received particular attention, because the large variations in lift and pitching moments encountered in dynamic stall can lead to blade vibrations and pitch link fatigue. Restricting to aerodynamics, the numerical prediction of dynamic stall is still a complex and challenging CFD problem, that, even in two dimensions at low speed, gathers the major difficulties of aerodynamics, such as the grid resolution requirements for the viscous phenomena at leading-edge bubbles or in mixing-layers, the bias of the numerical viscosity, and the major difficulties of the physical modeling, such as the turbulence models, the transition models, whose both determinant influences, already present in static maximal-lift or stall computations, are emphasized by the dynamic aspect of the phenomena.

[The male nurses' experiences of adaptation in clinical setting].

PubMed

Son, Haeng-Mi; Koh, Moon-Hee; Kim, Chun-Mi; Moon, Jin-Ha; Yi, Myung-Sun

2003-02-01

The purpose of this study was to identified the male nurses' encounter in adapting themselves in the hospital settings dominated by the female nurses in number. Data were collected through the in-depth interview of 16 male nurses and analysed through the grounded theory methodology. The behaviors of male nurses for job-adaptation can be summarized as a series of struggles to consolidate their own ground. They have made tremendous efforts to hold their own ground in the nursing profession composed of a large numbers of female nurses, while they have experienced many difficulties and problems as minorities. They have struggled to adapt themselves professionally through efforts such as; challenging the social and professional barriers, identifying the job identity, empowering themselves through self-development and dedication, expanding their influence among colleagues. In spite of these efforts, they had the perception that nursing is not a lifelong occupation for them. Thus, they had tendency to find outlets of change to occupations. A specific strategy is needed to provide an environment that is helpful for males in integrating into and adapting to the nursing profession.

Challenging Nurses’ Cultural Competence of Disability to Improve Interpersonal Interactions

PubMed Central

Roscigno, Cecelia I.

2013-01-01

Worldwide, at least 6.9 billion people have an impairment producing health condition (IPHC). Insensitive encounters with health care providers (HCPs) can result in negative appraisals, fear, and avoidance, but little is known about what things are commonly perceived as insensitive. A review of published narratives describing negative encounters with HCPs was conducted. Narrative analysis was used to compare, contrast, and synthesize six themes describing the common negative encounters: (a) ignoring or minimizing their knowledge; (b) detached interpersonal interactions; (c) placing a negative skew on their life quality; (d) a lack of HCP knowledge related to their complete needs; (e) assuming they should be asexual and childless; and, (f) an inherent power differential. The medical model of disability is perceived by individuals with IPHCs to inform negative encounters perceived as insensitive. This preliminary knowledge is important so we can address education needs, plan future research questions, and establish clinical practice improvements. PMID:23291869

Leaders' mental health at work: Empirical, methodological, and policy directions.

PubMed

Barling, Julian; Cloutier, Anika

2017-07-01

While employees' mental health is the focus of considerable attention from researchers, the public, and policymakers, leaders' mental health has almost escaped attention. We start by considering several reasons for this, followed by discussions of the effects of leaders' mental health on their own leadership behaviors, the emotional toll of high-quality leadership, and interventions to enhance leaders' mental health. We offer 8 possible directions for future research on leaders' mental health. Finally, we discuss methodological obstacles encountered when investigating leaders' mental health, and policy dilemmas raised by leaders' mental health. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Dynamic monitoring of compliant bodies impacting the water surface through local strain measurements

NASA Astrophysics Data System (ADS)

Panciroli, Riccardo; Biscarini, Chiara; Jannelli, Elio; Ubertini, Filippo; Ubertini, Stefano

2016-04-01

The understanding and the experimental characterization of the evolution of impulsive loading is crucial in several fields in structural, mechanical and ocean engineering, naval architecture and aerospace. In this regards, we developed an experimental methodology to reconstruct the deformed shape of compliant bodies subjected to impulsive loadings, as those encountered in water entry events, starting from a finite number of local strain measurements performed through Fiber Bragg Gratings. The paper discusses the potential applications of the proposed methodology for: i) real-time damage detection and structural health monitoring, ii) fatigue assessment and iii) impulsive load estimation.

Cumulative impact assessment: Application of a methodology

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

Witmer, G.W.; Bain, M.B.; Irving, J.S.

We expanded upon the Federal Energy Regulatory Commission's (FERC) Cluster Impact Assessment Procedure (CIAP) to provide a practical methodology for assessing potential cumulative impacts from multiple hydroelectric projects within a river basin. The objectives in designing the methodology were to allow the evaluation of a large number of combinations of proposed projects and to minimize constraints on the use of ecological knowledge for planning and regulating hydroelectric development at the river basin level. Interactive workshops and evaluative matrices were used to identify preferred development scenarios in the Snohomish (Washington) and Salmon (Idaho) River Basins. Although the methodology achieved its basicmore » objectives, some difficulties were encountered. These revolved around issues of (1) data quality and quantity, (2) alternatives analysis, (3) determination of project interactions, (4) determination of cumulative impact thresholds, and (5) the use of evaluative techniques to express degrees of impact. 8 refs., 1 fig., 2 tabs.« less

Some Findings Concerning Requirements in Agile Methodologies

NASA Astrophysics Data System (ADS)

Rodríguez, Pilar; Yagüe, Agustín; Alarcón, Pedro P.; Garbajosa, Juan

Agile methods have appeared as an attractive alternative to conventional methodologies. These methods try to reduce the time to market and, indirectly, the cost of the product through flexible development and deep customer involvement. The processes related to requirements have been extensively studied in literature, in most cases in the frame of conventional methods. However, conclusions of conventional methodologies could not be necessarily valid for Agile; in some issues, conventional and Agile processes are radically different. As recent surveys report, inadequate project requirements is one of the most conflictive issues in agile approaches and better understanding about this is needed. This paper describes some findings concerning requirements activities in a project developed under an agile methodology. The project intended to evolve an existing product and, therefore, some background information was available. The major difficulties encountered were related to non-functional needs and management of requirements dependencies.

Developing "My Asthma Diary": a process exemplar of a patient-driven arts-based knowledge translation tool.

PubMed

Archibald, Mandy M; Hartling, Lisa; Ali, Samina; Caine, Vera; Scott, Shannon D

2018-06-05

Although it is well established that family-centered education is critical to managing childhood asthma, the information needs of parents of children with asthma are not being met through current educational approaches. Patient-driven educational materials that leverage the power of the storytelling and the arts show promise in communicating health information and assisting in illness self-management. However, such arts-based knowledge translation approaches are in their infancy, and little is known about how to develop such tools for parents. This paper reports on the development of "My Asthma Diary" - an innovative knowledge translation tool based on rigorous research evidence and tailored to parents' asthma-related information needs. We used a multi-stage process to develop four eBook prototypes of "My Asthma Diary." We conducted formative research on parents' information needs and identified high quality research evidence on childhood asthma, and used these data to inform the development of the asthma eBooks. We established interdisciplinary consulting teams with health researchers, practitioners, and artists to help iteratively create the knowledge translation tools. We describe the iterative, transdisciplinary process of developing asthma eBooks which incorporates: (I) parents' preferences and information needs on childhood asthma, (II) quality evidence on childhood asthma and its management, and (III) the engaging and informative powers of storytelling and visual art as methods to communicate complex health information to parents. We identified four dominant methodological and procedural challenges encountered during this process: (I) working within an inter-disciplinary team, (II) quantity and ordering of information, (III) creating a composite narrative, and (IV) balancing actual and ideal management scenarios. We describe a replicable and rigorous multi-staged approach to developing a patient-driven, creative knowledge translation tool, which can be adapted for use with different populations and contexts. We identified specific procedural and methodological challenges that others conducting comparable work should consider, particularly as creative, patient-driven knowledge translation strategies continue to emerge across health disciplines.

Understanding the motivation and performance of community health volunteers involved in the delivery of health programmes in Kampala, Uganda: a realist evaluation protocol

PubMed Central

Vareilles, Gaëlle; Pommier, Jeanine; Kane, Sumit; Pictet, Gabriel; Marchal, Bruno

2015-01-01

Introduction The recruitment of community health volunteers to support the delivery of health programmes is a well-established approach in many countries, particularly where health services are not readily available. However, studies on management of volunteers are scarce and current research on human resource management of volunteers faces methodological challenges. This paper presents the protocol of a realist evaluation that aims at identifying the factors influencing the performance of community health volunteers involved in the delivery of a Red Cross immunisation programme in Kampala (Uganda) with a specific focus on motivation. Methods and analysis The realist evaluation cycle structures the protocol. To develop the theoretical basis for the evaluation, the authors conducted interviews and reviewed the literature on community health volunteers’ performance, management and organisational behaviour. This led to the formulation of the initial programme theory, which links the intervention inputs (capacity-building strategies) to the expected outcomes (positive work behaviour) with mechanisms that point in the direction of drivers of motivation. The contextual elements include components such as organisational culture, resource availability, etc. A case study design will be adopted. We define a case as a Red Cross branch, run by a programme manager, and will select two cases at the district level in Kampala. Mixed methods will be used in data collection, including individual interviews of volunteers, participant observation and document review. The thematic analysis will be based on the initial programme theory and will seek for context-mechanism-outcome configurations. Findings from the two cases will be compared. Discussion We discuss the scope for applying realist evaluation and the methodological challenges we encountered in developing this protocol. Ethics and dissemination The study was approved by the Ethical Committee at Rennes University Hospital, France. Results will be published in scientific journals, and communicated to respondents and relevant institutions. PMID:25631314

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

Psychosocial development in racially and ethnically diverse youth: conceptual and methodological challenges in the 21st century.

PubMed

Swanson, Dena Phillips; Spencer, Margaret Beale; Harpalani, Vinay; Dupree, Davido; Noll, Elizabeth; Ginzburg, Sofia; Seaton, Gregory

2003-01-01

As the US population becomes more diverse in the 21st century, researchers face many conceptual and methodological challenges in working with diverse populations. We discuss these issues for racially and ethnically diverse youth, using Spencer's phenomenological variant of ecological systems theory (PVEST) as a guiding framework. We present a brief historical background and discuss recurring conceptual flaws in research on diverse youth, presenting PVEST as a corrective to these flaws. We highlight the interaction of race, culture, socioeconomic status, and various contexts of development with identity formation and other salient developmental processes. Challenges in research design and interpretation of data are also covered with regard to both assessment of contexts and developmental processes. We draw upon examples from neighborhood assessments, ethnic identity development, and attachment research to illustrate conceptual and methodological challenges, and we discuss strategies to address these challenges. The policy implications of our analysis are also considered.

Methodological strategies in using home sleep apnea testing in research and practice.

PubMed

Miller, Jennifer N; Schulz, Paula; Pozehl, Bunny; Fiedler, Douglas; Fial, Alissa; Berger, Ann M

2017-11-14

Home sleep apnea testing (HSAT) has increased due to improvements in technology, accessibility, and changes in third party reimbursement requirements. Research studies using HSAT have not consistently reported procedures and methodological challenges. This paper had two objectives: (1) summarize the literature on use of HSAT in research of adults and (2) identify methodological strategies to use in research and practice to standardize HSAT procedures and information. Search strategy included studies of participants undergoing sleep testing for OSA using HSAT. MEDLINE via PubMed, CINAHL, and Embase with the following search terms: "polysomnography," "home," "level III," "obstructive sleep apnea," and "out of center testing." Research articles that met inclusion criteria (n = 34) inconsistently reported methods and methodological challenges in terms of: (a) participant sampling; (b) instrumentation issues; (c) clinical variables; (d) data processing; and (e) patient acceptability. Ten methodological strategies were identified for adoption when using HSAT in research and practice. Future studies need to address the methodological challenges summarized in this paper as well as identify and report consistent HSAT procedures and information.

The ethical junior: a typology of ethical problems faced by house officers

PubMed Central

McDougall, Rosalind; Sokol, Daniel K

2008-01-01

Although many studies have explored the experiences of doctors in their first postgraduate year, few have focused on the ethical issues encountered by this group. Based on an extensive literature review of research involving house officers, we argue that these doctors encounter a broad range of ‘everyday’ ethical challenges, from truth-telling to working in non-ideal conditions. We propose a typology of house officers' ethical issues and advocate prioritizing these issues in undergraduate medical ethics and law curricula. PMID:18299625

Teaching evolution in the Australian classroom

NASA Astrophysics Data System (ADS)

Vozzo, Les

A summary of the key issues of controversy encountered by science teachers in Australian classrooms. Evolution, cloning and gene manipulation, fertility control, artificial intelligence, irradiation of food, the use of nuclear energy, radiation from powerlines are some of the topics discussed and debated in classrooms. What are some of the difficulties encountered by teachers when students ask questions that raise moral dilemmas and challenges entrenched beliefs and views of the world. What are some of the teaching strategies used that deal with these difficulties.

Methodological and ethical challenges in studying patients' perceptions of coercion: a systematic mixed studies review.

PubMed

Soininen, Päivi; Putkonen, Hanna; Joffe, Grigori; Korkeila, Jyrki; Välimäki, Maritta

2014-06-04

Despite improvements in psychiatric inpatient care, patient restrictions in psychiatric hospitals are still in use. Studying perceptions among patients who have been secluded or physically restrained during their hospital stay is challenging. We sought to review the methodological and ethical challenges in qualitative and quantitative studies aiming to describe patients' perceptions of coercive measures, especially seclusion and physical restraints during their hospital stay. Systematic mixed studies review was the study method. Studies reporting patients' perceptions of coercive measures, especially seclusion and physical restraints during hospital stay were included. Methodological issues such as study design, data collection and recruitment process, participants, sampling, patient refusal or non-participation, and ethical issues such as informed consent process, and approval were synthesized systematically. Electronic searches of CINALH, MEDLINE, PsychINFO and The Cochrane Library (1976-2012) were carried out. Out of 846 initial citations, 32 studies were included, 14 qualitative and 18 quantitative studies. A variety of methodological approaches were used, although descriptive and explorative designs were used in most cases. Data were mainly collected in qualitative studies by interviews (n = 13) or in quantitative studies by self-report questionnaires (n = 12). The recruitment process was explained in 59% (n = 19) of the studies. In most cases convenience sampling was used, yet five studies used randomization. Patient's refusal or non-participation was reported in 37% (n = 11) of studies. Of all studies, 56% (n = 18) had reported undergone an ethical review process in an official board or committee. Respondents were informed and consent was requested in 69% studies (n = 22). The use of different study designs made comparison methodologically challenging. The timing of data collection (considering bias and confounding factors) and the reasons for non-participation of eligible participants are likewise methodological challenges, e.g. recommended flow charts could aid the information. Other challenges identified were the recruitment of large and representative samples. Ethical challenges included requesting participants' informed consent and respecting ethical procedures.

Editorial: Challenges for the usability of AR and VR for clinical neurosurgical procedures.

PubMed

de Ribaupierre, Sandrine; Eagleson, Roy

2017-10-01

There are a number of challenges that must be faced when trying to develop AR and VR-based Neurosurgical simulators, Surgical Navigation Platforms, and "Smart OR" systems. Trying to simulate an operating room environment and surgical tasks in Augmented and Virtual Reality is a challenge many are attempting to solve, in order to train surgeons or help them operate. What are some of the needs of the surgeon, and what are the challenges encountered (human computer interface, perception, workflow, etc). We discuss these tradeoffs and conclude with critical remarks.

Communicative challenges in the home care of older persons - a qualitative exploration.

PubMed

Sundler, Annelie J; Eide, Hilde; van Dulmen, Sandra; Holmström, Inger K

2016-10-01

To explore communicative challenges in encounters between nurse assistants and older persons during home care visits. The older population is increasing worldwide. Currently, there is a shift in care for older people from institutional care to home care. Providing home care in a person's home involves several challenges, including the complexity of communication. A descriptive observational design with a qualitative approach was used. The data consisted of audio recordings of real-life encounters during home care visits between nurse assistants and older persons, collected in 2014. A hermeneutic phenomenological analysis was conducted. Communicative challenges were identified: (a) in situations where the older persons had a different view than the nurse assistants on the care task and its content; and (b) when unexpected actions or turns occurred in the communication. Challenges included older person's existential issues, fragility and worries and concerns, which often appeared to be only vaguely expressed and difficult to verbally detect and tackle. This engendered a risk of misinterpretation or ignorance of these challenges. The findings point to the importance of communication as the key to facilitate person-centred home care. Communication training should focus more on addressing needs and existential issues in older persons. Person-centred home care for older persons needs to be addressed at both an individual and an organizational level. © 2016 John Wiley & Sons Ltd.

Challenges and motivators to physical activity faced by retired men when ageing: a qualitative study.

PubMed

Bredland, Ebba Langum; Söderström, Sylvia; Vik, Kjersti

2018-05-15

Active ageing reflects the message from World Health Organisation about addressing the challenge faced by the rapidly ageing population. Knowledge about barriers and facilitators to an active lifestyle must be given more attention. In addition, men seem to participate less in cultural activities and less in fall-prevention groups than women do. When mostly women work with the elderly in primary care, one might question whether the activities offered to older men meet their activity preferences. The aim of this study is to provide new knowledge about challenges and motivators encountered by retired men in maintaining physical activity when ageing. Nine retired men, aged between 66 and 83, wrote a Time Geographic Diary for 7 days each. Two focus group discussions with the men were held. A Systemic Text Condensation was used to analyse the data. The analyses identified three categories to describe challenges in being physical active: differences between men and women; meaningful physical activity; and environmental - especially socio-cultural - constraints. Motivating conditions were seen as: new activities to get younger friends, and more information about how to cope. To achieve the aim of active ageing, service providers as well as local authorities need to have a better understanding of the challenges retired men encounter when ageing. This study highlights vital aspects of the challenges faced by retired men in maintaining their physical activity level.

Near Real Time Integration of Satellite and Radar Data for Probabilistic Nearcasting of Severe Weather

NASA Astrophysics Data System (ADS)

Pilone, D.; Quinn, P.; Mitchell, A. E.; Baynes, K.; Shum, D.

2014-12-01

This talk introduces the audience to some of the very real challenges associated with visualizing data from disparate data sources as encountered during the development of real world applications. In addition to the fundamental challenges of dealing with the data and imagery, this talk discusses usability problems encountered while trying to provide interactive and user-friendly visualization tools. At the end of this talk the audience will be aware of some of the pitfalls of data visualization along with tools and techniques to help mitigate them. There are many sources of variable resolution visualizations of science data available to application developers including NASA's Global Imagery Browse Services (GIBS), however integrating and leveraging visualizations in modern applications faces a number of challenges, including: - Varying visualized Earth "tile sizes" resulting in challenges merging disparate sources - Multiple visualization frameworks and toolkits with varying strengths and weaknesses - Global composite imagery vs. imagery matching EOSDIS granule distribution - Challenges visualizing geographically overlapping data with different temporal bounds - User interaction with overlapping or collocated data - Complex data boundaries and shapes combined with multi-orbit data and polar projections - Discovering the availability of visualizations and the specific parameters, color palettes, and configurations used to produce them In addition to discussing the challenges and approaches involved in visualizing disparate data, we will discuss solutions and components we'll be making available as open source to encourage reuse and accelerate application development.

Reflections of the social environment in chimpanzee memory: applying rational analysis beyond humans.

PubMed

Stevens, Jeffrey R; Marewski, Julian N; Schooler, Lael J; Gilby, Ian C

2016-08-01

In cognitive science, the rational analysis framework allows modelling of how physical and social environments impose information-processing demands onto cognitive systems. In humans, for example, past social contact among individuals predicts their future contact with linear and power functions. These features of the human environment constrain the optimal way to remember information and probably shape how memory records are retained and retrieved. We offer a primer on how biologists can apply rational analysis to study animal behaviour. Using chimpanzees ( Pan troglodytes ) as a case study, we modelled 19 years of observational data on their social contact patterns. Much like humans, the frequency of past encounters in chimpanzees linearly predicted future encounters, and the recency of past encounters predicted future encounters with a power function. Consistent with the rational analyses carried out for human memory, these findings suggest that chimpanzee memory performance should reflect those environmental regularities. In re-analysing existing chimpanzee memory data, we found that chimpanzee memory patterns mirrored their social contact patterns. Our findings hint that human and chimpanzee memory systems may have evolved to solve similar information-processing problems. Overall, rational analysis offers novel theoretical and methodological avenues for the comparative study of cognition.

Reflections of the social environment in chimpanzee memory: applying rational analysis beyond humans

PubMed Central

Marewski, Julian N.; Schooler, Lael J.; Gilby, Ian C.

2016-01-01

In cognitive science, the rational analysis framework allows modelling of how physical and social environments impose information-processing demands onto cognitive systems. In humans, for example, past social contact among individuals predicts their future contact with linear and power functions. These features of the human environment constrain the optimal way to remember information and probably shape how memory records are retained and retrieved. We offer a primer on how biologists can apply rational analysis to study animal behaviour. Using chimpanzees (Pan troglodytes) as a case study, we modelled 19 years of observational data on their social contact patterns. Much like humans, the frequency of past encounters in chimpanzees linearly predicted future encounters, and the recency of past encounters predicted future encounters with a power function. Consistent with the rational analyses carried out for human memory, these findings suggest that chimpanzee memory performance should reflect those environmental regularities. In re-analysing existing chimpanzee memory data, we found that chimpanzee memory patterns mirrored their social contact patterns. Our findings hint that human and chimpanzee memory systems may have evolved to solve similar information-processing problems. Overall, rational analysis offers novel theoretical and methodological avenues for the comparative study of cognition. PMID:27853606

"Unequal Diversity" as a Knowledge Alliance: An Encounter of Paulo Freire's Dialogical Approach and Transdisciplinarity

ERIC Educational Resources Information Center

Novy, Andreas

2012-01-01

Purpose: The purpose of this self-reflective paper is to focus on practical efforts to combat inequality and foster intercultural dialogue in education. It introduces "knowledge alliances", a type of social practice open for education technologies. Design/methodology/approach: The paper is structured in a theoretical and an empirical…

Cognitive Difficulties in Struggling Comprehenders and Their Relation to Reading Comprehension: A Comparison of Group Selection and Regression-Based Models

ERIC Educational Resources Information Center

Barnes, Marcia A.; Stuebing, Karla K.; Fletcher, Jack M.; Barth, Amy E.; Francis, David J.

2016-01-01

Difficulties suppressing previously encountered but currently irrelevant information from working memory characterize less skilled comprehenders in studies in which they are matched to skilled comprehenders on word decoding and nonverbal IQ. These "extreme" group designs are associated with several methodological issues. When sample size…

Teaching Creative Thinking and Transitioning Students to the Workplace in an Academic Setting

ERIC Educational Resources Information Center

Senra, Michael; Fogler, H. Scott

2014-01-01

In their collegiate studies, students are given a wide range of concepts, theories, and equations to assist them in their future endeavors. However, students have not been sufficiently exposed to practical critical thinking methodologies that will benefit them as they encounter open-ended problems. A course developed at the University of Michigan…

The Development and Application of Distance Learning Courses on the Internet.

ERIC Educational Resources Information Center

Fuks, Hugo; Gerosa, Marco Aurelio; Lucena, Carlos Jose Pereira de

2002-01-01

Presents the methodology, results, and difficulties encountered in the development and delivery of a course through the Internet at a university in Rio de Janeiro. Provides a model for group work, including group discussions; and shows how a Web-based environment can be used to provide support and to facilitate cooperative learning. (Author/LRW)

Family Connections: Helping Early Head Start/Head Start Staff and Parents Address Mental Health Challenges

ERIC Educational Resources Information Center

Beardslee, William R.; Avery, Mary Watson; Ayoub, Catherine; Watts, Caroline L.

2009-01-01

Early Head Start/Head Start teachers and staff encounter parents who have wrestled with depression and other adversities every day. This article describes an innovative program of trainings for and consultation to Early Head Start/Head Start staff to help them effectively deal with mental heath challenges faced by parents and children. The program…

Challenging the Status Quo: The Enabling Role of Gender Sensitive Fathers, Inspirational Mothers and Surrogate Parents in Uganda

ERIC Educational Resources Information Center

Warrington, Molly

2013-01-01

Within a context where relatively few girls complete secondary education, 18 women were interviewed in Uganda with the objective of ascertaining how they were able to overcome the challenges they encountered to become well-qualified and successful career-women. An important finding from this research was that although parental involvement in…

Professional Experiences of Online Teachers in Wisconsin: Results from a Survey about Training and Challenges. REL 2016-110

ERIC Educational Resources Information Center

Zweig, Jacqueline; Stafford, Erin; Clements, Margaret; Pazzaglia, Angela M.

2015-01-01

REL Midwest, in partnership with the Midwest Virtual Education Research Alliance, analyzed the results of a survey administered to Wisconsin Virtual School teachers about the training in which they participated related to online instruction, the challenges they encounter while teaching online, and the type of training they thought would help them…

Challenges Pre-School Teachers Face in the Implementation of the Early Childhood Curriculum in the Cape Coast Metropolis

ERIC Educational Resources Information Center

Ntumi, Simon

2016-01-01

The study examined the challenges that pre-school teachers encounter in the implementation of the early childhood curriculum; exploring teaching methods employed by pre-schools teachers in the Cape Coast Metropolis. The study employed descriptive survey as the research design. A convenient sample of 62 pre-school teachers were selected from a…

Fourth-Grade Primary School Students' Thought Processes and Challenges Encountered during the Butter Beans Problem

ERIC Educational Resources Information Center

Sahin, Neslihan; Eraslan, Ali

2017-01-01

In parallel with mathematical modeling studies that have gradually drawn interest in recent years, the aim of this study is to investigate the thought processes of fourth-grade students in the Butter Beans Problem and to identify possible challenges in this process. For this purpose, a qualitative study was conducted at a university-foundation…

Challenges and Solutions to Assisting Older Adults in Completing the GED: A Study of What the Experts Say

ERIC Educational Resources Information Center

Brinkley-Etzkorn, Karen E.

2016-01-01

The purpose of this study was to investigate the challenges and solutions encountered by Adult Basic Education (ABE) programs currently serving older adults seeking a GED credential in states where this is the only high school equivalency option available. The following questions guided this research: (1) what are the perceived characteristics and…

The Impact of Bullying on School Performance in Six Selected Schools in South Carolina

ERIC Educational Resources Information Center

Cooper, Stephanie A.

2011-01-01

The nation's K-12 schools are faced with numerous critical challenges, such as elevating academic achievement, and meeting No Child Left Behind state standards (Kowalski et al., 2008). But bullying in schools is becoming one of the most challenging issues that school personnel are encountering. In a Stanford University, study it was revealed that…

Changes in the methodology used in the production of the Spanish CORINE: Uncertainty analysis of the new maps

NASA Astrophysics Data System (ADS)

García-Álvarez, David; Camacho Olmedo, María Teresa

2017-12-01

Since 2012 CORINE has been obtained in Spain from the generalization of a more detailed land cover map (SIOSE). This methodological change has meant the production of a new CORINE map, which is different from the existing ones. To analyze how different the new maps are from the previous ones, as well as the advantages and disadvantages of the new methodology, we carried out a comparison of the CORINE obtained from both methods (traditional and generalization) for the year 2006. The new CORINE is more detailed and it is more coherent with the rest of Spanish Land Use Land Cover (LULC) maps. However, problems have been encountered with regard to the meaning of its classes, the fragmentation of patches and the complexity of its perimeters.

Overcoming an obstacle in expanding a UMLS semantic type extent.

PubMed

Chen, Yan; Gu, Huanying; Perl, Yehoshua; Geller, James

2012-02-01

This paper strives to overcome a major problem encountered by a previous expansion methodology for discovering concepts highly likely to be missing a specific semantic type assignment in the UMLS. This methodology is the basis for an algorithm that presents the discovered concepts to a human auditor for review and possible correction. We analyzed the problem of the previous expansion methodology and discovered that it was due to an obstacle constituted by one or more concepts assigned the UMLS Semantic Network semantic type Classification. A new methodology was designed that bypasses such an obstacle without a combinatorial explosion in the number of concepts presented to the human auditor for review. The new expansion methodology with obstacle avoidance was tested with the semantic type Experimental Model of Disease and found over 500 concepts missed by the previous methodology that are in need of this semantic type assignment. Furthermore, other semantic types suffering from the same major problem were discovered, indicating that the methodology is of more general applicability. The algorithmic discovery of concepts that are likely missing a semantic type assignment is possible even in the face of obstacles, without an explosion in the number of processed concepts. Copyright © 2011 Elsevier Inc. All rights reserved.

Overcoming an Obstacle in Expanding a UMLS Semantic Type Extent

PubMed Central

Chen, Yan; Gu, Huanying; Perl, Yehoshua; Geller, James

2011-01-01

This paper strives to overcome a major problem encountered by a previous expansion methodology for discovering concepts highly likely to be missing a specific semantic type assignment in the UMLS. This methodology is the basis for an algorithm that presents the discovered concepts to a human auditor for review and possible correction. We analyzed the problem of the previous expansion methodology and discovered that it was due to an obstacle constituted by one or more concepts assigned the UMLS Semantic Network semantic type Classification. A new methodology was designed that bypasses such an obstacle without a combinatorial explosion in the number of concepts presented to the human auditor for review. The new expansion methodology with obstacle avoidance was tested with the semantic type Experimental Model of Disease and found over 500 concepts missed by the previous methodology that are in need of this semantic type assignment. Furthermore, other semantic types suffering from the same major problem were discovered, indicating that the methodology is of more general applicability. The algorithmic discovery of concepts that are likely missing a semantic type assignment is possible even in the face of obstacles, without an explosion in the number of processed concepts. PMID:21925287

Two Methodological Challenges for Teacher-Researchers: Reflexivity and Trustworthiness

ERIC Educational Resources Information Center

Xerri, Daniel

2018-01-01

Teacher research is lauded as a beneficial enterprise both for practitioners and for learners. However, teachers are sometimes accused of not possessing the necessary knowledge and skills to conduct research effectively. This article focuses on the need for teacher-researchers to find means of addressing the methodological challenges of engaging…

Counseling Psychology Research on Sexual (Orientation) Minority Issues: Conceptual and Methodological Challenges and Opportunities

ERIC Educational Resources Information Center

Moradi, Bonnie; Mohr, Jonathan J.; Worthington, Roger L.; Fassinger, Ruth E.

2009-01-01

This lead article of the special issue discusses conceptual and methodological considerations in studying sexual minority issues, particularly in research conducted by counseling psychologists (including the work represented in this special issue). First, the overarching challenge of conceptualizing and defining sexual minority populations is…

Theoretical Borderlands: Using Multiple Theoretical Perspectives to Challenge Inequitable Power Structures in Student Development Theory

ERIC Educational Resources Information Center

Abes, Elisa S.

2009-01-01

This article is an exploration of possibilities and methodological considerations for using multiple theoretical perspectives in research that challenges inequitable power structures in student development theory. Specifically, I explore methodological considerations when partnering queer theory and constructivism in research on lesbian identity…

'I still have no idea why this patient was here': An exploration of the difficulties GP trainees experience when gathering information.

PubMed

Giroldi, Esther; Veldhuijzen, Wemke; de Leve, Tijme; van der Weijden, Trudy; Bueving, Herman; van der Vleuten, Cees

2015-07-01

Collecting information during patient encounters is essential for the delivery of patient-centered care. To obtain insight into areas that require more attention in medical communication training, this study explores what difficulties GP trainees encounter when gathering information. In this phenomenological study, we observed a morning clinic of 15 GP trainees. To explore trainees' experiences with information-gathering, we held brief interviews after every consultation and a lengthier interview directly after the morning clinic. The resulting data were analyzed using template analysis. From trainees' reflections, we distilled five difficulties that trainees experience when gathering information: (1) Goal conflicts; (2) Ineffectiveness of trained communication skills in specific situations; (3) Trainees' distress hampers open communication; (4) Untrustworthy information; (5) Tunnel vision. Information-gathering is difficult for GP trainees. Current generic communication skills training does not seem to support trainees sufficiently to handle effectively the challenges they encounter during consultations. Medical communication training needs to support trainees in handling their goal-conflicts and feelings that hamper information-gathering, while also providing them with communication strategies adapted to handling specific challenging situations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Perspectives of school-work transitions among youth with spina bifida, their parents and health care providers.

PubMed

Lindsay, Sally; McPherson, Amy C; Maxwell, Joanne

2017-04-01

Purpose Youth with disabilities encounter many challenges in finding employment and transitioning to post-secondary education. In this article, we explore the nature of school-work transitions for youth with spina bifida, which few studies have previously addressed. Method We conducted in-depth interviews with 44 participants (nine youth and 12 young adults with spina bifida, 11 parents and 12 clinicians). We analyzed our data using a qualitative content analysis approach. Results We identified several enablers to school-work transitions, including professional support, social support and school accommodations. Lacking such support created several challenges for youth with spina bifida. We also identified several barriers to school-work transitions, including lack of education and information on finances, housing and transportation; discrimination and stigma; and challenges coping with spina bifida at school and work. Conclusions Although some supports are available, youth with spina bifida encounter many challenges in transitioning to post-secondary education and employment. With clinicians at the helm, efforts should be put in place within the health and social services system to better prepare youth, as they transition to adulthood, to become connected to appropriate information and resources to help them to succeed in their school and employment goals. Implications for Rehabilitation Youth with spina bifida encounter many challenges in transitioning to post-secondary education or work. Clinicians, educators and parents should continue to support youth with spina bifida in choosing their vocations, setting career goals and developing career plans. Starting from a young age, parents, clinicians and educators should help youth with spina bifida prepare for school work transitions by fostering their independence, life skills and self-management of spina bifida-related symptoms. Clinicians and educators should help connect youth with spina bifida to appropriate information and resources to support their school-work transitions, including information on finances, housing, transportation, school accommodations and employment supports.

Teaching Feminist Group Process within a Nursing Curriculum.

ERIC Educational Resources Information Center

Banister, Elizabeth; Schreiber, Rita

1999-01-01

Describes feminist group processes (praxis, empowerment, awareness, consensus, evolution) taught to nursing students through experiential learning activities. Explains changes in learner and teacher behavior and challenges that were encountered and overcome. (SK)

Navigation for Rendezvous and Orbit Missions to Small Solar-System Bodies

NASA Technical Reports Server (NTRS)

Helfrich, C. E.; Scheeres, D. J.; Williams, B. G.; Bollman, W. E.; Davis, R. P.; Synnott, S. P.; Yeomans, D. K.

1994-01-01

All previous spacecraft encounters with small solar-system bodies, such as asteroids and comets, have been flybys (e.g. Galileo's flybys of the asteroids Gaspra and Ida). Several future projects plan to build on the flyby experience and progress to the next level with rendezvous and orbit missions to small bodies. This presents several new issues and challenges for navigation which have never been considered before. This paper addresses these challenges by characterizing the different phases of a small body rendezvous and by describing the navigation requirements and goals of each phase. Prior to the encounter with the small body, improvements to its ephemeris and initial estimates of its physical parameters, e.g. size, shape, mass, rotation rate, rotation pole, and possibly outgassing, are made as accurately as ground-based measurements allow. This characterization can take place over years...

An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis.

PubMed

Pehlivantürk Kızılkan, Melis; Kanbur, Nuray; Akgül, Sinem; Alikaşifoğlu, Ayfer

2016-03-05

Low triiodothyronine syndrome is a physiological adaptation encountered in anorexia nervosa (AN) and generally improves with sufficient weight gain. However, when a primary thyroid pathology accompanies AN, both the evaluation of thyroid hormone levels and the management of the co-morbid disease become more challenging. Hashimoto thyroiditis could complicate the management of AN by causing hyper- or hypothyroidism. AN could also negatively affect the treatment of Hashimoto thyroiditis by altering body weight and metabolic rate, as well as by causing drug non-compliance. We present the case of a 15-year-old boy with comorbid AN restrictive sub-type and Hashimoto thyroiditis. In this case report, we aimed to draw attention to the challenges that could be encountered in the diagnosis, treatment, and follow-up of patients with AN when accompanied by Hashimoto thyroiditis.

An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis

PubMed Central

Pehlivantürk Kızılkan, Melis; Kanbur, Nuray; Akgül, Sinem; Alikaşifoğlu, Ayfer

2016-01-01

Low triiodothyronine syndrome is a physiological adaptation encountered in anorexia nervosa (AN) and generally improves with sufficient weight gain. However, when a primary thyroid pathology accompanies AN, both the evaluation of thyroid hormone levels and the management of the co-morbid disease become more challenging. Hashimoto thyroiditis could complicate the management of AN by causing hyper- or hypothyroidism. AN could also negatively affect the treatment of Hashimoto thyroiditis by altering body weight and metabolic rate, as well as by causing drug non-compliance. We present the case of a 15-year-old boy with comorbid AN restrictive sub-type and Hashimoto thyroiditis. In this case report, we aimed to draw attention to the challenges that could be encountered in the diagnosis, treatment, and follow-up of patients with AN when accompanied by Hashimoto thyroiditis. PMID:26757948

Challenges in sharing knowledge: reflections from the perspective of an expatriate nurse working in a South Sudanese hospital.

PubMed

Tjoflåt, I; Karlsen, B

2012-12-01

This account, based on the experience of the first author, aims to describe an example of practice from a hospital in South Sudan. The example illustrates a cross-cultural encounter and the challenges that a Sudanese nurse and an expatriate nurse face in sharing knowledge when providing patient care. The constructed practical example between nurses with different knowledge bases and experiences was characterized by the expatriate nurse giving her instructions and not allowing the Sudanese nurse to respond to them. This 'one-way' communication demonstrated that the expatriate nurse considered herself to have the better knowledge of nursing care. These aspects of the encounter formed the basis for the following discussion, which sheds light on how the expatriate nurse ideally could have worked by using a dialogue instead of one-way communication. The importance of having knowledge and understanding of the context in cross-cultural encounters was also emphasized. The discussion of this practical example can provide insight for other nurses when working in cultures other than their own into the importance of using a dialogue when sharing knowledge in a cross-cultural encounter. In addition, expatriates can be made aware of the importance of acquiring knowledge about the context for 'the other' when working cross culturally. Finally, it should be noted that the description and discussion of the experience reflect only the perspective of the expatriate nurse. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

Cross-cultural care encounters in paediatric care: minority ethnic parents' experiences.

PubMed

Tavallali, Azar Gashasb; Jirwe, Maria; Kabir, Zarina Nahar

2017-03-01

Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care. The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care. A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis. The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5). The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions. Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters. © 2016 Nordic College of Caring Science.

Ad hoc supervision of general practice registrars as a 'community of practice': analysis, interpretation and re-presentation.

PubMed

Clement, T; Brown, J; Morrison, J; Nestel, D

2016-05-01

General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

Mental hospital depopulation in Canada: patient perspectives.

PubMed

Herman, N J; Smith, C M

1989-06-01

This paper reviews briefly the history of mental health depopulation in Canada over the past 30 years. The term "deinstitutionalization" is often used but is unsatisfactory. Using an exploratory, qualitative, methodological approach, data were collected on the problems encountered by a disproportionate, stratified random sample of 139 formerly institutionalized patients living in various geographical locales in Eastern Canada. Adopting a symbolic interactionist theoretical approach, this study, in an effort to fill a neglect in the literature, attempted to discover what the everyday world(s) of Canadian ex-mental patients was really like. Problems encountered related to stigma, poor housing, lack of back living skills, poverty, unemployment and aftercare. Quotations from patients are provided to illustrate such themes. The findings are discussed.

Heterogeneous Effects in Education: The Promise and Challenge of Incorporating Intersectionality into Quantitative Methodological Approaches

ERIC Educational Resources Information Center

Schudde, Lauren

2018-01-01

To date, the theory of intersectionality has largely guided qualitative efforts in social science and education research. Translating the construct to new methodological approaches is inherently complex and challenging, but offers the possibility of breaking down silos that keep education researchers with similar interests--but different…

The Challenges to and the Need for International Research in Educational Leadership

ERIC Educational Resources Information Center

Brooks, Melanie Carol; Jean-Marie, Gaetane

2015-01-01

Purpose: The purpose of this paper is twofold: to discuss methodological challenges facing US scholars when conducting international research; and to present personal reflections as educational leadership faculty in the USA conducting and publishing on research undertaken in Haiti and Thailand. Design/Methodology/Approach: This study drew from…

The Challenge of Researching Violent Societies: Navigating Complexities in Ethnography

ERIC Educational Resources Information Center

Tshabangu, Icarbord

2009-01-01

Through use of a recent study researching democratic education and citizenship in Zimbabwe, this paper examines the methodological dilemmas and challenges faced by an ethnographer, particularly by a research student in a violent context. The article posits a bricolage strategy to navigate some of the dangers and methodological dilemmas inherent so…

Queering Methodologies: Challenging Scientific Constraint in the Appreciation of Queer and Trans Subjects

ERIC Educational Resources Information Center

Ferguson, Joshua M.

2013-01-01

Qualitative studies require a queer perspective to challenge stagnant forms of scientific discourse. This paper argues for a deconstruction of hegemonic qualitative practices in order to appreciate and listen to queer and trans subjects when employing qualitative research and methodologies. I focus on qualitative methods from an audiovisual…

Measuring Cognitive and Metacognitive Regulatory Processes during Hypermedia Learning: Issues and Challenges

ERIC Educational Resources Information Center

Azevedo, Roger; Moos, Daniel C.; Johnson, Amy M.; Chauncey, Amber D.

2010-01-01

Self-regulated learning (SRL) with hypermedia environments involves a complex cycle of temporally unfolding cognitive and metacognitive processes that impact students' learning. We present several methodological issues related to treating SRL as an event and strengths and challenges of using online trace methodologies to detect, trace, model, and…

The Psychological Study of Video Game Players: Methodological Challenges and Practical Advice

ERIC Educational Resources Information Center

King, Daniel; Delfabbro, Paul; Griffiths, Mark

2009-01-01

Video game playing has received increased academic interest over the last few decades, particularly with regard to the psychological understanding of addiction. Based on the many studies carried out by the authors, this paper summarises some of the methodological challenges which may arise when studying video game players, including obstacles…

“ Blaming, shaming, humiliation”: Stigmatising medical interactions among people with non-epileptic seizures

PubMed Central

Robson, Catherine; Lian, Olaug S.

2017-01-01

Background: People with non-epileptic seizures (NES) describe challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience difficult healthcare encounters. Methods: Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants’ texts from a social-constructionist perspective on health and illness. Results: The overarching narrative depicts a fundamental breakdown in patient-provider relationships. According to our data, the negative experiences of study participants emerge from more than practitioners’ lack of awareness of NES and access to information about the condition - to the extent that it is available. In examining the challenges people with NES encounter when interacting with health professionals, their main experiences centre on blame and humiliation. When exploring their experiences, theories of stigma serve as a useful theoretical framework. Conclusions: Normative judgements arising from psychogenic understandings of NES are stigmatising and restrict professional displays of respectful (patient-centred) care. Those with the condition depict being negatively stereotyped, illegitimated and held morally culpable by health professionals. Perceived to lack medical, moral and credible status, participants describe practitioners who treat them with disrespect, and some recount conduct that defies all ethical and professional obligations and standards. These encounters can have wide-ranging adverse consequences for patients: emotionally, physically, and for their future healthcare. The quality of healthcare interactions for people with NES requires urgent improvements. In addition to increased awareness of the condition, practitioners need to be conscious of making and acting on adverse moral appraisals when interacting with this patient group. PMID:29152594

" Blaming, shaming, humiliation": Stigmatising medical interactions among people with non-epileptic seizures.

PubMed

Robson, Catherine; Lian, Olaug S

2017-01-01

Background : People with non-epileptic seizures (NES) describe challenging relationships with health professionals, and explain negative interactions as common and expected. Despite these difficulties, little is known about how people with NES experience difficult healthcare encounters. Methods : Using a thematic discourse analysis approach, we analysed the free-text survey responses of 135 people with NES and asked: what kind of challenges do people living with this condition encounter when interacting with health professionals, and how do they experience the consequences of difficult interactions? We explore their experiences by interpreting the latent meaning of participants' texts from a social-constructionist perspective on health and illness. Results : The overarching narrative depicts a fundamental breakdown in patient-provider relationships. According to our data, the negative experiences of study participants emerge from more than practitioners' lack of awareness of NES and access to information about the condition - to the extent that it is available. In examining the challenges people with NES encounter when interacting with health professionals, their main experiences centre on blame and humiliation. When exploring their experiences, theories of stigma serve as a useful theoretical framework. Conclusions : Normative judgements arising from psychogenic understandings of NES are stigmatising and restrict professional displays of respectful (patient-centred) care. Those with the condition depict being negatively stereotyped, illegitimated and held morally culpable by health professionals. Perceived to lack medical, moral and credible status, participants describe practitioners who treat them with disrespect, and some recount conduct that defies all ethical and professional obligations and standards. These encounters can have wide-ranging adverse consequences for patients: emotionally, physically, and for their future healthcare. The quality of healthcare interactions for people with NES requires urgent improvements. In addition to increased awareness of the condition, practitioners need to be conscious of making and acting on adverse moral appraisals when interacting with this patient group.

New Mission Old Spacecraft: EPOXI's Approach to the Comet Hartley-2

NASA Technical Reports Server (NTRS)

Rieber, Richard R.; LaBorde, Gregory R.

2012-01-01

NASA's Deep Impact mission ended successfully in 2005 after an impact and close flyby of the comet 9P/Tempel-1. The Flyby spacecraft was placed in hibernation and was left to orbit the sun. In 2007, engineers at the Jet Propulsion Laboratory brought the spacecraft out of hibernation and successfully performed two additional missions. These missions were EPOCh, Extra-solar Planetary Observation and Characterization, a photometric investigation of transiting exo-planets, and DIXI, Deep Impact eXtended Investigation, which maneuvered the Flyby spacecraft towards a close encounter with the comet 103P/Hartley- 2 on 4 November 2010. The names of these two scientific investigations combine to form the overarching mission's name, EPOXI. The encounter with 103P/Hartley-2 was vastly different from the prime mission's encounter with 9P/Tempel-1. The geometry of encounter was nearly 180 ? different and 103P/Hartley-2 was approximately one-quarter the size of 9P/Tempel-1. Mission operations for the comet flyby were broken into three phases: a) Approach, b) Encounter, and c) Departure. This paper will focus on the approach phase of the comet encounter. It will discuss the strategies used to decrease both cost and risk while maximizing science return and some of the challenges experienced during operations.

Hypersonics. Volume 1 - Defining the hypersonic environment; Proceedings of the First Joint Europe/U.S. Short Course on Hypersonics, Paris, France, Dec. 7-11, 1987

NASA Astrophysics Data System (ADS)

Bertin, John J.; Glowinski, Roland; Periaux, Jacques

1989-05-01

The present work discusses the general characterization of hypersonic flows, the hypersonic phenomena to be encountered by the Hermes spacecraft, industrial methodologies for the design of hypersonic vehicles, the definition of aerodynamic methodology, and hypersonic airbreathing-propulsion vehicle design practices applicable to the U.S. National Aerospace Plane. Also discussed are real gas effects in the hypersonic regime, the influence of thermochemistry and of nonequilibrium and surface catalysis on hypersonic vehicle design, the modelling of nonequilibrium effects in high speed flows, air-dissociation thermochemistry, and rarefied gas dynamics effects for spacecraft.

Emerging Methodologies in Pediatric Palliative Care Research: Six Case Studies

PubMed Central

Nelson, Katherine E.; Gerhardt, Cynthia A.; Rosenberg, Abby R.; Widger, Kimberley; Faerber, Jennifer A.; Feudtner, Chris

2018-01-01

Given the broad focus of pediatric palliative care (PPC) on the physical, emotional, and spiritual needs of children with potentially life-limiting illnesses and their families, PPC research requires creative methodological approaches. This manuscript, written by experienced PPC researchers, describes issues encountered in our own areas of research and the novel methods we have identified to target them. Specifically, we discuss potential approaches to: assessing symptoms among nonverbal children, evaluating medical interventions, identifying and treating problems related to polypharmacy, addressing missing data in longitudinal studies, evaluating longer-term efficacy of PPC interventions, and monitoring for inequities in PPC service delivery. PMID:29495384

An almost-parameter-free harmony search algorithm for groundwater pollution source identification.

PubMed

Jiang, Simin; Zhang, Yali; Wang, Pei; Zheng, Maohui

2013-01-01

The spatiotemporal characterization of unknown sources of groundwater pollution is frequently encountered in environmental problems. This study adopts a simulation-optimization approach that combines a contaminant transport simulation model with a heuristic harmony search algorithm to identify unknown pollution sources. In the proposed methodology, an almost-parameter-free harmony search algorithm is developed. The performance of this methodology is evaluated on an illustrative groundwater pollution source identification problem, and the identified results indicate that the proposed almost-parameter-free harmony search algorithm-based optimization model can give satisfactory estimations, even when the irregular geometry, erroneous monitoring data, and prior information shortage of potential locations are considered.

Reducing Conservatism of Analytic Transient Response Bounds via Shaping Filters

NASA Technical Reports Server (NTRS)

Kwan, Aiyueh; Bedrossian, Nazareth; Jan, Jiann-Woei; Grigoriadis, Karolos; Hua, Tuyen (Technical Monitor)

1999-01-01

Recent results show that the peak transient response of a linear system to bounded energy inputs can be computed using the energy-to-peak gain of the system. However, analytically computed peak response bound can be conservative for a class of class bounded energy signals, specifically pulse trains generated from jet firings encountered in space vehicles. In this paper, shaping filters are proposed as a Methodology to reduce the conservatism of peak response analytic bounds. This Methodology was applied to a realistic Space Station assembly operation subject to jet firings. The results indicate that shaping filters indeed reduce the predicted peak response bounds.

Computational Evidence that Frequency Trajectory Theory Does Not Oppose but Emerges from Age-of-Acquisition Theory

ERIC Educational Resources Information Center

Mermillod, Martial; Bonin, Patrick; Meot, Alain; Ferrand, Ludovic; Paindavoine, Michel

2012-01-01

According to the age-of-acquisition hypothesis, words acquired early in life are processed faster and more accurately than words acquired later. Connectionist models have begun to explore the influence of the age/order of acquisition of items (and also their frequency of encounter). This study attempts to reconcile two different methodological and…

How Homeless Sector Workers Deal with the Death of Service Users: A Grounded Theory Study

ERIC Educational Resources Information Center

Lakeman, Richard

2011-01-01

Homeless sector workers often encounter the deaths of service users. A modified grounded theory methodology project was used to explore how workers make sense of, respond to, and cope with sudden death. In-depth interviews were undertaken with 16 paid homeless sector workers who had experienced the death of someone with whom they worked.…

Proximity with under Two-Year-Olds in Early Childhood Education: A Silent Pedagogical Encounter

ERIC Educational Resources Information Center

White, Elizabeth Jayne; Redder, Bridgette

2015-01-01

Using mixed methods to analyse the experience of a 4-month-old and a 10-month-old infant in a high-quality New Zealand education and care setting, this paper utilises dialogic methodology to foreground the importance of key teacher proximity to infant relationships with adults, peers and artefacts in a group context. Quantitative findings…

Is It Because of Partners or Partnerships?: An Investigation into the Main Obstacles of Developing International Partnerships in Four UK Universities

ERIC Educational Resources Information Center

Ayoubi, Rami M.; Massoud, Hiba

2012-01-01

Purpose: The main aim of the current study is to explore and model the major obstacles that UK universities encounter when developing international partnerships with overseas universities. Design/methodology/approach: Focusing on the obstacles to developing international partnerships, the study results are developed from 24 interviews with senior…

Higher Education Ranking and Leagues Tables: Lessons Learned from Benchmarking

ERIC Educational Resources Information Center

Proulx, Roland

2007-01-01

The paper intends to contribute to the debate on ranking and league tables by adopting a critical approach to ranking methodologies from the point of view of a university benchmarking exercise. The absence of a strict benchmarking exercise in the ranking process has been, in the opinion of the author, one of the major problems encountered in the…

Using Yes-No Recognition Tests to Assess Student Memory for Course Content

ERIC Educational Resources Information Center

Smith, Dale L.; Barker, Lewis

2008-01-01

We report 3 experiments using yes-no recognition tests of student memory for course content. Each test consisted of items encountered in the course and an equal number of foils. Experiment 1 involved an initial test of the methodology and addressed test reliability. Experiments 2 and 3 examined performance before and after completion of courses in…

"¿Qué Estoy Haciendo Aquí? (What Am I Doing Here?)": Chicanos/Latinos(as) Navigating Challenges and Inequalities During Their First Year of Graduate School

ERIC Educational Resources Information Center

Ramirez, Elvia

2014-01-01

Based on in-depth qualitative interviews, this study analyzed the challenges and structural inequities that Chicanos/Latinos(as) encountered and resisted during their first year of graduate school. Grounded in intersectionality theory, this study analyzed how race, class, and gender inequalities that are embedded in the graduate schooling process…

Lesson Study Model: The Challenge of Transforming a Global Idea into Local Practice

ERIC Educational Resources Information Center

Grimsaeth, Gerd; Hallås, Bjørg Oddrun

2016-01-01

The lesson study (LS) model, which originated in Japan, has become popular all over the world. This article will highlight some of the challenges encountered when the LS model was picked up and introduced in a local school context in a Norwegian municipality. The article views this process in the light of research on LS-model transfer into local…

Challenges of Using Audio-Visual Aids as Warm-Up Activity in Teaching Aviation English

ERIC Educational Resources Information Center

Sahin, Mehmet; Sule, St.; Seçer, Y. E.

2016-01-01

This study aims to find out the challenges encountered in the use of video as audio-visual material as a warm-up activity in aviation English course at high school level. This study is based on a qualitative study in which focus group interview is used as the data collection procedure. The participants of focus group are four instructors teaching…

A New Vision of Professional Development for University Teachers in Libya "It's Not an Event, It Is a Process"

ERIC Educational Resources Information Center

Suwaed, Hameda; Rahouma, Wesam

2015-01-01

Being a university teacher in the Libya is most of the time described as a challenge. In the case of the current unstable situation in Libya, the task is formidable in many cases. This paper investigates the challenges encountered by Alzawia university teachers in four colleges. It attempts to answer the following questions: what are the…

Robotic Telesurgery Research

DTIC Science & Technology

2010-03-01

piece of tissue. Full Mobility Manipulator Robot The primary challenge with the design of a full mobility robot is meeting the competing design...streamed through an embedded plug-in for VLC player using asf/wmv encoding with 200ms buffering. A benchtop test of the remote user interface was...encountered in ensuring quality video is being made available to the surgeon. A significant challenge has been to consistently provide high quality video

Educators' Experiences Learning to Meet Adaptive Challenges Involving English Learners within the Learning-Oriented Leadership Model: A Qualitative Study

ERIC Educational Resources Information Center

Benis Scheier-Dolberg, Sarah Elizabeth.

2014-01-01

Little is known about how engaging in the learning-oriented leadership model (Drago-Severson, 2004b, 2009, 2012a) can support educators to address the adaptive challenges they encounter in their day-to-day work teaching English learners. My qualitative study examined how 11 educators whose school leaders implement the learning-oriented leadership…

Challenges to Autonomous Navigation in Complex Urban Terrain

DTIC Science & Technology

2012-03-23

a, Robert E. Karlsen a, Chip DiBerardino b, Edward Mottern b, & N. Joseph Kott, III a aU.S. Army Tank- Automotive Research, Development & Engineering...threat, but this becomes especially challenging when dealing with humans or animals that may change trajectory, suddenly and without warning. The...people and animals . In urban environments, the number of potential vehicle to civilian encounters increases exponentially as the urban population

Post-Structural Methodology at the Quilting Point: Intercultural Encounters.

PubMed

Gillett, Grant

Lacan's quilting point connects a network of signifiers with the lived world as a place of voices, memory, and adaptation "seen in" the mirror of language. Crossing cultures can obscure the ways we make sense of the world. Some planes of signification, in aiming to be universal in their knowledge (such as the natural sciences), try to track objects and events independent of our thoughts about them and the ways that signifiers may slide past each other. However, cross-structural comparison and the analysis of cross cultural encounters cannot treat its objects of interest that way. Thus we need a theory and methodology that effectively connects the multilayered discourses of subjectivities from diverse cultures and allows triangulation between them in relation to points of shared experience. At such points we need a critical attitude to our own framework and an openness to the uneasy reflective equilibrium that uncovers assumptions and modes of thinking that will hamper us. Quilting points are such points where different discourses converge on a single event or set of events so as to mark "vertical" connections allowing tentative alignments between ways of meaning so that we can begin to build real cross-cultural understanding.

The lived experience of volunteering in a palliative care biography service.

PubMed

Beasley, Elizabeth; Brooker, Joanne; Warren, Narelle; Fletcher, Jane; Boyle, Christopher; Ventura, Adriana; Burney, Susan

2015-10-01

Many patients approaching death experience hopelessness, helplessness, and a depressed mood, and these factors can contribute to a difficult end-of-life (EoL) period. Biography services may assist patients in finding meaning and purpose at this time. The aim of our study was to investigate the lived experience of volunteers involved in a biography service in Melbourne, Australia, using a qualitative methodology. The participants were 10 volunteers who had participated in a biography service within a private palliative care service. Each volunteer was interviewed separately using a study-specific semistructured interview guide. The transcripts of these interviews were then subjected to thematic analysis. Analysis yielded the following themes: motivations for volunteering; dealing with death, dying, and existential issues; psychosocial benefits of volunteering; and benefits and challenges of working with patients and their families. Our results indicated that volunteering gave the volunteers a deeper appreciation of existential issues, and helped them to be more appreciative of their own lives and gain a deeper awareness of the struggles other people experience. They also suggested that volunteers felt that their involvement contributed to their own personal development, and was personally rewarding. Furthermore, the results highlighted that volunteers found that encounters with family members were sometimes challenging. While some were appreciative, others imposed time limits, became overly reliant on the volunteers, and were sometimes offended, hurt, and angered by what was included in the final biography. It is hoped that the findings of the current study will provide direction for improvements in the biography services that will benefit patients, family members, and volunteers. In particular, our findings highlight the need to provide ongoing support for volunteers to assist them in handling the challenges of volunteering in a palliative care setting.

Confidentiality in participatory research: Challenges from one study.

PubMed

Petrova, Elmira; Dewing, Jan; Camilleri, Michelle

2016-06-01

This article presents key ethical challenges that were encountered when conducting a participatory qualitative research project with a very specific, small group of nurses, in this case with practice development nurses in Malta. With the small number of nurses employed in practice development roles in Malta, there are numerous difficulties of maintaining confidentiality. Poorly constructed interventions by the researcher could have resulted in detrimental effects to research participants and the overall trustworthiness of the research. Generally, ethical guidelines for research exist to reinforce validity of research; however, there is not an established consensus on how these strategies can be utilised in some types of qualitative field work. The researcher used an exploratory case study methodology. The sample consisted of 10 participants who were interviewed twice using face-to-face interviews, over a period of 2 months. The study was ethically reviewed by the University Research Ethics Committee and the Faculty Research Ethics Committee, University of Malta. The participants referred to in this article have been given adequate information about the study and their consent has been obtained. Numerous strategies for ensuring confidentiality during recruitment of the participants, during data collection, during transcription and data analysis and during dissemination of research results assisted the researcher in responding to potential and actual ethical issues. This article emphasises the main strategies that can be used to respond to ethical challenges when researching with a small easily identifiable group. The learning discussed here may be relevant to or even transferable to other similar research studies or research contexts. These methods fostered a greater credibility throughout the research process and predisposed the participants to greater trust, and thus, they disclosed their experiences and speak more freely, thus enhancing the quality of the study. © The Author(s) 2014.

The Development of the Guide to Economic Analysis and Research (GEAR) Online Resource for Low- and Middle-Income Countries' Health Economics Practitioners: A Commentary.

PubMed

Adeagbo, Chiaki Urai; Rattanavipapong, Waranya; Guinness, Lorna; Teerawattananon, Yot

2018-05-01

Public health authorities around the world are increasingly using economic evaluation to set priorities and inform decision making in health policy, especially in the development of health benefit packages. Nevertheless, researchers in low- and middle-income countries (LMICs) encounter many barriers when conducting economic evaluations. In 2015, the Health Intervention and Technology Assessment Program identified key technical and context-specific challenges faced in conducting and using health economic evaluations in LMICs. On the basis of these research findings, the Guide to Economic Analysis and Research (GEAR) online resource (www.gear4health.com) was developed as a reliable aid to researchers in LMICs that would help overcome those challenges. Funded by the Thailand Research Fund and the Bill and Melinda Gates Foundation, GEAR is a free online resource that provides a visual aid tool for planning economic evaluation studies (GEAR mind maps), a repository of national and international economic evaluation guidelines (GEAR guideline comparison), and an active link to a network of volunteer international experts (GEAR: Ask an expert). GEAR will evolve over time to provide relevant, reliable, and up-to-date information through inputs from its users (e.g., periodic survey on methodological challenges) and experts (e.g., in responding to users' questions). The objective of this commentary was to give a brief description of the development and key features of this unique collective information hub aimed at facilitating high-quality research and empowering health care decision makers and stakeholders to use economic evaluation evidence. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Resources and Recommendations for Using Transcriptomics to Address Grand Challenges in Comparative Biology.

PubMed

Mykles, Donald L; Burnett, Karen G; Durica, David S; Joyce, Blake L; McCarthy, Fiona M; Schmidt, Carl J; Stillman, Jonathon H

2016-12-01

High-throughput RNA sequencing (RNA-seq) technology has become an important tool for studying physiological responses of organisms to changes in their environment. De novo assembly of RNA-seq data has allowed researchers to create a comprehensive catalog of genes expressed in a tissue and to quantify their expression without a complete genome sequence. The contributions from the "Tapping the Power of Crustacean Transcriptomics to Address Grand Challenges in Comparative Biology" symposium in this issue show the successes and limitations of using RNA-seq in the study of crustaceans. In conjunction with the symposium, the Animal Genome to Phenome Research Coordination Network collated comments from participants at the meeting regarding the challenges encountered when using transcriptomics in their research. Input came from novices and experts ranging from graduate students to principal investigators. Many were unaware of the bioinformatics analysis resources currently available on the CyVerse platform. Our analysis of community responses led to three recommendations for advancing the field: (1) integration of genomic and RNA-seq sequence assemblies for crustacean gene annotation and comparative expression; (2) development of methodologies for the functional analysis of genes; and (3) information and training exchange among laboratories for transmission of best practices. The field lacks the methods for manipulating tissue-specific gene expression. The decapod crustacean research community should consider the cherry shrimp, Neocaridina denticulata, as a decapod model for the application of transgenic tools for functional genomics. This would require a multi-investigator effort. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Structural Design Exploration of an Electric Powered Multi-Propulsor Wing Configuration

NASA Technical Reports Server (NTRS)

Moore, James B.; Cutright, Steve

2017-01-01

Advancements in aircraft electric propulsion may enable an expanded operational envelope for electrically powered vehicles compared to their internal combustion engine counterparts. High aspect ratio wings provide additional lift and drag reduction for a proposed multi-propulsor design, however, the challenge is to reduce the weight of wing structures while maintaining adequate structural and aeroelastic margins. Design exploration using a conventional design-and-build philosophy coupled with a finite element method (FEM)-based design of experiments (DOE) strategy are presented to examine high aspect ratio wing structures that have spanwise distributed electric motors. Multiple leading-edge-mounted engine masses presented a challenge to design a wing within acceptable limits for dynamic and aeroelastic stability. Because the first four primary bending eigenmodes of the proposed wing structure are very sensitive to outboard motor placement, safety-of-flight requirements drove the need for multiple spars, rib attachments, and outboard structural reinforcements in the design. Global aeroelasticity became an increasingly important design constraint during the on-going design process, with outboard motor pod flutter ultimately becoming a primary design constraint. Designers successively generated models to examine stress, dynamics, and aeroelasticity concurrently. This research specifically addressed satisfying multi-disciplinary design criteria to generate fluid-structure interaction solution sets, and produced high aspect ratio primary structure designs for the NASA Scalable Convergent Electric Propulsion Technology and Operations Research (SCEPTOR) project in the Aeronautic Research Mission Directorate at NASA. In this paper, a dynamics-driven, quasi-inverse design methodology is presented to address aerodynamic performance goals and structural challenges encountered for the SCEPTOR demonstrator vehicle. These results are compared with a traditional computer aided design based approach.

Development of a conceptually equivalent Chinese-language translation of the US Household Food Security Survey Module for Chinese immigrants to the USA

PubMed Central

Kwan, Christine ML; Napoles, Anna M; Chou, Jeyling; Seligman, Hilary K

2014-01-01

Objective To develop a conceptually equivalent Chinese-language translation of the eighteen-item US Household Food Security Survey Module. Design In the current qualitative study, we (i) highlight methodological challenges which arise in developing survey instruments that will be used to make comparisons across language groups and (ii) describe the development of a Chinese-language translation of the US Household Food Security Survey Module, called the San Francisco Chinese Food Security Module. Setting Community sites in San Francisco, CA, USA. Subjects We conducted cognitive interviews with twenty-two community members recruited from community sites hosting food pantries and with five professionals recruited from clinical settings. Results Development of conceptually equivalent surveys can be difficult. We highlight challenges related to dialect, education, literacy (e.g. preferences for more or less formal phrasing), English words and phrases for which there is no Chinese language equivalent (e.g. ‘balanced meals’ and ‘eat less than you felt you should’) and response formats. We selected final translations to maximize: (i) consistency of the Chinese translation with the intent of the English version; (ii) clarity; and (iii) similarities in understanding across dialects and literacy levels. Conclusions Survey translation is essential for conducting research in many communities. The challenges encountered illustrate how literal translations can affect the conceptual equivalence of survey items across languages. Cognitive interview methods should be routinely used for survey translation when such non-equivalence is suspected, such as in surveys addressing highly culturally bound behaviours such as diet and eating behaviours. Literally translated surveys lacking conceptual equivalence may magnify or obscure important health inequalities. PMID:24642365

Lessons we are learning: using participatory action research to integrate palliative care, health promotion and public health through the DöBra research program in Sweden.

PubMed

Tishelman, Carol

2018-01-01

Public health and health promotion approaches to end-of-life (EoL) research and care are still rare in Sweden. People remain generally ill-prepared for encounters with death and unable to advocate for quality EoL care; this may be reflected in Sweden's low scores for community engagement in the 2015 Quality of Death index. We have consolidated our endeavours into a cohesive national transdisciplinary research program, DöBra (a pun meaning both 'dying well' and 'awesome' in Swedish). In DöBra, we investigate how culture, the environment and conversation can promote constructive change and support better quality of life and death among the general population, in specific subgroups and in interventions directed to staff caring for dying individuals, their friends and families. DöBra uses ideas from new public health and the Ottawa Charter as umbrella theoretical frameworks and participatory action research as an overarching methodological approach. In DöBra we aim to achieve change in communities in a broad sense. In this interactive workshop, we therefore focus on the particular challenges we encounter in conducting stringent research when trying to catalyse, rather than control, change processes. We will share our ideas, experiences, reflections, tools and approaches as well as results, related to using a variety of strategies to bring together a broad range of stakeholders to co-create experience-based evidence through innovative approaches. We begin by linking theory, research and practice through discussion of the overarching ideas and individual projects, with the second part of the session based on audience engagement with various tools used in DöBra.

Negotiating treatment preferences: Physicians' formulations of patients' stance.

PubMed

Landmark, Anne Marie Dalby; Svennevig, Jan; Gulbrandsen, Pål

2016-01-01

Eliciting patients' values and treatment preferences is an essential element in models of shared decision making, yet few studies have investigated the interactional realizations of how physicians do this in authentic encounters. Drawing on video-recorded encounters from Norwegian secondary care, the present study uses the fine-grained empirical methodology of conversation analysis (CA) to identify one conversational practice physicians use, namely, formulations of patients' stance, in which physicians summarize or paraphrase their understanding of the patient's stance towards treatment. The purpose of this study is twofold: (1) to explore what objectives formulations of patients' stance achieve while negotiating treatment and (2) to discuss these objectives in relation to core requirements in shared decision making. Our analysis demonstrates that formulating the patient's stance is a practice physicians use in order to elicit, check, and establish patients' attitudes towards treatment. This practice is in line with general recommendations for making shared decisions, such as exploring and checking patients' preferences and values. However, the formulations may function as a device for doing more than merely checking and establishing common ground and bringing up patients' preferences and views: Accompanied by subtle deprecating expressions, they work to delegitimize the patients' stances and indirectly convey the physicians' opposing stance. Once established, these positions can be used as a basis for challenging and potentially altering the patient's attitude towards the decision, thereby making it more congruent with the physician's view. Therefore, in addition to bringing up patients' views towards treatment, we argue that physicians may use formulations of patients' stance as a resource for directing the patient towards decisions that are congruent with the physician's stance in situations with potential disagreement, whilst (ostensibly) avoiding a more authoritarian or paternalistic approach. Copyright © 2015 Elsevier Ltd. All rights reserved.

Next-Generation Ground Network Architecture for Communications and Tracking of Interplanetary Smallsats

NASA Astrophysics Data System (ADS)

Cheung, K.-M.; Abraham, D.; Arroyo, B.; Basilio, E.; Babuscia, A.; Duncan, C.; Lee, D.; Oudrhiri, K.; Pham, T.; Staehle, R.; Waldherr, S.; Welz, G.; Wyatt, J.; Lanucara, M.; Malphrus, B.; Bellardo, J.; Puig-Suari, J.; Corpino, S.

2015-08-01

As small spacecraft venture out of Earth orbit, they will encounter challenges not experienced or addressed by the numerous low Earth orbit (LEO) CubeSat and smallsat missions staged to date. The LEO CubeSats typically use low-cost, proven CubeSat radios, antennas, and university ground stations with small apertures. As more ambitious yet cost-constrained space mission concepts to the Moon and beyond are being developed, CubeSats and smallsats have the potential to provide a more affordable platform for exploring deep space and performing the associated science. Some of the challenges that have, so far, slowed the proliferation of small interplanetary spacecraft are those of communications and navigation. Unlike Earth-orbiting spacecraft that navigate via government services such as North American Aerospace Defense Command's (NORAD's) tracking elements or the Global Positioning Satellite (GPS) system, interplanetary spacecraft would have to operate in a fundamentally different manner that allows the deep-space communications link to provide both command/telemetry and the radiometric data needed for navigation. Another challenge occurs when smallsat and CubeSat missions would involve multiple spacecraft that require near-simultaneous communication and/or navigation, but have a very limited number of ground antenna assets, as well as available spectrum, to support their links. To address these challenges, the Jet Propulsion Laboratory (JPL) and the Deep Space Network (DSN) it operates for NASA are pursuing the following efforts: (1) Developing a CubeSat-compatible, DSN-compatible transponder -- Iris -- which a commercial vendor can then make available as a product line. (2) Developing CubeSat-compatible high-gain antennas -- deployable reflectors, reflectarrays, and inflatable antennas. (3) Streamlining access and utilization processes for DSN and related services such as the Advanced Multi-Mission Operations System (AMMOS). (4) Developing methodologies for tracking and operating multiple spacecraft simultaneously, including spectrum coordination. (5) Coordination and collaboration with non-DSN facilities. This article further describes the communications and tracking challenges facing interplanetary smallsats and CubeSats, and the next-generation ground network architecture being evolved to mitigate those challenges.

Toxicological challenges to microbial bioethanol production and strategies for improved tolerance

DOE PAGES

Akinsho, Hannah; Rydzak, Thomas; Borole, Abhijeet P.; ...

2015-09-30

Bioethanol production output has increased steadily over the last two decades and is now beginning to become competitive with traditional liquid transportation fuels due to advances in engineering, the identification of new production host organisms, and the development of novel biodesign strategies. A significant portion of these efforts has been dedicated to mitigating the toxicological challenges encountered across the bioethanol production process. From the release of potentially cytotoxic or inhibitory compounds from input feedstocks, through the metabolic co-synthesis of ethanol and potentially detrimental byproducts, and to the potential cytotoxicity of ethanol itself, each stage of bioethanol production requires the applicationmore » of genetic or engineering controls that ensure the host organisms remain healthy and productive to meet the necessary economies required for large scale production. In addition, as production levels continue to increase, there is an escalating focus on the detoxification of the resulting waste streams to minimize their environmental impact. Thus, this review will present the major toxicological challenges encountered throughout each stage of the bioethanol production process and the commonly employed strategies for reducing or eliminating potential toxic effects.« less

Women in chronic pain: sense of control and encounters with health professionals.

PubMed

Skuladottir, Hafdis; Halldorsdottir, Sigridur

2008-07-01

An evolving theory on "women's sense of control while in chronic pain and the results of the quality of their encounters with health professionals" is introduced in this article. According to the theory, the main challenge of women in chronic pain is to maintain a sense of control of self and the pain to avoid demoralization, which is seen as a potential threat for all women in chronic pain. To retain a sense of control, women are challenged to learn to live with the pain and cope with the unpredictability and incurability of the pain. They are challenged to find meaning in their suffering, to create personal space, and to be self-protective as well as to keep a positive self-image and self-esteem while trying to live a "normal" life in dignity in spite of the pain and warding off isolation and demoralization. Health professionals are seen as potentially powerful people in the lives of women in chronic pain. Empowerment or disempowerment from them greatly influences whether women in chronic pain are demoralized or not.

Respiratory Health in Migrant Populations: A Crisis Overlooked

PubMed Central

Holguin, Fernando; Moughrabieh, M. Anas; Ojeda, Victoria; Patel, Sanjay R.; Peyrani, Paula; Pinedo, Miguel; Celedón, Juan C.; Douglas, Ivor S.; Upson, Dona J.

2017-01-01

The crisis in the Middle East has raised awareness about the challenges encountered by migrant populations, in particular, health-care access and delivery. Similar challenges are encountered by migrant populations around the world, including those entering the United States as refugees and/or survivors of torture as well as Mexicans and other Latin Americans crossing the border. During the 2016 International American Thoracic Society Meeting held in San Francisco, California, a group of researchers and health-care providers discussed these challenges at a minisymposium devoted to the respiratory health of migrants. The discussion focused on the increased incidence of airway diseases among individuals migrating to more developed countries, the problems created by sleep disorders and their implications for cardiovascular and mental health, the challenges inherent in the control of infections in refugee populations, and the problems resulting from deportation. The group also discussed the potential impact of novel strategies made available by Internet-based technologies and how these strategies could be deployed to support worldwide efforts in assisting migrants and refugees, even in countries that find themselves in the direst circumstances. These presentations are summarized in this document, which is not meant to be exhaustive, but to improve awareness about the challenges confronted by migrants and their host nations regarding respiratory health-care access and delivery, and about the need for adequate investment of resources to better define these challenges through research and for the development of efficient strategies for intervention. PMID:28146384

Researching the experience of kidney cancer patients.

PubMed

Taylor, K

2002-09-01

The author's personal experience as a kidney cancer patient, researcher and founder of a kidney cancer support group forms the basis for consideration of the challenges involved in researching patients' experiences. The researcher needs to understand the variability of those experiences in both clinical and psychological-emotional terms, and in relation to the personal, familial and social contexts of the patient. It is also essential to define the purpose of the research and to show how an understanding of personal experiences of cancer can be used to enhance the quality of care for cancer patients. The research encounter with a patient is also in some respects a therapeutic encounter requiring a considerable degree of sensitivity on the part of the researcher. The person-centred approach of Carl Rogers is of value in supporting such an encounter.

A review of the current state-of-the-art methodology for handling bias and uncertainty in performing criticality safety evaluations. Final report

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

Disney, R.K.

1994-10-01

The methodology for handling bias and uncertainty when calculational methods are used in criticality safety evaluations (CSE`s) is a rapidly evolving technology. The changes in the methodology are driven by a number of factors. One factor responsible for changes in the methodology for handling bias and uncertainty in CSE`s within the overview of the US Department of Energy (DOE) is a shift in the overview function from a ``site`` perception to a more uniform or ``national`` perception. Other causes for change or improvement in the methodology for handling calculational bias and uncertainty are; (1) an increased demand for benchmark criticalsmore » data to expand the area (range) of applicability of existing data, (2) a demand for new data to supplement existing benchmark criticals data, (3) the increased reliance on (or need for) computational benchmarks which supplement (or replace) experimental measurements in critical assemblies, and (4) an increased demand for benchmark data applicable to the expanded range of conditions and configurations encountered in DOE site restoration and remediation.« less

Methodological and ethical challenges in studying patients’ perceptions of coercion: a systematic mixed studies review

PubMed Central

2014-01-01

Background Despite improvements in psychiatric inpatient care, patient restrictions in psychiatric hospitals are still in use. Studying perceptions among patients who have been secluded or physically restrained during their hospital stay is challenging. We sought to review the methodological and ethical challenges in qualitative and quantitative studies aiming to describe patients’ perceptions of coercive measures, especially seclusion and physical restraints during their hospital stay. Methods Systematic mixed studies review was the study method. Studies reporting patients’ perceptions of coercive measures, especially seclusion and physical restraints during hospital stay were included. Methodological issues such as study design, data collection and recruitment process, participants, sampling, patient refusal or non-participation, and ethical issues such as informed consent process, and approval were synthesized systematically. Electronic searches of CINALH, MEDLINE, PsychINFO and The Cochrane Library (1976-2012) were carried out. Results Out of 846 initial citations, 32 studies were included, 14 qualitative and 18 quantitative studies. A variety of methodological approaches were used, although descriptive and explorative designs were used in most cases. Data were mainly collected in qualitative studies by interviews (n = 13) or in quantitative studies by self-report questionnaires (n = 12). The recruitment process was explained in 59% (n = 19) of the studies. In most cases convenience sampling was used, yet five studies used randomization. Patient’s refusal or non-participation was reported in 37% (n = 11) of studies. Of all studies, 56% (n = 18) had reported undergone an ethical review process in an official board or committee. Respondents were informed and consent was requested in 69% studies (n = 22). Conclusions The use of different study designs made comparison methodologically challenging. The timing of data collection (considering bias and confounding factors) and the reasons for non-participation of eligible participants are likewise methodological challenges, e.g. recommended flow charts could aid the information. Other challenges identified were the recruitment of large and representative samples. Ethical challenges included requesting participants’ informed consent and respecting ethical procedures. PMID:24894162

Patient-centered communication strategies for patients with aphasia: discrepancies between what patients want and what physicians do.

PubMed

Morris, Megan A; Clayman, Marla L; Peters, Kaitlin J; Leppin, Aaron L; LeBlanc, Annie

2015-04-01

Communication during clinical encounters can be challenging with patients with communication disabilities. Physicians have the potential to positively affect the encounter by using communication strategies that engage the patient in patient-centered communication. We engaged patients and their physicians in defining their preferences for patient-centered communication strategies, then evaluated the use of the identified strategies during observed clinical encounters. We video-recorded 25 clinical encounters with persons with aphasia. All encounters were previously scheduled with community physicians and a companion was present. Following each encounter, physicians completed a brief questionnaire and the person with aphasia and his or her companion participated in a video elicitation interview. While many of the communication strategies identified and described by physicians, patients and companions were similar, patients and companions identified three additional key communication strategies. These strategies included (1) using visual aids, (2) writing down key words while speaking, and (3) using gestures. In the video recorded clinical encounters, no physicians wrote down key words while speaking and only one used a visual aid during the clinical encounter. The frequency with which physicians used gestures varied greatly, even within the same patient, suggesting the use of gestures was independent of patient or companion characteristics. To maximize patient-centered communication with patients with communication disabilities, physicians should use "disability-specific" communication strategies. Our study suggests that physicians should routinely ask patients and companions about communication preferences and then incorporate identified communication strategies into their communication style. Copyright © 2015 Elsevier Inc. All rights reserved.

An investigation of how university sports team athletic therapists and physical therapists experience ethical issues.

PubMed

Riendeau, Catherine; Parent-Houle, Valérie; Lebel-Gabriel, Marie Eve; Gauvin, Patrick; Liu, Le Yu; Pearson, Isabelle; Hunt, Matthew R

2015-03-01

Qualitative study using interpretive description methodology. The purpose of this study was to better understand how ethical issues are experienced by university sports team athletic therapists and physical therapists. In clinical practice, sports teams are associated with a range of ethical issues. Issues commonly reported in the literature include confidentiality, return-to-play decisions, conflicts of interest, advertising, doping, and use of local anesthetic. To date, there has been limited examination of how athletic therapists and physical therapists involved with sports teams experience these ethical issues, and limited exploration of how these ethical issues, when encountered, are shaped by therapists' professional roles and responsibilities. Semi-structured interviews were conducted with 11 athletic or physical therapists working with sports teams in 5 Canadian provinces. The data were analyzed inductively, using a recursive approach and constant comparative techniques. Four key themes were developed relating to the participants' experiences of ethical issues: establishing and maintaining professional boundaries, striving for respectful and effective collaboration, seeking answers to ethical concerns, and living with the repercussions of challenging decisions. While many ethical issues reported by participants resemble those faced by sports medicine physicians, they are experienced in distinctive ways, due to differences in professional roles and identities. Issues concerning professional boundaries were also more prominent for the study participants than the literature has reported them to be for sports medicine physicians. Effective communication and enhanced collaboration appear to be key elements in managing these ethical challenges.

Using different methods to communicate: how adults with severe acquired communication difficulties make decisions about the communication methods they use and how they experience them.

PubMed

Paterson, Helen; Carpenter, Christine

2015-01-01

This study aimed to explore how adults with severe acquired communication difficulties experience and make decisions about the communication methods they use. The primary objectives were to explore their perceptions of different communication methods, how they choose communication methods to use in different situations and with different communication partners, and what facilitates their decision-making. A qualitative phenomenological approach was used. Data collection methods were face-to-face video-recorded interviews using each participant's choice of communication method and e-mail interviews. The methodological challenges of involving participants with severe acquired communication disorders in research were addressed in the study design. Seven participants, all men, were recruited from a long-term care setting in a rehabilitation hospital. The data analysis process was guided by Colaizzi's (1978) analytic framework. Four main themes were identified: communicating in the digital age – e-mail and social media, encountering frustrations in using communication technologies, role and identity changes and the influences of communication technology and seeking a functional interaction using communication technologies. Adults with acquired communication difficulties find digital communication, such as e-mail and social media, and mainstream technologies, such as iPads, beneficial in communicating with others. Current communication technologies present a number of challenges for adults with disabilities and are limited in their communicative functions to support desired interactions. The implications for AAC technology development and speech and language therapy service delivery are addressed.

A regulator's view of comparative effectiveness research.

PubMed

Temple, Robert

2012-02-01

'Comparative effectiveness' is the current enthusiasm, and for good reason. After knowing a treatment works, the most critical question is how it compares with alternatives. Comparative studies are not commonly conducted by drug companies and they represent a significant methodological challenge. Comparative data could include evidence of overall superiority to an alternative or advantages in identifiable subsets, for example, people who do not respond to or tolerate alternatives, or members of a genetic subset and could also include convincing evidence that there is little difference between two treatments. To describe regulations, guidance, and Food and Drug Administration experience related to studies of comparative effectiveness, including approaches to showing superiority and problems encountered in showing similarity. Review of Food and Drug Administration regulations and guidance and experience with showing superiority and similarity, particularly related to randomized trials and epidemiologic studies. Methods exist, and they have been successful for showing overall superiority of one drug over another, advantages in specific population subsets. Efforts to show true equivalence face problems of definition and very large sample sizes needed to rule out small differences. There is need for further discussion of what is meant by similarity or equivalence of two treatments. Comparative studies are challenging because differences between effective therapies are likely to be small and can be detected reliably only in randomized trials, often large ones. Despite the difficulties, comparative trials have been successful and we clearly would like to see more of them.

Examining organizational change in primary care practices: experiences from using ethnographic methods.

PubMed

Russell, Grant; Advocat, Jenny; Geneau, Robert; Farrell, Barbara; Thille, Patricia; Ward, Natalie; Evans, Samantha

2012-08-01

Qualitative methods are an important part of the primary care researcher's toolkit providing a nuanced view of the complexity in primary care reform and delivery. Ethnographic research is a comprehensive approach to qualitative data collection, including observation, in-depth interviews and document analysis. Few studies have been published outlining methodological issues related to ethnography in this setting. This paper examines some of the challenges of conducting an ethnographic study in primary care setting in Canada, where there recently have been major reforms to traditional methods of organizing primary care services. This paper is based on an ethnographic study set in primary care practices in Ontario, Canada, designed to investigate changes to organizational and clinical routines in practices undergoing transition to new, interdisciplinary Family Health Teams (FHTs). The study was set in six new FHTs in Ontario. This paper is a reflexive examination of some of the challenges encountered while conducting an ethnographic study in a primary care setting. Our experiences in this study highlight some potential benefits of and difficulties in conducting an ethnographic study in family practice. Our study design gave us an opportunity to highlight the changes in routines within an organization in transition. A study with a clinical perspective requires training, support, a mixture of backgrounds and perspectives and ongoing communication. Despite some of the difficulties, the richness of this method has allowed the exploration of a number of additional research questions that emerged during data analysis.

Challenges in the nurse's role in rehabilitation contexts.

PubMed

Christiansen, Bjørg; Feiring, Marte

2017-10-01

To shed light on how nurses perceive particular challenges that they experience in encounters with patients in rehabilitation wards. Rehabilitation is a tailor-made process that allows someone with impairment to live well. Many rehabilitation institutions embrace strong beliefs in patient participation as well as awareness of and listening to the needs and wishes of patients. To our knowledge, few studies have investigated the challenges encountered by nurses from patients in rehabilitation contexts and how these challenges might influence their roles as nurses. This study has a qualitative design that is based on three focus group interviews with nurses working in three rehabilitation wards. A convenience sample of 15 nurses, five from each ward, was recruited to participate in focus group interviews. The participants worked in wards for patients suffering mainly from stroke and head injuries. The analysis is inspired by hermeneutic principles to explore the participants' challenges in their role in rehabilitation contexts. Data analyses identified three main themes surrounding the challenges experienced by nurses: (1) Adjusting patients' and next of kin's expectations, (2) Tailoring support and information, (3) Recognising patients' knowledge. Our results from the three rehabilitation wards indicate that nurses display various educative strategies. There is, however, a need for further empirical work into how knowledgeable patients and next of kin create new challenges with implications for the nurse's role within rehabilitation contexts. The study highlights the educative aspects of the nurse's role in relation to patients and next of kin on rehabilitation wards as significant contributors to recovery processes. © 2016 John Wiley & Sons Ltd.

Research Methodology in Second Language Studies: Trends, Concerns, and New Directions

ERIC Educational Resources Information Center

King, Kendall A.; Mackey, Alison

2016-01-01

The field of second language studies is using increasingly sophisticated methodological approaches to address a growing number of urgent, real-world problems. These methodological developments bring both new challenges and opportunities. This article briefly reviews recent ontological and methodological debates in the field, then builds on these…

A Comparison of Randomised Controlled Trials in Health and Education

ERIC Educational Resources Information Center

Torgerson, Carole J.; Torgerson, David J.; Birks, Yvonne F.; Porthouse, Jill

2005-01-01

Health care and educational trials face similar methodological challenges. Methodological reviews of health care trials have shown that a significant proportion have methodological flaws. Whether or not educational trials have a similar proportion of poor-quality trials is unknown. The authors undertook a methodological comparison between health…

The Challenges of Managing Transnational Education Partnerships: The Views of "Home-Based" Managers vs "In-Country" Managers

ERIC Educational Resources Information Center

Healey, Nigel Martin

2018-01-01

Purpose: The purpose of this paper is to investigate the challenges of managing transnational education (TNE) partnerships from the perspective of the home university managers. Design/methodology/approach: The study adopts a qualitative, "insider researcher" methodology. It uses a sample set of eight mangers who operate from the home…

Adding value to the learning process by online peer review activities: towards the elaboration of a methodology to promote critical thinking in future engineers

NASA Astrophysics Data System (ADS)

Dominguez, Caroline; Nascimento, Maria M.; Payan-Carreira, Rita; Cruz, Gonçalo; Silva, Helena; Lopes, José; Morais, Maria da Felicidade A.; Morais, Eva

2015-09-01

Considering the results of research on the benefits and difficulties of peer review, this paper describes how teaching faculty, interested in endorsing the acquisition of communication and critical thinking (CT) skills among engineering students, has been implementing a learning methodology throughout online peer review activities. While introducing a new methodology, it is important to weight the advantages found and the conditions that might have restrained the activity outcomes, thereby modulating its overall efficiency. Our results show that several factors are decisive for the success of the methodology: the use of specific and detailed orientation guidelines for CT skills, the students' training on how to deliver a meaningful feedback, the opportunity to counter-argument, the selection of good assignments' examples, and the constant teacher's monitoring of the activity. Results also tackle other aspects of the methodology such as the thinking skills evaluation tools (grades and tests) that most suit our reality. An improved methodology is proposed taking in account the encountered limitations, thus offering the possibility to other interested institutions to use/test and/or improve it.

Exotic encounters with dental implants: managing complications with unidentified systems.

PubMed

Mattheos, N; Janda, M Schittek

2012-06-01

As the application of dental implants increases worldwide, so is the number of technical and biological complications that general dental practitioners will be called to manage, while maintaining implant patients. In addition, the greater patient mobility encountered today combined with a growing trend of 'dental implant tourism' will very often result in situations where the dentist is requested to deal with complications in implants placed elsewhere and which sometimes might be of an 'exotic' system one cannot directly recognize. Such a situation can pose significant challenges to even experienced clinicians. The challenges are not only in the scientific field, but often include professional and ethical implications. This case report will discuss strategies for the management of implant complications in cases of unidentified implant systems. Critical factors in such situations would be the clinician's experience and special training, the correct radiographic technique, as well as access to the appropriate tools and devices. © 2012 Australian Dental Association.

The role of radiology in diagnosis and management of drug mules: an update with new challenges and new diagnostic tools

PubMed Central

Cengel, Ferhat

2016-01-01

Emergency physicians and radiologists have been increasingly encountering internal concealment of illegal drugs. The packages commonly contain powdered solid drugs such as cocaine, heroin, methamphetamine and hashish, but they may also contain cocaine in the liquid form. The second type of package has recently been more commonly encountered, and poses a greater diagnostic challenge. As clinical evaluation and laboratory tests frequently fail to make the correct diagnosis, imaging examination is typically required. Imaging methods assume a vital role in the diagnosis, follow-up and management. Abdominal X-ray, ultrasonography, CT and MRI are used for the imaging purposes. Among the aforementioned methods, low-dose CT is state-of-the-art in these cases. It is of paramount importance that radiologists have a full knowledge of the imaging characteristics of these packages and accurately guide physicians and security officials. PMID:26867003

Making sense of grounded theory in medical education.

PubMed

Kennedy, Tara J T; Lingard, Lorelei A

2006-02-01

Grounded theory is a research methodology designed to develop, through collection and analysis of data that is primarily (but not exclusively) qualitative, a well-integrated set of concepts that provide a theoretical explanation of a social phenomenon. This paper aims to provide an introduction to key features of grounded theory methodology within the context of medical education research. In this paper we include a discussion of the origins of grounded theory, a description of key methodological processes, a comment on pitfalls encountered commonly in the application of grounded theory research, and a summary of the strengths of grounded theory methodology with illustrations from the medical education domain. The significant strengths of grounded theory that have resulted in its enduring prominence in qualitative research include its clearly articulated analytical process and its emphasis on the generation of pragmatic theory that is grounded in the data of experience. When applied properly and thoughtfully, grounded theory can address research questions of significant relevance to the domain of medical education.

An Investigation into the Challenges In-Service Student Teachers Encounter in Transformational Geometry, "Reflection and Rotation". The Case of Mufulira College of Education

ERIC Educational Resources Information Center

Kambilombilo, Dennis; Sakala, Whyson

2015-01-01

The study was conducted to investigate the challenges in-service mathematics student teachers face in transformational geometry; reflection and rotation. The Van Hiele Theory of levels of Thought was used as the theoretical framework for this study. A case study was undertaken using a written test. The research was carried on second and third…

Tuberculosis control in prisons: current situation and research gaps.

PubMed

Dara, Masoud; Acosta, Colleen D; Melchers, Natalie V S Vinkeles; Al-Darraji, Haider A A; Chorgoliani, Dato; Reyes, Hernan; Centis, Rosella; Sotgiu, Giovanni; D'Ambrosio, Lia; Chadha, Sarabjit S; Migliori, Giovanni Battista

2015-03-01

Tuberculosis (TB) in penitentiary services (prisons) is a major challenge to TB control. This review article describes the challenges that prison systems encounter in TB control and provides solutions for the more efficient use of limited resources based on the three pillars of the post-2015 End TB Strategy. This paper also proposes research priorities for TB control in prisons based on current challenges. Articles (published up to 2011) included in a recent systematic review on TB control in prisons were further reviewed. In addition, relevant articles in English (published 1990 to May 2014) were identified by searching keywords in PubMed and Google Scholar. Article bibliographies and conference abstracts were also hand-searched. Despite being a serious cause of morbidity and mortality among incarcerated populations, many prison systems encounter a variety of challenges that hinder TB control. These include, but are not limited to, insufficient laboratory capacity and diagnostic tools, interrupted supply of medicines, weak integration between civilian and prison TB services, inadequate infection control measures, and low policy priority for prison healthcare. Governmental commitment, partnerships, and sustained financing are needed in order to facilitate improvements in TB control in prisons, which will translate to the wider community. Copyright © 2015 World Health Organization. Published by Elsevier Ltd.. All rights reserved.

Managing challenging interactions with family caregivers in the cancer setting: Guidelines for clinicians (TRIO Guidelines-2).

PubMed

Laidsaar-Powell, Rebekah; Butow, Phyllis; Boyle, Frances; Juraskova, Ilona

2018-06-01

Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members. TRIO Guidelines were based on a comprehensive review of literature, relevant guidelines, and feedback from an expert advisory group (n = 10). Draft guidelines underwent two rounds of evaluation via an online Delphi consensus process involving international experts (n = 35). Guidelines incorporate topic areas, strategies, and sub-strategies on managing challenging family involvement (7 topics). Example wording, behaviours and level of evidence are provided. Challenging triadic interactions require skillful navigation, and the TRIO Guidelines provide clear, specific, and evidence-based strategies for clinicians to utilise in these potentially stressful encounters. Training based on these guidelines may improve both patient care and clinician confidence. Implementation of these guidelines into medical/nursing curricula and as a component of continuing professional development programs will likely be highly beneficial. Copyright © 2018 Elsevier B.V. All rights reserved.

Encounters with immigrant customers: perspectives of Danish community pharmacy staff on challenges and solutions.

PubMed

Mygind, Anna; Espersen, Sacha; Nørgaard, Lotte Stig; Traulsen, Janine M

2013-06-01

To explore the challenges that Danish community pharmacy staff encounter when serving non-Western immigrant customers. Special attention was paid to similarities and differences between the perceptions of pharmacists and pharmacy assistants. A questionnaire was distributed to one pharmacist and one pharmacy assistant employed at each of the 55 community pharmacies located in the five local councils in Denmark with the highest number of immigrant inhabitants. The total response rate was 76% (84/110). Most respondents found that the needs of immigrant customers were not sufficiently assessed at the counter (n = 55, 65%), and that their latest encounter with an immigrant customer was less satisfactory than a similar encounter with an ethnic Danish customer (n = 48, 57%) (significantly more pharmacists than assistants: odds ratio, OR, 3.19; 95% confidence interval, CI, 1.27-8.04). Forty-two per cent (n = 35) perceived that immigrant customers put pressure on pharmacy staff resources, while 27% (n = 23) found that the immigrant customer group make work more interesting. More pharmacists than assistants agreed on the latter (OR, 3.43; 95% CI, 1.04-11.33). Within the past 14 days, 86% (n = 72) experienced that their advice and counselling were not understood by immigrant customers, whereas 49% (n = 41) experienced lack of understanding by ethnic Danes; and 30% (n = 25) had consciously refrained from counselling an immigrant, whereas 19% (n = 16) had done so with an ethnic Dane. Use of under-aged children as interpreters during the past month was reported by 79% of respondents. Regarding suggestions on how to improve encounters with immigrant customers, most respondents listed interventions aimed at patients, general practitioners and pharmaceutical companies. Community pharmacy staff report poorer quality in their encounters with immigrant customers, including sub-optimal counselling and frequent use of under-aged children as interpreters. Our study also reveals certain differences across personnel groups, which may be explained by differences in level of education. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.