New roles and challenges within the healthcare workforce: a Heideggerian perspective.

PubMed

Wilson, Anthea

2015-01-01

The purpose of this paper is to explore insights based on the phenomenology of Martin Heidegger, on the dynamic relationships between human experience and work roles. Drawing on the findings of a hermeneutic phenomenological study of nurse mentors, the topics of new roles and role challenges are explored, along with a consideration of their relevance to wider issues of workforce redesign. Heidegger's philosophy of Dasein, in particular his concepts of inauthentic and authentic self, provided an interpretational lens. This paper applies these philosophical concepts to challenges associated with a changing workforce. Concepts elaborating human existence as proposed by Heidegger may offer analytic structures for understanding shifts in the lived experience of a changing workplace. In particular, the concepts could help managers to explore the implications of introducing novel work roles or extending roles. The understanding gained can also extend to situations where work practices may need to be challenged. As work roles and skill mix undergo rapid shifts, this paper offers an original way of understanding the experience of work roles.

Business aspects of cardiovascular computed tomography: tackling the challenges.

PubMed

Bateman, Timothy M

2008-01-01

The purpose of this article is to provide a comprehensive understanding of the business issues surrounding provision of dedicated cardiovascular computed tomographic imaging. Some of the challenges include high up-front costs, current low utilization relative to scanner capability, and inadequate payments. Cardiovascular computed tomographic imaging is a valuable clinical modality that should be offered by cardiovascular centers-of-excellence. With careful consideration of the business aspects, moderate-to-large size cardiology programs should be able to implement an economically viable cardiovascular computed tomographic service.

Conceptual Resources for Constructing the Concepts of Electricity: The Role of Models, Analogies and Imagination

ERIC Educational Resources Information Center

Taber, Keith S.; de Trafford, Tom; Quail, Teresa

2006-01-01

The topic of electricity offers considerable challenge for the teacher hoping to provide students with an insight into scientific ways of thinking about circuits. The concepts used to make sense of electric circuits are abstract and students are expected to develop conceptual models of the relationship between non-observable qualities (current,…

Geographical Education and the Environment: Assessment Situations from Cartographic Expression

ERIC Educational Resources Information Center

de Gonzalez, Monica Rodriguez

2007-01-01

Even though the appearance and spread of new technologies offer considerable challenges in the design of far reaching and complex pre-test and assessment situations which are in keeping with the trends of teaching and learning, the thematic map is still an insuperable document to value either integral training or academic performance of future…

Baltimore Education Research Consortium: A Consideration of Past, Present, and Future

ERIC Educational Resources Information Center

Connolly, Faith; Plank, Stephen; Rone, Tracy

2012-01-01

In this paper, we offer an overview of the history and development of the Baltimore Education Research Consortium (BERC). As a part of this overview, we describe challenges and dilemmas encountered during the founding years of this consortium. We also highlight particular benefits or sources of satisfaction we have realized in the course of…

Dual-readout calorimetry

NASA Astrophysics Data System (ADS)

Lee, Sehwook; Livan, Michele; Wigmans, Richard

2018-04-01

In the past 20 years, dual-readout calorimetry has emerged as a technique for measuring the properties of high-energy hadrons and hadron jets that offers considerable advantages compared with the instruments that are currently used for this purpose in experiments at the high-energy frontier. The status of this experimental technique and the challenges faced for its further development are reviewed.

Ethics of birth at the limits of viability: the risky business of prediction.

PubMed

Shinwell, Eric S

2015-01-01

Infants born at the limits of viability present neonatologists in particular and society in general with difficult challenges. Ethical and legal considerations establish a framework for action, although this varies between countries, departments and individuals and shows dynamic changes over time. This brief review includes a vignette telling a familiar story. In this case, the parents ask searching questions and the caring, knowledgeable neonatologist uses up-to-date information to offer empathic and thoughtful guidance - a challenge for all. © 2015 S. Karger AG, Basel.

The Relationship between Balancing Reactions and Reaction Lifetimes: A Consideration of the Potassium-Argon Radiometric Method for Dating Minerals

ERIC Educational Resources Information Center

Howard, William A.

2005-01-01

A detailed examination of a commonly accepted practice in geology offers an example of how to stimulate critical thinking, teaches students how to read reactions, and challenges students to formulate better experiments for determining mineral ages more accurately. A demonstration of a Potassium-Argon radiometric method for dating minerals is…

The Virtual Desktop: Options and Challenges in Selecting a Secure Desktop Infrastructure Based on Virtualization

DTIC Science & Technology

2011-10-01

Fortunately, some products offer centralized management and deployment tools for local desktop implementation . Figure 5 illustrates the... implementation of a secure desktop infrastructure based on virtualization. It includes an overview of desktop virtualization, including an in-depth...environment in the data centre, whereas LHVD places it on the endpoint itself. Desktop virtualization implementation considerations and potential

Resolve and Resources to Get a Qualified Teacher in Every Classroom. Challenge to Lead Series

ERIC Educational Resources Information Center

Cornett, Lynn M.; Gaines, Gale F.

2004-01-01

This report highlights how key parts of the teacher work force "system" should work together and helps you ask--and answer--questions about emerging solutions that offer promise. Policy-makers in SREB states should focus on five policy areas in which there is now considerable data, plus three emerging policy areas that are growing in importance.…

Recruiting and enrolling pregnant adolescents for research.

PubMed

Kaiser, Margaret M; Hays, Bevely J

2006-01-01

Difficulty obtaining a sample is not justification for failure to study a hard-to-enroll population, particularly a vulnerable population such as pregnant adolescents. Recruitment of a representative, adequate sample of pregnant adolescents for a recent instrument development study provided multiple challenges. Although carefully developed, the sampling plan required several modifications to achieve the sample (n=145). Those challenges and the ensuing modifications to the sampling plan are discussed in relation to (a) access/institutional concerns, (b) the human subject's protection considerations, and (c) developmental/personal concerns of the pregnant adolescents. Recommendations for sampling strategies for future research are offered.

Implementation Considerations for Multisite Clinical Trials with Cognitive Neuroscience Tasks

PubMed Central

Keefe, Richard S. E.; Harvey, Philip D.

2008-01-01

Multisite clinical trials aimed at cognitive enhancement across various neuropsychiatric conditions have employed standard neuropsychological tests as outcome measures. While these tests have enjoyed wide clinical use and have proven reliable and predictive of functional disability, a number of implementation challenges have arisen when these tests are used in clinical trials. These issues are likely to be magnified in future studies when cognitive neuroscience (CN) procedures are explored in these trials, because in their current forms CN procedures are less standardized and more difficult to teach and monitor. For multisite trials, we anticipate that the most challenging issues will include assuring tester competence, monitoring tester performance, specific challenges with complex assessment methods, and having resources available for adequate monitoring of data quality. Suggestions for overcoming these implementation challenges are offered. PMID:18495645

Nanofluidics: A New Arena for Materials Science.

PubMed

Xu, Yan

2018-01-01

A significant growth of research in nanofluidics is achieved over the past decade, but the field is still facing considerable challenges toward the transition from the current physics-centered stage to the next application-oriented stage. Many of these challenges are associated with materials science, so the field of nanofluidics offers great opportunities for materials scientists to exploit. In addition, the use of unusual effects and ultrasmall confined spaces of well-defined nanofluidic environments would offer new mechanisms and technologies to manipulate nanoscale objects as well as to synthesize novel nanomaterials in the liquid phase. Therefore, nanofluidics will be a new arena for materials science. In the past few years, burgeoning progress has been made toward this trend, as overviewed in this article, including materials and methods for fabricating nanofluidic devices, nanofluidics with functionalized surfaces and functional material components, as well as nanofluidics for manipulating nanoscale materials and fabricating new nanomaterials. Many critical challenges as well as fantastic opportunities in this arena lie ahead. Some of those, which are of particular interest, are also discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Establishing the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS): Operationalizing Community-based Research in a Large National Quantitative Study.

PubMed

Loutfy, Mona; Greene, Saara; Kennedy, V Logan; Lewis, Johanna; Thomas-Pavanel, Jamie; Conway, Tracey; de Pokomandy, Alexandra; O'Brien, Nadia; Carter, Allison; Tharao, Wangari; Nicholson, Valerie; Beaver, Kerrigan; Dubuc, Danièle; Gahagan, Jacqueline; Proulx-Boucher, Karène; Hogg, Robert S; Kaida, Angela

2016-08-19

Community-based research has gained increasing recognition in health research over the last two decades. Such participatory research approaches are lauded for their ability to anchor research in lived experiences, ensuring cultural appropriateness, accessing local knowledge, reaching marginalized communities, building capacity, and facilitating research-to-action. While having these positive attributes, the community-based health research literature is predominantly composed of small projects, using qualitative methods, and set within geographically limited communities. Its use in larger health studies, including clinical trials and cohorts, is limited. We present the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), a large-scale, multi-site, national, longitudinal quantitative study that has operationalized community-based research in all steps of the research process. Successes, challenges and further considerations are offered. Through the integration of community-based research principles, we have been successful in: facilitating a two-year long formative phase for this study; developing a novel survey instrument with national involvement; training 39 Peer Research Associates (PRAs); offering ongoing comprehensive support to PRAs; and engaging in an ongoing iterative community-based research process. Our community-based research approach within CHIWOS demanded that we be cognizant of challenges managing a large national team, inherent power imbalances and challenges with communication, compensation and volunteering considerations, and extensive delays in institutional processes. It is important to consider the iterative nature of community-based research and to work through tensions that emerge given the diverse perspectives of numerous team members. Community-based research, as an approach to large-scale quantitative health research projects, is an increasingly viable methodological option. Community-based research has several advantages that go hand-in-hand with its obstacles. We offer guidance on implementing this approach, such that the process can be better planned and result in success.

DCE-MRI, DW-MRI, and MRS in Cancer: Challenges and Advantages of Implementing Qualitative and Quantitative Multi-parametric Imaging in the Clinic

PubMed Central

Winfield, Jessica M.; Payne, Geoffrey S.; Weller, Alex; deSouza, Nandita M.

2016-01-01

Abstract Multi-parametric magnetic resonance imaging (mpMRI) offers a unique insight into tumor biology by combining functional MRI techniques that inform on cellularity (diffusion-weighted MRI), vascular properties (dynamic contrast-enhanced MRI), and metabolites (magnetic resonance spectroscopy) and has scope to provide valuable information for prognostication and response assessment. Challenges in the application of mpMRI in the clinic include the technical considerations in acquiring good quality functional MRI data, development of robust techniques for analysis, and clinical interpretation of the results. This article summarizes the technical challenges in acquisition and analysis of multi-parametric MRI data before reviewing the key applications of multi-parametric MRI in clinical research and practice. PMID:27748710

Cryptography and the Internet: lessons and challenges

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

McCurley, K.S.

1996-12-31

The popularization of the Internet has brought fundamental changes to the world, because it allows a universal method of communication between computers. This carries enormous benefits with it, but also raises many security considerations. Cryptography is a fundamental technology used to provide security of computer networks, and there is currently a widespread engineering effort to incorporate cryptography into various aspects of the Internet. The system-level engineering required to provide security services for the Internet carries some important lessons for researchers whose study is focused on narrowly defined problems. It also offers challenges to the cryptographic research community by raising newmore » questions not adequately addressed by the existing body of knowledge. This paper attempts to summarize some of these lessons and challenges for the cryptographic research community.« less

Internet research in an international context.

PubMed

Baernholdt, Marianne; Clarke, Sean P

2006-02-01

Computers and the Internet provide researchers with new options in surveying. When using electronic surveys, several practical and methodological issues need to be considered such as whether the majority of the surveyed population has Internet access and whether an e-mail or a Web-based survey is most appropriate. Other important considerations relate to Internet security issues and, in international research, the possibility of language barriers. Despite these challenges, electronic surveys offer a promising alternative to conventional mail surveys.

Using Smartphones to Collect Behavioral Data in Psychological Science: Opportunities, Practical Considerations, and Challenges

PubMed Central

Harari, Gabriella M.; Lane, Nicholas D.; Wang, Rui; Crosier, Benjamin S.; Campbell, Andrew T.; Gosling, Samuel D.

2017-01-01

Smartphones now offer the promise of collecting behavioral data unobtrusively, in situ, as it unfolds in the course of daily life. Data can be collected from the onboard sensors and other phone logs embedded in today’s off-the-shelf smartphone devices. These data permit fine-grained, continuous collection of people’s social interactions (e.g., speaking rates in conversation, size of social groups, calls, and text messages), daily activities (e.g., physical activity and sleep), and mobility patterns (e.g., frequency and duration of time spent at various locations). In this article, we have drawn on the lessons from the first wave of smartphone-sensing research to highlight areas of opportunity for psychological research, present practical considerations for designing smartphone studies, and discuss the ongoing methodological and ethical challenges associated with research in this domain. It is our hope that these practical guidelines will facilitate the use of smartphones as a behavioral observation tool in psychological science. PMID:27899727

Using Smartphones to Collect Behavioral Data in Psychological Science: Opportunities, Practical Considerations, and Challenges.

PubMed

Harari, Gabriella M; Lane, Nicholas D; Wang, Rui; Crosier, Benjamin S; Campbell, Andrew T; Gosling, Samuel D

2016-11-01

Smartphones now offer the promise of collecting behavioral data unobtrusively, in situ, as it unfolds in the course of daily life. Data can be collected from the onboard sensors and other phone logs embedded in today's off-the-shelf smartphone devices. These data permit fine-grained, continuous collection of people's social interactions (e.g., speaking rates in conversation, size of social groups, calls, and text messages), daily activities (e.g., physical activity and sleep), and mobility patterns (e.g., frequency and duration of time spent at various locations). In this article, we have drawn on the lessons from the first wave of smartphone-sensing research to highlight areas of opportunity for psychological research, present practical considerations for designing smartphone studies, and discuss the ongoing methodological and ethical challenges associated with research in this domain. It is our hope that these practical guidelines will facilitate the use of smartphones as a behavioral observation tool in psychological science. © The Author(s) 2016.

Using Patient Avatars to Promote Health Data Sharing Applications: Perspectives and Regulatory Challenges.

PubMed

Dahi, Alan; Forgó, Nikolaus; Jensen, Sarah; Stauch, Marc

2016-04-01

The potential of ICT to address problems in modern healthcare is considerable, and an ICT-driven revolution in healthcare appears imminent. Such developments maybe viewed largely in positive terms. Thus they should result in enhanced treatment and care options, empowering patients--including by permitting greater self-management of illness outside hospital, while offering economic benefits and costs savings over traditional healthcare provision. However, the new possibilities also present manifold risks, such as of data breaches, encroachments on subject autonomy, as well as of other harms. This article considers some of the key regulatory challenges against the background of the progress of the current EU Commission-sponsored 'MyHealthAvatar' project.

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

PubMed

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

2007-12-01

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

The Report of the 2016-2017 Advocacy Standing Committee.

PubMed

Jordan, Ronald P; Bratberg, Jeffrey; Congdon, Heather B; Cross, L Brian; Hill, Lucas G; Marrs, Joel C; McBane, Sarah; Lang, William G; Ekoma, Jeffrey O

2017-10-01

Based on the growing importance of community engagement and the recognition of its importance by the American Association of Colleges of Pharmacy (AACP), the committee offers several examples of community engagement activities for consideration and replication by our academy and beyond. These activities, including those of winning institutions of the Lawrence J. Weaver Transformational Community Engagement Award, can be mapped to the core components of community engagement presented in Table 1. The committee, using an implementation readiness framework, provides the reader with insight into the challenges that may impact successful community engagement and encourages our academy to continue its work to support faculty capacity in this area. Toward that end, the committee offers a policy statement that encourages schools and colleges of pharmacy to have an office or designate a faculty member whose focus is specifically on community engagement. The committee also offers a recommendation that the core components be included in the criteria for the Weaver Award.

Quantitative computational models of molecular self-assembly in systems biology

PubMed Central

Thomas, Marcus; Schwartz, Russell

2017-01-01

Molecular self-assembly is the dominant form of chemical reaction in living systems, yet efforts at systems biology modeling are only beginning to appreciate the need for and challenges to accurate quantitative modeling of self-assembly. Self-assembly reactions are essential to nearly every important process in cell and molecular biology and handling them is thus a necessary step in building comprehensive models of complex cellular systems. They present exceptional challenges, however, to standard methods for simulating complex systems. While the general systems biology world is just beginning to deal with these challenges, there is an extensive literature dealing with them for more specialized self-assembly modeling. This review will examine the challenges of self-assembly modeling, nascent efforts to deal with these challenges in the systems modeling community, and some of the solutions offered in prior work on self-assembly specifically. The review concludes with some consideration of the likely role of self-assembly in the future of complex biological system models more generally. PMID:28535149

Quantitative computational models of molecular self-assembly in systems biology.

PubMed

Thomas, Marcus; Schwartz, Russell

2017-05-23

Molecular self-assembly is the dominant form of chemical reaction in living systems, yet efforts at systems biology modeling are only beginning to appreciate the need for and challenges to accurate quantitative modeling of self-assembly. Self-assembly reactions are essential to nearly every important process in cell and molecular biology and handling them is thus a necessary step in building comprehensive models of complex cellular systems. They present exceptional challenges, however, to standard methods for simulating complex systems. While the general systems biology world is just beginning to deal with these challenges, there is an extensive literature dealing with them for more specialized self-assembly modeling. This review will examine the challenges of self-assembly modeling, nascent efforts to deal with these challenges in the systems modeling community, and some of the solutions offered in prior work on self-assembly specifically. The review concludes with some consideration of the likely role of self-assembly in the future of complex biological system models more generally.

Application of nanotechnology for the encapsulation of botanical insecticides for sustainable agriculture: prospects and promises.

PubMed

de Oliveira, Jhones Luiz; Campos, Estefânia Vangelie Ramos; Bakshi, Mansi; Abhilash, P C; Fraceto, Leonardo Fernandes

2014-12-01

This review article discusses the use of nanotechnology in combination with botanical insecticides in order to develop systems for pest control in agriculture. The main types of botanical insecticides are described, together with different carrier systems and their potential uses. The botanical insecticides include those based on active principles isolated from plant extracts, as well as essential oils derived from certain plants. The advantages offered by the systems are highlighted, together with the main technological challenges that must be resolved prior to future implementation of the systems for agricultural pest control. The use of botanical insecticides associated with nanotechnology offers considerable potential for increasing agricultural productivity, while at the same time reducing impacts on the environment and human health.

Advancements in Nanomedicine for Multiple Myeloma.

PubMed

Detappe, Alexandre; Bustoros, Mark; Mouhieddine, Tarek H; Ghoroghchian, P Peter

2018-06-01

In the past decades, considerable progress has been made in our understanding and treatment of multiple myeloma. Several challenges remain including our abilities to longitudinally image tumor responses to treatment, to combine various therapeutic agents with different mechanisms of action but with overlapping toxicities, and to efficiently harness the power of the immune system to augment remission and/or to induce permanent cures. Nanomedicine may help to address many of these outstanding issues, affording novel diagnostic capabilities and offering disruptive technologies that promise to revolutionize treatment. Here, we review recent developments and the future of nanomedicine for multiple myeloma, highlighting new considerations in nanoparticle designs that may help to augment active targeting, to facilitate longitudinal imaging, and to improve drug delivery. Copyright © 2018 Elsevier Ltd. All rights reserved.

Defining Operational Space Suit Requirements for Commercial Orbital Spaceflight

NASA Technical Reports Server (NTRS)

Alpert, Brian K.

2015-01-01

As the commercial spaceflight industry transitions from suborbital brevity to orbital outposts, spacewalking will become a major consideration for tourists, scientists, and hardware providers. The challenge exists to develop a space suit designed for the orbital commercial spaceflight industry. The unique needs and requirements of this industry will drive space suit designs and costs that are unlike any existing product. Commercial space tourists will pay for the experience of a lifetime, while scientists may not be able to rely on robotics for all operations and external hardware repairs. This study was aimed at defining space suit operational and functional needs across the spectrum of spacewalk elements, identifying technical design drivers and establishing appropriate options. Recommendations from the analysis are offered for consideration

Prenatal screening: current practice, new developments, ethical challenges.

PubMed

de Jong, Antina; Maya, Idit; van Lith, Jan M M

2015-01-01

Prenatal screening pathways, as nowadays offered in most Western countries consist of similar tests. First, a risk-assessment test for major aneuploides is offered to pregnant women. In case of an increased risk, invasive diagnostic tests, entailing a miscarriage risk, are offered. For decades, only conventional karyotyping was used for final diagnosis. Moreover, several foetal ultrasound scans are offered to detect major congenital anomalies, but the same scans also provide relevant information for optimal support of the pregnancy and the delivery. Recent developments in prenatal screening include the application of microarrays that allow for identifying a much broader range of abnomalities than karyotyping, and non-invasive prenatal testing (NIPT) that enables reducing the number of invasive tests for aneuploidies considerably. In the future, broad NIPT may become possible and affordable. This article will briefly address the ethical issues raised by these technological developments. First, a safe NIPT may lead to routinisation and as such challenge the central issue of informed consent and the aim of prenatal screening: to offer opportunity for autonomous reproductive choice. Widening the scope of prenatal screening also raises the question to what extent 'reproductive autonomy' is meant to expand. Finally, if the same test is used for two different aims, namely detection of foetal anomalies and pregnancy-related problems, non-directive counselling can no longer be taken as a standard. Our broad outline of the ethical issues is meant as an introduction into the more detailed ethical discussions about prenatal screening in the other articles of this special issue. © 2014 John Wiley & Sons Ltd.

Engineering brain-computer interfaces: past, present and future.

PubMed

Hughes, M A

2014-06-01

Electricity governs the function of both nervous systems and computers. Whilst ions move in polar fluids to depolarize neuronal membranes, electrons move in the solid-state lattices of microelectronic semiconductors. Joining these two systems together, to create an iono-electric brain-computer interface, is an immense challenge. However, such interfaces offer (and in select clinical contexts have already delivered) a method of overcoming disability caused by neurological or musculoskeletal pathology. To fulfill their theoretical promise, several specific challenges demand consideration. Rate-limiting steps cover a diverse range of disciplines including microelectronics, neuro-informatics, engineering, and materials science. As those who work at the tangible interface between brain and outside world, neurosurgeons are well placed to contribute to, and inform, this cutting edge area of translational research. This article explores the historical background, status quo, and future of brain-computer interfaces; and outlines the challenges to progress and opportunities available to the clinical neurosciences community.

The psychosocial challenges of solid organ transplant recipients during childhood.

PubMed

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

2012-11-01

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

Multifunctionalities driven by ferroic domains

NASA Astrophysics Data System (ADS)

Yang, J. C.; Huang, Y. L.; He, Q.; Chu, Y. H.

2014-08-01

Considerable attention has been paid to ferroic systems in pursuit of advanced applications in past decades. Most recently, the emergence and development of multiferroics, which exhibit the coexistence of different ferroic natures, has offered a new route to create functionalities in the system. In this manuscript, we step from domain engineering to explore a roadmap for discovering intriguing phenomena and multifunctionalities driven by periodic domain patters. As-grown periodic domains, offering exotic order parameters, periodic local perturbations and the capability of tailoring local spin, charge, orbital and lattice degrees of freedom, are introduced as modeling templates for fundamental studies and novel applications. We discuss related significant findings on ferroic domain, nanoscopic domain walls, and conjunct heterostructures based on the well-organized domain patterns, and end with future prospects and challenges in the field.

Japan's advanced medicine.

PubMed

Sho, Ri; Narimatsu, Hiroto; Murakami, Masayasu

2013-10-01

Like health care systems in other developed countries, Japan's health care system faces significant challenges due to aging of the population and economic stagnation. Advanced medicine (Senshin Iryou) is a unique system of medical care in Japan offering highly technology-driven medical care that is not covered by public health insurance. Advanced medicine has recently developed and expanded as part of health care reform. Will it work? To answer this question, we briefly trace the historical development of advanced medicine and describe the characteristics and current state of advanced medical care in Japan. We then offer our opinions on the future of advanced medicine with careful consideration of its pros and cons. We believe that developing advanced medicine is an attempt to bring health care reform in line rather than the goal of health care reform.

Communicating about ocean health: theoretical and practical considerations

PubMed Central

McComas, Katherine A.; Byrne, Sahara E.

2016-01-01

As anthropogenic stressors threaten the health of marine ecosystems, there is a need to better understand how the public processes and responds to information about ocean health. Recent studies of public perceptions about ocean issues report high concern but limited knowledge, prompting calls for information campaigns to mobilize public support for ocean restoration policy. Drawing on the literature from communication, psychology and related social science disciplines, we consider a set of social-cognitive challenges that researchers and advocates are likely to encounter when communicating with the public about ocean health and emerging marine diseases—namely, the psychological distance at which ocean issues are construed, the unfamiliarity of aquatic systems to many members of the public and the potential for marine health issues to be interpreted through politicized schemas that encourage motivated reasoning over the dispassionate consideration of scientific evidence. We offer theory-based strategies to help public outreach efforts address these challenges and present data from a recent experiment exploring the role of message framing (emphasizing the public health or environmental consequences of marine disease) in shaping public support for environmental policy. PMID:26880833

Communicating about ocean health: theoretical and practical considerations.

PubMed

Schuldt, Jonathon P; McComas, Katherine A; Byrne, Sahara E

2016-03-05

As anthropogenic stressors threaten the health of marine ecosystems, there is a need to better understand how the public processes and responds to information about ocean health. Recent studies of public perceptions about ocean issues report high concern but limited knowledge, prompting calls for information campaigns to mobilize public support for ocean restoration policy. Drawing on the literature from communication, psychology and related social science disciplines, we consider a set of social-cognitive challenges that researchers and advocates are likely to encounter when communicating with the public about ocean health and emerging marine diseases--namely, the psychological distance at which ocean issues are construed, the unfamiliarity of aquatic systems to many members of the public and the potential for marine health issues to be interpreted through politicized schemas that encourage motivated reasoning over the dispassionate consideration of scientific evidence. We offer theory-based strategies to help public outreach efforts address these challenges and present data from a recent experiment exploring the role of message framing (emphasizing the public health or environmental consequences of marine disease) in shaping public support for environmental policy. © 2016 The Author(s).

Providing indigent care: strategic issues in management, marketing and ethics.

PubMed

Summers, J

1986-08-01

Uncompensated cares poses considerable management, marketing and ethical challenges to health care managers. A variety of responses are examined which offer the possibility of reducing the need for inpatient care and the cost of that care as well as for the enhancement of the organization's positioning in the marketing and sales environment. Some of the programs will require support from local community agencies or employers, but others will be quite feasible without such support. Additionally, the programs build on sensitivity to the hospital mission as opposed to turning away from it.

Old Dad Chiro: his thoughts, words, and deeds

PubMed Central

Brown, Myron D.

2010-01-01

Objective This article offers the author's opinions about some of the thoughts, words, and deeds of the profession's founder, Daniel David Palmer. Discussion Reviewing D.D. Palmer's writings is challenging because he was the discoverer and founder of a developing profession and therefore his thoughts and words were rapidly evolving. Statements made by Palmer without judicious consideration of context could easily be misunderstood. Conclusion D.D. Palmer was individualistic and enigmatic. This commentary provides a look at the whole in an attempt to reveal the character and spirit of the founder. PMID:22693470

The challenge of informed consent and return of results in translational genomics: empirical analysis and recommendations.

PubMed

Henderson, Gail E; Wolf, Susan M; Kuczynski, Kristine J; Joffe, Steven; Sharp, Richard R; Parsons, D Williams; Knoppers, Bartha M; Yu, Joon-Ho; Appelbaum, Paul S

2014-01-01

As exome and genome sequencing move into clinical application, questions surround how to elicit consent and handle potential return of individual genomic results. This study analyzes nine consent forms used in NIH-funded sequencing studies. Content analysis reveals considerable heterogeneity, including in defining results that may be returned, identifying potential benefits and risks of return, protecting privacy, addressing placement of results in the medical record, and data-sharing. In response to lack of consensus, we offer recommendations. © 2014 American Society of Law, Medicine & Ethics, Inc.

The Report of the 2016-2017 Advocacy Standing Committee

PubMed Central

Jordan, Ronald P.; Bratberg, Jeffrey; Congdon, Heather B.; Cross, L. Brian; Hill, Lucas G.; Marrs, Joel C.; McBane, Sarah; Lang, William G.; Ekoma, Jeffrey O.

2017-01-01

EXECUTIVE SUMMARY Based on the growing importance of community engagement and the recognition of its importance by the American Association of Colleges of Pharmacy (AACP), the committee offers several examples of community engagement activities for consideration and replication by our academy and beyond. These activities, including those of winning institutions of the Lawrence J. Weaver Transformational Community Engagement Award, can be mapped to the core components of community engagement presented in Table 1. The committee, using an implementation readiness framework, provides the reader with insight into the challenges that may impact successful community engagement and encourages our academy to continue its work to support faculty capacity in this area. Toward that end, the committee offers a policy statement that encourages schools and colleges of pharmacy to have an office or designate a faculty member whose focus is specifically on community engagement. The committee also offers a recommendation that the core components be included in the criteria for the Weaver Award. PMID:29200458

Introduction: Science, Sexuality, and Psychotherapy: Shifting Paradigms.

PubMed

Cerbone, Armand R

2017-08-01

This introduction presents an overview of the current issue (73, 8) of Journal of Clinical Psychology: In Session. This issue features a series of articles, with clinical cases, each presented to illustrate the challenges faced by individuals and couples whose sexual and gender identities and expressions do not comport with traditional and cultural norms. These articles also document the challenges to the therapists who treat them. Considered individually, each article underscores the need to recognize the importance of evidence in guiding psychotherapy in cases involving sexuality. The discussions in each article offer recommendations meant to help and guide psychotherapists. Considered collectively, they raise important questions and considerations about shifting paradigms of human sexuality. Implications for assessment and treatment of cases involving sexuality and gender identity are discussed and recommended. © 2017 Wiley Periodicals, Inc.

Addressing diversity and moving toward equity in hospital care.

PubMed

Cordova, Richard D; Beaudin, Christy L; Iwanabe, Kelly E

2010-01-01

Healthcare disparities are a major challenge for hospital and healthcare system leadership. Leaders must possess vision, visibility, and ability to drive organizational change toward an environment that fosters diversity and cultural competence. As challenging economic conditions force management to make difficult budgetary decisions, the integration of equity into the organization's core mission and strategic process is essential for sustainability. Building organizational capacity requires systematic actions including workforce composition, training and development, and policy advocacy. This article offers perspectives on the current state of diversity in hospitals, exemplars from pediatric hospitals, and considerations for the future. Healthcare leaders are influential in shaping the future of the organization through strategic planning and resource allocation to those efforts that enhance services, programs, and processes that support a culture of diversity and equity.

Modeling nanomaterial environmental fate in aquatic systems.

PubMed

Dale, Amy L; Casman, Elizabeth A; Lowry, Gregory V; Lead, Jamie R; Viparelli, Enrica; Baalousha, Mohammed

2015-03-03

Mathematical models improve our fundamental understanding of the environmental behavior, fate, and transport of engineered nanomaterials (NMs, chemical substances or materials roughly 1-100 nm in size) and facilitate risk assessment and management activities. Although today's large-scale environmental fate models for NMs are a considerable improvement over early efforts, a gap still remains between the experimental research performed to date on the environmental fate of NMs and its incorporation into models. This article provides an introduction to the current state of the science in modeling the fate and behavior of NMs in aquatic environments. We address the strengths and weaknesses of existing fate models, identify the challenges facing researchers in developing and validating these models, and offer a perspective on how these challenges can be addressed through the combined efforts of modelers and experimentalists.

Pathways from Autism Spectrum Disorder (ASD) Diagnosis to Genetic Testing

PubMed Central

Barton, Krysta S.; Tabor, Holly K.; Starks, Helene; Garrison, Nanibaa’ A.; Laurino, Mercy; Burke, Wylie

2017-01-01

Purpose This study examines challenges faced by families and health providers related to genetic testing for autism spectrum disorder (ASD). Methods This qualitative study of 14 parents and 15 health providers identified an unstandardized three-step process for families who pursue ASD genetic testing. Results Step 1 is the clinical diagnosis of ASD, confirmed by providers practicing alone or in a team. Step 2 is the offer of genetic testing to find an etiology. For those offered testing, step 3 involves the parents’ decision whether to pursue testing. Despite professional guidelines and recommendations, interviews describe considerable variability in approaches to genetic testing for ASD, a lack of consensus among providers, and questions about clinical utility. Many families in our study were unaware of the option for genetic testing; testing decisions by parents appear to be influenced by both provider recommendations and insurance coverage. Conclusion Consideration of genetic testing for ASD should take into account different views about the clinical utility of testing and variability in insurance coverage. Ideally, policy makers from the range of clinical specialties involved in ASD care should revisit policies to clarify the purpose of genetic testing for ASD and promote consensus about its appropriate use. PMID:29048417

Computational design of water-soluble α-helical barrels.

PubMed

Thomson, Andrew R; Wood, Christopher W; Burton, Antony J; Bartlett, Gail J; Sessions, Richard B; Brady, R Leo; Woolfson, Derek N

2014-10-24

The design of protein sequences that fold into prescribed de novo structures is challenging. General solutions to this problem require geometric descriptions of protein folds and methods to fit sequences to these. The α-helical coiled coils present a promising class of protein for this and offer considerable scope for exploring hitherto unseen structures. For α-helical barrels, which have more than four helices and accessible central channels, many of the possible structures remain unobserved. Here, we combine geometrical considerations, knowledge-based scoring, and atomistic modeling to facilitate the design of new channel-containing α-helical barrels. X-ray crystal structures of the resulting designs match predicted in silico models. Furthermore, the observed channels are chemically defined and have diameters related to oligomer state, which present routes to design protein function. Copyright © 2014, American Association for the Advancement of Science.

A Situated Practice of Ethics for Participatory Visual and Digital Methods in Public Health Research and Practice: A Focus on Digital Storytelling

PubMed Central

Hill, Amy L.; Flicker, Sarah

2014-01-01

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as “digital storytelling.” We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health. PMID:23948015

A situated practice of ethics for participatory visual and digital methods in public health research and practice: a focus on digital storytelling.

PubMed

Gubrium, Aline C; Hill, Amy L; Flicker, Sarah

2014-09-01

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health.

A perspective on tritium versus carbon-14: ensuring optimal label selection in pharmaceutical research and development.

PubMed

Krauser, Joel A

2013-01-01

Tritium ((3) H) and carbon-14 ((14) C) labels applied in pharmaceutical research and development each offer their own distinctive advantages and disadvantages coupled with benefits and risks. The advantages of (3) H have a higher specific activity, shorter half-life that allows more manageable waste remediation, lower material costs, and often more direct synthetic routes. The advantages of (14) C offer certain analytical benefits and less potential for label loss. Although (3) H labels offer several advantages, they might be overlooked as a viable option because of the concerns about its drawbacks. A main drawback often challenged is metabolic liability. These drawbacks, in some cases, might be overstated leading to underutilization of a perfectly viable option. As a consequence, label selection may automatically default to (14) C, which is a more conservative approach. To challenge this '(14) C-by-default' approach, pharmaceutical agents with strategically selected (3) H-labeling positions based on non-labeled metabolism data have been successfully implemented and evaluated for (3) H loss. From in-house results, the long term success of projects clearly would benefit from a thorough, objective, and balanced assessment regarding label selection ((3) H or (14) C). This assessment should be based on available project information and scientific knowledge. Important considerations are project applicability (preclinical and clinical phases), synthetic feasibility, costs, and timelines. Copyright © 2013 John Wiley & Sons, Ltd.

Zuwanderung und Integration als strategischer Ansatzpunkt städtischer Regenerierung - Das Beispiel der westfälischen Stadt Altena

NASA Astrophysics Data System (ADS)

Mantel, Anna; Engel, Susen; Nuissl, Henning

2018-03-01

The small town of Altena is among the fastest-shrinking cities in western Germany and has recently attracted national and international attention due to its "welcoming culture" for refugees. This can be understood within the context of the town's strategic urban development policies aiming to counter the demographic change. This article argues that a regeneration strategy directed towards immigration and integration can offer a chance for shrinking cities but is simultaneously faced with considerable challenges and uncertainties, which could be dealt with through an "integrative approach" to urban development.

New Assumptions to Guide SETI Research

NASA Technical Reports Server (NTRS)

Colombano, S. P.

2018-01-01

The recent Kepler discoveries of Earth-like planets offer the opportunity to focus our attention on detecting signs of life and technology in specific planetary systems, but I feel we need to become more flexible in our assumptions. The reason is that, while it is still reasonable and conservative to assume that life is most likely to have originated in conditions similar to ours, the vast time differences in potential evolutions render the likelihood of "matching" technologies very slim. In light of these challenges I propose a more "aggressive"� approach to future SETI exploration in directions that until now have received little consideration.

NASA space station software standards issues

NASA Technical Reports Server (NTRS)

Tice, G. D., Jr.

1985-01-01

The selection and application of software standards present the NASA Space Station Program with the opportunity to serve as a pacesetter for the United States software in the area of software standards. The strengths and weaknesses of each of the NASA defined software standards issues are summerized and discussed. Several significant standards issues are offered for NASA consideration. A challenge is presented for the NASA Space Station Program to serve as a pacesetter for the U.S. Software Industry through: (1) Management commitment to software standards; (2) Overall program participation in software standards; and (3) Employment of the best available technology to support software standards

Zuwanderung und Integration als strategischer Ansatzpunkt städtischer Regenerierung. Das Beispiel der westfälischen Stadt Altena

NASA Astrophysics Data System (ADS)

Mantel, Anna; Engel, Susen; Nuissl, Henning

2018-04-01

The small town of Altena is among the fastest-shrinking cities in western Germany and has recently attracted national and international attention due to its "welcoming culture" for refugees. This can be understood within the context of the town's strategic urban development policies aiming to counter the demographic change. This article argues that a regeneration strategy directed towards immigration and integration can offer a chance for shrinking cities but is simultaneously faced with considerable challenges and uncertainties, which could be dealt with through an "integrative approach" to urban development.

Internet and social network recruitment: two case studies.

PubMed

Johnson, Kathy A; Peace, Jane

2012-01-01

The recruitment of study participants is a significant research challenge. The Internet, with its ability to reach large numbers of people in networks connected by email, Facebook and other social networking mechanisms, appears to offer new avenues for recruitment. This paper reports recruitment experiences from two research projects that engaged the Internet and social networks in different ways for study recruitment. Drawing from the non-Internet recruitment literature, we speculate that the relationship with the source of the research and the purpose of the engaged social network should be a consideration in Internet or social network recruitment strategies.

NCI investment in nanotechnology: achievements and challenges for the future.

PubMed

Dickherber, Anthony; Morris, Stephanie A; Grodzinski, Piotr

2015-01-01

Nanotechnology offers an exceptional and unique opportunity for developing a new generation of tools addressing persistent challenges to progress in cancer research and clinical care. The National Cancer Institute (NCI) recognizes this potential, which is why it invests roughly $150 M per year in nanobiotechnology training, research and development. By exploiting the various capacities of nanomaterials, the range of nanoscale vectors and probes potentially available suggests much is possible for precisely investigating, manipulating, and targeting the mechanisms of cancer across the full spectrum of research and clinical care. NCI has played a key role among federal R&D agencies in recognizing early the value of nanobiotechnology in medicine and committing to its development as well as providing training support for new investigators in the field. These investments have allowed many in the research community to pursue breakthrough capabilities that have already yielded broad benefits. Presented here is an overview of how NCI has made these investments with some consideration of how it will continue to work with this research community to pursue paradigm-changing innovations that offer relief from the burdens of cancer. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Collaborative risk governance in informal urban areas: The case of Wallacedene temporary relocation area

PubMed Central

2017-01-01

Community-based disaster risk management (CBDRM) is an emancipatory approach that aims to empower local communities in reducing their own risks. A community risk assessment (CRA) is an essential element of CBDRM, incorporating highly participatory processes of hazard identification and vulnerability analysis. By incorporating local knowledge and insights, together with those contributed by other external role players, the nature of local risks can be more accurately identified, giving consideration to their causal factors, the nature of their realised impacts or potential effects on a local community and the challenges posed in addressing them. Reflecting on the process and outcomes of a CRA conducted in an informal settlement in the Cape Town metropolitan area, this article describes how one such risk assessment contributed to building local agency through a process of collaborative engagement. Offered as an example of possible best practice, it illustrates both the immediate and potentially longer term benefits to be derived from such a collaborative process, suggesting that a community-based risk assessment may contribute significantly to building more resilient communities. It concludes with a consideration of the challenges of sustaining longer term risk reduction efforts.

Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission

PubMed Central

Parham, Paul E.; Waldock, Joanna; Christophides, George K.; Hemming, Deborah; Agusto, Folashade; Evans, Katherine J.; Fefferman, Nina; Gaff, Holly; Gumel, Abba; LaDeau, Shannon; Lenhart, Suzanne; Mickens, Ronald E.; Naumova, Elena N.; Ostfeld, Richard S.; Ready, Paul D.; Thomas, Matthew B.; Velasco-Hernandez, Jorge; Michael, Edwin

2015-01-01

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is owing not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but also, perhaps most crucially, to the multitude of epidemiological, ecological and socio-economic factors that drive VBD transmission, and this complexity has generated considerable debate over the past 10–15 years. In this review, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions and, crucially, offer some solutions for the field. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector–pathogen systems. PMID:25688012

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.

Social Media in the Dental School Environment, Part A: Benefits, Challenges, and Recommendations for Use.

PubMed

Spallek, Heiko; Turner, Sharon P; Donate-Bartfield, Evelyn; Chambers, David; McAndrew, Maureen; Zarkowski, Pamela; Karimbux, Nadeem

2015-10-01

Social media consist of powerful tools that impact not only communication but relationships among people, thus posing an inherent challenge to the traditional standards of who we are as dental educators and what we can expect of each other. This article examines how the world of social media has changed dental education. Its goal is to outline the complex issues that social media use presents for academic dental institutions and to examine these issues from personal, professional, and legal perspectives. After providing an update on social media, the article considers the advantages and risks associated with the use of social media at the interpersonal, professional, and institutional levels. Policies and legal issues of which academic dental institutions need to be aware from a compliance perspective are examined, along with considerations and resources needed to develop effective social media policies. The challenge facing dental educators is how to capitalize on the benefits that social media offer, while minimizing risks and complying with the various forms of legal constraint.

Learning from the U.S. Department of Veterans Affairs Quality Enhancement Research Initiative: QUERI Series

PubMed Central

Graham, Ian D; Tetroe, Jacqueline

2009-01-01

As the recent collection of papers from the Quality Enhancement Research Initiative (QUERI) Series indicates, knowledge is leading to considerable action in the United States (U.S.) Department of Veterans Affairs (VA). The QUERI Series offers clinical researchers, implementation scientists, health systems, and health research funders from around the globe a unique window into the both the practice and science of implementation or knowledge translation (KT) in the VA. By describing successes and challenges as well as setbacks and disappointments, the QUERI Series is all the more useful. From the vantage point of Canadian KT researchers and officials at a national health research funding agency, we offer a number of observations and lessons that can be learned from QUERI. "Knowledge, if it does not determine action, is dead to us." Plotinus (Roman philosopher 205AD-270AD) PMID:19267920

Health-Related Quality of Life after Cystectomy and Urinary Diversion for Bladder Cancer

PubMed Central

Shih, Cheryl; Porter, Michael P.

2011-01-01

With multiple options for urinary diversion after radical cystectomy for bladder cancer that have comparable cancer control and complication rates, health-related quality of life (HRQOL) has become an important consideration. This article reviews the methods for defining HRQOL, the challenges in measuring HRQOL in bladder cancer, and the literature comparing HRQOL after various methods of urinary diversion. Recent contributions include the validation of HRQOL instruments specific to bladder cancer and the publication of several prospective studies measuring HRQOL outcomes after cystectomy and urinary diversion. There is no convincing evidence from existing literature that any particular method of urinary diversion offers superior HRQOL outcomes. Rather, there is growing evidence that good HRQOL can be achieved with patient education and consideration of each patient's clinical and psychosocial situation. Future research should utilize the validated bladder cancer specific HRQOL instruments and perhaps explore the impact of preoperative counseling on postoperative HRQOL. PMID:21826139

Research on environmental impact of water-based fire extinguishing agents

NASA Astrophysics Data System (ADS)

Wang, Shuai

2018-02-01

This paper offers current status of application of water-based fire extinguishing agents, the environmental and research considerations of the need for the study of toxicity research. This paper also offers systematic review of test methods of toxicity and environmental impact of water-based fire extinguishing agents currently available, illustrate the main requirements and relevant test methods, and offer some research findings for future research considerations. The paper also offers limitations of current study.

Ethical considerations when employing fake identities in online social networks for research.

PubMed

Elovici, Yuval; Fire, Michael; Herzberg, Amir; Shulman, Haya

2014-12-01

Online social networks (OSNs) have rapidly become a prominent and widely used service, offering a wealth of personal and sensitive information with significant security and privacy implications. Hence, OSNs are also an important--and popular--subject for research. To perform research based on real-life evidence, however, researchers may need to access OSN data, such as texts and files uploaded by users and connections among users. This raises significant ethical problems. Currently, there are no clear ethical guidelines, and researchers may end up (unintentionally) performing ethically questionable research, sometimes even when more ethical research alternatives exist. For example, several studies have employed "fake identities" to collect data from OSNs, but fake identities may be used for attacks and are considered a security issue. Is it legitimate to use fake identities for studying OSNs or for collecting OSN data for research? We present a taxonomy of the ethical challenges facing researchers of OSNs and compare different approaches. We demonstrate how ethical considerations have been taken into account in previous studies that used fake identities. In addition, several possible approaches are offered to reduce or avoid ethical misconducts. We hope this work will stimulate the development and use of ethical practices and methods in the research of online social networks.

Considerations that will determine if competency-based assessment is a sustainable innovation.

PubMed

Dauphinee, W Dale; Boulet, John R; Norcini, John J

2018-05-18

Educational assessment for the health professions has seen a major attempt to introduce competency based frameworks. As high level policy developments, the changes were intended to improve outcomes by supporting learning and skills development. However, we argue that previous experiences with major innovations in assessment offer an important road map for developing and refining assessment innovations, including careful piloting and analyses of their measurement qualities and impacts. Based on the literature, numerous assessment workshops, personal interactions with potential users, and our 40 years of experience in implementing assessment change, we lament the lack of a coordinated approach to clarify and improve measurement qualities and functionality of competency based assessment (CBA). To address this worrisome situation, we offer two roadmaps to guide CBA's further development. Initially, reframe and address CBA as a measurement development opportunity. Secondly, using a roadmap adapted from the management literature on sustainable innovation, the medical assessment community needs to initiate an integrated plan to implement CBA as a sustainable innovation within existing educational programs and self-regulatory enterprises. Further examples of down-stream opportunities to refocus CBA at the implementation level within faculties and within the regulatory framework of the profession are offered. In closing, we challenge the broader assessment community in medicine to step forward and own the challenge and opportunities to reframe CBA as an innovation to improve the quality of the clinical educational experience. The goal is to optimize assessment in health education and ultimately improve the public's health.

Dynamic Radioisotope Power System Development for Space Explorations

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

Qualls, A L

Dynamic power conversion offers the potential to produce radioisotope power systems (RPS) that generate higher power outputs and utilize the Pu-238 radioisotope more efficiently than Radioisotope Thermoelectric Generators (RTG). Additionally, dynamic systems also offer the potential of producing generators with significantly reduced power degradation over the course of deep space missions so that more power will be available at the end of the mission when it is needed for both powering the science and transmitting the results. The development of dynamic generators involves addressing technical issues not typically associated with traditional thermoelectric generators. Developing long-life, robust and reliable dynamic conversionmore » technology is challenging yet essential to building a suitable generator. Considerations include working within existing handling infrastructure where possible so that development costs can be kept low and integrating dynamic generators into spacecraft, which may be more complex than integration of static systems. Methods of interfacing to and controlling a dynamic generator must be considered and new potential failure modes must be taken into account. This paper will address some of the key issues of dynamic RPS design, development and adaption.Dynamic power conversion offers the potential to produce Radioisotope Power Systems (RPS) that generate higher power outputs and utilize the available heat source plutonium fuel more efficiently than Radioisotope Thermoelectric Generators. Additionally, dynamic systems offer the potential of producing generators with significantly reduced power degradation over the course of deep space missions so that more power would be available at the end of the mission, when it is needed most for both powering science instruments and transmitting the resulting data. The development of dynamic generators involves addressing technical issues not typically associated with traditional thermoelectric generators. Developing long-life, robust, and reliable dynamic conversion technology is challenging yet essential to building a suitable flight-ready generator. Considerations include working within existing hardware-handling infrastructure, where possible, so that development costs can be kept low, and integrating dynamic generators into spacecraft, which may be more complex than integration of static thermoelectric systems. Methods of interfacing to and controlling a dynamic generator must also be considered, and new potential failure modes must be taken into account. This paper will address some of the key issues of dynamic RPS design, development, and adaption.« less

Nanotechnology in dentistry: prevention, diagnosis, and therapy.

PubMed

Abou Neel, Ensanya Ali; Bozec, Laurent; Perez, Roman A; Kim, Hae-Won; Knowles, Jonathan C

2015-01-01

Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation.

Nanotechnology in dentistry: prevention, diagnosis, and therapy

PubMed Central

Abou Neel, Ensanya Ali; Bozec, Laurent; Perez, Roman A; Kim, Hae-Won; Knowles, Jonathan C

2015-01-01

Nanotechnology has rapidly expanded into all areas of science; it offers significant alternative ways to solve scientific and medical questions and problems. In dentistry, nanotechnology has been exploited in the development of restorative materials with some significant success. This review discusses nanointerfaces that could compromise the longevity of dental restorations, and how nanotechnolgy has been employed to modify them for providing long-term successful restorations. It also focuses on some challenging areas in dentistry, eg, oral biofilm and cancers, and how nanotechnology overcomes these challenges. The recent advances in nanodentistry and innovations in oral health-related diagnostic, preventive, and therapeutic methods required to maintain and obtain perfect oral health, have been discussed. The recent advances in nanotechnology could hold promise in bringing a paradigm shift in dental field. Although there are numerous complex therapies being developed to treat many diseases, their clinical use requires careful consideration of the expense of synthesis and implementation. PMID:26504385

An indoor navigation system for the visually impaired.

PubMed

Guerrero, Luis A; Vasquez, Francisco; Ochoa, Sergio F

2012-01-01

Navigation in indoor environments is highly challenging for the severely visually impaired, particularly in spaces visited for the first time. Several solutions have been proposed to deal with this challenge. Although some of them have shown to be useful in real scenarios, they involve an important deployment effort or use artifacts that are not natural for blind users. This paper presents an indoor navigation system that was designed taking into consideration usability as the quality requirement to be maximized. This solution enables one to identify the position of a person and calculates the velocity and direction of his movements. Using this information, the system determines the user's trajectory, locates possible obstacles in that route, and offers navigation information to the user. The solution has been evaluated using two experimental scenarios. Although the results are still not enough to provide strong conclusions, they indicate that the system is suitable to guide visually impaired people through an unknown built environment.

Amnesia and crime: a neuropsychiatric response.

PubMed

Wortzel, Hal S; Arciniegas, David B

2008-01-01

Bourget and Whitehurst's "Amnesia and Crime," published in a prior issue of the Journal, addresses a conceptually complex and clinically challenging subject. Their treatment emphasizes psychiatric conditions in which memory disturbances may arise that are relevant to criminal proceedings. However, their consideration of the neurobiology of memory, memory disturbances, and the neurobiological bases of interactions between psychiatric symptoms and memory merit further elaboration. The relevance of memory impairment to criminal matters requires forensic psychiatric experts to possess a basic understanding of the phenomenology and neurobiology of memory. The present authors describe briefly the phenomenology and neuroanatomy of memory, emphasizing first that memory is not a unitary cognitive domain, clinically or neurobiologically. The assertion that psychotic delusions produce memory impairment is challenged, and the description of "organic" amnesia, both semantically and in terms of its clinical features, is reframed. Resources on which to build a neuropsychiatric foundation for forensic psychiatric opinions on memory impairment surrounding criminal behavior are offered.

Molecular-based design and emerging applications of nanoporous carbon spheres

NASA Astrophysics Data System (ADS)

Liu, Jian; Wickramaratne, Nilantha P.; Qiao, Shi Zhang; Jaroniec, Mietek

2015-08-01

Over the past decade, considerable progress has been made in the synthesis and applications of nanoporous carbon spheres ranging in size from nanometres to micrometres. This Review presents the primary techniques for preparing nanoporous carbon spheres and the seminal research that has inspired their development, presented potential applications and uncovered future challenges. First we provide an overview of the synthesis techniques, including the Stöber method and those based on templating, self-assembly, emulsion and hydrothermal carbonization, with special emphasis on the design and functionalization of nanoporous carbon spheres at the molecular level. Next, we cover the key applications of these spheres, including adsorption, catalysis, separation, energy storage and biomedicine -- all of which might benefit from the regular geometry, good liquidity, tunable porosity and controllable particle-size distribution offered by nanoporous carbon spheres. Finally, we present the current challenges and opportunities in the development and commercial applications of nanoporous carbon spheres.

Molecular-based design and emerging applications of nanoporous carbon spheres.

PubMed

Liu, Jian; Wickramaratne, Nilantha P; Qiao, Shi Zhang; Jaroniec, Mietek

2015-08-01

Over the past decade, considerable progress has been made in the synthesis and applications of nanoporous carbon spheres ranging in size from nanometres to micrometres. This Review presents the primary techniques for preparing nanoporous carbon spheres and the seminal research that has inspired their development, presented potential applications and uncovered future challenges. First we provide an overview of the synthesis techniques, including the Stöber method and those based on templating, self-assembly, emulsion and hydrothermal carbonization, with special emphasis on the design and functionalization of nanoporous carbon spheres at the molecular level. Next, we cover the key applications of these spheres, including adsorption, catalysis, separation, energy storage and biomedicine — all of which might benefit from the regular geometry, good liquidity, tunable porosity and controllable particle-size distribution offered by nanoporous carbon spheres. Finally, we present the current challenges and opportunities in the development and commercial applications of nanoporous carbon spheres.

Assessing the 100-Year Climate Change Mitigation Potential of Large-Scale Tropical Forest Restoration Under the Bonn Challenge

NASA Astrophysics Data System (ADS)

Wheeler, C. E.; Mitchard, E. T.; Lewis, S. L.

2017-12-01

Restoring degraded and deforested tropical lands to sequester carbon is widely considered to offer substantial climate change mitigation opportunities, if conducted over large spatial scales. Despite this assertion, explicit estimates of how much carbon could be sequestered because of large-scale restoration are rare and have large uncertainties. This is principally due to the many different characteristics of land available for restoration, and different potential restoration activities, which together cause very different rates of carbon sequestration. For different restoration pathways: natural regeneration of degraded and secondary forest, timber plantations and agroforestry, we estimate carbon sequestration rates from the published literature. Then based on tropical restoration commitments made under the Bonn challenge and using carbon density maps, these carbon sequestration rates were used to predict total pan-tropical carbon sequestration to 2100. Restoration of degraded or secondary forest via natural regeneration offers the greatest carbon sequestration potential, considerably exceeding the carbon captured by either timber plantations or agroforestry. This is predominantly due to naturally regenerating forests representing a more permanent store of carbon in comparison to timber plantations and agroforestry land-use options, which, due to their rotational nature, result in the sequential return of carbon to the atmosphere. If the Bonn Challenge is to achieve its ambition of providing substantial climate change mitigation from restoration it must incorporate large areas of natural regeneration back to an intact forest state, otherwise it stands to be a missed opportunity in helping meet the Paris climate change goals.

Addressing challenges of heterogeneous tumor treatment through bispecific protein-mediated pretargeted drug delivery.

PubMed

Yang, Qi; Parker, Christina L; McCallen, Justin D; Lai, Samuel K

2015-12-28

Tumors are frequently characterized by genomically and phenotypically distinct cancer cell subpopulations within the same tumor or between tumor lesions, a phenomenon termed tumor heterogeneity. These diverse cancer cell populations pose a major challenge to targeted delivery of diagnostic and/or therapeutic agents, as the conventional approach of conjugating individual ligands to nanoparticles is often unable to facilitate intracellular delivery to the full spectrum of cancer cells present in a given tumor lesion or patient. As a result, many cancers are only partially suppressed, leading to eventual tumor regrowth and/or the development of drug-resistant tumors. Pretargeting (multistep targeting) approaches involving the administration of 1) a cocktail of bispecific proteins that can collectively bind to the entirety of a mixed tumor population followed by 2) nanoparticles containing therapeutic and/or diagnostic agents that can bind to the bispecific proteins accumulated on the surface of target cells offer the potential to overcome many of the challenges associated with drug delivery to heterogeneous tumors. Despite its considerable success in improving the efficacy of radioimmunotherapy, the pretargeting strategy remains underexplored for a majority of nanoparticle therapeutic applications, especially for targeted delivery to heterogeneous tumors. In this review, we will present concepts in tumor heterogeneity, the shortcomings of conventional targeted systems, lessons learned from pretargeted radioimmunotherapy, and important considerations for harnessing the pretargeting strategy to improve nanoparticle delivery to heterogeneous tumors. Copyright © 2015 Elsevier B.V. All rights reserved.

Magnetic-Assisted, Self-Healable, Yarn-Based Supercapacitor.

PubMed

Huang, Yang; Huang, Yan; Zhu, Minshen; Meng, Wenjun; Pei, Zengxia; Liu, Chang; Hu, Hong; Zhi, Chunyi

2015-06-23

Yarn-based supercapacitors have received considerable attention recently, offering unprecedented opportunities for future wearable electronic devices (e.g., smart clothes). However, the reliability and lifespan of yarn-based supercapacitors can be seriously limited by accidental mechanical damage during practical applications. Therefore, a supercapacitor endowed with mechanically and electrically self-healing properties is a brilliant solution to the challenge. Compared with the conventional planar-like or large wire-like structure, the reconnection of the broken yarn electrode composed of multiple tiny fibers (diameter <20 μm) is much more difficult and challenging, which directly affects the restoration of electrical conductivity after damage. Herein, a self-healable yarn-based supercapacitor that ensures the reconnection of broken electrodes has been successfully developed by wrapping magnetic electrodes around a self-healing polymer shell. The strong force from magnetic attraction between the broken yarn electrodes benefits reconnection of fibers in the yarn electrodes during self-healing and thus offers an effective strategy for the restoration of electric conductivity, whereas the polymer shell recovers the configuration integrity and mechanical strength. With the design, the specific capacitance of our prototype can be restored up to 71.8% even after four breaking/healing cycles with great maintenance of the whole device's mechanical properties. This work may inspire the design and fabrication of other distinctive self-healable and wearable electronic devices.

Pervasive assistive technology for people with dementia: a UCD case

PubMed Central

Rønn-Andersen, Kristoffer V.H.; Bień, Paulina; Özkil, Ali Gürcan; Forchhammer, Birgitte Hysse; Maier, Anja M.

2016-01-01

Smart mobile and wearable technology offers exciting opportunities to support people with dementia (PwD). Its ubiquity and popularity could even benefit user adoption – a great challenge for assistive technology (AT) for PwD that calls for user-centred design (UCD) methods. This study describes a user-centred approach to developing and testing AT based on off-the-shelf pervasive technologies. A prototype is created by combining a smartphone, smartwatch and various applications to offer six support features. This is tested among five end-users (PwD) and their caregivers. Controlled usability testing was followed by field testing in a real-world context. Data is gathered from video recordings, interaction logs, system usability scale questionnaires, logbooks, application usage logs and interviews structured on the unified theory of acceptance and use of technology model. The data is analysed to evaluate usability, usefulness and user acceptance. Results show some promise for user adoption, but highlight challenges to be overcome, emphasising personalisation and familiarity as key considerations. The complete findings regarding usability issues, usefulness of support features and four identified adoption profiles are used to provide a set of recommendations for practitioners and further research. These contribute toward UCD practices for improved smart, pervasive AT for dementia. PMID:28008366

Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission

DOE PAGES

Parham, Paul E.; Waldock, Joanna; Christophides, George K.; ...

2015-02-16

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is due not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but, perhaps most crucially, the multitude of epidemiological, ecological, and socioeconomic factors that drive VBD transmission, and this complexity has generated considerable debate over the last 10-15 years. Inmore » this article, and Theme Issue, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions, and, crucially, offer some solutions for the field moving forwards. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector-pathogen systems. This Theme Issue seeks to cover both, reflected in the breadth and depth of the topics and VBD-systems considered, itself strongly indicative of the challenging, but necessary, multidisciplinary nature of this research field.« less

Implementing quality initiatives in healthcare organizations: drivers and challenges.

PubMed

Abdallah, Abdallah

2014-01-01

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

Introversion and medical student education: challenges for both students and educators.

PubMed

Davidson, Bernard; Gillies, Ralph A; Pelletier, Allen L

2015-01-01

Introversion is one of the personality factors that has been shown to be associated with performance in medical school. Prior cross-sectional studies highlight performance evaluation differences between introverted and extraverted medical students, though the mechanisms and implications of these differences remain relatively unexplained and understudied. This gap in the literature has become more salient as medical schools are employing more interactive learning strategies into their curricula which may disproportionately challenge introverted learners. In this article, we provide an overview and working definition of introversion as a valid construct occurring on a continuum. We apply a goodness of fit model to explore how various medical training contexts may be more or less challenging for introverted students and the potential consequences of a poor fit. As preliminary support for these hypothesized challenges, we share observations from students self-identified as introverts. Examples include introverted students feeling at times like misfits, questioning a need to change their identity to succeed in medical school, and being judged as underperformers. We offer pragmatic suggestions for improving the fit between introverted students and their training contexts, such as teachers and students pausing between a question being asked and the initial response being offered and teachers differentiating between anxious and introverted behaviors. We conclude with suggested areas for future qualitative and quantitative research to examine how medical school curricula and the teaching environment may be differentially impacting the learning and health of introverted and extraverted students. Extraverted behaviors will continue to be an important part of medical training and practice, but the merits of introverted behaviors warrant further consideration as both medical training and practice evolve. Educators who make manageable adjustments to current teaching practices can improve the learning for both introverted and extraverted styles of academic engagement.

The history of head transplantation: a review.

PubMed

Lamba, Nayan; Holsgrove, Daniel; Broekman, Marike L

2016-12-01

Since the turn of the last century, the prospect of head transplantation has captured the imagination of scientists and the general public. Recently, head transplant has regained attention in popular media, as neurosurgeons have proposed performing this procedure in 2017. Given the potential impact of such a procedure, we were interested in learning the history of the technical hurdles that need to be overcome, and determine if it is even technically possible to perform such a procedure on humans today. We conducted a historical review of available literature on the technical challenges and developments of head transplantation. The many social, psychological, ethical, religious, cultural, and legal questions of head transplantation were beyond the scope of this review. Our historical review identified the following important technical considerations related to performing a head transplant: maintenance of blood flow to an isolated brain via vessel anastomosis; availability of immunosuppressive agents; spinal anastomosis and fusion following cord transfection; pain control in the recipient. Several animal studies have demonstrated success in maintaining recipient cerebral perfusion and achieving immunosuppression. However, there is currently sparse evidence in favor of successful spinal anastomosis and fusion after transection. While recent publications by an Italian group offer novel approaches to this challenge, research on this topic has been sparse and hinges on procedures performed in animal models in the 1970s. How transferrable these older methods are to the human nervous system is unclear and warrants further exploration. Our review identified several important considerations related to performing a viable head transplantation. Besides the technical challenges that remain, there are important ethical issues to consider, such as exploitation of vulnerable patients and informed consent. Thus, besides the remaining technical challenges, these ethical issues will also need to be addressed before moving these studies to the clinic.

Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission.

PubMed

Parham, Paul E; Waldock, Joanna; Christophides, George K; Hemming, Deborah; Agusto, Folashade; Evans, Katherine J; Fefferman, Nina; Gaff, Holly; Gumel, Abba; LaDeau, Shannon; Lenhart, Suzanne; Mickens, Ronald E; Naumova, Elena N; Ostfeld, Richard S; Ready, Paul D; Thomas, Matthew B; Velasco-Hernandez, Jorge; Michael, Edwin

2015-04-05

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is owing not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but also, perhaps most crucially, to the multitude of epidemiological, ecological and socio-economic factors that drive VBD transmission, and this complexity has generated considerable debate over the past 10-15 years. In this review, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions and, crucially, offer some solutions for the field. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector-pathogen systems. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Infusing and sustaining aging content in social work education: findings from GeroRich projects.

PubMed

Hash, Kristina M; Gottlieb, Jody; Harper-Dorton, Karen V; Crawley-Woods, Geraldine; Shelek-Furbee, Katherine; Smith, John David; Brown, Rita

2007-01-01

This article presents findings from experiences of 67 projects involved in GeroRich, an initiative funded by the John A. Hartford Foundation designed to infuse, enrich and sustain aging content in BSW and MSW curricula. Thematic qualitative analysis was used to uncover themes in answers to open-ended questions contained in End-of-Year 2 project reports. Content areas addressed by open-ended answers were: (1) successes and innovations, and (2) challenges requiring responses. Primary successes and innovations identified were as follows: curriculum enrichment, faculty and student involvement, student-learning activities and community. Challenges to be responded to were identified as lack of faculty involvement, competing demands on faculty and programs, and sustainability of project efforts. Examples of strategies implemented to overcome these obstacles include providing teaching resources, instituting financial and other supports, and developing strategic plans for sustaining content infusion post-funding. Experiences of the GeroRich projects offer practical considerations for other social work programs that accept the challenge of attracting and preparing students to work with the increasing population of older adults.

New science at the meso frontier: Dense nanostructure architectures for electrical energy storage

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

Rubloff, Gary W.; Lee, Sang Bok

2015-08-01

We examine the scientific challenges and opportunities presented at the mesoscale in the context of employing nanostructures for electrical energy storage. In order to capitalize on the power–energy and charge/discharge cycling stability that nanostructures offer, massive assemblies of nanostructures in networks must be organized into dense mesoscale architectures. With a fairly wide variety of architectures already demonstrated and more expected, the essential questions are whether regular or random 3-D arrangements are favorable, which embodiments should show best performance, and at what dimensional scaling? Dense packing raises challenging new questions about ion available and transport in highly confined electrolyte nanoenvironments, asmore » well as designs to balance ion transport in electrolyte and electron transport in electrodes over distances long compared to nanostructure characteristic dimensions. Architectures and dimensional scaling present important issues of defects, statistical outliers, and their dynamic evolution, which in turn control degradation and failure phenomena. These considerations promise a rich set of mesoscale scientific challenges crucial to exploiting storage nanostructures in mesoscale architectures for energy storage.« less

Observation Care: Ethical and Legal Considerations for the Emergency Physician.

PubMed

Ali, Nissa J; Jesus, John; Smulowitz, Peter B

2016-03-01

The Medicare observation rules remain controversial despite Centers for Medicare and Medicaid Services revisions and the new 2-midnight rule. The increased financial risks for patients and heightened awareness of the rule have placed emergency physicians (EPs) at the center of the controversy. This article reviews the primary ethical and legal (particularly with respect to the Emergency Medical Treatment and Active Labor Act) implications of the existing observation rule for EPs and offers practical solutions for EPs faced with counseling patients on the meaning and ramifications of the observation rule. We conclude that while we believe it does not violate the intent of the Emergency Medical Treatment and Active Labor Act to respond to patient questions about their admission status, the observation rules challenge the ethical principles of transparency related to the physician-patient relationship and justice as fairness. Guidance for physicians is offered to improve transparency and patient fairness. Copyright © 2016 Elsevier Inc. All rights reserved.

Current state of hematopoietic cell transplantation in CLL as smart therapies emerge.

PubMed

Kharfan-Dabaja, Mohamed A; El-Asmar, Jessica; Awan, Farrukh T; Hamadani, Mehdi; Ayala, Ernesto

2016-03-01

Novel therapies targeting various kinases downstream of the B-cell receptor have emerged along with monoclonal antibodies and BCL-2 antagonists, and are changing the therapeutic landscape of chronic lymphocytic leukemia. However, cure remains unattainable unless eligible patients are offered an allogeneic hematopoietic cell transplant. Access to allogeneic hematopoietic cell transplantation has expanded considerably with availability of reduced intensity conditioning regimens which is capable offering durable remissions even in poor-risk disease. Encouraging data from ibrutinib and venetoclax in Del17p is challenging the notion of disease eradication as the ultimate therapeutic goal to a new concept of merely disease control. By favoring the non-transplant approach, patients should be aware that there are no established salvage therapies, yet, to rescue disease progression after ibrutinib. When disease eradication is the desirable approach, a reduced intensity conditioning allogeneic hematopoietic cell transplant is the preferred choice at this time. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relative Binding Free Energy Calculations in Drug Discovery: Recent Advances and Practical Considerations.

PubMed

Cournia, Zoe; Allen, Bryce; Sherman, Woody

2017-12-26

Accurate in silico prediction of protein-ligand binding affinities has been a primary objective of structure-based drug design for decades due to the putative value it would bring to the drug discovery process. However, computational methods have historically failed to deliver value in real-world drug discovery applications due to a variety of scientific, technical, and practical challenges. Recently, a family of approaches commonly referred to as relative binding free energy (RBFE) calculations, which rely on physics-based molecular simulations and statistical mechanics, have shown promise in reliably generating accurate predictions in the context of drug discovery projects. This advance arises from accumulating developments in the underlying scientific methods (decades of research on force fields and sampling algorithms) coupled with vast increases in computational resources (graphics processing units and cloud infrastructures). Mounting evidence from retrospective validation studies, blind challenge predictions, and prospective applications suggests that RBFE simulations can now predict the affinity differences for congeneric ligands with sufficient accuracy and throughput to deliver considerable value in hit-to-lead and lead optimization efforts. Here, we present an overview of current RBFE implementations, highlighting recent advances and remaining challenges, along with examples that emphasize practical considerations for obtaining reliable RBFE results. We focus specifically on relative binding free energies because the calculations are less computationally intensive than absolute binding free energy (ABFE) calculations and map directly onto the hit-to-lead and lead optimization processes, where the prediction of relative binding energies between a reference molecule and new ideas (virtual molecules) can be used to prioritize molecules for synthesis. We describe the critical aspects of running RBFE calculations, from both theoretical and applied perspectives, using a combination of retrospective literature examples and prospective studies from drug discovery projects. This work is intended to provide a contemporary overview of the scientific, technical, and practical issues associated with running relative binding free energy simulations, with a focus on real-world drug discovery applications. We offer guidelines for improving the accuracy of RBFE simulations, especially for challenging cases, and emphasize unresolved issues that could be improved by further research in the field.

Updating energy security and environmental policy: Energy security theories revisited.

PubMed

Proskuryakova, L

2018-06-18

The energy security theories are based on the premises of sufficient and reliable supply of fossil fuels at affordable prices in centralized supply systems. Policy-makers and company chief executives develop energy security strategies based on the energy security theories and definitions that dominate in the research and policy discourse. It is therefore of utmost importance that scientists revisit these theories in line with the latest changes in the energy industry: the rapid advancement of renewables and smart grid, decentralization of energy systems, new environmental and climate challenges. The study examines the classic energy security concepts (neorealism, neoliberalism, constructivism and international political economy) and assesses if energy technology changes are taken into consideration. This is done through integrative literature review, comparative analysis, identification of 'international relations' and 'energy' research discourse with the use of big data, and case studies of Germany, China, and Russia. The paper offers suggestions for revision of energy security concepts through integration of future technology considerations. Copyright © 2018 Elsevier Ltd. All rights reserved.

Ethical considerations of teaching spirituality in the academy.

PubMed

Becker, Annette L

2009-11-01

Despite evidence in college students indicating a hunger for spiritual insight and spirituality's application in health care, there continues to be guardedness within the academy towards inclusion of curricula that address spirituality. The purpose of this article is to examine the ethical considerations of teaching spirituality in the academy by describing current trends, issues relevant to nursing education and practice, legitimate concerns of the academy, and the importance of an ethical instructional response when teaching about spirituality. Data supporting the interest and desire by students to explore meaning and purpose in the context of spirituality will be presented. Challenges and barriers inherent in teaching this topic will be described, including the affective response, the lack of a universally accepted definition of spirituality, and spirituality's relationship to religion. Pedagogical strategies consistent with an ethical instructional response will be discussed as the key to eliciting trust within the academy. A model of teaching spirituality and health will be offered to illustrate these possibilities.

The central nervous system--an additional consideration in 'rotator cuff tendinopathy' and a potential basis for understanding response to loaded therapeutic exercise.

PubMed

Littlewood, Chris; Malliaras, Peter; Bateman, Marcus; Stace, Richmond; May, Stephen; Walters, Stephen

2013-12-01

Tendinopathy is a term used to describe a painful tendon disorder but despite being a well-recognised clinical presentation, a definitive understanding of the pathoaetiology of rotator cuff tendinopathy remains elusive. Current explanatory models, which relate to peripherally driven nocioceptive mechanisms secondary to structural abnormality, or failed healing, appear inadequate on their own in the context of current literature. In light of these limitations this paper presents an extension to current models that incorporates the integral role of the central nervous system in the pain experience. The role of the central nervous system (CNS) is described and justified along with a potential rationale to explain the favourable response to loaded therapeutic exercises demonstrated by previous studies. This additional consideration has the potential to offer a useful way to explain pain to patients, for clinicians to prescribe appropriate therapeutic management strategies and for researchers to advance knowledge in relation to this clinically challenging problem. Copyright © 2013 Elsevier Ltd. All rights reserved.

Assessment of alternative disposal methods to reduce greenhouse gas emissions from municipal solid waste in India.

PubMed

Yedla, Sudhakar; Sindhu, N T

2016-06-01

Open dumping, the most commonly practiced method of solid waste disposal in Indian cities, creates serious environment and economic challenges, and also contributes significantly to greenhouse gas emissions. The present article attempts to analyse and identify economically effective ways to reduce greenhouse gas emissions from municipal solid waste. The article looks at the selection of appropriate methods for the control of methane emissions. Multivariate functional models are presented, based on theoretical considerations as well as the field measurements to forecast the greenhouse gas mitigation potential for all the methodologies under consideration. Economic feasibility is tested by calculating the unit cost of waste disposal for the respective disposal process. The purpose-built landfill system proposed by Yedla and Parikh has shown promise in controlling greenhouse gas and saving land. However, these studies show that aerobic composting offers the optimal method, both in terms of controlling greenhouse gas emissions and reducing costs, mainly by requiring less land than other methods. © The Author(s) 2016.

Protons -- The Future of Radiation Therapy?

NASA Astrophysics Data System (ADS)

Avery, Steven

2007-03-01

Cancer is the 2^nd highest cause of death in the United States. The challenges of controlling this disease remain more difficult as the population lives longer. Proton therapy offers another choice in the management of cancer care. Proton therapy has existed since the late 1950s and the first hospital based center in the United States opened in 1990. Since that time four hospital based proton centers are treating patients with other centers either under construction or under consideration. This talk will focus on an introduction to proton therapy: it's medical advantages over current treatment modalities, accelerators and beam delivery systems, applications to clinical radiation oncology and the future outlook for proton therapy.

Out-patient management of chronic heart failure.

PubMed

Terrovitis, John V; Anastasiou-Nana, Maria I; Nanas, John N

2005-09-01

Chronic heart failure is a clinical syndrome associated with an ominous long-term prognosis and major economic consequences for Western societies. In recent years, considerable progress has been made in the pharmacological management of heart failure, and several treatments have been confirmed to confer survival and symptomatic benefits. However, pharmaceuticals remain underutilised, and the combination of several different drugs present challenges for their optimal prescription, requiring a thorough knowledge of potential side effects and complex interactions. This article reviews in detail the evidence pertaining to the out-patient pharmacological management of chronic heart failure, and offers recommendations on the use of various drugs in complex clinical conditions, or in areas of ongoing controversy.

Amino acids as promoieties in prodrug design and development.

PubMed

Vig, Balvinder S; Huttunen, Kristiina M; Laine, Krista; Rautio, Jarkko

2013-10-01

Prodrugs are biologically inactive agents that upon biotransformation in vivo result in active drug molecules. Since prodrugs might alter the tissue distribution, efficacy and the toxicity of the parent drug, prodrug design should be considered at the early stages of preclinical development. In this regard, natural and synthetic amino acids offer wide structural diversity and physicochemical properties. This review covers the use of amino acid prodrugs to improve poor solubility, poor permeability, sustained release, intravenous delivery, drug targeting, and metabolic stability of the parent drug. In addition, practical considerations and challenges associated with the development of amino acid prodrugs are also covered. Copyright © 2012 Elsevier B.V. All rights reserved.

The effects of fluoride concentration and the level of cariogenic challenge on caries development in desalivated rats.

PubMed

Tabchoury, C M; Holt, T; Pearson, S K; Bowen, W H

1998-12-01

Dental caries is an infectious and transmissible disease that continues to affect the majority of people. The presence of carbohydrate, mainly sucrose in the diet, is an important factor in its occurrence. The amount of fluoride required for optimal protective effect where there is a high caries challenge is unclear. Differences in the intensity of cariogenic challenge, for whatever reason, may play a part in determining fluctuations in the effectiveness of fluoride. The purpose of this study was to evaluate the effect of different concentrations of fluoride on the development of caries and explore the cariostatic effect of fluoride under various levels of cariogenic challenge. The study comprises two experiments. In experiment I, 60 desalivated Sprague Dawley rats infected with Streptococcus sobrinus were offered the following to drink for 21 days: group (1), sterile distilled water (SDW); (2) 10 parts/10(6) F SDW; (3) 20 parts/10(6) F SDW; (4) 30 parts/10(6) F SDW; (5) 40 parts/10(6) F SDW. In experiment II, eight groups of 9 rats were placed in a König Höfer programmed feeder and were exposed to different levels of cariogenic challenge through varying frequency of eating and offered water containing 10 parts/10(6) F. In experiment I, exposure to 20, 30 and 40 parts/10(6) F reduced caries development significantly: fluoride, at 10 parts/10(6), reduced the severity of the carious lesions. In this model of severe cariogenic challenge, the results suggest that elevated concentrations of fluoride might be effective in patients at high caries risk. In experiment II, fluoride reduced the incidence and severity of smooth-surface caries in all groups. The protective effect of fluoride decreased as the number of exposures to sugar increased. It is concluded that the effectiveness of fluoride is influenced by the level of cariogenic challenge and that consideration should be given to adjusting the level of fluoride exposure based on perceived caries risk, and that there is a maximum therapeutic effect of fluoride beyond which no additional protection can be expected.

Abnormal emotion processing, but intact fairness and intentionality considerations during social decision-making in schizophrenia.

PubMed

de la Asuncion, Javier; Docx, Lise; Sabbe, Bernard; Morrens, Manuel; de Bruijn, Ellen R A

2015-01-01

Schizophrenia is a severe mental disorder that is highly characterized by social cognitive impairments. Most studies investigating these impairments focus on one specific social domain such as emotion recognition. However, in daily life, processing complex social situations relies on the combination of several social cognitive and affective processes simultaneously rather than one process alone. A modified version of the economically based Ultimatum Game was used to measure the interplay between fairness, intentionality, and emotion considerations during social decision-making. In this task, participants accept or reject fair and unfair monetary offers proposed intentionally or unintentionally by either angry, happy, neutral, or sad proposers. Behavioral data was collected from a group of schizophrenia patients (N = 35) and a group of healthy individuals (N = 30). Like healthy participants, schizophrenia patients differentiated between fair and unfair offers by rejecting unfair offers more compared to fair offers. However, overall patients did reject more fair offers, indicating that their construct of fairness operates within different margins. In both groups, intentional unfair offers were rejected more compared to unintentional ones, indicating a normal integration of intentionality considerations in schizophrenia. Importantly, healthy subjects also differentiated between proposers' emotion when rejecting unfair offers (more rejections from proposers depicting angry faces compared to proposers depicting, happy, neutral, or sad faces). Schizophrenia patients' decision behavior on the other hand, was not affected by the proposers' emotions. The current study thus shows that schizophrenia patients have specific problems with processing and integrating emotional information. Importantly, the finding that patients display normal fairness and intentionality considerations emphasizes preservation of central social cognitive processes in schizophrenia.

Direct to consumer genetic testing-law and policy concerns in Ireland.

PubMed

de Paor, Aisling

2017-11-25

With rapid scientific and technological advances, the past few years has witnessed the emergence of a new genetic era and a growing understanding of the genetic make-up of human beings. These advances have propelled the introduction of companies offering direct to consumer (DTC) genetic testing, which facilitates the direct provision of such tests to consumers, (for example, via the internet). Although DTC genetic testing offers benefits by enhancing consumer accessibility to such technology, promoting proactive healthcare and increasing genetic awareness, it presents a myriad of challenges, from an ethical, legal and regulatory perspective. As DTC genetic testing usually eliminates the need for a medical professional in accessing genetic tests, this lack of professional guidance and counselling may result in misinterpretation and confusion regarding results. In addition, an evident concern relates to the scientific validity and quality of these tests. A further problem arising is the lack or inadequacy of regulation in this field. Despite the increasing accessibility of DTC genetic testing, this legislative vacuum is apparent in Ireland, where there is no concrete legislation. This article explores the main ethical, legal and regulatory issues arising with the advent of rapid advances in DTC genetic testing in Ireland. Further, with inevitable future advances in genetic science, as well as increasing internet accessibility, the challenges presented are likely to become more amplified. In consideration of the ethical and legal challenges, this paper highlights the regulation of DTC genetic testing as a growing concern in Ireland, recognising its importance to both the scientific community as well as in respect of enhancing consumer confidence in such technologies.

Spatially explicit multi-criteria decision analysis for managing vector-borne diseases

PubMed Central

2011-01-01

The complex epidemiology of vector-borne diseases creates significant challenges in the design and delivery of prevention and control strategies, especially in light of rapid social and environmental changes. Spatial models for predicting disease risk based on environmental factors such as climate and landscape have been developed for a number of important vector-borne diseases. The resulting risk maps have proven value for highlighting areas for targeting public health programs. However, these methods generally only offer technical information on the spatial distribution of disease risk itself, which may be incomplete for making decisions in a complex situation. In prioritizing surveillance and intervention strategies, decision-makers often also need to consider spatially explicit information on other important dimensions, such as the regional specificity of public acceptance, population vulnerability, resource availability, intervention effectiveness, and land use. There is a need for a unified strategy for supporting public health decision making that integrates available data for assessing spatially explicit disease risk, with other criteria, to implement effective prevention and control strategies. Multi-criteria decision analysis (MCDA) is a decision support tool that allows for the consideration of diverse quantitative and qualitative criteria using both data-driven and qualitative indicators for evaluating alternative strategies with transparency and stakeholder participation. Here we propose a MCDA-based approach to the development of geospatial models and spatially explicit decision support tools for the management of vector-borne diseases. We describe the conceptual framework that MCDA offers as well as technical considerations, approaches to implementation and expected outcomes. We conclude that MCDA is a powerful tool that offers tremendous potential for use in public health decision-making in general and vector-borne disease management in particular. PMID:22206355

Ethical considerations in HIV prevention and vaccine research in resource-limited settings.

PubMed

Garner, Samual A; Anude, Chuka J; Adams, Elizabeth; Dawson, Liza

2014-09-01

HIV prevention research has been facing increasing ethical and operational challenges. Factors influencing the design and conduct of HIV prevention trials include a rapidly changing evidence base, new biomedical prevention methods and modalities being tested, a large diversity of countries, sites and populations affected by HIV and participating in trials, and challenges of developing and making available products that will be feasible and affordable for at-risk populations. To discuss these challenges, a meeting, Ethical considerations around novel combination prevention modalities in HIV prevention and vaccine trials in resource-limited settings, was convened by NIH/NIAID/Division of AIDS on April 22-23, 2013. Several themes emerged from the meeting: (1) because of both trial design and ethical complexities, choosing prevention packages and designing combination prevention research trials will need to be evaluated on a case by case basis in different clinical trials, countries, and health systems; (2) multilevel stakeholder engagement from the beginning is vital to a fair and transparent process and also to designing ethical and relevant trials; (3) research should generally be responsive to a host country's needs, and sponsors and stakeholders should work together to address potential barriers to future access; and finally, (4) another meeting including a broader group of stakeholders is needed to address many of the outstanding ethical issues raised by this meeting. We offer an overview of the meeting and the key discussion points and recommendations to help guide the design and conduct of future HIV prevention and vaccine research in resource-limited settings.

Geospatial Data as a Service: Towards planetary scale real-time analytics

NASA Astrophysics Data System (ADS)

Evans, B. J. K.; Larraondo, P. R.; Antony, J.; Richards, C. J.

2017-12-01

The rapid growth of earth systems, environmental and geophysical datasets poses a challenge to both end-users and infrastructure providers. For infrastructure and data providers, tasks like managing, indexing and storing large collections of geospatial data needs to take into consideration the various use cases by which consumers will want to access and use the data. Considerable investment has been made by the Earth Science community to produce suitable real-time analytics platforms for geospatial data. There are currently different interfaces that have been defined to provide data services. Unfortunately, there is considerable difference on the standards, protocols or data models which have been designed to target specific communities or working groups. The Australian National University's National Computational Infrastructure (NCI) is used for a wide range of activities in the geospatial community. Earth observations, climate and weather forecasting are examples of these communities which generate large amounts of geospatial data. The NCI has been carrying out significant effort to develop a data and services model that enables the cross-disciplinary use of data. Recent developments in cloud and distributed computing provide a publicly accessible platform where new infrastructures can be built. One of the key components these technologies offer is the possibility of having "limitless" compute power next to where the data is stored. This model is rapidly transforming data delivery from centralised monolithic services towards ubiquitous distributed services that scale up and down adapting to fluctuations in the demand. NCI has developed GSKY, a scalable, distributed server which presents a new approach for geospatial data discovery and delivery based on OGC standards. We will present the architecture and motivating use-cases that drove GSKY's collaborative design, development and production deployment. We show our approach offers the community valuable exploratory analysis capabilities, for dealing with petabyte-scale geospatial data collections.

17 CFR 230.251 - Scope of exemption.

Code of Federal Regulations, 2010 CFR

2010-04-01

... consideration must be reasonable at the time made. (c) Integration with other offerings. Offers and sales made... dealers with reasonable quantities of the offering circular for this purpose. (3) Continuous or delayed offerings. Continuous or delayed offerings may be made under this Regulation A if permitted by § 230.415. ...

Counterfactual comparison modulates fairness consideration in the mini-ultimatum game: an event-related potentials study.

PubMed

Liang, Jiafeng; Lin, Huiyan; Xiang, Jing; Wu, Hao; Li, Xu; Liang, Hongyu; Zheng, Xue

2015-04-01

Existing literature on the mini-ultimatum game indicates that counterfactual comparison between chosen and unchosen alternatives is of great importance for individual's fairness consideration. However, it is still unclear how counterfactual comparison influences the electrophysiological responses to unfair chosen offers. In conjunction with event-related potentials' (ERPs) technique, the current study aimed to explore the issue by employing a modified version of the mini-ultimatum game where a fixed set of two alternatives (unfair offer vs. fair alternative, unfair vs. hyperfair alternative, unfair offer vs. hyperunfair alternative) was presented before the chosen offer. The behavioral results showed that participants were more likely to accept unfair chosen offers when the unchosen alternative was hyperunfair than when the unchosen alternative was fair or hyperfair. The ERPs results showed that the feedback-related negativity (FRN) elicited by unfair chosen offers was insensitive to the type of unchosen alternative when correcting for possible overlap with other components. In contrast, unfair chosen offers elicited larger P300 amplitudes when the unchosen alternative was hyperunfair than when the unchosen alternative was fair or hyperfair. These findings suggest that counterfactual comparison may take effect at later stages of fairness consideration as reflected by the P300. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Children's decision making: When self-interest and moral considerations conflict.

PubMed

Tasimi, Arber; Johnson, Marcia K; Wynn, Karen

2017-09-01

When children's self-interests are at odds with their moral considerations, what do they do? In the current study of 5- and 6-year-olds (N=160), we asked (a) whether children would select the offering of a do-gooder over a neutral individual at a personal cost, (b) whether they would reject the offering of a wrongdoer over a neutral individual at a personal cost, and (c) whether these two types of decisions involve comparable levels of conflict. In the absence of material considerations, children preferred a nice character to a neutral one, but this preference was easily overcome for material gain; children accepted a larger offering from a neutral source over a smaller offering from a nice source. In contrast, children's aversion to negative characters was largely unaffected by the same material consideration; they rejected a larger offering from a mean source in favor of a smaller offering from a neutral source. In addition, children's response times indicated that deciding whether or not to "sell out" to a wrongdoer for personal gain engenders conflict but that deciding whether to take a lesser gain from a do-gooder does not. These findings indicate that children weigh both their own material interests and others' social behaviors when selecting social partners and, importantly, that an aversion to wrongdoers is a more powerful influence on these choices than an attraction to do-gooders. Copyright © 2017 Elsevier Inc. All rights reserved.

Web-based assessments of physical activity in youth: considerations for design and scale calibration.

PubMed

Saint-Maurice, Pedro F; Welk, Gregory J

2014-12-01

This paper describes the design and methods involved in calibrating a Web-based self-report instrument to estimate physical activity behavior. The limitations of self-report measures are well known, but calibration methods enable the reported information to be equated to estimates obtained from objective data. This paper summarizes design considerations for effective development and calibration of physical activity self-report measures. Each of the design considerations is put into context and followed by a practical application based on our ongoing calibration research with a promising online self-report tool called the Youth Activity Profile (YAP). We first describe the overall concept of calibration and how this influences the selection of appropriate self-report tools for this population. We point out the advantages and disadvantages of different monitoring devices since the choice of the criterion measure and the strategies used to minimize error in the measure can dramatically improve the quality of the data. We summarize strategies to ensure quality control in data collection and discuss analytical considerations involved in group- vs individual-level inference. For cross-validation procedures, we describe the advantages of equivalence testing procedures that directly test and quantify agreement. Lastly, we introduce the unique challenges encountered when transitioning from paper to a Web-based tool. The Web offers considerable potential for broad adoption but an iterative calibration approach focused on continued refinement is needed to ensure that estimates are generalizable across individuals, regions, seasons and countries.

Measurement of Physical Activity and Energy Expenditure in Wheelchair Users: Methods, Considerations and Future Directions.

PubMed

Nightingale, Tom E; Rouse, Peter C; Thompson, Dylan; Bilzon, James L J

2017-12-01

Accurately measuring physical activity and energy expenditure in persons with chronic physical disabilities who use wheelchairs is a considerable and ongoing challenge. Quantifying various free-living lifestyle behaviours in this group is at present restricted by our understanding of appropriate measurement tools and analytical techniques. This review provides a detailed evaluation of the currently available measurement tools used to predict physical activity and energy expenditure in persons who use wheelchairs. It also outlines numerous considerations specific to this population and suggests suitable future directions for the field. Of the existing three self-report methods utilised in this population, the 3-day Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) telephone interview demonstrates the best reliability and validity. However, the complexity of interview administration and potential for recall bias are notable limitations. Objective measurement tools, which overcome such considerations, have been validated using controlled laboratory protocols. These have consistently demonstrated the arm or wrist as the most suitable anatomical location to wear accelerometers. Yet, more complex data analysis methodologies may be necessary to further improve energy expenditure prediction for more intricate movements or behaviours. Multi-sensor devices that incorporate physiological signals and acceleration have recently been adapted for persons who use wheelchairs. Population specific algorithms offer considerable improvements in energy expenditure prediction accuracy. This review highlights the progress in the field and aims to encourage the wider scientific community to develop innovative solutions to accurately quantify physical activity in this population.

Oocyte cryopreservation beyond cancer: tools for ethical reflection.

PubMed

Linkeviciute, Alma; Peccatori, Fedro A; Sanchini, Virginia; Boniolo, Giovanni

2015-08-01

This article offers physicians a tool for structured ethical reflection on challenging situations surrounding oocyte cryopreservation in young healthy women. A systematic literature review offers a comprehensive overview of the ethical debate surrounding the practice. Ethical Counseling Methodology (ECM) offers a practical approach for addressing ethical uncertainties. ECM consists of seven steps: (i) case presentation; (ii) analysis of possible implications; (iii) presentation of ethical question(s); (iv) explanation of ethical terms; (v) presentation of the ethical arguments in favor of and against the procedure; (vi) examination of the individual patient's beliefs and wishes; and (vii) conclusive summary. The most problematic aspects in the ethical debate include the distinction between medical and non-medical use of oocyte cryopreservation, safety and efficiency of the procedure, and marketing practices aimed at healthy women. Female empowerment and enhanced reproductive choices (granted oocyte cryopreservation is a safe and efficient technique) are presented as ethical arguments supporting the practice, while ethical reservations towards oocyte cryopreservation are based on concerns about maternal and fetal safety and wider societal implications. Oocyte cryopreservation is gaining popularity among healthy reproductive age women. However, despite promised benefits it also involves risks that are not always properly communicated in commercialized settings. ECM offers clinicians a tool for structured ethical analysis taking into consideration a wide range of implications, various ethical standpoints, and patients' perceptions and beliefs.

7 CFR 1494.501 - Submission of offers to CCC.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Submission of offers to CCC. 1494.501 Section 1494... Program Operations § 1494.501 Submission of offers to CCC. (a) Consideration of offers. Unless otherwise specified in the Invitation, CCC will consider offers on a daily basis from the date of issuance of the...

7 CFR 1494.501 - Submission of offers to CCC.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 10 2012-01-01 2012-01-01 false Submission of offers to CCC. 1494.501 Section 1494....501 Submission of offers to CCC. (a) Consideration of offers. Unless otherwise specified in the Invitation, CCC will consider offers on a daily basis from the date of issuance of the Invitation until such...

7 CFR 1494.501 - Submission of offers to CCC.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 10 2013-01-01 2013-01-01 false Submission of offers to CCC. 1494.501 Section 1494....501 Submission of offers to CCC. (a) Consideration of offers. Unless otherwise specified in the Invitation, CCC will consider offers on a daily basis from the date of issuance of the Invitation until such...

7 CFR 1494.501 - Submission of offers to CCC.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 10 2014-01-01 2014-01-01 false Submission of offers to CCC. 1494.501 Section 1494....501 Submission of offers to CCC. (a) Consideration of offers. Unless otherwise specified in the Invitation, CCC will consider offers on a daily basis from the date of issuance of the Invitation until such...

7 CFR 1494.501 - Submission of offers to CCC.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Submission of offers to CCC. 1494.501 Section 1494... Program Operations § 1494.501 Submission of offers to CCC. (a) Consideration of offers. Unless otherwise specified in the Invitation, CCC will consider offers on a daily basis from the date of issuance of the...

LSPV+7, a branch-point-tolerant reconstructor for strong turbulence adaptive optics.

PubMed

Steinbock, Michael J; Hyde, Milo W; Schmidt, Jason D

2014-06-20

Optical wave propagation through long paths of extended turbulence presents unique challenges to adaptive optics (AO) systems. As scintillation and branch points develop in the beacon phase, challenges arise in accurately unwrapping the received wavefront and optimizing the reconstructed phase with respect to branch cut placement on a continuous facesheet deformable mirror. Several applications are currently restricted by these capability limits: laser communication, laser weapons, remote sensing, and ground-based astronomy. This paper presents a set of temporally evolving AO simulations comparing traditional least-squares reconstruction techniques to a complex-exponential reconstructor and several other reconstructors derived from the postprocessing congruence operation. The reconstructors' behavior in closed-loop operation is compared and discussed, providing several insights into the fundamental strengths and limitations of each reconstructor type. This research utilizes a self-referencing interferometer (SRI) as the high-order wavefront sensor, driving a traditional linear control law in conjunction with a cooperative point source beacon. The SRI model includes practical optical considerations and frame-by-frame fiber coupling effects to allow for realistic noise modeling. The "LSPV+7" reconstructor is shown to offer the best performance in terms of Strehl ratio and correction stability-outperforming the traditional least-squares reconstructed system by an average of 120% in the studied scenarios. Utilizing a continuous facesheet deformable mirror, these reconstructors offer significant AO performance improvements in strong turbulence applications without the need for segmented deformable mirrors.

Experiences of ethical issues when caring for children with cancer.

PubMed

Bartholdson, Cecilia; Lützén, Kim; Blomgren, Klas; Pergert, Pernilla

2015-01-01

The treatment for pediatric cancer is often physically, socially, and psychologically demanding and often gives rise to ethical issues. The purpose of this study was to describe healthcare professionals' experiences of ethical issues and ways to deal with these when caring for children with cancer. A study-specific questionnaire was given to healthcare professionals at a pediatric hospital in Sweden. Qualitative content analysis was used to analyze answers to open-ended questions. The data were sorted into 2 domains based on the objective of the study. In the next step, the data in each domain were inductively coded, generating categories and subcategories. The main ethical issues included concerns of (1) infringing on autonomy, (2) deciding on treatment levels, and (3) conflicting perspectives that constituted a challenge to collaboration. Professionals desired teamwork and reflection to deal with ethical concerns, and they needed resources for dealing with ethics. Interprofessional consideration needs to be improved. Forums and time for ethics reflections need to be offered to deal with ethical concerns in childhood cancer care. Experiences of ethical concerns and dealing with these in caring for children with cancer evoked strong feelings and moral perplexity among nursing staff. The study raises a challenging question: How can conflicting perspectives, lack of interprofessional consideration, and obstacles related to parents' involvement be "turned around," that is, contribute to a holistic perspective of ethics in cancer care of children?

Isotope effect of mercury diffusion in air

PubMed Central

Koster van Groos, Paul G.; Esser, Bradley K.; Williams, Ross W.; Hunt, James R.

2014-01-01

Identifying and reducing impacts from mercury sources in the environment remains a considerable challenge and requires process based models to quantify mercury stocks and flows. The stable isotope composition of mercury in environmental samples can help address this challenge by serving as a tracer of specific sources and processes. Mercury isotope variations are small and result only from isotope fractionation during transport, equilibrium, and transformation processes. Because these processes occur in both industrial and environmental settings, knowledge of their associated isotope effects is required to interpret mercury isotope data. To improve the mechanistic modeling of mercury isotope effects during gas phase diffusion, an experimental program tested the applicability of kinetic gas theory. Gas-phase elemental mercury diffusion through small bore needles from finite sources demonstrated mass dependent diffusivities leading to isotope fractionation described by a Rayleigh distillation model. The measured relative atomic diffusivities among mercury isotopes in air are large and in agreement with kinetic gas theory. Mercury diffusion in air offers a reasonable explanation of recent field results reported in the literature. PMID:24364380

Enhanced Requirements for Assessment in a Competency-Based, Time-Variable Medical Education System.

PubMed

Gruppen, Larry D; Ten Cate, Olle; Lingard, Lorelei A; Teunissen, Pim W; Kogan, Jennifer R

2018-03-01

Competency-based, time-variable medical education has reshaped the perceptions and practices of teachers, curriculum designers, faculty developers, clinician educators, and program administrators. This increasingly popular approach highlights the fact that learning among different individuals varies in duration, foundation, and goal. Time variability places particular demands on the assessment data that are so necessary for making decisions about learner progress. These decisions may be formative (e.g., feedback for improvement) or summative (e.g., decisions about advancing a student). This article identifies challenges to collecting assessment data and to making assessment decisions in a time-variable system. These challenges include managing assessment data, defining and making valid assessment decisions, innovating in assessment, and modeling the considerable complexity of assessment in real-world settings and richly interconnected social systems. There are hopeful signs of creativity in assessment both from researchers and practitioners, but the transition from a traditional to a competency-based medical education system will likely continue to create much controversy and offer opportunities for originality and innovation in assessment.

An Indoor Navigation System for the Visually Impaired

PubMed Central

Guerrero, Luis A.; Vasquez, Francisco; Ochoa, Sergio F.

2012-01-01

Navigation in indoor environments is highly challenging for the severely visually impaired, particularly in spaces visited for the first time. Several solutions have been proposed to deal with this challenge. Although some of them have shown to be useful in real scenarios, they involve an important deployment effort or use artifacts that are not natural for blind users. This paper presents an indoor navigation system that was designed taking into consideration usability as the quality requirement to be maximized. This solution enables one to identify the position of a person and calculates the velocity and direction of his movements. Using this information, the system determines the user's trajectory, locates possible obstacles in that route, and offers navigation information to the user. The solution has been evaluated using two experimental scenarios. Although the results are still not enough to provide strong conclusions, they indicate that the system is suitable to guide visually impaired people through an unknown built environment. PMID:22969398

Smart Polymeric Hydrogels for Cartilage Tissue Engineering: A Review on the Chemistry and Biological Functions.

PubMed

Eslahi, Niloofar; Abdorahim, Marjan; Simchi, Abdolreza

2016-11-14

Stimuli responsive hydrogels (SRHs) are attractive bioscaffolds for tissue engineering. The structural similarity of SRHs to the extracellular matrix (ECM) of many tissues offers great advantages for a minimally invasive tissue repair. Among various potential applications of SRHs, cartilage regeneration has attracted significant attention. The repair of cartilage damage is challenging in orthopedics owing to its low repair capacity. Recent advances include development of injectable hydrogels to minimize invasive surgery with nanostructured features and rapid stimuli-responsive characteristics. Nanostructured SRHs with more structural similarity to natural ECM up-regulate cell-material interactions for faster tissue repair and more controlled stimuli-response to environmental changes. This review highlights most recent advances in the development of nanostructured or smart hydrogels for cartilage tissue engineering. Different types of stimuli-responsive hydrogels are introduced and their fabrication processes through physicochemical procedures are reported. The applications and characteristics of natural and synthetic polymers used in SRHs are also reviewed with an outline on clinical considerations and challenges.

BOLD magnetic resonance imaging in nephrology

PubMed Central

Hall, Michael E; Jordan, Jennifer H; Juncos, Luis A; Hundley, W Gregory; Hall, John E

2018-01-01

Magnetic resonance (MR) imaging, a non-invasive modality that provides anatomic and physiologic information, is increasingly used for diagnosis of pathophysiologic conditions and for understanding renal physiology in humans. Although functional MR imaging methods were pioneered to investigate the brain, they also offer powerful techniques for investigation of other organ systems such as the kidneys. However, imaging the kidneys provides unique challenges due to potential complications from contrast agents. Therefore, development of non-contrast techniques to study kidney anatomy and physiology is important. Blood oxygen level-dependent (BOLD) MR is a non-contrast imaging technique that provides functional information related to renal tissue oxygenation in various pathophysiologic conditions. Here we discuss technical considerations, clinical uses and future directions for use of BOLD MR as well as complementary MR techniques to better understand renal pathophysiology. Our intent is to summarize kidney BOLD MR applications for the clinician rather than focusing on the complex physical challenges that functional MR imaging encompasses; however, we briefly discuss some of those issues. PMID:29559807

Family-centered care to promote successful community reintegration after war: it takes a nation.

PubMed

Glynn, Shirley M

2013-12-01

The papers in this section focus on public health responses and implementation considerations in addressing the challenges military families confront when parents go to war. While many military families show resilience, the challenges resulting from a decade of war with multiple deployments are detailed, as are innovative military and civilian programs designed to help service members and their families reintegrate successfully into the community. As more and more service members leave active duty, the burden of meeting military families' psychological needs will transition from the Department of Defense (DoD) and into the Veterans Administration (VA) and civilian arenas. While many strategies to support successful readjustment are offered, in this time of dwindling mental health resources and competing needs, it is unclear what priority the broader society places on meeting the needs of returning service members and their families. A growing emphasis on family-centered care in the Veterans Administration may help meet this gap.

From Cleanroom to Desktop: Emerging Micro-Nanofabrication Technology for Biomedical Applications

PubMed Central

Wang, Wei

2010-01-01

This review is motivated by the growing demand for low-cost, easy-to-use, compact-size yet powerful micro-nanofabrication technology to address emerging challenges of fundamental biology and translational medicine in regular laboratory settings. Recent advancements in the field benefit considerably from rapidly expanding material selections, ranging from inorganics to organics and from nanoparticles to self-assembled molecules. Meanwhile a great number of novel methodologies, employing off-the-shelf consumer electronics, intriguing interfacial phenomena, bottom-up self-assembly principles, etc., have been implemented to transit micro-nanofabrication from a cleanroom environment to a desktop setup. Furthermore, the latest application of micro-nanofabrication to emerging biomedical research will be presented in detail, which includes point-of-care diagnostics, on-chip cell culture as well as bio-manipulation. While significant progresses have been made in the rapidly growing field, both apparent and unrevealed roadblocks will need to be addressed in the future. We conclude this review by offering our perspectives on the current technical challenges and future research opportunities. PMID:21161384

Isotope effect of mercury diffusion in air.

PubMed

Koster van Groos, Paul G; Esser, Bradley K; Williams, Ross W; Hunt, James R

2014-01-01

Identifying and reducing impacts from mercury sources in the environment remains a considerable challenge and requires process based models to quantify mercury stocks and flows. The stable isotope composition of mercury in environmental samples can help address this challenge by serving as a tracer of specific sources and processes. Mercury isotope variations are small and result only from isotope fractionation during transport, equilibrium, and transformation processes. Because these processes occur in both industrial and environmental settings, knowledge of their associated isotope effects is required to interpret mercury isotope data. To improve the mechanistic modeling of mercury isotope effects during gas phase diffusion, an experimental program tested the applicability of kinetic gas theory. Gas-phase elemental mercury diffusion through small bore needles from finite sources demonstrated mass dependent diffusivities leading to isotope fractionation described by a Rayleigh distillation model. The measured relative atomic diffusivities among mercury isotopes in air are large and in agreement with kinetic gas theory. Mercury diffusion in air offers a reasonable explanation of recent field results reported in the literature.

Advanced Engineering Environments: Implications for Aerospace Manufacturing

NASA Technical Reports Server (NTRS)

Thomas, D.

2001-01-01

There are significant challenges facing today's aerospace industry. Global competition, more complex products, geographically-distributed design teams, demands for lower cost, higher reliability and safer vehicles, and the need to incorporate the latest technologies quicker all face the developer of aerospace systems. New information technologies offer promising opportunities to develop advanced engineering environments (AEEs) to meet these challenges. Significant advances in the state-of-the-art of aerospace engineering practice are envisioned in the areas of engineering design and analytical tools, cost and risk tools, collaborative engineering, and high-fidelity simulations early in the development cycle. These advances will enable modeling and simulation of manufacturing methods, which will in turn allow manufacturing considerations to be included much earlier in the system development cycle. Significant cost savings, increased quality, and decreased manufacturing cycle time are expected to result. This paper will give an overview of the NASA's Intelligent Synthesis Environment, the agency initiative to develop an AEE, with a focus on the anticipated benefits in aerospace manufacturing.

From cleanroom to desktop: emerging micro-nanofabrication technology for biomedical applications.

PubMed

Pan, Tingrui; Wang, Wei

2011-02-01

This review is motivated by the growing demand for low-cost, easy-to-use, compact-size yet powerful micro-nanofabrication technology to address emerging challenges of fundamental biology and translational medicine in regular laboratory settings. Recent advancements in the field benefit considerably from rapidly expanding material selections, ranging from inorganics to organics and from nanoparticles to self-assembled molecules. Meanwhile a great number of novel methodologies, employing off-the-shelf consumer electronics, intriguing interfacial phenomena, bottom-up self-assembly principles, etc., have been implemented to transit micro-nanofabrication from a cleanroom environment to a desktop setup. Furthermore, the latest application of micro-nanofabrication to emerging biomedical research will be presented in detail, which includes point-of-care diagnostics, on-chip cell culture as well as bio-manipulation. While significant progresses have been made in the rapidly growing field, both apparent and unrevealed roadblocks will need to be addressed in the future. We conclude this review by offering our perspectives on the current technical challenges and future research opportunities.

Disaster risk reduction and 'built-in' resilience: towards overarching principles for construction practice.

PubMed

Bosher, Lee; Dainty, Andrew

2011-01-01

The emerging emphasis on disaster risk reduction has broadened the range of experts whose knowledge must be garnered to resolve complex socio-technical challenges. This paper examines the role and position of the construction sector for addressing these concerns. Specifically, it examines the recursive nature of practices within the built environment, which can be seen as deeply ingraining fragmented approaches to the development process. These, in turn, render the industry a difficult arena within which to enact structural and cultural change. Based on a wide body of literature on resiliency a set of overarching principles are proffered to help inform efforts to overcome some of the barriers to creating a more resilient built environment. It is argued that these principles offer a point of departure for embedding resilience considerations at both project and institutional levels, although real change would demand challenging some of the conventions that currently underpin construction development. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Abnormal emotion processing, but intact fairness and intentionality considerations during social decision-making in schizophrenia

PubMed Central

de la Asuncion, Javier; Docx, Lise; Sabbe, Bernard; Morrens, Manuel; de Bruijn, Ellen R. A.

2015-01-01

Schizophrenia is a severe mental disorder that is highly characterized by social cognitive impairments. Most studies investigating these impairments focus on one specific social domain such as emotion recognition. However, in daily life, processing complex social situations relies on the combination of several social cognitive and affective processes simultaneously rather than one process alone. A modified version of the economically based Ultimatum Game was used to measure the interplay between fairness, intentionality, and emotion considerations during social decision-making. In this task, participants accept or reject fair and unfair monetary offers proposed intentionally or unintentionally by either angry, happy, neutral, or sad proposers. Behavioral data was collected from a group of schizophrenia patients (N = 35) and a group of healthy individuals (N = 30). Like healthy participants, schizophrenia patients differentiated between fair and unfair offers by rejecting unfair offers more compared to fair offers. However, overall patients did reject more fair offers, indicating that their construct of fairness operates within different margins. In both groups, intentional unfair offers were rejected more compared to unintentional ones, indicating a normal integration of intentionality considerations in schizophrenia. Importantly, healthy subjects also differentiated between proposers’ emotion when rejecting unfair offers (more rejections from proposers depicting angry faces compared to proposers depicting, happy, neutral, or sad faces). Schizophrenia patients’ decision behavior on the other hand, was not affected by the proposers’ emotions. The current study thus shows that schizophrenia patients have specific problems with processing and integrating emotional information. Importantly, the finding that patients display normal fairness and intentionality considerations emphasizes preservation of central social cognitive processes in schizophrenia. PMID:26257699

Next-generation sequencing for endocrine cancers: Recent advances and challenges.

PubMed

Suresh, Padmanaban S; Venkatesh, Thejaswini; Tsutsumi, Rie; Shetty, Abhishek

2017-05-01

Contemporary molecular biology research tools have enriched numerous areas of biomedical research that address challenging diseases, including endocrine cancers (pituitary, thyroid, parathyroid, adrenal, testicular, ovarian, and neuroendocrine cancers). These tools have placed several intriguing clues before the scientific community. Endocrine cancers pose a major challenge in health care and research despite considerable attempts by researchers to understand their etiology. Microarray analyses have provided gene signatures from many cells, tissues, and organs that can differentiate healthy states from diseased ones, and even show patterns that correlate with stages of a disease. Microarray data can also elucidate the responses of endocrine tumors to therapeutic treatments. The rapid progress in next-generation sequencing methods has overcome many of the initial challenges of these technologies, and their advantages over microarray techniques have enabled them to emerge as valuable aids for clinical research applications (prognosis, identification of drug targets, etc.). A comprehensive review describing the recent advances in next-generation sequencing methods and their application in the evaluation of endocrine and endocrine-related cancers is lacking. The main purpose of this review is to illustrate the concepts that collectively constitute our current view of the possibilities offered by next-generation sequencing technological platforms, challenges to relevant applications, and perspectives on the future of clinical genetic testing of patients with endocrine tumors. We focus on recent discoveries in the use of next-generation sequencing methods for clinical diagnosis of endocrine tumors in patients and conclude with a discussion on persisting challenges and future objectives.

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.

Massive Open Online Courses in Public Health

PubMed Central

Gooding, Ira; Klaas, Brian; Yager, James D.; Kanchanaraksa, Sukon

2013-01-01

Massive open online courses (MOOCs) represent a new and potentially transformative model for providing educational opportunities to learners not enrolled in a formal educational program. The authors describe the experience of developing and offering eight MOOCs on a variety of public health topics. Existing institutional infrastructure and experience with both for-credit online education and open educational resources mitigated the institutional risk and resource requirements. Although learners are able to enroll easily and freely and do so in large numbers, there is considerable variety in the level of participation and engagement among enrollees. As a result, comprehensive and accurate assessment of meaningful learning progress remains a major challenge for evaluating the effectiveness of MOOCs for providing public health education. PMID:24350228

Perspectives on clinical trial data transparency and disclosure.

PubMed

Alemayehu, Demissie; Anziano, Richard J; Levenstein, Marcia

2014-09-01

The increased demand for transparency and disclosure of data from clinical trials sponsored by pharmaceutical companies poses considerable challenges and opportunities from a statistical perspective. A central issue is the need to protect patient privacy and adhere to Good Clinical and Statistical Practices, while ensuring access to patient-level data from clinical trials to the wider research community. This paper offers options to navigate this dilemma and balance competing priorities, with emphasis on the role of good clinical and statistical practices as proven safeguards for scientific integrity, the importance of adopting best practices for reporting of data from secondary analyses, and the need for optimal collaboration among stakeholders to facilitate data sharing. Copyright © 2014 Elsevier Inc. All rights reserved.

Internet pharmacy: issues of access, quality, costs, and regulation.

PubMed

Crawford, Stephanie Y

2003-02-01

Internet pharmacy has been the focus of heightened interest over the past 3 years since the first major Web site was introduced in the United States. This paper addresses issues pertaining to Internet pharmacies that sell prescriptions and other products to consumers at the retail level. The Internet pharmacy industry has shifted rapidly in the short time span. This paper begins with a summary of historical considerations and the shifting organization of Internet pharmacy. The advantages and disadvantages of online pharmacy practice are listed. Issues of access, quality, and cost are described. The challenges in regulation at the state and federal levels are presented. Advice to consumers is offered regarding the use of Internet pharmacy sites for purchasing prescription drug products.

Illustrative case studies in the return of exome and genome sequencing results

PubMed Central

Amendola, Laura M; Lautenbach, Denise; Scollon, Sarah; Bernhardt, Barbara; Biswas, Sawona; East, Kelly; Everett, Jessica; Gilmore, Marian J; Himes, Patricia; Raymond, Victoria M; Wynn, Julia; Hart, Ragan; Jarvik, Gail P

2015-01-01

Whole genome and exome sequencing tests are increasingly being ordered in clinical practice, creating a need for research exploring the return of results from these tests. A goal of the Clinical Sequencing and Exploratory Research (CSER) consortium is to gain experience with this process to develop best practice recommendations for offering exome and genome testing and returning results. Genetic counselors in the CSER consortium have an integral role in the return of results from these genomic sequencing tests and have gained valuable insight. We present seven emerging themes related to return of exome and genome sequencing results accompanied by case descriptions illustrating important lessons learned, counseling challenges specific to these tests and considerations for future research and practice. PMID:26478737

Laser Resurfacing Pearls

PubMed Central

Shah, Sonia; Alam, Murad

2012-01-01

Ablative skin resurfacing using the carbon dioxide laser was long considered the gold standard for treatment of photoaging, acne scars, and rhytids. However, conventional full-face carbon dioxide resurfacing is associated with significant risk of side effects and a prolonged postoperative recovery period. Fractional resurfacing has recently revolutionized laser surgery by offering close to comparable results with minimal side effects and a more rapid recovery. Although fractional devices have grown in popularity, and have essentially replaced traditional resurfacing, fractional resurfacing can still be a challenging modality to control precisely due to hardware variations across comparable devices, the range of settings that can be used, and patient-specific considerations. Certain precautions and rules of thumb can reduce the risk associated with fractional resurfacing, and increase the likelihood of a good outcome. PMID:23904821

Laser resurfacing pearls.

PubMed

Shah, Sonia; Alam, Murad

2012-08-01

Ablative skin resurfacing using the carbon dioxide laser was long considered the gold standard for treatment of photoaging, acne scars, and rhytids. However, conventional full-face carbon dioxide resurfacing is associated with significant risk of side effects and a prolonged postoperative recovery period. Fractional resurfacing has recently revolutionized laser surgery by offering close to comparable results with minimal side effects and a more rapid recovery. Although fractional devices have grown in popularity, and have essentially replaced traditional resurfacing, fractional resurfacing can still be a challenging modality to control precisely due to hardware variations across comparable devices, the range of settings that can be used, and patient-specific considerations. Certain precautions and rules of thumb can reduce the risk associated with fractional resurfacing, and increase the likelihood of a good outcome.

Programming languages and compiler design for realistic quantum hardware.

PubMed

Chong, Frederic T; Franklin, Diana; Martonosi, Margaret

2017-09-13

Quantum computing sits at an important inflection point. For years, high-level algorithms for quantum computers have shown considerable promise, and recent advances in quantum device fabrication offer hope of utility. A gap still exists, however, between the hardware size and reliability requirements of quantum computing algorithms and the physical machines foreseen within the next ten years. To bridge this gap, quantum computers require appropriate software to translate and optimize applications (toolflows) and abstraction layers. Given the stringent resource constraints in quantum computing, information passed between layers of software and implementations will differ markedly from in classical computing. Quantum toolflows must expose more physical details between layers, so the challenge is to find abstractions that expose key details while hiding enough complexity.

Searching for the elusive gift: advances in talent identification in sport.

PubMed

Mann, David L; Dehghansai, Nima; Baker, Joseph

2017-08-01

The incentives for sport organizations to identify talented athletes from a young age continue to grow, yet effective talent identification remains a challenging task. This opinion paper examines recent advances in talent identification, focusing in particular on the emergence of new approaches that may offer promise to identify talent (e.g., small-sided games, genetic testing, and advanced statistical analyses). We appraise new multi-disciplinary and large-scale population studies of talent identification, provide a consideration of the most recent psychological predictors of performance, examine the emergence of new approaches that strive to diminish biases in talent identification, and look at the rise in interest in talent identification in Paralympic sport. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

"Less than a Vapor": Positioning Black lesbian women in history teacher education.

PubMed

Woodson, Ashley N

2017-10-02

In this article, I discuss the possibilities and implications of centering Black lesbian identities and relationships in history teacher education through a case study with one straight Black woman preservice history teacher named Danitra. Danitra's understanding and navigation of historical research on Black lesbians are discussed in relation to core themes of lesbian historiography and emancipatory historiography. Though the literature on this group is limited, I argue that critical considerations of Black lesbians' interests and experiences help educators to conceive of and teach about history, citizenship, justice, and sexuality in more liberatory ways. I conclude by offering recommendations to history teachers and teacher educators who hope to draw on lesbian and emancipatory historiographies to challenge discourses of invisibility in history teacher education classrooms.

Electrocatalysts by atomic layer deposition for fuel cell applications

DOE PAGES

Cheng, Niancai; Shao, Yuyan; Liu, Jun; ...

2016-01-22

Here, fuel cells are a promising technology solution for reliable and clean energy because they offer high energy conversion efficiency and low emission of pollutants. However, high cost and insufficient durability are considerable challenges for widespread adoption of polymer electrolyte membrane fuel cells (PEMFCs) in practical applications. Current PEMFCs catalysts have been identified as major contributors to both the high cost and limited durability. Atomic layer deposition (ALD) is emerging as a powerful technique for solving these problems due to its exclusive advantages over other methods. In this review, we summarize recent developments of ALD in PEMFCs with a focusmore » on design of materials for improved catalyst activity and durability. New research directions and future trends have also been discussed.« less

Programming languages and compiler design for realistic quantum hardware

NASA Astrophysics Data System (ADS)

Chong, Frederic T.; Franklin, Diana; Martonosi, Margaret

2017-09-01

Quantum computing sits at an important inflection point. For years, high-level algorithms for quantum computers have shown considerable promise, and recent advances in quantum device fabrication offer hope of utility. A gap still exists, however, between the hardware size and reliability requirements of quantum computing algorithms and the physical machines foreseen within the next ten years. To bridge this gap, quantum computers require appropriate software to translate and optimize applications (toolflows) and abstraction layers. Given the stringent resource constraints in quantum computing, information passed between layers of software and implementations will differ markedly from in classical computing. Quantum toolflows must expose more physical details between layers, so the challenge is to find abstractions that expose key details while hiding enough complexity.

Potential of plant proteins for medical applications.

PubMed

Reddy, Narendra; Yang, Yiqi

2011-10-01

Various natural and synthetic polymers are being explored to develop biomaterials for tissue engineering and drug delivery. Although proteins are preferable over carbohydrates and synthetic polymers, biomaterials developed from proteins lack the mechanical properties and/or biocompatibilities required for medical applications. Plant proteins are widely available, have low potential to be immunogenic and can be made into fibers, films, hydrogels and micro- and nano-particles for medical applications. Studies, mostly with zein, have demonstrated the potential of using plant proteins for tissue engineering and drug delivery. Although other plant proteins such as wheat gluten and soyproteins have also shown biocompatibility using in vitro studies, fabricating biomaterials such as nano-fibers and nano-particles from soy and wheat proteins offers considerable challenges. Copyright © 2011. Published by Elsevier Ltd.

Marketing Digital Offerings Is Different: Strategies for Teaching about Digital Offerings in the Marketing Classroom

ERIC Educational Resources Information Center

Roberts, Scott D.; Micken, Kathleen S.

2015-01-01

Digital offerings represent different challenges for marketers than do traditional goods and services. After reviewing the literature, the authors suggest ways that the marketing of digital goods and services might be better presented to and better understood by students. The well-known four challenges of services marketing model (e.g.,…

Challenge Activities for the Physical Education Classroom: Considerations

ERIC Educational Resources Information Center

McKenzie, Emily; Tapps, Tyler; Fink, Kevin; Symonds, Matthew L.

2018-01-01

The purpose of this article is to provide physical education teachers with the tools to develop and implement challenge course-like activities in their physical education classes. The article also covers environmental considerations for teachers who have the desire to create a challenge-based classroom setting in order to reach a wider and more…

Increasing persistency in lay and stabilising egg quality in longer laying cycles. What are the challenges?

PubMed Central

Bain, M. M.; Nys, Y.; Dunn, I.C.

2016-01-01

Abstract In the past 50 years, selection starting initially at the breed level and then using quantitative genetics coupled with a sophisticated breeding pyramid, has resulted in a very productive hybrid for a variety of traits associated with egg production.One major trait currently being developed further is persistency of lay and the concept of the “long life” layer. Persistency in lay however cannot be achieved without due consideration of how to sustain egg quality and the health and welfare of the birds in longer laying cycles. These multiple goals require knowledge and consideration of the bird’s physiology, nutritional requirements, which vary depending on age and management system, reproductive status and choice of the selection criteria applied.The recent advent of molecular genetics offers considerable hope that these multiple elements can be balanced for the good of all in the industry including the hens.The “long life” layer, which will be capable of producing 500 eggs in a laying cycle of 100 weeks, is therefore on the horizon, bringing with it the benefits of a more efficient utilisation of diminishing resources, including land, water, raw materials for feed as well as a reduction in waste, and an overall reduced carbon footprint. PMID:26982003

Increasing persistency in lay and stabilising egg quality in longer laying cycles. What are the challenges?

PubMed

Bain, M M; Nys, Y; Dunn, I C

2016-06-01

In the past 50 years, selection starting initially at the breed level and then using quantitative genetics coupled with a sophisticated breeding pyramid, has resulted in a very productive hybrid for a variety of traits associated with egg production. One major trait currently being developed further is persistency of lay and the concept of the "long life" layer. Persistency in lay however cannot be achieved without due consideration of how to sustain egg quality and the health and welfare of the birds in longer laying cycles. These multiple goals require knowledge and consideration of the bird's physiology, nutritional requirements, which vary depending on age and management system, reproductive status and choice of the selection criteria applied. The recent advent of molecular genetics offers considerable hope that these multiple elements can be balanced for the good of all in the industry including the hens. The "long life" layer, which will be capable of producing 500 eggs in a laying cycle of 100 weeks, is therefore on the horizon, bringing with it the benefits of a more efficient utilisation of diminishing resources, including land, water, raw materials for feed as well as a reduction in waste, and an overall reduced carbon footprint.

Forensic Evaluation of Deaf Individuals: Challenges and Strategies.

PubMed

Pollard, Robert Q; Berlinski, Brian T

2017-01-01

Forensic evaluation of deaf individuals presents unique challenges due to many examinees' fund of information deficits, potential for language deprivation, and examiners' frequent lack of creativity regarding communication methods. This article describes challenges most frequently encountered in competency to stand trial and criminal responsibility evaluations and offers strategies for overcoming them. The value of employing multiple communication methods, especially the use of illustrations, is emphasized. Suggestions also are offered regarding preparing evaluation reports and effectively communicating "key deaf fundamentals" to legal personnel. Encouragement is offered for qualified, sign-fluent professionals to engage in forensic work.

Production Design: Holding It Together.

ERIC Educational Resources Information Center

Connelly, James O.

1994-01-01

Discusses production design for videos. Outlines general considerations (opening, transitions, content areas, and closing) and specific considerations (typography, screen design, music, and sound effects). Offers an example. (SR)

Current HDTV overview in the United States, Japan, and Europe

NASA Astrophysics Data System (ADS)

Cripps, Dale E.

1991-08-01

Vast resources are being spent on three continents, preparing for the commercialization of HDTV. The forces that together will launch this new industry are moving at dizzying speeds. This paper covers the highlights of events past and present and offers some predictions for the future. Difficult standards problems that keep brakes on the industry, and that will continue for some time to come. Standards committees have been set up around the world and are hard at work. It is a job with considerable technical and political challenges. By the time major plans and resources come together for commercialization of HDTV, one can trust that there will be adequately stable standards. But to observe the current status is to see a mess. High definition is not only consumer television. Because of its versatility, it is much more likely to find its way first into areas offering high returns such as medicine, education, printing, corporate communications, military and space, and even criminal control. HDTV is very likely to deliver movies and cultural events to theaters, and may also become the platform for a new generation of computers.

An investor perspective on forming and funding your medical device start-up.

PubMed

Mas, Juan-Pablo; Hsueh, Brian

2017-06-01

Novel and transformative medical technologies of all forms have the potential to make a significant positive impact on the lives of patients and on the health care system, and one common pathway for guiding such innovations from concept through commercialization is via the formation of a company. For entrepreneurs looking to build a medical technology company, several common challenges await, including questions around how and where to raise funding. Here, we review key considerations for the formation of medical technology companies as viewed through the lens of an investor. We survey common sources of capital for early-stage companies, including grants, angel investors, and venture capital, and offer insights into how to differentiate among them to select the best partners for your start-up׳s needs. Finally, we discuss the critical components of pitching your ideas to potential investors, and offer guidance on best practices and common mistakes. We hope this primer on fundamental concepts and the various health care funding alternatives will prepare entrepreneurs to achieve their mission to improve patients׳ lives through commercialization of their medical innovations. Copyright © 2017 Elsevier Inc. All rights reserved.

Utility of simultaneous interventional radiology and operative surgery in a dedicated suite for seriously injured patients.

PubMed

D'Amours, Scott K; Rastogi, Pratik; Ball, Chad G

2013-12-01

In recent years, combined interventional radiology and operative suites have been proposed and are now becoming operational in select trauma centres. Given the infancy of this technology, this review aims to review the rationale, benefits and challenges of hybrid suites in the management of seriously injured patients. No specific studies exist that investigate outcomes within hybrid trauma suites. Endovascular and interventional radiology techniques have been successfully employed in thoracic, abdominal, pelvic and extremity trauma. Although the association between delayed haemorrhage control and poorer patient outcomes is intuitive, most supporting scientific data are outdated. The hybrid suite model offers the potential to expedite haemorrhage control through synergistic operative, interventional radiology and resuscitative platforms. Maximizing the utility of these suites requires trained multidisciplinary teams, ergonomic and workplace considerations, as well as a fundamental paradigm shift of trauma care. This often translates into a more damage-control orientated philosophy. Hybrid suites offer tremendous potential to expedite haemorrhage control in trauma patients. Outcome evaluations from trauma units that currently have operational hybrid suites are required to establish clearer guidelines and criteria for patient management.

Type 1 Diabetes in Young Adulthood

PubMed Central

Monaghan, Maureen; Helgeson, Vicki; Wiebe, Deborah

2015-01-01

Type 1 diabetes has traditionally been studied as a chronic illness of childhood. However, young adulthood is a critical time for the development and integration of lifelong diabetes management skills, and research is starting to identify unique challenges faced by youth with diabetes as they age into adulthood. Most young adults experience multiple transitions during this unstable developmental period, including changes in lifestyle (e.g., education, occupation, living situation), changes in health care, and shifting relationships with family members, friends, and intimate others. Young adults with type 1 diabetes must navigate these transitions while also assuming increasing responsibility for their diabetes care and overall health. Despite these critical health and psychosocial concerns, there is a notable lack of evidence-based clinical services and supports for young adults with type 1 diabetes. We review relevant evolving concerns for young adults with type 1 diabetes, including lifestyle considerations, health care transitions, psychosocial needs, and changes in supportive networks, and how type 1 diabetes impacts and is impacted by these key developmental considerations. Specific avenues for intervention and future research are offered. PMID:25901502

50 Years of Educational Progress and Challenge in Ghana. Research Monograph No. 33

ERIC Educational Resources Information Center

Akyeampong, Kwame

2010-01-01

In 2007 Ghana celebrated 50 years of independence from British colonial rule. The golden jubilee offered an opportunity to take stock of how the country had progressed in expanding education and the challenges for the future. This paper offers a critique of the journey, highlighting the challenges and progress. What reforms in education has taught…

The Effect of Enrollment in Middle School Challenge Courses on Advanced Placement Exams in Social Studies and Science

ERIC Educational Resources Information Center

Glaude-Bolte, Katherine

2010-01-01

Educators seek to guide students through appropriate programs and courses that prepare them for future success, in more advanced coursework and in other challenges of life. Some middle schools offer Challenge, or honors, courses for students who have demonstrated high ability. High schools often offer Advanced Placement (AP) courses, which are…

High-κ gate dielectrics: Current status and materials properties considerations

NASA Astrophysics Data System (ADS)

Wilk, G. D.; Wallace, R. M.; Anthony, J. M.

2001-05-01

Many materials systems are currently under consideration as potential replacements for SiO2 as the gate dielectric material for sub-0.1 μm complementary metal-oxide-semiconductor (CMOS) technology. A systematic consideration of the required properties of gate dielectrics indicates that the key guidelines for selecting an alternative gate dielectric are (a) permittivity, band gap, and band alignment to silicon, (b) thermodynamic stability, (c) film morphology, (d) interface quality, (e) compatibility with the current or expected materials to be used in processing for CMOS devices, (f) process compatibility, and (g) reliability. Many dielectrics appear favorable in some of these areas, but very few materials are promising with respect to all of these guidelines. A review of current work and literature in the area of alternate gate dielectrics is given. Based on reported results and fundamental considerations, the pseudobinary materials systems offer large flexibility and show the most promise toward successful integration into the expected processing conditions for future CMOS technologies, especially due to their tendency to form at interfaces with Si (e.g. silicates). These pseudobinary systems also thereby enable the use of other high-κ materials by serving as an interfacial high-κ layer. While work is ongoing, much research is still required, as it is clear that any material which is to replace SiO2 as the gate dielectric faces a formidable challenge. The requirements for process integration compatibility are remarkably demanding, and any serious candidates will emerge only through continued, intensive investigation.

Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps.

PubMed

O'Brien, Kelly K; Colquhoun, Heather; Levac, Danielle; Baxter, Larry; Tricco, Andrea C; Straus, Sharon; Wickerson, Lisa; Nayar, Ayesha; Moher, David; O'Malley, Lisa

2016-07-26

Scoping studies (or reviews) are a method used to comprehensively map evidence across a range of study designs in an area, with the aim of informing future research practice, programs and policy. However, no universal agreement exists on terminology, definition or methodological steps. Our aim was to understand the experiences of, and considerations for conducting scoping studies from the perspective of academic and community partners. Primary objectives were to 1) describe experiences conducting scoping studies including strengths and challenges; and 2) describe perspectives on terminology, definition, and methodological steps. We conducted a cross-sectional web-based survey with clinicians, educators, researchers, knowledge users, representatives from community-based organizations, graduate students, and policy stakeholders with experience and/or interest in conducting scoping studies to gain an understanding of experiences and perspectives on the conduct and reporting of scoping studies. We administered an electronic self-reported questionnaire comprised of 22 items related to experiences with scoping studies, strengths and challenges, opinions on terminology, and methodological steps. We analyzed questionnaire data using descriptive statistics and content analytical techniques. Survey results were discussed during a multi-stakeholder consultation to identify key considerations in the conduct and reporting of scoping studies. Of the 83 invitations, 54 individuals (65 %) completed the scoping questionnaire, and 48 (58 %) attended the scoping study meeting from Canada, the United Kingdom and United States. Many scoping study strengths were dually identified as challenges including breadth of scope, and iterative process. No consensus on terminology emerged, however key defining features that comprised a working definition of scoping studies included the exploratory mapping of literature in a field; iterative process, inclusion of grey literature; no quality assessment of included studies, and an optional consultation phase. We offer considerations for the conduct and reporting of scoping studies for researchers, clinicians and knowledge users engaging in this methodology. Lack of consensus on scoping terminology, definition and methodological steps persists. Reasons for this may be attributed to diversity of disciplines adopting this methodology for differing purposes. Further work is needed to establish guidelines on the reporting and methodological quality assessment of scoping studies.

15 CFR 1160.24 - Antitrust considerations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Partnership Initiative § 1160.24 Antitrust considerations. (a) The Department of Commerce will offer no... Strategic Partnership Initiative is to make the private sector aware of this vehicle and, where requested...

Cleaner cooking solutions to achieve health, climate, and economic cobenefits.

PubMed

Anenberg, Susan C; Balakrishnan, Kalpana; Jetter, James; Masera, Omar; Mehta, Sumi; Moss, Jacob; Ramanathan, Veerabhadran

2013-05-07

Nearly half the world's population must rely on solid fuels such as biomass (wood, charcoal, agricultural residues, and animal dung) and coal for household energy, burning them in inefficient open fires and stoves with inadequate ventilation. Household solid fuel combustion is associated with four million premature deaths annually; contributes to forest degradation, loss of habitat and biodiversity, and climate change; and hinders social and economic progress as women and children spend hours every day collecting fuel. Several recent studies, as well as key emerging national and international efforts, are making progress toward enabling wide-scale household adoption of cleaner and more efficient stoves and fuels. While significant challenges remain, these efforts offer considerable promise to save lives, improve forest sustainability, slow climate change, and empower women around the world.

HIV-1 treatment as prevention: the good, the bad, and the challenges.

PubMed

Smith, Kumi; Powers, Kimberly A; Kashuba, Angela D M; Cohen, Myron S

2011-07-01

This work focuses on the use of antiretroviral agents to prevent the sexual transmission of HIV-1. Two randomized clinical trials demonstrated that antiretroviral agents provided before exposure to HIV-1 offer substantial protection, ostensibly directly proportional to the concentration of antiretroviral therapy (ART) in the genital secretions. Intense focus on the use of HIV treatment as prevention has led to publication of modeling exercises, ecological studies, and observational studies, most of which support the potential benefits of ART. However, the logistical requirements for successful use of ART for prevention are considerable. ART will serve as a cornerstone of combination prevention of HIV-1. Continued research will be essential to measure anticipated benefits and to detect implementation barriers and untoward consequences of such a program, especially increases in primary ART resistance.

Expert Opinion and Recommendations for the Management of Attention-Deficit/Hyperactivity Disorder in Correctional Facilities.

PubMed

Scott, Duncan A; Gignac, Martin; Kronfli, Risk N; Ocana, Anthony; Lorberg, Gunter W

2016-01-01

There has been considerably less research on the management of adult attention-deficit/hyperactivity disorder (ADHD) among the inmates of correctional facilities than in the general community. While the successful identification and management of ADHD in the adult correctional setting offer potential benefits to the individuals themselves, to institutional staff, and to wider society, their implementation represents significant challenges. These include high prevalence rates, the low level of ADHD recognition, the high incidence of comorbid psychiatric disorders, and the high risk of abuse and diversion of prescribed medications. Here, the authors provide an overview of current recommendations for the identification and management of adults with ADHD in correctional settings and discuss possible strategies for their further development. © The Author(s) 2015.

Teaching and Learning with Hypervideo in Vocational Education and Training

ERIC Educational Resources Information Center

Cattaneo, Alberto A. P.; Nguyen, Anh Thu; Aprea, Carmela

2016-01-01

Audiovisuals offer increasing opportunities as teaching-and-learning materials while also confronting educators with significant challenges. Hypervideo provides one means of overcoming these challenges, offering new possibilities for interaction and support for reflective processes. However, few studies have investigated the instructional…

Navigating the challenges of digital health innovation: considerations and solutions in developing online and smartphone-application-based interventions for mental health disorders.

PubMed

Hill, Claire; Martin, Jennifer L; Thomson, Simon; Scott-Ram, Nick; Penfold, Hugh; Creswell, Cathy

2017-08-01

This article presents an analysis of challenges and considerations when developing digital mental health innovations. Recommendations include collaborative working between clinicians, researchers, industry and service users in order to successfully navigate challenges and to ensure e-therapies are engaging, acceptable, evidence based, scalable and sustainable. © The Royal College of Psychiatrists 2017.

STEM Education: An Incongruous Approach A Proposed Reform Model for a Large Suburban High School

NASA Astrophysics Data System (ADS)

Hughes, Patricia A.

It is unknown how the school can best influence the variables that determine pursuance of science study and career choice to bring about greater opportunity to learn challenging science curriculum for all students and promote Science Technology Engineering and Mathematics (STEM) education. Student decisions regarding the type of science class to elect in early secondary school years can impact their progression and academic success in subsequent rigorous and challenging offerings. Parents, counselors, peers, gender, socio-economic status and individual experience in previous coursework are variables of consideration. The purpose of this study is to examine these variables in a large suburban New Jersey School District aligned to STEM and Advanced Placement level course choice by students. Information regarding the influence of the variables can lead to a reform of the approach toward STEM education currently in place. The study will include a historical reflection of the approach to curriculum revision in the district. Increasing student enrollment in science courses beyond the required number stipulated for high school completion will open opportunities for entrance into STEM related careers or continued post secondary science study.

Initiating Intrapartum Nitrous Oxide in an Academic Hospital: Considerations and Challenges.

PubMed

Migliaccio, Laura; Lawton, Robyn; Leeman, Lawrence; Holbrook, Amanda

2017-05-01

A 50%-50% mixture of nitrous oxide and oxygen has long been used for managing pain during labor in many countries, but only recently has this intrapartum analgesic technique become popular in the United States. Nitrous oxide is considered minimal sedation and a safe pain management alternative. Many facilities are now interested in providing laboring women this analgesic option. The process of establishing use of nitrous oxide in a large institution can be complicated and may seem daunting. This brief report describes the challenges that occurred during the process of initiating nitrous oxide for pain management during childbirth at an academic medical center and discusses various committee roles. Nurses at the University of New Mexico Hospital now directly oversee the administration of nitrous oxide to women in labor in accordance to an established guideline. Despite limited available research, the guideline also allows offering nitrous oxide as a pain management technique for women with opioid dependence. Key components of the guideline and specifics related to education, cost, and safety are reviewed. © 2017 by the American College of Nurse-Midwives.

Innovative Robot Archetypes for In-Space Construction and Maintenance

NASA Technical Reports Server (NTRS)

Rehnmark, Fredrik; Ambrose, Robert O.; Kennedy, Brett; Diftler, Myron; Mehling Joshua; Brigwater, Lyndon; Radford, Nicolaus; Goza, S. Michael; Culbert, Christopher

2005-01-01

The space environment presents unique challenges and opportunities in the assembly, inspection and maintenance of orbital and transit spaceflight systems. While conventional Extra-Vehicular Activity (EVA) technology, out of necessity, addresses each of the challenges, relatively few of the opportunities have been exploited due to crew safety and reliability considerations. Extra-Vehicular Robotics (EVR) is one of the least-explored design spaces but offers many exciting innovations transcending the crane-like Space Shuttle and International Space Station Remote Manipulator System (RMS) robots used for berthing, coarse positioning and stabilization. Microgravity environments can support new robotic archetypes with locomotion and manipulation capabilities analogous to undersea creatures. Such diversification could enable the next generation of space science platforms and vehicles that are too large and fragile to launch and deploy as self-contained payloads. Sinuous manipulators for minimally invasive inspection and repair in confined spaces, soft-stepping climbers with expansive leg reach envelopes and free-flying nanosatellite cameras can access EVA worksites generally not accessible to humans in spacesuits. These and other novel robotic archetypes are presented along with functionality concepts

Restaurant challenge offers healthful meal options and builds diabetes awareness.

PubMed

Blair, Angela M; Drass, Janice A; Stone, Marylou; Rhoades, Deborah; Baldwin, Susan A; Russ, Kelsey M

2011-01-01

The Frederick Restaurant Challenge is an innovative project based on a collaborative effort among community organizations and partners designed to offer delicious healthful meal options at local restaurants during the month of November for American Diabetes Month. Local restaurants were challenged to participate and submitted recipes for healthful meals to the Frederick County Diabetes Coalition for review by registered dietitians. Diners voted on meals to determine the challenge winner(s), and were eligible to win prizes as well. Publicity prior to and during the month was effective in creating positive news about healthful meals when eating out, raised awareness about diabetes, and provided restaurants with desirable advertising opportunities. Feedback from restaurants and diners was overwhelmingly positive. The purpose of this article is to describe this successful low-budget project to encourage its replication in local communities. The Frederick Restaurant Challenge proved to be a very successful, innovative, low-budget project that met its intended goals: to develop healthful meal options for people with diabetes (or for anyone wishing to eat healthier); to demonstrate that healthful food can taste delicious; and to encourage restaurants to continue offering healthful options on their menus beyond the challenge month. Community interventions such as the Frederick Restaurant Challenge offer unique and important strategies for affecting change and raising awareness not only for people with diabetes but also for the entire community.

Investing in New Technology in Pulmonary Medicine: Navigating the Tortuous Path to Success.

PubMed

Kruklitis, Robert; French, Kim; Cangelosi, Michael Joseph; Kovitz, Kevin L

2017-09-01

The introduction of new technologies offers the promise to advance medicine. This occurs alongside improved efforts to control costs of health care by hospital administrators, the Centers for Medicare & Medicaid Services' (CMS) pivot to value programs, and commercial payers' efforts to reduce reimbursement. These trends present a challenge for the pulmonologist, among others, who must navigate increasingly complex and highly scrutinized evaluation processes used to secure new technology (NT). Health-care providers are turning toward value assessments while simultaneously tasked with the mission of offering state of the art technologies and services. Pulmonologists desiring NT are thus faced with increased scrutiny in their evaluation of costs and clinical data to support investments. Consideration of this scrutiny and further evidence to temper the evaluation will improve the likelihood of adoption and patient access to clinically impactful technology. The identification of this evidence may provide a comprehensive view of the clinical and economic benefits of such technologies to both administrators and pulmonary clinicians. It is imperative that all parties involved in the decision process work collaboratively to deploy value added and clinically impactful technologies. Although a physician group might invest in such NT, the capital required often leads such decisions to a larger organization such as a hospital, health-care system, or privately owned entity. This article aims to provide a framework for pulmonary clinicians to better understand the processes that purchasers use to evaluate NT, the pressures that influence their consideration, and what resources may be leveraged toward success. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Modernizing Evolutionary Anthropology : Introduction to the Special Issue.

PubMed

Mattison, Siobhán M; Sear, Rebecca

2016-12-01

Evolutionary anthropology has traditionally focused on the study of small-scale, largely self-sufficient societies. The increasing rarity of these societies underscores the importance of such research yet also suggests the need to understand the processes by which such societies are being lost-what we call "modernization"-and the effects of these processes on human behavior and biology. In this article, we discuss recent efforts by evolutionary anthropologists to incorporate modernization into their research and the challenges and rewards that follow. Advantages include that these studies allow for explicit testing of hypotheses that explore how behavior and biology change in conjunction with changes in social, economic, and ecological factors. In addition, modernization often provides a source of "natural experiments" since it may proceed in a piecemeal fashion through a population. Challenges arise, however, in association with reduced variability in fitness proxies such as fertility, and with the increasing use of relatively novel methodologies in evolutionary anthropology, such as the analysis of secondary data. Confronting these challenges will require careful consideration but will lead to an improved understanding of humanity. We conclude that the study of modernization offers the prospect of developing a richer evolutionary anthropology, by encompassing ultimate and proximate explanations for behavior expressed across the full range of human societies.

Cultural Challenges to Engaging Patients in Shared Decision Making

PubMed Central

Hawley, Sarah T.; Morris, Arden M.

2016-01-01

Objective Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. Discussion The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. Conclusion While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care. PMID:27461943

Cultural challenges to engaging patients in shared decision making.

PubMed

Hawley, Sarah T; Morris, Arden M

2017-01-01

Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care. Published by Elsevier Ireland Ltd.

Engaging science in a climate of values: tools for animal scientists tasked with addressing ethical problems.

PubMed

Croney, C C; Anthony, R

2010-04-01

In the United States, escalating concerns about current farm animal science and production methods have resulted not only in increased food animal protection policies, but also in animal welfare legislation. Animal scientists and industry leaders are apprehensive that such policies may be driven primarily by emotion and a lack of scientific understanding, and thus may have unforeseen consequences. However, decisions about animal care, and particularly animal welfare, cannot be made solely on the basis of science because the potential effects on producers, animals, and concerned citizens and the implications for the environment and on food prices must also be considered. Balancing the interests and values of all stakeholders in regard to animal welfare problems has presented a considerable challenge. Ethical accounting processes, such as the Ethical Matrix and the ethics assessment process by Campbell, offer models to combine socioethical concerns with relevant factual information, thereby facilitating decision making that is ethically responsible and that offers viable solutions. A case study is used to illustrate application of the ethics assessment process by Campbell that includes identification of the ethical problems, the embedded values, the relevant facts, and moral tests that can be applied. Awareness of these emerging ways of examining ethics that offer real solutions to conflicts of interests and not merely "one size fits all" answers should be an asset to animal and poultry scientists.

Selecting automation for the clinical chemistry laboratory.

PubMed

Melanson, Stacy E F; Lindeman, Neal I; Jarolim, Petr

2007-07-01

Laboratory automation proposes to improve the quality and efficiency of laboratory operations, and may provide a solution to the quality demands and staff shortages faced by today's clinical laboratories. Several vendors offer automation systems in the United States, with both subtle and obvious differences. Arriving at a decision to automate, and the ensuing evaluation of available products, can be time-consuming and challenging. Although considerable discussion concerning the decision to automate has been published, relatively little attention has been paid to the process of evaluating and selecting automation systems. To outline a process for evaluating and selecting automation systems as a reference for laboratories contemplating laboratory automation. Our Clinical Chemistry Laboratory staff recently evaluated all major laboratory automation systems in the United States, with their respective chemistry and immunochemistry analyzers. Our experience is described and organized according to the selection process, the important considerations in clinical chemistry automation, decisions and implementation, and we give conclusions pertaining to this experience. Including the formation of a committee, workflow analysis, submitting a request for proposal, site visits, and making a final decision, the process of selecting chemistry automation took approximately 14 months. We outline important considerations in automation design, preanalytical processing, analyzer selection, postanalytical storage, and data management. Selecting clinical chemistry laboratory automation is a complex, time-consuming process. Laboratories considering laboratory automation may benefit from the concise overview and narrative and tabular suggestions provided.

Treat All Students like the "Best" Students

ERIC Educational Resources Information Center

Bottoms, Gene

2007-01-01

What would happen if schools offered all students the same challenges and opportunities that some schools now offer only their "best" students? The Southern Regional Education Board addressed that question in 1987, when it developed the High Schools That Work Model. Blending challenging college-preparatory content with modern vocational and…

Coercion, incarceration, and chemical castration: an argument from autonomy.

PubMed

Douglas, Thomas; Bonte, Pieter; Focquaert, Farah; Devolder, Katrien; Sterckx, Sigrid

2013-10-01

In several jurisdictions, sex offenders may be offered chemical castration as an alternative to further incarceration. In some, agreement to chemical castration may be made a formal condition of parole or release. In others, refusal to undergo chemical castration can increase the likelihood of further incarceration though no formal link is made between the two. Offering chemical castration as an alternative to further incarceration is often said to be partially coercive, thus rendering the offender's consent invalid. The dominant response to this objection has been to argue that any coercion present in such cases is compatible with valid consent. In this article, we take a different tack, arguing that, even if consent would not be valid, offering chemical castration will often be supported by the very considerations that underpin concerns about consent: considerations of autonomy. This is because offering chemical castration will often increase the offender's autonomy, both at the time the offer is made and in the future.

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…

17 CFR 230.251 - Scope of exemption.

Code of Federal Regulations, 2012 CFR

2012-04-01

... consideration must be reasonable at the time made. (c) Integration with other offerings. Offers and sales made... confirmation of sale, unless it has been delivered to that person at an earlier time. (ii) Sales by a dealer...

17 CFR 230.251 - Scope of exemption.

Code of Federal Regulations, 2013 CFR

2013-04-01

... consideration must be reasonable at the time made. (c) Integration with other offerings. Offers and sales made... confirmation of sale, unless it has been delivered to that person at an earlier time. (ii) Sales by a dealer...

17 CFR 230.251 - Scope of exemption.

Code of Federal Regulations, 2014 CFR

2014-04-01

... consideration must be reasonable at the time made. (c) Integration with other offerings. Offers and sales made... confirmation of sale, unless it has been delivered to that person at an earlier time. (ii) Sales by a dealer...

Mold Charlatans.

ERIC Educational Resources Information Center

Woody, Daniel

2002-01-01

Offers a primer on toxic mold and its removal, warning against ignorant or unethical mold remediation companies and offering five considerations (checking references, considering the big picture, sampling more than the air, considering release, and considering the source) when hiring such services. (EV)

Getting my child to eat the right amount. Mothers' considerations when deciding how much food to offer their child at a meal

USDA-ARS?s Scientific Manuscript database

Feeding young children successfully requires parenting skills,trust that children will eat, and nutrition and child development knowledge to ensure that foods and the amounts offered are developmentally appropriate. Mothers are often responsible for determining how much food is offered to their chil...

Challenges in Offering Inner-City After-School Physical Activity Clubs

ERIC Educational Resources Information Center

Maljak, Kimberly; Garn, Alex; McCaughtry, Nate; Kulik, Noel; Martin, Jeffrey; Shen, Bo; Whalen, Laurel; Fahlman, Mariane

2014-01-01

Background: Offering physical activity clubs (PACs) for students in urban high schools can provide avenues for increased physical activity (PA); however, little is known about why some clubs are not successful. Purpose: The purpose of this qualitative study was to examine leaders' and students' perspectives on the challenges faced when…

Analysis of Latino Award Winning Children's Literature

ERIC Educational Resources Information Center

Gomm, Jeff; Heath, Melissa Allen; Mora, Pat

2017-01-01

In this article, we offer information about the specific challenges US Latino immigrant children face. We then determine which of these challenges are included in 72 award winning children's picture books, specifically created for and/or about Latino children. Our analysis offers information to assist school-based mental health professionals,…

Consider the Opportunities: A Response to No Child Left Behind

ERIC Educational Resources Information Center

Neel, Richard S.

2006-01-01

No Child Left Behind offers many challenges to those who work with children with EBD [emotional and behavioral disorders]. It also offers opportunities never before available for collaboration and cooperation between general and special educators. Two snapshots of opportunities are provided. The first summarizes some of the challenges our field…

Living in the Shadows: Plight of the Undocumented

PubMed Central

2016-01-01

The word “immigration” has become a household buzzword. The welcome sign on the Statue of Liberty that reads, “Give me your tired, your poor, your huddled masses yearning to breathe free,” however, is fading and has been replaced by many complicated conditions. What to do with the very large number of undocumented immigrants living in the United States and arriving at the United States every day commands considerable attention and has been the subject of breaking stories in the news. Working in the field of immigration demands an awareness of and sensitivity to diversity and cultural competence. Despite a “hot” sociopolitical climate when it comes to undocumented aliens and what to do with them, there are many ethical tenets that psychologists must be familiar with, among them rendering competent multicultural services. This article offers an overview of immigration law, the challenges of performing culturally competent assessments and consequences of failing to do so, and the plight of a particularly vulnerable group: unaccompanied children. Vignettes offer a personal look into the proceedings of 7 undocumented individuals in 4 major areas: asylum, hardship, U‐Visa, and VAWA. PMID:27552394

Training for the challenges of sexual violence against children and adolescents in four Brazilian capitals.

PubMed

Vieira, Luiza Jane Eyre de Souza; Silva, Raimunda Magalhães da; Cavalcanti, Ludmila Fontenele; Deslandes, Suely Ferreira

2015-11-01

This article analyzes the training offered to municipal public employees to confront sexual violence against children and adolescents in four Brazilian capitals. Based on a multiple case study, it focuses on the training programs offered in the 2010-2011 biennium by the municipal government for professionals and managers in the public health network. We analyzed 66 semi-structured interviews and written documents pertaining to the training actions. We observed an unequal investment among the capitals and a lack of specificity in the treatment of the themes. There is a considerable lack of institutional memory which complicates the analysis of professional training strategies. Healthcare was the field which trained their professionals the most, including the subject of notification in training content. We noted little investment in training oriented toward the prevention of violence and the promotion of protective relationships and links. We emphasized the inductive role of federal and state programs in the areas of Tourism and Education. Few initiatives included the participation of more than one public sector. We suggest the creation of a training plan about violence and the sexual rights of children and adolescents, and in particular about sexual violence.

Transforming Healthcare Delivery: Integrating Dynamic Simulation Modelling and Big Data in Health Economics and Outcomes Research.

PubMed

Marshall, Deborah A; Burgos-Liz, Lina; Pasupathy, Kalyan S; Padula, William V; IJzerman, Maarten J; Wong, Peter K; Higashi, Mitchell K; Engbers, Jordan; Wiebe, Samuel; Crown, William; Osgood, Nathaniel D

2016-02-01

In the era of the Information Age and personalized medicine, healthcare delivery systems need to be efficient and patient-centred. The health system must be responsive to individual patient choices and preferences about their care, while considering the system consequences. While dynamic simulation modelling (DSM) and big data share characteristics, they present distinct and complementary value in healthcare. Big data and DSM are synergistic-big data offer support to enhance the application of dynamic models, but DSM also can greatly enhance the value conferred by big data. Big data can inform patient-centred care with its high velocity, volume, and variety (the three Vs) over traditional data analytics; however, big data are not sufficient to extract meaningful insights to inform approaches to improve healthcare delivery. DSM can serve as a natural bridge between the wealth of evidence offered by big data and informed decision making as a means of faster, deeper, more consistent learning from that evidence. We discuss the synergies between big data and DSM, practical considerations and challenges, and how integrating big data and DSM can be useful to decision makers to address complex, systemic health economics and outcomes questions and to transform healthcare delivery.

Biometric identification: a holistic perspective

NASA Astrophysics Data System (ADS)

Nadel, Lawrence D.

2007-04-01

Significant advances continue to be made in biometric technology. However, the global war on terrorism and our increasingly electronic society have created the societal need for large-scale, interoperable biometric capabilities that challenge the capabilities of current off-the-shelf technology. At the same time, there are concerns that large-scale implementation of biometrics will infringe our civil liberties and offer increased opportunities for identity theft. This paper looks beyond the basic science and engineering of biometric sensors and fundamental matching algorithms and offers approaches for achieving greater performance and acceptability of applications enabled with currently available biometric technologies. The discussion focuses on three primary biometric system aspects: performance and scalability, interoperability, and cost benefit. Significant improvements in system performance and scalability can be achieved through careful consideration of the following elements: biometric data quality, human factors, operational environment, workflow, multibiometric fusion, and integrated performance modeling. Application interoperability hinges upon some of the factors noted above as well as adherence to interface, data, and performance standards. However, there are times when the price of conforming to such standards can be decreased local system performance. The development of biometric performance-based cost benefit models can help determine realistic requirements and acceptable designs.

Theoretical Approaches to Enhancing Motivation for Adherence to Antidepressant Medications.

PubMed

Hamrin, Vanya; Sinclair, Vaughn G; Gardner, Virginia

2017-04-01

Adherence to antidepressants is a major challenge in our health care system, with a high percentage of patients discontinuing their medications within six months. The purpose of this position paper is to discuss theoretical frameworks that address the psychological beliefs, benefits and barriers and feelings of autonomy that affect a person's willingness and motivation to take anti-depressant medications within a therapeutic relationship with a nurse practitioner. Three theoretical frameworks were selected to highlight particular perspectives relevant to enhancing patient motivation for medication adherence. The Self-Regulation Model, Health Belief Model, and Self-Determination Theory combined with motivational interviewing all offer guidance on strategies for improving adherence to antidepressants. The Self-Regulation Model underscores the importance of illness representations that prompt considering patient perceptions of depression that affect adherence. The Health Belief Model focuses on cost-benefit considerations that affect patient's adherence, along with perceived control. Finally, Self-Determination Theory combined with motivational interviewing offers strategies that enhance autonomy and optimize collaboration and motivation for adherence. These three theoretical models are applied to a vignette for a patient who is having difficulty with adherence to antidepressant medication. Copyright © 2016 Elsevier Inc. All rights reserved.

Under the Skin: Using Theories From Biology and the Social Sciences to Explore the Mechanisms Behind the Black–White Health Gap

PubMed Central

Darity, William A.

2010-01-01

Equity and social well-being considerations make Black–White health disparities an area of important concern. Although previous research suggests that discrimination- and poverty-related stressors play a role in African American health outcomes, the mechanisms are unclear. Allostatic load is a concept that can be employed to demonstrate how environmental stressors, including psychosocial ones, may lead to a cumulative physiological toll on the body. We discuss both the usefulness of this framework for understanding how discrimination can lead to worse health among African Americans, and the challenges for conceptualizing biological risk with existing data and methods. We also contrast allostatic load with theories of historical trauma such as posttraumatic slavery syndrome. Finally, we offer our suggestions for future interdisciplinary research on health disparities. PMID:20147678

Dental Management of a Pediatric Patient with Moyamoya Syndrome: A Rare Clinical Entity.

PubMed

Ko, Brittany L; Unkel, John H

2018-01-01

Moyamoya disease (MMD) is a rare cerebrovascular disorder involving progressive constriction of the internal carotid artery and its branches. The disease has a particularly aggressive course in very young patients, and early surgical intervention is often necessary to prevent permanent neurological damage. MMD patients have an increased risk of stroke development, which may be provoked by pain or anxiety. Currently, no reports of pediatric patients with MMD exist in the dental literature. The purpose of this paper was to discuss the dental management of a two-year-old with moyamoya disease who presented with early childhood caries and dental fear, offering recommendations for dental providers with emphasis on stroke prevention, collaboration with the medical team, anesthesia considerations for patients with increased stroke risk, and the challenges to maintain the oral health of a patient undergoing complex medical treatment.

Nurse education in competitive markets: the case for relationship marketing.

PubMed

Roberts, P M

1998-10-01

Since the National Health Service reforms of the late 1980s, nurse education has been increasingly subject to market forces. This new competitive environment presents not only threat, but also challenge and opportunity. Providers of nurse education who recognize the need for market orientation and develop responsive marketing strategies will maximize their potential for market retention and growth. Traditional marketing strategies have considerable limitations for public sector services. The new and growing field of relationship marketing offers nurse education an opportunity to retain and develop profitable relationships with both internal and external markets. This paper reviews the marketing arena in nurse education and proposes context-based qualitative research to ascertain definitive constructs of service quality. Such constructs might then be rooted in a theoretical framework of service quality measurement, and be measured within the disconfirmation paradigm of relationship marketing.

Practical Guidance and Ethical Considerations for Studies Using Photo-Elicitation Interviews

PubMed Central

Bugos, Eva; Frasso, Rosemary; FitzGerald, Elizabeth; True, Gala; Adachi-Mejia, Anna M.

2014-01-01

Photo-elicitation is a qualitative interviewing technique that has gained popularity in recent years. It is the foundation for photovoice projects and is a tool well-suited for community-based participatory research. Photo-elicitation yields rich data, and interview participants say these interviews encourage community awareness and engagement. This article draws on 9 studies, conducted by researchers at 3 institutions (the University of Pennsylvania, the Philadelphia Veterans Affairs Medical Center, and the Geisel School of Medicine at Dartmouth) in partnership with community-based organizations and students, in which 303 participants completed photo-elicitation interviews. We offer 8 practical suggestions for overcoming challenges encountered during photo-elicitation research and for managing ethical concerns about the use of visual data in public health research. Our guidelines can inform study design, protocol development, and institutional review board approval. PMID:25357257

Ethical considerations in the implementation of nutrigenetics/nutrigenomics.

PubMed

Hurlimann, Thierry; Robitaille, Julie; Vohl, Marie-Claude; Godard, Béatrice

2017-01-01

Awareness of ethical issues that may be raised by the implementation of nutrigenetic/nutrigenomic (NGx) testing and personalized nutrition, at an individual or a public health level, is crucial to ensure the latter's sound and effective implementation. NGx tests that are currently offered or developed have different natures and scopes. We provide an example of NGx testing on the MTHFR gene to illustrate the current challenges when it comes to grasp the meaning of the results of such testing. In addition, NGx testing is developed within an evolving landscape of new genomic technologies and occurs at a time when public health policies mainly focus on preventive and predictive healthcare, with an emphasis on increased individual responsibility. The ethical issues raised by such a context and the genetic nature of NGx testing both should be carefully evaluated.

How PV system ownership can impact the market value of residential homes

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

Klise, Geoffrey Taylor; Johnson, Jamie L.

2014-01-01

There are multiple ways for a homeowner to obtain the electricity generating and savings benefits offered by a photovoltaic (PV) system. These include purchasing a PV system through various financing mechanisms, or by leasing the PV system from a third party with multiple options that may include purchase, lease renewal or PV system removal. The different ownership options available to homeowners presents a challenge to appraisal and real estate professionals during a home sale or refinance in terms of how to develop a value that is reflective of the PV systems operational characteristics, local market conditions, and lender and underwritermore » requirements. This paper presents these many PV system ownership options with a discussion of what considerations an appraiser must make when developing the contributory value of a PV system to a residential property.« less

Dry powder antibiotic aerosol product development: inhaled therapy for tuberculosis.

PubMed

Hickey, Anthony J; Misra, Amit; Fourie, P Bernard

2013-11-01

Inhaled therapies offer a unique approach to the treatment of tuberculosis (TB) using a relevant target organ system as a route of administration. The number of research reports on this topic has been increasing exponentially in the last decade but studies of clinical efficacy have been rare in recent times. The challenge is to take many research findings and translate them into a strategy for product development. Dry powder inhalers are the dominant drug product under consideration by those interested in the inhaled therapy for TB. A range of factors including candidate drug, formulation, device selection, drug product testing for proof of concept, and preclinical and clinical purposes all demand different considerations. The following review is intended to raise awareness of a growing body of evidence, suggesting that inhaled therapy for TB is possible and desirable. In addition, it is intended to outline key elements of the product-development activity for this particular application that has not been discussed elsewhere in the literature. Hopefully, this will encourage those with development expertise to seriously contemplate the steps required to bring such products forward. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association.

Potential application of the consistency approach for vaccine potency testing.

PubMed

Arciniega, J; Sirota, L A

2012-01-01

The Consistency Approach offers the possibility of reducing the number of animals used for a potency test. However, it is critical to assess the effect that such reduction may have on assay performance. Consistency of production, sometimes referred to as consistency of manufacture or manufacturing, is an old concept implicit in regulation, which aims to ensure the uninterrupted release of safe and effective products. Consistency of manufacture can be described in terms of process capability, or the ability of a process to produce output within specification limits. For example, the standard method for potency testing of inactivated rabies vaccines is a multiple-dilution vaccination challenge test in mice that gives a quantitative, although highly variable estimate. On the other hand, a single-dilution test that does not give a quantitative estimate, but rather shows if the vaccine meets the specification has been proposed. This simplified test can lead to a considerable reduction in the number of animals used. However, traditional indices of process capability assume that the output population (potency values) is normally distributed, which clearly is not the case for the simplified approach. Appropriate computation of capability indices for the latter case will require special statistical considerations.

Responding to Public Health Emergencies on Tribal Lands: Jurisdictional Challenges and Practical Solutions.

PubMed

Barnard, Justin B

2015-01-01

Response to public health emergencies on tribal lands poses a unique challenge for state and tribal public health officials. The complexity and intensely situation-specific nature of federal Indian jurisprudence leaves considerable question as to which government entity, state or tribal, has jurisdiction on tribal lands to undertake basic emergency measures such as closure of public spaces, quarantine, compulsory medical examination, and investigation. That jurisdictional uncertainty, coupled with cultural differences and an often troubled history of tribal-state relations, threatens to significantly impede response to infectious disease outbreaks or other public health emergencies on tribal lands. Given that tribal communities may be disproportionately impacted by public health emergencies, it is critical that tribal, state, and local governments engage with each other in coordinated planning for public health threats. This Article is offered as a catalyst for such planning efforts. The Article identifies some of the most pressing jurisdictional issues that may confront governments responding to a public health emergency on tribal lands, with the aim of highlighting the nature of the problem and the need for action. The Article goes on to examine the most promising means of addressing jurisdictional uncertainty: intergovernmental agreements. Already utilized in many areas of shared interest between tribe and state, intergovernmental agreements offer neighboring state, local, and tribal governments a vehicle for delineating roles and authorities in an emergency, and may lay the groundwork for sharing resources. The Article surveys various representative tribal public health intergovernmental agreements, and concludes with suggestions for tribes and state or local governments looking to craft their own agreements.

System-on-Chip Considerations for Heterogeneous Integration of CMOS and Fluidic Bio-Interfaces.

PubMed

Datta-Chaudhuri, Timir; Smela, Elisabeth; Abshire, Pamela A

2016-12-01

CMOS chips are increasingly used for direct sensing and interfacing with fluidic and biological systems. While many biosensing systems have successfully combined CMOS chips for readout and signal processing with passive sensing arrays, systems that co-locate sensing with active circuits on a single chip offer significant advantages in size and performance but increase the complexity of multi-domain design and heterogeneous integration. This emerging class of lab-on-CMOS systems also poses distinct and vexing technical challenges that arise from the disparate requirements of biosensors and integrated circuits (ICs). Modeling these systems must address not only circuit design, but also the behavior of biological components on the surface of the IC and any physical structures. Existing tools do not support the cross-domain simulation of heterogeneous lab-on-CMOS systems, so we recommend a two-step modeling approach: using circuit simulation to inform physics-based simulation, and vice versa. We review the primary lab-on-CMOS implementation challenges and discuss practical approaches to overcome them. Issues include new versions of classical challenges in system-on-chip integration, such as thermal effects, floor-planning, and signal coupling, as well as new challenges that are specifically attributable to biological and fluidic domains, such as electrochemical effects, non-standard packaging, surface treatments, sterilization, microfabrication of surface structures, and microfluidic integration. We describe these concerns as they arise in lab-on-CMOS systems and discuss solutions that have been experimentally demonstrated.

New Processes for Freeze-Drying in Dual-Chamber Systems.

PubMed

Werk, T; Ludwig, I S; Luemkemann, J; Huwyler, J; Mahler, H-C; Haeuser, C R; Hafner, M

2016-01-01

Dual-chamber systems can offer self-administration and home care use for lyophilized biologics. Only a few products have been launched in dual-chamber systems so far-presumably due to dual-chamber systems' complex and costly drug product manufacturing process. Within this paper, two improved processes (both based on tray filling technology) for freeze-drying pharmaceuticals in dual-chamber systems are described. Challenges with regards to heat transfer were tackled by (1) performing the freeze-drying step in a needle-down orientation in combination with an aluminum block, or (2) freeze-drying the drug product "externally" in a metal cartridge with subsequent filling of the lyophilized cake into the dual-chamber system. Metal-mediated heat transfer was shown to be efficient in both cases and batch (unit-to-unit) homogeneity with regards to sublimation rate was increased. It was difficult to influence ice crystal size using different methods when in use with an aluminum block due to its heat capacity. Using such a metal carrier implies a large heat capacity leading to relatively small ice crystals. Compared to the established process, drying times were reduced by half using the new processes. The drying time was, however, longer for syringes compared to vials due to the syringe design (long and slim). The differences in drying times were less pronounced for aggressive drying cycles. The proposed processes may help to considerably decrease investment costs into dual-chamber system fill-finish equipment. Dual-chamber syringes offer self-administration and home care use for freeze-dried pharmaceuticals. Only a few products have been launched in dual-chamber syringes so far-presumably due to their complex and costly drug product manufacturing process. In this paper two improved processes for freeze-drying pharmaceuticals in dual-chamber syringes are described. The major challenge of freeze-drying is to transfer heat through a vacuum. The proposed processes cope with this challenge by (1) freeze-drying the drug product in the syringe in an orientation in which the product is closest to the heat source, or (2) freeze-drying the drug product outside the syringe in a metal tube. The latter requires filling the freeze-dried product subsequently into the dual-chamber syringe. Both processes were very efficient and promised to achieve similar freeze-drying conditions for all dual-chamber syringes within one production run. The proposed processes may help to considerably decrease investment costs into dual-chamber syringe fill-finish equipment. © PDA, Inc. 2016.

Language Teacher Identities in the Southern United States: Transforming Rural Schools

ERIC Educational Resources Information Center

Fogle, Lyn Wright; Moser, Kelly

2017-01-01

Foreign language (FL) and English as a Second Language (ESL) teaching present considerable challenges in the rural U.S. South. Local language ideologies, budgetary considerations, and challenges in other curricular areas (e.g., math and science) lead to marginalizing both FL and ESL in schools. This article examines the personal and professional…

Overcoming the glass ceiling: views from the cellar and the roof.

PubMed

McCrady, Barbara S

2012-12-01

Women's experiences as professionals and behavior therapists have changed considerably in the past 40 years. The author describes early challenges and experiences of discrimination as a young female professional. Although women's opportunities have improved considerably, women still experience unique career challenges and choices. The author provides some suggestions for women's career development.

Community Concepts of Argumentative Legitimacy: Challenging Norms in National-Circuit CEDA Debate.

ERIC Educational Resources Information Center

Broda-Bahm, Kenneth T.

As a critical activity, academic debate potentially offers its participants a wide choice in deciding how, and on what basis, a proposition can be defended or challenged. Despite this range of possibilities, CEDA (Cross Examination Debate Association) debate at the national level has developed a consistency in the types of arguments offered and…

Strategic Design for Delivery with Linked Transportation Assets : Trucks and Drones

DOT National Transportation Integrated Search

2018-01-01

Home delivery by drones as an alternative or complement to traditional delivery by trucks is attracting considerable attention from major retailers and services, as well as startups. While drone delivery may offer considerable economic savings, the f...

A Critical Examination of the Use of Trained Health Coaches to Decrease the Metabolic Syndrome for Participants of a Community-Based Diabetes Prevention and Management Program.

PubMed

Lucke-Wold, Brandon; Shawley, Samantha; Ingels, John Spencer; Stewart, Jonathan; Misra, Ranjita

2016-01-01

The epidemic of obesity and diabetes in the United States poses major challenge to the prevention and management of chronic diseases. Furthermore, when this is viewed in other components of the metabolic syndrome (i.e., the burden of high cholesterol and hypertension), the prevalence of the metabolic syndrome continues to rise in the USA continued challenge is how to deal with this epidemic from a medical and public health standpoint. Community Based Participatory Research (CBPR) is a unique approach and offers a novel perspective for answering this challenge. A critical set of goals for CBPR is to address health disparities and social inequalities while getting community members engaged in all aspects of the research process. Utilizing the West Virginia Diabetes Prevention and Management Program and trained Health Coaches as a model, we discuss topics of consideration related to CBPR, involving trained health coaches, optimizing early adoption of healthy lifestyle behaviors, and enhancing participation. Through careful project planning and design, questions regarding disparities increasing susceptibility and preventive efforts within the community can be addressed successfully. These topics are part of a broader integration of theories such as participatory research, community engagement, and outcomes measurement. The understanding of the pathophysiology and epidemiology of the metabolic syndrome can help frame an appropriate strategy for establishing long-term community-wide changes that promote health. In order to continue to improve investigations for preventing the metabolic syndrome, it will be necessary to have aggressive efforts at the individual and population level for developing culturally sensitive programs that start early and are sustainable in practical environments such as the workplace. In this comprehensive review, we will discuss practical considerations related to project design, implementation, and how to measure effectiveness in regards to reducing the burden of the metabolic syndrome.

Nesting doctoral students in collaborative North-South partnerships for health systems research.

PubMed

Loukanova, Svetla; Prytherch, Helen; Blank, Antje; Duysburgh, Els; Tomson, Göran; Gustafsson, Lars L; Sié, Ali; Williams, John; Leshabari, Melkizedeck; Haefeli, Walter E; Sauerborn, Rainer; Fonn, Sharon

2014-01-01

The European Union (EU) supports North-South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA). The aim of this study was to explore the challenges of, and facilitating factors for, 'nesting' doctoral students in North-South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs), and content analysis was undertaken. Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate). The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision). This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North-South projects. There are considerable challenges to the effective nesting of doctoral students within major collaborative research projects. However, ways can be found to overcome them. The nesting process ultimately helped the institutions involved in this example to take better advantage of the opportunities that collaborative projects offer to foster North-South partnerships as a contribution to the strengthening of local research capacity.

Study of Integration Considerations for Wireless Emergency Alerts

DTIC Science & Technology

2014-02-01

affect adoption. Section 4 presents a list of overall considerations for integrating a WEA messaging solution into an existing emergency management...in a product may negatively affect another de- sired quality. This section offers considerations for balancing an organization’s priorities con... affect what emergency management agencies can, should, and must do with respect to conducting exercises and issuing alerts. More information about

Top ten challenges when interfacing a laboratory information system to an electronic health record: Experience at a large academic medical center.

PubMed

Petrides, Athena K; Tanasijevic, Milenko J; Goonan, Ellen M; Landman, Adam B; Kantartjis, Michalis; Bates, David W; Melanson, Stacy E F

2017-10-01

Recent U.S. government regulations incentivize implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR to their laboratory information system (LIS). Reported long-term benefits include increased efficiency and improved quality and safety. In order to successfully implement an interfaced EHR-LIS, institutions must plan years in advance and anticipate the impact of an integrated system. It can be challenging to fully understand the technical, workflow and resource aspects and adequately prepare for a potentially protracted system implementation and the subsequent stabilization. We describe the top ten challenges that we encountered in our clinical laboratories following the implementation of an interfaced EHR-LIS and offer suggestions on how to overcome these challenges. This study was performed at a 777-bed, tertiary care center which recently implemented an interfaced EHR-LIS. Challenges were recorded during EHR-LIS implementation and stabilization and the authors describe the top ten. Our top ten challenges were selection and harmonization of test codes, detailed training for providers on test ordering, communication with EHR provider champions during the build process, fluid orders and collections, supporting specialized workflows, sufficient reports and metrics, increased volume of inpatient venipunctures, adequate resources during stabilization, unanticipated changes to laboratory workflow and ordering specimens for anatomic pathology. A few suggestions to overcome these challenges include regular meetings with clinical champions, advanced considerations of reports and metrics that will be needed, adequate training of laboratory staff on new workflows in the EHR and defining all tests including anatomic pathology in the LIS. EHR-LIS implementations have many challenges requiring institutions to adapt and develop new infrastructures. This article should be helpful to other institutions facing or undergoing a similar endeavor. Copyright © 2017 Elsevier B.V. All rights reserved.

Teaching about Contracts.

ERIC Educational Resources Information Center

Froman, Michael; Kosnoff, Kathy

1978-01-01

Presents teaching strategies for introducing high school students to contract law. Offers as a case study a contract agreement between pro football players and team owners. Stresses basic elements of contracts (offer, acceptance, consideration, and understanding the bargaining process). Journal available from the American Bar Association, 1155…

A Qualitative Study of Medical Oncologists’ Experiences of Their Profession and Workforce Sustainability

PubMed Central

Broom, Alex; Wong, W. K. Tim; Kirby, Emma; Sibbritt, David; Karikios, Deme; Harrup, Rosemary; Lwin, Zarnie

2016-01-01

Background Medical oncology is a steadily evolving field of medical practice and professional pathway for doctors, offering value, opportunity and challenge to those who chose this medical specialty. This study examines the experiences of a group of Australian medical oncologists, with an emphasis on their professional practice, career experiences, and existing and emerging challenges across career stages. Methods In-depth qualitative interviews were conducted with 22 medical oncologists, including advanced trainees, early-career consultants and senior consultants, focusing on: professional values and experiences; career prospects and pathways; and, the nexus of the characteristics of the profession and delivery of care. Results The following themes were emergent from the interviews: the need for professional reinvention and the pressure to perform; the importance, and often absence, of mentoring and feedback loops; the emotional labour of oncology; and, the impact of cascading workload volume on practice sustainability. Conclusions Understanding professional experiences, career trajectories and challenges at the workforce level are crucial for understanding what drives the oncological care day-to-day. The results indicate that there are considerable potential tensions between the realities of professional, workforce demands and expectations for patient care. Such tensions have real and significant consequences on individual medical oncologists with respect to their futures, aspirations, satisfaction with work, caring practices, interactions with patients and potentially therapeutic outcomes. PMID:27902706

Challenges in the development and reimbursement of personalized medicine-payer and manufacturer perspectives and implications for health economics and outcomes research: a report of the ISPOR personalized medicine special interest group.

PubMed

Faulkner, Eric; Annemans, Lieven; Garrison, Lou; Helfand, Mark; Holtorf, Anke-Peggy; Hornberger, John; Hughes, Dyfrig; Li, Tracy; Malone, Daniel; Payne, Katherine; Siebert, Uwe; Towse, Adrian; Veenstra, David; Watkins, John

2012-12-01

Personalized medicine technologies can improve individual health by delivering the right dose of the right drug to the right patient at the right time but create challenges in deciding which technologies offer sufficient value to justify widespread diffusion. Personalized medicine technologies, however, do not neatly fit into existing health technology assessment and reimbursement processes. In this article, the Personalized Medicine Special Interest Group of the International Society for Pharmacoeconomics and Outcomes Research evaluated key development and reimbursement considerations from the payer and manufacturer perspectives. Five key areas in which health economics and outcomes research best practices could be developed to improve value assessment, reimbursement, and patient access decisions for personalized medicine have been identified. These areas are as follows: 1 research prioritization and early value assessment, 2 best practices for clinical evidence development, 3 best practices for health economic assessment, 4 addressing health technology assessment challenges, and 5 new incentive and reimbursement approaches for personalized medicine. Key gaps in health economics and outcomes research best practices, decision standards, and value assessment processes are also discussed, along with next steps for evolving health economics and outcomes research practices in personalized medicine. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Optimizing Oral Bioavailability in Drug Discovery: An Overview of Design and Testing Strategies and Formulation Options.

PubMed

Aungst, Bruce J

2017-04-01

For discovery teams working toward new, orally administered therapeutic agents, one requirement is to attain adequate systemic exposure after oral dosing, which is best accomplished when oral bioavailability is optimized. This report summarizes the bioavailability challenges currently faced in drug discovery, and the design and testing methods and strategies currently utilized to address the challenges. Profiling of discovery compounds usually includes separate assessments of solubility, permeability, and susceptibility to first-pass metabolism, which are the 3 most likely contributors to incomplete oral bioavailability. An initial assessment of absorption potential may be made computationally, and high throughput in vitro assays are typically performed to prioritize compounds for in vivo studies. The initial pharmacokinetic study is a critical decision point in compound evaluation, and the importance of the effect the dosing vehicle or formulation can have on oral bioavailability, especially for poorly water soluble compounds, is emphasized. Dosing vehicles and bioavailability-enabling formulations that can be used for discovery and preclinical studies are described. Optimizing oral bioavailability within a chemical series or for a lead compound requires identification of the barrier limiting bioavailability, and methods used for this purpose are outlined. Finally, a few key guidelines are offered for consideration when facing the challenges of optimizing oral bioavailability in drug discovery. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention.

PubMed

Hanefeld, Johanna; Bond, Virginia; Seeley, Janet; Lees, Shelley; Desmond, Nicola

2015-12-01

Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population. © 2013 John Wiley & Sons Ltd.

Potential Impact and Study Considerations of Metabolomics in Cardiovascular Health and Disease: A Scientific Statement From the American Heart Association.

PubMed

Cheng, Susan; Shah, Svati H; Corwin, Elizabeth J; Fiehn, Oliver; Fitzgerald, Robert L; Gerszten, Robert E; Illig, Thomas; Rhee, Eugene P; Srinivas, Pothur R; Wang, Thomas J; Jain, Mohit

2017-04-01

Through the measure of thousands of small-molecule metabolites in diverse biological systems, metabolomics now offers the potential for new insights into the factors that contribute to complex human diseases such as cardiovascular disease. Targeted metabolomics methods have already identified new molecular markers and metabolomic signatures of cardiovascular disease risk (including branched-chain amino acids, select unsaturated lipid species, and trimethylamine- N -oxide), thus in effect linking diverse exposures such as those from dietary intake and the microbiota with cardiometabolic traits. As technologies for metabolomics continue to evolve, the depth and breadth of small-molecule metabolite profiling in complex systems continue to advance rapidly, along with prospects for ongoing discovery. Current challenges facing the field of metabolomics include scaling throughput and technical capacity for metabolomics approaches, bioinformatic and chemoinformatic tools for handling large-scale metabolomics data, methods for elucidating the biochemical structure and function of novel metabolites, and strategies for determining the true clinical relevance of metabolites observed in association with cardiovascular disease outcomes. Progress made in addressing these challenges will allow metabolomics the potential to substantially affect diagnostics and therapeutics in cardiovascular medicine. © 2017 American Heart Association, Inc.

Genetic heterogeneity in cholangiocarcinoma: a major challenge for targeted therapies

PubMed Central

Brandi, Giovanni; Farioli, Andrea; Astolfi, Annalisa; Biasco, Guido; Tavolari, Simona

2015-01-01

Cholangiocarcinoma (CC) encompasses a group of related but distinct malignancies whose lack of a stereotyped genetic signature makes challenging the identification of genomic landscape and the development of effective targeted therapies. Accumulated evidences strongly suggest that the remarkable genetic heterogeneity of CC may be the result of a complex interplay among different causative factors, some shared by most human cancers while others typical of this malignancy. Currently, considerable efforts are ongoing worldwide for the genetic characterization of CC, also using advanced technologies such as next-generation sequencing (NGS). Undoubtedly this technology could offer an unique opportunity to broaden our understanding on CC molecular pathogenesis. Despite this great potential, however, the high complexity in terms of factors potentially contributing to genetic variability in CC calls for a more cautionary application of NGS to this malignancy, in order to avoid possible biases and criticisms in the identification of candidate actionable targets. This approach is further justified by the urgent need to develop effective targeted therapies in this disease. A multidisciplinary approach integrating genomic, functional and clinical studies is therefore mandatory to translate the results obtained by NGS into effective targeted therapies for this orphan disease. PMID:26142706

Toward Perovskite Solar Cell Commercialization: A Perspective and Research Roadmap Based on Interfacial Engineering.

PubMed

Rajagopal, Adharsh; Yao, Kai; Jen, Alex K-Y

2018-06-08

High-efficiency and low-cost perovskite solar cells (PVKSCs) are an ideal candidate for addressing the scalability challenge of solar-based renewable energy. The dynamically evolving research field of PVKSCs has made immense progress in solving inherent challenges and capitalizing on their unique structure-property-processing-performance traits. This review offers a unique outlook on the paths toward commercialization of PVKSCs from the interfacial engineering perspective, relevant to both specialists and nonspecialists in the field through a brief introduction of the background of the field, current state-of-the-art evolution, and future research prospects. The multifaceted role of interfaces in facilitating PVKSC development is explained. Beneficial impacts of diverse charge-transporting materials and interfacial modifications are summarized. In addition, the role of interfaces in improving efficiency and stability for all emerging areas of PVKSC design are also evaluated. The authors' integral contributions in this area are highlighted on all fronts. Finally, future research opportunities for interfacial material development and applications along with scalability-durability-sustainability considerations pivotal for facilitating laboratory to industry translation are presented. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Management of Concurrent Pregnancy and Acute Lymphoblastic Malignancy in Teenaged Patients: Two Illustrative Cases and Review of the Literature

PubMed Central

Johnson, Liza-Marie; Church, Christopher L.; Gomez-Garcia, Wendy C.; Popescu, Marcela I.; Margolin, Judith F.; Ribeiro, Raul C.

2014-01-01

The usual age range of acute lymphoblastic malignancies (acute lymphoblastic leukemia and advanced-stage lymphoblastic lymphoma) includes teenagers and young adults (<22 years of age) and coincides with the age of fertility. Concurrence of acute lymphoblastic malignancy with pregnancy is therefore most likely to happen during the younger childbearing ages. However, the therapeutic challenges posed by the dual diagnosis of lymphoblastic malignancy and pregnancy have not specifically been studied in the context of age, and management guidelines for pregnant young patients are lacking. Inconsistency in defining the legal decision-making rights of pregnant teenaged patients adds a further level of complexity in this age group. Management of this challenging combination in the young patient therefore entails unique ethical considerations. Here we present two illustrative cases of teenage pregnancy complicated by acute lymphoblastic malignancy, review the available literature, and offer suggestions for the therapeutic management of such cases in adolescent and young adult patients. Importantly, practical management recommendations are provided in the context of clinical ethics principles that are universally applicable, including in developing countries, where the highest incidence of adolescent pregnancies has been documented. PMID:25538861

Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections.

PubMed

King, Joseph J; Nystrom, Lukas M; Reimer, Nickolas B; Gibbs, C Parker; Scarborough, Mark T; Wright, Thomas W

2016-01-01

Proximal humerus reconstructions after resection of tumors are challenging. Early success of the reverse shoulder arthroplasty for reconstructions has recently been reported. The reverse allograft-prosthetic composite offers the advantage of improved glenohumeral stability compared with hemiarthroplasty for proximal humeral reconstructions as it uses the deltoid for stability. This article describes the technique for treating proximal humeral tumors, including preoperative planning, biopsy principles, resection pearls, soft tissue tensioning, and specifics about reconstruction using the reverse allograft-prosthetic composite. Two cases are presented along with the functional outcomes with use of this technique. Biomechanical considerations during reconstruction are reviewed, including techniques to improve the deltoid compression force. Reported instability rates are less with reverse shoulder arthroplasty reconstruction as opposed to hemiarthroplasty or total shoulder arthroplasty reconstructions of tumor resections. Reported functional outcomes are promising for the reverse allograft-prosthetic composite reconstructions, although complications are reported. Reverse allograft-prosthetic composites are a promising option for proximal humeral reconstructions, although nonunion of the allograft-host bone junction continues to be a challenge for this technique. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Adaptive trials for tuberculosis: early reflections on theory and practice.

PubMed

Montgomery, C M

2016-08-01

Adaptive designs (ADs) have been proposed for anti-tuberculosis treatment trials. This call for innovation occurs against the backdrop of fundamental changes in the acceptable evidence base in anti-tuberculosis treatment. To contextualise ADs for tuberculosis (TB) and explore early responses from those working in the field. In this qualitative study investigating processes of theoretical and practical change in randomised controlled trials, 24 interviews were conducted with professionals involved in AD trials, half of whom worked in the TB field. Clinical trialists working on AD trials in TB are positive about the efficiency these designs offer, but remain cautious about their suitability. In addition to technical concerns, informants discussed the challenges of implementing AD in developing countries, including limited regulatory capacity to evaluate proposals, investments needed in infrastructure and site capacity, and challenges regarding informed consent. Respondents identified funding, interdisciplinary communication and regulatory and policy responses as additional concerns potentially affecting the success of AD for TB. Empirical research is needed into patient experiences of AD, including informed consent. Further consideration of the contexts of innovation in trial design is needed. These are fundamental to the successful translation of theory into practice.

Innovation in healthcare. The challenge for laboratory medicine.

PubMed

Price, Christopher P; St John, Andrew

2014-01-01

The delivery of healthcare is the product of a complex organization and it is not entirely surprising that innovation is not always considered to deliver on the expectations generated by invention. As policymakers and payers seek to improve the quality and value-for-money of healthcare, more attention is being directed at the barriers to innovation, and the challenges of translating inventions into outcomes. Laboratory medicine is one facet of healthcare that has generated considerable levels of invention but, while showing increasing volumes of activity over the past decades, it has not been recognized for generating the benefit in outcomes that might have been expected. One of the major reasons for this position has been the poor quality of evidence available to demonstrate the impact of laboratory investigations on health outcomes. Consequently an absence of evidence stifles the opportunity to develop the business case that demonstrates the link between test result and improved outcome. This has a major influence on the success of innovation in laboratory medicine. This review explores the process of innovation applied to laboratory medicine and offers an insight into how the impact of laboratory medicine on health outcomes can be improved. © 2013.

Continuous flow technology vs. the batch-by-batch approach to produce pharmaceutical compounds.

PubMed

Cole, Kevin P; Johnson, Martin D

2018-01-01

For the manufacture of small molecule drugs, many pharmaceutical innovator companies have recently invested in continuous processing, which can offer significant technical and economic advantages over traditional batch methodology. This Expert Review will describe the reasons for this interest as well as many considerations and challenges that exist today concerning continuous manufacturing. Areas covered: Continuous processing is defined and many reasons for its adoption are described. The current state of continuous drug substance manufacturing within the pharmaceutical industry is summarized. Current key challenges to implementation of continuous manufacturing are highlighted, and an outlook provided regarding the prospects for continuous within the industry. Expert commentary: Continuous processing at Lilly has been a journey that started with the need for increased safety and capability. Over twelve years the original small, dedicated group has grown to more than 100 Lilly employees in discovery, development, quality, manufacturing, and regulatory designing in continuous drug substance processing. Recently we have focused on linked continuous unit operations for the purpose of all-at-once pharmaceutical manufacturing, but the technical and business drivers that existed in the very beginning for stand-alone continuous unit operations in hybrid processes have persisted, which merits investment in both approaches.

The undermining effect of facial attractiveness on brain responses to fairness in the Ultimatum Game: an ERP study

PubMed Central

Ma, Qingguo; Hu, Yue; Jiang, Shushu; Meng, Liang

2015-01-01

To investigate the time course of the neural processing of facial attractiveness and its influence on fairness consideration during social interactions, event-related potentials (ERP) were recorded from 21 male subjects performing a two-person Ultimatum Game (UG). During this bargaining game, the male subjects played responders who decided whether to accept offers from female proposers, whose facial images (grouped as “attractive” and “unattractive”) were presented prior to the offer presentation. The behavioral data demonstrated that the acceptance ratio increased with the fairness level of the offers and, more importantly, the subjects were more likely to accept unfair offers when presented with the attractive-face condition compared with the unattractive-face condition. The reaction times (RTs) for five offers (1:9, 2:8, 3:7, 4:6, and 5:5) in the unattractive-face condition were not significantly different. In contrast, the subjects reacted slower to the attractive proposers' unfair offers and quicker to fair offers. The ERP analysis of the face presentation demonstrated a decreased early negativity (N2) and enhanced late positive potentials (LPPs) elicited by the attractive faces compared with the unattractive faces. In addition, the feedback-related negativity (FRN) in response to an offer presentation was not significantly different for the unfair (1:9 and 2:8) and fair (4:6 and 5:5) offers in the attractive-face condition. However, the unfair offers generated larger FRNs compared with the fair offers in the unattractive-face condition (consistent with prior studies). A similar effect was identified for P300. The present study demonstrated an undermining effect of proposer facial attractiveness on responder consideration of offer fairness during the UG. PMID:25805967

A pattern-based analysis of clinical computer-interpretable guideline modeling languages.

PubMed

Mulyar, Nataliya; van der Aalst, Wil M P; Peleg, Mor

2007-01-01

Languages used to specify computer-interpretable guidelines (CIGs) differ in their approaches to addressing particular modeling challenges. The main goals of this article are: (1) to examine the expressive power of CIG modeling languages, and (2) to define the differences, from the control-flow perspective, between process languages in workflow management systems and modeling languages used to design clinical guidelines. The pattern-based analysis was applied to guideline modeling languages Asbru, EON, GLIF, and PROforma. We focused on control-flow and left other perspectives out of consideration. We evaluated the selected CIG modeling languages and identified their degree of support of 43 control-flow patterns. We used a set of explicitly defined evaluation criteria to determine whether each pattern is supported directly, indirectly, or not at all. PROforma offers direct support for 22 of 43 patterns, Asbru 20, GLIF 17, and EON 11. All four directly support basic control-flow patterns, cancellation patterns, and some advance branching and synchronization patterns. None support multiple instances patterns. They offer varying levels of support for synchronizing merge patterns and state-based patterns. Some support a few scenarios not covered by the 43 control-flow patterns. CIG modeling languages are remarkably close to traditional workflow languages from the control-flow perspective, but cover many fewer workflow patterns. CIG languages offer some flexibility that supports modeling of complex decisions and provide ways for modeling some decisions not covered by workflow management systems. Workflow management systems may be suitable for clinical guideline applications.

Management of work-relevant upper limb disorders: a review.

PubMed

Burton, A Kim; Kendall, Nicholas A S; Pearce, Brian G; Birrell, Lisa N; Bainbridge, L Christopher

2009-01-01

Upper limb disorders (ULDs) are clinically challenging and responsible for considerable work loss. There is a need to determine effective approaches for their management. To determine evidence-based management strategies for work-relevant ULDs and explore whether a biopsychosocial approach is appropriate. Literature review using a best evidence synthesis. Data from articles identified through systematic searching of electronic databases and citation tracking were extracted into evidence tables. The information was synthesized into high-level evidence statements, which were ordered into themes covering classification/diagnosis, epidemiology, associations/risks and management/treatment, focusing on return to work or work retention and taking account of distinctions between non-specific complaints and specific diagnoses. Neither biomedical treatment nor ergonomic workplace interventions alone offer an optimal solution; rather, multimodal interventions show considerable promise, particularly for occupational outcomes. Early return to work, or work retention, is an important goal for most cases and may be facilitated, where necessary, by transitional work arrangements. The emergent evidence indicates that successful management strategies require all the players to be on side and acting in a coordinated fashion; this requires engaging employers and workers to participate. The biopsychosocial model applies: biological considerations should not be ignored, but psychosocial factors are more influential for occupational outcomes. Implementation of interventions that address the full range of psychosocial issues will require a cultural shift in the way the relationship between upper limb complaints and work is conceived and handled. Dissemination of evidence-based messages can contribute to the needed cultural shift.

Fidelity considerations in translational research: Eating As Treatment - a stepped wedge, randomised controlled trial of a dietitian delivered behaviour change counselling intervention for head and neck cancer patients undergoing radiotherapy.

PubMed

Beck, Alison Kate; Baker, Amanda; Britton, Ben; Wratten, Chris; Bauer, Judith; Wolfenden, Luke; Carter, Gregory

2015-10-15

The confidence with which researchers can comment on intervention efficacy relies on evaluation and consideration of intervention fidelity. Accordingly, there have been calls to increase the transparency with which fidelity methodology is reported. Despite this, consideration and/or reporting of fidelity methods remains poor. We seek to address this gap by describing the methodology for promoting and facilitating the evaluation of intervention fidelity in The EAT (Eating As Treatment) project: a multi-site stepped wedge randomised controlled trial of a dietitian delivered behaviour change counselling intervention to improve nutrition (primary outcome) in head and neck cancer patients undergoing radiotherapy. In accordance with recommendations from the National Institutes of Health Behaviour Change Consortium Treatment Fidelity Workgroup, we sought to maximise fidelity in this stepped wedge randomised controlled trial via strategies implemented from study design through to provider training, intervention delivery and receipt. As the EAT intervention is designed to be incorporated into standard dietetic consultations, we also address unique challenges for translational research. We offer a strong model for improving the quality of translational findings via real world application of National Institutes of Health Behaviour Change Consortium recommendations. Greater transparency in the reporting of behaviour change research is an important step in improving the progress and quality of behaviour change research. ACTRN12613000320752 (Date of registration 21 March 2013).

Recommendations for Culturally Sensitive Research Methods

ERIC Educational Resources Information Center

Awad, Germine H.; Patall, Erika A.; Rackley, Kadie R.; Reilly, Erin D.

2016-01-01

As the US continues to diversify, methods for accurately assessing human behavior must evolve. This paper offers multicultural research considerations at several stages of the research process for psychological research and consultation. Implications regarding the comparative research framework are discussed and suggestions are offered on how to…

Relative efficacy of cash versus vouchers in engaging opioid substitution treatment clients in survey-based research.

PubMed

Topp, Libby; Islam, M Mofizul; Day, Carolyn Ann

2013-04-01

Concerns that cash payments to people who inject drugs (PWID) to reimburse research participation will facilitate illicit drug purchases have led some ethical authorities to mandate department store/supermarket vouchers as research reimbursement. To examine the relative efficacy of the two forms of reimbursement in engaging PWID in research, clients of two public opioid substitution therapy clinics were invited to participate in a 20-30 min, anonymous and confidential interview about alcohol consumption on two separate occasions, 4 months apart. Under the crossover design, at Time 1, clients of Clinic 1 were offered $A20 cash as reimbursement, while clients of Clinic 2 were offered an $A20 voucher; at Time 2, the form of reimbursement was reversed. Using clinic records to determine the denominator (number of clients dosed), we found that compared with clients offered a voucher, a significantly higher proportion of clients who were offered cash participated in the survey (58% (139/241) vs 74% (186/252); χ(2)=14.27; p=0.0002). At first participation, respondents most commonly reported planning to purchase food/drinks/groceries (68%), cigarettes (21%) and transport/fuel (11%) with their payments, with those reimbursed in cash more likely to report planning to fund transport/fuel (19% vs 1%; p<.01) and less likely to report planning to purchase food/drinks/groceries (62% vs 76%; p=0.02). Just three out of 155 cash participants reported planning to purchase illicit drugs with their payment. Results demonstrate that modest cash payments enhanced recruitment of this group, an important consideration given the challenges of delineating the parameters of a population defined by illegal activity, seemingly without promoting excessive additional drug use.

SSTO vs TSTO design considerations—an assessment of the overall performance, design considerations, technologies, costs, and sensitivities of SSTO and TSTO designs using modern technologies

NASA Astrophysics Data System (ADS)

Penn, Jay P.

1996-03-01

It is generally believed by those skilled in launch system design that Single-Stage-To-Orbit (SSTO) designs are more technically challenging, more performance sensitive, and yield larger lift-off weights than do Two-Stage-To-Orbit designs (TSTO's) offering similar payload delivery capability. Without additional insight into the other considerations which drive the development, recurring costs, operability, and reliability of a launch fleet, an analyst may easily conclude that the higher performing, less sensitive TSTO designs, thus yield a better solution to achieving low cost payload delivery. This limited insight could justify an argument to eliminate the X-33 SSTO technology/demonstration development effort, and thus proceed directly to less risky TSTO designs. Insight into real world design considerations of launch vehicles makes the choice of SSTO vs TSTO much less clear. The presentation addresses a more comprehensive evaluation of the general class of SSTO and TSTO concepts. These include pure SSTO's, augmented SSTO's, Siamese Twin, and Pure TSTO designs. The assessment considers vehicle performance and scaling relationships which characterize real vehicle designs. The assessment also addresses technology requirements, operations and supportability, cost implications, and sensitivities. Results of the assessment indicate that the trade space between various SSTO and TSTO design approaches is complex and not yet fully understood. The results of the X-33 technology demonstrators, as well as additional parametric analysis is required to better define the relative performance and costs of the various design approaches. The results also indicate that with modern technologies and today's better understanding of vehicle design considerations, the perception that SSTO's are dramatically heavier and more sensitive than TSTO designs is more of a myth, than reality.

Managing Professional and Nurse-Patient Relationship Boundaries in Mental Health.

PubMed

Valente, Sharon M

2017-01-01

Caring nurse-patient relationships in mental health settings are key components in helping patients recover. These professional relationships provide a safe, trustworthy, reliable, and secure foundation for therapeutic interactions; however, nurses face challenges in setting and maintaining relationship boundaries. Although patients ask for special privileges, romantic interactions, and social media befriending, or offer expensive gifts, nurses must recognize that these boundary violations may erode trust and harm patients. These violations may also trigger discipline for nurses. Professional relationship guidelines must be applied with thoughtful consideration, and nurses must monitor their emotions and reactions in these relationships. The current article is a sharing of personal experiences about boundaries augmented by evidence in the literature, and focuses on managing potential boundary violations (i.e., social media, sexuality, over-involvement, and gift giving) in mental health settings. [Journal of Psychosocial Nursing and Mental Health Services, 55(1), 45-51.]. Copyright 2017, SLACK Incorporated.

Coming In: Queer Narratives of Sexual Self-Discovery.

PubMed

Rosenberg, Shoshana

2017-10-09

Many models of queer sexuality continue to depict a linear narrative of sexual development, beginning in repression/concealment and eventuating in coming out. The present study sought to challenge this by engaging in a hermeneutically informed thematic analysis of interviews with eight queer people living in Western Australia. Four themes were identified: "searching for identity," "society, stigma, and self," "sexual self-discovery," and "coming in." Interviewees discussed internalized homophobia and its impact on their life; experiences and implications of finding a community and achieving a sense of belonging; the concept of sexual self-discovery being a lifelong process; and sexuality as fluid, dynamic, and situational rather than static. The article concludes by suggesting that the idea of "coming in"-arriving at a place of acceptance of one's sexuality, regardless of its fluidity or how it is viewed by society-offers considerable analytic leverage for understanding the journeys of sexual self-discovery of queer-identified people.

Industrial bioprocesses: beyond routine applications of established methodologies.

PubMed

Junker, Beth

2010-04-15

The subject matter of manuscripts by industrial authors has primarily focused on elements with perceived commercial or regulatory significance. Once published, this information interacted and ultimately influenced manuscripts from authors of other affiliations, creating the rapid advancements that culminated in the current multi-billion dollar worldwide biotechnology industry. This paper discusses trends in "solely industrial" articles published in the specific journal of Biotechnology and Bioengineering over the past five decades of this journal's lifetime. "Solely industrial" articles were defined as papers in which all the authors were affiliated with industry. Data were gathered concerning "solely industrial" article distribution and frequency, authoring companies, subject classification, and category distribution. Selected articles and their impact were related to current and past technology milestones as well as associated challenges. Suggestions for areas of greater emphasis to influence the number and subject matter of "solely industrial" articles for the journal's sixth decade were offered for consideration.

Gene panel testing for inherited cancer risk.

PubMed

Hall, Michael J; Forman, Andrea D; Pilarski, Robert; Wiesner, Georgia; Giri, Veda N

2014-09-01

Next-generation sequencing technologies have ushered in the capability to assess multiple genes in parallel for genetic alterations that may contribute to inherited risk for cancers in families. Thus, gene panel testing is now an option in the setting of genetic counseling and testing for cancer risk. This article describes the many gene panel testing options clinically available to assess inherited cancer susceptibility, the potential advantages and challenges associated with various types of panels, clinical scenarios in which gene panels may be particularly useful in cancer risk assessment, and testing and counseling considerations. Given the potential issues for patients and their families, gene panel testing for inherited cancer risk is recommended to be offered in conjunction or consultation with an experienced cancer genetic specialist, such as a certified genetic counselor or geneticist, as an integral part of the testing process. Copyright © 2014 by the National Comprehensive Cancer Network.

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

The bacterial skin microbiome in psoriatic arthritis, an unexplored link in pathogenesis: challenges and opportunities offered by recent technological advances.

PubMed

Castelino, Madhura; Eyre, Stephen; Upton, Mathew; Ho, Pauline; Barton, Anne

2014-05-01

The resident microbial community, harboured by humans in sites such as the skin and gastrointestinal tract, is enormous, representing a candidate environmental factor affecting susceptibility to complex diseases, where both genetic and environmental risk factors are important. The potential of microorganisms to influence the human immune system is considerable, given their ubiquity. The impact of the host-gene-microbe interaction on the maintenance of health and the development of disease has not yet been assessed robustly in chronic inflammatory conditions. PsA represents a model inflammatory disease to explore the role of the microbiome because skin involvement and overlap with IBD implicates both the skin and gastrointestinal tract as sources of microbial triggers for PsA. In parallel with genetic studies, characterization of the host microbiota may benefit our understanding of the microbial contribution to disease pathogenesis-knowledge that may eventually inform the development of novel therapeutics.

Recent advances in ChIP-seq analysis: from quality management to whole-genome annotation.

PubMed

Nakato, Ryuichiro; Shirahige, Katsuhiko

2017-03-01

Chromatin immunoprecipitation followed by sequencing (ChIP-seq) analysis can detect protein/DNA-binding and histone-modification sites across an entire genome. Recent advances in sequencing technologies and analyses enable us to compare hundreds of samples simultaneously; such large-scale analysis has potential to reveal the high-dimensional interrelationship level for regulatory elements and annotate novel functional genomic regions de novo. Because many experimental considerations are relevant to the choice of a method in a ChIP-seq analysis, the overall design and quality management of the experiment are of critical importance. This review offers guiding principles of computation and sample preparation for ChIP-seq analyses, highlighting the validity and limitations of the state-of-the-art procedures at each step. We also discuss the latest challenges of single-cell analysis that will encourage a new era in this field. © The Author 2016. Published by Oxford University Press.

Research University STEM Faculty Members' Motivation to Engage in Teaching Professional Development: Building the Choir Through an Appeal to Extrinsic Motivation and Ego

NASA Astrophysics Data System (ADS)

Bouwma-Gearhart, Jana

2012-10-01

This paper reports on a qualitative, grounded-theory-based study that explored the motivations of science and engineering faculty to engage in teaching professional development at a major research university. Faculty members were motivated to engage in teaching professional development due to extrinsic motivations, mainly a weakened professional ego, and sought to bring their teaching identities in better concordance with their researcher identities. The results pose a challenge to a body of research that has concluded that faculty must be intrinsically motivated to participate in teaching professional development. Results confirmed a pre-espoused theory of motivation, self-determination theory; a discussion of research literature consideration during grounded theory research is offered. A framework for motivating more faculty members at research universities to engage in teaching professional development is provided.

Recent Progress in Genome Editing Approaches for Inherited Cardiovascular Diseases.

PubMed

Kaur, Balpreet; Perea-Gil, Isaac; Karakikes, Ioannis

2018-06-02

This review describes the recent progress in nuclease-based therapeutic applications for inherited heart diseases in vitro, highlights the development of the most recent genome editing technologies and discusses the associated challenges for clinical translation. Inherited cardiovascular disorders are passed from generation to generation. Over the past decade, considerable progress has been made in understanding the genetic basis of inherited heart diseases. The timely emergence of genome editing technologies using engineered programmable nucleases has revolutionized the basic research of inherited cardiovascular diseases and holds great promise for the development of targeted therapies. The genome editing toolbox is rapidly expanding, and new tools have been recently added that significantly expand the capabilities of engineered nucleases. Newer classes of versatile engineered nucleases, such as the "base editors," have been recently developed, offering the potential for efficient and precise therapeutic manipulation of the human genome.

A definition of the degree of controllability - A criterion for actuator placement

NASA Technical Reports Server (NTRS)

Viswanathan, C. N.; Longman, R. W.; Likins, P. W.

1979-01-01

The unsolved problem of how to control the attitude and shape of future very large flexible satellite structures represents a challenging problem for modern control theory. One aspect of this problem is the question of how to choose the number and locations throughout the spacecraft of the control system actuators. Starting from basic physical considerations, this paper develops a concept of the degree of controllability of a control system, and then develops numerical methods to generate approximate values of the degree of controllability for any spacecraft. These results offer the control system designer a tool which allows him to rank the effectiveness of alternative actuator distributions, and hence to choose the actuator locations on a rational basis. The degree of controllability is shown to take a particularly simple form when the satellite dynamics equations are in modal form. Examples are provided to illustrate the use of the concept on a simple flexible spacecraft.

Verification and quality control of routine hematology analyzers.

PubMed

Vis, J Y; Huisman, A

2016-05-01

Verification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and linearity throughout the expected range of results. Yet, which standard should be met or which verification limit be used is at the discretion of the laboratory specialist. This paper offers practical guidance on verification and quality control of automated hematology analyzers and provides an expert opinion on the performance standard that should be met by the contemporary generation of hematology analyzers. Therefore (i) the state-of-the-art performance of hematology analyzers for complete blood count parameters is summarized, (ii) considerations, challenges, and pitfalls concerning the development of a verification plan are discussed, (iii) guidance is given regarding the establishment of reference intervals, and (iv) different methods on quality control of hematology analyzers are reviewed. © 2016 John Wiley & Sons Ltd.

CT, MRI and PET imaging in peritoneal malignancy

PubMed Central

Sahdev, Anju; Reznek, Rodney H.

2011-01-01

Abstract Imaging plays a vital role in the evaluation of patients with suspected or proven peritoneal malignancy. Nevertheless, despite significant advances in imaging technology and protocols, assessment of peritoneal pathology remains challenging. The combination of complex peritoneal anatomy, an extensive surface area that may host tumour deposits and the considerable overlap of imaging appearances of various peritoneal diseases often makes interpretation difficult. Contrast-enhanced multidetector computed tomography (MDCT) remains the most versatile tool in the imaging of peritoneal malignancy. However, conventional and emerging magnetic resonance imaging (MRI) and positron emission tomography (PET)/CT techniques offer significant advantages over MDCT in detection and surveillance. This article reviews established and new techniques in CT, MRI and PET imaging in both primary and secondary peritoneal malignancies and provides an overview of peritoneal anatomy, function and modes of disease dissemination with illustration of common sites and imaging features of peritoneal malignancy. PMID:21865109

INCREASING CULTURALLY COMPETENT NEUROPSYCHOLOGICAL SERVICES FOR ETHNIC MINORITY POPULATIONS: A CALL TO ACTION

PubMed Central

Mindt, Monica Rivera; Byrd, Desiree; Saez, Pedro; Manly, Jennifer

2010-01-01

US demographic and sociopolitical shifts have resulted in a rapidly growing need for culturally competent neuropsychological services. However, clinical neuropsychology as a field has not kept pace with the needs of ethnic minority clients. In this discussion we review: historical precedents and the limits of universalism in neuropsychology; ethical/professional guidelines pertinent to neuropsychological practice with ethnic minority clients; critical cultural considerations in neuropsychology; current disparities germane to practice; and challenges to the provision of services to racial/ethnic minority clients. We provide a call to action for neuropsychologists and related organizations to advance multiculturalism and diversity within the field by increasing multicultural awareness and knowledge, multicultural education and training, multicultural neuropsychological research, and the provision of culturally competent neuropsychological services to racial/ethnic minority clients. Lastly, we discuss strategies for increasing the provision of culturally competent neuropsychological services, and offer several resources to meet these goals. PMID:20373222

Epigenetics Advancing Personalized Nanomedicine in Cancer Therapy

PubMed Central

Liu, Shujun

2012-01-01

Personalized medicine aims to deliver the right drug to a right patient at the right time. It offers unique opportunities to integrate new technologies and concepts to disease prognosis, diagnosis and therapeutics. While selective personalized therapies are conceptually impressive, the majority of cancer therapies have dismal outcome. Such therapeutic failure could result from no response, drug resistance, disease relapse or severe side effect from improper drug delivery. Nanomedicine, the application of nanotechnology in medicine, has a potential to advance the identification of diagnostic and prognostic biomarkers and the delivery of right drug to disease sites. Epigenetic aberrations dynamically contribute to cancer pathogenesis. Given the individualized traits of epigenetic biomarkers, epigenetic considerations would significantly refine personalized nanomedicine. This review aims to dissect the interface of personalized medicine with nanomedicine and epigenetics. I will outline the progress and highlight challenges and areas that can be further explored perfecting the personalized health care. PMID:22921595

Brain metastasis and treatment

PubMed Central

Ahluwalia, Manmeet S.; Vogelbaum, Michael V.; Chao, Samuel T.

2014-01-01

Despite major therapeutic advances in the management of patients with systemic malignancies, management of brain metastases remains a significant challenge. These patients often require multidisciplinary care that includes surgical resection, radiation therapy, chemotherapy, and targeted therapies. Complex decisions about the sequencing of therapies to control extracranial and intracranial disease require input from neurosurgeons, radiation oncologists, and medical/neuro-oncologists. With advances in understanding of the biology of brain metastases, molecularly defined disease subsets and the advent of targeted therapy as well as immunotherapeutic agents offer promise. Future care of these patients will entail tailoring treatment based on host (performance status and age) and tumor (molecular cytogenetic characteristics, number of metastases, and extracranial disease status) factors. Considerable work involving preclinical models and better clinical trial designs that focus not only on effective control of tumor but also on quality of life and neurocognition needs to be done to improve the outcome of these patients. PMID:25580268

Mesenchymal stem cells for bone repair and metabolic bone diseases.

PubMed

Undale, Anita H; Westendorf, Jennifer J; Yaszemski, Michael J; Khosla, Sundeep

2009-10-01

Human mesenchymal stem cells offer a potential alternative to embryonic stem cells in clinical applications. The ability of these cells to self-renew and differentiate into multiple tissues, including bone, cartilage, fat, and other tissues of mesenchymal origin, makes them an attractive candidate for clinical applications. Patients who experience fracture nonunion and metabolic bone diseases, such as osteogenesis imperfecta and hypophosphatasia, have benefited from human mesenchymal stem cell therapy. Because of their ability to modulate immune responses, allogeneic transplant of these cells may be feasible without a substantial risk of immune rejection. The field of regenerative medicine is still facing considerable challenges; however, with the progress achieved thus far, the promise of stem cell therapy as a viable option for fracture nonunion and metabolic bone diseases is closer to reality. In this review, we update the biology and clinical applicability of human mesenchymal stem cells for bone repair and metabolic bone diseases.

Maximum likelihood estimation and EM algorithm of Copas-like selection model for publication bias correction.

PubMed

Ning, Jing; Chen, Yong; Piao, Jin

2017-07-01

Publication bias occurs when the published research results are systematically unrepresentative of the population of studies that have been conducted, and is a potential threat to meaningful meta-analysis. The Copas selection model provides a flexible framework for correcting estimates and offers considerable insight into the publication bias. However, maximizing the observed likelihood under the Copas selection model is challenging because the observed data contain very little information on the latent variable. In this article, we study a Copas-like selection model and propose an expectation-maximization (EM) algorithm for estimation based on the full likelihood. Empirical simulation studies show that the EM algorithm and its associated inferential procedure performs well and avoids the non-convergence problem when maximizing the observed likelihood. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Synthesis and chemistry of elemental 2D materials

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

Mannix, Andrew J.; Kiraly, Brian; Hersam, Mark C.

2017-01-25

2D materials have attracted considerable attention in the past decade for their superlative physical properties. These materials consist of atomically thin sheets exhibiting covalent in-plane bonding and weak interlayer and layer-substrate bonding. Following the example of graphene, most emerging 2D materials are derived from structures that can be isolated from bulk phases of layered materials, which form a limited library for new materials discovery. Entirely synthetic 2D materials provide access to a greater range of properties through the choice of constituent elements and substrates. Of particular interest are elemental 2D materials, because they provide the most chemically tractable case formore » synthetic exploration. In this Review, we explore the progress made in the synthesis and chemistry of synthetic elemental 2D materials, and offer perspectives and challenges for the future of this emerging field.« less

Cell death induced by ozone and various non-thermal plasmas: therapeutic perspectives and limitations

PubMed Central

Lunov, Oleg; Zablotskii, Vitalii; Churpita, Olexander; Chánová, Eliška; Syková, Eva; Dejneka, Alexandr; Kubinová, Šárka

2014-01-01

Non-thermal plasma has been recognized as a promising tool across a vast variety of biomedical applications, with the potential to create novel therapeutic methods. However, the understanding of the molecular mechanisms behind non-thermal plasma cellular effects remains a significant challenge. In this study, we show how two types of different non-thermal plasmas induce cell death in mammalian cell cultures via the formation of multiple intracellular reactive oxygen/nitrogen species. Our results showed a discrepancy in the superoxide accumulation and lysosomal activity in response to air and helium plasma, suggesting that triggered signalling cascades might be grossly different between different plasmas. In addition, the effects of ozone, a considerable component of non-thermal plasma, have been simultaneously evaluated and have revealed much faster and higher cytotoxic effects. Our findings offer novel insight into plasma-induced cellular responses, and provide a basis for better controlled biomedical applications. PMID:25410636

Getting Personal: Head and Neck Cancer Management in the Era of Genomic Medicine

PubMed Central

Birkeland, Andrew C.; Uhlmann, Wendy R.; Brenner, J. Chad; Shuman, Andrew G.

2015-01-01

Background Genetic testing is rapidly becoming an important tool in the management of patients with head and neck cancer. As we enter the era of genomics and personalized medicine, providers should be aware of testing options, counseling resources, and the benefits, limitations and future of personalized therapy. Methods This manuscript offers a primer to assist clinicians treating patients in anticipating and managing the inherent practical and ethical challenges of cancer care in the genomic era. Results Clinical applications of genomics for head and neck cancer are emerging. We discuss the indications for genetic testing, types of testing available, implications for care, privacy/disclosure concerns and ethical considerations. Hereditary genetic syndromes associated with head and neck neoplasms are reviewed, and online genetics resources are provided. Conclusions This article summarizes and contextualizes the evolving diagnostic and therapeutic options that impact the care of patients with head and neck cancer in the genomic era. PMID:25995036

High time-resolved radon progeny measurements in the Arctic region (Svalbard islands, Norway): results and potentialities

NASA Astrophysics Data System (ADS)

Salzano, Roberto; Pasini, Antonello; Ianniello, Antonietta; Mazzola, Mauro; Traversi, Rita; Udisti, Roberto

2018-05-01

The estimation of radon progeny in the Arctic region represents a scientific challenge due to the required low limit of detection in consideration of the limited radon emanation associated with permafrost dynamics. This preliminary study highlighted, for the first time above 70° N, the possibility to monitor radon progeny in the Arctic region with a higher time resolution. The composition of the radon progeny offered the opportunity to identify air masses dominated by long-range transport, in presence or absence of near-constant radon progeny instead of long- and short-lived progenies. Furthermore, the different ratio between radon and thoron progenies evidenced the contributions of local emissions and atmospheric stability. Two different emanation periods were defined in accordance with the permafrost dynamics at the ground and several accumulation windows were recognized coherently to the meteo-climatic conditions occurring at the study site.

Perspectives of antiferromagnetic spintronics

NASA Astrophysics Data System (ADS)

Jungfleisch, Matthias B.; Zhang, Wei; Hoffmann, Axel

2018-04-01

Antiferromagnets are promising for future spintronic applications owing to their advantageous properties: They are magnetically ordered, but neighboring magnetic moments point in opposite directions, which results in zero net magnetization. This means antiferromagnets produce no stray fields and are insensitive to external magnetic field perturbations. Furthermore, they show intrinsic high frequency dynamics, exhibit considerable spin-orbit and magneto-transport effects. Over the past decade, it has been realized that antiferromagnets have more to offer than just being utilized as passive components in exchange bias applications. This development resulted in a paradigm shift, which opens the pathway to novel concepts using antiferromagnets for spin-based technologies and applications. This article gives a broad perspective on antiferromagnetic spintronics. In particular, the manipulation and detection of antiferromagnetic states by spintronics effects, as well as spin transport and dynamics in antiferromagnetic materials will be discussed. We will also outline current challenges and future research directions in this emerging field.

Bioreactor concepts for cell culture-based viral vaccine production.

PubMed

Gallo-Ramírez, Lilí Esmeralda; Nikolay, Alexander; Genzel, Yvonne; Reichl, Udo

2015-01-01

Vaccine manufacturing processes are designed to meet present and upcoming challenges associated with a growing vaccine market and to include multi-use facilities offering a broad portfolio and faster reaction times in case of pandemics and emerging diseases. The final products, from whole viruses to recombinant viral proteins, are very diverse, making standard process strategies hardly universally applicable. Numerous factors such as cell substrate, virus strain or expression system, medium, cultivation system, cultivation method, and scale need consideration. Reviewing options for efficient and economical production of human vaccines, this paper discusses basic factors relevant for viral antigen production in mammalian cells, avian cells and insect cells. In addition, bioreactor concepts, including static systems, single-use systems, stirred tanks and packed-beds are addressed. On this basis, methods towards process intensification, in particular operational strategies, the use of perfusion systems for high product yields, and steps to establish continuous processes are introduced.

More are better, but the details matter: combinations of multiple Fresnel zone plates for improved resolution and efficiency in X-ray microscopy

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

Li, Kenan; Jacobsen, Chris

Fresnel zone plates used for X-ray nanofocusing face high-aspect-ratio nanofabrication challenges in combining narrow transverse features (for high spatial resolution) along with extended optical modulation along the X-ray beam direction (to improve efficiency). The stacking of multiple Fresnel zone plates along the beam direction has already been shown to offer improved characteristics of resolution and efficiency when compared with thin single zone plates. Using multislice wave propagation simulation methods, here a number of new schemes for the stacking of multiple Fresnel zone plates are considered. These include consideration of optimal thickness and spacing in the axial direction, and methods tomore » capture a fraction of the light otherwise diffracted into unwanted orders, and instead bring it into the desired first-order focus. In conclusion, the alignment tolerances for stacking multiple Fresnel zone plates are also considered.« less

Advanced low-activation materials. Fibre-reinforced ceramic composites

NASA Astrophysics Data System (ADS)

Fenici, P.; Scholz, H. W.

1994-09-01

A serious safety and environmental concern for thermonuclear fusion reactor development regards the induced radioactivity of the first wall and structural components. The use of low-activation materials (LAM) in a demonstration reactor would reduce considerably its potential risk and facilitate its maintenance. Moreover, decommissioning and waste management including disposal or even recycling of structural materials would be simplified. Ceramic fibre-reinforced SiC materials offer highly appreciable low activation characteristics in combination with good thermomechanical properties. This class of materials is now under experimental investigation for structural application in future fusion reactors. An overview on the recent results is given, covering coolant leak rates, thermophysical properties, compatibility with tritium breeder materials, irradiation effects, and LAM-consistent purity. SiC/SiC materials present characteristics likely to be optimised in order to meet the fusion application challenge. The scope is to put into practice the enormous potential of inherent safety with fusion energy.

Devices of Responsibility: Over a Decade of Responsible Research and Innovation Initiatives for Nanotechnologies.

PubMed

Shelley-Egan, Clare; Bowman, Diana M; Robinson, Douglas K R

2017-10-10

Responsible research and innovation (RRI) has come to represent a change in the relationship between science, technology and society. With origins in the democratisation of science, and the inclusion of ethical and societal aspects in research and development activities, RRI offers a means of integrating society and the research and innovation communities. In this article, we frame RRI activities through the lens of layers of science and technology governance as a means of characterising the context in which the RRI activity is positioned and the goal of those actors promoting the RRI activities in shaping overall governance patterns. RRI began to emerge during a time of considerable deliberation about the societal and governance challenges around nanotechnology, in which stakeholders were looking for new ways of integrating notions of responsibility in nanotechnology research and development. For this reason, this article focuses on nanotechnology as the site for exploring the evolution and growth of RRI.

Critical gases for critical issues: CO2 technologies for oral drug delivery.

PubMed

Danan, Hana; Esposito, Pierandrea

2014-02-01

In recent years, CO2-based technologies have gained considerable interest in the pharmaceutical industry for their potential applications in drug formulation and drug delivery. The exploitation of peculiar properties of gases under supercritical conditions has been studied in the last 20 years with mixed results. Promising drug-delivery technologies, based on supercritical CO2, have mostly failed when facing challenges of industrial scaleability and economical viability. Nevertheless, a 'second generation' of processes, based on CO2 around and below critical point has been developed, possibly offering technology-based solutions to some of the current issues of pharmaceutical development. In this review, we highlight the most recent advancements in this field, with a particular focus on the potential of CO2-based technologies in addressing critical issues in oral delivery, and briefly discuss the future perspectives of dense CO2-assisted processes as enabling technologies in drug delivery.

A community-based approach to trials of aerobic exercise in aging and Alzheimer’s disease

PubMed Central

Vidoni, Eric D.; Van Sciver, Angela; Johnson, David K.; He, Jinghua; Honea, Robyn; Haines, Brian; Goodwin, Jami; Laubinger, M. Pat; Anderson, Heather S.; Kluding, Patricia M.; Donnelly, Joseph E.; Billinger, Sandra A.; Burns, Jeffrey M.

2012-01-01

The benefits of exercise for aging have received considerable attention in both the popular and academic press. The putative benefits of exercise for maximizing cognitive function and supporting brain health have great potential for combating Alzheimer’s disease (AD). Aerobic exercise offers a low-cost, low-risk intervention that is widely available and may have disease modifying effects. Demonstrating aerobic exercise alters the AD process would have enormous public health implications. The purpose of this paper is to a report the protocol of a current, community-based pilot study of aerobic exercise for AD to guide future investigation. This manuscript provides 1) an overview of possible benefits of exercise in those with dementia, 2) a rationale and recommendations for implementation of a community-based approach, 3) recommendation for implementation of similar study protocols, 4) unique challenges in conducting an exercise trial in AD. PMID:22903151

The agency problem and medical acting: an example of applying economic theory to medical ethics.

PubMed

Langer, Andreas; Schröder-Bäck, Peter; Brink, Alexander; Eurich, Johannes

2009-03-01

In this article, the authors attempt to build a bridge between economic theory and medical ethics to offer a new perspective to tackle ethical challenges in the physician-patient encounter. They apply elements of new institutional economics to the ethically relevant dimensions of the physician-patient relationship in a descriptive heuristic sense. The principal-agent theory can be used to analytically grasp existing action problems in the physician-patient relationship and as a basis for shaping recommendations at the institutional level. Furthermore, the patients' increased self-determination and modern opportunities for the medical laity to inform themselves lead to a less asymmetrical distribution of information between physician and patient and therefore require new interaction models. Based on the analysis presented here, the authors recommend that, apart from the physician's necessary individual ethics, greater consideration should be given to approaches of institutional ethics and hence to incentive systems within medical ethics.

New trends of short-term humanitarian medical volunteerism: professional and ethical considerations.

PubMed

Asgary, Ramin; Junck, Emily

2013-10-01

Short-term humanitarian medical volunteerism has grown significantly among both clinicians and trainees over the past several years. Increasingly, both volunteers and their respective institutions have faced important challenges in regard to medical ethics and professional codes that should not be overlooked. We explore these potential concerns and their risk factors in three categories: ethical responsibilities in patient care, professional responsibility to communities and populations, and institutional responsibilities towards trainees. We discuss factors increasing the risk of harm to patients and communities, including inadequate preparation, the use of advanced technology and the translation of Western medicine, issues with clinical epidemiology and test utility, difficulties with the principles of justice and clinical justice, the lack of population-based medicine, sociopolitical effects of foreign aid, volunteer stress management, and need for sufficient trainee supervision. We review existing resources and offer suggestions for future skill-based training, organisational responsibilities, and ethical preparation.

Graphene-based nanoprobes for molecular diagnostics.

PubMed

Chen, Shixing; Li, Fuwu; Fan, Chunhai; Song, Shiping

2015-10-07

In recent years, graphene has received widespread attention owing to its extraordinary electrical, chemical, optical, mechanical and structural properties. Lately, considerable interest has been focused on exploring the potential applications of graphene in life sciences, particularly in disease-related molecular diagnostics. In particular, the coupling of functional molecules with graphene as a nanoprobe offers an excellent platform to realize the detection of biomarkers, such as nucleic acids, proteins and other bioactive molecules, with high performance. This article reviews emerging graphene-based nanoprobes in electrical, optical and other assay methods and their application in various strategies of molecular diagnostics. In particular, this review focuses on the construction of graphene-based nanoprobes and their special advantages for the detection of various bioactive molecules. Properties of graphene-based materials and their functionalization are also comprehensively discussed in view of the development of nanoprobes. Finally, future challenges and perspectives of graphene-based nanoprobes are discussed.

Perspectives of antiferromagnetic spintronics

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

Jungfleisch, Matthias B.; Zhang, Wei; Hoffmann, Axel

2018-04-01

Antiferromagnets are promising for future spintronics applications owing to their interesting properties: They are magnetically ordered, but neighboring magnetic moments point in opposite directions which results in zero net magneti- zation. This means antiferromagnets produce no stray fields and are insensitive to external magnetic field perturbations. Furthermore, they show intrinsic high frequency dynamics, exhibit considerable spin-orbit and magneto-transport effects. Over the past decade, it has been realized that antiferromagnets have more to offer than just being utilized as passive components in exchange bias applications. This development resulted in a paradigm shift, which opens the pathway to novel concepts using antiferromagnetsmore » for spin-based technologies and applications. This article gives a broad per- spective on antiferromagnetic spintronics. In particular, the manipulation and detection of anitferromagnetic states by spintronics effects, as well as spin transport and dynamics in antiferromagnetic materials will be discussed. We will also outline current challenges and future research directions in this emerging field.« less

Opportunities for Intervention Strategies for Weight Management: Global Actions on Fluid Intake Patterns

PubMed Central

Lafontan, Max; Visscher, Tommy L.S.; Farpour-Lambert, Nathalie; Yumuk, Volkan

2015-01-01

Water is an essential nutrient for all physiological functions and particularly important for thermoregulation. About 60% of our body weight is made of water. Under standard conditions (18-20 °C and moderate activity), water balance is regulated within 0.2 % of body weight over a 24-hour period. Water requirement varies between individuals and according to environmental conditions. Concerning considerations related to obesity, the health impact of fluid intake is commonly overlooked. Fluid intake advices are missing in most of food pyramids offered to the public, and water requirements and hydration challenges remain often neglected. The purpose of this paper is to emphasize and discuss the role of water consumption in the context of other important public health measures for weight management. Attention will be focused on fluid intake patterns and hydration-related questions in the context of global interventions and/or physical activity programs settled in weight management protocols. PMID:25765164

Managing Emergency Situations in the Smart City: The Smart Signal.

PubMed

Asensio, Ángel; Blanco, Teresa; Blasco, Rubén; Marco, Álvaro; Casas, Roberto

2015-06-18

In a city there are numerous items, many of them unnoticed but essential; this is the case of the signals. Signals are considered objects with reduced technological interest, but in this paper we prove that making them smart and integrating in the IoT (Internet of Things) could be a relevant contribution to the Smart City. This paper presents the concept of Smart Signal, as a device conscious of its context, with communication skills, able to offer the best message to the user, and as a ubiquitous element that contributes with information to the city. We present the design considerations and a real implementation and validation of the system in one of the most challenging environments that may exist in a city: a tunnel. The main advantages of the Smart Signal are the improvement of the actual functionality of the signal providing new interaction capabilities with users and a new sensory mechanism of the Smart City.

Aerodynamics of a cycling team in a time trial: does the cyclist at the front benefit?

NASA Astrophysics Data System (ADS)

Íñiguez-de-la Torre, A.; Íñiguez, J.

2009-11-01

When seasonal journeys take place in nature, birds and fishes migrate in groups. This provides them not only with security but also a considerable saving of energy. The power they need to travel requires overcoming aerodynamic or hydrodynamic drag forces, which can be substantially reduced when the group travels in an optimal arrangement. Also in this area, humans imitate nature, which is especially evident in the practice of outdoor sports and motor competitions. Cycle races, in which speeds of up to 15 m s-1 are frequent, offer great opportunities to appreciate the advantage of travelling in a group. Here we present a brief analysis of the aerodynamics of a cycling team in a time-trial challenge, showing how each rider is favoured according to his position in the group. We conclude that the artificial tail wind created by the team also benefits the cyclist at the front by about 5%.

Elucidation of high sensitivity of δ-HMX: New insight from first principles simulations

NASA Astrophysics Data System (ADS)

Kuklja, Maija M.; Tsyshevsky, Roman V.; Sharia, Onise

2017-01-01

Understanding of a significant difference in sensitivities of β and δ phases of cyclotetramethylene-tetranitramine (HMX) has been long one of the challenges in the field of high energy density materials. Despite many experimental and theoretical efforts to explain the high sensitivity of the δ phase, convincing reasons behind the HMX behavior remained unclear. We established that the presence of a polar surface in δ-HMX has fundamental implications for stability and overall chemical behavior of the material. A comparative quantum-chemical analysis of decomposition mechanisms in polar δ-HMX and nonpolar β-HMX discovered a considerable difference in dominating dissociation reactions, activation barriers, and reaction rates. The polarization-induced charge transfer offered a logical explanation for different sensitivity of β-HMX and δ-HMX polymorphs to detonation initiation. Our conclusions also removed long-standing contradictions and explained a large range of experimental data on thermal decomposition of HMX.

Patient Electronic Health Records as a Means to Approach Genetic Research in Gastroenterology

PubMed Central

Ananthakrishnan, Ashwin N; Lieberman, David

2015-01-01

Electronic health records (EHR) are being increasingly utilized and form a unique source of extensive data gathered during routine clinical care. Through use of codified and free text concepts identified using clinical informatics tools, disease labels can be assigned with a high degree of accuracy. Analysis linking such EHR-assigned disease labels to a biospecimen repository has demonstrated that genetic associations identified in prospective cohorts can be replicated with adequate statistical power, and novel phenotypic associations identified. In addition, genetic discovery research can be performed utilizing clinical, laboratory, and procedure data obtained during care. Challenges with such research include the need to tackle variability in quality and quantity of EHR data and importance of maintaining patient privacy and data security. With appropriate safeguards, this novel and emerging field of research offers considerable promise and potential to further scientific research in gastroenterology efficiently, cost-effectively, and with engagement of patients and communities. PMID:26073373

Beyond Utterances: Distributed Cognition as a Framework for Studying Discourse in Adults with Acquired Brain Injury

PubMed Central

Duff, Melissa C.; Mutlu, Bilge; Byom, Lindsey; Turkstra, Lyn S.

2014-01-01

Considerable effort has been directed at understanding the nature of the communicative deficits observed in individuals with acquired brain injuries. Yet several theoretical, methodological, and clinical challenges remain. In this article, we examine distributed cognition as a framework for understanding interaction among communication partners, interaction of communication and cognition, and interaction with the environments and contexts of everyday language use. We review the basic principles of distributed cognition and the implications for applying this approach to the study of discourse in individuals with cognitive-communication disorders. We also review a range of protocols and findings from our research that highlight how the distributed cognition approach might offer a deeper understanding of communicative mechanisms and deficits in individuals with cognitive communication impairments. The advantages and implications of distributed cognition as a framework for studying discourse in adults with acquired brain injury are discussed. PMID:22362323

Quality and clinical supply considerations of Paediatric Investigation Plans for IV preparations-A case study with the FP7 CloSed project.

PubMed

Hanning, Sara M; Orlu Gul, Mine; Winslade, Jackie; Baarslag, Manuel A; Neubert, Antje; Tuleu, Catherine

2016-09-25

A Paediatric Investigation Plan (PIP) is a development plan that aims to ensure that sufficient data are obtained through studies in paediatrics to support the generation of marketing authorisation of medicines for children. This paper highlights some practical considerations and challenges with respect to PIP submissions and paediatric clinical trials during the pharmaceutical development phase, using the FP7-funded Clonidine for Sedation of Paediatric Patients in the Intensive Care Unit (CloSed) project as a case study. Examples discussed include challenges and considerations regarding formulation development, blinding and randomisation, product labelling and shipment and clinical trial requirements versus requirements for marketing authorisation. A significant quantity of information is required for PIP submissions and it is hoped that future applicants may benefit from an insight into some critical considerations and challenges faced in the CloSed project. Copyright © 2016 Elsevier B.V. All rights reserved.

River Rampage: Navigating Your Off-Site Adventure.

ERIC Educational Resources Information Center

Wheat, Ann; Munoz-Weingarten, Sandy

1996-01-01

The City of Phoenix offers a five-day river-based camping experience to at-risk and disabled teens. Describes how professional river outfitters are contracted to run the trips, staffing considerations, liability and safety considerations, and camper orientation. Evaluation showed that participants received lasting measurable benefits, including…

Aerospace Measurements: Challenges and Opportunities

NASA Technical Reports Server (NTRS)

Conway, Bruce A.

1992-01-01

New aerospace research initiatives offer both challenges and opportunities to rapidly-emerging electronics and electro-optics technology. Defining and implementing appropriate measurement technology development programs in response to the aeronautical ground facility research and testing needs of the new initiatives poses some particularly important problems. This paper discusses today's measurement challenges along with some of the technological opportunities which offer some hope for meeting the challenges, and describes measurement technology activities currently underway in the Langley Research Center's Instrument Research Division to address modern aerospace research and design engineering requirements. Projected and realized benefits and payoffs from the ongoing measurement and instrumentation efforts will be emphasized. A discussion of future trends in the aerospace measurement technology field will be included.

Assessing Social – Ecological Trade-Offs to Advance Ecosystem-Based Fisheries Management

PubMed Central

Voss, Rudi; Quaas, Martin F.; Schmidt, Jörn O.; Tahvonen, Olli; Lindegren, Martin; Möllmann, Christian

2014-01-01

Modern resource management faces trade-offs in the provision of various ecosystem goods and services to humanity. For fisheries management to develop into an ecosystem-based approach, the goal is not only to maximize economic profits, but to consider equally important conservation and social equity goals. We introduce such a triple-bottom line approach to the management of multi-species fisheries using the Baltic Sea as a case study. We apply a coupled ecological-economic optimization model to address the actual fisheries management challenge of trading-off the recovery of collapsed cod stocks versus the health of ecologically important forage fish populations. Management strategies based on profit maximization would rebuild the cod stock to high levels but may cause the risk of stock collapse for forage species with low market value, such as Baltic sprat (Fig. 1A). Economically efficient conservation efforts to protect sprat would be borne almost exclusively by the forage fishery as sprat fishing effort and profits would strongly be reduced. Unless compensation is paid, this would challenge equity between fishing sectors (Fig. 1B). Optimizing equity while respecting sprat biomass precautionary levels would reduce potential profits of the overall Baltic fishery, but may offer an acceptable balance between overall profits, species conservation and social equity (Fig. 1C). Our case study shows a practical example of how an ecosystem-based fisheries management will be able to offer society options to solve common conflicts between different resource uses. Adding equity considerations to the traditional trade-off between economy and ecology will greatly enhance credibility and hence compliance to management decisions, a further footstep towards healthy fish stocks and sustainable fisheries in the world ocean. PMID:25268117

Pathogen reduction and blood transfusion safety in Africa: strengths, limitations and challenges of implementation in low-resource settings.

PubMed

Ware, A D; Jacquot, C; Tobian, A A R; Gehrie, E A; Ness, P M; Bloch, E M

2018-01-01

Transfusion-transmitted infection risk remains an enduring challenge to blood safety in Africa. A high background incidence and prevalence of the major transfusion-transmitted infections (TTIs), dependence on high-risk donors to meet demand, suboptimal testing and quality assurance collectively contribute to the increased risk. With few exceptions, donor testing is confined to serological evaluation of human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) and syphilis. Barriers to implementation of broader molecular methods include cost, limited infrastructure and lack of technical expertise. Pathogen reduction (PR), a term used to describe a variety of methods (e.g. solvent detergent treatment or photochemical activation) that may be applied to blood following collection, offers the means to diminish the infectious potential of multiple pathogens simultaneously. This is effective against different classes of pathogen, including the major TTIs where laboratory screening is already implemented (e.g. HIV, HBV and HCV) as well pathogens that are widely endemic yet remain unaddressed (e.g. malaria, bacterial contamination). We sought to review the available and emerging PR techniques and their potential application to resource-constrained parts of Africa, focusing on the advantages and disadvantages of such technologies. PR has been slow to be adopted even in high-income countries, primarily given the high costs of use. Logistical considerations, particularly in low-resourced parts of Africa, also raise concerns about practicality. Nonetheless, PR offers a rational, innovative strategy to contend with TTIs; technologies in development may well present a viable complement or even alternative to targeted screening in the future. © 2017 International Society of Blood Transfusion.

Accessing new understandings of trauma-informed care with queer birthing women in a rural context.

PubMed

Searle, Jennifer; Goldberg, Lisa; Aston, Megan; Burrow, Sylvia

2017-11-01

Participant narratives from a feminist and queer phenomenological study aim to broaden current understandings of trauma. Examining structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma-informed strategies that reconstruct formerly disempowering perinatal relationships. Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Analysis of the qualitative data was guided by feminist and queer phenomenology. This was well suited to understanding queer women's storied narratives of trauma, including disempowering processes of structural marginalisation. Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer-identified women who had experiences of birthing in rural Nova Scotia, Canada. Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that reconstructs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. New trauma-informed assessment strategies reconstruct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re-experiencing the process of coming out as queer in opposition to the expectation of heterosexuality. © 2017 John Wiley & Sons Ltd.

Roadmap on optical energy conversion

NASA Astrophysics Data System (ADS)

Boriskina, Svetlana V.; Green, Martin A.; Catchpole, Kylie; Yablonovitch, Eli; Beard, Matthew C.; Okada, Yoshitaka; Lany, Stephan; Gershon, Talia; Zakutayev, Andriy; Tahersima, Mohammad H.; Sorger, Volker J.; Naughton, Michael J.; Kempa, Krzysztof; Dagenais, Mario; Yao, Yuan; Xu, Lu; Sheng, Xing; Bronstein, Noah D.; Rogers, John A.; Alivisatos, A. Paul; Nuzzo, Ralph G.; Gordon, Jeffrey M.; Wu, Di M.; Wisser, Michael D.; Salleo, Alberto; Dionne, Jennifer; Bermel, Peter; Greffet, Jean-Jacques; Celanovic, Ivan; Soljacic, Marin; Manor, Assaf; Rotschild, Carmel; Raman, Aaswath; Zhu, Linxiao; Fan, Shanhui; Chen, Gang

2016-07-01

For decades, progress in the field of optical (including solar) energy conversion was dominated by advances in the conventional concentrating optics and materials design. In recent years, however, conceptual and technological breakthroughs in the fields of nanophotonics and plasmonics combined with a better understanding of the thermodynamics of the photon energy-conversion processes reshaped the landscape of energy-conversion schemes and devices. Nanostructured devices and materials that make use of size quantization effects to manipulate photon density of states offer a way to overcome the conventional light absorption limits. Novel optical spectrum splitting and photon-recycling schemes reduce the entropy production in the optical energy-conversion platforms and boost their efficiencies. Optical design concepts are rapidly expanding into the infrared energy band, offering new approaches to harvest waste heat, to reduce the thermal emission losses, and to achieve noncontact radiative cooling of solar cells as well as of optical and electronic circuitries. Light-matter interaction enabled by nanophotonics and plasmonics underlie the performance of the third- and fourth-generation energy-conversion devices, including up- and down-conversion of photon energy, near-field radiative energy transfer, and hot electron generation and harvesting. Finally, the increased market penetration of alternative solar energy-conversion technologies amplifies the role of cost-driven and environmental considerations. This roadmap on optical energy conversion provides a snapshot of the state of the art in optical energy conversion, remaining challenges, and most promising approaches to address these challenges. Leading experts authored 19 focused short sections of the roadmap where they share their vision on a specific aspect of this burgeoning research field. The roadmap opens up with a tutorial section, which introduces major concepts and terminology. It is our hope that the roadmap will serve as an important resource for the scientific community, new generations of researchers, funding agencies, industry experts, and investors.

A framework for developing rural academic general practices: a qualitative case study in rural Victoria.

PubMed

Brown, J B; Morrison, Tracy; Bryant, Melanie; Kassell, Lisa; Nestel, Debra

2015-01-01

There is increasing pressure for Australian rural general practices to engage in educational delivery as a means of addressing workforce issues and accommodating substantial increases in learners. For practices that have now developed a strong focus on education, there is the challenge to complement this by engaging in research activity. This study develops a rural academic general practice framework to assist rural practices in developing both comprehensive educational activity and a strong research focus thus moving towards functioning as mature academic units. A case study research design was used with the unit of analysis at the level of the rural general practice. Purposively sampled practices were recruited and individual interviews conducted with staff (supervisors, practice managers, nurses), learners (medical students, interns and registrars) and patients. Three practices hosted 'multi-level learners', two practices hosted one learner group and one had no learners. Forty-four individual interviews were conducted with staff, learners and patients. Audio recordings were transcribed for thematic analysis. After initial inductive coding, deductive analysis was undertaken with reference to recent literature and the expertise of the research team resulting in the rural academic general practice framework. Three key themes emerged with embedded subthemes. For the first theme, organisational considerations, subthemes were values/vision/culture, patient population and clinical services, staffing, physical infrastructure/equipment, funding streams and governance. For the second theme, educational considerations, subthemes were processes, clinical supervision, educational networks and learner presence. Third, for research considerations, there were the subthemes of attitude to research and research activity. The framework maps the development of a rural academic practice across these themes in four progressive stages: beginning, emerging, consolidating and established. The data enabled a framework to be constructed to map rural general practice activity with respect to activity characteristic of an academic general practice. The framework offers guidance to practices seeking to transition towards becoming a mature academic practice. The framework also offers guidance to educational institutions and funding bodies to support the development of academic activity in rural general practices. The strengths and limitations of the study design are outlined.

Physics and technological aspects of nanofluidics.

PubMed

Bocquet, Lyderic; Tabeling, Patrick

2014-09-07

From a physical perspective, nanofluidics represents an extremely rich domain. It hosts many mechanisms acting on the nanoscale, which combine together or interact with the confinement to generate new phenomena. Superfast flows in carbon nanotubes, nonlinear electrokinetic transport, slippage over smooth surfaces, nanobubble stability, etc. are the most striking phenomena that have been unveiled over the past few years, and some of them are still awaiting an explanation. One may anticipate that new nanofluidic effects will be discovered in the future, but at the moment, the technological barrier is high. Fabrication of nanochannels is most often a tour de force, slow and costly. However, with the accumulation of technological skills along with the use of new nanofluidic materials (like nanotubes), nanofluidics is becoming increasingly accessible to experimentalists. Among the technological challenges faced by the field, fabricating devices mimicking natural nanometric systems, such as aquaporins, ionic pumps or kidney osmotic filtering, seems the most demanding in terms of groundbreaking ideas. Nanoflow characterization remains delicate, although considerable progress has been achieved over the past years. The targeted application of nanofluidics is not only in the field of genomics and membrane science--with disruptive developments to be expected for water purification, desalination, and energy harvesting--but also for oil and gas production from unconventional reservoirs. Today, in view of the markets that are targeted, nanofluidics may well impact the industry more than microfluidics; this would represent an unexpected paradox. These successes rely on using a variety of materials and technologies, using state-of-the-art nanofabrication, or low-tech inexpensive approaches. As a whole, nanofluidics is a fascinating field that is facing considerable challenges today. It possesses a formidable potential and offers much space for creative groundbreaking ideas.

Organ Transplantation in Iran; Current State and Challenges with a View on Ethical Consideration.

PubMed

Kiani, Mehrzad; Abbasi, Mahmoud; Ahmadi, Mehdi; Salehi, Bahare

2018-03-05

Organ transplantation is a new issue in medical science. It is an important achievement and a sign of the progression and ability of medical centers around the world. Governments, populations, the medical community and people involved in culture, art, and media all have a decisive role in the culture of organ donation, which is the only way to guarantee that the healthy organs of a brain-dead person can continue to work and save the lives of people in need of organ transplantation. The brain death phenomenon and its possible application in organ transplantation, while offering new hope for the salvation of a number of patients, has led to many ethical, cultural, and legal issues. Ethical issues in organ transplantation are very complicated due to many social factors such as religion, culture, and traditions of the affected communities. The ethical and legal points of removing organs from the body of a living or cadaveric source, the definition of brain death, the moral and legal conditions of the donor and the recipient, and the financial relationship between them and many others, are all critical issues in organ transplantation. While there may be no available explicit solution to these issues, they should be rigorously considered by the experts. Efforts to systematically eliminate barriers and solve problems in organ transplantation, can not only reduce the costs of maintaining brain-dead patients and encourage patients that need organ transplantation but can also prevent immoral and illegal activities. In this paper, we have reviewed the most important and current challenges in organ transplantation with a view to the ethical considerations, and we have suggested some strategies to extend it in Iran.

Rethinking autonomy: decision making between patient and surgeon in advanced illnesses

PubMed Central

Hinshaw, Daniel B.

2016-01-01

Patients with advanced illness such as advanced stage cancer presenting with the need for possible surgical intervention can be some of the most challenging cases for a surgeon. Often there are multiple factors influencing the decisions made. For patients they are facing not just the effects of the disease on their body, but the stark realization that the disease will also limit their life. Not only are these factors a consideration when patients are making decisions, but also the desire to make the decision that is best for themselves, the autonomous decision. Also included in this process for the patient facing the possible need for an intervention is the surgeon. While patient autonomy remains one of the main principles within medicine, guiding treatment decisions, there is also the surgeon’s autonomy to be considered. Surgeons determine if there is even a possible intervention to be offered to patients, a decision making process that respects surgeons’ autonomous choices and includes elements of paternalism as surgeons utilize their expertise to make decisions. Included in the treatment decisions that are made and the care of the patient is the impact patients’ outcomes have on the surgeon, the inherent drive to be the best for the patient and desire for good outcomes for the patient. While both the patient’s and surgeon’s autonomy are a dynamic interface influencing decision making, the main goal for the patient facing a palliative procedure is that of making treatment decisions based on the concept of shared decision making, always giving primary consideration to the patient’s goals and values. Lastly, regardless of the decision made, it is the responsibility of surgeons to their patients to be a source of support through this challenging time. PMID:27004224

Organ Transplantation in Iran; Current State and Challenges with a View on Ethical Consideration

PubMed Central

Kiani, Mehrzad; Abbasi, Mahmoud

2018-01-01

Organ transplantation is a new issue in medical science. It is an important achievement and a sign of the progression and ability of medical centers around the world. Governments, populations, the medical community and people involved in culture, art, and media all have a decisive role in the culture of organ donation, which is the only way to guarantee that the healthy organs of a brain-dead person can continue to work and save the lives of people in need of organ transplantation. The brain death phenomenon and its possible application in organ transplantation, while offering new hope for the salvation of a number of patients, has led to many ethical, cultural, and legal issues. Ethical issues in organ transplantation are very complicated due to many social factors such as religion, culture, and traditions of the affected communities. The ethical and legal points of removing organs from the body of a living or cadaveric source, the definition of brain death, the moral and legal conditions of the donor and the recipient, and the financial relationship between them and many others, are all critical issues in organ transplantation. While there may be no available explicit solution to these issues, they should be rigorously considered by the experts. Efforts to systematically eliminate barriers and solve problems in organ transplantation, can not only reduce the costs of maintaining brain-dead patients and encourage patients that need organ transplantation but can also prevent immoral and illegal activities. In this paper, we have reviewed the most important and current challenges in organ transplantation with a view to the ethical considerations, and we have suggested some strategies to extend it in Iran. PMID:29510570

Policy, Systems, and Environmental Change in the Mississippi Delta: Considerations for Evaluation Design

ERIC Educational Resources Information Center

Kegler, Michelle C.; Honeycutt, Sally; Davis, Melvin; Dauria, Emily; Berg, Carla; Dove, Cassandra; Gamble, Abigail; Hawkins, Jackie

2015-01-01

Community-level policy, systems, and environmental (PSE) change strategies may offer an economical and sustainable approach to chronic disease prevention. The rapidly growing number of untested but promising PSE strategies currently underway offers an exciting opportunity to establish practice-based evidence for this approach. This article…

75 FR 27602 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... rules governing offers and sales of securities made outside the United States without registration under... clarification of the extent to which Section 5 of the Securities Act applies to offers and sales of securities... collection techniques or other forms of information technology. Consideration will be given to comments and...

"Birth Control can Easily Take a Back Seat": Challenges Providing IUDs in Community Health Care Settings.

PubMed

Biggs, M Antonia; Kaller, Shelly; Harper, Cynthia C; Freedman, Lori; Mays, Aisha R

2018-01-01

To assess community health centers' (CHCs) capacity to offer streamlined intrauterine devices (IUDs) services. Prior to implementing a contraceptive training project, we surveyed health care staff (N=97) from 11 CHC sites that offer IUDs onsite. Twenty interviews with clinicians explored more deeply their challenges offering IUDs in the CHC setting. Most practices required multiple visits for IUD placement, most (66%) clinician survey respondents had placed an IUD and 19% had placed an IUD as emergency contraception. Need for screening tests, scheduling challenges, pressures to meet patient quotas, and lack of priority given to women's health hindered streamlined IUD provision. Although access to IUDs has increased, significant barriers to provision in CHC settings persist. Clinic policies may need to address a variety of system and provider-level barriers to meet the needs of patients.

Educational Fund Raising: Principles and Practice. American Council on Education Series on Higher Education.

ERIC Educational Resources Information Center

Worth, Michael J., Ed.

This volume offers 36 papers on higher education fundraising. Major topics treated are the development function, foundations of fund raising, annual giving, major gifts, campaigns, corporate and foundation support, special constituencies, managing development programs, special considerations for institutions, and special considerations for the…

Mesoamerica Writing at the Crossroads: The Late Formative.

ERIC Educational Resources Information Center

Stross, Brian

1990-01-01

Offers an overview of Later Formative period writing in Mesoamerica, and discusses recent findings. Asserts that analysis of the iconographic context of the script reveals considerable interdependence between text and context and provides a glimpse of the importance of cosmological considerations in the display of power. Discusses the importance…

Impact and Costs of Incentives to Reduce Attrition in Online Trials: Two Randomized Controlled Trials

PubMed Central

Murray, Elizabeth; Kalaitzaki, Eleftheria; White, Ian R; McCambridge, Jim; Thompson, Simon G; Wallace, Paul; Godfrey, Christine

2011-01-01

Background Attrition from follow-up is a major methodological challenge in randomized trials. Incentives are known to improve response rates in cross-sectional postal and online surveys, yet few studies have investigated whether they can reduce attrition from follow-up in online trials, which are particularly vulnerable to low follow-up rates. Objectives Our objective was to determine the impact of incentives on follow-up rates in an online trial. Methods Two randomized controlled trials were embedded in a large online trial of a Web-based intervention to reduce alcohol consumption (the Down Your Drink randomized controlled trial, DYD-RCT). Participants were those in the DYD pilot trial eligible for 3-month follow-up (study 1) and those eligible for 12-month follow-up in the DYD main trial (study 2). Participants in both studies were randomly allocated to receive an offer of an incentive or to receive no offer of an incentive. In study 1, participants in the incentive arm were randomly offered a £5 Amazon.co.uk gift voucher, a £5 charity donation to Cancer Research UK, or entry in a prize draw for £250. In study 2, participants in the incentive arm were offered a £10 Amazon.co.uk gift voucher. The primary outcome was the proportion of participants who completed follow-up questionnaires in the incentive arm(s) compared with the no incentive arm. Results In study 1 (n = 1226), there was no significant difference in response rates between those participants offered an incentive (175/615, 29%) and those with no offer (162/611, 27%) (difference = 2%, 95% confidence interval [CI] –3% to 7%). There was no significant difference in response rates among the three different incentives offered. In study 2 (n = 2591), response rates were 9% higher in the group offered an incentive (476/1296, 37%) than in the group not offered an incentive (364/1295, 28%) (difference = 9%, 95% CI 5% to 12%, P < .001). The incremental cost per extra successful follow-up in the incentive arm was £110 in study 1 and £52 in study 2. Conclusion Whereas an offer of a £10 Amazon.co.uk gift voucher can increase follow-up rates in online trials, an offer of a lower incentive may not. The marginal costs involved require careful consideration. Trial registration ISRCTN31070347; http://www.controlled-trials.com/ISRCTN31070347 (Archived by WebCite at http://www.webcitation.org/5wgr5pl3s) PMID:21371988

Whole-slide imaging: routine pathologic diagnosis.

PubMed

Cornish, Toby C; Swapp, Ryan E; Kaplan, Keith J

2012-05-01

Digital pathology systems offer pathologists an alternate, emerging mechanism to manage and interpret information. They offer increasingly fast and scalable hardware platforms for slide scanning and software that facilitates remote viewing, slide conferencing, archiving, and image analysis. Deployed initially and validated largely within the research and biopharmaceutical industries, WSI is increasingly being implemented for direct patient care. Improvements in image quality, scan times, and imageviewing browsers will hopefully allow pathologists to more seamlessly convert to digital pathology, much like our radiology colleagues have done before us. However, WSI creates both opportunities and challenges. Although niche applications of WSI technology for clinical, educational, and research purposes are clearly successful, it is evident that several areas still require attention and careful consideration before more widespread clinical adoption of WSI takes place. These include regulatory issues, development of standards of practice and validation guidelines, workflow modifications, as well as defining situations where WSI technology will really improve practice in a cost-effective way. Current progress on these and other issues, along with improving technology, will no doubt pave the way for increased adoption over the next decade, allowing the pathology community as a whole to harness the true potential of WSI for patient care. The digital decade will likely redefine how pathology is practiced and the role of the pathologist.

Reconstructing the historical distribution of the Amur Leopard (Panthera pardus orientalis) in Northeast China based on historical records

PubMed Central

Yang, Li; Huang, Mujiao; Zhang, Rui; Lv, Jiang; Ren, Yueheng; Jiang, Zhe; Zhang, Wei; Luan, Xiaofeng

2016-01-01

Abstract The range of the Amur leopard (Panthera pardus orientalis) has decreased dramatically over the last 100 years. This species is still under extreme risk of extinction and conservation efforts are rigorous. Understanding the long-term dynamics of the population decline would be helpful to offer insight into the mechanism behind the decline and endangerment and improve conservation perspectives and strategies. Historical data collection has been the challenge for reconstructing the historical distribution. In China, new gazetteers having systematic compilation and considerable local ecological data can be considered as an important complementary for reconstruction. Therefore, we have set up a data set (mainly based on the new gazetteers) in order to identify the historical range of the Amur Leopard from the 1950s to 2014. The result shows that the Amur leopard was historically widely distributed with large populations in Northeastern China, but it presented a sharp decline after the 1970s. The decline appeared from the plains to the mountains and northeast to southwest since the 1950s. Long-term historical data, mainly from new gazetteers, demonstrates that such resources are capable of tracking species change through time and offers an opportunity to reduce data shortage and enhance understanding in conservation. PMID:27408548

Public health ethical perspectives on the values of the European Commission's White Paper "Together for Health".

PubMed

Schröder-Bäck, Peter; Clemens, Timo; Michelsen, Kai; Schulte in den Bäumen, Tobias; Sørensen, Kristine; Borrett, Glenn; Brand, Helmut

2012-06-01

In 2007 the European Commission issued the White Paper: "Together for Health". Considered the EU Health Strategy for the years 2008-2013, it offers the cornerstones for setting priorities in EU health actions. The public health framework offered in this strategy is explicitly built on shared values--including the overarching values of universality, access to good quality care, equity and solidarity that reacted to certain health care challenges within the EU. This article analyses the Health Strategy via its ethical scope and considers implications for future health policy making. The Health Strategy and related documents are scrutinised to explore how the mentioned values are defined and enfolded. Additionally, scientific databases are searched for critical discussions of the value base of the Health Strategy. The results are discussed and reasoned from a public health ethical perspective. The Health Strategy is barely documented and discussed in the scientific literature. Furthermore, no attention was given to the value base of the Health Strategy. Our analysis shows that the mentioned values are particularly focussed on health care in general rather than on public health in particular. Besides this, the given values of the Health Strategy are redundant. An additional consideration of consequentialist public health ethics values would normatively strengthen a population-based health approach of EU health policy making.

Reconstructing the historical distribution of the Amur Leopard (Panthera pardus orientalis) in Northeast China based on historical records.

PubMed

Yang, Li; Huang, Mujiao; Zhang, Rui; Lv, Jiang; Ren, Yueheng; Jiang, Zhe; Zhang, Wei; Luan, Xiaofeng

2016-01-01

The range of the Amur leopard (Panthera pardus orientalis) has decreased dramatically over the last 100 years. This species is still under extreme risk of extinction and conservation efforts are rigorous. Understanding the long-term dynamics of the population decline would be helpful to offer insight into the mechanism behind the decline and endangerment and improve conservation perspectives and strategies. Historical data collection has been the challenge for reconstructing the historical distribution. In China, new gazetteers having systematic compilation and considerable local ecological data can be considered as an important complementary for reconstruction. Therefore, we have set up a data set (mainly based on the new gazetteers) in order to identify the historical range of the Amur Leopard from the 1950s to 2014. The result shows that the Amur leopard was historically widely distributed with large populations in Northeastern China, but it presented a sharp decline after the 1970s. The decline appeared from the plains to the mountains and northeast to southwest since the 1950s. Long-term historical data, mainly from new gazetteers, demonstrates that such resources are capable of tracking species change through time and offers an opportunity to reduce data shortage and enhance understanding in conservation.

The development and feasibility of an online aphasia group intervention and networking program - TeleGAIN.

PubMed

Pitt, Rachelle; Theodoros, Deborah; Hill, Anne J; Russell, Trevor

2017-09-04

Aphasia group therapy offers many benefits, however people with aphasia report difficulty accessing groups and speech-language pathologists are faced with many challenges in providing aphasia group therapy. Telerehabilitation may offer an alternative service delivery option. An online aphasia group therapy program - Telerehabilitation Group Aphasia Intervention and Networking (TeleGAIN) - has been developed according to the guidelines of the Medical Research Council (MRC) framework for complex interventions. The purpose of this paper is to describe the development of TeleGAIN and the results of a pilot trial to determine feasibility and acceptability. The development of TeleGAIN was informed through literature reviews in relevant topic areas, consideration of expert opinion and application of the social cognitive theory. TeleGAIN was then modelled through a feasibility pilot trial with four people with aphasia. TeleGAIN appeared to be feasible and acceptable to participants and able to be implemented as planned. Participant satisfaction with treatment was high and results suggested some potential for improvements in language functioning and communication-related quality of life. TeleGAIN appeared to be feasible and acceptable, however the study highlighted issues related to technology, clinical implementation and participant-specific factors that should be addressed prior to a larger trial.

Nanomechanical investigation of ion implanted single crystals - Challenges, possibilities and pitfall traps related to nanoindentation

NASA Astrophysics Data System (ADS)

Kurpaska, Lukasz

2017-10-01

Nanoindentation technique have developed considerably over last thirty years. Nowadays, commercially available systems offer very precise measurement in nano- and microscale, environmental noise cancelling (or at least noise suppressing), in situ high temperature indentation in controlled atmosphere and vacuum conditions and different additional options, among them dedicated indentation is one of the most popular. Due to its high precision, and ability to measure mechanical properties from very small depths (tens of nm), this technique become quite popular in the nuclear society. It is known that ion implantation (to some extent) can simulate the influence of neutron flux. However, depth of the material damage is very limited resulting in creation of thin layer of modified material over unmodified bulk. Therefore, only very precise technique, offering possibility to control depth of the measurement can be used to study functional properties of the material. For this reason, nanoindentation technique seems to be a perfect tool to investigate mechanical properties of ion implanted specimens. However, conducting correct nanomechanical experiment and extracting valuable mechanical parameters is not an easy task. In this paper a discussion about the nanoindentation tests performed on ion irradiated YSZ single crystal is presented. The goal of this paper is to discuss possible traps when studying mechanical properties of such materials and thin coatings.

Recent progress and considerations for AAV gene therapies targeting the central nervous system.

PubMed

Lykken, Erik Allen; Shyng, Charles; Edwards, Reginald James; Rozenberg, Alejandra; Gray, Steven James

2018-05-18

Neurodevelopmental disorders, as a class of diseases, have been particularly difficult to treat even when the underlying cause(s), such as genetic alterations, are understood. What treatments do exist are generally not curative and instead seek to improve quality of life for affected individuals. The advent of gene therapy via gene replacement offers the potential for transformative therapies to slow or even stop disease progression for current patients and perhaps minimize or prevent the appearance of symptoms in future patients. This review focuses on adeno-associated virus (AAV) gene therapies for diseases of the central nervous system. An overview of advances in AAV vector design for therapy is provided, along with a description of current strategies to develop AAV vectors with tailored tropism. Next, progress towards treatment of neurodegenerative diseases is presented at both the pre-clinical and clinical stages, focusing on a few select diseases to highlight broad categories of therapeutic parameters. Special considerations for more challenging cases are then discussed in addition to the immunological aspects of gene therapy. With the promising clinical trial results that have been observed for the latest AAV gene therapies and continued pre-clinical successes, the question is no longer whether a therapy can be developed for certain neurodevelopmental disorders, but rather, how quickly.

Teaching epidemiology in the digital age: considerations for academicians and their students.

PubMed

Caron, Rosemary M

2013-09-01

The way in which we prepare future public health professionals is changing because of the digital age. Online education is expanding the accessibility of public health training to students and practitioners with diverse backgrounds. Online courses offer many advantages for students, including flexible schedules, elimination of commuting time, and fostering interactions among students and the instructor. A few disadvantages of online courses for the student can include a feeling of isolation, difficulty adjusting to the time-intensive nature, and the required self-discipline to regularly tend to online course materials that immature and working students can find challenging. For faculty who are faced with teaching epidemiology in these changing times of the traditional face-to-face classroom and the virtual classroom, the core teaching principles of this science of public health remain unchanged, yet how they are delivered in the online environment adds a layer of complexity not previously encountered. This paper presents practical considerations for faculty who will be teaching online and their students who will be learning online. In addition, a framework for an online epidemiology course is presented as a model by which faculty interested in teaching epidemiology online can modify the course structure, content, and assessment tools to fit their needs. Copyright © 2013 Elsevier Inc. All rights reserved.

The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada Comment on "Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts".

PubMed

Lake, Stephanie; Kerr, Thomas

2016-09-10

A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization - adolescent usage and impaired driving - and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization - specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use - that have to date not received adequate attention. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A proposed clinical decision support architecture capable of supporting whole genome sequence information.

PubMed

Welch, Brandon M; Loya, Salvador Rodriguez; Eilbeck, Karen; Kawamoto, Kensaku

2014-04-04

Whole genome sequence (WGS) information may soon be widely available to help clinicians personalize the care and treatment of patients. However, considerable barriers exist, which may hinder the effective utilization of WGS information in a routine clinical care setting. Clinical decision support (CDS) offers a potential solution to overcome such barriers and to facilitate the effective use of WGS information in the clinic. However, genomic information is complex and will require significant considerations when developing CDS capabilities. As such, this manuscript lays out a conceptual framework for a CDS architecture designed to deliver WGS-guided CDS within the clinical workflow. To handle the complexity and breadth of WGS information, the proposed CDS framework leverages service-oriented capabilities and orchestrates the interaction of several independently-managed components. These independently-managed components include the genome variant knowledge base, the genome database, the CDS knowledge base, a CDS controller and the electronic health record (EHR). A key design feature is that genome data can be stored separately from the EHR. This paper describes in detail: (1) each component of the architecture; (2) the interaction of the components; and (3) how the architecture attempts to overcome the challenges associated with WGS information. We believe that service-oriented CDS capabilities will be essential to using WGS information for personalized medicine.

A Proposed Clinical Decision Support Architecture Capable of Supporting Whole Genome Sequence Information

PubMed Central

Welch, Brandon M.; Rodriguez Loya, Salvador; Eilbeck, Karen; Kawamoto, Kensaku

2014-01-01

Whole genome sequence (WGS) information may soon be widely available to help clinicians personalize the care and treatment of patients. However, considerable barriers exist, which may hinder the effective utilization of WGS information in a routine clinical care setting. Clinical decision support (CDS) offers a potential solution to overcome such barriers and to facilitate the effective use of WGS information in the clinic. However, genomic information is complex and will require significant considerations when developing CDS capabilities. As such, this manuscript lays out a conceptual framework for a CDS architecture designed to deliver WGS-guided CDS within the clinical workflow. To handle the complexity and breadth of WGS information, the proposed CDS framework leverages service-oriented capabilities and orchestrates the interaction of several independently-managed components. These independently-managed components include the genome variant knowledge base, the genome database, the CDS knowledge base, a CDS controller and the electronic health record (EHR). A key design feature is that genome data can be stored separately from the EHR. This paper describes in detail: (1) each component of the architecture; (2) the interaction of the components; and (3) how the architecture attempts to overcome the challenges associated with WGS information. We believe that service-oriented CDS capabilities will be essential to using WGS information for personalized medicine. PMID:25411644

Multilevel factorial experiments for developing behavioral interventions: power, sample size, and resource considerations.

PubMed

Dziak, John J; Nahum-Shani, Inbal; Collins, Linda M

2012-06-01

Factorial experimental designs have many potential advantages for behavioral scientists. For example, such designs may be useful in building more potent interventions by helping investigators to screen several candidate intervention components simultaneously and to decide which are likely to offer greater benefit before evaluating the intervention as a whole. However, sample size and power considerations may challenge investigators attempting to apply such designs, especially when the population of interest is multilevel (e.g., when students are nested within schools, or when employees are nested within organizations). In this article, we examine the feasibility of factorial experimental designs with multiple factors in a multilevel, clustered setting (i.e., of multilevel, multifactor experiments). We conduct Monte Carlo simulations to demonstrate how design elements-such as the number of clusters, the number of lower-level units, and the intraclass correlation-affect power. Our results suggest that multilevel, multifactor experiments are feasible for factor-screening purposes because of the economical properties of complete and fractional factorial experimental designs. We also discuss resources for sample size planning and power estimation for multilevel factorial experiments. These results are discussed from a resource management perspective, in which the goal is to choose a design that maximizes the scientific benefit using the resources available for an investigation. (c) 2012 APA, all rights reserved

Needs analysis of a flexible computerized management infrastructure

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

Usman, S.; Hajek, B. K.; Ali, S. F.

2006-07-01

The United States' Energy Policy Act of 2005 is expected to facilitate construction of new commercial nuclear power plants. In the meanwhile, current plants are in the process of obtaining licenses for extended operation beyond their predetermined design life. In this beneficial yet challenging situation, it seems desirable to develop a strategic plan for smooth and seamless transition from paper based procedure systems to computer based procedure systems for improved performance and safety of the existing nuclear power plants. Many utilities already maintain procedures using word processing software, but it is common to print paper copies for daily use. Atmore » this time it is highly desirable to better understand the collective as well as individual document management needs of a commercial nuclear power plant as they migrate to a computer based system. As a contributory role in initiating a strategic plan, this paper offers a comprehensive questionnaire that is suitable for conducting a survey to determine the related needs of the utilities. The questionnaire covers three major areas: Formatting and User Friendly Features; Technical and Environmental Considerations; and Safety, System Integrity and Regulatory Considerations. A plan to conduct the proposed survey is also outlined in the future work section of this paper. (authors)« less

Incorporating equity considerations in transport infrastructure evaluation: Current practice and a proposed methodology.

PubMed

Thomopoulos, N; Grant-Muller, S; Tight, M R

2009-11-01

Interest has re-emerged on the issue of how to incorporate equity considerations in the appraisal of transport projects and large road infrastructure projects in particular. This paper offers a way forward in addressing some of the theoretical and practical concerns that have presented difficulties to date in incorporating equity concerns in the appraisal of such projects. Initially an overview of current practice within transport regarding the appraisal of equity considerations in Europe is offered based on an extensive literature review. Acknowledging the value of a framework approach, research towards introducing a theoretical framework is then presented. The proposed framework is based on the well established MCA Analytic Hierarchy Process and is also contrasted with the use of a CBA based approach. The framework outlined here offers an additional support tool to decision makers who will be able to differentiate choices based on their views on specific equity principles and equity types. It also holds the potential to become a valuable tool for evaluators as a result of the option to assess predefined equity perspectives of decision makers against both the project objectives and the estimated project impacts. This framework may also be of further value to evaluators outside transport.

Centennial Challenges Program

NASA Technical Reports Server (NTRS)

Ortega, Sam; Eberly, Eric

2015-01-01

NASA's Centennial Challenges Program was initiated in 2005 to directly engage the public in the process of advanced technology development. The program offers incentive prizes to generate revolutionary solutions to problems of interest to NASA and the nation. The program seeks innovations from diverse and nontraditional sources. Competitors are not supported by government funding and awards are only made to successful teams when the challenges are met. In keeping with the spirit of the Wright Brothers and other American innovators, the Centennial Challenge prizes are offered to independent inventors including small businesses, student groups, and individuals. These independent inventors are sought to generate innovative solutions for technical problems of interest to NASA and the nation and to provide them with the opportunity to stimulate or create new business ventures.

School Provisions for Gifted, Talented and Able Students: A Response to Freeman

ERIC Educational Resources Information Center

Vidergor, Hava

2012-01-01

In this response to Joan Freeman's "A Quality of Giftedness," Have Vidergor states that provisions for gifted, talented, and excellent students should be offered by regular schools, taking into consideration levels of giftedness, offering a variety of interdisciplinary elective courses and subjects to about 20% of the school population,…

15 CFR 90.13 - Offer of hearing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Offer of hearing. 90.13 Section 90.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE PROCEDURE FOR CHALLENGING CERTAIN POPULATION AND INCOME ESTIMATES § 90.13 Offer of...

15 CFR 90.13 - Offer of hearing.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Offer of hearing. 90.13 Section 90.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE PROCEDURE FOR CHALLENGING CERTAIN POPULATION AND INCOME ESTIMATES § 90.13 Offer of...

15 CFR 90.13 - Offer of hearing.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false Offer of hearing. 90.13 Section 90.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE PROCEDURE FOR CHALLENGING CERTAIN POPULATION AND INCOME ESTIMATES § 90.13 Offer of...

15 CFR 90.13 - Offer of hearing.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Offer of hearing. 90.13 Section 90.13 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE PROCEDURE FOR CHALLENGING CERTAIN POPULATION AND INCOME ESTIMATES § 90.13 Offer of...

Evaluating the Buy or Rent Housing Decision.

ERIC Educational Resources Information Center

Davis, Joseph M.

This booklet offers guidelines by which a person can make an informed decision about whether buying or renting a house is the best individual alternative. Advantages and disadvantages of both buying and renting are listed. Cost considerations are discussed and compared along with such considerations as selection of the time to buy and estimation…

10 CFR 51.104 - NRC proceeding using public hearings; consideration of environmental impact statement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... environmental impact statement. 51.104 Section 51.104 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED....104 NRC proceeding using public hearings; consideration of environmental impact statement. (a)(1) In... scope of NEPA and this subpart are in issue, the NRC staff may not offer the final environmental impact...

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

Kandt, Alicen J

This presentation for the 2017 Energy Exchange in Tampa, Florida, offers information about advanced auditing technologies and techniques including alternative auditing approaches and considerations and caveats.

Challenges and Opportunities of Gas Engine Driven Heat Pumps: Two Case Studies

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

Abu-Heiba, Ahmad; Mahderekal, Dr. Isaac; Mehdizadeh Momen, Ayyoub

Gas engine driven heat pumps (GHP) currently hold a small market share. This share is considerably smaller than what the full potential of GHP technology can realize. Of the main benefits of the GHP technology is their better primary energy utilization mainly due to the ability to recover the engine heat. However, development and market penetration of GHP technology have been challenged by various market and technical barriers. The main barriers are the high initial cost, low awareness of the technology, and poor perception. On the other hand, several opportunities arise that the GHP technology can take advantage of tomore » increase its market share. The most direct opportunity is the abundance of cheap natural gas. This translates directly into monetary savings and higher ROI. GHPs offer the advantage of reducing the peak demand by 80% compared to electric counterpart. From the point of view of utilities, this eliminates the need for lower-efficiency peaking power plants and over-expansion only to cover maximum peak times. From the point of view of renewable customers, GHPs eliminate the need to buy power from the grid at a high price. This is especially important in hot climates with high cooling loads. When built and operated as distributed generation, GHPs can improve the reliability of power delivery to consumers. The paper discusses the challenges and opportunities as seen during the development and commercialization of two different GHP products; a 10-ton packaged unit and 5-ton split unit.« less

Nanotechnology in meat processing and packaging: potential applications - a review.

PubMed

Ramachandraiah, Karna; Han, Sung Gu; Chin, Koo Bok

2015-02-01

Growing demand for sustainable production, increasing competition and consideration of health concerns have led the meat industries on a path to innovation. Meat industries across the world are focusing on the development of novel meat products and processes to meet consumer demand. Hence, a process innovation, like nanotechnology, can have a significant impact on the meat processing industry through the development of not only novel functional meat products, but also novel packaging for the products. The potential benefits of utilizing nanomaterials in food are improved bioavailability, antimicrobial effects, enhanced sensory acceptance and targeted delivery of bioactive compounds. However, challenges exist in the application of nanomaterials due to knowledge gaps in the production of ingredients such as nanopowders, stability of delivery systems in meat products and health risks caused by the same properties which also offer the benefits. For the success of nanotechnology in meat products, challenges in public acceptance, economics and the regulation of food processed with nanomaterials which may have the potential to persist, accumulate and lead to toxicity need to be addressed. So far, the most promising area for nanotechnology application seems to be in meat packaging, but the long term effects on human health and environment due to migration of the nanomaterials from the packaging needs to be studied further. The future of nanotechnology in meat products depends on the roles played by governments, regulatory agencies and manufacturers in addressing the challenges related to the application of nanomaterials in food.

Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review

PubMed Central

Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

2016-01-01

During the United States economic recession of 2008–2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs. PMID:28042394

Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review.

PubMed

Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

2016-09-01

During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs.

Design Process of Flight Vehicle Structures for a Common Bulkhead and an MPCV Spacecraft Adapter

NASA Technical Reports Server (NTRS)

Aggarwal, Pravin; Hull, Patrick V.

2015-01-01

Design and manufacturing space flight vehicle structures is a skillset that has grown considerably at NASA during that last several years. Beginning with the Ares program and followed by the Space Launch System (SLS); in-house designs were produced for both the Upper Stage and the SLS Multipurpose crew vehicle (MPCV) spacecraft adapter. Specifically, critical design review (CDR) level analysis and flight production drawing were produced for the above mentioned hardware. In particular, the experience of this in-house design work led to increased manufacturing infrastructure for both Marshal Space Flight Center (MSFC) and Michoud Assembly Facility (MAF), improved skillsets in both analysis and design, and hands on experience in building and testing (MSA) full scale hardware. The hardware design and development processes from initiation to CDR and finally flight; resulted in many challenges and experiences that produced valuable lessons. This paper builds on these experiences of NASA in recent years on designing and fabricating flight hardware and examines the design/development processes used, as well as the challenges and lessons learned, i.e. from the initial design, loads estimation and mass constraints to structural optimization/affordability to release of production drawing to hardware manufacturing. While there are many documented design processes which a design engineer can follow, these unique experiences can offer insight into designing hardware in current program environments and present solutions to many of the challenges experienced by the engineering team.

Nanotechnology in Meat Processing and Packaging: Potential Applications — A Review

PubMed Central

Ramachandraiah, Karna; Han, Sung Gu; Chin, Koo Bok

2015-01-01

Growing demand for sustainable production, increasing competition and consideration of health concerns have led the meat industries on a path to innovation. Meat industries across the world are focusing on the development of novel meat products and processes to meet consumer demand. Hence, a process innovation, like nanotechnology, can have a significant impact on the meat processing industry through the development of not only novel functional meat products, but also novel packaging for the products. The potential benefits of utilizing nanomaterials in food are improved bioavailability, antimicrobial effects, enhanced sensory acceptance and targeted delivery of bioactive compounds. However, challenges exist in the application of nanomaterials due to knowledge gaps in the production of ingredients such as nanopowders, stability of delivery systems in meat products and health risks caused by the same properties which also offer the benefits. For the success of nanotechnology in meat products, challenges in public acceptance, economics and the regulation of food processed with nanomaterials which may have the potential to persist, accumulate and lead to toxicity need to be addressed. So far, the most promising area for nanotechnology application seems to be in meat packaging, but the long term effects on human health and environment due to migration of the nanomaterials from the packaging needs to be studied further. The future of nanotechnology in meat products depends on the roles played by governments, regulatory agencies and manufacturers in addressing the challenges related to the application of nanomaterials in food. PMID:25557827

New Unintended Adverse Consequences of Electronic Health Records

PubMed Central

Wright, A.; Ash, J.; Singh, H.

2016-01-01

Summary Although the health information technology industry has made considerable progress in the design, development, implementation, and use of electronic health records (EHRs), the lofty expectations of the early pioneers have not been met. In 2006, the Provider Order Entry Team at Oregon Health & Science University described a set of unintended adverse consequences (UACs), or unpredictable, emergent problems associated with computer-based provider order entry implementation, use, and maintenance. Many of these originally identified UACs have not been completely addressed or alleviated, some have evolved over time, and some new ones have emerged as EHRs became more widely available. The rapid increase in the adoption of EHRs, coupled with the changes in the types and attitudes of clinical users, has led to several new UACs, specifically: complete clinical information unavailable at the point of care; lack of innovations to improve system usability leading to frustrating user experiences; inadvertent disclosure of large amounts of patient-specific information; increased focus on computer-based quality measurement negatively affecting clinical workflows and patient-provider interactions; information overload from marginally useful computer-generated data; and a decline in the development and use of internally-developed EHRs. While each of these new UACs poses significant challenges to EHR developers and users alike, they also offer many opportunities. The challenge for clinical informatics researchers is to continue to refine our current systems while exploring new methods of overcoming these challenges and developing innovations to improve EHR interoperability, usability, security, functionality, clinical quality measurement, and information summarization and display. PMID:27830226

Nucleic acids-based tools for ballast water surveillance, monitoring, and research

NASA Astrophysics Data System (ADS)

Darling, John A.; Frederick, Raymond M.

2018-03-01

Understanding the risks of biological invasion posed by ballast water-whether in the context of compliance testing, routine monitoring, or basic research-is fundamentally an exercise in biodiversity assessment, and as such should take advantage of the best tools available for tackling that problem. The past several decades have seen growing application of genetic methods for the study of biodiversity, driven in large part by dramatic technological advances in nucleic acids analysis. Monitoring approaches based on such methods have the potential to increase dramatically sampling throughput for biodiversity assessments, and to improve on the sensitivity, specificity, and taxonomic accuracy of traditional approaches. The application of targeted detection tools (largely focused on PCR but increasingly incorporating novel probe-based methodologies) has led to a paradigm shift in rare species monitoring, and such tools have already been applied for early detection in the context of ballast water surveillance. Rapid improvements in community profiling approaches based on high throughput sequencing (HTS) could similarly impact broader efforts to catalogue biodiversity present in ballast tanks, and could provide novel opportunities to better understand the risks of biotic exchange posed by ballast water transport-and the effectiveness of attempts to mitigate those risks. These various approaches still face considerable challenges to effective implementation, depending on particular management or research needs. Compliance testing, for instance, remains dependent on accurate quantification of viable target organisms; while tools based on RNA detection show promise in this context, the demands of such testing require considerable additional investment in methods development. In general surveillance and research contexts, both targeted and community-based approaches are still limited by various factors: quantification remains a challenge (especially for taxa in larger size classes), gaps in nucleic acids reference databases are still considerable, uncertainties in taxonomic assignment methods persist, and many applications have not yet matured sufficiently to offer standardized methods capable of meeting rigorous quality assurance standards. Nevertheless, the potential value of these tools, their growing utilization in biodiversity monitoring, and the rapid methodological advances over the past decade all suggest that they should be seriously considered for inclusion in the ballast water surveillance toolkit.

Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation.

PubMed

New, Peter Wayne; Marshall, Ruth; Stubblefield, Michael D; Scivoletto, Giorgio

2017-03-01

People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs). Survey of rehabilitation health care professionals, consensus opinion from experts and literature search. Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada. Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor. Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission. Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs. A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes.

Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation

PubMed Central

Marshall, Ruth; Stubblefield, Michael D.; Scivoletto, Giorgio

2017-01-01

Background People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs). Design Survey of rehabilitation health care professionals, consensus opinion from experts and literature search. Setting Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada. Participants Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor. Outcomes Measures Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission. Results Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs. Conclusions A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes. PMID:27088581

Challenges Facing Teachers New to Working in Schools Overseas

ERIC Educational Resources Information Center

Halicioglu, Margaret L.

2015-01-01

This article considers the potential challenges facing teachers moving abroad for the first time, both professional challenges in their school and personal challenges in their private life. It suggests that such teachers embarking on a professional adventure overseas would benefit from careful consideration of the kind of school they will thrive…

Challenges in implementing individual placement and support in the Australian mental health service and policy context.

PubMed

Stirling, Yolande; Higgins, Kate; Petrakis, Melissa

2018-02-01

Objective Although Australia's service and policy context differs from that of the US, studies have highlighted potential for individual placement and support (IPS) to support competitive employment outcomes for people with severe and persistent mental illness. The aim of the present study was to explore why the model is not yet widely available. Methods A document analysis was conducted to discern reasons for challenges in implementation of IPS practice principles within the Australian service context. Results The document analysis illustrated that although policy acknowledges the importance of increasing employment rates for people with severe and persistent mental illness, consistent measures, change indicators, direction and time frames are lacking in policy and strategy documentation. Further, IPS principles are not consistently evident in guiding operational documentation that government-funded Disability Employment Services (DES) programs are mandated to adhere to. Conclusions For IPS to be readily implemented, it is necessary for government to offer support to agencies to partner and formal endorsement of the model as a preferred approach in tendering processes. Obligations and processes must be reviewed to ensure that model fidelity is achievable within the Australian Commonwealth policy and service context for programs to achieve competitive employment rates comparable to the most successful international programs. What is known about the topic? The IPS model has been established as the most efficacious approach to support people with severe and persistent mental ill health to gain and sustain employment internationally, yet little is known as to why this model has had very limited uptake in the Australian adult mental health service and policy context. What does this paper add? This paper provides an investigation into the achievability of IPS within DES philosophical and contractual arrangements. What are the implications for practitioners? Mental health practitioners are typically skilled in their understanding of individual or micro-level challenges faced by consumers in achieving vocational goals: working with symptoms, medication side effects, motivation and anxiety. The present study was designed to offer practitioners an increased understanding of service-level factors, because these present considerable challenges to achieving sustained employment. This paper is a call for greater advocacy towards better integration of employment and mental health service delivery in the Australian policy and practice context.

Pandemic Influenza and Pregnancy: An Opportunity to Reassess Maternal Bioethics

PubMed Central

Beigi, Richard H.

2009-01-01

Large-scale infectious epidemics present the medical community with numerous medical and ethical challenges. Recent attention has focused on the likelihood of an impending influenza pandemic caused by the H5N1 virus. Pregnant women in particular present policymakers with great challenges to planning for such a public health emergency. By recognizing the specific considerations needed for this population, we can preemptively address the issues presented by infectious disease outbreaks. We reviewed the important ethical challenges presented by pregnant women and highlighted the considerations for all vulnerable groups when planning for a pandemic at both the local and the national level. PMID:19461111

MARK TWAIN SUMMER INSTITUTE, 1965 SESSION. GENERAL CATALOGUE OF INFORMATION AND COURSES OFFERED.

ERIC Educational Resources Information Center

LEMEN, ROBERT F.

THE MARK TWAIN SUMMER INSTITUTE OFFERED CHALLENGING EDUCATIONAL OPPORTUNITIES, PROVIDED EXCELLENT TEACHERS AN OPPORTUNITY TO DEVELOP NEW TECHNIQUES, AND OFFERED AN "INTERN-TEACHER" PROGRAM. THE STUDENTS QUALIFIED TO ATTEND WERE ABLE SECONDARY STUDENTS FROM GRADES 9 THROUGH 12. EACH STUDENT WOULD TAKE ONE NON-CREDIT HIGH SCHOOL COURSE.…

The Global Fund and tuberculosis in Nicaragua: building sustainable capacity?

PubMed

Plamondon, Katrina M; Hanson, Lori; Labonté, Ronald; Abonyi, Sylvia

2008-01-01

The purpose of the study was to explore and provide feedback on local stakeholders' experiences with the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) as it related to capacity building for tuberculosis (TB) services in Nicaragua. An ethnomethodological approach was used to capture the experiences of three different groups: service providers, service recipients, and decision-makers. Data collection involved reviewing secondary texts and records, participant observation, and in-depth interviews and focus groups in both rural and urban municipalities. Stakeholders felt that Nicaragua's Global Fund project improved TB control, built human resource capacity and strengthened community involvement in TB programming; however, they noted several contextual and structural threats to sustainable capacity development. The nature of the GFATM's performance-based evaluation de-emphasized qualitative assessment and, at times, created pressure to meet numeric targets at the risk of decreasing quality. Contextual challenges often determined or limited the potential sustainability of activities. Two examples (training volunteer health workers and establishing TB Clubs) from the broader study are offered here to highlight these challenges from health systems and community perspectives. Current approaches to GFATM evaluation and accountability may compromise its positive impacts on capacity building in Nicaragua. Greater consideration needs to be given to ensuring more comprehensive evaluation of project implementation.

Hidden concerns of sharing research data by low/middle-income country scientists.

PubMed

Bezuidenhout, Louise; Chakauya, Ereck

2018-01-01

There has considerable interest in bringing low/middle-income countries (LMIC) scientists into discussions on Open Data - both as contributors and users. The establishment of in situ data sharing practices within LMIC research institutions is vital for the development of an Open Data landscape in the Global South. Nonetheless, many LMICs have significant challenges - resource provision, research support and extra-laboratory infrastructures. These low-resourced environments shape data sharing activities, but are rarely examined within Open Data discourse. In particular, little attention is given to how these research environments shape scientists' perceptions of data sharing (dis)incentives. This paper expands on these issues of incentivizing data sharing, using data from a quantitative survey disseminated to life scientists in 13 countries in sub-Saharan Africa. This interrogated not only perceptions of data sharing amongst LMIC scientists, but also how these are connected to the research environments and daily challenges experienced by them. The paper offers a series of analysis around commonly cited (dis)incentives such as data sharing as a means of improving research visibility; sharing and funding; and online connectivity. It identifies key areas that the Open Data community need to consider if true openness in research is to be established in the Global South.

BIG DATA ANALYTICS AND PRECISION ANIMAL AGRICULTURE SYMPOSIUM: Machine learning and data mining advance predictive big data analysis in precision animal agriculture.

PubMed

Morota, Gota; Ventura, Ricardo V; Silva, Fabyano F; Koyama, Masanori; Fernando, Samodha C

2018-04-14

Precision animal agriculture is poised to rise to prominence in the livestock enterprise in the domains of management, production, welfare, sustainability, health surveillance, and environmental footprint. Considerable progress has been made in the use of tools to routinely monitor and collect information from animals and farms in a less laborious manner than before. These efforts have enabled the animal sciences to embark on information technology-driven discoveries to improve animal agriculture. However, the growing amount and complexity of data generated by fully automated, high-throughput data recording or phenotyping platforms, including digital images, sensor and sound data, unmanned systems, and information obtained from real-time noninvasive computer vision, pose challenges to the successful implementation of precision animal agriculture. The emerging fields of machine learning and data mining are expected to be instrumental in helping meet the daunting challenges facing global agriculture. Yet, their impact and potential in "big data" analysis have not been adequately appreciated in the animal science community, where this recognition has remained only fragmentary. To address such knowledge gaps, this article outlines a framework for machine learning and data mining and offers a glimpse into how they can be applied to solve pressing problems in animal sciences.

Technology-delivered adaptations of motivational interviewing for health-related behaviors: A systematic review of the current research

PubMed Central

Shingleton, Rebecca M.; Palfai, Tibor P.

2015-01-01

Objectives The aims of this paper were to describe and evaluate the methods and efficacy of technology-delivered motivational interviewing interventions (TAMIs), discuss the challenges and opportunities of TAMIs, and provide a framework for future research. Methods We reviewed studies that reported using motivational interviewing (MI) based components delivered via technology and conducted ratings on technology description, comprehensiveness of MI, and study methods. Results The majority of studies were fully-automated and included at least one form of media rich technology to deliver the TAMI. Few studies provided complete descriptions of how MI components were delivered via technology. Of the studies that isolated the TAMI effects, positive changes were reported. Conclusion Researchers have used a range of technologies to deliver TAMIs suggesting feasibility of these methods. However, there are limited data regarding their efficacy, and strategies to deliver relational components remain a challenge. Future research should better characterize the components of TAMIs, empirically test the efficacy of TAMIs with randomized controlled trials, and incorporate fidelity measures. Practice Implications TAMIs are feasible to implement and well accepted. These approaches offer considerable potential to reduce costs, minimize therapist and training burden, and expand the range of clients that may benefit from adaptations of MI. PMID:26298219

One-Dimensional Electron Transport Layers for Perovskite Solar Cells

PubMed Central

Thakur, Ujwal K.; Kisslinger, Ryan; Shankar, Karthik

2017-01-01

The electron diffusion length (Ln) is smaller than the hole diffusion length (Lp) in many halide perovskite semiconductors meaning that the use of ordered one-dimensional (1D) structures such as nanowires (NWs) and nanotubes (NTs) as electron transport layers (ETLs) is a promising method of achieving high performance halide perovskite solar cells (HPSCs). ETLs consisting of oriented and aligned NWs and NTs offer the potential not merely for improved directional charge transport but also for the enhanced absorption of incoming light and thermodynamically efficient management of photogenerated carrier populations. The ordered architecture of NW/NT arrays affords superior infiltration of a deposited material making them ideal for use in HPSCs. Photoconversion efficiencies (PCEs) as high as 18% have been demonstrated for HPSCs using 1D ETLs. Despite the advantages of 1D ETLs, there are still challenges that need to be overcome to achieve even higher PCEs, such as better methods to eliminate or passivate surface traps, improved understanding of the hetero-interface and optimization of the morphology (i.e., length, diameter, and spacing of NWs/NTs). This review introduces the general considerations of ETLs for HPSCs, deposition techniques used, and the current research and challenges in the field of 1D ETLs for perovskite solar cells. PMID:28468280

Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.

PubMed

Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne

2018-06-01

Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.

Arch Venture Partners' investment considerations for CBRNE products and opportunities

NASA Astrophysics Data System (ADS)

Crandell, K.; Lazarus, S.; Gardner, P. J.

2008-04-01

ARCH is interested in building leading, highly-valued companies from leading research. Toward that end we value innovations created by the leading researchers in the world, many of which are funded to solve critical scientific challenges including those in the instrumentation and CBRNE area. The most important CBRNE innovations we have seen at ARCH are breakthroughs involving significant unaddressed technology risk and have the potential for broad proprietary intellectual property as a result. The model ARCH has evolved in instrumentation is to look for a breakthrough innovation, with strong intellectual property and continue to strengthen the patent estate through the life of the company. ARCH looks to build companies around leading interdisciplinary scientific and engineering teams, and we favor platform technology that can be applied to multiple market applications both commercial and government. As part of a strategy to build a great company, addressing important CBRNE challenges can help a company strengthen its technical team and its IP estate. This supports a focus on early low volume markets on the way toward addressing a fuller portfolio of applications. Experienced Venture Capitalists can help this process by identifying important executive talent, partners and applications, offering financial syndication strength, and helping shape the company's strategy to maximize the ultimate value realized.

A comprehensive review of electrocoagulation for water treatment: Potentials and challenges.

PubMed

Moussa, Dina T; El-Naas, Muftah H; Nasser, Mustafa; Al-Marri, Mohammed J

2017-01-15

Electrocoagulation is an effective electrochemical approach for the treatment of different types of contaminated water and has received considerable attention in recent years due its high efficiency in dealing with numerous stubborn pollutants. It has been successful in dealing with organic and inorganic contaminants with negligible or almost no generation of by-product wastes. During the past decade, vast amount of research has been devoted to utilizing electrocoagulation for the treatment of several types of wastewater, ranging from polluted groundwater to highly contaminated refinery wastewater. This paper offers a comprehensive review of recent literature that has been dedicated to utilizing electrocoagulation for water treatment, focusing on current successes on specific applications in water and wastewater treatment, as well as potentials for future applications. The paper examines such aspects as theory, potential applications, current challenges, recent developments as well as economical concerns associated with the technology. Most of the recent EC research has been focusing on pollutant-specific evaluation without paying attention to cell design, process modeling or industrial applications. This review attempts to highlight the main achievements in the area and outlines the major shortcomings with recommendations for promising research options that can enhance the technology and broaden its range of applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lessons Learned and Challenges in Building a Filipino Health Coalition

PubMed Central

Aguilar, David E.; Abesamis-Mendoza, Noilyn; Ursua, Rhodora; Divino, Lily Ann M.; Cadag, Kara; Gavin, Nicholas P.

2010-01-01

In recent years, community-based coalitions have become an effective channel to addressing various health problems within specific ethnic communities. The purpose of this article is twofold: (a) to describe the process involved in building the Kalusugan Coalition (KC), a Filipino American health coalition based in New York City, and (b) to highlight the lessons learned and the challenges from this collaborative venture. The challenges described also offer insights on how the coalition development process can be greatly affected by the partnership with an academic institution on a community-based research project. Because each cultural group has unique issues and concerns, the theoretical framework used by KC offers creative alternatives to address some of the challenges regarding coalition infrastructures, leadership development, unexpected change of coalition dynamics, and cultural nuances. PMID:19098260

Framing the Socialisation Process of the DBA Candidate: What Can Universities Offer and What Should Candidates Bring?

ERIC Educational Resources Information Center

Pervan, Simon; Blackman, Deborah; Sloan, Terry; Wallace, Michelle; Vocino, Andrea; Byrne, Cathy

2016-01-01

In Australia, the Doctorate of Business Administration (DBA) remains a popular program but considerable anguish persists within the university sector over just what it is offering students. In this article, we use the process of postgraduate socialisation to understand how candidates, supervisors and administrators navigate pathways to successful…

Assistive Technology in Rehabilitation: Improving Impact through Policy

ERIC Educational Resources Information Center

Lewis, Allen N.; Cooper, Rory A.; Seelman, Kate D.; Cooper, Rosemarie; Schein, Richard M.

2012-01-01

This paper addresses the topic of assistive technology (AT) to offer a direction for its future role within the rehabilitation profession. A brief overview of the five AT legislative acts to date is provided. Next, future considerations for AT are offered in the context of what we know within the U.S. and global communities followed by the…

Designing Learning

ERIC Educational Resources Information Center

Balasubramanian, Nathan; Frieler, Jana L.; Asp, Elliott

2008-01-01

It is a challenge for schools with large populations of students from low-income, migrant, and international families to ensure that every student reaches proficiency on challenging state academic achievement standards and state academic assessments. Traditionally, schools across the country have tended to cope with this challenge by offering a…

Design considerations for community mental health management information systems.

PubMed

Lowe, B H; Sugarman, B

1978-01-01

Many community mental health centers are presently faced with the necessity of implementing a management information system. This article offers guidelines for centers dealing with this situation. Whether a center chooses to adapt an existing system or develop one of its own, careful planning prior to the implementation of the system can help ensure that it will meet the needs of the center and operate successfully. The guidelines are organized into the categories of data considerations, people considerations, and system considerations. The first two categories are of general interest, whereas the last category is more technical in nature.

When Sexual and Religious Orientation Collide: Considerations in Working with Conflicted Same-Sex Attracted Male Clients

ERIC Educational Resources Information Center

Haldeman, Douglas C.

2004-01-01

The debate among scholars and gay activists and religious/political activists about the appropriateness and efficacy of conversion therapy has left out a number of individuals for whom neither gay-affirmative nor conversion therapy may be indicated. The present discussion, through the use of case material, offers considerations for the…

21 CFR 558.3 - Definitions and general considerations applicable to this part.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Definitions and general considerations applicable to this part. 558.3 Section 558.3 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH...” (added on top of usual ration) on or offered “free-choice” (e.g., supplement) in conjunction with other...

Understanding and motivating health care employees: integrating Maslow's hierarchy of needs, training and technology.

PubMed

Benson, Suzanne G; Dundis, Stephen P

2003-09-01

This paper applies Maslow's Hierarchy of Needs Model to the challenges of understanding and motivating employees in a rapidly changing health care industry. The perspective that Maslow's Model brings is an essential element that should be considered as the health care arena is faced with reorganization, re-engineering, mergers, acquisitions, increases in learning demands, and the escalating role of technology in training. This paper offers a new perspective related to how Maslow's Model, as used in business/organizational settings, can be directly related to current workforce concerns: the need for security and freedom from stress, social belongingness, self-esteem, self-actualization, altered work/social environments, and new opportunities for learning and self-definition. Changes in health care will continue at an accelerated pace and with these changes will come the need for more and more training. The use of technology in training has heightened access, faster distribution, innovation and increased collaboration. However, with this technology come attendant challenges including keeping up with the technology, the increased pace of training, depersonalization, and fear of the unknown. The Maslow model provides a means for understanding these challenges in terms of universal individual needs. How does one motivate employees in the face of increased demands, particularly when they are being asked to meet these demands with fewer resources? The answer is, in large part, to make the employee feel secure, needed, and appreciated. This is not at all easy, but if leaders take into consideration the needs of the individual, the new technology that provides challenges and opportunities for meeting those needs, and provides the training to meet both sets of needs, enhanced employee motivation and commitment is possible.

Difficult relationships between parents and physicians of children with cancer: A qualitative study of parent and physician perspectives.

PubMed

Mack, Jennifer W; Ilowite, Maya; Taddei, Sarah

2017-02-15

Previous work on difficult relationships between patients and physicians has largely focused on the adult primary care setting and has typically held patients responsible for challenges. Little is known about experiences in pediatrics and more serious illness; therefore, we examined difficult relationships between parents and physicians of children with cancer. This was a cross-sectional, semistructured interview study of parents and physicians of children with cancer at the Dana-Farber Cancer Institute and Boston Children's Hospital (Boston, Mass) in longitudinal primary oncology relationships in which the parent, physician, or both considered the relationship difficult. Interviews were audiotaped, transcribed, and subjected to a content analysis. Dyadic parent and physician interviews were performed for 29 relationships. Twenty were experienced as difficult by both parents and physicians; 1 was experienced as difficult by the parent only; and 8 were experienced as difficult by the physician only. Parent experiences of difficult relationships were characterized by an impaired therapeutic alliance with physicians; physicians experienced difficult relationships as demanding. Core underlying issues included problems of connection and understanding (n = 8), confrontational parental advocacy (n = 16), mental health issues (n = 2), and structural challenges to care (n = 3). Although problems of connection and understanding often improved over time, problems of confrontational advocacy tended to solidify. Parents and physicians both experienced difficult relationships as highly distressing. Although prior conceptions of difficult relationships have held patients responsible for challenges, this study has found that difficult relationships follow several patterns. Some challenges, such as problems of connection and understanding, offer an opportunity for healing. However, confrontational advocacy appears especially refractory to repair; special consideration of these relationships and avenues for repairing them are needed. Cancer 2017;123:675-681. © 2016 American Cancer Society. © 2016 American Cancer Society.

Opportunities and challenges of nanotechnology in the green economy.

PubMed

Iavicoli, Ivo; Leso, Veruscka; Ricciardi, Walter; Hodson, Laura L; Hoover, Mark D

2014-10-07

In a world of finite resources and ecosystem capacity, the prevailing model of economic growth, founded on ever-increasing consumption of resources and emission pollutants, cannot be sustained any longer. In this context, the "green economy" concept has offered the opportunity to change the way that society manages the interaction of the environmental and economic domains. To enable society to build and sustain a green economy, the associated concept of "green nanotechnology" aims to exploit nano-innovations in materials science and engineering to generate products and processes that are energy efficient as well as economically and environmentally sustainable. These applications are expected to impact a large range of economic sectors, such as energy production and storage, clean up-technologies, as well as construction and related infrastructure industries. These solutions may offer the opportunities to reduce pressure on raw materials trading on renewable energy, to improve power delivery systems to be more reliable, efficient and safe as well as to use unconventional water sources or nano-enabled construction products therefore providing better ecosystem and livelihood conditions.However, the benefits of incorporating nanomaterials in green products and processes may bring challenges with them for environmental, health and safety risks, ethical and social issues, as well as uncertainty concerning market and consumer acceptance. Therefore, our aim is to examine the relationships among guiding principles for a green economy and opportunities for introducing nano-applications in this field as well as to critically analyze their practical challenges, especially related to the impact that they may have on the health and safety of workers involved in this innovative sector. These are principally due to the not fully known nanomaterial hazardous properties, as well as to the difficulties in characterizing exposure and defining emerging risks for the workforce. Interestingly, this review proposes action strategies for the assessment, management and communication of risks aimed to precautionary adopt preventive measures including formation and training of employees, collective and personal protective equipment, health surveillance programs to protect the health and safety of nano-workers. It finally underlines the importance that occupational health considerations will have on achieving an effectively sustainable development of nanotechnology.

Beyond bankable dollars: establishing a business case for improving health care.

PubMed

Bailit, Michael; Dyer, Mary Beth

2004-09-01

To address widespread deficiencies in the quality of health care, the authors argue that health care organizations need to be able to make a "business case" for improving quality--a compelling rationale for financial investment in quality improvement programs. The authors' framework for such a business case is organized around three broad areas: direct financial considerations, strategic considerations, and internal organizational considerations. Within these categories, they offer a total of 10 specific business case arguments, with examples, for investing in quality improvement.

Nesting doctoral students in collaborative North–South partnerships for health systems research

PubMed Central

Loukanova, Svetla; Prytherch, Helen; Blank, Antje; Duysburgh, Els; Tomson, Göran; Gustafsson, Lars L.; Sié, Ali; Williams, John; Leshabari, Melkizedeck; Haefeli, Walter E.; Sauerborn, Rainer; Fonn, Sharon

2014-01-01

Background The European Union (EU) supports North–South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA). Objective The aim of this study was to explore the challenges of, and facilitating factors for, ‘nesting’ doctoral students in North–South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. Design This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs), and content analysis was undertaken. Results Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate). The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision). This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North–South projects. Conclusion There are considerable challenges to the effective nesting of doctoral students within major collaborative research projects. However, ways can be found to overcome them. The nesting process ultimately helped the institutions involved in this example to take better advantage of the opportunities that collaborative projects offer to foster North–South partnerships as a contribution to the strengthening of local research capacity. PMID:25030216

The Challenge and Challenging of Childhood Studies? Learning from Disability Studies and Research with Disabled Children

ERIC Educational Resources Information Center

Tisdall, E. Kay M.

2012-01-01

Childhood studies have argued for the social construction of childhood, respecting children and childhood in the present, and recognising children's agency and rights. Such perspectives have parallels to, and challenges for, disability studies. This article considers such parallels and challenges, leading to a (re)consideration of research claims…

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…

News Festival: Science on stage deadline approaches Conference: Welsh conference attracts teachers Data: New phase of CERN openlab tackles exascale IT challenges for science Meeting: German Physical Society holds its physics education spring meeting Conference: Association offers golden opportunity in Norway Competition: So what's the right answer then?

NASA Astrophysics Data System (ADS)

2012-07-01

Festival: Science on stage deadline approaches Conference: Welsh conference attracts teachers Data: New phase of CERN openlab tackles exascale IT challenges for science Meeting: German Physical Society holds its physics education spring meeting Conference: Association offers golden opportunity in Norway Competition: So what's the right answer then?

Ethical Issues in Providing Online Psychotherapeutic Interventions

PubMed Central

2000-01-01

The Internet offers psychotherapists a new communication medium through which they can deliver psychotherapeutic interventions that are appropriate to the medium. Yet online psychotherapy also offers new ethical challenges for therapists interested in providing online psychotherapeutic services. The differences between interactive text-based communication and in-person verbal communication create new ethical challenges not previously encountered in face-to-face therapy. This article will examine the Internet's potential for providing online psychotherapeutic interventions and will review the ethical issues involved with providing interactive text-based psychotherapy. PMID:11720924

Give in or Get out? Responding to Professional Challenges

ERIC Educational Resources Information Center

Young, Robert B.

2011-01-01

In this chapter, the author offers some themes that emerged from a set of conversations that he had with six student affairs leaders. The leaders faced an array of challenges involving athletics, academic discipline, cultural identity, institutional image, personal attributes, policy, residence life, and state politics. Their challengers were…

Challenges in Delivering Distance Education

ERIC Educational Resources Information Center

Chawdhry, Adnan A.

2010-01-01

Despite the challenges that exist with DE (Distance Education), university and faculty can provide a strong learning environment for their students if they understand and mitigate the challenges of the DE program. This paper describes a case study of a DE program that offers classroom instruction for multiple sites that are connected using a…

SchoolDude's Affordable Solutions for Educational Operations Challenges

ERIC Educational Resources Information Center

School Administrator, 2005

2005-01-01

School administrators face one of the most daunting challenges in history--providing quality learning environments during a tremendous financial crisis. The crisis may seem overwhelming, but web-native operations management technology offered by SchoolDude.com can help them overcome these challenges. The Internet makes technology more affordable…

Brain Activity in Fairness Consideration during Asset Distribution: Does the Initial Ownership Play a Role?

PubMed Central

Wu, Yin; Hu, Jie; van Dijk, Eric; Leliveld, Marijke C.; Zhou, Xiaolin

2012-01-01

Previous behavioral studies have shown that initial ownership influences individuals’ fairness consideration and other-regarding behavior. However, it is not entirely clear whether initial ownership influences the brain activity when a recipient evaluates the fairness of asset distribution. In this study, we randomly assigned the bargaining property (monetary reward) to either the allocator or the recipient in the ultimatum game and let participants of the study, acting as recipients, receive either disadvantageous unequal, equal, or advantageous unequal offers from allocators while the event-related potentials (ERPs) were recorded. Behavioral results showed that participants were more likely to reject disadvantageous unequal and equal offers when they initially owned the property as compared to when they did not. The two types of unequal offers evoked more negative going ERPs (the MFN) than the equal offers in an early time window and the differences were not modulated by the initial ownership. In a late time window, however, the P300 responses to division schemes were affected not only by the type of unequal offers but also by whom the property was initially assigned to. These findings suggest that while the MFN may function as a general mechanism that evaluates whether the offer is consistent or inconsistent with the equity rule, the P300 is sensitive to top-down controlled processes, into which factors related to the allocation of attentional resources, including initial ownership and personal interests, come to play. PMID:22761850

Alma Mater: Design and Experience in the Women's Colleges from Their Nineteenth-Century Beginnings to the 1930s.

ERIC Educational Resources Information Center

Horowitz, Helen Lefkowitz

The creation and development of 10 women's colleges are discussed: Mount Holyoke, Vassar, Wellesley, Smith, Radcliffe, Bryn Mawr, and Barnard (the Seven Sisters colleges), and Sarah Lawrence, Bennington, and Scripps. Consideration is given to: how each of these colleges offered to women an education equal to that offered by the best men's…

Adaptive Driving Equipment: Selection and Major Considerations [and] Battery Powered Scooters and 3-Wheelers. Information Support Packets #1 and #2.

ERIC Educational Resources Information Center

Stevens, John H.

Two brief guides offer suggestions for persons with physical disabilities who are considering the purchase of adaptive driving equipment, battery-powered scooters, or three wheelers. The first guide offers guidelines for individuals considering purchase of special hand controls or other modifications or a van lift to enhance their independence in…

Considerations and Recommendations for Implementing a Dual-Enrollment Program: Bridging the Gap between High School and College Level Science

ERIC Educational Resources Information Center

Lukes, Laura A.

2014-01-01

Dual-enrollment (DE) science courses offer a way to strengthen the science, technology, engineering, and mathematics pipeline between high school and college. These courses offer high school students the opportunity to experience college science in a more supported environment, allowing them to adjust to the different academic and social demands…

Systems metabolic engineering of microorganisms to achieve large-scale production of flavonoid scaffolds.

PubMed

Wu, Junjun; Du, Guocheng; Zhou, Jingwen; Chen, Jian

2014-10-20

Flavonoids possess pharmaceutical potential due to their health-promoting activities. The complex structures of these products make extraction from plants difficult, and chemical synthesis is limited because of the use of many toxic solvents. Microbial production offers an alternate way to produce these compounds on an industrial scale in a more economical and environment-friendly manner. However, at present microbial production has been achieved only on a laboratory scale and improvements and scale-up of these processes remain challenging. Naringenin and pinocembrin, which are flavonoid scaffolds and precursors for most of the flavonoids, are the model molecules that are key to solving the current issues restricting industrial production of these chemicals. The emergence of systems metabolic engineering, which combines systems biology with synthetic biology and evolutionary engineering at the systems level, offers new perspectives on strain and process optimization. In this review, current challenges in large-scale fermentation processes involving flavonoid scaffolds and the strategies and tools of systems metabolic engineering used to overcome these challenges are summarized. This will offer insights into overcoming the limitations and challenges of large-scale microbial production of these important pharmaceutical compounds. Copyright © 2014 Elsevier B.V. All rights reserved.

Intercollegiate Athletics Today and Tomorrow: The President's Challenge

ERIC Educational Resources Information Center

Hanford, George H.

1977-01-01

Colleges and university presidents must come to terms with the challenges posed by intercollegiate athletics. The author offers concrete ideas and suggestions aimed at breaking through the confusion surrounding intercollegiate athletics. (Editor/LBH)

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

Tor, Osman Bulent; Shahidehpour, Mohammad

In moving toward restructuring, transmission expansion planning is a major challenge. The authors offer a general perspective on TEP issues, then address the specific challenges in Turkey and propose several strategies toward managing physical and financial risks in that country. (author)

One dozen considerations when working with women in substance abuse groups.

PubMed

Bright, Charlotte Lyn; Osborne, Victoria A; Greif, Geoffrey L

2011-01-01

Women and men have different histories, presentations, and behaviors in substance abuse groups. Twelve considerations are offered for the beginning group leader when encountering women with substance abuse issues. These include understanding sexism, what brings women to treatment, and how women behave in group treatment. Implications for clinical practice with women in single-gender and mixed-gender groups are included.

Alcohol advertising and adolescents.

PubMed

Strasburger, Victor C

2002-04-01

Considerable research now exists that the media may exert a powerful influence on adolescents' drug-taking behavior. Teens view an average of 2,000 beer and wine ads per year in the US. In addition, television shows, movies, and music videos contain considerable amounts of alcohol use. This article will discuss the available research and offers suggestions to make the media healthier for teenagers.

Research considerations when studying disasters.

PubMed

Cox, Catherine Wilson

2008-03-01

Nurses play an integral role during disasters because they are called upon more than any other health care professional during disaster response efforts; consequently, nurse researchers are interested in studying the issues that impact nurses in the aftermath of a disaster. This article offers research considerations for nurse scientists when developing proposals related to disaster research and identifies resources and possible funding sources for their projects.

At-Risk Youth: Considerations for State-Level Policymakers, Including a Summary of Recent State-Level Actions in the Region.

ERIC Educational Resources Information Center

Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

In response to the growing dropout problem, most of the northeastern states (and islands) and many of their local districts have implemented policies and programs designed to reduce the number of students leaving school. This paper presents some observations, culled from various reports, for policymakers' consideration. Section I offers a set of…

Bridging the Gap: The Challenges of Employing Entrepreneurial Processes within University Settings

ERIC Educational Resources Information Center

Wardale, Dorothy; Lord, Linley

2016-01-01

In Australia and elsewhere, universities face increasing pressure to improve research output and quality, particularly through partnerships with industry. This raises interesting challenges for academic staff with considerable industry experience who are "new" to academe. Some of these challenges were faced by the authors who have been…

The Case against Preadoption Genetic Testing.

ERIC Educational Resources Information Center

Freundlich, Madelyn D.

1998-01-01

Examines the medical, psychosocial, and ethical considerations concerning presymptomatic genetic testing in evaluating children for adoption. Offers an ethical framework for rejecting such a practice. (JPB)

Visual analysis of mass cytometry data by hierarchical stochastic neighbour embedding reveals rare cell types.

PubMed

van Unen, Vincent; Höllt, Thomas; Pezzotti, Nicola; Li, Na; Reinders, Marcel J T; Eisemann, Elmar; Koning, Frits; Vilanova, Anna; Lelieveldt, Boudewijn P F

2017-11-23

Mass cytometry allows high-resolution dissection of the cellular composition of the immune system. However, the high-dimensionality, large size, and non-linear structure of the data poses considerable challenges for the data analysis. In particular, dimensionality reduction-based techniques like t-SNE offer single-cell resolution but are limited in the number of cells that can be analyzed. Here we introduce Hierarchical Stochastic Neighbor Embedding (HSNE) for the analysis of mass cytometry data sets. HSNE constructs a hierarchy of non-linear similarities that can be interactively explored with a stepwise increase in detail up to the single-cell level. We apply HSNE to a study on gastrointestinal disorders and three other available mass cytometry data sets. We find that HSNE efficiently replicates previous observations and identifies rare cell populations that were previously missed due to downsampling. Thus, HSNE removes the scalability limit of conventional t-SNE analysis, a feature that makes it highly suitable for the analysis of massive high-dimensional data sets.

Wearable and Implantable Wireless Sensor Network Solutions for Healthcare Monitoring

PubMed Central

Darwish, Ashraf; Hassanien, Aboul Ella

2011-01-01

Wireless sensor network (WSN) technologies are considered one of the key research areas in computer science and the healthcare application industries for improving the quality of life. The purpose of this paper is to provide a snapshot of current developments and future direction of research on wearable and implantable body area network systems for continuous monitoring of patients. This paper explains the important role of body sensor networks in medicine to minimize the need for caregivers and help the chronically ill and elderly people live an independent life, besides providing people with quality care. The paper provides several examples of state of the art technology together with the design considerations like unobtrusiveness, scalability, energy efficiency, security and also provides a comprehensive analysis of the various benefits and drawbacks of these systems. Although offering significant benefits, the field of wearable and implantable body sensor networks still faces major challenges and open research problems which are investigated and covered, along with some proposed solutions, in this paper. PMID:22163914

Phonon bottleneck identification in disordered nanoporous materials

NASA Astrophysics Data System (ADS)

Romano, Giuseppe; Grossman, Jeffrey C.

2017-09-01

Nanoporous materials are a promising platform for thermoelectrics in that they offer high thermal conductivity tunability while preserving good electrical properties, a crucial requirement for high-efficiency thermal energy conversion. Understanding the impact of the pore arrangement on thermal transport is pivotal to engineering realistic materials, where pore disorder is unavoidable. Although there has been considerable progress in modeling thermal size effects in nanostructures, it has remained a challenge to screen such materials over a large phase space due to the slow simulation time required for accurate results. We use density functional theory in connection with the Boltzmann transport equation to perform calculations of thermal conductivity in disordered porous materials. By leveraging graph theory and regressive analysis, we identify the set of pores representing the phonon bottleneck and obtain a descriptor for thermal transport, based on the sum of the pore-pore distances between such pores. This approach provide a simple tool to estimate phonon suppression in realistic porous materials for thermoelectric applications and enhance our understanding of heat transport in disordered materials.

Epilepsy after cerebral infection: review of the literature and the potential for surgery.

PubMed

Ramantani, Georgia; Holthausen, Hans

2017-06-01

The risk of unprovoked seizures in population-based cohorts of cerebral infection survivors is 7-8% in developed countries, rising to considerably higher rates in resource-poor countries. The main risk factors for epilepsy after cerebral infection, besides acute seizures, are infection-associated brain lesions and status epilepticus during the acute phase. Despite the high prevalence of pharmacoresistant epilepsies after cerebral infections, especially in patients with MRI-identifiable lesions, only a small minority undergoes epilepsy surgery. However, excellent surgical candidates are particularly those with a history of meningitis or encephalitis in early childhood, hippocampal sclerosis on MRI, as well as a history, seizure semiology, and EEG-findings compatible with the diagnosis of a mesial temporal lobe epilepsy syndrome. More challenging are patients with neocortical/extratemporal lobe epilepsies post cerebral infection. Finally, patients with a severe hemispheric injury with contralateral hemiparesis are candidates for hemispherectomy/hemispherotomy. This review attempts to shed some light on this frequent cause of symptomatic focal epilepsy, with an emphasis on the chances offered by epilepsy surgery.

Generating unique IDs from patient identification data using security models.

PubMed

Mohammed, Emad A; Slack, Jonathan C; Naugler, Christopher T

2016-01-01

The use of electronic health records (EHRs) has continued to increase within healthcare systems in the developed and developing nations. EHRs allow for increased patient safety, grant patients easier access to their medical records, and offer a wealth of data to researchers. However, various bioethical, financial, logistical, and information security considerations must be addressed while transitioning to an EHR system. The need to encrypt private patient information for data sharing is one of the foremost challenges faced by health information technology. We describe the usage of the message digest-5 (MD5) and secure hashing algorithm (SHA) as methods for encrypting electronic medical data. In particular, we present an application of the MD5 and SHA-1 algorithms in encrypting a composite message from private patient information. The results show that the composite message can be used to create a unique one-way encrypted ID per patient record that can be used for data sharing. The described software tool can be used to share patient EMRs between practitioners without revealing patients identifiable data.

Human Locomotion under Reduced Gravity Conditions: Biomechanical and Neurophysiological Considerations

PubMed Central

Sylos-Labini, Francesca; Ivanenko, Yuri P.

2014-01-01

Reduced gravity offers unique opportunities to study motor behavior. This paper aims at providing a review on current issues of the known tools and techniques used for hypogravity simulation and their effects on human locomotion. Walking and running rely on the limb oscillatory mechanics, and one way to change its dynamic properties is to modify the level of gravity. Gravity has a strong effect on the optimal rate of limb oscillations, optimal walking speed, and muscle activity patterns, and gait transitions occur smoothly and at slower speeds at lower gravity levels. Altered center of mass movements and interplay between stance and swing leg dynamics may challenge new forms of locomotion in a heterogravity environment. Furthermore, observations in the lack of gravity effects help to reveal the intrinsic properties of locomotor pattern generators and make evident facilitation of nonvoluntary limb stepping. In view of that, space neurosciences research has participated in the development of new technologies that can be used as an effective tool for gait rehabilitation. PMID:25247179

Microelectromechanical Systems for Aerodynamics Applications

NASA Technical Reports Server (NTRS)

Mehregany, Mehran; DeAnna, Russell G.; Reshotko, Eli

1996-01-01

Microelectromechanical systems (MEMS) embody the integration of sensors, actuators, and electronics on a single substrate using integrated circuit fabrication techniques and compatible micromachining processes. Silicon and its derivatives form the material base for the MEMS technology. MEMS devices, including micro-sensors and micro-actuators, are attractive because they can be made small (characteristic dimension about microns), be produced in large numbers with uniform performance, include electronics for high performance and sophisticated functionality, and be inexpensive. MEMS pressure sensors, wall-shear-stress sensors, and micromachined hot-wires are nearing application in aeronautics. MEMS actuators face a tougher challenge since they have to be scaled (up) to the physical phenomena that are being controlled. MEMS actuators are proposed, for example, for controlling the small structures in a turbulent boundary layer, for aircraft control, for cooling, and for mixing enhancement. Data acquisition or control logistics require integration of electronics along with the transducer elements with appropriate consideration of analog-to-digital conversion, multiplexing, and telemetry. Altogether, MEMS technology offers exciting opportunities for aerodynamics applications both in wind tunnels and in flight

Wearable and implantable wireless sensor network solutions for healthcare monitoring.

PubMed

Darwish, Ashraf; Hassanien, Aboul Ella

2011-01-01

Wireless sensor network (WSN) technologies are considered one of the key research areas in computer science and the healthcare application industries for improving the quality of life. The purpose of this paper is to provide a snapshot of current developments and future direction of research on wearable and implantable body area network systems for continuous monitoring of patients. This paper explains the important role of body sensor networks in medicine to minimize the need for caregivers and help the chronically ill and elderly people live an independent life, besides providing people with quality care. The paper provides several examples of state of the art technology together with the design considerations like unobtrusiveness, scalability, energy efficiency, security and also provides a comprehensive analysis of the various benefits and drawbacks of these systems. Although offering significant benefits, the field of wearable and implantable body sensor networks still faces major challenges and open research problems which are investigated and covered, along with some proposed solutions, in this paper.

The AcCell series 2000 as a support system for training and evaluation in educational and clinical settings.

PubMed

Greening, S E; Grohs, D H; Guidos, B J

1997-01-01

Providing effective training, retraining and evaluation programs, including proficiency testing programs, for cytoprofessionals is a challenge shared by many academic and clinical educators internationally. In cytopathology the quality of training has immediately transferable and critically important impacts on satisfactory performance in the clinical setting. Well-designed interactive computer-assisted instruction and testing programs have been shown to enhance initial learning and to reinforce factual and conceptual knowledge. Computer systems designed not only to promote diagnostic accuracy but to integrate and streamline work flow in clinical service settings are candidates for educational adaptation. The AcCell 2000 system, designed as a diagnostic screening support system, offers technology that is adaptable to educational needs during basic and in-service training as well as testing of screening proficiency in both locator and identification skills. We describe the considerations, approaches and applications of the AcCell 2000 system in education programs for both training and evaluation of gynecologic diagnostic screening proficiency.

The potential for land sparing to offset greenhouse gas emissions from agriculture

NASA Astrophysics Data System (ADS)

Lamb, Anthony; Green, Rhys; Bateman, Ian; Broadmeadow, Mark; Bruce, Toby; Burney, Jennifer; Carey, Pete; Chadwick, David; Crane, Ellie; Field, Rob; Goulding, Keith; Griffiths, Howard; Hastings, Astley; Kasoar, Tim; Kindred, Daniel; Phalan, Ben; Pickett, John; Smith, Pete; Wall, Eileen; Zu Ermgassen, Erasmus K. H. J.; Balmford, Andrew

2016-05-01

Greenhouse gas emissions from global agriculture are increasing at around 1% per annum, yet substantial cuts in emissions are needed across all sectors. The challenge of reducing agricultural emissions is particularly acute, because the reductions achievable by changing farming practices are limited and are hampered by rapidly rising food demand. Here we assess the technical mitigation potential offered by land sparing--increasing agricultural yields, reducing farmland area and actively restoring natural habitats on the land spared. Restored habitats can sequester carbon and can offset emissions from agriculture. Using the UK as an example, we estimate net emissions in 2050 under a range of future agricultural scenarios. We find that a land-sparing strategy has the technical potential to achieve significant reductions in net emissions from agriculture and land-use change. Coupling land sparing with demand-side strategies to reduce meat consumption and food waste can further increase the technical mitigation potential--however, economic and implementation considerations might limit the degree to which this technical potential could be realized in practice.

Crosslinguistic application of English-centric rhythm descriptors in motor speech disorders.

PubMed

Liss, Julie M; Utianski, Rene; Lansford, Kaitlin

2013-01-01

Rhythmic disturbances are a hallmark of motor speech disorders, in which the motor control deficits interfere with the outward flow of speech and by extension speech understanding. As the functions of rhythm are language-specific, breakdowns in rhythm should have language-specific consequences for communication. The goals of this paper are to (i) provide a review of the cognitive-linguistic role of rhythm in speech perception in a general sense and crosslinguistically; (ii) present new results of lexical segmentation challenges posed by different types of dysarthria in American English, and (iii) offer a framework for crosslinguistic considerations for speech rhythm disturbances in the diagnosis and treatment of communication disorders associated with motor speech disorders. This review presents theoretical and empirical reasons for considering speech rhythm as a critical component of communication deficits in motor speech disorders, and addresses the need for crosslinguistic research to explore language-universal versus language-specific aspects of motor speech disorders. Copyright © 2013 S. Karger AG, Basel.

[Listeriosis in pregnancy--case report].

PubMed

Barlik, Magdalena; Seremak-Mrozikiewicz, Agnieszka; Drews, Krzysztof

2014-04-01

Listeriosis is a rather rare infectious disease but its incidence in pregnancy is over 20 times higher than in the general population. Pregnant women with listeriosis comprise one-third of all listeriosis cases. Listeriosis is a foodborne disease. Sporadic as well as epidemic cases of listeriosis are usually related to contaminated processed food, especially meat dishes served in fast-food restaurants and dairy products. Pregnant women are at an increased risk for listeriosis infection. Unfortunately the symptoms are not specific and the diagnosis presents a considerable challenge. Although the literature offers some case reports on a complicated course of listeriosis during pregnancy the infection usually runs a mild course in pregnant women. Regardless, fetal or neonatal infection is related to very high risk of lethal complications in the newborn, among others: sepsis, meningitis or pneumonia. In this paper we present a case of a 28-year-old gravida with listeriosis. We described the course of the infection, diagnostic process and treatment in both, the mother and the newborn.

Fault dating in the Canadian Rocky Mountains: Evidence for late Cretaceous and early Eocene orogenic pulses

USGS Publications Warehouse

van der Pluijm, B.A.; Vrolijk, P.J.; Pevear, D.R.; Hall, C.M.; Solum, J.

2006-01-01

Fault rocks from the classic Rocky Mountain foreland fold-and-thrust belt in south-western Canada were dated by Ar analysis of clay grain-size fractions. Using X-ray diffraction quantification of the detrital and authigenic component of each fraction, these determinations give ages for individual faults in the area (illite age analysis). The resulting ages cluster around 72 and 52 Ma (here called the Rundle and McConnell pulses, respectively), challenging the traditional view of gradual forward progression of faulting and thrust-belt history of the area. The recognition of spatially and temporally restricted deformation episodes offers field support for theoretical models of critically stressed wedges, which result in geologically reasonable strain rates for the area. In addition to regional considerations, this study highlights the potential of direct dating of shallow fault rocks for our understanding of upper-crustal kinematics and regional tectonic analysis of ancient orogens. ?? 2006 Geological Society of America.

Thriving on Pressure: A Factor Mixture Analysis of Sport Performers' Responses to Competitive Encounters.

PubMed

Brown, Daniel J; Arnold, Rachel; Standage, Martyn; Fletcher, David

2017-12-01

Although considerable research exists on performers' responses to sporting encounters, little is known about thriving in sport contexts. The current study examined if distinct response patterns existed between sport performers who thrived in competitive encounters compared with those who did not. Participants were 535 sport performers (134 women; M age  = 23.60 years, SD age  = 8.08; M competing  = 11.84 years, SD competing  = 7.11). Results of factor mixture analysis supported a four-profile solution comprising a thriving group (n = 146), a low-functioning group (n = 38), and two groups characterized by scores marginally above (n = 131) and below (n = 209) the sample mean. Profile membership was found to be predicted by personal enablers (viz., personal resilient qualities, psychological skills use) and process variables (viz., basic psychological need satisfaction and frustration, challenge appraisal). This examination of thriving in sport performers offers significant implications for research and practice.

Comb-based radiofrequency photonic filters with rapid tunability and high selectivity

NASA Astrophysics Data System (ADS)

Supradeepa, V. R.; Long, Christopher M.; Wu, Rui; Ferdous, Fahmida; Hamidi, Ehsan; Leaird, Daniel E.; Weiner, Andrew M.

2012-03-01

Photonic technologies have received considerable attention regarding the enhancement of radiofrequency electrical systems, including high-frequency analogue signal transmission, control of phased arrays, analog-to-digital conversion and signal processing. Although the potential of radiofrequency photonics for the implementation of tunable electrical filters over broad radiofrequency bandwidths has been much discussed, the realization of programmable filters with highly selective filter lineshapes and rapid reconfigurability has faced significant challenges. A new approach for radiofrequency photonic filters based on frequency combs offers a potential route to simultaneous high stopband attenuation, fast tunability and bandwidth reconfiguration. In one configuration, tuning of the radiofrequency passband frequency is demonstrated with unprecedented (~40 ns) speed by controlling the optical delay between combs. In a second, fixed filter configuration, cascaded four-wave mixing simultaneously broadens and smoothes the comb spectra, resulting in Gaussian radiofrequency filter lineshapes exhibiting an extremely high (>60 dB) main lobe to sidelobe suppression ratio and (>70 dB) stopband attenuation.

[Pulse oximetry screening of critical congenital heart defects in the neonatal period. The Spanish National Neonatal Society recommendation].

PubMed

Sánchez Luna, Manuel; Pérez Muñuzuri, Alejandro; Sanz López, Ester; Leante Castellanos, José Luis; Benavente Fernández, Isabel; Ruiz Campillo, César W; Sánchez Redondo, M Dolores; Vento Torres, Máximo; Rite Gracia, Segundo

2018-02-01

Due to its severity, as well as the consequences of a late diagnosis, critical congenital heart defects (CCHD) represent a challenging situation, making an early diagnosis necessary and ideally before symptoms appear when circulatory collapse or death of the newborn can occur. Due to this, a prenatal and very early postnatal diagnosis is very important. Prenatal ultrasound screening and physical examination of the newborn can miss a considerable number of CCHD cases. Pulse oximetry screening has been demonstrated to be an effective, non-invasive, inexpensive, and well accepted tool in the early diagnosis of CCHD. The Spanish National Society of Neonatology, through its Standards Committee, and based on the current evidence, recommend the implementation of pulse oximetry screening of CCHD in Spain, and then to offer the best therapy possible to these newborn infants. Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Crosslinguistic Application of English-Centric Rhythm Descriptors in Motor Speech Disorders

PubMed Central

Liss, Julie M.; Utianski, Rene; Lansford, Kaitlin

2014-01-01

Background Rhythmic disturbances are a hallmark of motor speech disorders, in which the motor control deficits interfere with the outward flow of speech and by extension speech understanding. As the functions of rhythm are language-specific, breakdowns in rhythm should have language-specific consequences for communication. Objective The goals of this paper are to (i) provide a review of the cognitive- linguistic role of rhythm in speech perception in a general sense and crosslinguistically; (ii) present new results of lexical segmentation challenges posed by different types of dysarthria in American English, and (iii) offer a framework for crosslinguistic considerations for speech rhythm disturbances in the diagnosis and treatment of communication disorders associated with motor speech disorders. Summary This review presents theoretical and empirical reasons for considering speech rhythm as a critical component of communication deficits in motor speech disorders, and addresses the need for crosslinguistic research to explore language-universal versus language-specific aspects of motor speech disorders. PMID:24157596

Behavioural fever is a synergic signal amplifying the innate immune response.

PubMed

Boltaña, Sebastian; Rey, Sonia; Roher, Nerea; Vargas, Reynaldo; Huerta, Mario; Huntingford, Felicity Anne; Goetz, Frederick William; Moore, Janice; Garcia-Valtanen, Pablo; Estepa, Amparo; Mackenzie, S

2013-09-07

Behavioural fever, defined as an acute change in thermal preference driven by pathogen recognition, has been reported in a variety of invertebrates and ectothermic vertebrates. It has been suggested, but so far not confirmed, that such changes in thermal regime favour the immune response and thus promote survival. Here, we show that zebrafish display behavioural fever that acts to promote extensive and highly specific temperature-dependent changes in the brain transcriptome. The observed coupling of the immune response to fever acts at the gene-environment level to promote a robust, highly specific time-dependent anti-viral response that, under viral infection, increases survival. Fish that are not offered a choice of temperatures and that therefore cannot express behavioural fever show decreased survival under viral challenge. This phenomenon provides an underlying explanation for the varied functional responses observed during systemic fever. Given the effects of behavioural fever on survival and the fact that it exists across considerable phylogenetic space, such immunity-environment interactions are likely to be under strong positive selection.

Polysaccharide-derived mesoporous materials (Starbon®) for sustainable separation of complex mixtures.

PubMed

Zuin, Vânia G; Budarin, Vitaliy L; De Bruyn, Mario; Shuttleworth, Peter S; Hunt, Andrew J; Pluciennik, Camille; Borisova, Aleksandra; Dodson, Jennifer; Parker, Helen L; Clark, James H

2017-09-21

The recovery and separation of high value and low volume extractives are a considerable challenge for the commercial realisation of zero-waste biorefineries. Using solid-phase extractions (SPE) based on sustainable sorbents is a promising method to enable efficient, green and selective separation of these complex extractive mixtures. Mesoporous carbonaceous solids derived from renewable polysaccharides are ideal stationary phases due to their tuneable functionality and surface structure. In this study, the structure-separation relationships of thirteen polysaccharide-derived mesoporous materials and two modified types as sorbents for ten naturally-occurring bioactive phenolic compounds were investigated. For the first time, a comprehensive statistical analysis of the key molecular and surface properties influencing the recovery of these species was carried out. The obtained results show the possibility of developing tailored materials for purification, separation or extraction, depending on the molecular composition of the analyte. The wide versatility and application span of these polysaccharide-derived mesoporous materials offer new sustainable and inexpensive alternatives to traditional silica-based stationary phases.

Evaluating Sustainability Models for Interoperability through Brokering Software

NASA Astrophysics Data System (ADS)

Pearlman, Jay; Benedict, Karl; Best, Mairi; Fyfe, Sue; Jacobs, Cliff; Michener, William; Nativi, Stefano; Powers, Lindsay; Turner, Andrew

2016-04-01

Sustainability of software and research support systems is an element of innovation that is not often discussed. Yet, sustainment is essential if we expect research communities to make the time investment to learn and adopt new technologies. As the Research Data Alliance (RDA) is developing new approaches to interoperability, the question of uptake and sustainability is important. Brokering software sustainability is one of the areas that is being addressed in RDA. The Business Models Team of the Research Data Alliance Brokering Governance Working Group examined several support models proposed to promote the long-term sustainability of brokering middleware. The business model analysis includes examination of funding source, implementation frameworks and challenges, and policy and legal considerations. Results of this comprehensive analysis highlight advantages and disadvantages of the various models with respect to the specific requirements for brokering services. We offer recommendations based on the outcomes of this analysis that suggest that hybrid funding models present the most likely avenue to long term sustainability.

Identifying the policy implications of competency-based education.

PubMed

Taber, Sarah; Frank, Jason R; Harris, Kenneth A; Glasgow, Nicholas J; Iobst, William; Talbot, Martin

2010-01-01

At their 2009 consensus conference, the International CBME Collaborators proposed a number of central tenets of CBME in order to advance the field of medical education. Although the proposed conceptualization of CBME offers several advantages and opportunities, including a greater emphasis on outcomes, a mechanism for the promotion of learner-centred curricula, and the potential to move away from time-based training and credentialing in medicine, it is also associated with several significant barriers to adoption. This paper examines the concepts of CBME through a broad educational policy lens, identifying considerations for medical education leaders, health care institutions, and policy-makers at both the meso (program, institutional) and macro (health care system, inter-jurisdictional, and international) levels. Through this analysis, it is clear that CBME is associated with a number of complex challenges and questions, and cannot be considered in isolation from the complex systems in which it functions. Much more work is needed to engage stakeholders in dialogue, to debate the issues, and to identify possible solutions.

A practical field guide to conducting nursing research in low- and middle-income countries.

PubMed

LeBaron, Virginia T; Iribarren, Sarah J; Perri, Seneca; Beck, Susan L

2015-01-01

The purpose of this report is to offer practical guidance to nurse investigators interested in international research in low- and middle-income countries (LMICs). Lessons learned and strategies for planning and implementing an international research project are addressed. Four nurse researchers who conducted studies in diverse international settings (Argentina, India, South Africa, and Tanzania) describe their collective experiences regarding study planning and implementation; data collection using a variety of methods; and cultural, contextual and ethical considerations. Nurses who undertake international health research projects, particularly in LMICs, can face unique challenges and opportunities. Recommendations for success include advance planning, remaining flexible, having a backup plan, cultivating an attitude of curiosity and cultural humility, establishing collaborative and respectful partnerships, and budgeting adequate time. Nurse scientists often receive little training and support to conduct international research. Guidance to undertake research projects in LMICs can build capacity for nurses to make significant contributions to global health. Copyright © 2015 Elsevier Inc. All rights reserved.

Immunogenicity and protection efficacy of subunit-based smallpox vaccines using variola major antigens.

PubMed

Sakhatskyy, Pavlo; Wang, Shixia; Zhang, Chuanyou; Chou, Te-Hui; Kishko, Michael; Lu, Shan

2008-02-05

The viral strain responsible for smallpox infection is variola major (VARV). As a result of the successful eradication of smallpox with the vaccinia virus (VACV), the general population is no longer required to receive a smallpox vaccine, and will have no protection against smallpox. This lack of immunity is a concern due to the potential for use of smallpox as a biological weapon. Considerable progress has been made in the development of subunit-based smallpox vaccines resulting from the identification of VACV protective antigens. It also offers the possibility of using antigens from VARV to formulate the next generation subunit-based smallpox vaccines. Here, we show that codon-optimized DNA vaccines expressing three VARV antigens (A30, B7 and F8) and their recombinant protein counterparts elicited high-titer, cross-reactive, VACV neutralizing antibody responses in mice. Vaccinated mice were protected from intraperitoneal and intranasal challenges with VACV. These results suggest the feasibility of a subunit smallpox vaccine based on VARV antigen sequences to induce immunity against poxvirus infection.

An Update to Returning Genetic Research Results to Individuals: Perspectives of the Industry Pharmacogenomics Working Group

PubMed Central

Prucka, Sandra K; Arnold, Lester J; Brandt, John E; Gilardi, Sandra; Harty, Lea C; Hong, Feng; Malia, Joanne; Pulford, David J

2015-01-01

The ease with which genotyping technologies generate tremendous amounts of data on research participants has been well chronicled, a feat that continues to become both faster and cheaper to perform. In parallel to these advances come additional ethical considerations and debates, one of which centers on providing individual research results and incidental findings back to research participants taking part in genetic research efforts. In 2006 the Industry Pharmacogenomics Working Group (I-PWG) offered some ‘Points-to-Consider’ on this topic within the context of the drug development process from those who are affiliated to pharmaceutical companies. Today many of these points remain applicable to the discussion but will be expanded upon in this updated viewpoint from the I-PWG. The exploratory nature of pharmacogenomic work in the pharmaceutical industry is discussed to provide context for why these results typically are not best suited for return. Operational challenges unique to this industry which cause barriers to returning this information are also explained. PMID:24471556

Epidemiology, Diagnosis, and Management of Clostridium difficile Infection in Patients with Inflammatory Bowel Disease

PubMed Central

Rao, Krishna; Higgins, Peter D. R.

2016-01-01

Clostridium difficile infection (CDI) is a major source of morbidity and mortality for the US healthcare system, and frequently complicates the course of inflammatory bowel disease (IBD). Patients with IBD are more likely to be colonized with C. difficile and develop active infection than the general population. They are also more likely to have severe CDI and develop subsequent complications such as IBD flare, colectomy, or death. Even after successful initial treatment and recovery, recurrent CDI is common. Management of CDI in IBD is fraught with diagnostic and therapeutic challenges, since the clinical presentations of CDI and IBD flare have considerable overlap. Fecal microbiota transplantation can be successful in curing recurrent CDI when other treatments have failed, but may also trigger IBD flare and this warrants caution. New, experimental treatments including vaccines, monoclonal antibodies, and non-toxigenic strains of C. difficile offer promise but are not yet available for clinicians. A better understanding of the complex relationship between the gut microbiota, CDI, and IBD is needed. PMID:27120571

Supercritical fluid technology: a promising approach in pharmaceutical research.

PubMed

Girotra, Priti; Singh, Shailendra Kumar; Nagpal, Kalpana

2013-02-01

Supercritical fluids possess the unique properties of behaving like liquids and gases, above their critical point. Supercritical fluid technology has recently emerged as a green and novel technique for various processes such as solubility enhancement of poorly soluble drugs, plasticization of polymers, surface modification, nanosizing and nanocrystal modification, and chromatographic extraction. Research interest in this area has been fuelled because of the numerous advantages that the technology offers over the conventional methods. This work aims to review the merits, demerits, and various processes such as rapid expansion of supercritical solutions (RESS), particles from gas saturated solutions (PGSS), gas antisolvent process (GAS), supercritical antisolvent process (SAS) and polymerization induced phase separation (PIPS), that have enabled this technology to considerably raise the interest of researchers over the past two decades. An insight has been given into the numerous applications of this technology in pharmaceutical industry and the future challenges which must be appropriately dealt with to make it effective on a commercial scale.

Use of Social Media to Target Information-Driven Arms Control and Nonproliferation Verification

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

Kreyling, Sean J.; Williams, Laura S.; Gastelum, Zoe N.

There has been considerable discussion within the national security community, including a recent workshop sponsored by the U.S. State Department, about the use of social media for extracting patterns of collective behavior and influencing public perception in areas relevant to arms control and nonproliferation. This paper seeks to explore if, and how, social media can be used to supplement nonproliferation and arms control inspection and monitoring activities on states and sites of greatest proliferation relevance. In this paper, we set the stage for how social media can be applied in this problem space and describe some of the foreseen challenges,more » including data validation, sources and attributes, verification, and security. Using information analytics and data visualization capabilities available at Pacific Northwest National Laboratory (PNNL), we provide graphical examples of some social media "signatures" of potential relevance for nonproliferation and arms control purposes. We conclude by describing a proposed case study and offering recommendations both for further research and next steps by the policy community.« less

A hybrid approach EMD-HW for short-term forecasting of daily stock market time series data

NASA Astrophysics Data System (ADS)

Awajan, Ahmad Mohd; Ismail, Mohd Tahir

2017-08-01

Recently, forecasting time series has attracted considerable attention in the field of analyzing financial time series data, specifically within the stock market index. Moreover, stock market forecasting is a challenging area of financial time-series forecasting. In this study, a hybrid methodology between Empirical Mode Decomposition with the Holt-Winter method (EMD-HW) is used to improve forecasting performances in financial time series. The strength of this EMD-HW lies in its ability to forecast non-stationary and non-linear time series without a need to use any transformation method. Moreover, EMD-HW has a relatively high accuracy and offers a new forecasting method in time series. The daily stock market time series data of 11 countries is applied to show the forecasting performance of the proposed EMD-HW. Based on the three forecast accuracy measures, the results indicate that EMD-HW forecasting performance is superior to traditional Holt-Winter forecasting method.

Experimental panic provocation in healthy man—a translational role in anti-panic drug development?

PubMed Central

Kellner, Michael

2011-01-01

Experimental neurochemical provocation of panic attacks in susceptible human subjects has considerably expanded our knowledge of the pathophysiology and psychopharmacology of panic disorder. Some panicogens also elicit short-lived panic-like states in healthy man. This offers the opportunity to assess the anti-panic action of drugs in proof-of-concept studies. However, from current data it is still unclear whether experimental panic in healthy man is a valid translational model. Most such studies in healthy volunteers have been performed using a cholecystokinin tetrapeptide (CCK-4) challenge. While CCK-4 panic was blocked by alprazolam pretreatment, escitalopram showed negative results in healthy man. Preliminary findings on novel investigational drugs and a few problematic results will be reviewed. Small sample sizes in many panic provocation studies, lack of dose-response aspects, and still-insufficient knowledge about the biological underpinning of experimental and spontaneous panic limit the interpretation of existing findings and should inspire further research. PMID:22275853

Managing Emergency Situations in the Smart City: The Smart Signal

PubMed Central

Asensio, Ángel; Blanco, Teresa; Blasco, Rubén; Marco, Álvaro; Casas, Roberto

2015-01-01

In a city there are numerous items, many of them unnoticed but essential; this is the case of the signals. Signals are considered objects with reduced technological interest, but in this paper we prove that making them smart and integrating in the IoT (Internet of Things) could be a relevant contribution to the Smart City. This paper presents the concept of Smart Signal, as a device conscious of its context, with communication skills, able to offer the best message to the user, and as a ubiquitous element that contributes with information to the city. We present the design considerations and a real implementation and validation of the system in one of the most challenging environments that may exist in a city: a tunnel. The main advantages of the Smart Signal are the improvement of the actual functionality of the signal providing new interaction capabilities with users and a new sensory mechanism of the Smart City. PMID:26094626

Big data uncertainties.

PubMed

Maugis, Pierre-André G

2018-07-01

Big data-the idea that an always-larger volume of information is being constantly recorded-suggests that new problems can now be subjected to scientific scrutiny. However, can classical statistical methods be used directly on big data? We analyze the problem by looking at two known pitfalls of big datasets. First, that they are biased, in the sense that they do not offer a complete view of the populations under consideration. Second, that they present a weak but pervasive level of dependence between all their components. In both cases we observe that the uncertainty of the conclusion obtained by statistical methods is increased when used on big data, either because of a systematic error (bias), or because of a larger degree of randomness (increased variance). We argue that the key challenge raised by big data is not only how to use big data to tackle new problems, but to develop tools and methods able to rigorously articulate the new risks therein. Copyright © 2016. Published by Elsevier Ltd.

Patient Electronic Health Records as a Means to Approach Genetic Research in Gastroenterology.

PubMed

Ananthakrishnan, Ashwin N; Lieberman, David

2015-10-01

Electronic health records (EHRs) are being increasingly utilized and form a unique source of extensive data gathered during routine clinical care. Through use of codified and free text concepts identified using clinical informatics tools, disease labels can be assigned with a high degree of accuracy. Analysis linking such EHR-assigned disease labels to a biospecimen repository has demonstrated that genetic associations identified in prospective cohorts can be replicated with adequate statistical power and novel phenotypic associations identified. In addition, genetic discovery research can be performed utilizing clinical, laboratory, and procedure data obtained during care. Challenges with such research include the need to tackle variability in quality and quantity of EHR data and importance of maintaining patient privacy and data security. With appropriate safeguards, this novel and emerging field of research offers considerable promise and potential to further scientific research in gastroenterology efficiently, cost-effectively, and with engagement of patients and communities. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Pembrolizumab and its use in the treatment of recurrent or metastatic head and neck cancer.

PubMed

Sheth, Siddharth; Weiss, Jared

2018-02-21

Until recently, palliative options for the treatment of platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) have been cytotoxic chemotherapy and EGFR inhibitors. These agents offer limited efficacy with substantial toxicity. The development of novel immune checkpoint inhibitors has challenged the standard treatment. Pembrolizumab is a potent and highly selective humanized monoclonal antibody that blocks the interaction between PD-1, an immune checkpoint receptor and its ligands PD-L1 and -2. In August 2016, the US FDA approved the use of pembrolizumab in R/M HNSCC following disease progression on or after platinum-containing chemotherapy. This review highlights the pharmacology, therapeutic efficacy and tolerability data relevant to the use of pembrolizumab for the treatment of R/M HNSCC. Readers will gain greater insight into the HNSCC tumor microenvironment, available biomarkers, and learn about important clinical considerations associated with the use of pembrolizumab and similar immune checkpoint inhibitors.

Generic medicines: solutions for a sustainable drug market?

PubMed

Dylst, Pieter; Vulto, Arnold; Godman, Brian; Simoens, Steven

2013-10-01

Generic medicines offer equally high-quality treatment as originator medicines do at much lower prices. As such, they represent a considerable opportunity for authorities to obtain substantial savings. At the moment, the pharmaceutical landscape is changing and many pharmaceutical companies have altered their development and commercial strategies, combining both originator and generic divisions. In spite of this, the generic medicines industry is currently facing a number of challenges: delayed market access; the limited price differential with originator medicines; the continuous downwards pressure on prices; and the negative perception regarding generic medicines held by some key stakeholder groups. This could jeopardize the long-term sustainability of the generic manufacturing industry. Therefore, governments must focus on demand-side policies, alongside policies to accelerate market access, as the generic medicines industry will only be able to deliver competitive and sustainable prices if they are ensured a high volume. In the future, the generic medicines industry will increasingly look to biosimilars and generic versions of orphan drugs to expand their business.

Nutrition and sustainability: an emerging food policy discourse.

PubMed

Lang, Tim; Barling, David

2013-02-01

It is well known that food has a considerable environmental impact. Less attention has been given to mapping and analysing the emergence of policy responses. This paper contributes to that process. It summarises emerging policy development on nutrition and sustainability, and explores difficulties in their integration. The paper describes some policy thinking at national, European and international levels of governance. It points to the existence of particular policy hotspots such as meat and dairy, sustainable diets and waste. Understanding the environmental impact of food systems challenges nutrition science to draw upon traditions of thinking which have recently been fragmented. These perspectives (life sciences, social and environmental) are all required if policy engagement and clarification is to occur. Sustainability issues offer opportunities for nutrition science and scientists to play a more central role in the policy analysis of future food systems. The task of revising current nutrition policy advice to become sustainable diet advice needs to begin at national and international levels.

How can video supported reflection enhance teachers' professional development?

NASA Astrophysics Data System (ADS)

McCullagh, John F.

2012-03-01

This paper responds to Eva Lundqvist, Jonas Almqvist and Leif Ostman's account of how the manner of teaching can strongly influence pupil learning by recommending video supported reflection as a means by which teachers can transform the nature of their practice. Given the complex nature of the many conditions which influence and control teachers' actions the reframing of routine practice through reflection-in-action can prove challenging. This response paper describes how video can empower teachers to take greater control of their progress and allows for a more social constructivist approach to professional development. Along with a consideration of the difficulties associated with the notion of `reflection' and a short case study, the paper uses Lev Semenovich Vygotsky's zone of proximal development and the notion of scaffolding to propose that video offers a Video Supported Zone of Proximal Development which can ease the process of teacher development. In capturing permanent and exchangeable representations of practice video encourages a collaborative approach to reflection and is consistent with the original ideas of John Dewey.

Recent advances in metamaterial split-ring-resonator circuits as biosensors and therapeutic agents.

PubMed

RoyChoudhury, Sohini; Rawat, Vaishali; Jalal, Ahmed Hasnain; Kale, S N; Bhansali, Shekhar

2016-12-15

Potential applications of thin film metamaterials are diverse and their realization to offer miniaturized waveguides, antennas and shielding patterns are on anvil. These artificially engineered structures can produce astonishing electromagnetic responses because of their constituents being engineered at much smaller dimensions than the wavelength of the incident electromagnetic wave, hence behaving as artificial materials. Such micro-nano dimensions of thin film metamaterial structures can be customized for various applications due to their exclusive responses to not only electromagnetic, but also to acoustic and thermal waves that surpass the natural materials' properties. In this paper, the recent major advancements in the emerging fields of diagnostics (sensors) and therapeutics involving thin film metamaterials have been reviewed and underlined; discussing their edge over conventional counterpart techniques; concentrating on their design considerations and feasible ways of achieving them. Challenges faced in sensitivity, precision, accuracy and factors that interfere with the degree of performance of the sensors are also dealt with, herein. Copyright © 2016 Elsevier B.V. All rights reserved.

Considerations of Alloy 617 Application in the Gen IV Nuclear Reactor Systems - Part II: Metallurgical Property Challenges

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

Ren, Weiju

2010-01-01

Alloy 617 is currently considered as a leading candidate material for high temperature components in the Gen IV Nuclear Reactor Systems. Because of the unprecedented severe working conditions beyond its commercial service experience required by the Gen IV systems, the alloy faces various challenges in both mechanical and metallurgical properties. Following a previous paper discussing the mechanical property challenges, this paper is focused on the challenges and issues in metallurgical properties of the alloy for the intended nuclear application. Considerations are given in details about its metallurgical stability and aging evolution, aging effects on mechanical properties, potential Co hazard, andmore » internal oxidation. Some research and development activities are suggested with discussions on viability to satisfy the Gen IV Nuclear Reactor System needs.« less

The cardio-respiratory effects of intra-abdominal hypertension: Considerations for critical care nursing practice.

PubMed

Christensen, Martin; Craft, Judy

2018-02-01

Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondary intra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation. Recent work suggests that intensive care unit nurses are often unaware of the secondary effects of intra-abdominal pressure and therefore this is not monitored effectively. Therefore being aware of the cardio-respiratory effects may alert theintensive care nurse nurse to the development of intra-abdominal hypertension. The aim of this paper is to discuss the pathophysiology associated with the cardio-respiratory effects seen with intra-abdominal hypertension in the critically ill. In particular it will discuss how intra-abdominal hypertension can inadvertently be overlooked because of the low flow states that it produces which could be misconstrued as something else. It will also discuss how intra-abdominal hypertension impedes ventilation and respiratory mechanics which can often result in a non-cardiogenic pulmonary oedema. To close, the paper will offer some implications for critical care nursing practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Known unknowns: building an ethics of uncertainty into genomic medicine.

PubMed

Newson, Ainsley J; Leonard, Samantha J; Hall, Alison; Gaff, Clara L

2016-09-01

Genomic testing has reached the point where, technically at least, it can be cheaper to undertake panel-, exome- or whole genome testing than it is to sequence a single gene. An attribute of these approaches is that information gleaned will often have uncertain significance. In addition to the challenges this presents for pre-test counseling and informed consent, a further consideration emerges over how - ethically - we should conceive of and respond to this uncertainty. To date, the ethical aspects of uncertainty in genomics have remained under-explored. In this paper, we draft a conceptual and ethical response to the question of how to conceive of and respond to uncertainty in genomic medicine. After introducing the problem, we articulate a concept of 'genomic uncertainty'. Drawing on this, together with exemplar clinical cases and related empirical literature, we then critique the presumption that uncertainty is always problematic and something to be avoided, or eradicated. We conclude by outlining an 'ethics of genomic uncertainty'; describing how we might handle uncertainty in genomic medicine. This involves fostering resilience, welfare, autonomy and solidarity. Uncertainty will be an inherent aspect of clinical practice in genomics for some time to come. Genomic testing should not be offered with the explicit aim to reduce uncertainty. Rather, uncertainty should be appraised, adapted to and communicated about as part of the process of offering and providing genomic information.

Reflections as near-peer facilitators of an inquiry project for undergraduate anatomy: Successes and challenges from a term of trial-and-error.

PubMed

Anstey, Lauren M; Michels, Alison; Szymus, Julianna; Law, Wyanne; Edwin Ho, Man-Hymn; Qu, Fei; Yeung, Ralph T T; Chow, Natalie

2014-01-01

Near-peer facilitators (senior students serving as facilitators to their more junior peers) bring a unique student-based perspective to teaching. With fewer years of teaching experience however, students who become involved in a facilitator role typically develop related skills quickly through a process of trial-and-error within the classroom. The aim of this paper is to report on the authors' own experiences and reflections as student near-peer facilitators for an inquiry-based project in an undergraduate anatomy course. Three areas of the facilitator experience are explored: (1) offering adequate guidance as facilitators of inquiry, (2) motivating students to engage in the inquiry process, and (3) fostering creativity in learning. A practical framework for providing guidance to students is discussed which offers facilitators a scaffold for asking questions and assisting students through the inquiry process. Considerations for stimulating intrinsic motivations toward inquiry learning are made, paying attention to ways in which facilitators might influence feelings of motivation towards learning. Also, the role of creativity in inquiry learning is explored by highlighting the actions facilitators can take to foster a creative learning environment. Finally, recommendations are made for the development of formalized training programs that aid near-peer facilitators in the acquisition of facilitation skills before entering into a process of trial-and-error within the classroom. © 2013 American Association of Anatomists.

Feminism and psychology: critiques of methods and epistemology.

PubMed

Eagly, Alice H; Riger, Stephanie

2014-10-01

Starting in the 1960s, many of the critiques of psychological science offered by feminist psychologists focused on its methods and epistemology. This article evaluates the current state of psychological science in relation to this feminist critique. The analysis relies on sources that include the PsycINFO database, the Publication Manual of the American Psychological Association (American Psychological Association, 2010), and popular psychology methods textbooks. After situating the feminist critique within the late-20th-century shift of science from positivism to postpositivism, the inquiry examines feminists' claims of androcentric bias in (a) the underrepresentation of women as researchers and research participants and (b) researchers' practices in comparing women and men and describing their research findings. In most of these matters, psychology manifests considerable change in directions advocated by feminists. However, change is less apparent in relation to some feminists' criticisms of psychology's reliance on laboratory experimentation and quantitative methods. In fact, the analyses documented the rarity in high-citation journals of qualitative research that does not include quantification. Finally, the analysis frames feminist methodological critiques by a consideration of feminist epistemologies that challenge psychology's dominant postpositivism. Scrutiny of methods textbooks and journal content suggests that within psychological science, especially as practiced in the United States, these alternative epistemologies have not yet gained substantial influence. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Ecosystem context and historical contingency in apex predator recoveries.

PubMed

Stier, Adrian C; Samhouri, Jameal F; Novak, Mark; Marshall, Kristin N; Ward, Eric J; Holt, Robert D; Levin, Phillip S

2016-05-01

Habitat loss, overexploitation, and numerous other stressors have caused global declines in apex predators. This "trophic downgrading" has generated widespread concern because of the fundamental role that apex predators can play in ecosystem functioning, disease regulation, and biodiversity maintenance. In attempts to combat declines, managers have conducted reintroductions, imposed stricter harvest regulations, and implemented protected areas. We suggest that full recovery of viable apex predator populations is currently the exception rather than the rule. We argue that, in addition to well-known considerations, such as continued exploitation and slow life histories, there are several underappreciated factors that complicate predator recoveries. These factors include three challenges. First, a priori identification of the suite of trophic interactions, such as resource limitation and competition that will influence recovery can be difficult. Second, defining and accomplishing predator recovery in the context of a dynamic ecosystem requires an appreciation of the timing of recovery, which can determine the relative density of apex predators and other predators and therefore affect competitive outcomes. Third, successful recovery programs require designing adaptive sequences of management strategies that embrace key environmental and species interactions as they emerge. Consideration of recent research on food web modules, alternative stable states, and community assembly offer important insights for predator recovery efforts and restoration ecology more generally. Foremost among these is the importance of a social-ecological perspective in facilitating a long-lasting predator restoration while avoiding unintended consequences.

Ecosystem context and historical contingency in apex predator recoveries

PubMed Central

Stier, Adrian C.; Samhouri, Jameal F.; Novak, Mark; Marshall, Kristin N.; Ward, Eric J.; Holt, Robert D.; Levin, Phillip S.

2016-01-01

Habitat loss, overexploitation, and numerous other stressors have caused global declines in apex predators. This “trophic downgrading” has generated widespread concern because of the fundamental role that apex predators can play in ecosystem functioning, disease regulation, and biodiversity maintenance. In attempts to combat declines, managers have conducted reintroductions, imposed stricter harvest regulations, and implemented protected areas. We suggest that full recovery of viable apex predator populations is currently the exception rather than the rule. We argue that, in addition to well-known considerations, such as continued exploitation and slow life histories, there are several underappreciated factors that complicate predator recoveries. These factors include three challenges. First, a priori identification of the suite of trophic interactions, such as resource limitation and competition that will influence recovery can be difficult. Second, defining and accomplishing predator recovery in the context of a dynamic ecosystem requires an appreciation of the timing of recovery, which can determine the relative density of apex predators and other predators and therefore affect competitive outcomes. Third, successful recovery programs require designing adaptive sequences of management strategies that embrace key environmental and species interactions as they emerge. Consideration of recent research on food web modules, alternative stable states, and community assembly offer important insights for predator recovery efforts and restoration ecology more generally. Foremost among these is the importance of a social-ecological perspective in facilitating a long-lasting predator restoration while avoiding unintended consequences. PMID:27386535

Mechanistic explanation, cognitive systems demarcation, and extended cognition.

PubMed

van Eck, Dingmar; Looren de Jong, Huib

2016-10-01

Approaches to the Internalism-Externalism controversy in the philosophy of mind often involve both (broadly) metaphysical and explanatory considerations. Whereas originally most emphasis seems to have been placed on metaphysical concerns, recently the explanation angle is getting more attention. Explanatory considerations promise to offer more neutral grounds for cognitive systems demarcation than (broadly) metaphysical ones. However, it has been argued that explanation-based approaches are incapable of determining the plausibility of internalist-based conceptions of cognition vis-à-vis externalist ones. On this perspective, improved metaphysics is the route along which to solve the Internalist-Externalist stalemate. In this paper we challenge this claim. Although we agree that explanation-orientated approaches have indeed so far failed to deliver solid means for cognitive system demarcation, we elaborate a more promising explanation-oriented framework to address this issue. We argue that the mutual manipulability account of constitutive relevance in mechanisms, extended with the criterion of 'fat-handedness', is capable of plausibly addressing the cognitive systems demarcation problem, and thus able to decide on the explanatory traction of Internalist vs. Externalist conceptions, on a case-by-case basis. Our analysis also highlights why some other recent mechanistic takes on the problem of cognitive systems demarcation have been unsuccessful. We illustrate our claims with a case on gestures and learning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Environmental Considerations for a Geothermal Development in the Jemez Mountains of Central New Mexico

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

Sabo, David G.

The demonstration nature of the Baca Geothermal Project and the contractual arrangements between Public Service Company of New Me (PNM) and Union Geothermal Company of New Mexico (Union) with the Department of Energy mandate on environmental monitoring effort previously not seen for an energy development of this size. One of the most often stated goals of the Baca Project is to demonstrate the acceptability and viability of geothermal energy in an environmentally responsible manner. If this statement is to be followed, then a program would have to be developed which would (1) identify all the environmental baseline parameters, (2) monitormore » them during construction and operation, and (3) alleviate any possible negative impacts. The situation of the Baca project in the Jemez Mountains of north-central New Mexico offers a challenging vehicle with which to demonstrate the acceptability of geothermal energy. A few of the reasons for this are: these mountains are one of the most heavily used recreational resource areas in the state, numerous prehistoric people utilized the canyons and have left considerable archeological resources, the mountains are home for a number of individuals who prefer their serenity to the hustle and bustle of urban dwelling, and finally, the mountains are considered sacred by a number of local Indian tribes, a few of which use the mountaintop as religious sites.« less

Introduction to the special section from recent Association of Psychologists in Academic Health Centers (APAHC) programs.

PubMed

Klepac, Robert K; Dixon, Kim E

2010-12-01

The Association of Psychologists in Academic Health Centers (APAHC) offers programming at the annual American Psychological Association (APA) conventions as well as periodic APAHC conferences. Participants from academic health centers across the country convened in St. Louis, Missouri, October 15-17, 2009, for the 4th National Conference of the Association of Psychologists in Academic Health Centers (APAHC). The title of the conference was ''Psychologists in Academic Health Centers: Facing Tomorrow's Challenges to AHC Programs and Careers.'' Efforts were made to include topics relevant to academic health center (AHC) practice including the unique challenges of working in AHCs and issues pertinent to the different stages of AHC careers. To facilitate networking, opportunities for discussion among conferees and presenters with shared interests and concerns were provided throughout the conference. This paper introduces the special section of JCPMS dedicated to the conference and provides a brief overview of its development and organization. Articles selected for inclusion represent a sampling of the four conference themes: (1) challenges to AHC programs, (2) staying current in critical clinical areas, (3) professional issues and challenges, and (4) challenges to developing careers. Post-conference evaluation data are presented as evidence of the need for further conferences with similar foci. The programming offered by APAHC at the APA convention in San Diego in 2010 built on the themes offered at the 2009 APAHC conference.

Risk-benefit considerations in the treatment of relapsing-remitting multiple sclerosis

PubMed Central

Lugaresi, Alessandra; di Ioia, Maria; Travaglini, Daniela; Pietrolongo, Erika; Pucci, Eugenio; Onofrj, Marco

2013-01-01

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system and mainly affects young adults. Its natural history has changed in recent years with the advent of disease-modifying drugs, which have been available since the early 1990s. The increasing number of first-line and second-line treatment options, together with the variable course of the disease and patient lifestyles and expectations, makes the therapeutic decision a real challenge. The aim of this review is to give a comprehensive overview of the main present and some future drugs for relapsing-remitting MS, including risk-benefit considerations, to enable readers to draw their own conclusions regarding the risk-benefit assessment of personalized treatment strategies, taking into account not only treatment-related but also disease-related risks. We performed a Medline literature search to identify studies on the treatment of MS with risk stratification and risk-benefit considerations. We focused our attention on studies of disease-modifying, immunomodulating, and immunosuppressive drugs, including monoclonal antibodies. Here we offer personal considerations, stemming from long-term experience in the treatment of MS and thorough discussions with other neurologists closely involved in the care of patients with the disease. MS specialists need to know not only the specific risks and benefits of single drugs, but also about drug interactions, either in simultaneous or serial combination therapy, and patient comorbidities, preferences, and fears. This has to be put into perspective, considering also the risks of untreated disease in patients with different clinical and radiological characteristics. There is no single best treatment strategy, but therapy has to be tailored to the patient. This is a time-consuming task, rich in complexity, and influenced by the attitude towards risk on the parts of both the patient and the clinical team. The broader the MS drug market becomes, the harder it will be for the clinician to help the patient decide which therapeutic strategy to opt for. PMID:23836975

Assessment of Montana road weather information system : final report

DOT National Transportation Integrated Search

2017-01-01

Weather presents considerable challenges to highway agencies both in terms of safety and operations. State transportation agencies have developed road weather information systems (RWIS) to address such challenges. Road weather information has been us...

Planning for planetary protection : challenges beyond Mars

NASA Technical Reports Server (NTRS)

Belz, Andrea P.; Cutts, James A.

2006-01-01

This document summarizes the technical challenges to planetary protection for these targets of interest and outlines some of the considerations, particularly at the system level, in designing an appropriate technology investment strategy for targets beyond Mars.

Natural areas and urban populations: communication and environmental education challenges and actions in outdoor recreation

Treesearch

Deborah J. Chavez

2005-01-01

Challenges, opportunities, and actions exist in areas where large urban populations interface with natural areas, such as outdoor recreation sites in southern California. Challenges in the interface include intense recreation use, public safety issues, and complex information strategies. Research results on communications and environmental education offer opportunities...

Challenging the Comfortable Stereotypes: Rural Education and Rural Development.

ERIC Educational Resources Information Center

Sher, Jonathan P.

This paper discusses the question of standardization and educational equity among rural school systems and offers three "fundamental challenges" for educators. The first challenge is to take seriously the power of education and to resist the temptation to reduce expectations placed on education and educators. The power of education is illustrated…

Economic Evaluation of Adolescent Addiction Programs: Methodological Challenges and Recommendations

PubMed Central

Homer, Jenny F.; Drummond, Michael F.; French, Michael T.

2008-01-01

This paper identifies and describes several methodological challenges encountered in economic evaluations of substance abuse interventions for adolescents. Topics include study design, the choice of perspective, the estimation of costs and outcomes, and the generalizability of results. Recommendations are offered for confronting these challenges using examples from adolescent addiction research. PMID:19027640

Understanding Diversity of English Language Learners: Identification of ELLs and ELLs with Disabilities

ERIC Educational Resources Information Center

Wang, Charity

2014-01-01

English Language Learners (ELLs) are one of the fastest growing student populations throughout the country. With ELLs come unique challenges schools must navigate to best serve these students. One challenge is the identification of these students and proper placement and service within ELL programs offered by schools. Another challenge is…

How major restaurant chains plan their menus: the role of profit, demand, and health.

PubMed

Glanz, Karen; Resnicow, Ken; Seymour, Jennifer; Hoy, Kathy; Stewart, Hayden; Lyons, Mark; Goldberg, Jeanne

2007-05-01

Increased away-from-home eating is associated with lower diet quality, and may contribute to the increasing prevalence of overweight and obesity. Healthier food choices in restaurants may help mitigate the rise in obesity and improve diet quality. This study sought to understand the views of executives at major U.S. restaurant chains regarding the process, motivation for, and challenges of offering healthier options on their menus. The Healthy Menu Study used in-depth structured telephone interviews with 41 senior menu development and marketing executives at leading casual dining and fast-food restaurant chains. The interview guide covered menu trends, influences on introduction and continuation of new menu items, and barriers to adding healthy foods. Data analysis included tabulation of responses, identification of themes, and examination of subgroup differences. Growing sales and increasing profits are the most important considerations, mentioned by 61% of respondents; health and nutrition were noted as important by 21%. Restaurants may try to avoid losing groups with a "health seeker" by offering healthier foods (low in fat and calories, more fruits and vegetables) (27% of chains), but operators believe demand for healthier foods is not widespread. Additional obstacles to including healthier menu items are short shelf life of produce (46%), increased preparation time, low sales, and high labor costs. Not surprisingly, profit margins are the primary determinants of why restaurants do or do not add and continue to serve healthier food options. Without an increase in consumer demand, it is unlikely the restaurant industry will increase their offering of healthy food choices. Insight into the restaurant industry perspective is important for developing promising strategies to encourage healthier eating patterns.

The challenges for nut-allergic consumers of eating out.

PubMed

Leftwich, J; Barnett, J; Muncer, K; Shepherd, R; Raats, M M; Hazel Gowland, M; Lucas, J S

2011-02-01

For individuals with a nut allergy, the avoidance of allergens is particularly challenging in situations where they are not preparing their own food. Many allergic reactions occur when eating outside the home. To identify and explore the challenges faced by nut-allergic individuals (NAIs) when they are eating in restaurants and other eating establishments. A qualitative interview study was conducted with 32 adults with a clinical history of allergy to peanuts and/or tree nuts. The main strategies that participants adopted to manage the risk of allergic reactions when eating outside the home were avoidance and communication. They avoided types of restaurants, meal courses or particular foods. Seeking familiarity was a key strategy that enabled NAIs to reduce uncertainty and anxiety. Language differences were a major barrier to confident communication about food content. The need to check whether the food on offer may contain nuts was a source of social embarrassment for many participants and the desire to avoid this sometimes led to increased risk taking. Some did not disclose their allergy to restaurant staff as they feared a conservative reaction that would further constrain food choices. NAIs often have to plan where to eat out. The consequent lack of spontaneity was a source of regret to some. Communication patterns of nut-allergic adults are often grounded in legitimate everyday social considerations around embarrassment, choice and spontaneity. Education and training strategies are needed that recognize and take account of this. Focusing on communication deficits of NAIs may be unhelpful; responsibility for food safety must be shared with the food industry. © 2010 Blackwell Publishing Ltd.

A Comprehensive Review of Credit Instructional Programs Offered by Pasadena City Colleges, 1981-1982. Volume I. Summary Report.

ERIC Educational Resources Information Center

Carvell Education Managment Planning, Inc., Los Angeles, CA.

The first part of a report on a comprehensive review of the credit instructional programs offered by Pasadena City College (PCC), this volume provides a description of the evaluation procedures used, and a discussion of general issues that are major considerations for program improvement. Section I introduces the program review in terms of its…

A comprehensive scoring system to evaluate patient-centred risk factors regarding lower extremity amputation.

PubMed

Miller, M S; Newgent, E W; O'Connell, S M; Broadus, C

2017-10-01

Care of the patient with a presumed life- or limb-threatening lower extremity wound poses many challenges. The mindset regarding potential outcomes of such conditions is mostly driven by the experiences and expertise of those providing the care. This mindset generally appears as two primary actions presented to the afflicted patient: attempted resolution of the problem via medical, surgical or combination treatment, with the hope of low recurrence risk, or exacerbation and amputation-amputations at a level sufficient to, at least in the mind of the surgeon, eliminate the problem. Achieving the former outcome is dependent on a number of factors associated with both patient and caregiver. If healing is achieved, the secondary goal of prevention of recurrence may be no less arduous, with failure most likely resulting in amputation. Clearly, these considerations appear to be based more on the health professionals perception, of the patient's physical and medical status rather than on patient-centred considerations. This article will review considerations and recommendations for lower extremity amputation, and the short- and long-term implications. Based on our research, there is clear need for a set of criteria against which to weigh not just the medical issues, but also definitive patient-centred issues when considering a lower extremity amputation. We offer a set of patient-centred, easily verified and recognised criteria that we believe addresses this need. The goal of the Miller-Newgent Amputation Scale (MENACE) is to provide a decision base from which to consider and evaluate all factors in determining the need for a lower extremity amputation. This involves identification of patient-centred issues, which are likely to produce satisfactory short- and long-term physical and quality-of-life outcomes if the amputation does proceed.

Clarifying Resilience in the Context of Homeland Security

DTIC Science & Technology

2013-03-01

Resilience Is a Complex Adaptive System of Systems ( CASoS ) ....60 4. Resilience Is Experienced and Demonstrated in Different Ways ..60 5. Resilience Is...The inclusion of a resilience module into existing homeland security training programs broadens the practitioner’s knowledge base from a basic level...psychology offer several considerations for the homeland security practitioner. The first consideration maintains that a de -emphasis on the

Computer science security research and human subjects: emerging considerations for research ethics boards.

PubMed

Buchanan, Elizabeth; Aycock, John; Dexter, Scott; Dittrich, David; Hvizdak, Erin

2011-06-01

This paper explores the growing concerns with computer science research, and in particular, computer security research and its relationship with the committees that review human subjects research. It offers cases that review boards are likely to confront, and provides a context for appropriate consideration of such research, as issues of bots, clouds, and worms enter the discourse of human subjects review.

Driving and flying with epilepsy.

PubMed

Drazkowski, Joseph F

2007-07-01

Transportation issues in industrialized nations play an important role in the lives of most citizens. The acts of flying and driving, especially in the United States, intersect with many peoples' lives on almost a daily basis. Although some larger cities have modern and efficient public transportation systems, many do not, thus placing considerable responsibility on the individual to manage their own transportation needs. A person with epilepsy faces considerable challenges when it comes to transportation. Defining these challenges and understanding how to deal with the person with epilepsy and transportation issues is the focus of this article.

Land-Use Intensity of Electricity Production: Comparison Across Multiple Sources

NASA Astrophysics Data System (ADS)

Swain, M.; Lovering, J.; Blomqvist, L.; Nordhaus, T.; Hernandez, R. R.

2015-12-01

Land is an increasingly scarce global resource that is subject to competing pressures from agriculture, human settlement, and energy development. As countries concerned about climate change seek to decarbonize their power sectors, renewable energy sources like wind and solar offer obvious advantages. However, the land needed for new energy infrastructure is also an important environmental consideration. The land requirement of different electricity sources varies considerably, but there are very few studies that offer a normalized comparison. In this paper, we use meta-analysis to calculate the land-use intensity (LUI) of the following electricity generation sources: wind, solar photovoltaic (PV), concentrated solar power (CSP), hydropower, geothermal, nuclear, biomass, natural gas, and coal. We used data from existing studies as well as original data gathered from public records and geospatial analysis. Our land-use metric includes land needed for the generation facility (e.g., power plant or wind farm) as well as the area needed to mine fuel for natural gas, coal, and nuclear power plants. Our results found the lowest total LUI for nuclear power (115 ha/TWh/y) and the highest LUI for biomass (114,817 ha/TWh/y). Solar PV and CSP had a considerably lower LUI than wind power, but both were an order of magnitude higher than fossil fuels (which ranged from 435 ha/TWh/y for natural gas to 579 ha/TWh/y for coal). Our results suggest that a large build-out of renewable electricity, though it would offer many environmental advantages over fossil fuel power sources, would require considerable land area. Among low-carbon energy sources, relatively compact sources like nuclear and solar have the potential to reduce land requirements.

75 FR 34489 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... report sales and use of proceeds in Regulation A offerings. We estimate that approximately 100 issuers... the use of automated collection techniques or other forms of information technology. Consideration...

Survey Shows Variation in Ph.D. Methods Training.

ERIC Educational Resources Information Center

Steeves, Leslie; And Others

1983-01-01

Reports on a 1982 survey of journalism graduate studies indicating considerable variation in research methods requirements and emphases in 23 universities offering doctoral degrees in mass communication. (HOD)

Co-enrolment of Participants into Multiple Cancer Trials: Benefits and Challenges.

PubMed

Cafferty, F H; Coyle, C; Rowley, S; Berkman, L; MacKensie, M; Langley, R E

2017-07-01

Opportunities to enter patients into more than one clinical trial are not routinely considered in cancer research and experiences with co-enrolment are rarely reported. Potential benefits of allowing appropriate co-enrolment have been identified in other settings but there is a lack of evidence base or guidance to inform these decisions in oncology. Here, we discuss the benefits and challenges associated with co-enrolment based on experiences in the Add-Aspirin trial - a large, multicentre trial recruiting across a number of tumour types, where opportunities to co-enrol patients have been proactively explored and managed. The potential benefits of co-enrolment include: improving recruitment feasibility; increased opportunities for patients to participate in trials; and collection of robust data on combinations of interventions, which will ensure the ongoing relevance of individual trials and provide more cohesive evidence to guide the management of future patients. There are a number of perceived barriers to co-enrolment in terms of scientific, safety and ethical issues, which warrant consideration on a trial-by-trial basis. In many cases, any potential effect on the results of the trials will be negligible - limited by a number of factors, including the overlap in trial cohorts. Participant representatives stress the importance of autonomy to decide about trial enrolment, providing a compelling argument for offering co-enrolment where there are multiple trials that are relevant to a patient and no concerns regarding safety or the integrity of the trials. A number of measures are proposed for managing and monitoring co-enrolment. Ensuring acceptability to (potential) participants is paramount. Opportunities to enter patients into more than one cancer trial should be considered more routinely. Where planned and managed appropriately, co-enrolment can offer a number of benefits in terms of both scientific value and efficiency of study conduct, and will increase the opportunities for patients to participate in, and benefit from, clinical research. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Overview of an REU program: A case study in gender parity, ethnic diversity, and community college students

NASA Astrophysics Data System (ADS)

Pearson, J. K.; Noriega, G.; Benthien, M. L.

2017-12-01

The Undergraduate Studies in Earthquake Information Technology (USEIT) is an REU Internship Program focused in multi-disciplinary, collaborative research offered through the Southern California Earthquake Center (SCEC); a research consortium focused on earthquake science. USEIT is an 8-week intensive undergraduate research program. The program is designed for interns to work as a collaborative engine to solve an overarching real-world earthquake problem referred to as the "Grand Challenge". The interns are organized in teams and paired with mentors that have expertise in their specific task in the Grand Challenge. The program is focused around earthquake system science, where students have the opportunity to use super computers, programming platforms, geographic information systems, and internally designed and developed visualization software. The goal of the USEIT program is to motivate undergraduates from diverse backgrounds towards careers in science and engineering through team-based research in the field of earthquake information technology. Efforts are made to recruit students with diverse backgrounds, taking into consideration gender, ethnic background, socioeconomic standing, major, college year, and institution type (2-year and 4-year colleges). USEIT has a partnership with two local community colleges to recruit underserved students. Our emphasis is to attract students that would 1) grow and develop technical skills, soft skills, and confidence from the program, and 2) provide perspective and innovation to the program. USEIT offers on-campus housing to provide a submerged learning environment, recruits diverse majors to foster interdisciplinary collaboration, maintains a full time in lab mentor for day-to-day intern needs, takes students on field trips to provide context to their research, and plans activities and field trips for team building and morale. Each year metrics are collected through exit surveys, personal statements, and intern experience statements. We highlight lessons learned, including a need for pre-program engagement to ensure student success.

Roadmap on optical energy conversion

DOE PAGES

Boriskina, Svetlana V.; Green, Martin A.; Catchpole, Kylie; ...

2016-06-24

For decades, progress in the field of optical (including solar) energy conversion was dominated by advances in the conventional concentrating optics and materials design. In recent years, however, conceptual and technological breakthroughs in the fields of nanophotonics and plasmonics combined with a better understanding of the thermodynamics of the photon energy-conversion processes reshaped the landscape of energy-conversion schemes and devices. Nanostructured devices and materials that make use of size quantization effects to manipulate photon density of states offer a way to overcome the conventional light absorption limits. Novel optical spectrum splitting and photon-recycling schemes reduce the entropy production in themore » optical energy-conversion platforms and boost their efficiencies. Optical design concepts are rapidly expanding into the infrared energy band, offering new approaches to harvest waste heat, to reduce the thermal emission losses, and to achieve noncontact radiative cooling of solar cells as well as of optical and electronic circuitries. Light-matter interaction enabled by nanophotonics and plasmonics underlie the performance of the third- and fourth-generation energy-conversion devices, including up- and down-conversion of photon energy, near-field radiative energy transfer, and hot electron generation and harvesting. Finally, the increased market penetration of alternative solar energy-conversion technologies amplifies the role of cost-driven and environmental considerations. This roadmap on optical energy conversion provides a snapshot of the state of the art in optical energy conversion, remaining challenges, and most promising approaches to address these challenges. Leading experts authored 19 focused short sections of the roadmap where they share their vision on a specific aspect of this burgeoning research field. The roadmap opens up with a tutorial section, which introduces major concepts and terminology. As a result, it is our hope that the roadmap will serve as an important resource for the scientific community, new generations of researchers, funding agencies, industry experts, and investors.« less

Charging stations location model based on spatiotemporal electromobility use patterns

NASA Astrophysics Data System (ADS)

Pagany, Raphaela; Marquardt, Anna; Zink, Roland

2016-04-01

One of the major challenges for mainstream adoption of electric vehicles is the provision of infrastructure for charging the batteries of the vehicles. The charging stations must not only be located dense enough to allow users to complete their journeys, but the electric energy must also be provided from renewable sources in order to truly offer a transportation with less CO2 emissions. The examination of potential locations for the charging of electric vehicles can facilitate the adaption of electromobility and the integration of electronic vehicles in everyday life. A geographic information system (GIS) based model for optimal location of charging stations in a small and regional scale is presented. This considers parameters such as the forecast of electric vehicle use penetration, the relevant weight of diverse point of interests and the distance between parking area and destination for different vehicle users. In addition to the spatial scale the temporal modelling of the energy demand at the different charging locations has to be considerate. Depending on different user profiles (commuters, short haul drivers etc.) the frequency of charging vary during the day, the week and the year. In consequence, the spatiotemporal variability is a challenge for a reliable energy supply inside a decentralized renewable energy system. The presented model delivers on the one side the most adequate identified locations for charging stations and on the other side the interaction between energy supply and demand for electromobility under the consideration of temporal aspects. Using ESRI ArcGIS Desktop, first results for the case study region of Lower Bavaria are generated. The aim of the concept is to keep the model transferable to other regions and also open to integrate further and more detailed user profiles, derived from social studies about i.e. the daily behavior and the perception of electromobility in a next step.

Criteria for the prioritization of public health interventions for climate-sensitive vector-borne diseases in Quebec.

PubMed

Hongoh, Valerie; Gosselin, Pierre; Michel, Pascal; Ravel, André; Waaub, Jean-Philippe; Campagna, Céline; Samoura, Karim

2017-01-01

Prioritizing resources for optimal responses to an ever growing list of existing and emerging infectious diseases represents an important challenge to public health. In the context of climate change, there is increasing anticipated variability in the occurrence of infectious diseases, notably climate-sensitive vector-borne diseases. An essential step in prioritizing efforts is to identify what considerations and concerns to take into account to guide decisions and thus set disease priorities. This study was designed to perform a comprehensive review of criteria for vector-borne disease prioritization, assess their applicability in a context of climate change with a diverse cross-section of stakeholders in order to produce a baseline list of considerations to use in this decision-making context. Differences in stakeholder choices were examined with regards to prioritization of these criteria for research, surveillance and disease prevention and control objectives. A preliminary list of criteria was identified following a review of the literature. Discussions with stakeholders were held to consolidate and validate this list of criteria and examine their effects on disease prioritization. After this validation phase, a total of 21 criteria were retained. A pilot vector-borne disease prioritization exercise was conducted using PROMETHEE to examine the effects of the retained criteria on prioritization in different intervention domains. Overall, concerns expressed by stakeholders for prioritization were well aligned with categories of criteria identified in previous prioritization studies. Weighting by category was consistent between stakeholders overall, though some significant differences were found between public health and non-public health stakeholders. From this exercise, a general model for climate-sensitive vector-borne disease prioritization has been developed that can be used as a starting point for further public health prioritization exercises relating to research, surveillance, and prevention and control interventions in a context of climate change. Multi-stakeholder engagement in prioritization can help broaden the range of criteria taken into account, offer opportunities for early identification of potential challenges and may facilitate acceptability of any resulting decisions.

Making a Drama out of Transition: Challenges and Opportunities at Times of Change

ERIC Educational Resources Information Center

Hammond, Nick

2016-01-01

This case study explored how teachers and children perceive challenges and opportunities at transition. Using Forum Theatre (FT), an interactive drama approach, children were able to show aspects of transitions they perceived as challenging and how these barriers may be overcome. FT offered a tangible reference point for children to discuss their…

Environmental decision support systems (EDSS) development - Challenges and best practices

Treesearch

B. S. McIntosh; J. C. Ascough II; S. Chen; J. Chew; S. Cuddy; A. Elmahdi; D. Haase; J. Harou; D. Hepting; A. J. Jakeman; A. Kassahun; S. Lautenbach; K. Matthews; W. Merritt; N. W. T. Quinn; I. Rodriguez-Roda; S. Sieber; M. Stavenga; A. Sulis; J. Ticehurst; M. J. Twery; M. Volk; M. Wrobel; H. van Delden; S. El-Sawah; A. Rizzoli; A. Voinov

2011-01-01

Despite the perceived value of DSS in informing environmental and natural resource management, DSS tools often fail to be adopted by intended end users. By drawing together the experience of a global group of EDSS developers, we have identified and assessed key challenges in EDSS development and offer recommendations to resolve them. Challenges related to engaging end...

Perceived Challenges in Primary Literature in a Master's Class: Effects of Experience and Instruction

ERIC Educational Resources Information Center

Lie, Richard; Abdullah, Christopher; He, Wenliang; Tour, Ella

2016-01-01

Primary literature offers rich opportunities to teach students how to "think like a scientist," but the challenges students face when they attempt to read research articles are not well understood. Here, we present an analysis of what master's students perceive as the most challenging aspects of engaging with primary literature. We…

When Bible and Science Interact: Teachers' Pedagogic and Value Challenges in Teaching Religious Minority Students in Higher Education Settings

ERIC Educational Resources Information Center

Novis-Deutsch, Nurit; Lifshitz, Chen

2016-01-01

The integration of highly religious minority students into institutions of higher education poses significant pedagogical and value challenges for students and teachers alike. We offer a framework for analyzing such challenges, distinguishing between practical concerns, identity issues and value conflicts. By contrasting a deficit perspective to…

Massachusetts Substance Use Disorder Treatment Organizations’ Perspectives on the Affordable Care Act: Changes in Payment, Services, and System Design

PubMed Central

Quinn, Amity E.; Stewart, Maureen T.; Brolin, Mary; Horgan, Constance; Lane, Nancy E.

2017-01-01

The Affordable Care Act (ACA) expanded insurance benefits and coverage for substance use disorder (SUD) treatment and encouraged delivery and payment reforms. Massachusetts passed a similar reform in 2006. This study aims to assess Massachusetts SUD treatment organizations’ responses to the ACA. Organizational interviews addressing challenges of and responses to the ACA were conducted in-person June–December 2014 with 31 leaders at 12 treatment organizations across Massachusetts. Many organizations were affiliated with medical or social services and offered a range of SUD services. Sampling was based on services offered (detoxification only, detoxification and outpatient, outpatient only). Framework analysis was used. Challenges identified were considered similar to ongoing challenges, not unique to the ACA. Organizations experienced insurance expansions in 2006 and faced new challenges, including insurance coverage, payment arrangements, expansion of services, and system design. System design efforts included care coordination/integration, workforce development, and health information technology. Differences in responses related to connections with medical and social service organizations. Many organizations engaged in efforts to respond to changing policies by expanding capacity and services. Offering a range of SUD treatment (e.g., detoxification and outpatient) and affiliating with a medical organization could enable organizations to respond to new insurance, delivery, and payment reforms. PMID:28350232

Challenges and Opportunities for Testing Students Who Are Deaf or Hard of Hearing: Information for Educators on Creating Test Equity. Test Equity Considerations: Schools

ERIC Educational Resources Information Center

PEPNet-West, 2010

2010-01-01

For most students, test taking is a challenge. For students who are deaf or hard of hearing, classroom quizzes, tests, and exams are even more challenging. Standardized tests--The SAT, ACT, state proficiency tests, No Child Left Behind annual tests, and psychoeducational evaluations--present additional challenges for students who are deaf or hard…

The Missing Curriculum Link: Personal Financial Planning

ERIC Educational Resources Information Center

Neidermeyer, Adolph A.; Neidermeyer, Presha E.

2010-01-01

With increasing personal and business financial challenges facing today's professionals, we, as business school faculty, have a responsibility to offer the educational background that should enable rising professionals to successfully manage finances. Unfortunately, the results of a recent analysis of curriculum offerings in Personal Financial…

Determining the Ecosystem Services Important for Urban Landscapes

EPA Science Inventory

Urban ecosystems present special considerations and challenges in researching and evaluating ecosystem functions and services. A case study of nitrate retention and loss in forested, urban wetlands illustrates these challenges. Water table dynamics, in situ nitrogen cy...

Brownfields Green Avenue Sites: Technical Memorandum - Conceptual Design for Sustainable Redevelopment

EPA Pesticide Factsheets

This technical memorandum briefly describes the site and proposed conceptual site plan, indicates conceptual design considerations, specifies recommended green and sustainable features, and offers other recommendations

Magnesium-Based Micromotors: Water-Powered Propulsion, Multifunctionality, and Biomedical and Environmental Applications.

PubMed

Chen, Chuanrui; Karshalev, Emil; Guan, Jianguo; Wang, Joseph

2018-06-01

The new capabilities and functionalities of synthetic micro/nanomotors open up considerable opportunities for diverse environmental and biomedical applications. Water-powered micromachines are particularly attractive for realizing many of these applications. Magnesium-based motors directly use water as fuel to generate hydrogen bubbles for their propulsion, eliminating the requirement of common toxic fuels. This Review highlights the development of new Mg-based micromotors and discusses the chemistry that makes it extremely attractive for micromotor applications. Understanding these Mg properties and its transient nature is essential for controlling the propulsion efficiency, lifetime, and overall performance. The unique and attractive behavior of Mg offers significant advantages, including efficient water-powered movement, remarkable biocompatibility, controlled degradation, convenient functionalization, and built-in acid neutralization ability, and has paved the way for multifunctional micromachines for diverse real-life applications, including operation in living animals. A wide range of such Mg motor-based applications, including the detection and destruction of environmental threats, effective in-vivo cargo delivery, and autonomous release, have been demonstrated. In conclusion, the current challenges, future opportunities, and performance improvements of the Mg-based micromotors are discussed. With continuous innovation and attention to key challenges, it is expected that Mg-based motors will have a profound impact on diverse biomedical and environmental applications. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A fallacious jar? The peculiar relation between descriptive premises and normative conclusions in neuroethics.

PubMed

Wagner, Nils-Frederic; Northoff, Georg

2015-06-01

Ethical questions have traditionally been approached through conceptual analysis. Inspired by the rapid advance of modern brain imaging techniques, however, some ethical questions appear in a new light. For example, hotly debated trolley dilemmas have recently been studied by psychologists and neuroscientists alike, arguing that their findings can support or debunk moral intuitions that underlie those dilemmas. Resulting from the wedding of philosophy and neuroscience, neuroethics has emerged as a novel interdisciplinary field that aims at drawing conclusive relationships between neuroscientific observations and normative ethics. A major goal of neuroethics is to derive normative ethical conclusions from the investigation of neural and psychological mechanisms underlying ethical theories, as well as moral judgments and intuitions. The focus of this article is to shed light on the structure and functioning of neuroethical arguments of this sort, and to reveal particular methodological challenges that lie concealed therein. We discuss the methodological problem of how one can--or, as the case may be, cannot--validly infer normative conclusions from neuroscientific observations. Moreover, we raise the issue of how preexisting normative ethical convictions threaten to invalidate the interpretation of neuroscientific data, and thus arrive at question-begging conclusions. Nonetheless, this is not to deny that current neuroethics rightly presumes that moral considerations about actual human lives demand empirically substantiated answers. Therefore, in conclusion, we offer some preliminary reflections on how the discussed methodological challenges can be met.

Clinical 3T MR imaging: mastering the challenges.

PubMed

Tanenbaum, Lawrence N

2006-02-01

3T MRI is ready to meet the needs of clinical practice. SAR limitations are minimized by technical advances and surface coils are available for all core applications. With appropriate adjustments to scanning protocols, one can master the challenges of scanning at 3T; studies of the brain, spine, chest, abdomen, pelvis, vasculature, and extremities can be consistently higher in quality than are those obtained at 1.5T. The superior studies that are obtainable at 3T have great appeal to clinicians who are sophisticated about MR technology in areas, such as neurology, orthopedics, vascular surgery, and oncology,and encourage a shift in referrals toward practices that invest in higher field technology. The greater sensitivity to magnetic susceptibility offers unique benefits in functional neuroimaging, and available software/hardware packages enhance clinical setting feasibility, which adds a source of new referrals. The greater overall signal of 3T can be manipulated to make scanning more comfortable and with less motion artifact because scan times could be half as long. Spectacular anatomic delineation that is provided by high-definition scanning at true 1024 resolution can improve preoperative assessment and may improve sensitivity to smaller lesions. 3T provides practices with an advantage that is sought increasingly by high field strength purchasers in a competitive market. Only cost considerations stand in the way of the eventual domination of 3T systems in the high field strength market.

Kernel-based whole-genome prediction of complex traits: a review.

PubMed

Morota, Gota; Gianola, Daniel

2014-01-01

Prediction of genetic values has been a focus of applied quantitative genetics since the beginning of the 20th century, with renewed interest following the advent of the era of whole genome-enabled prediction. Opportunities offered by the emergence of high-dimensional genomic data fueled by post-Sanger sequencing technologies, especially molecular markers, have driven researchers to extend Ronald Fisher and Sewall Wright's models to confront new challenges. In particular, kernel methods are gaining consideration as a regression method of choice for genome-enabled prediction. Complex traits are presumably influenced by many genomic regions working in concert with others (clearly so when considering pathways), thus generating interactions. Motivated by this view, a growing number of statistical approaches based on kernels attempt to capture non-additive effects, either parametrically or non-parametrically. This review centers on whole-genome regression using kernel methods applied to a wide range of quantitative traits of agricultural importance in animals and plants. We discuss various kernel-based approaches tailored to capturing total genetic variation, with the aim of arriving at an enhanced predictive performance in the light of available genome annotation information. Connections between prediction machines born in animal breeding, statistics, and machine learning are revisited, and their empirical prediction performance is discussed. Overall, while some encouraging results have been obtained with non-parametric kernels, recovering non-additive genetic variation in a validation dataset remains a challenge in quantitative genetics.

Using e-cigarettes in the home to reduce smoking and secondhand smoke: disadvantaged parents' accounts.

PubMed

Rowa-Dewar, Neneh; Rooke, Catriona; Amos, Amanda

2017-02-01

Electronic cigarettes (e-cigarettes) are subject to considerable public health debate. Most public health experts agree that for smokers who find it particularly challenging to quit, e-cigarettes may reduce harm. E-cigarette use in the home may also reduce children's secondhand smoke (SHS) exposure, although e-cigarette vapour may pose risks. This is the first qualitative study to explore disadvantaged parents' views and experiences of e-cigarettes in relation to reducing SHS exposure in the home. Interviews with 25 disadvantaged parents from Edinburgh who smoked and had children aged 1-3 were conducted in 2013, with 17 re-interviewed in 2014. Accounts of e-cigarette perceptions and use were analysed thematically. E-cigarettes were seen by some as potentially valuable in helping quitting or reducing smoking in difficult circumstances, and protecting children from SHS when smoking outside is constrained. However, parents raised concerns about safety issues and continuing their nicotine addiction. In relation to children, concerns included possible health effects of the vapour, children playing with them and role-modelling e-cigarette use. While significant concerns remain about e-cigarettes, for some parents who find it challenging to quit or safely leave their children to smoke outside, e-cigarettes may offer potential for reducing the harm to them and their children. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

PubMed

Gillespie, Mary

2010-11-01

Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Postcolonial foldings of space and identity in science education: limits, transformations, prospects

NASA Astrophysics Data System (ADS)

Zembylas, Michalinos; Avraamidou, Lucy

2008-12-01

The four essays reviewed here constitute a worthwhile attempt to discuss various aspects of postcolonial theory, and offer constructive ideas to ongoing academic as well as public conversations with respect to whether science education can meet the challenges of educating an increasingly diverse population in the 21st century. These essays are grounded in the assumption that it is difficult to make meaningful and transformative changes in science education so that educators' efforts take into consideration the dramatic changes (i.e., diverse culture and racial origins, language, economic status etc.) of `an era of globalization' in order to meet the demands of today's schools. Each of these four essays problematizes various aspects of the social and cultural conditions of science education nowadays using different `postcolonial' ideas to interpret the implications for science learning and teaching. Although the term `postcolonial' has certainly multiple meanings in the literature, we use this term here to describe the philosophical position of these essays to challenge long-standing and hegemonic practices and taken-for-granted assumptions in science education. Through critical analysis of these essays, we engage in a dialogue with the authors, focusing on two of what seem crucial issues in understanding the potential contributions as well as the risks of postcolonial concepts in science education; these issues are space and identity. We choose these issues because they permeate all four essays in interesting and often provocative ways.

Unconventional Tools for an Unconventional Resource: Community and Landscape Planning for Shale in the Marcellus Region

NASA Astrophysics Data System (ADS)

Murtha, T., Jr.; Orland, B.; Goldberg, L.; Hammond, R.

2014-12-01

Deep shale natural gas deposits made accessible by new technologies are quickly becoming a considerable share of North America's energy portfolio. Unlike traditional deposits and extraction footprints, shale gas offers dispersed and complex landscape and community challenges. These challenges are both cultural and environmental. This paper describes the development and application of creative geospatial tools as a means to engage communities along the northern tier counties of Pennsylvania, experiencing Marcellus shale drilling in design and planning. Uniquely combining physical landscape models with predictive models of exploration activities, including drilling, pipeline construction and road reconstruction, the tools quantify the potential impacts of drilling activities for communities and landscapes in the commonwealth of Pennsylvania. Dividing the state into 9836 watershed sub-basins, we first describe the current state of Marcellus related activities through 2014. We then describe and report the results of three scaled predictive models designed to investigate probable sub-basins where future activities will be focused. Finally, the core of the paper reports on the second level of tools we have now developed to engage communities in planning for unconventional gas extraction in Pennsylvania. Using a geodesign approach we are working with communities to transfer information for comprehensive landscape planning and informed decision making. These tools not only quantify physical landscape impacts, but also quantify potential visual, aesthetic and cultural resource implications.

Global trends and challenges in deceased donor kidney allocation.

PubMed

Wu, Diana A; Watson, Christopher J; Bradley, J Andrew; Johnson, Rachel J; Forsythe, John L; Oniscu, Gabriel C

2017-06-01

Worldwide, the number of patients able to benefit from kidney transplantation is greatly restricted by the severe shortage of deceased donor organs. Allocation of this scarce resource is increasingly challenging and complex. Striking an acceptable balance between efficient use of (utility) and fair access to (equity) the limited supply of donated kidneys raises controversial but important debates at ethical, medical, and social levels. There is no international consensus on the recipient and donor factors that should be considered in the kidney allocation process. There is a general trend toward a reduction in the influence of human leukocyte antigen mismatch and an increase in the importance of other factors shown to affect posttransplant outcomes, such as cold ischemia, duration of dialysis, donor and recipient age, and comorbidity. Increased consideration of equity has led to improved access to transplantation for disadvantaged patient groups. There has been an overall improvement in the transparency and accountability of allocation policies. Novel and contentious approaches in kidney allocation include the use of survival prediction scores as a criterion for accessing the waiting list and at the point of organ offering with matching of predicted graft and recipient survival. This review compares the diverse international approaches to deceased donor kidney allocation and their evolution over the last decade. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Heutagogy: An alternative practice based learning approach.

PubMed

Bhoyrub, John; Hurley, John; Neilson, Gavin R; Ramsay, Mike; Smith, Margaret

2010-11-01

Education has explored and utilised multiple approaches in attempts to enhance the learning and teaching opportunities available to adult learners. Traditional pedagogy has been both directly and indirectly affected by andragogy and transformational learning, consequently widening our understandings and approaches toward view teaching and learning. Within the context of nurse education, a major challenge has been to effectively apply these educational approaches to the complex, unpredictable and challenging environment of practice based learning. While not offered as a panacea to such challenges, heutagogy is offered in this discussion paper as an emerging and potentially highly congruent educational framework to place around practice based learning. Being an emergent theory its known conceptual underpinnings and possible applications to nurse education need to be explored and theoretically applied. Through placing the adult learner at the foreground of grasping learning opportunities as they unpredictability emerge from a sometimes chaotic environment, heutagogy can be argued as offering the potential to minimise many of the well published difficulties of coordinating practice with faculty teaching and learning. Copyright © 2010 Elsevier Ltd. All rights reserved.

Practising virtue: a challenge to the view that a virtue centred approach to ethics lacks practical content.

PubMed

Begley, Ann Marie

2005-11-01

A virtue centred approach to ethics has been criticized for being vague owing to the nature of its central concept, the paradigm person. From the perspective of the practitioner the most damaging charge is that virtue ethics fails to be action guiding and, in addition to this, it does not offer any means of act appraisal. These criticisms leave virtue ethics in a weak position vis-à-vis traditional approaches to ethics. The criticism is, however, challenged by Hursthouse in her analysis of the accounts of right action offered by deontology, utilitarianism and virtue ethics. It is possible to defend the action guiding nature of virtue ethics: there are virtue rules and exemplars to guide action. Insights from Aristotle's practical approach to ethics are considered alongside Hursthouse's analysis and it is suggested that virtue ethics is also capable of facilitating action appraisal. It is at the same time acknowledged that approaches to virtue ethics vary widely and that the challenges offered here would be rejected by those who embrace a radical replacement virtue approach.

Cyber-Terrorism and Cyber-Crime: There Is a Difference

DTIC Science & Technology

The terms cyber -terrorism and cyber -crime have many varying definitions depending on who is defining them. For example, individuals with expertise in...considerations and, when investigating a cyber -attack, procedural considerations. By examining the strengths and weaknesses of several definitions offered by...national security, law enforcement, industry, law, and scholars, this research constructs a list of parameters to consider when formulating definitions for cyber -terrorism and cyber -crime.

The Cambridge Garden House Hotel Riot of 1970 and Its Place in the History of British Student Protests

ERIC Educational Resources Information Center

Crook, David

2006-01-01

This article highlights a violent incident in the history of British student protests and outlines the judicial process that resulted. A wider consideration of student protests of the late 1960s and early 1970s, both in the UK and overseas is offered, together with some consideration of the significance of this particular case. At the time of the…

Practicalities and Research Considerations for Conducting Childhood Obesity Prevention Interventions with Families

PubMed Central

Morgan, Philip J.; Jones, Rachel A.; Collins, Clare E.; Hesketh, Kylie D.; Young, Myles D.; Burrows, Tracy L.; Magarey, Anthea M.; Brown, Helen L.; Hinkley, Trina; Perry, Rebecca A.; Brennan, Leah; Spence, Alison C.; Campbell, Karen J.

2016-01-01

Internationally, childhood obesity is a major public health concern. Given the established difficulties in treating obesity, designing and evaluating effective obesity prevention interventions are research priorities. As parents play a crucial role in establishing positive health behaviours in children, they are a key target for child obesity prevention programs. However, recruiting and engaging parents in such interventions can be a considerable challenge for researchers and practitioners. Members of the ‘Parenting, Child Behaviour and Well-being’ stream of the Australasian Child and Adolescent Obesity Research Network (ACAORN) have considerable and varied expertise in conducting such interventions and can provide insights into addressing these challenges. This paper aims to highlight considerations regarding the design, implementation, and evaluation of obesity prevention interventions with families and provide practical insights and recommendations for researchers and practitioners conducting family-based research in this area. Case studies of three family-based interventions conducted by ACAORN members are highlighted to provide examples and contextualise the recommendations proposed. PMID:27834820

The Prepayment Dilemma: A Consumer's Guide from ALA.

ERIC Educational Resources Information Center

Laughrey, Edna; And Others

1977-01-01

Because prepayment problems have led to complaints from librarians, the Bookdealer-Library Relations Committee of the American Library Association offers considerations to serve as guidelines in making prepayment decisions. (JPF)

7 CFR 1468.20 - Application for CFO program participation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... program payments allowed, offering to apply more conservation practices to the land in order to increase... benefits; (4) Soil productivity; (5) Conservation compliance considerations; (6) Likelihood to remain in...

Near Real-Time Call Detail Record ETL Flows

NASA Astrophysics Data System (ADS)

Cochinwala, Munir; Panagos, Euthimios

Telecommunication companies face significant business challenges as they strive to reduce subscriber churn and increase average revenue per user (ARPU) by offering new services and incorporating new functionality into existing services. The increased number of service offerings and available functionality result in an ever growing volume of call detail records (CDRs). For many services (e.g., pre-paid), CDRs need to be processed and analyzed in near real-time for several reasons, including charging, on-line subscriber access to their accounts, and analytics for predicting subscriber usage and preventing fraudulent activity. In this paper, we describe the challenges associated with near real-time extract, transform, and load (ETL) of CDR data warehouse flows for supporting both the operational and business intelligence needs of telecommunication services, and we present our approach to addressing these challenges.

A geographic information system screening tool to tackle diffuse pollution through the use of sustainable drainage systems.

PubMed

Todorovic, Zorica; Breton, Neil P

2014-01-01

Sustainable drainage systems (SUDS) offer many benefits that traditional solutions do not. Traditional approaches are unable to offer a solution to problems of flood management and water quality. Holistic consideration of the wide range of benefits from SUDS can result in advantages such as improved flood resilience and water quality enhancement through consideration of diffuse pollution sources. Using a geographical information system (GIS) approach, diffuse pollutant sources and opportunities for SUDS are easily identified. Consideration of potential SUDS locations results in source, site and regional controls, leading to improved water quality (to meet Water Framework Directive targets). The paper will discuss two different applications of the tool, the first of which is where the pollutant of interest is known. In this case the outputs of the tool highlight and isolate the areas contributing the pollutants and suggest the adequate SUDS measures to meet the required criteria. The second application is where the tool identifies likely pollutants at a receiving location, and SUDS measures are proposed to reduce pollution with assessed efficiencies.

Technical and conceptual considerations for using animated stimuli in studies of animal behavior.

PubMed

Chouinard-Thuly, Laura; Gierszewski, Stefanie; Rosenthal, Gil G; Reader, Simon M; Rieucau, Guillaume; Woo, Kevin L; Gerlai, Robert; Tedore, Cynthia; Ingley, Spencer J; Stowers, John R; Frommen, Joachim G; Dolins, Francine L; Witte, Klaudia

2017-02-01

Rapid technical advances in the field of computer animation (CA) and virtual reality (VR) have opened new avenues in animal behavior research. Animated stimuli are powerful tools as they offer standardization, repeatability, and complete control over the stimulus presented, thereby "reducing" and "replacing" the animals used, and "refining" the experimental design in line with the 3Rs. However, appropriate use of these technologies raises conceptual and technical questions. In this review, we offer guidelines for common technical and conceptual considerations related to the use of animated stimuli in animal behavior research. Following the steps required to create an animated stimulus, we discuss (I) the creation, (II) the presentation, and (III) the validation of CAs and VRs. Although our review is geared toward computer-graphically designed stimuli, considerations on presentation and validation also apply to video playbacks. CA and VR allow both new behavioral questions to be addressed and existing questions to be addressed in new ways, thus we expect a rich future for these methods in both ultimate and proximate studies of animal behavior.

Technical and conceptual considerations for using animated stimuli in studies of animal behavior

PubMed Central

Rosenthal, Gil G.; Reader, Simon M.; Rieucau, Guillaume; Woo, Kevin L.; Gerlai, Robert; Tedore, Cynthia; Ingley, Spencer J.; Stowers, John R.; Frommen, Joachim G.; Dolins, Francine L.; Witte, Klaudia

2017-01-01

Abstract Rapid technical advances in the field of computer animation (CA) and virtual reality (VR) have opened new avenues in animal behavior research. Animated stimuli are powerful tools as they offer standardization, repeatability, and complete control over the stimulus presented, thereby “reducing” and “replacing” the animals used, and “refining” the experimental design in line with the 3Rs. However, appropriate use of these technologies raises conceptual and technical questions. In this review, we offer guidelines for common technical and conceptual considerations related to the use of animated stimuli in animal behavior research. Following the steps required to create an animated stimulus, we discuss (I) the creation, (II) the presentation, and (III) the validation of CAs and VRs. Although our review is geared toward computer-graphically designed stimuli, considerations on presentation and validation also apply to video playbacks. CA and VR allow both new behavioral questions to be addressed and existing questions to be addressed in new ways, thus we expect a rich future for these methods in both ultimate and proximate studies of animal behavior. PMID:29491958

Genetic counselors' views and experiences with the clinical integration of genome sequencing.

PubMed

Machini, Kalotina; Douglas, Jessica; Braxton, Alicia; Tsipis, Judith; Kramer, Kate

2014-08-01

In recent years, new sequencing technologies known as next generation sequencing (NGS) have provided scientists the ability to rapidly sequence all known coding as well as non-coding sequences in the human genome. As the two emerging approaches, whole exome (WES) and whole genome (WGS) sequencing, have started to be integrated in the clinical arena, we sought to survey health care professionals who are likely to be involved in the implementation process now and/or in the future (e.g., genetic counselors, geneticists and nurse practitioners). Two hundred twenty-one genetic counselors- one third of whom currently offer WES/WGS-participated in an anonymous online survey. The aims of the survey were first, to identify barriers to the implementation of WES/WGS, as perceived by survey participants; second, to provide the first systematic report of current practices regarding the integration of WES/WGS in clinic and/or research across the US and Canada and to illuminate the roles and challenges of genetic counselors participating in this process; and third to evaluate the impact of WES/WGS on patient care. Our results showed that genetic counseling practices with respect to WES/WGS are consistent with the criteria set forth in the ACMG 2012 policy statement, which highlights indications for testing, reporting, and pre/post test considerations. Our respondents described challenges related to offering WES/WGS, which included billing issues, the duration and content of the consent process, result interpretation and disclosure of incidental findings and variants of unknown significance. In addition, respondents indicated that specialty area (i.e., prenatal and cancer), lack of clinical utility of WES/WGS and concerns about interpretation of test results were factors that prevented them from offering this technology to patients. Finally, study participants identified the aspects of their professional training which have been most beneficial in aiding with the integration of WES/WGS into the clinical setting (molecular/clinical genetics, counseling and bioethics) and suggested that counseling aids (to assist them when explaining aspects of these tests to patients) and webinars focused on WES/WGS (for genetic counselors and other health care professionals) would be useful educational tools. Future research should permit us to further enhance our knowledge of pitfalls and benefits associated with the introduction of these powerful technologies in patient care and to further explore the roles and opportunities for genetic counselors in this rapidly evolving field.

Cultural Considerations in Counseling Couples Who Experience Infertility

ERIC Educational Resources Information Center

Burnett, Judith A.

2009-01-01

Infertility creates challenges affecting various aspects of couples' intimate lives. Practices regarding reproduction are often shaped by cultural messages. Culturally sensitive treatment methods help counselors provide effective therapy to couples with fertility problems. This article describes cultural influences, challenges, and counseling…

Refocusing reference services outside the library building: one library's experience.

PubMed

Lubker, Irene M; Henderson, Margaret E; Canevari, Catharine S; Wright, Barbara A

2010-07-01

In response to changing user needs, the library sought ways to meet new challenges and engage users outside of the building. Librarians were removed from the service desk in order to offer support at locations around campus. The service desk in the library was staffed primarily by paraprofessionals with librarians providing support as needed. Targeted staff training was offered, and different scheduling models were used over a period of time. Restructuring the service desk was a complicated endeavor but provided a number of benefits including expansion of services. Along the way, challenges were met and recognized as learning opportunities.

Validation of sterilizing grade filtration.

PubMed

Jornitz, M W; Meltzer, T H

2003-01-01

Validation consideration of sterilizing grade filters, namely 0.2 micron, changed when FDA voiced concerns about the validity of Bacterial Challenge tests performed in the past. Such validation exercises are nowadays considered to be filter qualification. Filter validation requires more thorough analysis, especially Bacterial Challenge testing with the actual drug product under process conditions. To do so, viability testing is a necessity to determine the Bacterial Challenge test methodology. Additionally to these two compulsory tests, other evaluations like extractable, adsorption and chemical compatibility tests should be considered. PDA Technical Report # 26, Sterilizing Filtration of Liquids, describes all parameters and aspects required for the comprehensive validation of filters. The report is a most helpful tool for validation of liquid filters used in the biopharmaceutical industry. It sets the cornerstones of validation requirements and other filtration considerations.

Centennial_Challenges_2017_2

NASA Image and Video Library

2017-08-14

NASA Centennial Challenges were initiated in 2005 to directly engage the public in the process of advanced technology development. The program offers incentive prizes to generate revolutionary solutions to problems of interest to NASA and the nation. The program seeks innovations from diverse and non-traditional sources. Competitors are not supported by government funding and awards are only made to successful teams when the challenges are met.

Transportation systems health : concepts, applications & significance.

DOT National Transportation Integrated Search

2015-12-01

This report offers conceptual and analytical frameworks and application examples to address the question: how can broader statewide (or national) objectives be achieved while formally taking into consideration different regional priorities and constr...

Adaptation workbook: Chapter 3

Treesearch

Maria Janowiak; Patricia Butler; Chris Swanston; Linda Parker; Matt St. Pierre; Leslie Brandt

2012-01-01

Climate change imposes many challenges on the long-term management of ecosystems and is becoming an increasingly important consideration in land management planning and decisionmaking at a variety of spatial scales. The process outlined in this chapter helps managers incorporate climate change considerations into management planning and activities, while complementing...

Offering Behavioral Assistance to Latino Students Demonstrating Challenging Behaviors

ERIC Educational Resources Information Center

Moreno, Gerardo; Bullock, Lyndal M.

2015-01-01

Challenging behaviors can significantly alter the learning environment of any classroom. Traditionally, schools have implemented practices that remove the offending student from the classroom, deliver punitive disciplinary actions, or refer the student to special education evaluation. Unfortunately, such practices have demonstrated little…

Cotton breeding-challenges and opportunities

USDA-ARS?s Scientific Manuscript database

Competition with synthetic fibers is one of the greatest challenges facing today’s cotton industry. Improved fiber quality is essential to increase US cotton’s competitiveness in the global market place. Enhanced fiber quality also offers an opportunity to capture more value from cotton production. ...

Reframing University Engagement

ERIC Educational Resources Information Center

Manners, Paul

2013-01-01

In "Universities without Walls: Engaging Our World," Janice Reid provided an excellent survey of the traditions and perspectives that underpin university engagement, and pointed to some of the challenges that remain in genuinely "mainstreaming" this work. In this commentary, Paul Manners offers a further challenge: that those…

How should the completeness and quality of curated nanomaterial data be evaluated?

NASA Astrophysics Data System (ADS)

Marchese Robinson, Richard L.; Lynch, Iseult; Peijnenburg, Willie; Rumble, John; Klaessig, Fred; Marquardt, Clarissa; Rauscher, Hubert; Puzyn, Tomasz; Purian, Ronit; Åberg, Christoffer; Karcher, Sandra; Vriens, Hanne; Hoet, Peter; Hoover, Mark D.; Hendren, Christine Ogilvie; Harper, Stacey L.

2016-05-01

Nanotechnology is of increasing significance. Curation of nanomaterial data into electronic databases offers opportunities to better understand and predict nanomaterials' behaviour. This supports innovation in, and regulation of, nanotechnology. It is commonly understood that curated data need to be sufficiently complete and of sufficient quality to serve their intended purpose. However, assessing data completeness and quality is non-trivial in general and is arguably especially difficult in the nanoscience area, given its highly multidisciplinary nature. The current article, part of the Nanomaterial Data Curation Initiative series, addresses how to assess the completeness and quality of (curated) nanomaterial data. In order to address this key challenge, a variety of related issues are discussed: the meaning and importance of data completeness and quality, existing approaches to their assessment and the key challenges associated with evaluating the completeness and quality of curated nanomaterial data. Considerations which are specific to the nanoscience area and lessons which can be learned from other relevant scientific disciplines are considered. Hence, the scope of this discussion ranges from physicochemical characterisation requirements for nanomaterials and interference of nanomaterials with nanotoxicology assays to broader issues such as minimum information checklists, toxicology data quality schemes and computational approaches that facilitate evaluation of the completeness and quality of (curated) data. This discussion is informed by a literature review and a survey of key nanomaterial data curation stakeholders. Finally, drawing upon this discussion, recommendations are presented concerning the central question: how should the completeness and quality of curated nanomaterial data be evaluated?Nanotechnology is of increasing significance. Curation of nanomaterial data into electronic databases offers opportunities to better understand and predict nanomaterials' behaviour. This supports innovation in, and regulation of, nanotechnology. It is commonly understood that curated data need to be sufficiently complete and of sufficient quality to serve their intended purpose. However, assessing data completeness and quality is non-trivial in general and is arguably especially difficult in the nanoscience area, given its highly multidisciplinary nature. The current article, part of the Nanomaterial Data Curation Initiative series, addresses how to assess the completeness and quality of (curated) nanomaterial data. In order to address this key challenge, a variety of related issues are discussed: the meaning and importance of data completeness and quality, existing approaches to their assessment and the key challenges associated with evaluating the completeness and quality of curated nanomaterial data. Considerations which are specific to the nanoscience area and lessons which can be learned from other relevant scientific disciplines are considered. Hence, the scope of this discussion ranges from physicochemical characterisation requirements for nanomaterials and interference of nanomaterials with nanotoxicology assays to broader issues such as minimum information checklists, toxicology data quality schemes and computational approaches that facilitate evaluation of the completeness and quality of (curated) data. This discussion is informed by a literature review and a survey of key nanomaterial data curation stakeholders. Finally, drawing upon this discussion, recommendations are presented concerning the central question: how should the completeness and quality of curated nanomaterial data be evaluated? Electronic supplementary information (ESI) available: (1) Detailed information regarding issues raised in the main text; (2) original survey responses. See DOI: 10.1039/c5nr08944a

Perceived Challenges in Primary Literature in a Master’s Class: Effects of Experience and Instruction

PubMed Central

Lie, Richard; Abdullah, Christopher; He, Wenliang; Tour, Ella

2016-01-01

Primary literature offers rich opportunities to teach students how to “think like a scientist,” but the challenges students face when they attempt to read research articles are not well understood. Here, we present an analysis of what master’s students perceive as the most challenging aspects of engaging with primary literature. We examined 69 pairs of pre- and postcourse responses from students enrolled in a master’s-level course that offered a structured analysis of primary literature. On the basis of these responses, we identified six categories of challenges. Before instruction, “techniques” and “experimental data” were the most frequently identified categories of challenges. The majority of difficulties students perceived in the primary literature corresponded to Bloom’s lower-order cognitive skills. After instruction, “conclusions” were identified as the most difficult aspect of primary literature, and the frequency of challenges that corresponded to higher-order cognitive skills increased significantly among students who reported less experience with primary literature. These changes are consistent with a more competent perception of the primary literature, in which these students increasingly focus on challenges requiring critical thinking. Students’ difficulties identified here can inform the design of instructional approaches aimed to teach students how to critically read scientific papers. PMID:27909027

75 FR 10822 - Notice of the March 24, 2010 Millennium Challenge Corporation Board of Directors Meeting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

... MILLENNIUM CHALLENGE CORPORATION [MCC FR 10-03] Notice of the March 24, 2010 Millennium Challenge... and Date: 10 a.m. to 12 p.m., Wednesday, March 24, 2010. Place: Department of State, 2201 C Street, NW... consideration of classified information and the meeting will be closed to the public. Dated: March 5, 2010...

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

Extracurricular Business Planning Competitions: Challenging the Assumptions

ERIC Educational Resources Information Center

Watson, Kayleigh; McGowan, Pauric; Smith, Paul

2014-01-01

Business planning competitions [BPCs] are a commonly offered yet under-examined extracurricular activity. Given the extent of sceptical comment about business planning, this paper offers what the authors believe is a much-needed critical discussion of the assumptions that underpin the provision of such competitions. In doing so it is suggested…

The Five Central Psychological Challenges Facing Effective Mobile Learning

ERIC Educational Resources Information Center

Terras, Melody M.; Ramsay, Judith

2012-01-01

Web 2.0 technology not only offers the opportunity of massively parallel interconnected networks that support the provision of information and communication anytime and anywhere but also offers immense opportunities for collaboration and sharing of user-generated content. This information-rich environment may support both formal and informal…

Chemical Librarianship: Challenges and Opportunities.

ERIC Educational Resources Information Center

Somerville, Arleen N., Ed.

1997-01-01

This volume is a collection of 12 papers of particular interest to librarians specializing in chemistry. The articles discuss the educational role of librarians in several types of institutions, offer new ways of providing information, and describe ways of coping with increasing prices and formats of journals. The first paper offers an overview of…

The Arts for Whose Children? A Challenge to Educators.

ERIC Educational Resources Information Center

Fuller, Frank, Jr.

1994-01-01

The arts deserve an integral place in schools, since they provide outlets for individuality, enhance thinking and language skills, and possess intrinsic educational value. Arts counter modern society's awesome drive for conformity by offering opportunities for authenticity and spontaneity. Arts offer the last glimmer of warmth and humaneness in a…

EDUCATIONAL ENRICHMENT PROGRAM - 1964.

ERIC Educational Resources Information Center

FUNK, JOHN H.

THE EDUCATIONAL ENRICHMENT PROGRAM - 1964 WAS A COOPERATIVE UNDERTAKING OF SIX INDEPENDENT SCHOOLS IN OR NEAR BOSTON AND A NUMBER OF INTERESTED ORGANIZATIONS THAT OFFERED THE USE OF THEIR FACILITIES AND PERSONNEL TO AN URBAN COMMUNITY DURING THE NONSCHOOL MONTHS. THE AIM OF THE PROGRAM WAS TO OFFER CHALLENGING AND EXPLORATORY STUDY WHICH COULD…

Challenges and Considerations When Conducting an Online Course.

ERIC Educational Resources Information Center

Leh, Amy Sheng Chieh; Som, Yahya Mat

This paper reports challenges of and suggestions for conducting online courses, focusing on the following areas: (1) instructional format, including transferring classroom activities to online activities without affecting students' concentration, motivation, thought, mastery, and comprehension; (2) methods of instruction, including developing an…

Informed consent in the context of pharmacogenomic research: ethical considerations.

PubMed

Howard, H C; Joly, Y; Avard, D; Laplante, N; Phillips, M; Tardif, J C

2011-06-01

Although the scientific research surrounding pharmacogenomics (PGx) has been relatively plentiful, the ethical research concerning this discipline has developed rather conservatively. Following investigation of the ethical, legal and social issues (ELSI) of PGx research, as well as consulting with key stakeholders, we identified six outstanding ethical issues raised by the informed consent process in PGx research: (1) scope of consent; (2) consent to 'add-on' studies; (3) protection of personal information; (4) commercialization; (5) data sharing; and (6) potential risks stemming from population-based research. In discussing these six areas as well as offering specific considerations, this article offers a solid base from which future practical guidelines for informed consent in PGx research can be constructed. As such, this effort works toward filling the ELSI gap and provides ethical support to the numerous PGx projects undertaken by researchers every year.

Considerations for the effects of military deployment on children and families.

PubMed

Lincoln, Alan J; Sweeten, Kathie

2011-01-01

Children of deployed military personnel represent a unique subculture in the United States. While many children exhibit high levels of resiliency, others will struggle with the impact of a parent who has gone to war. This article looks at some of the stressors of deployment as experienced by children and offers three case examples as well as clinical considerations for those who work with the children and families of the deployed.

Bacterial bloodstream infections in the allogeneic hematopoietic cell transplant patient: new considerations for a persistent nemesis.

PubMed

Dandoy, C E; Ardura, M I; Papanicolaou, G A; Auletta, J J

2017-08-01

Bacterial bloodstream infections (BSI) cause significant transplant-related morbidity and mortality following allogeneic hematopoietic cell transplantation (allo-HCT). This manuscript reviews the risk factors for and the bacterial pathogens causing BSIs in allo-HCT recipients in the contemporary transplant period. In addition, it offers insight into emerging resistant pathogens and reviews clinical management considerations to treat and strategies to prevent BSIs in allo-HCT patients.

Special Educator Evaluation: Cautions, Concerns and Considerations

ERIC Educational Resources Information Center

Semmelroth, Carrie L.; Johnson, Evelyn s.; Allred, Keith W.

2013-01-01

There is currently little consensus on how special education teachers should be evaluated in a way that is effective, fair and responsive to their unique teaching responsibilities. In this paper, we explain several of the current approaches to teacher evaluation under consideration, and then provide an overview of the challenges associated with…

Symposium on Contemporary Challenges

ERIC Educational Resources Information Center

Berry, David A.; Graff, Gerald; Nelson, Cary

2010-01-01

In this article, the authors discuss contemporary challenges. David Berry offers advice on teaching the humanities at a community college; Gerald Graff examines how the traditional organization of universities undermines student learning; and Cary Nelson considers the effects on the humanities of the increasing reliance on contingent faculty.

Using a Common Experience to Teach Introductory Managerial Accounting

ERIC Educational Resources Information Center

King, Gail Hoover; McConnell, Cheryl

2010-01-01

Teaching introductory accounting courses can be both challenging and rewarding. In introductory financial and managerial accounting, students struggle with the unfamiliar terminology and concepts. However, managerial accounting offers distinct challenges in that managerial accounting reports used for decision-making are not publically available,…

Challenges and Concerns Faced by Doctoral Candidates Seeking Academic Positions.

ERIC Educational Resources Information Center

Porter, Dion; Donnell, Chandra; Buck, Tina; Edwards, Yolanda

A panel discussion offered suggestions and recommendations for faculty and institutions of rehabilitation counseling education on more effective recruitment methods. Strategies were also considered for potential faculty members. Candidates seeking academic positions in rehabilitation counseling education face many challenges. Location of program;…

Engaging primary care patients to use a patient-centered personal health record.

PubMed

Krist, Alex H; Woolf, Steven H; Bello, Ghalib A; Sabo, Roy T; Longo, Daniel R; Kashiri, Paulette; Etz, Rebecca S; Loomis, John; Rothemich, Stephen F; Peele, J Eric; Cohn, Jeffrey

2014-01-01

Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care. We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively. A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P <.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake. By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems. © 2014 Annals of Family Medicine, Inc.

Nano-Sized Cyclodextrin-Based Molecularly Imprinted Polymer Adsorbents for Perfluorinated Compounds—A Mini-Review

PubMed Central

Karoyo, Abdalla H.; Wilson, Lee D.

2015-01-01

Recent efforts have been directed towards the design of efficient and contaminant selective remediation technology for the removal of perfluorinated compounds (PFCs) from soils, sediments, and aquatic environments. While there is a general consensus on adsorption-based processes as the most suitable methodology for the removal of PFCs from aquatic environments, challenges exist regarding the optimal materials design of sorbents for selective uptake of PFCs. This article reviews the sorptive uptake of PFCs using cyclodextrin (CD)-based polymer adsorbents with nano- to micron-sized structural attributes. The relationship between synthesis of adsorbent materials and their structure relate to the overall sorption properties. Hence, the adsorptive uptake properties of CD-based molecularly imprinted polymers (CD-MIPs) are reviewed and compared with conventional MIPs. Further comparison is made with non-imprinted polymers (NIPs) that are based on cross-linking of pre-polymer units such as chitosan with epichlorohydrin in the absence of a molecular template. In general, MIPs offer the advantage of selectivity, chemical tunability, high stability and mechanical strength, ease of regeneration, and overall lower cost compared to NIPs. In particular, CD-MIPs offer the added advantage of possessing multiple binding sites with unique physicochemical properties such as tunable surface properties and morphology that may vary considerably. This mini-review provides a rationale for the design of unique polymer adsorbent materials that employ an intrinsic porogen via incorporation of a macrocyclic compound in the polymer framework to afford adsorbent materials with tunable physicochemical properties and unique nanostructure properties. PMID:28347047