Promoting Positive Social Behavior in Physical Education

ERIC Educational Resources Information Center

Balderson, Daniel; Sharpe, Tom

2004-01-01

An ongoing challenge that both classroom and physical education teachers face on a daily basis is how to organize and manage large groups of students. This is particularly true in many urban settings where classrooms and gymnasiums are typically understaffed and/or under equipped. Educators in these settings often struggle with how to minimize…

The physical properties, morphology and viscoelasticity of biobased sponges prepared from un-tanned hides

USDA-ARS?s Scientific Manuscript database

One of our research endeavors to address ongoing challenges faced by the U.S. hide and leather industries is to develop innovative uses and novel biobased products from hides to improve prospective markets and to secure a viable future for hides and leather industries. We had previously investigate...

Actuarial Science at One Four-Year Comprehensive University

ERIC Educational Resources Information Center

Charlwood, Kevin E.

2014-01-01

Building an Actuarial Science program designated as advanced requires dedicated faculty, support from the administration, and a core group of strong students. Washburn University may serve as a model for those wishing to start or enhance such a program at their institution. We face three main ongoing challenges: first, the hiring and retention of…

CareerTech VISION 2012--Transforming CTE Together

ERIC Educational Resources Information Center

Bray, Janet B.

2012-01-01

As the leader in career and technical education (CTE), the Association for Career and Technical Education (ACTE) understands the ongoing challenges faced by the CTE community. That is why ACTE has created CareerTech VISION 2012, a bold and visionary event that addresses the evolving needs of the global society and meets all individual and…

Five Recession-Driven Strategies for Planning and Managing Campus Facilities

ERIC Educational Resources Information Center

Rudden, Michael S.

2010-01-01

Colleges and universities continue to face significant fiscal challenges in the current recession. A review of ongoing campus facilities planning projects, coupled with a review of more than 30 recent campus master planning requests for proposals and the relevant literature, indicates that colleges and universities are finding innovative ways to…

Proceedings: Wildland Fire in the Appalachians: Discussions Among Managers and Scientists

Treesearch

Thomas A. Waldrop

2014-01-01

Many challenges face fire managers and scientists in the Appalachian Mountains because of the region’s diverse topography and limited research supporting prescribed burning. This conference was designed to promote communication among managers, researchers, and other interested parties. These proceedings contain 30 papers and abstracts that describe ongoing research,...

A Variety of Diversity: Facing Higher Education's Educational Challenges

NASA Astrophysics Data System (ADS)

Dey, Eric L.

2008-10-01

First among the many important challenges facing American higher education is the need to improve the effectiveness of our educational programs. Public concern has heightened the sense of urgency for colleges and universities to make progress on improving and measuring educational outcomes, which is made more challenging by the varieties of diversity facing us. Diversity is not just an issue related to student recruitment or experience, but rather it is one that also relates to institutions and their faculties. New educational methods must address such diversity to be effective, and one possible example can be found in ongoing research at the University of Michigan that explores the educational implications of implementing a web-based lecture capture system in large lecture courses. Student use of and reactions to such systems is important, as is the potential to influence course performance for students in general, but also for underrepresented and at-risk student subpopulations. In addition to helping bring our current landscape into focus, this paper will identify effective practices as well as continuing challenges to improving educational practice for undergraduate students.

Planetary Cartography - Activities and Current Challenges

NASA Astrophysics Data System (ADS)

Nass, Andrea; Di, Kaichang; Elgner, Stephan; van Gasselt, Stephan; Hare, Trent; Hargitai, Henrik; Karachevtseva, Irina; Kereszturi, Akos; Kersten, Elke; Kokhanov, Alexander; Manaud, Nicolas; Roatsch, Thomas; Rossi, Angelo Pio; Skinner, James, Jr.; Wählisch, Marita

2018-05-01

Maps are one of the most important tools for communicating geospatial information between producers and receivers. Geospatial data, tools, contributions in geospatial sciences, and the communication of information and transmission of knowledge are matter of ongoing cartographic research. This applies to all topics and objects located on Earth or on any other body in our Solar System. In planetary science, cartography and mapping have a history dating back to the roots of telescopic space exploration and are now facing new technological and organizational challenges with the rise of new missions, new global initiatives, organizations and opening research markets. The focus of this contribution is to introduce the community to the field of planetary cartography and its historic foundation, to highlight some of the organizations involved and to emphasize challenges that Planetary Cartography has to face today and in the near future.

Resilience: The Role of Optimism, Perceived Parental Autonomy Support and Perceived Social Support in First Year University Students

ERIC Educational Resources Information Center

Dawson, Michelle; Pooley, Julie Ann

2013-01-01

Throughout our lifespan we face many challenges which are often referred to as transitions. The move to university is one such transition which may place individuals at risk of suffering ongoing significant life stress, anxiety and uncertainty. Optimism, promotion of independent functioning (PIF), promotion of volitional functioning (PVF) and…

An Ethical Solution to the Challenges in Teaching Anatomy with Dissection in the Chinese Culture

ERIC Educational Resources Information Center

Zhang, Luqing; Wang, Yunfeng; Xiao, Ming; Han, Qunying; Ding, Jiong

2008-01-01

Universities and medical schools in China are faced with an ongoing shortage of cadavers for education and research because of insufficient numbers of cadaver donations. This article will examine the main obstacles to cadaver donation in the Chinese culture. These include superstitious traditional views about the body, a lack of legislation…

Strategizing for the Future: Evolving Cultural Resource Centers in Higher Education

ERIC Educational Resources Information Center

Shek, Yen Ling

2013-01-01

Cultural resource centers have been an ongoing and integral component to creating a more welcoming campus climate for Students of Color since its establishment in the 1960s. While the racial dynamics may have changed, many of the challenges Students of Color faced on predominantly White campuses have not. Interestingly, cultural resource centers…

The Management of Publicly Funded Regional Universities during Times of Fiscal Distress

ERIC Educational Resources Information Center

Rogers, Philip Gregory

2013-01-01

Strategic financial management is being redefined as a result of the ongoing fiscal challenges facing the nation's public colleges and universities. The Great Recession reached its peak in 2009 and the era of "business as usual" for public higher education quickly faded. A "new normal" has emerged that is causing leaders to…

Becoming an Artist: Exploring the Motivations of Undergraduate Students at a Regional Australian University

ERIC Educational Resources Information Center

Daniel, Ryan; Johnstone, Robert

2017-01-01

Despite the well-documented challenges that artists face in developing and sustaining a viable career, there is ongoing interest and enrolment in higher education programmes in the creative and performing arts. At the same time, extant research demonstrates that a higher education degree does not necessarily lead to enhanced career success for…

Marshall Space Flight Center Research and Technology Report 2016

NASA Technical Reports Server (NTRS)

Tinker, M. L.; Abney, M. B. (Compiler); Reynolds, D. W. (Compiler); Morris, H. C. (Compiler)

2017-01-01

Marshall Space Flight Center is essential to human space exploration and our work is a catalyst for ongoing technological development. As we address the challenges facing human deep space exploration, we advance new technologies and applications here on Earth, expand scientific knowledge and discovery, create new economic opportunities, and continue to lead global space exploration.

Help-Seeking Behaviours of Adolescents in Relation to Terrorist Attacks: The Perceptions of Israeli Parents

ERIC Educational Resources Information Center

Tatar, Moshe; Amram, Sima; Kelman, Talia

2011-01-01

Exposure to terrorism poses a challenge for children and adolescents as well as parents. For many years, Israeli citizens have been exposed to ongoing terrorist attacks. The present article is aimed at revealing the reactions of Israeli parents when facing terrorist attacks and their perceptions regarding the help-seeking behaviours of their…

This Bud's for You: Understanding International Intellectual Property Law through the Ongoing Dispute over the Budweiser Trademark

ERIC Educational Resources Information Center

Bird, Robert C.

2006-01-01

There is little doubt that topics related to beer would be of some interest to college students. Anheuser-Busch, well known for its Budweiser beer and humorous advertising, faces a global trademark challenge to its "Budweiser" name. This battle between a global American company and a small Czech brewery is an opportunity for interesting…

Revisiting School District Consolidation Issues. Education Policy Brief. Volume 8, Number 3, Summer 2010

ERIC Educational Resources Information Center

Spradlin, Terry E.; Carson, Fatima R.; Hess, Sara E.; Plucker, Jonathan A.

2010-01-01

In light of a slow economic recovery from the Great Recession, state and local governments are faced with the challenge of providing services to citizens amidst ongoing budgetary woes. For instance, although the most recent Indiana revenue collections for the month of August were above revised projections to help start fiscal year 2011 (which…

Imagining a Future, Living in the Present and Remembering the Past

ERIC Educational Resources Information Center

Spencer, Stephanie

2017-01-01

The remit for this short piece was to identify themes emerging from the articles in this edition by Julie McLeod, Duncan Waite and Eugenie Samier, to consider how these themes reflect on the current field, and to identify their ongoing relevance. Additionally, I was asked to consider the current challenges that the field is facing and what this…

Perceptual Learning Styles Modalities Utilizing the Multimodal Paired Associates Learning Test: An Analysis of Latinos Born in Central and South America

ERIC Educational Resources Information Center

Ramirez, Matias

2017-01-01

Businesses and Human Resources professionals face the ongoing challenge of continuously upskilling and developing employees. Changes to processes or procedures, changes in technology, changes in job functions, and updates or changes to compliance laws or regulations are all reasons that employees must attend and complete employer-developed…

Penile Hygiene: Puberty, Paraphimosis and Personal Care for Men and Boys with an Intellectual Disability

ERIC Educational Resources Information Center

Wilson, N. J.; Cumella, S.; Parmenter, T. R.; Stancliffe, R. J.; Shuttleworth, R. P.

2009-01-01

Background: Supporting men and boys with an intellectual disability (ID) to meet their penile hygiene needs is perhaps one of the least acknowledged but most confronting issues facing care staff. The delivery of intimate hygiene can be a challenging topic particularly as it has been drawn into the emerging sexuality discourse and the ongoing abuse…

Expanding Entrepreneurial Strategies to Increase Revenues: A Study of Three Distinctive Higher Education Institutions with Practical Application at a Community College

ERIC Educational Resources Information Center

Kakar, Casandra Gwen

2011-01-01

Higher education institutions in the state of Arizona have experienced a reduction in government funding due to the economic challenges the state is facing combined with an ongoing national recession. Three higher education institutions studied are located in Phoenix, Arizona. The three higher education institutions are Phoenix College, Arizona…

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

PubMed

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

2014-07-01

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

Perceptions of the Impact of Online Learning as a Distance-Based Learning Model on the Professional Practices of Working Nurses in Northern Ontario

ERIC Educational Resources Information Center

Carter, Lorraine; Hanna, Mary; Warry, Wayne

2016-01-01

Nurses in Canada face diverse challenges to their ongoing educational pursuits. As a result, they have been early adopters of courses and programs based on distance education principles and, in particular, online learning models. In the study described in this paper, nurses studying at two northern universities, in programs involving online…

How Are They Doing? Listening as Fathers of Children with Autism Spectrum Disorder Compare Themselves to Fathers of Children Who Are Typically Developing

ERIC Educational Resources Information Center

Cheuk, Samantha; Lashewicz, Bonnie

2016-01-01

The growing prevalence of autism spectrum disorder is accompanied by ongoing efforts to understand and support parents in the face of challenges related to their child's autism spectrum disorder. Although fathers are increasingly hands-on in raising children, research focus on parenting children with autism spectrum disorder continues to be skewed…

Meeting the Complex Needs of Urban Youth and Their Families through the 4Rs 2Ss Family Strengthening Program: The "Real World" Meets Evidence-Informed Care

ERIC Educational Resources Information Center

Small, Latoya A.; Jackson, Jerrold; Gopalan, Geetha; McKay, Mary McKernan

2015-01-01

Background: Youth living in poverty face compounding familial and environmental was challenges in utilizing effective community mental health services. Ongoing stressors increase their drop-out rate in mental health service use. Difficulties also exist in staying engaged in services when involved with the child welfare system. This study examines…

Mike's Educational Program: Long Island, New York. Case Study. Social Relationships of Children and Adolescents with Deaf-Blindness Research Project.

ERIC Educational Resources Information Center

Mar, Harvey H.; Sall, Nancy

This case study describes the educational history and current program of Mike, a mainstreamed sixth-grader with deaf-blindness. It addresses the boy's successes and the ongoing challenges faced by his family, his educational team, and his peers. Background information notes his diagnosis of total blindness and moderate to severe hearing loss, his…

An Issue of Learning: The Effect of Visual Split Attention in Classes for Deaf and Hard of Hearing Students

ERIC Educational Resources Information Center

Mather, Susan M.; Clark, M. Diane

2012-01-01

One of the ongoing challenges teachers of students who are deaf or hard of hearing face is managing the visual split attention implicit in multimedia learning. When a teacher presents various types of visual information at the same time, visual learners have no choice but to divide their attention among those materials and the teacher and…

Challenges Faced and Support Received: Older Adults' Perceptions of Hurricane Sandy.

PubMed

Heid, Allison R; Schug, Seran; Cartwright, Francine P; Pruchno, Rachel

2017-02-01

Individuals exposed to natural disasters are at risk for negative physical and psychological outcomes. Older adults may be particularly vulnerable; however, social support can act as a resource to help individuals respond to severe stressors. This study explored the challenges older people faced before, during, and after Hurricane Sandy in October 2012 and the people they turned to for support. Semi-structured interviews were conducted with 20 older adults in New Jersey drawn from the ORANJ BOWL (Ongoing Research on Aging in New Jersey - Bettering Opportunities for Wellness in Life) research panel, who experienced high levels of primary home damage during Hurricane Sandy. Content analysis of interview transcripts classified older adults' perceptions on how they "made it" through-the challenges they faced and the support they received. The findings suggested that older adults experienced emotional, instrumental, social, and financial challenges before, during, and after the storm. However, by relying on family and friends, as well as neighbors and community networks, older people were able to respond to stressors. Our findings carry implications for ensuring that older adults are connected to social networks before, during, and after disasters. The role of neighbors is particularly important when disasters strike. (Disaster Med Public Health Preparedness. 2017;11:39-47).

Implementing three evidence-based program models: early lessons from the Teen Pregnancy Prevention Replication Study.

PubMed

Kelsey, Meredith; Layzer, Jean

2014-03-01

This article describes some of the early implementation challenges faced by nine grantees participating in the Teen Pregnancy Prevention Replication Study and their response to them. The article draws on information collected as part of a comprehensive implementation study. Sources include site and program documents; program officer reports; notes from site investigation, selection and negotiation; ongoing communications with grantees as part of putting the study into place; and semi-structured interviews with program staff. The issues faced by grantees in implementing evidence-based programs designed to prevent teen pregnancy varied by program model. Grantees implementing a classroom-based curriculum faced challenges in delivering the curriculum within the constraints of school schedules and calendars (program length and size of class). Grantees implementing a culturally tailored curriculum faced a series of challenges, including implementing the intervention as part of the regular school curriculum in schools with diverse populations; low attendance when delivered as an after-school program; and resistance on the part of schools to specific curriculum content. The third set of grantees, implementing a program in clinics, faced challenges in identifying and recruiting young women into the program and in retaining young women once they were in the program. The experiences of these grantees reflect some of the complexities that should be carefully considered when choosing to replicate evidence-based programs. The Teen Pregnancy Prevention replication study will provide important context for assessing the effectiveness of some of the more widely replicated evidence-based programs. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Current Situation and Reforms Making Way for Future Positive Developments in the National Education System of Bulgaria: An Overview

ERIC Educational Resources Information Center

Genova, Teodora

2015-01-01

This paper on the education system of Bulgaria is aimed at presenting its structure, current situation, problems and challenges that it faces, and on-going reforms leading to some positive trends in the development of the national education sector. At the moment of writing this paper in the year 2015, we will mark the 1160th anniversary of the…

Application of Artificial Intelligence technology to the analysis and synthesis of reliable software systems

NASA Technical Reports Server (NTRS)

Wild, Christian; Eckhardt, Dave

1987-01-01

The development of a methodology for the production of highly reliable software is one of the greatest challenges facing the computer industry. Meeting this challenge will undoubtably involve the integration of many technologies. This paper describes the use of Artificial Intelligence technologies in the automated analysis of the formal algebraic specifications of abstract data types. These technologies include symbolic execution of specifications using techniques of automated deduction and machine learning through the use of examples. On-going research into the role of knowledge representation and problem solving in the process of developing software is also discussed.

Challenges and opportunities in dermal/transdermal delivery

PubMed Central

Paudel, Kalpana S; Milewski, Mikolaj; Swadley, Courtney L; Brogden, Nicole K; Ghosh, Priyanka; Stinchcomb, Audra L

2010-01-01

Transdermal drug delivery is an exciting and challenging area. There are numerous transdermal delivery systems currently available on the market. However, the transdermal market still remains limited to a narrow range of drugs. Further advances in transdermal delivery depend on the ability to overcome the challenges faced regarding the permeation and skin irritation of the drug molecules. Emergence of novel techniques for skin permeation enhancement and development of methods to lessen skin irritation would widen the transdermal market for hydrophilic compounds, macromolecules and conventional drugs for new therapeutic indications. As evident from the ongoing clinical trials of a wide variety of drugs for various clinical conditions, there is a great future for transdermal delivery of drugs. PMID:21132122

[Adherence to the Ongoing Education Program for family doctors in a southeastern Brazilian state].

PubMed

d'Ávila, Luciana Souza; Assis, Lucília Nunes de; Melo, Marilene Barros de; Brant, Luiz Carlos

2014-02-01

Ongoing Health Education is a strategy for transformation of health practices, though the adherence of professionals is one of the challenges facing its implementation. Thus, the objective of this study was to investigate the factors associated with adherence of family doctors to the Ongoing Education Program in a southeastern Brazilian state from the perception of supervisors. It is a cross-sectional and quantitative study with the use of online questionnaires. Data were analyzed using the chi-square test with ongoing correction to determine the association between structure, topics, activities and difficulties of the supervisors working in Ongoing Health Education, difficulties of the physicians in Primary Health Care (PHC) and poor and good adherence to the program. Excellent medical participation was statistically related to the adequacy of physical space (p = 0.001), a multidisciplinary approach (p = 0.035) and epidemiological aspects (p = 0.043). Low adherence was associated with the inadequacy of the physical structure, difficulty understanding the methodology, less time in a supervisory position, multiple workdays, among others. A good adherence to Ongoing Health Education is a possibility for collective reconstruction of the everyday work of physicians in Primary Health Care.

Nursing care of AIDS patients in Uganda.

PubMed

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

2007-07-01

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

NASA's Microgravity Science Research Program

NASA Technical Reports Server (NTRS)

1996-01-01

The ongoing challenge faced by NASA's Microgravity Science Research Program is to work with the scientific and engineering communities to secure the maximum return from our Nation's investments by: assuring that the best possible science emerges from the science community for microgravity investigations; ensuring the maximum scientific return from each investigation in the most timely and cost-effective manner; and enhancing the distribution of data and applications of results acquired through completed investigations to maximize their benefits.

Motivating Treatment Seeking and Behavior Change by Untreated Military Personnel

DTIC Science & Technology

2014-09-01

health challenges in addressing substance use disorders among active-duty personnel (Institute of Medicine , 2012). Over the past decade of ongoing...illicit substances in the past month, the Institute of Medicine (2012) recently issued a major report that declared substance use in the military to be a...health con- cerns facing the military. Recently, the DoD charged the Institute of Medicine with the task of assessing and an- alyzing the policies and

Information Technology: Department of Veterans Affairs Faces Ongoing Management Challenges

DTIC Science & Technology

2011-05-11

developing joint IT capabilities for the James A. Lovell Federal Health Care Center ( FHCC ) in North Chicago, Illinois. The FHCC is to be the first VA/DOD...solutions, and department officials did not determine whether the IT capabilities developed for the FHCC could or would be implemented at other VA...DOD’s decision to focus on developing VLER, modernizing their separate electronic health record systems, and developing IT capabilities for FHCC

Tank-automotive robotics

NASA Astrophysics Data System (ADS)

Lane, Gerald R.

1999-07-01

To provide an overview of Tank-Automotive Robotics. The briefing will contain program overviews & inter-relationships and technology challenges of TARDEC managed unmanned and robotic ground vehicle programs. Specific emphasis will focus on technology developments/approaches to achieve semi- autonomous operation and inherent chassis mobility features. Programs to be discussed include: DemoIII Experimental Unmanned Vehicle (XUV), Tactical Mobile Robotics (TMR), Intelligent Mobility, Commanders Driver Testbed, Collision Avoidance, International Ground Robotics Competition (ICGRC). Specifically, the paper will discuss unique exterior/outdoor challenges facing the IGRC competing teams and the synergy created between the IGRC and ongoing DoD semi-autonomous Unmanned Ground Vehicle and DoT Intelligent Transportation System programs. Sensor and chassis approaches to meet the IGRC challenges and obstacles will be shown and discussed. Shortfalls in performance to meet the IGRC challenges will be identified.

Food systems transition and disruptive low carbon innovation: implications for a food security research agenda.

PubMed

Tyfield, David

2011-07-01

There is a growing consensus that we are facing epochal challenges in global food security. Moreover, these challenges are multiple and complex. Meeting these challenges will involve nothing less than a wholesale socio-technical transition of the agri-food system. Optimizing the efficacy of the contribution of research to such a food security agenda will probably also need new institutional mechanisms and career structures to facilitate new kinds of collaborations and ongoing, longer-term projects. In short, the multiple challenges of food security demand a different political economy of research for effective intervention by science. In making this argument, the paper summarizes the major findings of a recent report regarding the potential impact of so-called 'disruptive' low-carbon innovations in China.

The context, influences and challenges for undergraduate nurse clinical education: Continuing the dialogue.

PubMed

Forber, Jan; DiGiacomo, Michelle; Davidson, Patricia; Carter, Bernie; Jackson, Debra

2015-11-01

Approaches to clinical education are highly diverse and becoming increasingly complex to sustain in complex milieu To identify the influences and challenges of providing nurse clinical education in the undergraduate setting and to illustrate emerging solutions. A discursive exploration into the broad and varied body of evidence including peer reviewed and grey literature. Internationally, enabling undergraduate clinical learning opportunities faces a range of challenges. These can be illustrated under two broad themes: (1) legacies from the past and the inherent features of nurse education and (2) challenges of the present, including, population changes, workforce changes, and the disconnection between the health and education sectors. Responses to these challenges are triggering the emergence of novel approaches, such as collaborative models. Ongoing challenges in providing accessible, effective and quality clinical learning experiences are apparent. Copyright © 2015 Elsevier Ltd. All rights reserved.

Science-policy challenges for biodiversity, public health and urbanization: examples from Belgium

NASA Astrophysics Data System (ADS)

Keune, H.; Kretsch, C.; De Blust, G.; Gilbert, M.; Flandroy, L.; Van den Berge, K.; Versteirt, V.; Hartig, T.; De Keersmaecker, L.; Eggermont, H.; Brosens, D.; Dessein, J.; Vanwambeke, S.; Prieur-Richard, A. H.; Wittmer, H.; Van Herzele, A.; Linard, C.; Martens, P.; Mathijs, E.; Simoens, I.; Van Damme, P.; Volckaert, F.; Heyman, P.; Bauler, T.

2013-06-01

Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human-nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem-human/public health-urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed.

National Conference on the Development of Statewide Preservation Programs. Report of a Conference on the Current Status and Future Directions of Statewide Programs for the Preservation of Our Intellectual Heritage (Washington, D.C., March 1-3, 1989).

ERIC Educational Resources Information Center

Morrow, Carolyn Clark, Ed.

This report presents some of the prominent features of a national invitational conference whose goal was to provide a national forum to discuss ongoing preservation efforts in individual states; describe the preservation challenge faced by all states in common; review the kinds of materials at risk; and alert administrators to the opportunities…

Legal issues affecting children with preexisting conditions during public health emergencies.

PubMed

Rutkow, Lainie; Vernick, Jon S; Wissow, Lawrence S; Tung, Gregory J; Marum, Felicity; Barnett, Daniel J

2013-06-01

Among the millions of children in the United States exposed to public health emergencies in recent years, those with preexisting health conditions face particular challenges. A public health emergency may, for example, disrupt treatment regimens or cause children to be separated from caregivers. Ongoing shortages of pediatricians and pediatric subspecialists may further exacerbate the risks that children with preexisting conditions face in disaster circumstances. The US Department of Homeland Security recently called for better integration of children's needs into all preparedness activities. To aid in this process, multiple legal concerns relevant to pediatricians and pediatric policymakers must be identified and addressed. Obtaining informed consent from children and parents may be particularly challenging during certain public health emergencies. States may need to invoke legal protections for children who are separated from caregivers during emergencies. Maintaining access to prescription medications may also require pediatricians to use specific legal mechanisms. In addition to practitioners, recommendations are given for policymakers to promote effective pediatric response to public health emergencies.

Economic performance of water storage capacity expansion for food security

NASA Astrophysics Data System (ADS)

Gohar, Abdelaziz A.; Ward, Frank A.; Amer, Saud A.

2013-03-01

SummaryContinued climate variability, population growth, and rising food prices present ongoing challenges for achieving food and water security in poor countries that lack adequate water infrastructure. Undeveloped storage infrastructure presents a special challenge in northern Afghanistan, where food security is undermined by highly variable water supplies, inefficient water allocation rules, and a damaged irrigation system due three decades of war and conflict. Little peer-reviewed research to date has analyzed the economic benefits of water storage capacity expansions as a mechanism to sustain food security over long periods of variable climate and growing food demands needed to feed growing populations. This paper develops and applies an integrated water resources management framework that analyzes impacts of storage capacity expansions for sustaining farm income and food security in the face of highly fluctuating water supplies. Findings illustrate that in Afghanistan's Balkh Basin, total farm income and food security from crop irrigation increase, but at a declining rate as water storage capacity increases from zero to an amount equal to six times the basin's long term water supply. Total farm income increases by 21%, 41%, and 42% for small, medium, and large reservoir capacity, respectively, compared to the existing irrigation system unassisted by reservoir storage capacity. Results provide a framework to target water infrastructure investments that improve food security for river basins in the world's dry regions with low existing storage capacity that face ongoing climate variability and increased demands for food security for growing populations.

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

PubMed

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

2009-01-01

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

Integrating International Engineering Organizations For Successful ISS Operations

NASA Technical Reports Server (NTRS)

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

2006-01-01

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

The making of extraordinary psychological phenomena.

PubMed

Lamont, Peter

2012-01-01

This article considers the extraordinary phenomena that have been central to unorthodox areas of psychological knowledge. It shows how even the agreed facts relating to mesmerism, spiritualism, psychical research, and parapsychology have been framed as evidence both for and against the reality of the phenomena. It argues that these disputes can be seen as a means through which beliefs have been formulated and maintained in the face of potentially challenging evidence. It also shows how these disputes appealed to different forms of expertise, and that both sides appealed to belief in various ways as part of the ongoing dispute about both the facts and expertise. Finally, it shows how, when a formal Psychology of paranormal belief emerged in the twentieth century, it took two different forms, each reflecting one side of the ongoing dispute about the reality of the phenomena. © 2012 Wiley Periodicals, Inc.

Commentary: restarting NTD programme activities after the Ebola outbreak in Liberia.

PubMed

Thomas, Brent C; Kollie, Karsor; Koudou, Benjamin; Mackenzie, Charles

2017-05-01

It is widely known that the recent Ebola Virus Disease (EVD) in West Africa caused a serious disruption to the national health system, with many of ongoing disease focused programmes, such as mass drug administration (MDA) for onchocerciasis (ONC), lymphatic filariasis (LF) and schistosomiasis (SCH), being suspended or scaled-down. As these MDA programmes attempt to restart post-EVD it is important to understand the challenges that may be encountered. This commentary addresses the opinions of the major health sectors involved, as well as those of community members, regarding logistic needs and challenges faced as these important public health programmes consider restarting. There appears to be a strong desire by the communities to resume NTD programme activities, although it is clear that some important challenges remain, the most prominent being those resulting from the severe loss of trained staff.

Smart textiles: Challenges and opportunities

NASA Astrophysics Data System (ADS)

Cherenack, Kunigunde; van Pieterson, Liesbeth

2012-11-01

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

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

PubMed

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

2009-01-24

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

Food and forensic molecular identification: update and challenges.

PubMed

Teletchea, Fabrice; Maudet, Celia; Hänni, Catherine

2005-07-01

The need for accurate and reliable methods for animal species identification has steadily increased during past decades, particularly with the recent food scares and the overall crisis of biodiversity primarily resulting from the huge ongoing illegal traffic of endangered species. A relatively new biotechnological field, known as species molecular identification, based on the amplification and analysis of DNA, offers promising solutions. Indeed, despite the fact that retrieval and analysis of DNA in processed products is a real challenge, numerous technically consistent methods are now available and allow the detection of animal species in almost any organic substrate. However, this field is currently facing a turning point and should rely more on knowledge primarily from three fundamental fields--paleogenetics, molecular evolution and systematics.

Managing the pursuit of health and wealth: the key challenges

PubMed Central

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

2009-01-01

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

Can We Capitalize on the Virtues of Vaccines? Insights from the Polio Eradication Initiative

PubMed Central

Aylward, R. Bruce; Heymann, David L.

2005-01-01

Twenty-five years after the eradication of smallpox, the ongoing effort to eradicate poliomyelitis has grown into the largest international health initiative ever undertaken. By 2004, however, the polio eradication effort was threatened by a challenge regularly faced by public health policymakers everywhere—misperception about the benefits and risks of vaccines. The propagation of false rumors about oral poliovirus vaccine safety led to the reinfection of 13 previously polio-free countries and the largest polio epidemic in Africa in recent years. With deft management of such challenges by local, national, and international health authorities, poliomyelitis, a disease that threatened children everywhere just 2 generations ago, could soon be relegated to history like smallpox before it. PMID:15855451

Issues in access to safe drinking water and basic hygiene for persons with physical disabilities in rural Cambodia.

PubMed

MacLeod, Marin; Pann, Mala; Cantwell, Ray; Moore, Spencer

2014-12-01

An estimated 1.6 million people die from diarrheal diseases each year due to lack of access to safe water and sanitation, and persons with physical disabilities face additional barriers. In Cambodia, approximately 5% of the population is disabled, presenting substantial obstacles in accessing these basic services. The purpose of this study was twofold: first, to identify the challenges facing persons with physical disabilities in accessing safe household water and basic hygiene in rural Cambodia; and, second, to use these results to generate policy and practice recommendations for the water and sanitation hygiene sector implementing water treatment system interventions in rural settings. Fifteen field interviews were conducted with persons with physical disabilities. Thematic analysis was used to identify six main themes. The results indicated that environmental barriers to access were greater in the workplace than household settings and those persons with disabilities had greater awareness about safe drinking water compared to basic hygiene. Additionally, lack of physical strength, distance to water, and lack of financial means were noted as common access barriers. The findings support ongoing research and offer insight into the particular challenges facing persons with physical disabilities in rural areas in accessing safe drinking water and basic hygiene.

Risk analysis for U.S. offshore wind farms: the need for an integrated approach.

PubMed

Staid, Andrea; Guikema, Seth D

2015-04-01

Wind power is becoming an increasingly important part of the global energy portfolio, and there is growing interest in developing offshore wind farms in the United States to better utilize this resource. Wind farms have certain environmental benefits, notably near-zero emissions of greenhouse gases, particulates, and other contaminants of concern. However, there are significant challenges ahead in achieving large-scale integration of wind power in the United States, particularly offshore wind. Environmental impacts from wind farms are a concern, and these are subject to a number of on-going studies focused on risks to the environment. However, once a wind farm is built, the farm itself will face a number of risks from a variety of hazards, and managing these risks is critical to the ultimate achievement of long-term reductions in pollutant emissions from clean energy sources such as wind. No integrated framework currently exists for assessing risks to offshore wind farms in the United States, which poses a challenge for wind farm risk management. In this "Perspective", we provide an overview of the risks faced by an offshore wind farm, argue that an integrated framework is needed, and give a preliminary starting point for such a framework to illustrate what it might look like. This is not a final framework; substantial work remains. Our intention here is to highlight the research need in this area in the hope of spurring additional research about the risks to wind farms to complement the substantial amount of on-going research on the risks from wind farms. © 2015 Society for Risk Analysis.

A Fine Line: Ethical Issues Facing Childbirth Educators Negotiating Evidence, Beliefs, and Experience

PubMed Central

Morton, Christine H

2009-01-01

The trend toward evidence-based information in childbirth education has been ongoing for some time. Lamaze educators are encouraged to present evidence for the Six Care Practices That Support Normal Birth to pregnant women in their childbirth classes. In a previous article published in The Journal of Perinatal Education, my colleague and I provided an overview of the dilemmas facing American childbirth educators. Childbirth education is a domain in which many types of authoritative knowledge are used: evidence, beliefs, and experience. In our study, educators told us their goal is to provide class participants with unbiased information that allows women to choose what is best for them. In this article, I further analyze educators’ dilemmas and challenges in presenting unbiased information, and I discuss some ethical considerations in educators’ practices. PMID:19436597

A Longitudinal Investigation of Syndemic Conditions Among Young Gay, Bisexual, and Other MSM: The P18 Cohort Study.

PubMed

Halkitis, Perry N; Kapadia, Farzana; Bub, Kristen L; Barton, Staci; Moreira, Alvaro D; Stults, Christopher B

2015-06-01

The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=600) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV.

A longitudinal investigation of syndemic conditions among young gay, bisexual, and other MSM: The P18 Cohort Study

PubMed Central

Halkitis, Perry N.; Kapadia, Farzana; Bub, Kristen L.; Barton, Staci; Moreira, Alvaro D.; Stults, Christopher B.

2014-01-01

The persistence of disparities in STI/HIV risk among a new generation of emerging adult gay, bisexual, and other men who have sex with men (YMSM) warrant holistic frameworks and new methodologies for investigating the behaviors related to STI/HIV in this group. In order to better understand the continued existence of these disparities in STI/HIV risk among YMSM, the present study evaluated the presence and persistence of syndemic conditions among YMSM by examining the co-occurrence of alcohol and drug use, unprotected sexual behavior, and mental health burden over time. Four waves of data, collected over the first 18 months of a 7 wave, 36-month prospective cohort study of YMSM (n=598) were used to examine the extent to which measurement models of drug use, unprotected sexual behavior, and mental health burden remained consistent across time using latent class modeling. Health challenges persisted across time as these YMSM emerged into young adulthood and the measurement models for the latent constructs of drug use and unprotected sexual behavior were essentially consistent across time whereas models for mental health burden varied over time. In addition to confirming the the robustness of our measurement models which capture a more holistic understandings of the health conditions of drug use, unprotected sex, and mental health burden, these findings underscore the ongoing health challenges YMSM face as they mature into young adulthood. These ongoing health challenges, which have been understood as forming a syndemic, persist over time, and add further evidence to support ongoing and vigilant comprehensive health programming for sexual minority men that move beyond a sole focus on HIV. PMID:25192900

Mainstreaming Climate Change: Recent and Ongoing Efforts to Understand, Improve, and Expand Consideration of Climate Change in Federal Water Resources Planning

NASA Astrophysics Data System (ADS)

Ferguson, I. M.; McGuire, M.; Broman, D.; Gangopadhyay, S.

2017-12-01

The Bureau of Reclamation is a Federal agency tasked with developing and managing water supply and hydropower projects in the Western U.S. Climate and hydrologic variability and change significantly impact management actions and outcomes across Reclamation's programs and initiatives, including water resource planning and operations, infrastructure design and maintenance, hydropower generation, and ecosystem restoration, among others. Planning, design, and implementation of these programs therefore requires consideration of future climate and hydrologic conditions will impact program objectives. Over the past decade, Reclamation and other Federal agencies have adopted new guidelines, directives, and mandates that require consideration of climate change in water resources planning and decision making. Meanwhile, the scientific community has developed a large number of climate projections, along with an array of models, methods, and tools to facilitate consideration of climate projections in planning and decision making. However, water resources engineers, planners, and decision makers continue to face challenges regarding how best to use the available data and tools to support major decisions, including decisions regarding infrastructure investments and long-term operating criteria. This presentation will discuss recent and ongoing research towards understanding, improving, and expanding consideration of climate projections and related uncertainties in Federal water resources planning and decision making. These research efforts address a variety of challenges, including: How to choose between available climate projection datasets and related methods, models, and tools—many of which are considered experimental or research tools? How to select an appropriate decision framework when design or operating alternatives may differ between climate scenarios? How to effectively communicate results of a climate impacts analysis to decision makers? And, how to improve robustness and resilience of water resources systems in the face of significant uncertainty? Discussion will focus on the intersection between technical challenges and decision making paradigms and the need for improved scientist-decision maker engagement through the lens of this Federal water management agency.

The State as Community in Community-based Participatory Research

PubMed Central

Goold, Susan Dorr; Rowe, Zachary; Szymecko, Lisa; Coombe, Chris; Danis, Marion; Hammad, Adnan; Calhoun, Karen; Salman, Cengiz

2017-01-01

Background Community-based participatory research (CBPR) typically defines communities by geography, ethnicity, shared health needs, or some combination. Objectives We describe a CBPR project aiming to engage diverse minority and underserved communities throughout Michigan in deliberations about health research priorities. Methods A Steering Committee (SC) with 15 members from minority and underserved communities, and 4 members from research organizations led the project, with the help of regional advisory groups (RAGs) formed at the SC’s request. Evaluation of the SC used questionnaires, focused group discussion, and review of SC meetings to describe engagement, partnership, and communication. Lessons Learned An academic-community partnership with a diverse, dispersed and broadly defined community found value in RAGs, dedicated academic staff, face-to-face meetings, varied communication modalities, capacity building tailored to varying levels of CBPR experience, and ongoing evaluation. Conclusions A geographically and culturally diverse partnership presents challenges and opportunities in representativeness, relationship building, capacity building, and communication. PMID:28569676

Regulatory toxicology in the twenty-first century: challenges, perspectives and possible solutions.

PubMed

Tralau, Tewes; Oelgeschläger, Michael; Gürtler, Rainer; Heinemeyer, Gerhard; Herzler, Matthias; Höfer, Thomas; Itter, Heike; Kuhl, Thomas; Lange, Nikola; Lorenz, Nicole; Müller-Graf, Christine; Pabel, Ulrike; Pirow, Ralph; Ritz, Vera; Schafft, Helmut; Schneider, Heiko; Schulz, Thomas; Schumacher, David; Zellmer, Sebastian; Fleur-Böl, Gaby; Greiner, Matthias; Lahrssen-Wiederholt, Monika; Lampen, Alfonso; Luch, Andreas; Schönfelder, Gilbert; Solecki, Roland; Wittkowski, Reiner; Hensel, Andreas

2015-06-01

The advent of new testing systems and "omics"-technologies has left regulatory toxicology facing one of the biggest challenges for decades. That is the question whether and how these methods can be used for regulatory purposes. The new methods undoubtedly enable regulators to address important open questions of toxicology such as species-specific toxicity, mixture toxicity, low-dose effects, endocrine effects or nanotoxicology, while promising faster and more efficient toxicity testing with the use of less animals. Consequently, the respective assays, methods and testing strategies are subject of several research programs worldwide. On the other hand, the practical application of such tests for regulatory purposes is a matter of ongoing debate. This document summarizes key aspects of this debate in the light of the European "regulatory status quo", while elucidating new perspectives for regulatory toxicity testing.

Personalized medicine and stroke prevention: where are we?

PubMed

Kim, Joosup; Thrift, Amanda G; Nelson, Mark R; Bladin, Christopher F; Cadilhac, Dominique A

2015-01-01

There are many recommended pharmacological and non-pharmacological therapies for the prevention of stroke, and an ongoing challenge is to improve their uptake. Personalized medicine is seen as a possible solution to this challenge. Although the use of genetic information to guide health care could be considered as the apex of personalized medicine, genetics is not yet routinely used to guide prevention of stroke. Currently personalized aspects of prevention of stroke include tailoring interventions based on global risk, the utilization of individualized management plans within a model of organized care, and patient education. In this review we discuss the progress made in these aspects of prevention of stroke and present a case study to illustrate the issues faced by health care providers and patients with stroke that could be overcome with a personalized approach to the prevention of stroke.

The Development of Solar Sail Propulsion for NASA Science Missions to the Inner Solar System

NASA Technical Reports Server (NTRS)

Montgomery, Edward E, IV; Johnson, Charles Les

2004-01-01

This paper examines recent assessments of the technology challenges facing solar sails, identifies the systems and technologies needing development, and the approach employed by NASA's In-space Propulsion Program in NASA to achieve near term products that move this important technology from low technology readiness level (TRL) toward the goal of application to science missions in near earth space and beyond. The status of on-going efforts to design, build, and test ground demonstrators of alternate approaches to structures (inflatable versus rigid), membrane materials, optical shape sensing, and attitude control will be presented along with planned future investments.

Veterans' informal caregivers in the "sandwich generation": a systematic review toward a resilience model.

PubMed

Smith-Osborne, Alexa; Felderhoff, Brandi

2014-01-01

Social work theory advanced the formulation of the construct of the sandwich generation to apply to the emerging generational cohort of caregivers, most often middle-aged women, who were caring for maturing children and aging parents simultaneously. This systematic review extends that focus by synthesizing the literature on sandwich generation caregivers for the general aging population with dementia and for veterans with dementia and polytrauma. It develops potential protective mechanisms based on empirical literature to support an intervention resilience model for social work practitioners. This theoretical model addresses adaptive coping of sandwich- generation families facing ongoing challenges related to caregiving demands.

The Fermi Unix Environment - Dealing with Adolescence

NASA Astrophysics Data System (ADS)

Pordes, Ruth; Nicholls, Judy; Wicks, Matt

Fermilab's Computing Division started early in the definition implemention and promulgation of a common environment for Users across the Laboratory's UNIX platforms and installations. Based on our experience over nearly five years, we discuss the status of the effort ongoing developments and needs, some analysis of where we could have done better, and identify future directions to allow us to provide better and more complete service to our customers. In particular, with the power of the new PCs making enthusiastic converts of physicists to the pc world, we are faced with the challenge of expanding the paradigm to non-UNIX platforms in a uniform and consistent way.

BPMN, Toolsets, and Methodology: A Case Study of Business Process Management in Higher Education

NASA Astrophysics Data System (ADS)

Barn, Balbir S.; Oussena, Samia

This chapter describes ongoing action research which is exploring the use of BPMN and a specific toolset - Intalio Designer to capture the “as is” essential process model of part of an overarching large business process within higher education. The chapter contends that understanding the efficacy of the BPMN notation and the notational elements to use is not enough. Instead, the effectiveness of a notation is determined by the notation, the toolset that is being used, and methodological consideration. The chapter presents some of the challenges that are faced in attempting to develop computation independent models in BPMN using toolsets such as Intalio Designer™.

Bridging the Gap: Adaptive Games and Student-Centered VLEs

NASA Astrophysics Data System (ADS)

Del Blanco, Ángel; Torrente, Javier; Moreno-Ger, Pablo; Fernández-Manjón, Baltasar

The widely used e-learning technology is facing new challenges such as how to produce student-centered systems that can be adapted to the needs of each student. Those objectives should be met in a standard compliant way to simplify general adoption. In this context, educational videogames are proposed as an ideal medium to facilitate adaptation and tracking of the students’ performance for assessment purposes. However, there are still barriers between the gaming and e-learning worlds preventing their mutual interaction. In this paper we propose a middleware to bridge this gap, integrating adaptive educational videogames in e-learning environments with a special focus on the ongoing standardization efforts.

Usability and accessibility in consumer health informatics current trends and future challenges.

PubMed

Goldberg, Larry; Lide, Bettijoyce; Lowry, Svetlana; Massett, Holly A; O'Connell, Trisha; Preece, Jennifer; Quesenbery, Whitney; Shneiderman, Ben

2011-05-01

It is a truism that, for innovative eHealth systems to have true value and impact, they must first and foremost be usable and accessible by clinicians, consumers, and other stakeholders. In this paper, current trends and future challenges in the usability and accessibility of consumer health informatics will be described. Consumer expectations of their healthcare providers and healthcare records in this new era of consumer-directed care will be explored, and innovative visualizations, assistive technologies, and other ways that healthcare information is currently being provided and/or shared will be described. Challenges for ensuring the usability of current and future systems will also be discussed. An innovative model for conducting systematic, timely, user-centered research on consumer-facing websites at the National Cancer Institute (NCI) and the ongoing efforts at the National Institute of Standards and Technology (NIST) to promote health information technology (HIT) usability standards and evaluation criteria will also be presented. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.

An international borderland of concern: Conservation of biodiversity in the Lower Rio Grande Valley

USGS Publications Warehouse

Leslie,, David M.

2016-07-20

The Lower Rio Grande Valley (LRGV) of southern Texas is located on the United States-Mexico borderland and represents a 240-kilometer (150-mile) linear stretch that ends at the Gulf of Mexico. The LRGV represents a unique transition between temperate and tropical conditions and, as such, sustains an exceptionally high diversity of plants and animals—some of them found in few, or no other, places in the United States. Examples include Leopardus pardalis albescens (northern ocelot) and Falco femoralis septentrionalis (northern aplomado falcon)—both endangered in the United States and emblematic of the LRGV. The U.S. Fish and Wildlife Service (USFWS) manages three national wildlife refuges (Santa Ana, Lower Rio Grande Valley, and Laguna Atascosa) that together make up the South Texas Refuge Complex, which actively conserves biodiversity in about 76,006 hectares (187,815.5 acres) of native riparian and upland habitats in the LRGV. These diminished habitats harbor many rare, threatened, and endangered species. This report updates the widely used 1988 USFWS biological report titled “Tamaulipan Brushland of the Lower Rio Grande Valley of South Texas: Description, Human Impacts, and Management Options” by synthesizing nearly 400 peer-reviewed scientific publications that have resulted from biological and sociological research conducted specifically in the four Texas counties of the LRGV in the past nearly 30 years. This report has three goals: (1) synthesize scientific insights gained since 1988 related to the biology and management of the LRGV and its unique biota, focusing on flora and fauna of greatest conservation concern; (2) update ongoing challenges facing Federal and State agencies and organizations that focus on conservation or key natural resources in the LRGV; and (3) redefine conservation opportunities and land-acquisition strategies that are feasible and appropriate today, given the many new and expanding constraints that challenge conservation activities in the LRGV. The LRGV faces every contemporary conservation challenge of the 21st century, but ongoing human population growth and its associated demands, international border issues, and oil, gas, and alternative energy development dominate impacts that affect conservation in the LRGV. Continued careful syntheses of existing and future information collected in the LRGV are needed on many biological and sociological topics to guide conservation activities. Quick response will no doubt be necessary to face contemporary and difficult-to-predict challenges such as climate change, diminished water availability and quality, spread of invasive species, and habitat loss and fragmentation. Complexities of a guarded international borderland add pressure to small patches of native habitat that remain in many places of the LRGV, particularly along the Rio Grande. Large connected corridors of restored native habitat could be the best option to maintain, and even enhance, the exceptional biodiversity of the LRGV in the face of exceptional human demand.

Changing societies and four tasks of schooling: Challenges for strongly differentiated educational systems

NASA Astrophysics Data System (ADS)

van de Werfhorst, Herman G.

2014-05-01

Changing labour markets, increased calls for selection and excellence, and increased diversity and individualisation have repercussions on how educational systems can prepare youth for work, optimise knowledge production, achieve equality of opportunity, and socialise students into active civic engagement. This paper discusses four central tasks of schooling and examines to what extent societal developments challenge education policy to deliver on the tasks at hand. Particular attention is given to the challenges Europe's strongly diversified educational systems are currently facing. Both the Netherlands and Germany, for example, have been offering vocationally-oriented pathways alongside traditional academic higher education for some time. But today's ongoing changes in job descriptions, mainly due to ever-accelerating technological developments, are causing a risk of skills obsolescence which can only be avoided by continuous upskilling and/or reskilling of a sufficiently flexible workforce. Overcoming differences of intelligence as well as differences of diverse socioeconomic, ethnic and linguistic backgrounds by way of education is another challenge, as is fostering "soft" skills and political awareness. This paper investigates the effectiveness of current education systems in preparing citizens for a functioning modern society.

Can Holistic Processing Be Learned for Inverted Faces?

ERIC Educational Resources Information Center

Robbins, Rachel; McKone, Elinor

2003-01-01

The origin of "special" processing for upright faces has been a matter of ongoing debate. If it is due to generic expertise, as opposed to having some innate component, holistic processing should be learnable for stimuli other than upright faces. Here we assess inverted faces. We trained subjects to discriminate identical twins using up to 1100…

On the challenges and mechanisms of embodied decisions

PubMed Central

Cisek, Paul; Pastor-Bernier, Alexandre

2014-01-01

Neurophysiological studies of decision-making have focused primarily on elucidating the mechanisms of classic economic decisions, for which the relevant variables are the values of expected outcomes and action is simply the means of reporting the selected choice. By contrast, here we focus on the particular challenges of embodied decision-making faced by animals interacting with their environment in real time. In such scenarios, the choices themselves as well as their relative costs and benefits are defined by the momentary geometry of the immediate environment and change continuously during ongoing activity. To deal with the demands of embodied activity, animals require an architecture in which the sensorimotor specification of potential actions, their valuation, selection and even execution can all take place in parallel. Here, we review behavioural and neurophysiological data supporting a proposed brain architecture for dealing with such scenarios, which we argue set the evolutionary foundation for the organization of the mammalian brain. PMID:25267821

Overcoming challenges faced by breastfeeding mothers.

PubMed

Amir, Lisa H; Bearzatto, Anita

2016-08-01

Women who are breastfeeding often consult their general practitioner (GP) with concerns about nipple and breast pain, or the adequacy of their milk supply. Common concerns for their breastfed infant include slow weight gain, 'fussiness' with breastfeeding and 'funny stools'. This article offers suggestions for clinicians to support breastfeeding women and their infants. Good attachment to the breast is important to reduce nipple pain and trauma, and to ensure adequate breast drainage and ongoing milk supply. Other causes of nipple pain include vasospasm, dermatitis and infection. Breast pain may be due to blocked ducts, mastitis or abscess. Very early mastitis may be treated by improved emptying. Slow weight gain in a breastfed infant may indicate a medical problem or low supply of breast milk. Some infants have breastfeeding challenges because they are small or premature, or from anatomical issues affecting feeding. In such cases, further help from a lactation consultant may be beneficial.

On the viability of supporting institutional sharing of remote laboratory facilities

NASA Astrophysics Data System (ADS)

Lowe, David; Dang, Bridgette; Daniel, Keith; Murray, Stephen; Lindsay, Euan

2015-11-01

Laboratories are generally regarded as critical to engineering education, and yet educational institutions face significant challenges in developing and maintaining high-quality laboratory facilities. Remote laboratories are increasingly being explored as a partial solution to this challenge, with research showing that - for the right learning outcomes - they can be viable adjuncts or alternatives to conventional hands-on laboratories. One consequential opportunity arising from the inherent support for distributed access is the possibility of cross-institutional shared facilities. While both technical feasibility and pedagogic implications of remote laboratories have been well studied within the literature, the organisational and logistical issues associated with shared facilities have received limited consideration. This paper uses an existing national-scale laboratory sharing initiative, along with a related survey and laboratory sharing data, to analyse a range of factors that can affect engagement in laboratory sharing. The paper also discusses the implications for supporting ongoing laboratory sharing.

Towards a global human embryonic stem cell bank.

PubMed

Lott, Jason P; Savulescu, Julian

2007-08-01

An increasingly unbridgeable gap exists between the supply and demand of transplantable organs. Human embryonic stem cell technology could solve the organ shortage problem by restoring diseased or damaged tissue across a range of common conditions. However, such technology faces several largely ignored immunological challenges in delivering cell lines to large populations. We address some of these challenges and argue in favor of encouraging contribution or intentional creation of embryos from which widely immunocompatible stem cell lines could be derived. Further, we argue that current immunological constraints in tissue transplantation demand the creation of a global stem cell bank, which may hold particular promise for minority populations and other sub-groups currently marginalized from organ procurement and allocation systems. Finally, we conclude by offering a number of practical and ethically oriented recommendations for constructing a human embryonic stem cell bank that we hope will help solve the ongoing organ shortage problem.

A conceptual scheme for cophasing across gaps in segmented pupils with a laser guide star Fizeau interferometer

NASA Astrophysics Data System (ADS)

Tuthill, Peter

2016-08-01

Finding and maintaining an accurate cophasing solution for the large primary mirrors which comprise the coming generation of Extremely Large Telescopes has required a significant technological development effort that is still ongoing. Mirrors based on an assembly of a few large segments, such as the Giant Magellan Telescope (GMT - under construction) and the Large Binocular Telescope (LBT - operational) face a particular challenge: elements must be cophased across a gaps ranging from tens of centimeters to meters. Although it is widely believed that laser guide stars are not useful for this specific application, this paper advances a new concept that challenges this orthodoxy. By projecting a Fizeau interference pattern into the sky, and analyzing the form of the backscattered image, it is shown that at least in principle it is possible to cophase across arbitrary gaps.

Freshwater Metaviromics and Bacteriophages: A Current Assessment of the State of the Art in Relation to Bioinformatic Challenges

PubMed Central

Bruder, Katherine; Malki, Kema; Cooper, Alexandria; Sible, Emily; Shapiro, Jason W.; Watkins, Siobhan C.; Putonti, Catherine

2016-01-01

Advances in bioinformatics and sequencing technologies have allowed for the analysis of complex microbial communities at an unprecedented rate. While much focus is often placed on the cellular members of these communities, viruses play a pivotal role, particularly bacteria-infecting viruses (bacteriophages); phages mediate global biogeochemical processes and drive microbial evolution through bacterial grazing and horizontal gene transfer. Despite their importance and ubiquity in nature, very little is known about the diversity and structure of viral communities. Though the need for culture-based methods for viral identification has been somewhat circumvented through metagenomic techniques, the analysis of metaviromic data is marred with many unique issues. In this review, we examine the current bioinformatic approaches for metavirome analyses and the inherent challenges facing the field as illustrated by the ongoing efforts in the exploration of freshwater phage populations. PMID:27375355

Working at the frontline in cases of elder abuse: 'it keeps me awake at night'.

PubMed

Cairns, Jane; Vreugdenhil, Anthea

2014-03-01

To explore the experiences of frontline health and welfare practitioners in working with older people experiencing abuse. In-depth interviews with 16 Tasmanian community-based health and welfare practitioners regarding their experiences of working in 49 recent cases of elder abuse. Interview transcripts were analysed using thematic analysis. All participants found working in cases of elder abuse challenging and the work itself was perceived as difficult, complex and at times dangerous. The cumulative effect of intimidating work contexts, practice dilemmas and a lack of support resulted in frustration and stress for many practitioners. Nevertheless, participants were committed to providing ongoing services and support for older people experiencing abuse. Frontline practitioners working in cases of elder abuse face significant challenges and could be better supported through strengthening organisational elder abuse policies, increased management support and more age-inclusive family violence support services. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

The Massachusetts HIV, hepatitis, addiction services integration (HHASI) experience: responding to the comprehensive needs of individuals with co-occurring risks and conditions.

PubMed

Hoffman, Heidi L; Castro-Donlan, Carolyn A; Johnson, Victoria M; Church, Daniel R

2004-01-01

Categorical funding mechanisms traditionally used to fund public health programs are a challenge to providers serving individuals with complex needs that often span multiple service areas. Integration--a formalized, collaborative process among service systems--responds to the challenge by decreasing fragmentation of care and improving coordination. In 2000, the Massachusetts Department of Public Health (MDPH) received a one-year planning grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to evaluate opportunities for integrating HIV/AIDS programs and substance abuse treatment programs. The project was later expanded to include viral hepatitis programming. Outcomes include the development of a strategic plan, joint procurement initiatives, and an ongoing commitment to sustain inter-bureau integration efforts, even in the face of substantial budget reductions. Integrated approaches can promote greater efficiency, improving communication and coordination among clients, providers, and government funding agencies.

Rewards and unique challenges faced by African-American custodial grandmothers: the importance of future planning.

PubMed

Crowther, Martha R; Huang, Chao-Hui Sylvia; Allen, Rebecca S

2015-01-01

This exploratory study examined the context and consequences of custodial grandparenting, along with attitudes and preferences regarding future planning among 22 African-American custodial grandmothers. A mixed-method research design was employed. Based on our integration of two theories regarding future planning and health behavior change, caregiving, emotional distress, religiosity and spirituality, and future planning were assessed using questionnaires along with semi-structured interviews. African-American custodial grandmothers (mean age M = 53.64, SD = 9.58) perceived their caregiving role as rewarding (72%) yet challenging (86%). More than 40% reported significant emotional distress (CES-D ≥ 16) that warrants clinical attention. Findings showed that while 64% of study participants had future plans regarding who will substitute in their caregiving role if they become incapacitated, only 9% had completed a living will. Three major themes emerged regarding custodial grandmothers' caregiving role which includes: (1) rewards; (2) challenges including feeling overwhelmed and health concerns; and (3) caregiving decisions including conflicts between 'My plan was…/put self on-hold' for grandchildren and difficulty with future planning. These themes highlighted the dynamics of caregiving across time, including current context and the ongoing process of decision-making. Findings suggest that while African-American custodial grandmothers find caregiving rewarding, they face unique challenges in contemplating and developing future plans. Custodial grandmothers think about substitute caregivers for their grandchildren but need assistance communicating a plan focused on their own needs for future care. Culturally sensitive interventions designed to facilitate effective utilization of future plans within this caregiver population are needed.

Heat and moisture exchange devices for patients undergoing total laryngectomy.

PubMed

Icuspit, Pearl; Yarlagadda, Bharat; Garg, Shweta; Johnson, Theresa; Deschler, Daniel

2014-01-01

Patients undergoing total laryngectomy face the challenge of an altered anatomy with the resultant changes in quality of life and significant requirements for post-operative care. Increased production of secretions and sputum, the need for ongoing suctioning, and the formation of stomal crusting require meticulous post-operative care. The use of Heat and Moisture Exchange (HME) devices has been shown to decrease the effect of these factors. This article describes the nature of these devices and their use. The literature is reviewed regarding the long term benefits and new data are presented suggesting an immediate post-operative benefit as well. Finally, costs and other considerations for successful use of HME devices are presented.

The Summer Food Service Program and the Ongoing Hunger Crisis in Mississippi.

PubMed

Cobern, Jade A; Shell, Kathryn J; Henderson, Everett R; Beech, Bettina M; Batlivala, Sarosh P

2015-10-01

Food insecurity is simply defined as uncertain access to adequate food. Nearly 50 million Americans, 16 million of whom are children, are food insecure. Mississippi has 21% food insecure citizens, and has the most food insecure county in the nation. Our state's school system's National Breakfast and Lunch Programs help combat food insecurity, but a gap still exists. This gap widens during the summer. In this paper, we describe the Mississippi Summer Food Service Program. While the program has had success in our state, it still faces challenges. Organized action by physicians in Mississippi and the Mississippi State Medical Association could significantly increase participation in these programs that are vital to our state.

The Fermi Unix environment -- Dealing with adolescence

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

Pordes, R.; Nicholls, J.; Wicks, M.

1995-10-01

Fermilab`s Computing Division started early in the definition implementation and promulgation of a common environment for Users across the Laboratory`s UNIX platforms and installations. Based on the authors experience over nearly five years, they discuss the status of the effort, ongoing developments and needs, some analysis of where they could have done better, and identify future directions to allow them to provide better and more complete service to their customers. In particular, with the power of the new PCs making enthusiastic converts of physicists to the pc world, they are faced with the challenge of expanding the paradigm to non-UNIXmore » platforms in a uniform and consistent way.« less

Regulatory system reform of occupational health and safety in China.

PubMed

Wu, Fenghong; Chi, Yan

2015-01-01

With the explosive economic growth and social development, China's regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined.

Regulatory system reform of occupational health and safety in China

PubMed Central

WU, Fenghong; CHI, Yan

2015-01-01

With the explosive economic growth and social development, China’s regulatory system of occupational health and safety now faces more and more challenges. This article reviews the history of regulatory system of occupational health and safety in China, as well as the current reform of this regulatory system in the country. Comprehensive, a range of laws, regulations and standards that promulgated by Chinese government, duties and responsibilities of the regulatory departments are described. Problems of current regulatory system, the ongoing adjustments and changes for modifying and improving regulatory system are discussed. The aim of reform and the incentives to drive forward more health and safety conditions in workplaces are also outlined. PMID:25843565

Towards a new paradigm in health research and practice? Collaborations for Leadership in Applied Health Research and Care.

PubMed

Martin, Graham P; McNicol, Sarah; Chew, Sarah

2013-01-01

Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are a new UK initiative to promote collaboration between universities and healthcare organisations in carrying out and applying the findings of applied health research. But they face significant, institutionalised barriers to their success. This paper seeks to analyse these challenges and discuss prospects for overcoming them. The paper draws on in-depth qualitative interview data from the first round of an ongoing evaluation of one CLAHRC to understand the views of different stakeholders on its progress so far, challenges faced, and emergent solutions. The breadth of CLAHRCs' missions seems crucial to mobilise the diverse stakeholders needed to succeed, but also produces disagreement about what the prime goal of the Collaborations should be. A process of consensus building is necessary to instil a common vision among CLAHRC members, but deep-seated institutional divisions continue to orient them in divergent directions, which may need to be overcome through other means. This analysis suggests some of the key means by which those involved in joint enterprises such as CLAHRCs can achieve consensus and action towards a current goal, and offers recommendations for those involved in their design, commissioning and performance management.

"It's a small price to pay for life": faecal occult blood test (FOBT) screening for colorectal cancer, perceived barriers and facilitators.

PubMed

Reeder, Anthony I

2011-03-25

To clarify perceptions influencing FOBT screening participation among the NZ European target population. Participants (30 female, 20 male; 50-71 years) recruited through urban (Auckland, Wellington, Christchurch) GP surgeries for in-depth, face-to-face interviews (digitally recorded and professionally transcribed verbatim). A pragmatic approach focused on aggregating transcript content. Participants believed early CRC lacked distinguishing signs and symptoms, but was treatable and suitable for screening, although slow development may undermine any sense of urgency. FOBT inaccuracies caused concern, particularly false negatives, but ongoing testing could reduce anxiety. Specimen collection was awkward, challenged social norms and individual squeamishness, but provided peace of mind, was painless, simple and private without high cost technological or professional involvement. Lacking preventive attitudes and experience of health responsibilities and screening, men were less likely to participate than women. CRC lacked public profile, highlighting government responsibility, before programme implementation, to resource high-profile education, largely through TV. General practitioner support and promotion was seen as critical. Inadequate health system capacity and resourcing was problematic. Despite challenging barriers, participants identified opportunities to increase FOBT screening participation, especially promotion to raise CRC profile, overcome perceived normative barriers and build self-efficacy. Adequate resourcing is essential to support appropriate promotion and timely programme delivery.

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

Germain, Shawn

Nuclear Power Plant (NPP) refueling outages create some of the most challenging activities the utilities face in both tracking and coordinating thousands of activities in a short period of time. Other challenges, including nuclear safety concerns arising from atypical system configurations and resource allocation issues, can create delays and schedule overruns, driving up outage costs. Today the majority of the outage communication is done using processes that do not take advantage of advances in modern technologies that enable enhanced communication, collaboration and information sharing. Some of the common practices include: runners that deliver paper-based requests for approval, radios, telephones, desktopmore » computers, daily schedule printouts, and static whiteboards that are used to display information. Many gains have been made to reduce the challenges facing outage coordinators; however; new opportunities can be realized by utilizing modern technological advancements in communication and information tools that can enhance the collective situational awareness of plant personnel leading to improved decision-making. Ongoing research as part of the Light Water Reactor Sustainability Program (LWRS) has been targeting NPP outage improvement. As part of this research, various applications of collaborative software have been demonstrated through pilot project utility partnerships. Collaboration software can be utilized as part of the larger concept of Computer-Supported Cooperative Work (CSCW). Collaborative software can be used for emergent issue resolution, Outage Control Center (OCC) displays, and schedule monitoring. Use of collaboration software enables outage staff and subject matter experts (SMEs) to view and update critical outage information from any location on site or off.« less

Consequences of ongoing civil conflict in Somalia: evidence for public health responses.

PubMed

Guha-Sapir, Debarati; Ratnayake, Ruwan

2009-08-01

Debarati Guha-Sapir and Ruwan Ratnayake use field data to demonstrate the severe vulnerability faced by much of the Somalian population due to ongoing conflict, and call for concerted public health interventions and access to food aid especially in southern Somalia.

ïSCOPE: Safer care for older persons (in residential) environments: A study protocol

PubMed Central

2011-01-01

Background The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. Aims Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012) proof-of-principle pilot study conducted in seven nursing homes in western Canada. The purpose of the study is to evaluate the feasibility of engaging front line staff to use quality improvement methods to integrate best practices into resident care. The goals of the study are to improve the quality of work life for staff, in particular healthcare aides, and to improve residents' quality of life. Methods/design The study has parallel research and quality improvement intervention arms. It includes an education and support intervention for direct caregivers to improve the safety and quality of their care delivery. We hypothesize that this intervention will improve not only the care provided to residents but also the quality of work life for healthcare aides. The study employs tools adapted from the Institute for Healthcare Improvement's Breakthrough Series: Collaborative Model and Canada's Safer Healthcare Now! improvement campaign. Local improvement teams in each nursing home (1 to 2 per facility) are led by healthcare aides (non-regulated caregivers) and focus on the management of specific areas of resident care. Critical elements of the program include local measurement, virtual and face-to-face learning sessions involving change management, quality improvement methods and clinical expertise, ongoing virtual and in person support, and networking. Discussion There are two sustainability challenges in this study: ongoing staff and leadership engagement, and organizational infrastructure. Addressing these challenges will require strategic planning with input from key stakeholders for sustaining quality improvement initiatives in the long-term care sector. PMID:21745382

iSPUW: integrated sensing and prediction of urban water for sustainable cities

NASA Astrophysics Data System (ADS)

Noh, S. J.; Nazari, B.; Habibi, H.; Norouzi, A.; Nabatian, M.; Seo, D. J.; Bartos, M. D.; Kerkez, B.; Lakshman, L.; Zink, M.; Lee, J.

2016-12-01

Many cities face tremendous water-related challenges in this Century of the City. Urban areas are particularly susceptible not only to excesses and shortages of water but also to impaired water quality. To addresses these challenges, we synergistically integrate advances in computing and cyber-infrastructure, environmental modeling, geoscience, and information science to develop integrative solutions for urban water challenges. In this presentation, we describe the various efforts that are currently ongoing in the Dallas-Fort Worth Metroplex (DFW) area for iSPUW: real-time high-resolution flash flood forecasting, inundation mapping for large urban areas, crowdsourcing of water observations in urban areas, real-time assimilation of crowdsourced observations for street and river flooding, integrated control of lawn irrigation and rainwater harvesting for water conservation and stormwater management, feature mining with causal discovery for flood prediction, and development of the Arlington Urban Hydroinformatics Testbed. Analyzed is the initial data of sensor network for water level and lawn monitoring, and cellphone applications for crowdsourcing flood reports. New data assimilation approaches to deal with categorical and continuous observations are also evaluated via synthetic experiments.

Lessons learned from the New York State mental health response to the September 11, 2001, attacks.

PubMed

Sederer, Lloyd I; Lanzara, Carol B; Essock, Susan M; Donahue, Sheila A; Stone, James L; Galea, Sandro

2011-09-01

In the aftermath of the September 11, 2001, attacks on the World Trade Center, the public mental health system in New York City mounted the largest mental health disaster response in history, called Project Liberty. The successes and challenges of Project Liberty are evaluated. The development of Project Liberty is summarized and analyzed from the perspective of the New York State and New York City officials and scientists who led the disaster response. Lessons learned that have implications for mental health support in future disaster responses are offered. A high level of interagency collaboration, engagement of nongovernmental organizations to provide services, media education efforts, and ongoing program evaluation all contributed to the program's successes. Mental health professionals' limited experiences with trauma, options for funding treatment, duration of clinical program, and existing needs assessments methodologies all proved challenging. Project Liberty was a massive and invaluable resource during the years of rebuilding in New York City in the wake of the attacks. Challenges faced have led to lessons of generalizable import for other mental health responses to large-scale events.

Chasing rainbow notions: enacting community psychology in the classroom and beyond in post-1994 South Africa.

PubMed

Ngonyama ka Sigogo, Thabani; Hooper, Megan; Long, Carol; Lykes, M Brinton; Wilson, Kenneth; Zietkiewicz, Estelle

2004-03-01

This paper discusses tensions and contradictions experienced by a group of psychologists in post-1994 South Africa as we struggled to develop an MA program in community psychology. Situating our work within the history of the subdiscipline and the historical context confronting South Africans in the "wake of apartheid," we explore models of community psychology that informed praxis under apartheid and contemporary challenges confronting a country in transition. We discuss three tensions that inform the ongoing program development. These include (1) the construction and deconstruction of Western and indigenous knowledge systems; (2) assessment and intervention at multiple levels and from differing value perspectives; and (3) paradoxes experienced by a team of university-educated, primarily White academic staff committed to challenging oppression. We conclude our discussion by suggesting that, within these shifting sands of economic, political, cultural, and institutional change community psychology must, of necessity, resist rigid self-definition and seek to position itself as a "work-in-progress." We suggest that this seemingly anomalous self-description may be suggestive for other community psychologists-in-the-making facing similar challenges within the majority world.

Overcoming Health System Challenges for Women and Children Living With HIV Through the Global Plan.

PubMed

Modi, Surbhi; Callahan, Tegan; Rodrigues, Jessica; Kajoka, Mwikemo D; Dale, Helen M; Langa, Judite O; Urso, Marilena; Nchephe, Matsepeli I; Bongdene, Helene; Romano, Sostena; Broyles, Laura N

2017-05-01

To meet the ambitious targets set by the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan), the initial 22 priority countries quickly developed innovative approaches for overcoming long-standing health systems challenges and providing HIV testing and treatment to pregnant and breastfeeding women and their infants. The Global Plan spurred programs for prevention of mother-to-child HIV transmission to integrate HIV-related care and treatment into broader maternal, newborn, and child health services; expand the effectiveness of the health workforce through task sharing; extend health services into communities; strengthen supply chain and commodity management systems; reduce diagnostic and laboratory hurdles; and strengthen strategic supervision and mentorship. The article reviews the ongoing challenges for prevention of mother-to-child HIV transmission programs as they continue to strive for elimination of vertical transmission of HIV infection in the post-Global Plan era. Although progress has been rapid, health systems still face important challenges, particularly follow-up and diagnosis of HIV-exposed infants, continuity of care, and the promotion of services that are respectful and client centered.

'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making.

PubMed

Cleary, Michelle; Raeburn, Toby; Escott, Phil; West, Sancia; Lopez, Violeta

2018-05-09

In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers' participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care. © 2018 Australian College of Mental Health Nurses Inc.

Overcoming Health System Challenges for Women and Children Living With HIV Through the Global Plan

PubMed Central

Modi, Surbhi; Callahan, Tegan; Rodrigues, Jessica; Kajoka, Mwikemo D.; Dale, Helen M.; Langa, Judite O.; Urso, Marilena; Nchephe, Matsepeli I.; Bongdene, Helene; Romano, Sostena; Broyles, Laura N.

2017-01-01

To meet the ambitious targets set by the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan), the initial 22 priority countries quickly developed innovative approaches for overcoming long-standing health systems challenges and providing HIV testing and treatment to pregnant and breastfeeding women and their infants. The Global Plan spurred programs for prevention of mother-to-child HIV transmission to integrate HIV-related care and treatment into broader maternal, newborn, and child health services; expand the effectiveness of the health workforce through task sharing; extend health services into communities; strengthen supply chain and commodity management systems; reduce diagnostic and laboratory hurdles; and strengthen strategic supervision and mentorship. The article reviews the ongoing challenges for prevention of mother-to-child HIV transmission programs as they continue to strive for elimination of vertical transmission of HIV infection in the post-Global Plan era. Although progress has been rapid, health systems still face important challenges, particularly follow-up and diagnosis of HIV-exposed infants, continuity of care, and the promotion of services that are respectful and client centered. PMID:28399000

Nanotechnology Strategies To Advance Outcomes in Clinical Cancer Care.

PubMed

Hartshorn, Christopher M; Bradbury, Michelle S; Lanza, Gregory M; Nel, Andre E; Rao, Jianghong; Wang, Andrew Z; Wiesner, Ulrich B; Yang, Lily; Grodzinski, Piotr

2018-01-23

Ongoing research into the application of nanotechnology for cancer treatment and diagnosis has demonstrated its advantages within contemporary oncology as well as its intrinsic limitations. The National Cancer Institute publishes the Cancer Nanotechnology Plan every 5 years since 2005. The most recent iteration helped codify the ongoing basic and translational efforts of the field and displayed its breadth with several evolving areas. From merely a technological perspective, this field has seen tremendous growth and success. However, an incomplete understanding of human cancer biology persists relative to the application of nanoscale materials within contemporary oncology. As such, this review presents several evolving areas in cancer nanotechnology in order to identify key clinical and biological challenges that need to be addressed to improve patient outcomes. From this clinical perspective, a sampling of the nano-enabled solutions attempting to overcome barriers faced by traditional therapeutics and diagnostics in the clinical setting are discussed. Finally, a strategic outlook of the future is discussed to highlight the need for next-generation cancer nanotechnology tools designed to address critical gaps in clinical cancer care.

Governance of water resources in the phase of change: a case study of the implementation of the EU Water Framework Directive in Sweden.

PubMed

Hammer, Monica; Balfors, Berit; Mörtberg, Ulla; Petersson, Mona; Quin, Andrew

2011-03-01

In this article, focusing on the ongoing implementation of the EU Water Framework Directive, we analyze some of the opportunities and challenges for a sustainable governance of water resources from an ecosystem management perspective. In the face of uncertainty and change, the ecosystem approach as a holistic and integrated management framework is increasingly recognized. The ongoing implementation of the Water Framework Directive (WFD) could be viewed as a reorganization phase in the process of change in institutional arrangements and ecosystems. In this case study from the Northern Baltic Sea River Basin District, Sweden, we focus in particular on data and information management from a multi-level governance perspective from the local stakeholder to the River Basin level. We apply a document analysis, hydrological mapping, and GIS models to analyze some of the institutional framework created for the implementation of the WFD. The study underlines the importance of institutional arrangements that can handle variability of local situations and trade-offs between solutions and priorities on different hierarchical levels.

Low-level awareness accompanies "unconscious" high-level processing during continuous flash suppression.

PubMed

Gelbard-Sagiv, Hagar; Faivre, Nathan; Mudrik, Liad; Koch, Christof

2016-01-01

The scope and limits of unconscious processing are a matter of ongoing debate. Lately, continuous flash suppression (CFS), a technique for suppressing visual stimuli, has been widely used to demonstrate surprisingly high-level processing of invisible stimuli. Yet, recent studies showed that CFS might actually allow low-level features of the stimulus to escape suppression and be consciously perceived. The influence of such low-level awareness on high-level processing might easily go unnoticed, as studies usually only probe the visibility of the feature of interest, and not that of lower-level features. For instance, face identity is held to be processed unconsciously since subjects who fail to judge the identity of suppressed faces still show identity priming effects. Here we challenge these results, showing that such high-level priming effects are indeed induced by faces whose identity is invisible, but critically, only when a lower-level feature, such as color or location, is visible. No evidence for identity processing was found when subjects had no conscious access to any feature of the suppressed face. These results suggest that high-level processing of an image might be enabled by-or co-occur with-conscious access to some of its low-level features, even when these features are not relevant to the processed dimension. Accordingly, they call for further investigation of lower-level awareness during CFS, and reevaluation of other unconscious high-level processing findings.

An academic health center sees both challenges and enabling forces as it creates an accountable care organization.

PubMed

Tallia, Alfred F; Howard, Jenna

2012-11-01

Health care reform presents academic health centers with an opportunity to test new systems of care, such as accountable care organizations (ACOs), that are intended to improve patients' health and well-being, mitigate the anticipated shortage in primary care providers, and bend the cost curve. In its ongoing efforts to develop an ACO, the Robert Wood Johnson Medical School, an academic health center, has found helpful a rapidly evolving competitive environment and insurers willing to experiment with new models of care. But the center has also encountered six types of barriers: conceptual, financial, cultural, regulatory, organizational, and historical. How this academic health center has faced these barriers offers valuable lessons to other health systems engaged in creating ACOs.

Interview with Dr Bernard Pécoul, Executive Director of the Drugs for Neglected Diseases Initiative.

PubMed

Pécoul, Bernard

2009-05-01

A significant number of product-development partnerships have arisen in the past 10 years to tackle diseases that mainly affect developing countries. With their coherent research and development leadership, they have become key players in identifying gaps and overcoming bottlenecks in order to deliver medicines to those who need them most in the developing world. Dr Bernard Pécoul is the Executive Director of one such partnership, the Drugs for Neglected Diseases Initiative (DNDi). Under his leadership, the DNDi has built the largest and most robust R&D portfolio for three of the most neglected diseases. He speaks to Future Medicinal Chemistry about challenges facing neglected disease R&D and the DNDi's ongoing work.

48 CFR 1480.903 - Award in the face of challenge.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

48 CFR 1480.903 - Award in the face of challenge.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

After-school programs for low-income children: promise and challenges.

PubMed

Halpern, R

1999-01-01

Children's out-of-school time, long a low-level source of public concern, has recently emerged as a major social issue. This, in turn, has heightened interest in the heterogeneous field of after-school programs. This article provides a profile of after-school programs for low-income children, focusing on supply and demand, program emphases, and program sponsors and support organizations. It also discusses the major challenges facing the field in the areas of facilities, staffing, and financing. Details and examples are drawn from the ongoing evaluation of a specific after-school program initiative called MOST (Making the Most of Out-of-School Time), which seeks to strengthen after-school programs in Boston, Chicago, and Seattle. Looking ahead, the article highlights the pros and cons of options for increasing coverage to reach more low-income children, strengthening programs, expanding funding, and articulating an appropriate role for after-school programs to fill in the lives of low-income children.

Interactions between biomass-burning aerosols and clouds over Southeast Asia: current status, challenges, and perspectives.

PubMed

Lin, Neng-Huei; Sayer, Andrew M; Wang, Sheng-Hsiang; Loftus, Adrian M; Hsiao, Ta-Chih; Sheu, Guey-Rong; Hsu, N Christina; Tsay, Si-Chee; Chantara, Somporn

2014-12-01

The interactions between aerosols, clouds, and precipitation remain among the largest sources of uncertainty in the Earth's energy budget. Biomass-burning aerosols are a key feature of the global aerosol system, with significant annually-repeating fires in several parts of the world, including Southeast Asia (SEA). SEA in particular provides a "natural laboratory" for these studies, as smoke travels from source regions downwind in which it is coupled to persistent stratocumulus decks. However, SEA has been under-exploited for these studies. This review summarizes previous related field campaigns in SEA, with a focus on the ongoing Seven South East Asian Studies (7-SEAS) and results from the most recent BASELInE deployment. Progress from remote sensing and modeling studies, along with the challenges faced for these studies, are also discussed. We suggest that improvements to our knowledge of these aerosol/cloud effects require the synergistic use of field measurements with remote sensing and modeling tools. Copyright © 2014 Elsevier Ltd. All rights reserved.

Women in academic surgery: why is the playing field still not level?

PubMed

Seemann, Natashia M; Webster, Fiona; Holden, Helen Alyx; Moulton, Carol-Anne E; Baxter, Nancy; Desjardins, Christine; Cil, Tulin

2016-02-01

The purpose of this study was to explore career satisfaction and advancement for women in academic surgery. A 48-item web-based survey was emailed to women surgeons in academic centers across Canada, exploring career advancement, family planning, mentorship, discrimination, and career satisfaction. The survey response rate was 38% (81 of 212); 18% of participants felt they experienced gender discrimination in medical school, 36% in residency, 12% in fellowship, and 41% as staff surgeons. More than half felt that their gender had played a role in the career challenges they faced. Responses to open-ended questions suggested that many surgeons struggled to balance their academic careers with family life. Despite this, participants rated their career satisfaction very highly. There remain ongoing challenges for women in academic surgery including lack of gender equality, appropriate mentorship, and accommodations for surgeons with families. Continued advancement of women in academic surgery is dependent on addressing these concerns. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-11-01

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

Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009-2013).

PubMed

de Lesquen, Henri; Beranger, Fabien; Berbis, Julie; Boddaert, Guillaume; Poichotte, Antoine; Pons, Francois; Avaro, Jean-Philippe

2016-09-01

This study reports the challenges faced by French military surgeons in the management of thoracic injury during the latest Afghanistan war. From January 2009 to April 2013, all of the civilian, French and Coalition casualties admitted to French NATO Combat Support Hospital situated on Kabul were prospectively recorded in the French Military Health Service Registry (OPEX(®)). Only penetrating and blunt thoracic trauma patients were retrospectively included. Eighty-nine casualties were included who were mainly civilian (61%) and men (94%) with a mean age of 27.9 years old. Surgeons dealt with polytraumas (78%), severe injuries (mean Injury Severity Score=39.2) and penetrating wounds (96%) due to explosion in 37%, gunshot in 53% and stabbing in 9%. Most of casualties were first observed or drained (n=56). In this non-operative group more than 40% of casualties needed further actions. In the operative group, Damage Control Thoracotomy (n=22) was performed to stop ongoing bleeding and air leakage and Emergency Department Thoracotomy (n=11) for agonal patient. Casualties suffered from hemothorax (60%), pneumothorax (39%), diaphragmatic (37%), lung (35%), heart or great vessels (20%) injuries. The main actions were diaphragmatic sutures (n=25), lung resections (wedge n=6, lobectomy n=4) and haemostasis (intercostal artery ligation n=3, heart injury repairs n=5, great vessels injury repairs n=5). Overall mortality was 11%. The rate of subsequent surgery was 34%. The analysis of the OPEX(®) registry reflects the thoracic surgical challenges of general (visceral) surgeons serving in combat environment during the latest Afghanistan War. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interviewing with or without the partner present?--an underexposed dilemma between ethics and methodology in nursing research.

PubMed

Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth

2016-04-01

To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda

PubMed Central

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Objectives Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. Methods This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. Results The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Conclusions Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services. PMID:26405800

Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda.

PubMed

Chi, Primus Che; Bulage, Patience; Urdal, Henrik; Sundby, Johanne

2015-01-01

Maternal and neonatal mortality and morbidity rates are particularly grim in conflict, post-conflict and other crisis settings, a situation partly blamed on non-availability and/or poor quality of emergency obstetric and neonatal care (EmONC) services. The aim of this study was to explore the barriers to effective delivery of EmONC services in post-conflict Burundi and Northern Uganda, in order to provide policy makers and other relevant stakeholders context-relevant data on improving the delivery of these lifesaving services. This was a qualitative comparative case study that used 42 face-to-face semi-structured in-depth interviews and 4 focus group discussions for data collection. Participants were 32 local health providers and 37 staff of NGOs working in the area of maternal health. Data was analysed using the framework approach. The availability, quality and distribution of EmONC services were major challenges across the sites. The barriers in the delivery of quality EmONC services were categorised into two major themes; human resources-related challenges, and systemic and institutional failures. While some of the barriers were similar, others were unique to specific sites. The common barriers included shortage of qualified staff; lack of essential installations, supplies and medications; increasing workload, burn-out and turnover; and poor data collection and monitoring systems. Barriers unique to Northern Uganda were demoralised personnel and lack of recognition; poor referral system; inefficient drug supply system; staff absenteeism in rural areas; and poor coordination among key personnel. In Burundi, weak curriculum; poor harmonisation and coordination of training; and inefficient allocation of resources were the unique challenges. To improve the situation across the sites, efforts are ongoing to improve the training and recruitment of more staff; harmonise and strengthen the curriculum and training; increase the number of EmONC facilities; and improve staff supervision, monitoring and support. Post-conflict health systems face different challenges in the delivery of EmONC services and as such require context-specific interventions to improve the delivery of these services.

From Online Student to Online Instructor: Assistive Strategies

ERIC Educational Resources Information Center

McKnight, Jodi

2012-01-01

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

Plagiarism Due to Misunderstanding: Online Instructor Perceptions

ERIC Educational Resources Information Center

Greenberger, Scott; Holbeck, Rick; Steele, John; Dyer, Thomas

2016-01-01

Plagiarism is an ongoing problem in higher education. This problem exists in both online and face-to-face modalities. The literature indicates that there are three ways higher education institutions define plagiarism, which includes theft, deception, and misunderstanding. Plagiarism due to misunderstanding has received less attention in the…

A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners.

PubMed

Boyle, Eileen; Saunders, Rosemary; Drury, Vicki

2016-07-01

To explore patient experiences of type 2 diabetes mellitus care delivered by general practice nurses in collaboration with the general practitioner. Australian general practice nurses are expanding their role in multidisciplinary type 2 diabetes care with limited research on patient perceptions of care provision within this collaborative model. Qualitative interpretive. Purposeful sampling was used to invite the patients (n = 10). Data were collected from semi-structured face-to-face interviews. Braun and Clarke's () inductive coding thematic analysis process was used to interpret the data. All participants experienced their General Practice Nurse consultation as a clinical assessment for their General Practitioner. While they appreciated the extra time with the General Practice Nurse, they were unsure of the purpose of the consultation beyond clinical assessment. They described the ongoing challenge of living with T2DM and identified a need for additional information and advice. The results suggest that the model of general practice nurse type 2 diabetes care has an important role to play in the delivery of effective ongoing care of patients. However, this role requires further development to ensure that it is understood by the patients as a role that not only conducts clinical assessments but also provides relevant education and self-management support as part of a collaborative approach to care delivery with General Practitioners. The findings are relevant to primary health care clinicians providing diabetes care to inform more relevant supportive care by general practice nurses. © 2016 John Wiley & Sons Ltd.

How do temperate bryophytes face the challenge of a changing environment? Lessons from the past and predictions for the future.

PubMed

Désamoré, Aurélie; Laenen, Benjamin; Stech, Michael; Papp, Beata; Hedenäs, Lars; Mateo, Ruben G; Vanderpoorten, Alain

2012-09-01

Bryophytes are a group of early land plants, whose specific ecophysiological and biological features, including poikilohydry, sensitivity to moderately high temperature and high dispersal ability, make them ideal candidates for investigating the impact of climate changes. Employing a combined approach of species distribution modelling (SDM) and molecular phylogeography in the temperate moss Homalothecium sericeum, we explore the significance of the Mediterranean refugia, contrasting the southern and northern refugia hypotheses, determine the extent to which recolonization of previously glaciated areas has been facilitated by the high dispersal ability of the species and make predictions on the extent to which it will be impacted by ongoing climate change. The Mediterranean areas exhibit the highest nucleotidic diversities and host a mixture of ancestral, endemic and more recently derived haplotypes. Extra-Mediterranean areas exhibit low genetic diversities and Euro-Siberian populations display a significant signal of expansion that is identified to be of Euro-Siberian origin, pointing to the northern refugia hypothesis. The SDMs predict a global net increase in range size owing to ongoing climate change, but substantial range reductions in southern areas. Presence of a significant phylogeographical signal at different spatial scales suggests, however, that dispersal limitations might constitute, as opposed to the traditional view of spore-producing plants as efficient dispersers, a constraint for migration. This casts doubts about the ability of the species to face the massive extinctions predicted in the southern areas, threatening their status of reservoir of genetic diversity. © 2012 Blackwell Publishing Ltd.

Family-based therapy for dementia caregivers: clinical observations

PubMed Central

MITRANI, V. B.; CZAJA, S. J.

2008-01-01

Family caregiving for dementia patients is a major social and clinical problem. Family caregivers face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected increase in the number of people with dementia, there is a need to identify approaches that will help families manage the challenges of caregiving. Social support from friends and family members has consistently been found to mediate caregiver outcomes, yet many caregivers face problems with isolation and estrangement from family members. In this regard, family-based therapy is a promising intervention for increasing social support for caregivers, and enhancing their quality of life and ability to provide care.This paper will discuss how family-based therapy can be applied as an intervention for family caregivers of dementia patients.The clinical implications of specific interactional patterns will be presented via case examples from an ongoing clinical trial with white American and Cuban American caregivers of dementia patients.The intent is to demonstrate how identification of interactional patterns is a valuable tool for implementing family-based interventions. PMID:18548132

What can medical educators learn from the Rio 2016 Olympic Games?

PubMed

Church, Helen; Murdoch-Eaton, Deborah; Patel, Rakesh; Sandars, John

2017-06-01

Medical Educators face an ongoing challenge in optimizing preparedness for practice for newly qualified doctors. Junior doctors have highlighted specific areas in which they do not feel adequately equipped to undertake their duties, including managing the acutely unwell patient. In these highly stressful, time-critical scenarios it might be assumed that a lack of knowledge underpins these feelings of apprehension from junior medics; however, having studied, trained and passed examinations to demonstrate such knowledge, perhaps other factors should be considered. The recent Olympic Games in Rio demonstrated the impact of sport psychology techniques in allowing athletes to achieve their optimum performance in the face of adversity. The use of mental and behavioral strategies to control feelings of anxiety and low self-efficacy are pivotal for athletes to deliver their best performance under extreme pressure. We consider whether such techniques could improve the preparedness of the newest recruits to the healthcare system, and the impact this could have on patient care. Finally, suggestions for potential research directions within this area are offered to stimulate interest amongst the research community.

78 FR 54432 - Development of Inward Leakage Standards for Half-Mask Air-Purifying Particulate Respirators

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... location: Bruceton Research Center, NIOSH National Personal Protective Technology Laboratory (NPPTL), 626... preliminary results of their independently completed or ongoing research. NIOSH reviewed all comments... distribution of face width and face length, was developed by NIOSH in 2007, based on research completed in 2003...

Increasing Student Engagement Using Asynchronous Learning

ERIC Educational Resources Information Center

Northey, Gavin; Bucic, Tania; Chylinski, Mathew; Govind, Rahul

2015-01-01

Student engagement is an ongoing concern for educators because of its positive association with deep learning and educational outcomes. This article tests the use of a social networking site (Facebook) as a tool to facilitate asynchronous learning opportunities that complement face-to-face interactions and thereby enable a stronger learning…

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

Telerehabilitation clinical and vocational applications for assistive technology: research, opportunities, and challenges.

PubMed

Schmeler, Mark R; Schein, Richard M; McCue, Michael; Betz, Kendra

2009-01-01

Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent in coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise may be troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper.

Challenges in managing elderly people with diabetes in primary care settings in Norway

PubMed Central

2013-01-01

Abstract Objective To explore the experiences and clinical challenges that nurses and nursing assistants face when providing high-quality diabetes-specific management and care for elderly people with diabetes in primary care settings. Design Focus-group interviews. Subjects and setting Sixteen health care professionals: 12 registered nurses and four nursing assistants from nursing homes (10), district nursing service (5), and a service unit (1) were recruited by municipal managers who had local knowledge and knew the workforce. All the participants were women aged 32–59 years with clinical experience ranging from 1.5 to 38 years. Results Content analysis revealed a discrepancy between the level of expertise which the participants described as important to delivering high-quality care and their capacity to deliver such care. The discrepancy was due to lack of availability and access to current information, limited ongoing support, lack of cohesion among health care professionals, and limited confidence and autonomy. Challenges to delivering high-quality care included complex, difficult patient situations and lack of confidence to make decisions founded on evidence-based guidelines. Conclusion Participants lacked confidence and autonomy to manage elderly people with diabetes in municipal care settings. Lack of information, support, and professional cohesion made the role challenging. PMID:24205973

Coping Styles as Moderating the Relationships between Terrorist Attacks and Well-Being Outcomes

ERIC Educational Resources Information Center

Braun-Lewensohn, Orna; Celestin-Westreich, Smadar; Celestin, Leon-Patrice; Verleye, Gino; Verte, Dominique; Ponjaert-Kristoffersen, Ingrid

2009-01-01

This study aims to explore use of coping strategies among adolescents and their relationships with well being in the context of ongoing terrorism. Furthermore, we aim to explore to what extent coping styles in addition to exposure variables explain well being of adolescents facing ongoing terror. During September 2003, after three years of ongoing…

Managing climate change refugia for climate adaptation

USGS Publications Warehouse

Morelli, Toni L.; Jackson, Stephen T.

2016-01-01

Refugia have long been studied from paleontological and biogeographical perspectives to understand how populations persisted during past periods of unfavorable climate. Recently, researchers have applied the idea to contemporary landscapes to identify climate change refugia, here defined as areas relatively buffered from contemporary climate change over time that enable persistence of valued physical, ecological, and socio-cultural resources. We differentiate historical and contemporary views, and characterize physical and ecological processes that create and maintain climate change refugia. We then delineate how refugia can fit into existing decision support frameworks for climate adaptation and describe seven steps for managing them. Finally, we identify challenges and opportunities for operationalizing the concept of climate change refugia. Managing climate change refugia can be an important option for conservation in the face of ongoing climate change.

Radiation and cancer risk: a continuing challenge for epidemiologists

PubMed Central

2011-01-01

This paper provides a perspective on epidemiological research on radiation and cancer, a field that has evolved over its six decade history. The review covers the current framework for assessing radiation risk and persistent questions about the details of these risks: is there a threshold and more generally, what is the shape of the dose-response relationship? How do risks vary over time and with age? What factors modify the risk of radiation? The example of radon progeny and lung cancer is considered as a case study, illustrating the modeling of epidemiological data to derive quantitative models and the coherence of the epidemiological and biological evidence. Finally, the manuscript considers the need for ongoing research, even in the face of research over a 60-year span. PMID:21489214

Trading off short-term and long-term risk: minimizing the threat of Laysan duck extinction from catastrophes and sea-level rise

USGS Publications Warehouse

Reynolds, Michelle; McGowan, Conor P.; Converse, Sarah J.; Mattsson, Brady; Hatfield, Jeffrey S.; McClung, Andrew; Mehrhoff, Loyal; Walters, Jeffrey R.; Uyehara, Kim

2010-01-01

Conservation of oceanic island species presents many ecological and logistical challenges. The Northwestern Hawaiian Islands (NWHI) include 300,000 km2 of ocean waters and 10 groups of sub-tropical islands and atolls of high conservation value. Designated as Papahanaumokuakea Marine National Monument, the islands provide habitat for four endangered species of terrestrial birds. Despite their protected status, many of these species are faced with the ongoing threat of extinction due to stochastic catastrophes such as disease, invasive mammal introductions, tsunamis, and hurricanes. To reduce the risk that a single catastrophe would lead to extinction, managers propose to restore multiple "insurance" populations on islands currently unoccupied by these species to increase their range and overall numbers.

Professional Development Strategies to Enhance Nurses' Knowledge and Maintain Safe Practice.

PubMed

Bindon, Susan L

2017-08-01

Maintaining competence is a professional responsibility for nurses. Individual nurses are accountable for their practice, as outlined in the American Nurses Association's Nursing: Scope and Standards of Practice. Nurses across clinical settings face the sometimes daunting challenge of staying abreast of regulatory mandates, practice changes, equipment updates, and other workplace expectations. In the complex, evolving perioperative setting, professional development is a priority, and the need for ongoing education is critical. However, nurses' efforts to engage in their own development can be hampered by a lack of time, limited access to educational resources, or cost concerns. This article provides an overview of nursing professional development and offers some resources to help individual nurses maintain or enhance their knowledge, skills, and attitudes. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

The battle within: understanding the physiology of war-zone stress exposure.

PubMed

Bruner, Victoria E; Woll, Pamela

2011-01-01

Faced with pervasive loss, life threat, and moral conflict in the field of battle, the human body and brain adapt to extraordinary circumstances in extraordinary ways. These adaptations come at a high price, and many men and women returning from Iraq and Afghanistan are paying that price every day. For the clinician who seeks to help, an understanding of the physiology of war-zone stress and resilience is an essential foundation, both for recovery from post-traumatic stress disorder and other conditions, and for addressing the stigma and shame that keep many service members and veterans from seeking and accepting the help and support they need. This article explores ways in which the body and brain adapt to war-zone stress, resulting challenges, and implications for clinical services and ongoing recovery.

Managing Climate Change Refugia for Climate Adaptation.

PubMed

Morelli, Toni Lyn; Daly, Christopher; Dobrowski, Solomon Z; Dulen, Deanna M; Ebersole, Joseph L; Jackson, Stephen T; Lundquist, Jessica D; Millar, Constance I; Maher, Sean P; Monahan, William B; Nydick, Koren R; Redmond, Kelly T; Sawyer, Sarah C; Stock, Sarah; Beissinger, Steven R

2016-01-01

Refugia have long been studied from paleontological and biogeographical perspectives to understand how populations persisted during past periods of unfavorable climate. Recently, researchers have applied the idea to contemporary landscapes to identify climate change refugia, here defined as areas relatively buffered from contemporary climate change over time that enable persistence of valued physical, ecological, and socio-cultural resources. We differentiate historical and contemporary views, and characterize physical and ecological processes that create and maintain climate change refugia. We then delineate how refugia can fit into existing decision support frameworks for climate adaptation and describe seven steps for managing them. Finally, we identify challenges and opportunities for operationalizing the concept of climate change refugia. Managing climate change refugia can be an important option for conservation in the face of ongoing climate change.

Managing Climate Change Refugia for Climate Adaptation

PubMed Central

Daly, Christopher; Dobrowski, Solomon Z.; Dulen, Deanna M.; Ebersole, Joseph L.; Jackson, Stephen T.; Lundquist, Jessica D.; Millar, Constance I.; Maher, Sean P.; Monahan, William B.; Nydick, Koren R.; Redmond, Kelly T.; Sawyer, Sarah C.; Stock, Sarah; Beissinger, Steven R.

2016-01-01

Refugia have long been studied from paleontological and biogeographical perspectives to understand how populations persisted during past periods of unfavorable climate. Recently, researchers have applied the idea to contemporary landscapes to identify climate change refugia, here defined as areas relatively buffered from contemporary climate change over time that enable persistence of valued physical, ecological, and socio-cultural resources. We differentiate historical and contemporary views, and characterize physical and ecological processes that create and maintain climate change refugia. We then delineate how refugia can fit into existing decision support frameworks for climate adaptation and describe seven steps for managing them. Finally, we identify challenges and opportunities for operationalizing the concept of climate change refugia. Managing climate change refugia can be an important option for conservation in the face of ongoing climate change. PMID:27509088

The challenge of doing what is right in renal transplantation: balancing equity and utility.

PubMed

Courtney, Aisling E; Maxwell, Alexander P

2009-01-01

Arguably the greatest challenge faced by the transplant community is the disparity between the number of persons waiting for a solid organ transplant and the finite supply of donor organs. For renal transplantation the gap between supply and demand has risen annually reflecting the increasing prevalence of end-stage renal disease versus the relatively static deceased donor organ pool. Maximising the benefit from this scarce resource raises difficult ethical issues. For most patients on dialysis therapy a successful transplant offers improved quality and quantity of life, but the absolute gain in survival provided by a donated organ varies greatly depending on recipient factors such as age and co-morbid illnesses. The philosophies of equity (a fair opportunity for everyone in need to receive a transplant) and utility (optimal profit from each organ) are often competing. National allocation schemes and local policies regarding assessment of potential recipients and acceptance of organs are designed to balance these ethical principles in a standardized and socially acceptable manner. The ongoing debate surrounding these issues and modifications to such policies reflect the evolving clinical picture of renal transplantation and the challenge in maintaining equipoise between renal transplant utility and equity. Copyright 2008 S. Karger AG, Basel.

Advanced life support (ALS) instructors experience of ALS education in Western Australia: a qualitative exploratory research study.

PubMed

Taplin, John; McConigley, Ruth

2015-04-01

When cardiac arrest occurs, timely competent advanced life support (ALS) interventions by nursing staff can influence patient outcomes. Ongoing ALS education influences maintenance of competency and avoids skill decay. To explore the methods of ALS education delivery for nurses in the workplace; describe the issues relating to maintaining ALS competency; explore ALS competency decay for nurses and develop recommendations for the provision of continuing ALS education. A qualitative exploratory design was used to study ALS education provision in the workplace. Data were collected from ALS nurse experts in Western Australia by face-to-face and phone interviews. Semi-structured interviews were conducted and organised around a set of predetermined questions. Two major themes were identified; the first theme Demand and Supply describes the increasing demand for ALS education for nurses and the challenges with providing timely cost effective traditional face-to-face ALS education. The second theme, Choosing The Best Education Options describes new ways to provide ALS education using emerging technologies. The study suggested that using e-learning methods would assist with educating the maximum amount of nurses in a timely manner and e-learning and teleconferencing offer opportunities to reach nurses in distant locations. Delivering ALS education more frequently than annually would increase skills maintenance and lessen skill decay. Further research is required to explore which blended e-learning model is best suited to ALS education. Copyright © 2014 Elsevier Ltd. All rights reserved.

Online Resource Utilization in a Hybrid Course in Engineering Graphics

ERIC Educational Resources Information Center

Wiebe, Eric N.; Branoff, Theodore J.; Shreve, Mark A.

2011-01-01

This presentation focuses on an ongoing instructional innovation research and development project centered around the development of a blended, online and face-to-face introductory engineering graphics course. The work presented here is an in-depth analysis of how students make use of the online resources to supplement the instructional support…

Beginning Teacher Induction in Secondary Schools: A Best Practice Case Study

ERIC Educational Resources Information Center

Kearney, Sean

2017-01-01

Beginning teacher induction is becoming an increasingly popular process in acculturating teachers to their new careers. The problems that teachers face early in their careers are well known, and effective and ongoing induction is one of the foremost practices for alleviating the pressures that teachers face early in their careers. While induction…

Anticipated Ongoing Interaction versus Channel Effects of Relational Communication in Computer-Mediated Interaction.

ERIC Educational Resources Information Center

Walther, Joseph B.

1994-01-01

Assesses the related effects of anticipated future interaction and different communication media (computer-mediated versus face-to-face communication) on the communication of relational intimacy and composure. Shows that the assignment of long-term versus short-term partnerships has a larger impact on anticipated future interaction reported by…

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Supporting new science teachers in pursuing socially just science education

NASA Astrophysics Data System (ADS)

Ruggirello, Rachel; Flohr, Linda

2017-10-01

This forum explores contradictions that arose within the partnership between Teach for America (TFA) and a university teacher education program. TFA is an alternate route teacher preparation program that places individuals into K-12 classrooms in low-income school districts after participating in an intense summer training program and provides them with ongoing support. This forum is a conversation about the challenges we faced as new science teachers in the TFA program and in the Peace Corps program. We both entered the teaching field with science degrees and very little formal education in science education. In these programs we worked in a community very different from the one we had experienced as students. These experiences allow us to address many of the issues that were discussed in the original paper, namely teaching in an unfamiliar community amid challenges that many teachers face in the first few years of teaching. We consider how these challenges may be amplified for teachers who come to teaching through an alternate route and may not have as much pedagogical training as a more traditional teacher education program provides. The forum expands on the ideas presented in the original paper to consider the importance of perspectives on socially just science education. There is often a disconnect between what is taught in teacher education programs and what teachers actually experience in urban classrooms and this can be amplified when the training received through alternate route provides a different framework as well. This forum urges universities and alternate route programs to continue to find ways to authentically partner using practical strategies that bring together the philosophies and goals of all stakeholders in order to better prepare teachers to partner with their students to achieve their science learning goals.

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

ERIC Educational Resources Information Center

Ahumada, Luis; Galdames, Sergio; Clarke, Simon

2016-01-01

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

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

PubMed

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

2013-04-24

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

Cancer survivorship: challenges and changing paradigms.

PubMed

Gilbert, Scott M; Miller, David C; Hollenbeck, Brent K; Montie, James E; Wei, John T

2008-02-01

We summarize the potential issues faced by cancer survivors, define a conceptual framework for cancer survivorship, describe challenges associated with improving the quality of survivorship care and outline proposed survivorship programs that may be implemented going forward. We performed a nonsystematic review of current cancer survivorship literature. Given the comprehensive scope and high profile, the recent report by the Institute of Medicine, From Cancer Patient to Cancer Survivor: Lost in Transition, served as the principal guide for the review. In recognition of the increasing number of cancer survivors in the United States survivorship has become an important health care concern. The recent report by the Institute of Medicine comprehensively outlined deficits in the care provided to cancer survivors, and proposed mechanisms to improve the coordination and quality of followup care for this increasing number of Americans. Measures to achieve these objectives include improving communication between health care providers through a survivorship care plan, providing evidence based surveillance guidelines and assessing different models of survivorship care. Implementing coordinated survivorship care broadly will require additional health care resources, and commitment from health care providers and payers. Research demonstrating the effectiveness of survivorship care will be important on this front. Potential shortcomings in the recognition and management of ongoing issues faced by cancer survivors may impact the overall quality of long-term care in this increasing population. Although programs to address these issues have been proposed, there is substantial work to be done in this area.

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

PubMed Central

Kehl, Karen A.; Gartner, Constance M.

2010-01-01

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

Putting Faces on the Data: What Great Leaders Do!

ERIC Educational Resources Information Center

Sharratt, Lyn; Fullan, Michael

2012-01-01

Students are people--not data. Assessment data can bury you or give you focused information on how to reach every student. "Putting Faces on the Data" shows how to develop a common language for sharing all students' progress with all teachers and leaders and how to use ongoing assessment to inform instruction. Based on worldwide research from more…

Science education in urban settings: Seeking new ways of praxis through critical ethnography

NASA Astrophysics Data System (ADS)

Calabrese Barton, Angela

2001-10-01

The challenges faced in urban science education are deeply rooted in the ongoing struggle for racial, class and gender equity. Part of this struggle is tied to huge differences in class and involves making more equitable the distribution of resources. Another part of this struggle is tied to the rich diversity of children who attend urban schools and involves generating new ways of understanding, valuing, and genuinely incorporating into school-based practices the culture, language, beliefs, and experiences that these children bring to school. Thus, this article argues that to address these two challenges - and indeed to achieve a more just science education for all urban students - explicitly political research methodologies must be considered and incorporated into urban education. One potential route for this is critical ethnography, for this kind of methodology emerges collaboratively from the lives of the researcher and the researched and is centrally about praxis and a political commitment to the struggle for liberation and in defense of human rights. In making this argument, I have drawn from stories from my own research with homeless children.

Probes, Moons, and Kinetic Plasma Wakes

NASA Astrophysics Data System (ADS)

Hutchinson, I. H.; Malaspina, D.; Zhou, C.

2017-10-01

Nonmagnetic objects as varied as probes in tokamaks or moons in space give rise to flowing plasma wakes in which strong distortions of the ion and electron velocity distributions cause electrostatic instabilities. Non-linear phenomena such as electron holes are then produced. Historic probe theory largely ignores the resulting unstable character of the wake, but since we can now simulate computationally the non-linear wake phenomena, a timely challenge is to reassess the influence of these instabilities both on probe measurements and on the wakes themselves. Because the electron instability wavelengths are very short (typically a few Debye-lengths), controlled laboratory experiments face serious challenges in diagnosing them. That is one reason why they have long been neglected as an influence in probe interpretation. Space-craft plasma observations, by contrast, easily obtain sub-Debye-length resolution, but have difficulty with larger-scale reconstruction of the plasma spatial variation. In addition to surveying our developing understanding of wakes in magnetized plasmas, ongoing analysis of Artemis data concerning electron holes observed in the solar-wind lunar wake will be featured. Work partially supported by NASA Grant NNX16AG82G.

Is "processed" a four-letter word? The role of processed foods in achieving dietary guidelines and nutrient recommendations.

PubMed

Dwyer, Johanna T; Fulgoni, Victor L; Clemens, Roger A; Schmidt, David B; Freedman, Marjorie R

2012-07-01

This paper, based on the symposium "Is 'Processed' a Four-Letter Word? The Role of Processed Foods in Achieving Dietary Guidelines and Nutrient Recommendations in the U.S." describes ongoing efforts and challenges at the nutrition-food science interface and public health; addresses misinformation about processed foods by showing that processed fruits and vegetables made important dietary contributions (e.g., fiber, folate, potassium, vitamins A and C) to nutrient intake among NHANES 2003-2006 participants, that major sources of vitamins (except vitamin K) were provided by enrichment and fortification and that enrichment and fortification helped decrease the percentage of the population below the Estimated Average Requirement for vitamin A, thiamin, folate, and iron; describes how negative consumer perceptions and consumer confusion about processed foods led to the development of science-based information on food processing and technology that aligns with health objectives; and examines challenges and opportunities faced by food scientists who must balance consumer preferences, federal regulations, and issues surrounding food safety, cost, unintended consequences, and sustainability when developing healthful foods that align with dietary guidelines.

A Global Model for Effective Use and Evaluation of e-Learning in Health

PubMed Central

Farrington, Conor; Brayne, Carol

2013-01-01

Abstract Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of “information overload” have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and “digital literacy” and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning. PMID:23472702

The FLEXGene repository: exploiting the fruits of the genome projects by creating a needed resource to face the challenges of the post-genomic era.

PubMed

Brizuela, Leonardo; Richardson, Aaron; Marsischky, Gerald; Labaer, Joshua

2002-01-01

Thanks to the results of the multiple completed and ongoing genome sequencing projects and to the newly available recombination-based cloning techniques, it is now possible to build gene repositories with no precedent in their composition, formatting, and potential. This new type of gene repository is necessary to address the challenges imposed by the post-genomic era, i.e., experimentation on a genome-wide scale. We are building the FLEXGene (Full Length EXpression-ready) repository. This unique resource will contain clones representing the complete ORFeome of different organisms, including Homo sapiens as well as several pathogens and model organisms. It will consist of a comprehensive, characterized (sequence-verified), and arrayed gene repository. This resource will allow full exploitation of the genomic information by enabling genome-wide scale experimentation at the level of functional/phenotypic assays as well as at the level of protein expression, purification, and analysis. Here we describe the rationale and construction of this resource and focus on the data obtained from the Saccharomyces cerevisiae project.

Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

PubMed

Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

2015-11-01

Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.

A global model for effective use and evaluation of e-learning in health.

PubMed

Ruggeri, Kai; Farrington, Conor; Brayne, Carol

2013-04-01

Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of "information overload" have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and "digital literacy" and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

A service-oriented approach to assessing the infrastructure value index.

PubMed

Amaral, R; Alegre, H; Matos, J S

Many national and regional administrations are currently facing challenges to ensure long-term sustainability of urban water services, as infrastructures continue to accumulate alarming levels of deferred maintenance and rehabilitation. The infrastructure value index (IVI) has proven to be an effective tool to support long-term planning, in particular by facilitating the ability to communicate and to create awareness. It is given by the ratio between current value of an infrastructure and its replacement cost. Current value is commonly estimated according to an asset-oriented approach, which is based on the concept of useful life of individual components. The standard values assumed for the useful lives can vary significantly, which leads to valuations that are just as different. Furthermore, with water companies increasingly focused on the customer, effective service-centric asset management is essential now more than ever. This paper shows results of on-going research work, which aims to explore a service-oriented approach for assessing the IVI. The paper presents the fundamentals underlying this approach, discusses and compares results obtained from both perspectives and points to challenges that still need to be addressed.

Animal models of post-ischemic forced use rehabilitation: methods, considerations, and limitations

PubMed Central

2013-01-01

Many survivors of stroke experience arm impairments, which can severely impact their quality of life. Forcing use of the impaired arm appears to improve functional recovery in post-stroke hemiplegic patients, however the mechanisms underlying improved recovery remain unclear. Animal models of post-stroke rehabilitation could prove critical to investigating such mechanisms, however modeling forced use in animals has proven challenging. Potential problems associated with reported experimental models include variability between stroke methods, rehabilitation paradigms, and reported outcome measures. Herein, we provide an overview of commonly used stroke models, including advantages and disadvantages of each with respect to studying rehabilitation. We then review various forced use rehabilitation paradigms, and highlight potential difficulties and translational problems. Lastly, we discuss the variety of functional outcome measures described by experimental researchers. To conclude, we outline ongoing challenges faced by researchers, and the importance of translational communication. Many stroke patients rely critically on rehabilitation of post-stroke impairments, and continued effort toward progression of rehabilitative techniques is warranted to ensure best possible treatment of the devastating effects of stroke. PMID:23343500

The importance of living botanical collections for plant biology and the “next generation” of evo-devo research

PubMed Central

Dosmann, Michael; Groover, Andrew

2012-01-01

Living botanical collections include germplasm repositories, long-term experimental plantings, and botanical gardens. We present here a series of vignettes to illustrate the central role that living collections have played in plant biology research, including evo-devo research. Looking toward the future, living collections will become increasingly important in support of future evo-devo research. The driving force behind this trend is nucleic acid sequencing technologies, which are rapidly becoming more powerful and cost-effective, and which can be applied to virtually any species. This allows for more extensive sampling, including non-model organisms with unique biological features and plants from diverse phylogenetic positions. Importantly, a major challenge for sequencing-based evo-devo research is to identify, access, and propagate appropriate plant materials. We use a vignette of the ongoing 1,000 Transcriptomes project as an example of the challenges faced by such projects. We conclude by identifying some of the pinch points likely to be encountered by future evo-devo researchers, and how living collections can help address them. PMID:22737158

Integrated Data Capturing Requirements for 3d Semantic Modelling of Cultural Heritage: the Inception Protocol

NASA Astrophysics Data System (ADS)

Di Giulio, R.; Maietti, F.; Piaia, E.; Medici, M.; Ferrari, F.; Turillazzi, B.

2017-02-01

The generation of high quality 3D models can be still very time-consuming and expensive, and the outcome of digital reconstructions is frequently provided in formats that are not interoperable, and therefore cannot be easily accessed. This challenge is even more crucial for complex architectures and large heritage sites, which involve a large amount of data to be acquired, managed and enriched by metadata. In this framework, the ongoing EU funded project INCEPTION - Inclusive Cultural Heritage in Europe through 3D semantic modelling proposes a workflow aimed at the achievements of efficient 3D digitization methods, post-processing tools for an enriched semantic modelling, web-based solutions and applications to ensure a wide access to experts and non-experts. In order to face these challenges and to start solving the issue of the large amount of captured data and time-consuming processes in the production of 3D digital models, an Optimized Data Acquisition Protocol (DAP) has been set up. The purpose is to guide the processes of digitization of cultural heritage, respecting needs, requirements and specificities of cultural assets.

Progress and future direction for the interim safe storage and disposal of Hanford high-level waste

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

Kinzer, J.E.; Wodrich, D.D.; Bacon, R.F.

This paper describes the progress made at the largest environmental cleanup program in the United States. Substantial advances in methods to start interim safe storage of Hanford Site high-level wastes, waste characterization to support both safety- and disposal-related information needs, and proceeding with cost-effective disposal by the U.S. Department of Energy (DOE) and its Hanford Site contractors, have been realized. Challenges facing the Tank Waste Remediation System (TWRS) Program, which is charged with the dual and parallel missions of interim safe storage and disposal of the high-level tank waste stored at the Hanford Site, are described. In these times ofmore » budget austerity, implementing an ongoing program that combines technical excellence and cost effectiveness is the near-term challenge. The technical initiatives and progress described in this paper are made more cost effective by DOE`s focus on work force productivity improvement, reduction of overhead costs, and reduction, integration and simplification of DOE regulations and operations requirements to more closely model those used in the private sector.« less

Commercial Video Games As Therapy: A New Research Agenda to Unlock the Potential of a Global Pastime.

PubMed

Colder Carras, Michelle; Van Rooij, Antonius J; Spruijt-Metz, Donna; Kvedar, Joseph; Griffiths, Mark D; Carabas, Yorghos; Labrique, Alain

2017-01-01

Emerging research suggests that commercial, off-the-shelf video games have potential applications in preventive and therapeutic medicine. Despite these promising findings, systematic efforts to characterize and better understand this potential have not been undertaken. Serious academic study of the therapeutic potential of commercial video games faces several challenges, including a lack of standard terminology, rapidly changing technology, societal attitudes toward video games, and understanding and accounting for complex interactions between individual, social, and cultural health determinants. As a vehicle to launch a new interdisciplinary research agenda, the present paper provides background information on the use of commercial video games for the prevention, treatment, and rehabilitation of mental and other health conditions, and discusses ongoing grassroots efforts by online communities to use video games for healing and recovery.

A literature review for large-scale health information system project planning, implementation and evaluation.

PubMed

Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

2017-01-01

Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Generations of interdisciplinarity in bioinformatics

PubMed Central

Bartlett, Andrew; Lewis, Jamie; Williams, Matthew L.

2016-01-01

Bioinformatics, a specialism propelled into relevance by the Human Genome Project and the subsequent -omic turn in the life science, is an interdisciplinary field of research. Qualitative work on the disciplinary identities of bioinformaticians has revealed the tensions involved in work in this “borderland.” As part of our ongoing work on the emergence of bioinformatics, between 2010 and 2011, we conducted a survey of United Kingdom-based academic bioinformaticians. Building on insights drawn from our fieldwork over the past decade, we present results from this survey relevant to a discussion of disciplinary generation and stabilization. Not only is there evidence of an attitudinal divide between the different disciplinary cultures that make up bioinformatics, but there are distinctions between the forerunners, founders and the followers; as inter/disciplines mature, they face challenges that are both inter-disciplinary and inter-generational in nature. PMID:27453689

Microbiological Quantitative Risk Assessment

NASA Astrophysics Data System (ADS)

Dominguez, Silvia; Schaffner, Donald W.

The meat and poultry industry faces ongoing challenges due to the natural association of pathogens of concern (e.g., Salmonella, Campylobacter jejuni, Escherichia coli O157:H7) with a variety of domesticated food animals. In addition, pathogens such as Listeria monocytogenes pose a significant cross-contamination risk during further meat and poultry processing, distribution, and storage. Furthermore, the meat and poultry industries are constantly changing with the addition of new products, use of new raw materials, and targeting of new consumer populations, each of which may give rise to potential new risks. National and international regulations are increasingly using a “risk-based” approach to food safety (where the regulatory focus is driven by the magnitude of the risk), so risk assessment is becoming a valuable tool to systematically organize and evaluate the potential public health risk posed by food processing operations.

Environmental Progression: The Psychological Justification for Reframing Climate Change and Global Warming

NASA Astrophysics Data System (ADS)

Veldey, S. H.

2016-12-01

On-going research in climate science communication through environmental media has uncovered critical barriers to reducing denial and increasing agency in addressing the threat of climate change. Similar to framing of our changing environment as "global warming", the term "climate change" also fails to properly frame the most critical challenge our species has faced. In a set of preliminary studies, significant changes in climate crisis denial, both positive and negative, have resulted from different media messaging. Continuation of this research utilizes social judgement theory (SJT) to classify a broader spectrum of effective avenues for environmental communication. The specificity of the terms global warming and climate change limit inclusion of issues critical to understanding their impacts. Now that the masses know what climate change is, it's time to teach them what it means.

The NIH analytical methods and reference materials program for dietary supplements.

PubMed

Betz, Joseph M; Fisher, Kenneth D; Saldanha, Leila G; Coates, Paul M

2007-09-01

Quality of botanical products is a great uncertainty that consumers, clinicians, regulators, and researchers face. Definitions of quality abound, and include specifications for sanitation, adventitious agents (pesticides, metals, weeds), and content of natural chemicals. Because dietary supplements (DS) are often complex mixtures, they pose analytical challenges and method validation may be difficult. In response to product quality concerns and the need for validated and publicly available methods for DS analysis, the US Congress directed the Office of Dietary Supplements (ODS) at the National Institutes of Health (NIH) to accelerate an ongoing methods validation process, and the Dietary Supplements Methods and Reference Materials Program was created. The program was constructed from stakeholder input and incorporates several federal procurement and granting mechanisms in a coordinated and interlocking framework. The framework facilitates validation of analytical methods, analytical standards, and reference materials.

Development of the INEEL Site Wide Vadose Zone Roadmap

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

Yonk, Alan Keith

2001-09-01

The INEEL Vadose Zone Roadmap was developed to identify inadquacies in current knowledge, to assist in contaminant management capabilities relative to the INEEL vadose zone, and to ensure that ongoing and planned Science and Technology developments will meet the risk management challenges facing the INEEL in coming years. The primary objective of the Roadmap is to determine the S&T needs that will facilitate monitoring, characterization, prediction, and assessment activities necessary to support INEEL risk management decisions and to ensure that long-term stewardship of contaminated sites at the INEEL is achieved. The mission of the Roadmap is to insure that themore » long-term S&T strategy is aligned with site programs, that it takes advantage of progress made to date, and that it can assist in meeting the milestones and budgets of operations.« less

Preventing ARDS

PubMed Central

Beitler, Jeremy R.; Schoenfeld, David A.

2014-01-01

Advances in critical care practice have led to a substantial decline in the incidence of ARDS over the past several years. Low tidal volume ventilation, timely resuscitation and antimicrobial administration, restrictive transfusion practices, and primary prevention of aspiration and nosocomial pneumonia have likely contributed to this reduction. Despite decades of research, there is no proven pharmacologic treatment of ARDS, and mortality from ARDS remains high. Consequently, recent initiatives have broadened the scope of lung injury research to include targeted prevention of ARDS. Prediction scores have been developed to identify patients at risk for ARDS, and clinical trials testing aspirin and inhaled budesonide/formoterol for ARDS prevention are ongoing. Future trials aimed at preventing ARDS face several key challenges. ARDS has not been validated as an end point for pivotal clinical trials, and caution is needed when testing toxic therapies that may prevent ARDS yet potentially increase mortality. PMID:25288000

Commercial Video Games As Therapy: A New Research Agenda to Unlock the Potential of a Global Pastime

PubMed Central

Colder Carras, Michelle; Van Rooij, Antonius J.; Spruijt-Metz, Donna; Kvedar, Joseph; Griffiths, Mark D.; Carabas, Yorghos; Labrique, Alain

2018-01-01

Emerging research suggests that commercial, off-the-shelf video games have potential applications in preventive and therapeutic medicine. Despite these promising findings, systematic efforts to characterize and better understand this potential have not been undertaken. Serious academic study of the therapeutic potential of commercial video games faces several challenges, including a lack of standard terminology, rapidly changing technology, societal attitudes toward video games, and understanding and accounting for complex interactions between individual, social, and cultural health determinants. As a vehicle to launch a new interdisciplinary research agenda, the present paper provides background information on the use of commercial video games for the prevention, treatment, and rehabilitation of mental and other health conditions, and discusses ongoing grassroots efforts by online communities to use video games for healing and recovery. PMID:29403398

Nursing implications of personalized and precision medicine.

PubMed

Vorderstrasse, Allison A; Hammer, Marilyn J; Dungan, Jennifer R

2014-05-01

Identify and discuss the nursing implications of personalized and precision oncology care. PubMed, CINAHL. The implications in personalized and precision cancer nursing care include interpretation and clinical use of novel and personalized information including genetic testing; patient advocacy and support throughout testing, anticipation of results and treatment; ongoing chronic monitoring; and support for patient decision-making. Attention must also be given to the family and ethical implications of a personalized approach to care. Nurses face increasing challenges and opportunities in communication, support, and advocacy for patients given the availability of advanced testing, care and treatment in personalized and precision medicine. Nursing education and continuing education, clinical decision support, and health systems changes will be necessary to provide personalized multidisciplinary care to patients, in which nurses play a key role. Copyright © 2014 Elsevier Inc. All rights reserved.

Homeland Security. Management Challenges Facing Federal Leadership

DTIC Science & Technology

2002-12-01

Security Management Challenges Facing Federal Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...including attention to management practices and key success factors. HOMELAND SECURITY Management Challenges Facing Federal Leadership www.gao.gov/cgi...significant management and coordination challenges if it is to provide this leadership and be successful in preventing and responding to any future

Powering nanorobotic devices: challenges and future strategies

NASA Astrophysics Data System (ADS)

Sankar, Krishna Moorthi

2014-04-01

Nanotechnology, even after 55 years since its foundation (1959 Richard Feynman's speech - `There is lot of space in the bottom'), is still in its infancy. However, of late, there has been a large increase in the research being done in this field in many prominent Universities and Research institutions across the globe. Nanorobotics is the combination of Nanotechnology and the science of Robotics, to create robots that are only a few nanometres (10-9 metres) in size. Nanobots are yet to be made. But with the current pace of ongoing researches, scientists predict that nanobots will be made a reality by next ten years. The main proposed function of nanobots is to use them in the medical field to interact with cells or intra-cellular substances and prevent or reverse structural and genetical problems and diseases. One of the major challenges faced while creating a nanobot to travel through human body is to power it. Nanobots would require a very small yet highly potential source of energy. There are many hypothesised energy sources for nanobots which are either already available within the human body naturally or which are to be supplied externally. But, all of these energy sources pose a few challenges which need to be addressed if they are to be used to power nanobots. These challenges can be overcome using a number of strategies that can be used to make an economically, ecologically and medically viable energy source.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA.

PubMed

Doyle, John T; Kindness, Larry; Realbird, James; Eggers, Margaret J; Camper, Anne K

2018-03-21

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps-especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges.

Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA

PubMed Central

Doyle, John T.; Kindness, Larry; Realbird, James; Camper, Anne K.

2018-01-01

Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. PMID:29561815

Telerehabilitation Clinical and Vocational Applications for Assistive Technology: Research, Opportunities, and Challenges

PubMed Central

Schmeler, Mark R.; Schein, Richard M.; McCue, Michael; Betz, Kendra

2009-01-01

Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent in coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise may be troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper. PMID:25945163

Synergistic vulnerabilities: antiretroviral treatment among women in Uganda.

PubMed

Winchester, Margaret S

2015-01-01

Despite being an early success story in the reduction of HIV infection rates, Uganda faces myriad challenges in the recent era of accelerated antiretroviral treatment (ARV) scale-up. For those able to access treatment, ongoing vulnerabilities of poverty and violence compound treatment-related costs and concerns. This paper explores experiences of one particularly vulnerable population - women on ARVs who have also experienced intimate partner violence (IPV). Data were collected over 12 months in Uganda. They include ethnographic interviews (n = 40) drawn from a larger sample of women on ARV and semi-structured interviews with policy-makers and service providers (n = 42), examining the intersection of experiences and responses to treatment from multiple perspectives. Women's narratives show that due to treatment, immediate health concerns take on secondary importance, while other forms of vulnerability, including IPV and poverty, can continue to shape treatment experiences and the decision to stay in violent relationships. Providers likewise face difficulties in overburdened clinics, though they recognise women's concerns and the importance of considering other forms of vulnerability in treatment. This analysis makes the case for integrating treatment with other types of social services and demonstrates the importance of understanding the ways in which synergistic and compounding vulnerabilities confound treatment scale-up efforts.

Deteriorating food security in India

NASA Astrophysics Data System (ADS)

Milesi, C.; Samanta, A.; Hashimoto, H.; Kumar, K.; Ganguly, S.; Thenkabail, P. S.; Srivastava, A. N.; Nemani, R. R.; Myneni, R. B.

2009-12-01

One of the major challenges we face on our planet is increasing agricultural production to meet the dietary requirements of an additional 2.5 billion people by the mid of the century while limiting cropland expansion and other damages to natural resources. This problem is even more so challenging given that nearly all the population growth will take place where the majority of the hungry live today and where ongoing and future climate changes are projected to most negatively impact agricultural production, the semi-arid tropics (SAT). The SAT contain 40% of the global irrigated and rainfed croplands in over 50 developing countries and a growing population of over a billion and half people, many of which live in absolute poverty and strongly depend on agriculture that is constrained by chronic water shortages. Rates of food grain production in many of the countries of the SAT have progressively increased since the mid 1960s aided by the Green Revolution and relatively favourable climatic conditions. However, aggregated agricultural production statistics indicate that the rate of food grain production has recently stalled or declined in several of the countries in this region, escalating the concerns over matters of food security, that is availability of food and one’s access to it, in a region where many people live in extreme poverty, depend on an agrarian economy and are expected to face increasingly worse climatic conditions in the near future. In this paper we analyze the agricultural deceleration and its drivers over the country of India, which faces the daunting challenge of needing a 50-100% increase in yields of major crops by the middle to the 21st century to feed its growing population. We analyze the long term (1982-2006) record of the Normalized Difference Vegetation Index (NDVI) from the National Oceanic and Atmospheric Administration’s Advanced Very High Resolution Radiometer (NOAA/AVHRR) together with climate, land use, and crop production statistics. We show that while there are no significant changes in long-term precipitation, there are geographically matching patterns of enhanced crop production and irrigation expansion with groundwater, initially, but both of which have levelled off in the past decade. In addition to increasing pressure on water resources, a decline in expansion of cropland area, a warming climate and increasing air pollution compound to challenging long term food security in India.

Coordinated clinical and financial analysis as a powerful tool to influence vendor pricing.

PubMed

Logan, Catherine A; Wu, Roger Y; Mulley, Debra; Smith, Paul C; Schwaitzberg, Steven D

2010-01-01

As costs continue to outpace reimbursements, hospital administrators and clinicians face increasing pressure to justify new capital purchases. Massachusetts Health Care Reform has added further economic challenges for Disproportionate Share Hospitals (DSH), as resources formerly available to treat the uninsured have been redirected. In this challenging climate, many hospitals still lack a standardized process for technology planning and/or vendor negotiation. : The purpose of this study was to determine whether a simple, coordinated clinical and financial analysis of a technology, Endoscopic Carpal Tunnel Release (ECTR), is sufficient to impact vendor pricing at Cambridge Health Alliance (CHA), a disproportionate share hospital (DSH) in Cambridge, Massachusetts. This case study addressed the topic of technology adoption, a complex decision-making process every hospital administration faces. Taking note of other hospitals approaches to instill a strategic management culture, CHA combined a literature review on clinical outcomes and financial analysis on profitability. Clinical effectiveness was evaluated through a literature review. The financial analysis was based on a retrospective inquiry of fixed and variable costs, reimbursement rates, actual payer mix, and profitability of adopting ECTR over open carpal tunnel release at CHA. This clinical and financial analysis was then shared with the vendor. A literature review revealed that although there are short-term benefits to ECTR, there is little to no difference in long-term outcomes to justify a calculated incremental loss of $91.49 in revenue per case. Sharing this analysis with the vendor resulted in a 30% price reduction. A revised cost analysis demonstrated a $53.51 incremental gain in revenue per case. CHA has since elected to offer ECTR to its patients. Smaller hospital systems often have modest leverage in vendor negotiations. Our results suggest that the development of adoption criteria and an evidence-based managerial approach can create dialogue with vendors and directly impact pricing. Coordinated clinical and financial analysis is a powerful tool, enabling administrators, clinicians, and medical device suppliers to work constructively to provide patients access to innovative technology, even in the face of a challenging payer mix. Ongoing assessment of clinical outcomes and financial data must be performed to reflect the most up-to-date scientific and economic climate.

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

ERIC Educational Resources Information Center

Black, Ronald

2017-01-01

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

Toward Deepening Cultural and Language Understanding: The Design and Practice of a Hybrid Business Chinese Course

ERIC Educational Resources Information Center

Wang, Haidan

2014-01-01

This article introduces an ongoing effort to use Internet resources in an Advanced Business Chinese for Professionals (ABCP) course in order to deepen learners' language and cultural understanding. This course blends face-to-face (F2F) classroom instruction and online communications using Brix, an online course management system developed by the…

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

ERIC Educational Resources Information Center

DuBose, Cheryl O.

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-02-01

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

Current Status of the Milky Stork Re-introduction Programme in Malaysia and Its Challenges

PubMed Central

Ismail, Ahmad; Rahman, Faid

2016-01-01

This review discussed the current status of the Milky Stork Re-introduction Programme in Malaysia and the challenges it faced. Although it has continued for almost seven years, more challenges appeared as time elapsed mainly due to the arising conflicts between the implementation of conservation policy versus the development projects in Kuala Gula. Hence, the released population is struggling to adapt mainly due to the reduction of suitable habitat for nesting and disturbed foraging areas by the continuous anthropogenic activities. Furthermore, the lack of appropriate training among captive storks prior to being released also slows the adaptation of the birds in their new habitat. The increasing pattern of pollution in the area is also highlighted. Several suggestions were given to help improve the current re-introduction programme. These include improvements to the captive training method, improvement of the existing enclosure’s condition and environment, protection of remaining mangrove forest, creation of a buffer zone to mitigate the increasing pollution level in the area, close monitoring of the released population, and maintaining continuous support and awareness among the public. Considering the ongoing anthropogenic activities that may impair the status of Kuala Gula as an important bird sanctuary, emphasis should be given to achieve sustainable development throughout the area. PMID:27688848

We stop for no storm: coping with an environmental disaster and public health research.

PubMed

Reifsnider, Elizabeth; Bishop, Sheryl L; An, Kyungeh; Mendias, Elnora; Welker-Hood, Kristen; Moramarco, Michael W; Davila, Yolanda R

2014-01-01

Coping with natural disasters is part of the public nurses' role, and the public health nursing (PHN) researcher is doubly challenged with continuing to conduct community-based research in the midst of the disaster. The PHN may provide service along with attempting to continue the research. The challenges faced by public/community health nurse researchers as a result of hurricane Ike are discussed to provide lessons for other public/community health researchers who may be affected by natural disasters in the future. It is important to consider challenges for recruitment and retention of research subjects after a disaster, impact of natural disasters on ongoing research, and opportunities for research to be found in coping with natural disasters. A community-based study that was in progress at the time of hurricane Ike will be used as an example for coping with a natural disaster. We will present "lessons learned" in the hope of helping researchers consider what can go wrong with research studies in the midst of natural disasters and how to proactively plan for keeping research reliable and valid when natural disasters occur. We will also discuss the opportunities for collaborations between researchers and the community following any disaster. © 2014 Wiley Periodicals, Inc.

Integrated landscape approaches to managing social and environmental issues in the tropics: learning from the past to guide the future.

PubMed

Reed, James; Van Vianen, Josh; Deakin, Elizabeth L; Barlow, Jos; Sunderland, Terry

2016-07-01

Poverty, food insecurity, climate change and biodiversity loss continue to persist as the primary environmental and social challenges faced by the global community. As such, there is a growing acknowledgement that conventional sectorial approaches to addressing often inter-connected social, environmental, economic and political challenges are proving insufficient. An alternative is to focus on integrated solutions at landscape scales or 'landscape approaches'. The appeal of landscape approaches has resulted in the production of a significant body of literature in recent decades, yet confusion over terminology, application and utility persists. Focusing on the tropics, we systematically reviewed the literature to: (i) disentangle the historical development and theory behind the framework of the landscape approach and how it has progressed into its current iteration, (ii) establish lessons learned from previous land management strategies, (iii) determine the barriers that currently restrict implementation of the landscape approach and (iv) provide recommendations for how the landscape approach can contribute towards the fulfilment of the goals of international policy processes. This review suggests that, despite some barriers to implementation, a landscape approach has considerable potential to meet social and environmental objectives at local scales while aiding national commitments to addressing ongoing global challenges. © 2016 John Wiley & Sons Ltd.

Using online learning in a traditional face-to-face environment.

PubMed

Kozlowski, Dawn

2002-01-01

A model for designing online learning was developed and implemented in a Registered Nurse-to-Bachelor of Science in Nursing course using online and face-to-face methodologies. The combination of online and face-to-face learning modalities may help the student who is a novice Internet explorer or seasoned Web navigator by offering technological support as well as providing constant in-person feedback regarding course requirements. The face-to-face component facilitates a sense of community and peer support that sometimes is lacking in an entirely online course. During the 2 semesters this model was used, students expressed satisfaction with having the course facilitator/professor physically available for consultation and advisement. Evaluation of this online/on-site course is ongoing and uses computer-administered qualitative questionnaires, a facilitator-moderated focus group, and Likert-type course evaluations.

Community in Online Higher Education: Challenges and Opportunities

ERIC Educational Resources Information Center

Arasaratnam-Smith, Lily A.; Northcote, Maria

2017-01-01

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

Challenges of Virtual School Leadership

ERIC Educational Resources Information Center

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

2015-01-01

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

Utilization of community pharmacy space to enhance privacy: a qualitative study.

PubMed

Hattingh, H Laetitia; Emmerton, Lynne; Ng Cheong Tin, Pascale; Green, Catherine

2016-10-01

Community pharmacists require access to consumers' information about their medicines and health-related conditions to make informed decisions regarding treatment options. Open communication between consumers and pharmacists is ideal although consumers are only likely to disclose relevant information if they feel that their privacy requirements are being acknowledged and adhered to. This study sets out to explore community pharmacy privacy practices, experiences and expectations and the utilization of available space to achieve privacy. Qualitative methods were used, comprising a series of face-to-face interviews with 25 pharmacists and 55 pharmacy customers in Perth, Western Australia, between June and August 2013. The use of private consultation areas for certain services and sensitive discussions was supported by pharmacists and consumers although there was recognition that workflow processes in some pharmacies may need to change to maximize the use of private areas. Pharmacy staff adopted various strategies to overcome privacy obstacles such as taking consumers to a quieter part of the pharmacy, avoiding exposure of sensitive items through packaging, lowering of voices, interacting during pharmacy quiet times and telephoning consumers. Pharmacy staff and consumers regularly had to apply judgement to achieve the required level of privacy. Management of privacy can be challenging in the community pharmacy environment, and on-going work in this area is important. As community pharmacy practice is increasingly becoming more involved in advanced medication and disease state management services with unique privacy requirements, pharmacies' layouts and systems to address privacy challenges require a proactive approach. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Evolving Techniques of Documentation of a World Heritage Site in Lahore

NASA Astrophysics Data System (ADS)

Arif, R.; Essa, K.

2017-08-01

Lahore is an ancient, culturally rich city amidst which are embedded two world heritage sites. The state of historic preservation in the country is impoverished with a dearth of training and poor documentation skills, thus these monuments are decaying and in dire need of attention. The Aga Khan Cultural Service - Pakistan is one of the first working in heritage conservation in the country. AKCSP is currently subjecting the UNESCO World Heritage site of the Mughal era Lahore Fort to an intensive and multi-faceted architectural documentation process. This is presented here as a case study to chart the evolution of documentation techniques and enunciate the spectrum of challenges faced in the documentation of an intricate Mughal heritage site for conservation in the Pakistani context. 3D - laser scanning is used for the purpose of heritage conservation for the first time, and since has been utilised on heritage buildings and urban fabric in ongoing projects. These include Lahore Fort, Walled city of Lahore as well as the Baltit Fort, a project restored in the past, assisting in the maintenance of conserved buildings. The documentation team is currently discovering the full potential of this technology especially its use in heritage conservation simultaneously overcoming challenges faced. Moreover negotiating solutions to auto-generate 2D architectural drawings from the 3D pointcloud output. The historic architecture is juxtaposed with contemporary technology in a region where such a combination is rarely found. The goal is to continually develop the documentation methodologies whilst investigating other technologies in the future.

Gender identity in disorders of sex development: review article.

PubMed

Yang, Jennifer H; Baskin, Laurence S; DiSandro, Michael

2010-01-01

Many concerns have been raised regarding the treatment and long-term outcome of infants born with complex genital anomalies. Debate among clinicians, psychologists, ethicists, and patient advocate groups regarding the optimal management of these individuals is ongoing. Although determining the most appropriate gender is a difficult task, this review will help clarify some of the issues at hand. A literature review which addresses the challenges of advising families about gender identity in infants and children with disorders of sex development. The evidence for endocrine effects on neurobiological development with regard to sexual behavior is compelling, although the existing outcome studies are largely anecdotal and somewhat contradictory. Gender assignment in infants born with a disorder of sex development remains only one of the many difficult decisions faced by both the treatment team and the family. Improved long-term follow-up of these patients will provide much needed feedback on previous and contemporary management. 2010 Elsevier Inc. All rights reserved.

Clinical development of Ebola vaccines

PubMed Central

Sridhar, Saranya

2015-01-01

The ongoing outbreak of Ebola virus disease in West Africa highlighted the lack of a licensed drug or vaccine to combat the disease and has renewed the urgency to develop a pipeline of Ebola vaccines. A number of different vaccine platforms are being developed by assessing preclinical efficacy in animal models and expediting clinical development. Over 15 different vaccines are in preclinical development and 8 vaccines are now in different stages of clinical evaluation. These vaccines include DNA vaccines, virus-like particles and viral vectors such as live replicating vesicular stomatitis virus (rVSV), human and chimpanzee adenovirus, and vaccinia virus. Recently, in preliminary results reported from the first phase III trial of an Ebola vaccine, the rVSV-vectored vaccine showed promising efficacy. This review charts this rapidly advancing area of research focusing on vaccines in clinical development and discusses the future opportunities and challenges faced in the licensure and deployment of Ebola vaccines. PMID:26668751

Improving Voluntary Environmental Management Programs: Facilitating Learning and Adaptation

NASA Astrophysics Data System (ADS)

Genskow, Kenneth D.; Wood, Danielle M.

2011-05-01

Environmental planners and managers face unique challenges understanding and documenting the effectiveness of programs that rely on voluntary actions by private landowners. Programs, such as those aimed at reducing nonpoint source pollution or improving habitat, intend to reach those goals by persuading landowners to adopt behaviors and management practices consistent with environmental restoration and protection. Our purpose with this paper is to identify barriers for improving voluntary environmental management programs and ways to overcome them. We first draw upon insights regarding data, learning, and adaptation from the adaptive management and performance management literatures, describing three key issues: overcoming information constraints, structural limitations, and organizational culture. Although these lessons are applicable to a variety of voluntary environmental management programs, we then present the issues in the context of on-going research for nonpoint source water quality pollution. We end the discussion by highlighting important elements for advancing voluntary program efforts.

Physics Teaching in Times of Change

NASA Astrophysics Data System (ADS)

Dykstra, Dewey

2006-05-01

Powerful political forces have been at play in building a mandate to change the schools. The latest, on-going manifestation is in the No Child Left Behind Act, but the mandate for change was being formulated in the early 1980s in the A Nation at Risk report. As physicists we may feel somewhat removed from such goings on, but our children attend school and their teachers come through our classrooms. Physics education research offers extensive, carefully collected data on the consequences of standard physics teaching. The data challenges conventional beliefs about physics learning. It is said that times of crisis represent both opportunity and danger. Because the mandates to change are up to the individual states, each of us in our own state has the opportunity to shift the focus in physics/science teaching toward something better. We also face the danger that existing physics/science teaching will be even more deeply entrenched than it already is.

Facing the challenges of new melanoma-targeted therapies: Treatment of severe fevers associated with dabrafenib/trametinib combination therapy.

PubMed

Lindsay, Julian N; Barras, Michael

2015-08-01

With the emergence of new oral therapies for metastatic melanoma to the market, as well as ongoing pre-marketing trials and special access schemes, it is important to keep up to date with the side effect profiles of these medications. A common side effect associated with the BRAF inhibitor dabrafenib is severe fever symptoms such as pyrexia and rigors/chills; however, treatment options are limited. We report a patient who was debilitated by severe pyrexia and rigors caused by dabrafenib used in combination with trametinib to treat metastatic melanoma, who was treated with low-dose steroids. To our knowledge, the use of prednisolone for the treatment and prevention of further dabrafenib-associated pyrexia is not published; however, it is a low risk and low cost option that was very effective in this case. © The Author(s) 2014.

Adapting agriculture to climate change in Kenya: household strategies and determinants.

PubMed

Bryan, Elizabeth; Ringler, Claudia; Okoba, Barrack; Roncoli, Carla; Silvestri, Silvia; Herrero, Mario

2013-01-15

Countries in Sub-Saharan Africa are particularly vulnerable to climate change, given dependence on agricultural production and limited adaptive capacity. Based on farm household and Participatory Rural Appraisal data collected from districts in various agroecological zones in Kenya, this paper examines farmers' perceptions of climate change, ongoing adaptation measures, and factors influencing farmers' decisions to adapt. The results show that households face considerable challenges in adapting to climate change. While many households have made small adjustments to their farming practices in response to climate change (in particular, changing planting decisions), few households are able to make more costly investments, for example in agroforestry or irrigation, although there is a desire to invest in such measures. This emphasizes the need for greater investments in rural and agricultural development to support the ability of households to make strategic, long-term decisions that affect their future well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

The impact of Alzheimer disease genetics on expert and advanced gerontological nursing practice.

PubMed

Schutte, D L

1998-11-01

Alzheimer disease (AD), a progressive neurodegenerative disorder, is the most common cause of dementia in the United States, affecting as many as 4 million people. Extensive research is under way to identify environmental and genetic risk factors for this complex disease. Currently, four genes are associated with an increased risk for AD: the amyloid precursor protein gene on chromosome 21, the Presenilin I gene on chromosome 14, the Presenilin II gene on chromosome 1, and the apolipoprotein E gene on chromosome 19. Expert and advanced practice gerontological nurses are faced with new challenges as a result of these gene discoveries. Gerontological nurses should assess for relevant environmental and genetic risk factors; obtain comprehensive family health histories recorded as pedigrees; integrate genetic information into diagnosis, intervention, and evaluation strategies; initiate and coordinate referrals to genetic specialists; and provide ongoing emotional and decision-making support for patients and families experiencing AD.

The Association between Education and Mortality for Adults with Intellectual Disability.

PubMed

Landes, Scott D

2017-03-01

Although the relationship between education and mortality is well documented in the general population, it has not been examined for adults with intellectual disability. Informed by fundamental cause theory, I explore the association between education and mortality in a sample of 4,241 adults with intellectual disability from the 1986-2009 National Health Interview Survey with Linked Mortality Files through 2011. Cox regression models were utilized to analyze the predictive effect of education on mortality risk while taking into account birth cohort differences. Increased education was associated with lower mortality risk for adults with intellectual disability, and this relationship strengthened in later birth cohorts who had greater access to the public education system. Comparison with a sample of 21,205 adults without intellectual disability demonstrates that the association between education and mortality risk was not as robust for adults with intellectual disability and highlights the ongoing socioeconomic challenges faced by this population.

Thinking and working relationally: interviewing and constructing hypotheses to create compassionate understanding.

PubMed

Sheinberg, Marcia; Brewster, Mary Kim

2014-12-01

In the initial interviews of family therapy sessions, the therapist faces the challenge of obtaining and organizing the information that is most relevant toward understanding the essential concerns that families and couples bring to therapy. This article describes the process of clinical interviewing and case conceptualization used in training family therapists at the Ackerman Institute for the Family. This approach helps the therapist bring forward, and organize, specific information into relational hypotheses, or systemic-relational conceptualizations, that allow both family members and the therapist to understand presenting problems within their relational contexts. While always provisional, relational hypotheses help anchor the therapist in a systemic-relational frame and provide a conceptual through-line to guide the ongoing work of the therapy. The process of interviewing and the construction of clear and complex conceptualizations of presenting problems are illustrated through case examples. © 2014 Family Process Institute.

The design of a fast Level 1 Track trigger for the ATLAS High Luminosity Upgrade

NASA Astrophysics Data System (ADS)

Miller Allbrooke, Benedict Marc; ATLAS Collaboration

2017-10-01

The ATLAS experiment at the high-luminosity LHC will face a five-fold increase in the number of interactions per collision relative to the ongoing Run 2. This will require a proportional improvement in rejection power at the earliest levels of the detector trigger system, while preserving good signal efficiency, due to the increase in the likelihood of individual trigger thresholds being passed as a result of pile-up related activity. One critical aspect of this improvement will be the implementation of precise track reconstruction, through which sharper turn-on curves, b-tagging and tau-tagging techniques can in principle be implemented. The challenge of such a project comes in the development of a fast, precise custom electronic device integrated in the hardware-based first trigger level of the experiment, with repercussions propagating as far as the detector read-out philosophy.

76 FR 66754 - Federal Bureau of Prisons

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

...) faces continued growth in its inmate population resulting from on-going Federal law enforcement programs..., would help to meet population capacity needs in a timely fashion, conform to Federal law, and maintain...

Challenges Faced by Female-Students in Engineering-Education

ERIC Educational Resources Information Center

Madara, Diana Starovoytova; Cherotich, Sharon

2016-01-01

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

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

ERIC Educational Resources Information Center

Silvernail, David L.; Linet, Sarah R.

2014-01-01

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

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

PubMed Central

2013-01-01

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

Operation and challenges of home-based medical practices in the US: findings from six aggregated case studies.

PubMed

Norman, Gregory J; Orton, Kristann; Wade, Amy; Morris, Andrea M; Slaboda, Jill C

2018-01-27

Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U.S. geographic regions, we conducted a six-site HBPC practice assessment to better understand different operation structures, common challenges, and approaches to delivering HBPC. Six practices varying in size, care team composition and location agreed to participate. At each site we conducted unstructured interviews with key informants and directly observed practices and procedures in the field and back office. The aggregated case studies revealed important issues focused on team composition, patient characteristics, use of technology and urgent care delivery. Common challenges across the practices included provider retention and unmet community demand for home-based care services. Most practices, regardless of size, faced challenges around using electronic medical records (EMRs) and scheduling systems not designed for use in a mobile practice. Although many practices offered urgent care, practices varied in the methods used to provide care including the use of community paramedics and telehealth technology. Learnings compiled from these observations can inform other HBPC practices as to potential best practices that can be implemented in an effort to improve efficiency and scalability of HBPC so that seniors with multiple chronic conditions can receive comprehensive primary care services in their homes.

Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions.

PubMed

Muir, Ryan T; Wang, Shelly; Warf, Benjamin C

2016-11-01

OBJECTIVE Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Significant health disparities exist for the treatment of hydrocephalus in developing nations due to a combination of medical, environmental, and socioeconomic factors. This review aims to provide the international neurosurgery community with an overview of the current challenges and future directions of neurosurgical care for children with hydrocephalus in low-income countries. METHODS The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. RESULTS Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. CONCLUSIONS Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

If It Doesn't Work, Why Do We Still Do It? The Continuing Use of Subtalar Joint Neutral Theory in the Face of Overpowering Critical Research.

PubMed

Harradine, Paul; Gates, Lucy; Bowen, Catherine

2018-03-01

The use of subtalar joint neutral (STJN) in the assessment and treatment of foot-related musculoskeletal symptomology is common in daily practice and still widely taught. The main pioneer of this theory was Dr Merton L. Root, and it has been labeled with a variety of names: "the foot morphology theory," "the subtalar joint neutral theory," or simply "Rootian theory" or "Root model." The theory's core concepts still underpin a common approach to musculoskeletal assessment of the foot, as well as the consequent design of foot orthoses. The available literature continues to point to Dr Root's theory as the most prevalently utilized. Concurrently, the worth of this theory has been challenged due to its poor reliability and limited external validity. This Viewpoint reviews the main clinical areas of the STJN theory, and concludes with a possible explanation and concerns for its ongoing use. To support our view, we will discuss (1) historical inaccuracies, (2) challenges with reliability, and (3) concerns with validity. J Orthop Sports Phys Ther 2018;48(3):130-132. doi:10.2519/jospt.2018.0604.

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.

Advancing Methods for U.S. Transgender Health Research

PubMed Central

Reisner, Sari L.; Deutsch, Madeline B.; Bhasin, Shalender; Bockting, Walter; Brown, George R.; Feldman, Jamie; Garofalo, Rob; Kreukels, Baudewijntje; Radix, Asa; Safer, Joshua D.; Tangpricha, Vin; T’Sjoen, Guy; Goodman, Michael

2016-01-01

Purpose of Review To describe methodological challenges, gaps, and opportunities in U.S. transgender health research. Recent Findings Lack of large prospective observational studies and intervention trials, limited data on risks and benefits of gender affirmation (e.g., hormones and surgical interventions), and inconsistent use of definitions across studies hinder evidence-based care for transgender people. Systematic high-quality observational and intervention-testing studies may be carried out using several approaches, including general population-based, health systems-based, clinic-based, venue-based, and hybrid designs. Each of these approaches has its strength and limitations; however, harmonization of research efforts is needed. Ongoing development of evidence-based clinical recommendations will benefit from a series of observational and intervention studies aimed at identification, recruitment, and follow-up of transgender people of different ages, from different racial, ethnic, and socioeconomic backgrounds and with diverse gender identities. Summary Transgender health research faces challenges that include standardization of lexicon, agreed-upon population definitions, study design, sampling, measurement, outcome ascertainment, and sample size. Application of existing and new methods is needed to fill existing gaps, increase the scientific rigor and reach of transgender health research, and inform evidence-based prevention and care for this underserved population. PMID:26845331

Gene Editing of Microalgae: Scientific Progress and Regulatory Challenges in Europe

PubMed Central

Spicer, Andrew

2018-01-01

It is abundantly clear that the development of gene editing technologies, represents a potentially powerful force for good with regard to human and animal health and addressing the challenges we continue to face in a growing global population. This now includes the development of approaches to modify microalgal strains for potential improvements in productivity, robustness, harvestability, processability, nutritional composition, and application. The rapid emergence and ongoing developments in this area demand a timely review and revision of the current definitions and regulations around genetically modified organisms (GMOs), particularly within Europe. Current practices within the EU provide exemptions from the GMO directives for organisms, including crop plants and micro-organisms that are produced through chemical or UV/radiation mutagenesis. However, organisms generated through gene editing, including microalgae, where only genetic changes in native genes are made, remain currently under the GMO umbrella; they are, as such, excluded from practical and commercial opportunities in the EU. In this review, we will review the advances that are being made in the area of gene editing in microalgae and the impact of regulation on commercial advances in this area with consideration to the current regulatory framework as it relates to GMOs including GM microalgae in Europe. PMID:29509719

Gene Editing of Microalgae: Scientific Progress and Regulatory Challenges in Europe.

PubMed

Spicer, Andrew; Molnar, Attila

2018-03-06

It is abundantly clear that the development of gene editing technologies, represents a potentially powerful force for good with regard to human and animal health and addressing the challenges we continue to face in a growing global population. This now includes the development of approaches to modify microalgal strains for potential improvements in productivity, robustness, harvestability, processability, nutritional composition, and application. The rapid emergence and ongoing developments in this area demand a timely review and revision of the current definitions and regulations around genetically modified organisms (GMOs), particularly within Europe. Current practices within the EU provide exemptions from the GMO directives for organisms, including crop plants and micro-organisms that are produced through chemical or UV/radiation mutagenesis. However, organisms generated through gene editing, including microalgae, where only genetic changes in native genes are made, remain currently under the GMO umbrella; they are, as such, excluded from practical and commercial opportunities in the EU. In this review, we will review the advances that are being made in the area of gene editing in microalgae and the impact of regulation on commercial advances in this area with consideration to the current regulatory framework as it relates to GMOs including GM microalgae in Europe.

Systems for the management of respiratory disease in primary care--an international series: United Kingdom.

PubMed

Worth, Allison; Pinnock, Hilary; Fletcher, Monica; Hoskins, Gaylor; Levy, Mark L; Sheikh, Aziz

2011-03-01

The UK National Health Service (NHS) is essentially publicly funded through general taxation. Challenges facing the NHS include the rise in prevalence of long-term conditions and financial pressures. NATIONAL POLICY TRENDS: Political devolution within the UK has led to variations in the way services are organised and delivered between the four nations. PRIMARY CARE RESPIRATORY SERVICES IN THE UK: Primary care is the first point of contact with services. Most respiratory conditions are managed here, including prevention, diagnosis, treatment and palliative care. Respiratory disease accounts for more primary care consultations than any other type of illness, with 24 million consultations annually. Equitable access to care is an ongoing challenge: telehealthcare is being tried as a possible solution for monitoring of asthma and COPD. REFERRAL AND ACCESS TO SPECIALIST CARE: Referrals for specialist advice are usually to a secondary care respiratory physician, though respiratory General Practitioners with a Special Interest (GPwSIs) are an option in some localities. Prevalence of asthma and COPD is high. Asthma services are predominantly nurse-led. Self-management strategies are widely promoted but poorly implemented. COPD is high on the policy agenda with a shift in focus to preventive lung health and longterm condition management.

Virtual Microscopy: A Useful Tool for Meeting Evolving Challenges in the Veterinary Medical Curriculum

NASA Astrophysics Data System (ADS)

Kogan, Lori R.; Dowers, Kristy L.; Cerda, Jacey R.; Schoenfeld-Tacher, Regina M.; Stewart, Sherry M.

2014-12-01

Veterinary schools, similar to many professional health programs, face a myriad of evolving challenges in delivering their professional curricula including expansion of class size, costs to maintain expensive laboratories, and increased demands on veterinary educators to use curricular time efficiently and creatively. Additionally, exponential expansion of the knowledge base through ongoing biomedical research, educational goals to increase student engagement and clinical reasoning earlier in the curriculum, and students' desire to access course materials and enhance their educational experience through the use of technology all support the need to reassess traditional microscope laboratories within Professional Veterinary Medical (PVM) educational programs. While there is clear justification for teaching veterinary students how to use a microscope for clinical evaluation of cytological preparations (i.e., complete blood count, urinalysis, fecal analysis, fine needle aspirates, etc.), virtual microscopy may be a viable alternative to using light microscopy for teaching and learning fundamental histological concepts. This article discusses results of a survey given to assess Professional Veterinary Medical students' perceptions of using virtual microscope for learning basic histology/microscopic anatomy and implications of these results for using virtual microscopy as a pedagogical tool in teaching first-year Professional Veterinary Medical students' basic histology.

Improving laboratory efficiencies to scale-up HIV viral load testing.

PubMed

Alemnji, George; Onyebujoh, Philip; Nkengasong, John N

2017-03-01

Viral load measurement is a key indicator that determines patients' response to treatment and risk for disease progression. Efforts are ongoing in different countries to scale-up access to viral load testing to meet the Joint United Nations Programme on HIV and AIDS target of achieving 90% viral suppression among HIV-infected patients receiving antiretroviral therapy. However, the impact of these initiatives may be challenged by increased inefficiencies along the viral load testing spectrum. This will translate to increased costs and ineffectiveness of scale-up approaches. This review describes different parameters that could be addressed across the viral load testing spectrum aimed at improving efficiencies and utilizing test results for patient management. Though progress is being made in some countries to scale-up viral load, many others still face numerous challenges that may affect scale-up efficiencies: weak demand creation, ineffective supply chain management systems; poor specimen referral systems; inadequate data and quality management systems; and weak laboratory-clinical interface leading to diminished uptake of test results. In scaling up access to viral load testing, there should be a renewed focus to address efficiencies across the entire spectrum, including factors related to access, uptake, and impact of test results.

The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS

PubMed Central

Nevedal, Andrea; Sankar, Andrea

2016-01-01

Purpose of the Study: Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker’s (1997) life course disruption theory, we explored older African Americans’ experiences of living with HIV/AIDS. Design and Methods: A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Results: Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Implications: Older African Americans’ discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. PMID:26035889

Is “Processed” a Four-Letter Word? The Role of Processed Foods in Achieving Dietary Guidelines and Nutrient Recommendations123

PubMed Central

Dwyer, Johanna T.; Fulgoni, Victor L.; Clemens, Roger A.; Schmidt, David B.

2012-01-01

This paper, based on the symposium “Is ‘Processed’ a Four-Letter Word? The Role of Processed Foods in Achieving Dietary Guidelines and Nutrient Recommendations in the U.S.” describes ongoing efforts and challenges at the nutrition–food science interface and public health; addresses misinformation about processed foods by showing that processed fruits and vegetables made important dietary contributions (e.g., fiber, folate, potassium, vitamins A and C) to nutrient intake among NHANES 2003–2006 participants, that major sources of vitamins (except vitamin K) were provided by enrichment and fortification and that enrichment and fortification helped decrease the percentage of the population below the Estimated Average Requirement for vitamin A, thiamin, folate, and iron; describes how negative consumer perceptions and consumer confusion about processed foods led to the development of science-based information on food processing and technology that aligns with health objectives; and examines challenges and opportunities faced by food scientists who must balance consumer preferences, federal regulations, and issues surrounding food safety, cost, unintended consequences, and sustainability when developing healthful foods that align with dietary guidelines. PMID:22797990

The Syrian public health and humanitarian crisis: A 'displacement' in global governance?

PubMed

Akbarzada, Sumaira; Mackey, Tim K

2018-07-01

Ongoing failure by the international community to resolve the Syrian conflict has led to destruction of critical infrastructure. This includes the collapse of the Syrian health system, leaving millions of internally displaced persons (IDPs) in urgent need of healthcare services. As the conflict intensifies, IDP populations are suffering from infectious and non-communicable disease risks, poor maternal and child health outcomes, trauma, and mental health issues, while healthcare workers continually exit the country. Healthcare workers who remain face significant challenges, including systematic attacks on healthcare facilities and conditions that severely inhibit healthcare delivery and assistance. Within this conflict-driven public health crisis, the most susceptible population is arguably the IDP. Though the fundamental 'right to health' is a recognised international legal principle, its application is inadequate due to limited recognition by the UN Security Council and stymied global governance by the broader international community. These factors have also negatively impacted other vulnerable groups other than IDPs, such as refugees and ethnic minorities, who may or may not be displaced. Hence, this article reviews the current Syrian conflict, assesses challenges with local and global governance for IDPs, and explores potential governance solutions needed to address this health and humanitarian crisis.

Challenges Facing Teachers New to Working in Schools Overseas

ERIC Educational Resources Information Center

Halicioglu, Margaret L.

2015-01-01

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

An Exploration of Challenges Facing Division III Athletic Directors

ERIC Educational Resources Information Center

Engbers, Jeffrey L.

2011-01-01

The purpose of this study was to establish a basic understanding of the challenges associated with directing athletic programs at NCAA Division III Institutions. Specifically, this study identified the frequency, intensity, and time allocated to common challenges facing the position of the NCAA Division III AD. The challenges were examined using…

The Challenges Facing School Governing Bodies in England: A "Perfect Storm"?

ERIC Educational Resources Information Center

James, Chris; Brammer, Steve; Connolly, Michael; Spicer, David Eddy; James, Jane; Jones, Jeff

2013-01-01

The governing bodies of publicly funded schools in England are currently facing a number of substantive challenges of various kinds. Many of the challenges are long-standing, while others relate to the current context for governing wrought by recent education policy developments initiated by central government. A number of the challenges are…

Eco-evolutionary effects on population recovery following catastrophic disturbance

PubMed Central

Weese, Dylan J; Schwartz, Amy K; Bentzen, Paul; Hendry, Andrew P; Kinnison, Michael T

2011-01-01

Fine-scale genetic diversity and contemporary evolution can theoretically influence ecological dynamics in the wild. Such eco-evolutionary effects might be particularly relevant to the persistence of populations facing acute or chronic environmental change. However, experimental data on wild populations is currently lacking to support this notion. One way that ongoing evolution might influence the dynamics of threatened populations is through the role that selection plays in mediating the ‘rescue effect’, the ability of migrants to contribute to the recovery of populations facing local disturbance and decline. Here, we combine experiments with natural catastrophic events to show that ongoing evolution is a major determinant of migrant contributions to population recovery in Trinidadian guppies (Poecilia reticulata). These eco-evolutionary limits on migrant contributions appear to be mediated by the reinforcing effects of natural and sexual selection against migrants, despite the close geographic proximity of migrant sources. These findings show that ongoing adaptive evolution can be a double-edged sword for population persistence, maintaining local fitness at a cost to demographic risk. Our study further serves as a potent reminder that significant evolutionary and eco-evolutionary dynamics might be at play even where the phenotypic status quo is largely maintained generation to generation. PMID:25567978

Adolescents with type 1 diabetes mellitus and attention-deficit/hyperactivity disorder require specific support from healthcare professionals.

PubMed

Lindblad, Ida; Engström, Ann-Charlotte; Nylander, Charlotte; Fernell, Elisabeth

2017-12-01

Managing type 1 diabetes mellitus requires efficient cognitive and executive skills, and adolescents who have attention-deficit/hyperactivity disorder (ADHD) may face specific challenges. This study explored young people's experiences of diabetes treatment and care. In a population-based study, comprising 175 patients aged 5-16 years with type 1 diabetes mellitus in two Swedish counties, we found that eight also met criteria for ADHD. Six of these, aged 14.5-16 years, participated 2013-2014 in interviews that targeted aspects of their diabetes treatment. Conducted by two psychologists, these used the inductive qualitative, semi-structured interview format. The two boys and four girls all reported difficulties in creating routines for their diabetes treatment and that problems were aggravated during stress. They had been criticised by their parents and the diabetes team when their blood levels indicated inadequate diabetes control. They requested ongoing information, involvement of their friends, group meetings and easy access to the healthcare system during difficult times. Patients with type 1 diabetes mellitus and concomitant ADHD faced problems with their diabetes management, especially during stressful situations. Diabetes care provision should pay particular attention to patients with co-existing neuropsychiatric and neurodevelopmental disorders such as ADHD. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

A qualitative process evaluation of training for non-physician clinicians/associate clinicians (NPCs/ACs) in emergency maternal, neonatal care and clinical leadership, impact on clinical services improvements in rural Tanzania: the ETATMBA project

PubMed Central

Ellard, David R; Shemdoe, Aloisia; Mazuguni, Festo; Mbaruku, Godfrey; Davies, David; Kihaile, Paul; Pemba, Senga; Bergström, Staffan; Nyamtema, Angelo; Mohamed, Hamed-Mahfoudh; O'Hare, Joseph Paul

2016-01-01

Objectives The Enhancing Human Resources and Use of Appropriate Training for Maternal and Perinatal Survival in sub-Saharan Africa (ETATMBA) project is training non-physician clinicians as advanced clinical leaders in emergency maternal and newborn care in Tanzania and Malawi. The main aims of this process evaluation were to explore the implementation of the programme of training in Tanzania, how it was received, how or if the training has been implemented into practice and the challenges faced along the way. Design Qualitative interviews with trainees, trainers, district officers and others exploring the application of the training into practice. Participants During late 2010 and 2011, 36 trainees including 19 assistant medical officers one senior clinical officer and 16 nurse midwives/nurses (anaesthesia) were recruited from districts across rural Tanzania and invited to join the ETATMBA training programme. Results Trainees (n=36) completed the training returning to 17 facilities, two left and one died shortly after training. Of the remaining trainees, 27 were interviewed at their health facility. Training was well received and knowledge and skills were increased. There were a number of challenges faced by trainees, not least that their new skills could not be practised because the facilities they returned to were not upgraded. Nonetheless, there is evidence that the training is having an effect locally on health outcomes, like maternal and neonatal mortality, and the trainees are sharing their new knowledge and skills with others. Conclusions The outcome of this evaluation is encouraging but highlights that there are many ongoing challenges relating to infrastructure (including appropriate facilities, electricity and water) and the availability of basic supplies and drugs. This cadre of workers is a dedicated and valuable resource that can make a difference, which with better support could make a greater contribution to healthcare in the country. PMID:26873045

Strengthening Indonesia's health workforce through partnerships.

PubMed

Kurniati, A; Rosskam, E; Afzal, M M; Suryowinoto, T B; Mukti, A G

2015-09-01

Indonesia faces critical challenges pertaining to human resources for health (HRH). These relate to HRH policy, planning, mismatch between production and demand, quality, renumeration, and mal-distribution. This paper provides a state of the art review of the existing conditions in Indonesia, innovations to tackle the problems, results of the innovations to date, and a picture of the on-going challenges that have yet to be met. Reversing this crisis level shortage of HRH requires an inclusive approach to address the underlying challenges. In 2010 the government initiated multi-stakeholder coordination for HRH, using the Country Coordination and Facilitation approach. The process requires committed engagement and coordination of relevant stakeholders to address priority health needs. This manuscript is a formative evaluation of the program using documentary study and analysis. Consistent with Indonesia's decentralized health system, since 2011 local governments also started establishing provincial multi-stakeholder committees and working groups for HRH development. Through this multi-stakeholder approach with high level government support and leadership, Indonesia was able to carry out HRH planning by engaging 164 stakeholders. Multi-stakeholder coordination has produced positive results in Indonesia by bringing about a number of innovations in HRH development to achieve UHC, fostered partnerships, attracted international attention, and galvanized multi-stakeholder support in improving the HRH situation. This approach also has facilitated mobilizing technical and financial support from domestic and international partners for HRH development. Applying the multi-stakeholder engagement and coordination process in Indonesia has proved instrumental in advancing the country's work to achieve Universal Health Coverage and the Millennium Development Goals by 2015. Indonesia continues to face an HRH crisis but the collaborative process provides an opportunity to achieve results. Indonesia's experience indicates that irrespective of geographical or economic status, countries can benefit from multi-stakeholder coordination and engagement to increase access to health workers, strengthen health systems, as well as achieve and sustain UHC. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Challenges in Modeling Debris-Flow Initiation during the Exceptional September 2013 Northern Colorado Front Range Rainstorm

NASA Astrophysics Data System (ADS)

Baum, R. L.; Coe, J. A.; Godt, J.; Kean, J. W.

2014-12-01

Heavy rainfall during 9 - 13 September 2013 induced about 1100 debris flows in the foothills and mountains of the northern Colorado Front Range. Eye-witness accounts and fire-department records put the times of greatest landslide activity during the times of heaviest rainfall on September 12 - 13. Antecedent soil moisture was relatively low, particularly at elevations below 2250 m where many of the debris flows occurred, based on 45 - 125 mm of summer precipitation and absence of rainfall for about 2 weeks before the storm. Mapping from post-event imagery and field observations indicated that most debris flows initiated as small, shallow landslides. These landslides typically formed in colluvium that consisted of angular clasts in a sandy or silty matrix, depending on the nature of the parent bedrock. Weathered bedrock was partially exposed in the basal surfaces of many of the shallow source areas at depths ranging from 0.2 to 5 m, and source areas commonly occupied less than 500 m2. Although 49% of the source areas occurred in swales and 3 % in channels, where convergent flow might have contributed to pore-pressure build up during the rainfall, 48% of the source areas occurred on open slopes. Upslope contributing areas of most landslides (58%) were small (< 1000 m2) and 78% of the slides occurred on south-facing slopes (90°≤ aspect ≤270°). These observations pose challenges for modeling initiation of the debris flows. Effects of variable soil depth and properties, vegetation, and rainfall must be examined to explain the dominance of debris flows on south-facing slopes. Accounting for the small sizes and mixed swale and open-slope settings of source areas demands new approaches for resolving soil-depth and physical-properties variability. The low-moisture initial conditions require consideration of unsaturated zone effects. Ongoing fieldwork and computational modeling are aimed at addressing these challenges related to initiation of the September 2013 debris flows.

Challenges of International Students in a Japanese University: Ethnographic Perspectives

ERIC Educational Resources Information Center

Lee, Ju Seong

2017-01-01

The author investigates what challenges four international students (Vietnamese, Filipino, Brazilian, and Chinese) faced and how they coped with these dilemmas in a Japanese language program during the first semester in 2014. Multiple apparatuses (e.g., field notes, face-to-face oral interviews, focal group conversations, and semi-structured…

Integrating cancer survivors' experiences into UK cancer registries: design and development of the ePOCS system (electronic Patient-reported Outcomes from Cancer Survivors)

PubMed Central

Ashley, L; Jones, H; Thomas, J; Forman, D; Newsham, A; Morris, E; Johnson, O; Velikova, G; Wright, P

2011-01-01

Background: Understanding the psychosocial challenges of cancer survivorship, and identifying which patients experience ongoing difficulties, is a key priority. The ePOCS (electronic patient-reported outcomes from cancer survivors) project aims to develop and evaluate a cost-efficient, UK-scalable electronic system for collecting patient-reported outcome measures (PROMs), at regular post-diagnostic timepoints, and linking these with clinical data in cancer registries. Methods: A multidisciplinary team developed the system using agile methods. Design entailed process mapping the system's constituent parts, data flows and involved human activities, and undertaking usability testing. Informatics specialists built new technical components, including a web-based questionnaire tool and tracking database, and established component-connecting data flows. Development challenges were overcome, including patient usability and data linkage and security. Results: We have developed a system in which PROMs are completed online, using a secure questionnaire administration tool, accessed via a public-facing website, and the responses are linked and stored with clinical registry data. Patient monitoring and communications are semiautomated via a tracker database, and patient correspondence is primarily Email-based. The system is currently honed for clinician-led hospital-based patient recruitment. Conclusions: A feasibility test study is underway. Although there are possible challenges to sustaining and scaling up ePOCS, the system has potential to support UK epidemiological PROMs collection and clinical data linkage. PMID:22048035

Muslims in America: Identity, Diversity and the Challenge of Understanding. 2001 Carnegie Challenge.

ERIC Educational Resources Information Center

Afridi, Sam

This paper discusses challenges and opportunities facing Muslims in the United States, where between 5 to 8 million Muslims live (the fastest growing religion in the country). American Muslims face many challenges, and the public has little understanding of the teachings and practice of Islam. Muslims are prone to negative stereotypes, ethnic…

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

PubMed

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

2016-02-29

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

Chile Informed Question Paper - Military

DTIC Science & Technology

2003-01-01

superior military strength and regional economic integration. Internally, Chile also faces little threat; however, militants from the Mapuche ...considered a significant threat.11 The most significant internal security concern is the ongoing campaign by Mapuche indigenous community militants to

Army Communicator. Volume 32, Number 3, Summer 2007

DTIC Science & Technology

2007-01-01

goal of bringing people from across the Army together to talk about the issues and challenges they are experiencing in the field and try to work out...actually facing the challenges . Each work- shop had a mediator who collected information on issues being faced and suggested solutions to these problems...these possible items that Signal Center actions may be put forth to bring about resolutions to the challenges facing the warfighter in the field. “I

ASF: Facing the Challenges for 15 Years and Counting

NASA Astrophysics Data System (ADS)

La Belle-Hamer, N.; Nicoll, J.; Atwood, D.; Arko, S.

2006-12-01

The Alaska Satellite Facility (ASF) of the Geophysical Institute, University of Alaska Fairbanks, has just celebrated its 15th year of experience in satellite remote sensing. ASF is involved in a wide range of activities - - from downlinking satellite data to developing data analysis tools, value-added products, and training for Synthetic Aperture Radar (SAR) users. Satellite remote sensing data are acquired, processed, analyzed, and archived by ASF from several satellites; ASF has built expertise in handling and manipulating the data, SAR in particular. SAR is the only satellite imagery in the world today that can be acquired at any time of the day or night and during adverse weather conditions. It can be used to develop value-added products to aid in global climate change research. Examples include the SAR-derived coastal winds in the Gulf of Alaska and Bering Sea; monitoring of the major ice shelves in the Arctic and Antarctic; and examining the impact on sea level from the Greenland ice sheets and glaciers. The challenges facing the use of remote-sensing data in climate change research can be divided into three major categories: economical, political, and technical. The expense of designing, building, and launching a satellite is substantial. The costs of the ground segment including data management can be substantial and should not be neglected. The US agency funding climate often has the research community pushing for new missions against declining federal budgets in direct competition with ongoing missions. On the political front, data policy, data ownership, and cost recovery are issues often perceived as insurmountable by the user community. The technical issues, while challenging, are often the easiest to solve. The Japan Aerospace Exploration Agency, with the successful launch of the Advanced Land Observing System (ALOS), has embarked on a new way of handling the ground segment with the introduction of international data nodes. ASF will serve with NOAA as the Americas ALOS Data Node. With the success of the ALOS data node structure, it may well be that international cooperation will become the standard method for overcoming the challenges of global climate change research.

Exploring the challenges faced by polytechnic students

NASA Astrophysics Data System (ADS)

Matore, Mohd Effendi @ Ewan Mohd; Khairani, Ahmad Zamri

2015-02-01

This study aims to identify other challenges besides those already faced by students, in seven polytechnics in Malaysia as a continuation to the previous research that had identified 52 main challenges faced by students using the Rasch Model. The explorative study focuses on the challenges that are not included in the Mooney Problem Checklist (MPCL). A total of 121 polytechnic students submitted 183 written responses through the open questions provided. Two hundred fifty two students had responded from a students' perspective on the dichotomous questions regarding their view on the challenges faced. The data was analysed qualitatively using the NVivo 8.0. The findings showed that students from Politeknik Seberang Perai (PSP) gave the highest response, which was 56 (30.6%) and Politeknik Metro Kuala Lumpur (PMKL) had the lowest response of 2 (1.09%). Five dominant challenges were identified, which were the English language (32, 17.5%), learning (14, 7.7%), vehicles (13, 7.1%), information technology and communication (ICT) (13, 7.1%), and peers (11, 6.0%). This article, however, focus on three apparent challenges, namely, English language, vehicles, as well as computer and ICT, as the challenges of learning and peers had been analysed in the previous MPCL. The challenge of English language that had been raised was regarding the weakness in commanding the aspects of speech and fluency. The computer and ICT challenge covered the weakness in mastering ICT and computers, as well as computer breakdowns and low-performance computers. The challenge of vehicles emphasized the unavailability of vehicles to attend lectures and go elsewhere, lack of transportation service in the polytechnic and not having a valid driving license. These challenges are very relevant and need to be discussed in an effort to prepare polytechnics in facing the transformational process of polytechnics.

Patients' needs following colorectal cancer diagnosis: where does primary care fit in?

PubMed

Browne, Susan; Dowie, Al; Mitchell, Elizabeth; Mitchell, Liz; Wyke, Sally; Ziebland, Sue; Campbell, Neil; Macleod, Una

2011-11-01

Colorectal cancer is the third most common cancer in the UK. Patients with colorectal cancer spend most of their time in the community, but the role of primary care in their management and follow-up is unclear. To explore colorectal cancer patients' experiences of psychosocial problems and their management in primary and specialist care. Longitudinal qualitative study of participants recruited from three hospitals in the west of Scotland and interviewed in their own homes. In-depth interviews with 24 participants with a new diagnosis of colorectal cancer, and then follow-up interviews 12 months later. Participants' needs following a diagnosis for colorectal cancer included physical, psychological, and social issues. GPs played a key role in diagnosis, after which they were less involved. Participants valued GPs making unsolicited contact and offering support. Participants described being well supported by clinical nurse specialists who are expert in the illness, and who provide continuity of care and psychological support. A year after diagnosis, when there was less contact with GPs and clinical nurse specialists, participants still faced challenges associated with the ongoing impact of colorectal cancer. While some patients enjoyed straightforward recoveries from surgery, others experienced longer-term implications from their disease and treatment, particularly bowel-function issues, fatigue, anxiety, and sexual problems. The potential for primary care to contribute more to the ongoing care of colorectal cancer patients was identified.

Challenges and Changes Faced by Rural Superintendents

ERIC Educational Resources Information Center

Lamkin, Marcia L.

2006-01-01

This research study was designed to build grounded theory about the challenges faced by rural superintendents. Participating rural superintendents identified five areas that presented a challenge but that also applied to superintendents in other settings: school law, finance, personnel, government mandates, and district or board policies. Further,…

Finding a Trans-Affirmative Provider: Challenges Faced by Trans and Gender Diverse Psychologists and Psychology Trainees.

PubMed

Dickey, Lore M; Singh, Anneliese A

2017-08-01

This article explores some of the challenges faced by trans and gender diverse (TGD) individuals who not only are attempting to access trans-affirmative care, but who are also members of the very profession from which they are seeking services. The authors explore challenges related to finding supervision, accessing care for assessment services, and finding a provider for personal counseling. With each example, the authors unpack the challenges and also address the implications for training for all involved. Based on these challenges that TGD psychologists and trainees face in attempting to access care, the authors provide recommendations related to trans-affirmative training for psychologists. © 2017 Wiley Periodicals, Inc.

The Invisible Army

PubMed Central

2017-01-01

ABSTRACT The “invisible army” of clinical microbiologists is facing major changes and challenges. The rate of change in both the science and technology is accelerating with no end in sight, putting pressure on our army to learn and adapt as never before. Health care funding in the United States is undergoing dramatic change which will require a new set of assumptions about how clinical microbiology is practiced here. A major challenge facing the discipline is the replacement of a generation of clinical microbiologists. In my opinion, it is incumbent on us in the invisible army to continue to work with the American Society for Microbiology (ASM) in meeting the future challenges faced by our discipline. In this commentary, I will first discuss some recent history of clinical microbiology within ASM and then some current challenges we face. PMID:28659316

In their own words: treating very young BRCA1/2 mutation-positive women with care and caution.

PubMed

Hoskins, Lindsey M; Werner-Lin, Allison; Greene, Mark H

2014-01-01

Young women who have been identified as carrying a deleterious mutation in BRCA1 or BRCA2 face a unique set of challenges related to managing cancer risk during a demographically-dense stage of life. They may struggle with decision-making in the absence of clear age-specific guidelines for medical management and because they have not yet fully developed the capacity to make life-altering decisions confidently. This study sought a patient-centered perspective on the dilemmas faced by 18-24 year olds who completed BRCA1/2 gene mutation testing prior to their 25(th) birthdays. This study integrated qualitative data from three independent investigations of BRCA1/2-positive women recruited through cancer risk clinics, hospital-based research centers, and online organizations. All 32 participants were women aged 21-25 who tested positive for a BRCA1/2 gene mutation between 2 and 60 months prior to data collection. Investigators used techniques of grounded theory and interpretive description to conduct both within and cross-study analysis. Participants expressed needs for (1) greater clarity in recommendations for screening and prevention before age 25, especially with consideration of early and regular exposure to radiation associated with mammography or to hormones used in birth control, and (2) ongoing contact with providers to discuss risk management protocols as they become available. Health care needs during the young adult years evolve with the cognitive capacity to address abrupt and pressing change. Specific needs of women in this population include a desire to balance autonomous decision-making with supportive guidance, a need for clear, accurate and consistent medical recommendations. Optimally, these women are best cared for by a team of genetically-oriented providers as part of a sustained program of ongoing support, rather than seen in an episodic, crisis-driven fashion. A discussion of insurance issues and provider-patient cultural differences is presented.

The burden of terrorism in Malaysia.

PubMed

Abul Aziz, Azhar

2003-01-01

In the peace-loving, moderate and progressive country of Muslim-dominated Malaysia, violence generally is alien to the culture. Terrorism initially took shape during the post-independence, communist era by jungle recalcitrant actions. In recent years, this has been superceded by a more internationally related trend of violence. Only very few incidents were based locally, while the majority were linked to international groups or organizations abroad, including the Kumpulan Mujahidin Malaysia (KMM), Jemaah Islamiyah (JI), and the Abu Sayyaf Group (ASG). Kidnapping with ransom seemed to have been the most commone modus operandi, while killing and robbery accounted for very few of these incidents. The number of victims in each event so far has been small, and smaller for those physically harmed or killed. This pattern of terrorist attacks suggests that the current level of provision of emergency medical services is sufficient to handle such incidents. Recent advances in local emergency medicine also have witnessed the establishment of various teaching and training modules, a pivotal role played by university hospitals and supported by the Ministry of Health. However, the spate of ongoing events of mass destruction such as the conflict in Israel/Palestine, wars in Afghanistan and Iraq, the World Trade Center and Pentagon tragedies of 11 September 2001, and the Bali bombing in Indonesia, remain as great concerns to Malaysians. Both the government and the people of Malaysia abhor such unjustified uses of terror, and take every measure to curtail them. The National Security Council policies of Arahan No. 18 and Arahan No. 20 detail specific roles and responsibilities of various agencies in managing terrorism and disasters respectively, while the use of the stern Internal Security Act that allows indefinite detention without trial, evidently has been an efficient intelligence and security apparatus. With more recent developments of terrorist events regionally and globally, Malaysia continues to face an ongoing threat from such activities. Various measures have been and will be actively undertaken both by government and non-governmental agencies in facing these challenges.

Healthcare providers’ knowledge, experience and challenges of reporting adverse events following immunisation: a qualitative study

PubMed Central

2013-01-01

Background Healthcare provider spontaneous reporting of suspected adverse events following immunisation (AEFI) is central to monitoring post-licensure vaccine safety, but little is known about how healthcare professionals recognise and report to surveillance systems. The aim of this study was explore the knowledge, experience and attitudes of medical and nursing professionals towards detecting and reporting AEFI. Methods We conducted a qualitative study, using semi-structured, face to face interviews with 13 Paediatric Emergency Department consultants from a tertiary paediatric hospital, 10 General Practitioners, 2 local council immunisation and 4 General Practice nurses, recruited using purposive sampling in Adelaide, South Australia, between December 2010 and September 2011. We identified emergent themes related to previous experience of an AEFI in practice, awareness and experience of AEFI reporting, factors that would facilitate or impede reporting and previous training in vaccine safety. Thematic analysis was used to analyse the data. Results AEFI reporting was infrequent across all groups, despite most participants having reviewed an AEFI. We found confusion about how to report an AEFI and variability, according to the provider group, as to the type of events that would constitute a reportable AEFI. Participants’ interpretation of a “serious” or “unexpected” AEFI varied across the three groups. Common barriers to reporting included time constraints and unsatisfactory reporting processes. Nurses were more likely to have received formal training in vaccine safety and reporting than medical practitioners. Conclusions This study provides an overview of experience and beliefs of three healthcare professional groups in relation to identifying and reporting AEFI. The qualitative assessment reveals differences in experience and awareness of AEFI reporting across the three professional groups. Most participants appreciated the importance of their role in AEFI surveillance and monitoring the ongoing safety of vaccines. Future initiatives to improve education, such as increased training to health care providers, particularly, medical professionals, are required and should be included in both undergraduate curricula and ongoing, professional development. PMID:23945045

Children at Risk: Global Views on Challenges Facing Children

ERIC Educational Resources Information Center

Neugebauer, Roger

2011-01-01

Members of the World Forum community were invited to respond to the question: "What is the most urgent challenge facing young children in your country?" Here are some of their responses. Jamils Richard Achunji Anguaseh mentions that in Cameroon, young children face lots of insecurity, both from health hazards and poor parenting practices. There…

Challenges in the management of community pharmacies in Malaysia

PubMed Central

2017-01-01

Background: The provision of professional pharmacy services by community pharmacists continues to be limited, particularly in low and middle income countries. It was postulated that multiple management challenges faced by community pharmacists contribute to this situation. Objective: The primary aim of the research was to determine the challenges faced in the management of community pharmacies in Sarawak (the largest state in Malaysia), and practical strategies to cope and overcome the challenges. Methods: Semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling were employed to ensure a diverse group of informants. The interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Data collection, coding, interpretation were carried out iteratively until theoretical saturation. Results: Twenty respondents from different demographic characteristics were recruited. Six major themes were identified. Management challenges faced by community pharmacists traverse five major domains: market competition, legislative issues, customers’ knowledge and expectations, macroeconomic impacts and operational challenges. Most of these challenges require government intervention to be resolved. In the meantime, improving customer service and expanding the range of professional services were seen as the most viable strategies to cope with existing challenges. The main concern is that current legislative and economic landscape may hinder these strategies. Enactment of dispensing separation and more protective measures against market competition were suggested to alleviate the challenges faced. Conclusion: Numerous management challenges faced by community pharmacists that distract them from delivering professional pharmacy services have been highlighted. Urgent affirmative actions by the government are warranted in supporting community pharmacists to realise and maximise their potentials. PMID:28690697

How international medical graduates view their learning needs for UK GP training.

PubMed

Warwick, Christopher

2014-03-01

International medical graduates (IMGs) form a vital group of general practitioners (GPs) in the NHS. They are known to face additional challenges above and beyond those faced by UK medical graduates in the course of their GP training. Whilst they are a heterogeneous group of professionals, their views on what they need to learn, and how they are supported, are often distant from those of the educators responsible for planning their education. This study was undertaken, through narrative-based focus groups, to explore the issues which matter to the IMGs, in an attempt to empower their voices about their experiences in GP training, and to see what lessons could be drawn from these views. The findings confirmed the central importance, and considerable challenge involved, in making an effective transition into the culture of the NHS and UK general practice. The IMGs felt that induction needed to be an on-going, iterative process of learning which continued throughout training, with a more effective individualised learning needs analysis at the start of GP training. Lack of sophisticated language skills was highlighted as a real concern. Recognition that their lack of knowledge about the NHS at the start of training should not be seen as an indicator of deficiency, but a clue to what they needed to learn were also key messages. IMGs also felt the earlier in their training they undertook a GP placement, the quicker they would start to understand the culture of general practice in the UK. Further work following on from this research should include how to manage change in the educational network for these barriers to be overcome.

Impact of conflict on medical education: a cross-sectional survey of students and institutions in Iraq

PubMed Central

Barnett-Vanes, Ashton; Shawki, Marwan; Ismail, Omar Abdulkadir; Fung, Chi; Kedia, Tara

2016-01-01

Objective This study surveyed all Iraqi medical schools and a cross-section of Iraqi medical students regarding their institutional and student experiences of medical education amidst ongoing conflict. The objective was to better understand the current resources and challenges facing medical schools, and the impacts of conflict on the training landscape and student experience, to provide evidence for further research and policy development. Setting Deans of all Iraqi medical schools registered in the World Directory of Medical Schools were invited to participate in a survey electronically. Medical students from three Iraqi medical schools were invited to participate in a survey electronically. Outcomes Primary: Student enrolment and graduation statistics; human resources of medical schools; dean perspectives on impact of conflict. Secondary: Medical student perspectives on quality of teaching, welfare and future career intentions. Findings Of 24 medical schools listed in the World Directory of Medical Schools, 15 replied to an initial email sent to confirm their contact details, and 8 medical schools responded to our survey, giving a response rate from contactable medical schools of 53% and overall of 33%. Five (63%) medical schools reported medical student educational attainment being impaired or significantly impaired; 4 (50%) felt the quality of training medical schools could offer had been impaired or significantly impaired due to conflict. A total of 197 medical students responded, 62% of whom felt their safety had been threatened due to violent insecurity. The majority (56%) of medical students intended to leave Iraq after graduating. Conclusions Medical schools are facing challenges in staff recruitment and adequate resource provision; the majority believe quality of training has suffered as a result. Medical students are experiencing added psychological stress and lower quality of teaching; the majority intend to leave Iraq after graduation. PMID:26883241

Complementary education for healthcare personnel: a strategy to increase hospital performance.

PubMed

Ghanem, Mohamed

2014-01-01

The German healthcare system is facing ongoing radical change and development. The increasing tendency to urge hospitals and medical staff to work in a profit-oriented way constitute among other factors clear present and future challenges. Physicians and surgeons in particular increasingly complain of increasing stress attributed to measures aiming at cost reduction in hospitals. The highest priority must always be patient satisfaction and the delivery of good medical and human service. Problem description: The health care market in Germany has become an increasingly complex business with uncertain and unpredictable future events. Strategic planning has to enable hospitals to quickly and flexibly adapt strategies to changes in the environment that become essential to their success. The most important task is to develop a strategy that can be applied with success in all possible future scenarios. This is known as the core strategy. The core strategy for hospitals in Germany is complementary education of the medical staff as well as top management. Accordingly, courses, workshops or even part-time graduate or postgraduate education in business and economics are recommended for the medical staff. As far as non-medical hospital executives are concerned, there is no better way than to host them in a hospital department for a period of 6-12 months. This paves the way for understanding and accepting each others' opinion which increases hospital performance. Proper and complementary education of the medical staff as well as of non-medical top executives and managers of hospitals is recommended as the core strategy. This harmonizes both professional medical and managerial efforts with a synergy effect that allows soundly facing the increasingly challenging environment of the health care sector in general and in hospitals in particular.

The Time Bomb Continues to Tick.

ERIC Educational Resources Information Center

Schaw, Walter A.

1989-01-01

Higher Education faces two issues in capital renewal and replacement: (1) quantifying and funding the accumulated backlog of capital needs due to deferred maintenance, and (2) developing an ongoing funding plan to ensure backlogs do not accumulate in the future. (MSE)

Challenges When Introducing Electronic Exam

ERIC Educational Resources Information Center

Kuikka, Matti; Kitola, Markus; Laakso, Mikko-Jussi

2014-01-01

Time pressures often necessitate the use of more efficient exam tools, such as electronic exams (e-exams), instead of traditional paper exams. However, teachers may face challenges when introducing e-exams in a higher education context. This paper describes what kinds of challenges teachers may face when introducing e-exams, based on experiences…

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

ERIC Educational Resources Information Center

Wardale, Dorothy; Lord, Linley

2016-01-01

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

Confronting Unsuccessful Practices: Repositioning Teacher Identities in English Education

ERIC Educational Resources Information Center

Vetter, Amy; Hartman, Shana V.; Reynolds, Jeanie M.

2016-01-01

Teacher education programs attempt to prepare preservice teachers for the various challenges faced in the classroom. One particular challenge new teachers face is how to handle unsuccessful practices. This paper argues that confronting ineffective practices require that teachers respond to complex and dynamic challenges, making change difficult…

Challenges Faced by Project Competition Participants and Recommended Solutions

ERIC Educational Resources Information Center

Demirel, Turgay; Baydas, Ozlem; Yilmaz, Rabia M.; Goktas, Yuksel

2013-01-01

The numbers of project competitions and interest in this kind of competition have been steadily increasing in Turkey. Accordingly, it is important to determine what challenges teachers and students may face while preparing themselves for project competitions, so that recommendations may be made to overcome these challenges. This study investigated…

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

ERIC Educational Resources Information Center

Paquette, Paige Fuller

2009-01-01

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

The Challenges of Adopting the Learning Organisation Philosophy in a Singapore School

ERIC Educational Resources Information Center

Retna, Kala S.; Tee, Ng Pak

2006-01-01

Purpose: To report on a case study that examines how the Learning Organisation (LO) concept can be applied in a Singapore school and the challenges that the school faces in the process. Design/methodology/approach: A qualitative research inquiry was adopted using ethnographic methods. Data includes in-depth face-to-face interviews, observation of…

Challenges Faced by Undergraduate Military Students at American Public University System

ERIC Educational Resources Information Center

Machuca, Ana; Torres, Karin; Morris, Pamela; Whitley, William

2014-01-01

This paper will summarize some of challenges faced by military students enrolled in an associate and bachelors online program at American Public University System (APUS). The survey results on which the study is based exposed the following problems faced by military personnel: 48.7% had difficulties working around military obligations, 33.3%…

Applying the Rasch Model to Measure Acculturation Challenges Faced by Saudi Female Students in the United States

ERIC Educational Resources Information Center

Hakami, Samah Mohammed

2012-01-01

The purpose of this study was to explore the major acculturation challenges faced by Saudi female students who study in the U.S. and to develop a scale to measure potential acculturation challenges. The construction of the scale was based on a table of specification that included nine domains of possible acculturation challenges: (a)…

Challenges for Novice School Leaders: Facing Today's Issues in School Administration

ERIC Educational Resources Information Center

Beam, Andrea P.; Claxton, Russell L.; Smith, Samuel J.

2016-01-01

Challenges for novice school leaders evolve as information is managed differently and as societal and regulatory expectations change. This study addresses unique challenges faced by practicing school administrators (n = 159) during their first three years in a school leadership position. It focuses on their perceptions, how perceptions of present…

Leading Schools Facing Challenging Circumstances: Some Insights from Western Australia

ERIC Educational Resources Information Center

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

2016-01-01

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

The Value of Conceptual Models in Coping with Complexity and Interdisciplinarity in Environmental Sciences Education

ERIC Educational Resources Information Center

Fortuin, Karen P. J.; van Koppen, C. S. A.; Leemans, Rik

2011-01-01

Conceptual models are useful for facing the challenges of environmental sciences curriculum and course developers and students. These challenges are inherent to the interdisciplinary and problem-oriented character of environmental sciences curricula. In this article, we review the merits of conceptual models in facing these challenges. These…

CAEP Challenges for a Mid-South U.S. College Teacher Education Program

ERIC Educational Resources Information Center

Moffett, David W.

2016-01-01

What are the challenges faced by a mid-south liberal arts college teacher education program, in its attempt to successfully meet the new Council for the Accreditation of Educator Preparation (CAEP) accreditation requirements? The Investigator studied the Educator Program Provider (EPP) during academic year 2015-2016. The challenges faced by the…

Challenges of Attending E-Learning Studies in Nigeria

ERIC Educational Resources Information Center

Bugi, Stephan Z.

2012-01-01

This study set out to find out what challenges the E-leaner faces in the Nigerian environment. Survey research design was used to obtain the opinion of 200 randomly selected E-learners in Kaduna metropolis. Their responses revealed that the most prominent challenges they face are, Inadequate Power supply, Internet connectivity problems, Efficacy…

Challenges and Instructional Approaches Impacting the Literacy Performance of English Language Learners

ERIC Educational Resources Information Center

Markham, Paul L.; Gordon, Karen E.

2007-01-01

For English Language Learners (ELLs), the process of becoming literate in English is daunting. Not only are these students faced with the same literacy challenges faced by native English-speaking students, but they are also challenged with extensive diversity issues relating to substantial differences in linguistic, cultural, and academic…

Configural face processing impacts race disparities in humanization and trust

PubMed Central

Cassidy, Brittany S.; Krendl, Anne C.; Stanko, Kathleen A.; Rydell, Robert J.; Young, Steven G.; Hugenberg, Kurt

2018-01-01

The dehumanization of Black Americans is an ongoing societal problem. Reducing configural face processing, a well-studied aspect of typical face encoding, decreases the activation of human-related concepts to White faces, suggesting that the extent that faces are configurally processed contributes to dehumanization. Because Black individuals are more dehumanized relative to White individuals, the current work examined how configural processing might contribute to their greater dehumanization. Study 1 showed that inverting faces (which reduces configural processing) reduced the activation of human-related concepts toward Black more than White faces. Studies 2a and 2b showed that reducing configural processing affects dehumanization by decreasing trust and increasing homogeneity among Black versus White faces. Studies 3a–d showed that configural processing effects emerge in racial outgroups for whom untrustworthiness may be a more salient group stereotype (i.e., Black, but not Asian, faces). Study 4 provided evidence that these effects are specific to reduced configural processing versus more general perceptual disfluency. Reduced configural processing may thus contribute to the greater dehumanization of Black relative to White individuals. PMID:29910510

Engendering the bureaucracy? Challenges and opportunities for mainstreaming gender in Ministries of Health under sector-wide approaches.

PubMed

Theobald, Sally; Tolhurst, Rachel; Elsey, Helen; Standing, Hilary; Standing, Helen

2005-05-01

The increasing ascendancy of 'gender mainstreaming' as the central approach to improving gender equity has largely determined strategies to integrate a gender focus in sector-wide approaches (SWAps). This paper explores the impetus for and process of gender mainstreaming in SWAps in the Ministries of Health in Uganda, Ghana, Malawi and Mozambique, and outlines some achievements and challenges. The shifting and contested relationships between the Ministry of Health, donors and other government ministries (such as Ministries of Finance and Ministries of Women's Affairs/Gender) are important in shaping the opportunities and constraints faced in gender mainstreaming. The refocusing of resource allocation to different sectors has led to changes in the balance of power between the various actors at the national level, with diverse implications for promoting gender equity in health. Some of the achievements to date and ongoing challenges are explored through concrete examples from different countries. These include: the development of structures for mainstreaming, including the dilemmas of the 'focal points' approach and the role of national gender mainstreaming machinery; the need for training and building capacity to identify and address gender issues, which involves engaging with new languages and concepts, and developing new skills; building alliances, consensus and momentum; integrating gender concerns into policy and planning documents; and promoting gender equity in human resources in the health sector. Cross-cutting themes underlying these challenges are the need for gender-specific information and ways to finance mainstreaming strategies. Implications are drawn for ways forward, without losing sight of the challenge of translating discourses of gender mainstreaming, and its central ideal of social transformation, into pragmatic strategies in the bureaucratic environment.

Young persons with visual impairment: challenges of participation.

PubMed

Salminen, Anna-Liisa; Karhula, Maarit E

2014-07-01

To describe the challenges to activity and participation faced by young people with visual impairment within the framework of the International Classification of Functioning (ICF). 14 young persons (aged 16-22 years) with visual impairment and their parents (n = 22) participated in the study. The Canadian Occupational Performance Measure (COPM) was used to describe challenges of participation as perceived by the young persons themselves. Individual interviews with the young persons and their parents were used to investigate in more depth the challenges the young persons face with regard to participation. Young persons with visual impairment face challenges to participation most frequently with regard to mobility, domestic life, interpersonal interaction and relationships, major life areas, and leisure activities. The environment in which they live has a central role as a barrier or facilitator of participation. The challenges related to activities and participation that young persons with visual impairment face are diverse. It is important that these challenges are assessed individually and with the help of subjective measures. Serving as a broad framework for classifying the data, the ICF proved to be a useful tool, but used strictly at category level it may limit the coding of data and narrow interpretation.

Becoming a nurse faculty leader: facing challenges through reflecting, persevering and relating in new ways.

PubMed

Horton-Deutsch, Sara; Young, Patricia K; Nelson, Kristine A

2010-05-01

The aim of the present study was to explore the experience of becoming a nurse faculty leader. In a recent interpretation of 23 interviews conducted with nurse faculty leaders from across the United States about their experiences of becoming a leader three themes were identified: being thrust into leadership, taking risks and facing challenges. This interpretive phenomenological study further explicates three aspects of how nurse educators faced challenges in becoming and serving as a leader. Facing challenges meant reflecting, persevering through difficulties and learning to relate to others in new ways. Exemplars of participant experiences are provided for concreteness, to assist readers in determining how findings resonate with their own experience and how they can actualize this resonance in their own leadership practice. In the present study, reflecting, persevering through difficulties and learning to relate with others in a new way was how leaders faced challenges. Leadership development opportunities that facilitate self-exploration, caring and thoughtful interactions with others and values clarification serve as the foundation for becoming a nurse faculty leader who is, in turn, able to build leadership capacity in other individuals and organizations.

AGU, Science and Engagement with the Energy Industry

NASA Astrophysics Data System (ADS)

Leinen, M.; Davidson, E. A.

2016-12-01

The relationship between science and society evolves over time and the social, political, and economic factors shaping this relationship are complex. When problems facing society become more challenging, the public, NGOs, and policy makers call for science to more directly inform solutions, to assure accountability for the use of funds and to address conflicts of interest. But when policy solutions for such challenges require significant economic and societal tradeoffs, discussion of the science can become polarized and politicized. When this occurs, AGU's policies that uphold the highest standards of scientific integrity, address conflicts of interests and promote independence for members are even more important. These policies are implemented through processes for: a) control of science presented at meeting and in publications; b) requirements for data cited in publications to be publicly accessible, and c) an organizational support policy that prohibits sponsors from influencing science presented in AGU programs. The private sector wields vast influence on human behavior and governmental policy through commerce and lobbying. These actions can be controversial when the profit motive appears incongruent with other societal opinions of what is in the public interest. Climate change is an example of this tension, where the economic exploitation of fossil fuels has complex effects on food and energy security as well as on the environment. Nonetheless, the AGU Board unanimously agreed that given our mission to advance science to create a more sustainable earth, engagement of the private sector rather than disengagement is the best way to influence decision makers on all sides because we believe that the private sector needs to be part of any solutions. We plan to use our convening power and scientific authority to bring together diverse views on climate change solutions from the private, NGO, policy, decision-maker and scientific sectors to begin a substantial, responsible and on-going dialogue. We want this dialogue to inform issues of energy, environment, security and the associated economic and societal benefits and tradeoffs in addressing climate change. AGU will share our initial ideas for convening such engagement and in the future will inform our membership on the successes and the on-going challenges.

Genetics in primary health care and the National Policy on Comprehensive Care for People with Rare Diseases in Brazil: opportunities and challenges for professional education.

PubMed

Melo, Débora Gusmão; de Paula, Pamela Karen; de Araujo Rodrigues, Stephania; da Silva de Avó, Lucimar Retto; Germano, Carla Maria Ramos; Demarzo, Marcelo Marcos Piva

2015-07-01

As discoveries regarding the genetic contribution to disease have grown rapidly, health care professionals are expected to incorporate genetic and genomic perspectives into health education and practice. Genetic competencies common to all health professionals have been identified by the US National Coalition for Health Professional Education in Genetics (NCHPEG), which defined the knowledge, skills, and attitudes required to achieve these competencies. The aim of this study is to analyze genetic competencies of primary health care professionals in Brazil. It is a descriptive survey study, whereby doctors, nurses, and dentists were invited to participate by answering a questionnaire including 11 issues based on competencies established by the NCHPEG. Data were presented as percentages. Differences between groups of participants were assessed by the Fisher exact test, with the level of significance set at p < 0.05. Results showed that concerning knowledge, about 80 % of the participants recognized basic genetics terminology, but practitioners had difficulty in identifying patterns of inheritance. Regarding clinical skills, practitioners were able to recognize facial dysmorphias and identify situations where referral of patients to specialists was necessary. Nevertheless, there were challenges in the process of valuing and gathering information about family history. Regarding attitudes, 68.9 % of the participants thought about the comprehensiveness of care but faced challenges in counselling parents. The results of this study may contribute to developing an ongoing education program for primary health care professionals, leading to a strategy to overcome the challenges of including genetics in the Brazilian Unified Health System.

Focusing a Transition: Challenges Facing the New Administration

DTIC Science & Technology

2016-09-01

FOCUSING A TRANSITION Challenges Facing the New Administration A Report by the Defense Business Board 2016 This report, DBB Report FY16-5, is a ...Facing the New Administration A Report by the Defense Business Board 5 Table of Contents INTRODUCTION...While reviewing the budget, the team should develop a list of items to propose for immediate termination. The Board offers the following

Defense Infrastructure: Challenges Increase Risks for Providing Timely Infrastructure Support for Army Installations Expecting Substantial Personnel Growth

DTIC Science & Technology

2007-09-01

Office Why GAO Did This Study Highlights Accountability Integrity Reliability September 2007 DEFENSE INFRASTRUCTURE Challenges Increase Risks for...authority to conduct evaluations on his own initiative. It addresses (1) the challenges and associated risks the Army faces in providing for timely...but it faces several complex implementation challenges that risk late provision of needed infrastructure to adequately support incoming personnel

A qualitative exploration of the major challenges facing pharmacovigilance in Saudi Arabia.

PubMed

Aljadhey, Hisham; Mahmoud, Mansour A; Alshammari, Thamir M; Al-Dhaeefi, Mohammed; Le Louet, Herve; Perez-Gutthann, Susana; Pitts, Peter J

2015-09-01

To explore the challenges facing pharmacovigilance in Saudi Arabia and formulate recommendations to improve it from the perspective of healthcare professionals in Saudi Arabia. This was a qualitative study of 4 focus group discussions with pharmacists, physicians, and academicians held under the auspices of the King Saud University School of Pharmacy and the Center for Medicine in the Public Interest, Riyadh, Saudi Arabia. A total of 29 eligible healthcare professionals were invited to participate in the discussion. The predefined themes of the study were the current practice and major challenges facing pharmacovigilance in regulatory bodies, hospitals, the community, and academia, as well as recommendations to improve pharmacovigilance practice.  Of the 29 participants invited, 27 attended the discussion. Challenges facing regulatory bodies included complicated adverse drug reactions (ADR) reporting forms, lack of feedback on ADRs submitted to the Saudi Food and Drug Authority, lack of decisions from the local authority to withdraw medications, and lack of data on pharmacovigilance. The challenges to pharmacovigilance in hospitals included the lack of knowledge of the significance of ADR reporting, workload, blaming culture, and lack of collaboration between regulatory bodies and hospitals. However, challenges facing pharmaceutical industries included the lack of drug manufacturers in Saudi Arabia and lack of interest in pharmacovigilance. Recommendations to improve pharmacovigilance included the need for communication, stronger regulatory requirements, the need for research, the need for unified ADRs reporting, and continuous education and training.  The study has identified the challenges facing pharmacovigilance in Saudi Arabia and made certain recommendations to overcome them. These recommendations might be helpful for regulatory bodies to enhance spontaneous reporting and promote pharmacovigilance.

Medical aspects of pediatric rehabilitation after moderate to severe traumatic brain injury.

PubMed

Cantore, Lisa; Norwood, Kenneth; Patrick, Peter

2012-01-01

Recovery from severe traumatic brain injury (TBI) is prolonged, complicated and challenging. Medical rehabilitation is the bridge from acute medical care and stabilization to community reintegration. The process of caring for the recovering brain introduces unknown challenges of neural plasticity with demands to restore and to also move the child and family back to the developmental trajectory they once knew. While the ongoing focus is to maintain and advance medical stability, co- morbid conditions are addressed, and a plan for ongoing health is established. While no one manuscript can cover all of the medical aspects, this article will present in a "systems review" manner the most challenging and demanding medical conditions that children may confront following severe brain injury.

Calling It Quits.

ERIC Educational Resources Information Center

Stover, Del

1990-01-01

Faced with ongoing budget battles, frustrating contract negotiations, and unappreciative parents, many board members are tempted to resign. Fatigue, deteriorating relations among colleagues, and abuse of power by superintendents and other board members are other reasons for resigning. A sidebar offers advice to board members mulling over their…

Finding Erich Jantsch's Five Crucial Innovations: A Study of Four Small Colleges

ERIC Educational Resources Information Center

MacVie, Leah

2017-01-01

Institutions of higher education have faced many challenges over the last few decades. Though many large institutions have the resources needed to respond to these challenges, small institutions have had to be innovative in the ways in which they are adapting. There are similarities between the external challenges that institutions face today and…

The Challenges Faced by Chinese Higher Education as It Expands in Scale

ERIC Educational Resources Information Center

Xiaohao, Ding

2004-01-01

This article reports the challenges faced by Chinese higher education as it expands in scale. The scale of China's higher education has seen unprecedented expansion in recent years. This article explores the new opportunities and challenges that such expansion brings to China's higher education. The author states that, aside from the many…

Reflecting on the Challenges of Applied Theatre in Kenya

ERIC Educational Resources Information Center

Okuto, Maxwel; Smith, Bobby

2017-01-01

In this article the authors draw on their own experience and research in applied theatre in Kenya in order to reflect on challenges currently facing practitioners working in the country. In order to outline the range of challenges faced by practitioners, issues related to the wider landscapes of government and politics in Kenya are explored,…

Special Education in Rural Schools: Why Less Takes More

ERIC Educational Resources Information Center

Bouck, Emily C.; Albaugh, Diane; Bouck, Mary K.

2005-01-01

Everyone can understand the challenges teachers face in organizing and supervising field trips, challenges that are even greater when the students have special needs and live in poverty. But how daunting, the authors ask, are the challenges these students face every day? Very few people who have never tried it are truly aware of all the…

International Graduate Students' Academic Writing Practices in Malaysia: Challenges and Solutions

ERIC Educational Resources Information Center

Singh, Manjet Kaur Mehar

2015-01-01

This article focuses on the challenges faced by non-native English speaking international graduate students in their academic writing practices while they studied at a university in Malaysia as well as the solutions they employed when faced with the challenges. Academic Literacies Questionnaire was used to collect data. Based on 131 participants,…

A Content Analysis Concerning the Studies on Challenges Faced by Novice Teachers

ERIC Educational Resources Information Center

Kozikoglu, Ishak

2017-01-01

The purpose of this research is to analyze the studies concerning challenges faced by novice teachers in terms of various aspects and compare challenges according to location of the studies conducted in Turkey and abroad. A total of 30 research studies were included in detailed analysis. This is a descriptive study based on qualitative research…

Mentoring Matters: The Challenge for Teacher Education

ERIC Educational Resources Information Center

McCann, Thomas M.; Ed.; Johannessen, Larry, Ed.

2009-01-01

Beginning teachers face many challenges and difficulties; as a result, one-third will leave the profession in the first three years and nearly half will be gone within their first five years in the profession. The challenge facing university teacher education programs is to fix the hole in the bottom of the bucket and find strategic new ways to…

Developing a Strong Direct Care Workforce.

PubMed

Stear, Lynda A

The aging population of the United States has led to a need for more direct care workers to provide personal care to older adults and disabled people in their homes. The U.S. Bureau of Labor Statistics predicts employment of paraprofessionals in home care will grow 49% between 2012 and 2022 as the baby boomer generation ages and requires more assistance in activities of daily living. The typical direct care worker is a female aged 25 to 54 years old, a demographic that is projected to remain flat in the coming years. Direct care workers typically are poorly paid for work that is labor-intensive and often work in less than optimal working conditions. It is important that agencies hiring direct care workers understand the challenges these workers face and institute sound hiring practices and provide proper training and ongoing supervision. It is possible to have a quality direct care team. Proper training, role modeling, and supervision will improve employee satisfaction, decrease turnover, and improve care outcomes for patients.

Information and communication technology and climate change adaptation: Evidence from selected mining companies in South Africa

PubMed Central

Nhamo, Godwell

2016-01-01

The mining sector is a significant contributor to the gross domestic product of many global economies. Given the increasing trends in climate-induced disasters and the growing desire to find lasting solutions, information and communication technology (ICT) has been introduced into the climate change adaptation mix. Climate change-induced extreme weather events such as flooding, drought, excessive fog, and cyclones have compounded the environmental challenges faced by the mining sector. This article presents the adoption of ICT innovation as part of the adaptation strategies towards reducing the mining sector’s vulnerability and exposure to climate change disaster risks. Document analysis and systematic literature review were adopted as the methodology. Findings from the study reflect how ICT intervention orchestrated changes in communication patterns which are tailored towards the reduction in climate change vulnerability and exposure. The research concludes with a proposition that ICT intervention must be part of the bigger and ongoing climate change adaptation agenda in the mining sector.

Shared reality of the abusive and the vulnerable: the experience of aging for parents living with abusive adult children coping with mental disorder.

PubMed

Band-Winterstein, Tova; Smeloy, Yael; Avieli, Hila

2014-11-01

Increasing numbers of aging parents are finding themselves in the role of caregiver for their mentally ill adult child due to global deinstitutionalization policy. The aim of this paper is to describe the daily aging experience of parents abused by an adult child with mental disorder and the challenges confronting them in this shared reality. Data collection was performed through in-depth semi-structured interviews with 16 parents, followed by content analysis. Three major themes emerged: (a) old age as a platform for parent's vulnerability facing ongoing abuse; (b) "whose needs come first?" in a shared reality of abusive and vulnerable protagonists; (c) changes in relationship dynamics. Old age becomes an arena for redefined relationships combining increased vulnerability, needs of both sides, and its impact on the well-being of the aging parents. This calls for better insights and deeper understanding in regard to intervention with such families.

Empowering Lay-Counsellors with Technology: Masivukeni, a Standardized Multimedia Counselling Support Tool to Deliver ART Counselling.

PubMed

Gouse, H; Robbins, R N; Mellins, C A; Kingon, A; Rowe, J; Henry, M; Remien, R H; Pearson, A; Victor, F; Joska, J A

2018-05-19

Lay-counsellors in resource-limited settings convey critical HIV- and ART-information, and face challenges including limited training and variable application of counselling. This study explored lay-counsellors and Department of Health (DoH) perspectives on the utility of a multimedia adherence counselling program. Masivukeni, an mHealth application that provides scaffolding for delivering standardized ART counselling was used in a 3-year randomized control trail at two primary health care clinics in Cape Town, South Africa. In this programmatic and descriptive narrative report, we describe the application; lay-counsellors' response to open-ended questions regarding their experience with using Masivukeni; and perspectives of the City of Cape Town and Western Cape Government DoH, obtained through ongoing engagements and feedback sessions. Counsellors reported Masivukeni empowered them to provide high quality counselling. DoH indicated strong support for a future implementation study assessing feasibility for larger scale roll-out. Masivukeni has potential as a counselling tool in resource-limited settings.

Policy Making to Build Relationships: A Grounded Theory Analysis of Interviews and Documents Relating to H1N1, Ebola, and the U.S. Public Health Preparedness Network.

PubMed

Myers, Nathan

2016-01-01

In the last five years, the American public health emergency preparedness and response system has been tested by two significant threats, H1N1 and Ebola. While neither proved as dangerous as initially feared, these viruses highlighted on-going issues with collaborations in the field of public health and health care. Strengths were identified within the network, but also challenges that must be resolved before the U.S. faces a major pandemic. Employing interview data from public health emergency response practitioners and documentary evidence from the H1N1 and Ebola responses, this qualitative analysis uses the grounded theory approach to identify key areas for collaborative improvement. The grounded theory developed calls for a stronger policy framework at the federal level to facilitate more collaboration between U.S. agencies and facilitate more collaboration at the state and local level.

A component-based problem list subsystem for the HOLON testbed. Health Object Library Online.

PubMed Central

Law, V.; Goldberg, H. S.; Jones, P.; Safran, C.

1998-01-01

One of the deliverables of the HOLON (Health Object Library Online) project is the specification of a reference architecture for clinical information systems that facilitates the development of a variety of discrete, reusable software components. One of the challenges facing the HOLON consortium is determining what kinds of components can be made available in a library for developers of clinical information systems. To further explore the use of component architectures in the development of reusable clinical subsystems, we have incorporated ongoing work in the development of enterprise terminology services into a Problem List subsystem for the HOLON testbed. We have successfully implemented a set of components using CORBA (Common Object Request Broker Architecture) and Java distributed object technologies that provide a functional problem list application and UMLS-based "Problem Picker." Through this development, we have overcome a variety of obstacles characteristic of rapidly emerging technologies, and have identified architectural issues necessary to scale these components for use and reuse within an enterprise clinical information system. PMID:9929252

Developing the leadership skills of new graduates to influence practice environments: a novice nurse leadership program.

PubMed

Dyess, Susan; Sherman, Rose

2011-01-01

The authors of the recently published Institute of Medicine on the Future of Nursing report emphasized the importance of preparing nurses to lead change to advance health care in the United States. Other scholars linked practice environments to safe quality care. In order for nurses to fully actualize this role in practice environments, they need to possess leadership skills sets that identify and respond to challenges faced. New nurses are no exception. This article presents a program with a 5-year track record that is designed to support transition and enhance the skill sets of leadership for new nurses in their first year of practice. Qualitative and quantitative evaluation measurements at baseline and postprogram provided data for evaluation of the first 4 cohorts in the program. Evaluative outcomes presented indicate that new nurses gained leadership and translational research skills that contributed to their ability to influence practice environments. Nonetheless, practice environments continue to need improvement and ongoing leadership from all levels of nursing must be upheld.

Understanding the hepatitis C virus life cycle paves the way for highly effective therapies

PubMed Central

Scheel, Troels K H; Rice, Charles M

2014-01-01

More than two decades of intense research has provided a detailed understanding of hepatitis C virus (HCV), which chronically infects 2% of the world's population. This effort has paved the way for the development of antiviral compounds to spare patients from life-threatening liver disease. An exciting new era in HCV therapy dawned with the recent approval of two viral protease inhibitors, used in combination with pegylated interferon-α and ribavirin; however, this is just the beginning. Multiple classes of antivirals with distinct targets promise highly efficient combinations, and interferon-free regimens with short treatment duration and fewer side effects are the future of HCV therapy. Ongoing and future trials will determine the best antiviral combinations and whether the current seemingly rich pipeline is sufficient for successful treatment of all patients in the face of major challenges, such as HCV diversity, viral resistance, the influence of host genetics, advanced liver disease and other co-morbidities. PMID:23836234

Time to face the fats: what can mass spectrometry reveal about the structure of lipids and their interactions with proteins?

PubMed

Brown, Simon H J; Mitchell, Todd W; Oakley, Aaron J; Pham, Huong T; Blanksby, Stephen J

2012-09-01

Since the 1950s, X-ray crystallography has been the mainstay of structural biology, providing detailed atomic-level structures that continue to revolutionize our understanding of protein function. From recent advances in this discipline, a picture has emerged of intimate and specific interactions between lipids and proteins that has driven renewed interest in the structure of lipids themselves and raised intriguing questions as to the specificity and stoichiometry in lipid-protein complexes. Herein we demonstrate some of the limitations of crystallography in resolving critical structural features of ligated lipids and thus determining how these motifs impact protein binding. As a consequence, mass spectrometry must play an important and complementary role in unraveling the complexities of lipid-protein interactions. We evaluate recent advances and highlight ongoing challenges towards the twin goals of (1) complete structure elucidation of low, abundant, and structurally diverse lipids by mass spectrometry alone, and (2) assignment of stoichiometry and specificity of lipid interactions within protein complexes.

Time to Face the Fats: What Can Mass Spectrometry Reveal about the Structure of Lipids and Their Interactions with Proteins?

NASA Astrophysics Data System (ADS)

Brown, Simon H. J.; Mitchell, Todd W.; Oakley, Aaron J.; Pham, Huong T.; Blanksby, Stephen J.

2012-09-01

Since the 1950s, X-ray crystallography has been the mainstay of structural biology, providing detailed atomic-level structures that continue to revolutionize our understanding of protein function. From recent advances in this discipline, a picture has emerged of intimate and specific interactions between lipids and proteins that has driven renewed interest in the structure of lipids themselves and raised intriguing questions as to the specificity and stoichiometry in lipid-protein complexes. Herein we demonstrate some of the limitations of crystallography in resolving critical structural features of ligated lipids and thus determining how these motifs impact protein binding. As a consequence, mass spectrometry must play an important and complementary role in unraveling the complexities of lipid-protein interactions. We evaluate recent advances and highlight ongoing challenges towards the twin goals of (1) complete structure elucidation of low, abundant, and structurally diverse lipids by mass spectrometry alone, and (2) assignment of stoichiometry and specificity of lipid interactions within protein complexes.

Marketers don't wear plaid: marketing and health care administration in the Canadian context.

PubMed

Rigby, J M; Backman, A M

1997-01-01

Marketing has a bad reputation among Canadian health managers, even though marketing solutions may address many of their problems. This article provides an overview of current understandings of marketing and how they may be applied to health care situations. Marketing should be considered an ongoing process. This is particularly helpful if we understand the root task of health managers as creating and promoting exchanges--with governments, physicians, nurses, other health workers and client groups. Exchanges that are desirable to the health care community will more likely occur if the true costs and benefits of health services are analyzed, understood and imaginatively communicated. The public constantly evaluates the health system. Constant evaluation implies a need for marketing directed internally at staff and those within the health system, and externally at constituents outside the system. Properly understood and practiced, marketing can be part of the innovative solutions health care managers develop and apply as they deal with the difficult challenges facing them in Canada's current health care environment.

The UK Sport perspective on detecting growth hormone abuse.

PubMed

Stow, M R; Wojek, N; Marshall, J

2009-08-01

Human growth hormone (hGH) is seen as a doping risk in sport because of its possible anabolic and lipolytic effects. As a result of this hGH is prohibited for athletes to use both in and out-of-competition by the World Anti-Doping Agency (WADA) requiring Anti-Doping Organisations to work with research teams in identifying ways to detect hGH abuse. This paper reviews and discusses the UK Sport perspective on the challenges faced in detecting hGH and in particular draws upon the experiences gained during the collaborative efforts with the GH-2004 research team in achieving the implementation of the Marker Method for hGH detection. In 2008 significant progress has been made; there is one test for detecting HGH approved for use in anti-doping and a second detection method pending. This is a strong reflection of the ongoing research efforts in anti-doping and the progress being made by the Anti-Doping Organisations in reducing the risk that doping poses to sport.

A component-based problem list subsystem for the HOLON testbed. Health Object Library Online.

PubMed

Law, V; Goldberg, H S; Jones, P; Safran, C

1998-01-01

One of the deliverables of the HOLON (Health Object Library Online) project is the specification of a reference architecture for clinical information systems that facilitates the development of a variety of discrete, reusable software components. One of the challenges facing the HOLON consortium is determining what kinds of components can be made available in a library for developers of clinical information systems. To further explore the use of component architectures in the development of reusable clinical subsystems, we have incorporated ongoing work in the development of enterprise terminology services into a Problem List subsystem for the HOLON testbed. We have successfully implemented a set of components using CORBA (Common Object Request Broker Architecture) and Java distributed object technologies that provide a functional problem list application and UMLS-based "Problem Picker." Through this development, we have overcome a variety of obstacles characteristic of rapidly emerging technologies, and have identified architectural issues necessary to scale these components for use and reuse within an enterprise clinical information system.

Medicine, madness and murderers: the context of English forensic psychiatric hospitals.

PubMed

McDonald, Ruth; Furtado, Vivek; Völlm, Birgit

2017-08-21

Purpose The purpose of this paper is to add to the understanding of context by shedding light on the relationship between context and organisational actors' abilities to resolve ongoing challenges. Design/methodology/approach The authors used qualitative data collection (interviews and focus groups with staff and site visits to English forensic psychiatry hospitals) and the analysis was informed by Lefebvre's writings on space. Findings Responses to ongoing challenges were both constrained and facilitated by the context, which was negotiated and co-produced by the actors involved. Various (i.e. societal and professional) dimensions of context interacted to create tensions, which resulted in changes in service configuration. These changes were reconciled, to some extent, via discourse. Despite some resolution, the co-production of context preserved contradictions which mean that ongoing challenges were modified, but not resolved entirely. Originality/value The paper highlights the importance of viewing context as co-produced in a continuous manner. This helps us to delineate and understand its dynamic nature and its relationship with the everyday actions and beliefs of the organisational actors concerned.

The Google Online Marketing Challenge and Research Opportunities

ERIC Educational Resources Information Center

Neale, Larry; Treiblmaier, Horst; Henderson, Vani; Hunter, Lee; Hudson, Karen; Murphy, Jamie

2009-01-01

The Google Online Marketing Challenge is an ongoing collaboration between Google and academics, to give students experiential learning. The Challenge gives student teams US$200 in AdWords, Google's flagship advertising product, to develop online marketing campaigns for actual businesses. The end result is an engaging in-class exercise that…

Looking to the eyes influences the processing of emotion on face-sensitive event-related potentials in 7-month-old infants.

PubMed

Vanderwert, Ross E; Westerlund, Alissa; Montoya, Lina; McCormick, Sarah A; Miguel, Helga O; Nelson, Charles A

2015-10-01

Previous studies in infants have shown that face-sensitive components of the ongoing electroencephalogram (the event-related potential, or ERP) are larger in amplitude to negative emotions (e.g., fear, anger) versus positive emotions (e.g., happy). However, it is still unclear whether the negative emotions linked with the face or the negative emotions alone contribute to these amplitude differences. We simultaneously recorded infant looking behaviors (via eye-tracking) and face-sensitive ERPs while 7-month-old infants viewed human faces or animals displaying happy, fear, or angry expressions. We observed that the amplitude of the N290 was greater (i.e., more negative) to angry animals compared to happy or fearful animals; no such differences were obtained for human faces. Eye-tracking data highlighted the importance of the eye region in processing emotional human faces. Infants that spent more time looking to the eye region of human faces showing fearful or angry expressions had greater N290 or P400 amplitudes, respectively. © 2014 Wiley Periodicals, Inc.

New Ethical Challenges within Environmental and Sustainability Education: A Response

ERIC Educational Resources Information Center

Todd, Sharon

2016-01-01

One of the major points to grow out of the four papers presented in this issue is how to think of education in relation to the various challenges facing the biosphere, facing the future of human and other than human life forms, and facing the sheer difficulties of planning what to do about them. The differences in the role of education, of course,…

The Challenge of Fostering Healthy Organizations: An Empirical Study on the Role of Workplace Relational Civility in Acceptance of Change and Well-Being

PubMed Central

Di Fabio, Annamaria; Giannini, Marco; Loscalzo, Yura; Palazzeschi, Letizia; Bucci, Ornella; Guazzini, Andrea; Gori, Alessio

2016-01-01

The world of work in the twenty-first century is characterized by globalization, instability, and unavoidable change. Organizations need to develop a positive relational environment in the workplace thereby enabling workers to enhance their personal resources in order to face with on-going changes in the sphere of work for promoting their well-being. Against this background, the aim of this research was to examine the relationship between workplace relational civility and both acceptance of change and well-being (hedonic well-being as well as eudaimonic well-being) beyond the effect of personality traits. The following instruments were administered to 261 Italian workers: the Ten Item Personality Inventory (TIPI), the Acceptance of Change Scale (ACS), the Satisfaction With Life Scale (SWLS), and the Meaningful Life Measure (MLM). The results of hierarchical regression analyses revealed that workplace relational civility explained a percentage of incremental variance beyond personality traits in relation to acceptance of change, life satisfaction, and meaning in life. These results underscore the positive relationship between workplace relational civility and acceptance of change, hedonic well-being, and eudaimonic well-being, offering new research and intervention opportunities to meet the challenge of fostering healthy organizations. PMID:27917131

Addiction research centres and the nurturing of creativity. Monitoring the European drug situation: the ongoing challenge for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

PubMed

Griffiths, Paul; Mounteney, Jane; Lopez, Dominique; Zobel, Frank; Götz, Wolfgang

2012-02-01

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the designated hub for drug-related information in the European Union. The organization's role is to provide the European Union (EU) and its Member States with a factual overview of European drug problems and a common information framework to support the drugs debate. In order to achieve its mission, the EMCDDA coordinates and relies on a network of 30 national monitoring centres, the Reitox National Focal Points. The Centre publishes on a wide range of drug-related topics, across epidemiology, interventions, laws and policies. Every November, the EMCDDA publishes its Annual Report, providing a yearly update on the European drug situation, translated into 23 EU languages. In line with its founding regulation, the EMCDDA has a role acting as an interface between the worlds of science and policy. While not a research centre in the formal sense, the results the Centre generates serve as catalysts for new research questions and help to identify priorities. Current challenges facing the agency include continuing to increase scientific standards while maintaining a strong institutional role, as well as supporting European efforts to identify, share and codify best practice in the drugs field. © 2011 EMCDDA.

Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site.

PubMed

Higashi, Robin T; Craddock Lee, Simon J; Leonard, Tammy; Cuate, Erica L; Cole, Jay; Pruitt, Sandi L

2015-10-01

Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants' health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. CCS clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community-academic collaboration, establishes a much-needed opportunity for ongoing clinical research and intervention among this underserved population. © 2015 Wiley Periodicals, Inc.

Cultured meat from stem cells: challenges and prospects.

PubMed

Post, Mark J

2012-11-01

As one of the alternatives for livestock meat production, in vitro culturing of meat is currently studied. The generation of bio-artificial muscles from satellite cells has been ongoing for about 15 years, but has never been used for generation of meat, while it already is a great source of animal protein. In order to serve as a credible alternative to livestock meat, lab or factory grown meat should be efficiently produced and should mimic meat in all of its physical sensations, such as visual appearance, smell, texture and of course, taste. This is a formidable challenge even though all the technologies to create skeletal muscle and fat tissue have been developed and tested. The efficient culture of meat will primarily depend on culture conditions such as the source of medium and its composition. Protein synthesis by cultured skeletal muscle cells should further be maximized by finding the optimal combination of biochemical and physical conditions for the cells. Many of these variables are known, but their interactions are numerous and need to be mapped. This involves a systematic, if not systems, approach. Given the urgency of the problems that the meat industry is facing, this endeavor is worth undertaking. As an additional benefit, culturing meat may provide opportunities for production of novel and healthier products. Copyright © 2012 Elsevier Ltd. All rights reserved.

Penile hygiene: puberty, paraphimosis and personal care for men and boys with an intellectual disability.

PubMed

Wilson, N J; Cumella, S; Parmenter, T R; Stancliffe, R J; Shuttleworth, R P

2009-02-01

Supporting men and boys with an intellectual disability (ID) to meet their penile hygiene needs is perhaps one of the least acknowledged but most confronting issues facing care staff. The delivery of intimate hygiene can be a challenging topic particularly as it has been drawn into the emerging sexuality discourse and the ongoing abuse narrative. Compounding this challenge is the lack of guidance in intimate care for support staff. In addition, whereas the male with an ID outnumber the female, female care staff greatly outnumber male staff. Whether this situation affects outcomes for men and boys with an ID is unknown but it is an issue which should be examined. This paper reports data from two separate studies, one quantitative the other qualitative, which sought to explore penile hygiene as a male health issue. Results show the practice of care staff to be inconsistent, the views and values of care staff to be divergent. Some patterns and contextual differences were identified depending upon the gender of care staff. An emerging dialogue described some of the positive contributions that male staff make to men and boys with an ID. The penile health needs of men and boys with an ID are being compromised by a lack of guidance, training, knowledge and limited gender-sensitive care.

Exploring Powered Wheelchair Users and Their Caregivers’ Perspectives on Potential Intelligent Power Wheelchair Use: A Qualitative Study

PubMed Central

Kairy, Dahlia; Rushton, Paula W.; Archambault, Philippe; Pituch, Evelina; Torkia, Caryne; El Fathi, Anas; Stone, Paula; Routhier, François; Forget, Robert; Demers, Louise; Pineau, Joelle; Gourdeau, Richard

2014-01-01

Power wheelchairs (PWCs) can have a positive impact on user well-being, self-esteem, pain, activity and participation. Newly developed intelligent power wheelchairs (IPWs), allowing autonomous or collaboratively-controlled navigation, could enhance mobility of individuals not able to use, or having difficulty using, standard PWCs. The objective of this study was to explore the perspectives of PWC users (PWUs) and their caregivers regarding if and how IPWs could impact on current challenges faced by PWUs, as well as inform current development of IPWs. A qualitative exploratory study using individual interviews was conducted with PWUs (n = 12) and caregivers (n = 4). A semi-structured interview guide and video were used to facilitate informed discussion regarding IPWs. Thematic analysis revealed three main themes: (1) “challenging situations that may be overcome by an IPW” described how the IPW features of obstacle avoidance, path following, and target following could alleviate PWUs’ identified mobility difficulties; (2) “cautious optimism concerning IPW use revealed participants” addresses concerns regarding using an IPW as well as technological suggestions; (3) “defining the potential IPW user” revealed characteristics of PWUs that would benefit from IPW use. Findings indicate how IPW use may help overcome PWC difficulties and confirm the importance of user input in the ongoing development of IPWs. PMID:24566051

Cancer epidemiology in the freely associated U.S. Pacific Island jurisdictions: challenges and methodologic issues.

PubMed

Katz, Alan R; Palafox, Neal A; Johnson, David B; Yamada, Seiji; Ou, Alan C; Minami, Jill S

2004-09-01

The health care systems of the U.S.-associated Pacific Island jurisdictions, especially the three freely associated states (Federated States of Micronesia, Republic of the Marshall Islands, and Republic of Belau), are faced with problems similar to developing countries such as malnutrition and infectious diseases, as well as diseases relating to westernization such as diabetes, heart disease, and cancer. Although cancer has emerged as an important cause of morbidity and mortality in the Pacific, little population-based data are currently available. This paper addresses some of the practical and methodological challenges to obtaining accurate and reliable cancer data in these jurisdictions. This paper discusses the use of annualized period prevalence to allow for some measurement of cancer burden when cancer incidence cannot be accurately calculated. This method, however, has its own limitations as cancer prevalence relates to both incidence and duration of illness, and numerous factors impact survival potential (i.e., preexisting diseases, lifestyle practices, and access to treatment). In addition, under-ascertainment and data quality issues will impact any cancer morbidity or mortality measurements. Thus, improvement in the health care systems, including the creation and ongoing support of active cancer registries would be the optimal approach to better delineating cancer occurrence and risk for the populations of these Pacific Island jurisdictions.

Climate change and forests of the future: Managing in the face of uncertainty

USGS Publications Warehouse

Millar, C.I.; Stephenson, N.L.; Stephens, S.L.

2007-01-01

We offer a conceptual framework for managing forested ecosystems under an assumption that future environments will be different from present but that we cannot be certain about the specifics of change. We encourage flexible approaches that promote reversible and incremental steps, and that favor ongoing learning and capacity to modify direction as situations change. We suggest that no single solution fits all future challenges, especially in the context of changing climates, and that the best strategy is to mix different approaches for different situations. Resources managers will be challenged to integrate adaptation strategies (actions that help ecosystems accommodate changes adaptively) and mitigation strategies (actions that enable ecosystems to reduce anthropogenic influences on global climate) into overall plans. Adaptive strategies include resistance options (forestall impacts and protect highly valued resources), resilience options (improve the capacity of ecosystems to return to desired conditions after disturbance), and response options (facilitate transition of ecosystems from current to new conditions). Mitigation strategies include options to sequester carbon and reduce overall greenhouse gas emissions. Priority-setting approaches (e.g., triage), appropriate for rapidly changing conditions and for situations where needs are greater than available capacity to respond, will become increasingly important in the future. ?? 2007 by the Ecological Society of America.

Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site

PubMed Central

Higashi, Robin T.; Craddock Lee, Simon J.; Leonard, Tammy; Cuate, Erica L.; Cole, Jay

2015-01-01

Abstract Background Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. Methods : Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants’ health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. Results Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. Conclusion CCS clients represent a high‐need, under‐reached population willing to engage in health‐related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community–academic collaboration, establishes a much‐needed opportunity for ongoing clinical research and intervention among this underserved population. PMID:26277918

Marketed Marine Natural Products in the Pharmaceutical and Cosmeceutical Industries: Tips for Success

PubMed Central

Martins, Ana; Vieira, Helena; Gaspar, Helena; Santos, Susana

2014-01-01

The marine environment harbors a number of macro and micro organisms that have developed unique metabolic abilities to ensure their survival in diverse and hostile habitats, resulting in the biosynthesis of an array of secondary metabolites with specific activities. Several of these metabolites are high-value commercial products for the pharmaceutical and cosmeceutical industries. The aim of this review is to outline the paths of marine natural products discovery and development, with a special focus on the compounds that successfully reached the market and particularly looking at the approaches tackled by the pharmaceutical and cosmetic companies that succeeded in marketing those products. The main challenges faced during marine bioactives discovery and development programs were analyzed and grouped in three categories: biodiversity (accessibility to marine resources and efficient screening), supply and technical (sustainable production of the bioactives and knowledge of the mechanism of action) and market (processes, costs, partnerships and marketing). Tips to surpass these challenges are given in order to improve the market entry success rates of highly promising marine bioactives in the current pipelines, highlighting what can be learned from the successful and unsuccessful stories that can be applied to novel and/or ongoing marine natural products discovery and development programs. PMID:24549205

The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS.

PubMed

Nevedal, Andrea; Sankar, Andrea

2016-08-01

Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker's (1997) life course disruption theory, we explored older African Americans' experiences of living with HIV/AIDS. A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Older African Americans' discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Exploring powered wheelchair users and their caregivers' perspectives on potential intelligent power wheelchair use: a qualitative study.

PubMed

Kairy, Dahlia; Rushton, Paula W; Archambault, Philippe; Pituch, Evelina; Torkia, Caryne; El Fathi, Anas; Stone, Paula; Routhier, François; Forget, Robert; Demers, Louise; Pineau, Joelle; Gourdeau, Richard

2014-02-21

Power wheelchairs (PWCs) can have a positive impact on user well-being, self-esteem, pain, activity and participation. Newly developed intelligent power wheelchairs (IPWs), allowing autonomous or collaboratively-controlled navigation, could enhance mobility of individuals not able to use, or having difficulty using, standard PWCs. The objective of this study was to explore the perspectives of PWC users (PWUs) and their caregivers regarding if and how IPWs could impact on current challenges faced by PWUs, as well as inform current development of IPWs. A qualitative exploratory study using individual interviews was conducted with PWUs (n = 12) and caregivers (n = 4). A semi-structured interview guide and video were used to facilitate informed discussion regarding IPWs. Thematic analysis revealed three main themes: (1) "challenging situations that may be overcome by an IPW" described how the IPW features of obstacle avoidance, path following, and target following could alleviate PWUs' identified mobility difficulties; (2) "cautious optimism concerning IPW use revealed participants" addresses concerns regarding using an IPW as well as technological suggestions; (3) "defining the potential IPW user" revealed characteristics of PWUs that would benefit from IPW use. Findings indicate how IPW use may help overcome PWC difficulties and confirm the importance of user input in the ongoing development of IPWs.

Simulation of groundwater and surface-water resources of the Santa Rosa Plain watershed, Sonoma County, California

USGS Publications Warehouse

Woolfenden, Linda R.; Nishikawa, Tracy

2014-01-01

Water managers in the Santa Rosa Plain face the challenge of meeting increasing water demand with a combination of Russian River water, which has uncertainties in its future availability; local groundwater resources; and ongoing and expanding recycled water and water from other conservation programs. To address this challenge, the U.S. Geological Survey, in cooperation with the Sonoma County Water Agency, the cities of Cotati, Rohnert Park, Santa Rosa, and Sebastopol, the town of Windsor, the California American Water Company, and the County of Sonoma, undertook development of a fully coupled groundwater and surface-water model to better understand and to help manage the hydrologic resources in the Santa Rosa Plain watershed. The purpose of this report is to (1) describe the construction and calibration of the fully coupled groundwater and surface-water flow model for the Santa Rosa Plain watershed, referred to as the Santa Rosa Plain hydrologic model; (2) present results from simulation of the Santa Rosa Plain hydrologic model, including water budgets, recharge distributions, streamflow, and the effect of pumping on water-budget components; and (3) present the results from using the model to evaluate the potential hydrologic effects of climate change and variability without pumpage for water years 2011-99 and with projected pumpage for water years 2011-40.

The Challenge of Fostering Healthy Organizations: An Empirical Study on the Role of Workplace Relational Civility in Acceptance of Change and Well-Being.

PubMed

Di Fabio, Annamaria; Giannini, Marco; Loscalzo, Yura; Palazzeschi, Letizia; Bucci, Ornella; Guazzini, Andrea; Gori, Alessio

2016-01-01

The world of work in the twenty-first century is characterized by globalization, instability, and unavoidable change. Organizations need to develop a positive relational environment in the workplace thereby enabling workers to enhance their personal resources in order to face with on-going changes in the sphere of work for promoting their well-being. Against this background, the aim of this research was to examine the relationship between workplace relational civility and both acceptance of change and well-being (hedonic well-being as well as eudaimonic well-being) beyond the effect of personality traits. The following instruments were administered to 261 Italian workers: the Ten Item Personality Inventory (TIPI), the Acceptance of Change Scale (ACS), the Satisfaction With Life Scale (SWLS), and the Meaningful Life Measure (MLM). The results of hierarchical regression analyses revealed that workplace relational civility explained a percentage of incremental variance beyond personality traits in relation to acceptance of change, life satisfaction, and meaning in life. These results underscore the positive relationship between workplace relational civility and acceptance of change, hedonic well-being, and eudaimonic well-being, offering new research and intervention opportunities to meet the challenge of fostering healthy organizations.

Precision medicine needs pioneering clinical bioinformaticians.

PubMed

Gómez-López, Gonzalo; Dopazo, Joaquín; Cigudosa, Juan C; Valencia, Alfonso; Al-Shahrour, Fátima

2017-10-25

Success in precision medicine depends on accessing high-quality genetic and molecular data from large, well-annotated patient cohorts that couple biological samples to comprehensive clinical data, which in conjunction can lead to effective therapies. From such a scenario emerges the need for a new professional profile, an expert bioinformatician with training in clinical areas who can make sense of multi-omics data to improve therapeutic interventions in patients, and the design of optimized basket trials. In this review, we first describe the main policies and international initiatives that focus on precision medicine. Secondly, we review the currently ongoing clinical trials in precision medicine, introducing the concept of 'precision bioinformatics', and we describe current pioneering bioinformatics efforts aimed at implementing tools and computational infrastructures for precision medicine in health institutions around the world. Thirdly, we discuss the challenges related to the clinical training of bioinformaticians, and the urgent need for computational specialists capable of assimilating medical terminologies and protocols to address real clinical questions. We also propose some skills required to carry out common tasks in clinical bioinformatics and some tips for emergent groups. Finally, we explore the future perspectives and the challenges faced by precision medicine bioinformatics. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Performance and accountability : challenges facing the Department of Transportation

DOT National Transportation Integrated Search

2001-02-14

For surface transportation safety, DOT continues to face challenges in improving the safety of highways and pipelines. While the Department of Transportation appears to be making progress on some initiatives to reduce the number of large truck crashe...

Toward a Social Psychophysics of Face Communication.

PubMed

Jack, Rachael E; Schyns, Philippe G

2017-01-03

As a highly social species, humans are equipped with a powerful tool for social communication-the face. Although seemingly simple, the human face can elicit multiple social perceptions due to the rich variations of its movements, morphology, and complexion. Consequently, identifying precisely what face information elicits different social perceptions is a complex empirical challenge that has largely remained beyond the reach of traditional methods. In the past decade, the emerging field of social psychophysics has developed new methods to address this challenge, with the potential to transfer psychophysical laws of social perception to the digital economy via avatars and social robots. At this exciting juncture, it is timely to review these new methodological developments. In this article, we introduce and review the foundational methodological developments of social psychophysics, present work done in the past decade that has advanced understanding of the face as a tool for social communication, and discuss the major challenges that lie ahead.

Changing therapeutic paradigms in CMV retinitis in AIDS.

PubMed

Piper, H; Ciulla, T A; Danis, R P; Pratt, L M

2000-12-01

Cytomegalovirus (CMV) retinitis is a common ocular complication of immunosuppression. The management of CMV retinitis has been continuously evolving over the last decade. The mainstay of therapy remains ganciclovir and foscarnet. However, increasing resistance and ongoing toxicities to these agents remain a challenge. Additional frequently utilised agents include cidofovir and fomivirsen. The advent of highly active antiretroviral therapy (HAART) has allowed the restoration of immunocompetency to many patients previously challenged by CMV infection. In some circumstances, HAART has even eliminated the need for ongoing antiviral therapy. This paper reviews the current treatment modalities, including their toxicities and dosing recommendations.

Geritalk: communication skills training for geriatric and palliative medicine fellows.

PubMed

Kelley, Amy S; Back, Anthony L; Arnold, Robert M; Goldberg, Gabrielle R; Lim, Betty B; Litrivis, Evgenia; Smith, Cardinale B; O'Neill, Lynn B

2012-02-01

Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n = 18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P < .001). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. © 2012, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Recent Updates on Novel Approaches in Insulin Drug Delivery: A Review of Challenges and Pharmaceutical Implications.

PubMed

Pandey, Manisha; Choudhury, Hira; Yi, Cheah Xiao; Mun, Chen Wei; Ping, Goh Khang; Rou, Guee Xin; Singh, Bhalqish Jeet Kaur A/P Ambar Jeet; Jhee, Angel Ng Ann; Chin, Lee Kai; Kesharwani, Prashant; Gorain, Bapi; Hussain, Zahid

2018-05-22

Diabetes mellitus, a metabolic disorder of glucose metabolism, is mainly associated with insulin resistance to the body cells, or impaired production of insulin by the pancreatic β-cells. Insulin is mainly required to regulate glucose metabolism in type 1 diabetes mellitus patients; however, many patients with type 2 diabetes mellitus also require insulin, especially when their condition cannot be controlled solely by oral hypoglycemic agents. Hence, major researches are ongoing attempting to improve the delivery of insulin in order to make it more convenient to patients who experience side effects from the conventional treatment procedure or non-adherence to insulin regimen due to multiple comorbid conditions. Conventionally, insulin is administered via subcutaneous route which is also one of the sole reasons of patient's non-compliance due to the invasiveness of this method. Several attempts have been done to improve patient compliance, reduce side effects, improve delivery adherence, and to enhance pharmaceutical performance of the insulin therapy. Despite of facing substantial challenges in developing efficient delivery systems for insulin, vast researches have been carried out for the development of smart delivery systems to delivery insulin via ocular, buccal, pulmonary, oral, transdermal, as well as rectal routes. Therefore, the present review was aimed to overview the challenges encountered with the current insulin delivery systems and to summarize recent advancements in technology of various novel insulin delivery systems being discovered and introduced in the current market. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Geritalk: Communication Skills Training for Geriatrics and Palliative Medicine Fellows

PubMed Central

Kelley, Amy S.; Back, Anthony L.; Arnold, Robert M.; Goldberg, Gabrielle R.; Lim, Betty B.; Litrivis, Evgenia; Smith, Cardinale B.; O’Neill, Lynn B.

2011-01-01

Expert communication is essential to high quality care for older patients with serious illness. While the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatrics and palliative medicine fellows is often inadequate or unavailable. We drew upon the educational principles and format of an evidence-based, interactive teaching method, to develop an intensive communication skills training course designed specifically to address the common communication challenges faced by geriatrics and palliative medicine fellows. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques prior to the course. Geriatrics and palliative medicine fellows were recruited to participate in the course and 100% (n=18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on 5-point scale). Compared to before the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, p<0.01). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, tailored to the specific needs of geriatrics and palliative medicine fellows, improved fellows’ self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills. PMID:22211768

Unmet medical needs in systemic lupus erythematosus

PubMed Central

2012-01-01

Systemic lupus erythematosus (SLE) is an autoimmune disease of diverse manifestations, with onset usually in young women in the third to fourth decade of life. The chronic nature of this relapsing remitting disease leads to organ damage accrual over time. Mortality and morbidity are increased in patients with SLE compared with the general population. Therapeutic advances over the last few decades have led to significant improvements in patient outcomes. Five-year survival has improved to over 90% from a low of 50% in the 1950s. However, multiple aspects of the management of SLE patients are still far from optimal. Early diagnosis remains a challenge; diagnostic delays leading to delay in definitive treatment are common. Monitoring treatment remains problematic due to the paucity of sensitive biomarkers. Current treatment regimens rely heavily on corticosteroids, even though corticosteroids are well known to cause organ damage. Treatment of refractory disease manifestations such as nephritis, recalcitrant cutaneous lesions and neurological involvement require new approaches with greater efficacy. Cognitive dysfunction is common in SLE patients, but early recognition and adequate treatment are yet to be established. Premature accelerated atherosclerosis remains a leading cause of morbidity and mortality. Fatigue is one of the most disabling symptoms, and contributes to the poor quality of life in patients with SLE. Ongoing research in SLE faces many challenges, including enrollment of homogeneous patient populations, use of reliable outcome measures and a standard control arm. The current review will highlight some of the outstanding unmet challenges in the management of this complex disease. PMID:23281889

The Brotherhood Medical Center: Collaborative Foundation of Maternity and Children's Healthcare Facility for Displaced Syrians.

PubMed

Aburas, Rahma; Najeeb, Amina; Baageel, Laila; Mackey, Tim K

2018-01-01

The United Nations has declared the Syrian conflict, with more than 50% of Syria's population currently displaced, as the worst humanitarian crisis of the twenty-first century. The Syrian conflict has led to a collapse of infrastructure, including access to critical and lifesaving healthcare services. Women and children account for approximately 75% of internally displaced Syrians and refugees. This population is also particularly vulnerable to poor health outcomes, a condition worsened by lack of access to maternal and child health services. In response to this crisis, a partnership of Saudi and Syrian physicians established a non-profit healthcare facility named the Brotherhood Medical Center (BMC) to serve women and children within a safe area near the Syrian-Turkish border. The project began in September 2014 and was implemented in three phases of establishment, phased construction and formal launch and operation. Currently, the BMC is working at about 70% of its capacity and is run in partnership with the Syrian Expatriate Medical Association. Although there was strong initial support from donors, the BMC continues to face many financial and operational challenges, including difficulties in transferring money to Syria, shortage of medical supplies, and lack of qualified medical personnel. Despite these challenges, the BMC represents a critical model and an important case study of the challenges of delivering healthcare services to underserved populations during an ongoing conflict. However, more robust support from the international community is needed to ensure it continues its important health and humanitarian mission.

Behavioral responses of Pacific lamprey to alarm cues

USGS Publications Warehouse

Porter, Laurie L.; Hayes, Michael C.; Jackson, Aaron D.; Burke, Brian J.; Moser, Mary L.; Wagner, R. Steven

2017-01-01

Pacific lamprey (Entosphenus tridentatus), an anadromous ectoparasite, faces several challenges during adult migration to spawning grounds. Developing methods to address these challenges is critical to the success of ongoing conservation efforts. The challenges are diverse, and include anthropogenic alterations to the ecosystem resulting in loss of habitat, impassable barriers such as dams, climate change impacts, and altered predator fields. We conducted a behavioral study to understand how adult migrating Pacific lamprey respond to potential alarm cues: White Sturgeon (Acipenser transmontanus), human saliva, decayed Pacific lamprey, and river otter (Lontra canadensis). Research has shown that some species of lamprey can be guided to a location using odors and similar cues may be useful as a management tool for Pacific lamprey. Experiments were conducted over 2 nights and measured the number of entries (count) and duration of time spent (occupancy) by adult lamprey in each arm of a two-choice maze. During the first night, no odor was added to test for selection bias between arms. During the second night odor was added to one arm of the maze. Contrary to expectations, lamprey were significantly attracted to the river otter odor in both count and occupancy. No significant differences were found in the response of lamprey to the other three odors. Results from this study indicate that Pacific lamprey do respond to some odors; however, additional tests are necessary to better identify the types of odors and concentrations that elicit a repeatable response.

Factor for felons: how can we provide haemophilia care to the incarcerated?

PubMed

Lambing, A; Kachalsky, E; Mueller, L M; Kuriakose, P

2015-11-01

In 2011, 6.98-million offenders were documented in the adult correctional system, with state operating costs designated 12% towards medical care ($11.97 day per inmate) for the general population. Common co-existing health problems identified are: arthritis (13%), hypertension (11%), asthma (10%) and heart problems (6%). Less than 5% of inmates have health issues related to cancer, diabetes, liver or renal problems and communicable diseases. The leading cause of death is suicide (33.2%), followed by heart disease (26.1%). Despite these statistics quality is lacking. Given these statistics, one would expect that a small proportion of patients from Hemophilia Treatment Center (HTC) will spend some time within the justice system. Currently there are no data addressing haemophilia care needs while incarcerated. This article will review the current health care issues in the adult correctional system. Additionally, six case reports of incarcerated haemophiliacs will be highlighted exploring the successes and challenges with maintaining haemophilia care addressing the priority of meeting the haemophilia care needs verses the penal system regulations. It can be expected that at some point, the HTC will experience a patient incarcerated for some period of time. The HTC will continue to advocate for their patient within this system, despite the many challenges faced. Despite the challenges outlined, ongoing communication and education with the correctional system, education of the medical personnel and prison personnel remains the priority as we advocate for our patients. Continued strategies in these areas are paramount. © 2015 John Wiley & Sons Ltd.

Pose-Invariant Face Recognition via RGB-D Images.

PubMed

Sang, Gaoli; Li, Jing; Zhao, Qijun

2016-01-01

Three-dimensional (3D) face models can intrinsically handle large pose face recognition problem. In this paper, we propose a novel pose-invariant face recognition method via RGB-D images. By employing depth, our method is able to handle self-occlusion and deformation, both of which are challenging problems in two-dimensional (2D) face recognition. Texture images in the gallery can be rendered to the same view as the probe via depth. Meanwhile, depth is also used for similarity measure via frontalization and symmetric filling. Finally, both texture and depth contribute to the final identity estimation. Experiments on Bosphorus, CurtinFaces, Eurecom, and Kiwi databases demonstrate that the additional depth information has improved the performance of face recognition with large pose variations and under even more challenging conditions.

Software process assessments

NASA Technical Reports Server (NTRS)

Miller, Sharon E.; Tucker, George T.; Verducci, Anthony J., Jr.

1992-01-01

Software process assessments (SPA's) are part of an ongoing program of continuous quality improvements in AT&T. Their use was found to be very beneficial by software development organizations in identifying the issues facing the organization and the actions required to increase both quality and productivity in the organization.

Case Studies of Two High-Poverty High-Performing Schools

ERIC Educational Resources Information Center

Gehrke, Lori R.

2010-01-01

The existing literature on learning organizations emphasize that leadership and strong organizational culture are central to their successful development. Whereas schools continue to face government control, accountability, and financial restraints, they are also working diligently to engage in ongoing school improvement practices to provide…

Developing an online professional network for veterinary education: the NOVICE project.

PubMed

Baillie, Sarah; Kinnison, Tierney; Forrest, Neil; Dale, Vicki H M; Ehlers, Jan P; Koch, Michael; Mándoki, Mira; Ciobotaru, Emilia; de Groot, Esther; Boerboom, Tobias B B; van Beukelen, Peter

2011-01-01

An online professional network for veterinarians, veterinary students, veterinary educationalists, and ICT (Information and Communication Technology) educationalists is being developed under the EU (European Union) Lifelong Learning Programme. The network uses Web 2.0, a term used to describe the new, more interactive version of the Internet, and includes tools such as wikis, blogs, and discussion boards. Focus groups conducted with qualified and student veterinarians within the project's five founding countries (The Netherlands, Germany, United Kingdom, Hungary, Romania) demonstrated that online professional communities can be valuable for accessing information and establishing contacts. Online networks have the potential to overcome common challenges to face-to-face communities-such as distance, cost, and timing-but they have their own drawbacks, such as security and professionalism issues. The Network Of Veterinary ICt in Education (NOVICE) was developed using Elgg, an open-source, free social networking platform, after several software options had been considered. NOVICE aims to promote the understanding of Web 2.0, confidence to use social software tools, and participation in an online community. Therefore, the Web site contains help sections, Frequently Asked Questions, and access to support from ICT experts. Five months after the network's launch (and just over one year into the project) 515 members from 28 countries had registered. Further research will include analysis of a core group's activities, which will inform ongoing support for and development of informal, lifelong learning in a veterinary context.

Facilitating the High School-to-College Transition for Students with Psychiatric Disabilities: Information and Strategies for School Counselors

ERIC Educational Resources Information Center

Fier, Sara M.; Brzezinski, Lynda G.

2010-01-01

The transition from high school to college is challenging for many students. In addition to the typical challenges faced by students starting college, students with previously diagnosed psychiatric disabilities have illness-related challenges to face as they transition to college. This article provides information on the current state of concerns…

College Students with High-Functioning Autism Spectrum Disorder: Best Practices for Successful Transition to the World of Work

ERIC Educational Resources Information Center

Dipeolu, Abiola O.; Storlie, Cassandra; Johnson, Carol

2015-01-01

The transition from college to work is a challenging time for students with autism spectrum disorder. College counselors who understand the challenges students face adjusting to the world of work can position themselves to be change agents for this population. This article illuminates the challenges facing these students to help close the…

Challenges Faced by Pre-Service Chemistry Teachers Teaching in a Laboratory and Their Solution Proposals

ERIC Educational Resources Information Center

Yalcin-Celik, Ayse; Kadayifci, Hakki; Uner, Sinem; Turan-Oluk, Nurcan

2017-01-01

This study examines the challenges faced by pre-service chemistry teachers teaching in a laboratory and their proposed solutions to these challenges. The study was conducted in a 13-week-long methodology course. Written statements from participants and observations from researchers were used as data sources. From these data, it was found that the…

Investigation of the Challenges, Mentoring Needs, and Support for Business and Marketing Teachers

ERIC Educational Resources Information Center

Yohon, Teresa

2005-01-01

The purpose of this study was to determine the challenges that new business/marketing teachers face as well as the current support structures available to them and to determine experienced business/marketing teachers perceptions of the challenges faced by new teachers as well as the types of support that they were willing to provide to new…

Challenges Faced by a Faith-Based School in a Rural, Predominantly Secular Setting: Implications

ERIC Educational Resources Information Center

Evangelinou-Yiannakis, Angela

2016-01-01

A new, independent Catholic school in rural Australia has had to face significant challenges in relation to its distinct Catholic ethos and curriculum. The challenges have included resistance from parents of the School with regard to the weekly time allocation for Religious Education, the nature of the faith-based curriculum, and the way in which…

Challenges for nurses who work in community mental health centres in the West Bank, Palestine.

PubMed

Marie, Mohammad; Hannigan, Ben; Jones, Aled

2017-01-01

Nurses in Palestine (occupied Palestinian territory) work in a significantly challenging environment. The mental health care system is underdeveloped and under-resourced. For example, the total number of nurses who work in community mental health centres in the West Bank is seventeen, clearly insufficient in a total population of approximately three million. This research explored daily challenges that Palestinian community mental health nurses (CMHNs) face within and outside their demanding workplaces. An interpretive qualitative design was chosen. Face-to-face interviews were completed with fifteen participants. Thirty-two hours of observations of the day-to-day working environment and workplace routines were conducted in two communities' mental health centres. Written documents relating to practical job-related policies were also collected from various workplaces. Thematic analysis was used across all data sources resulting in four main themes, which describe the challenges faced by CMHNs. These themes consist of the context of unrest, stigma, lack of resources, and organisational or mental health system challenges. The study concludes with a better understanding of challenges in nursing which draws on wider cultural contexts and resilience. The outcomes from this study can be used to decrease the challenges for health professionals and enhance the mental health care system in Palestine.

A Cost-Effectiveness Analysis of Blended Versus Face-to-Face Delivery of Evidence-Based Medicine to Medical Students.

PubMed

Maloney, Stephen; Nicklen, Peter; Rivers, George; Foo, Jonathan; Ooi, Ying Ying; Reeves, Scott; Walsh, Kieran; Ilic, Dragan

2015-07-21

Blended learning describes a combination of teaching methods, often utilizing digital technologies. Research suggests that learner outcomes can be improved through some blended learning formats. However, the cost-effectiveness of delivering blended learning is unclear. This study aimed to determine the cost-effectiveness of a face-to-face learning and blended learning approach for evidence-based medicine training within a medical program. The economic evaluation was conducted as part of a randomized controlled trial (RCT) comparing the evidence-based medicine (EBM) competency of medical students who participated in two different modes of education delivery. In the traditional face-to-face method, students received ten 2-hour classes. In the blended learning approach, students received the same total face-to-face hours but with different activities and additional online and mobile learning. Online activities utilized YouTube and a library guide indexing electronic databases, guides, and books. Mobile learning involved self-directed interactions with patients in their regular clinical placements. The attribution and differentiation of costs between the interventions within the RCT was measured in conjunction with measured outcomes of effectiveness. An incremental cost-effectiveness ratio was calculated comparing the ongoing operation costs of each method with the level of EBM proficiency achieved. Present value analysis was used to calculate the break-even point considering the transition cost and the difference in ongoing operation cost. The incremental cost-effectiveness ratio indicated that it costs 24% less to educate a student to the same level of EBM competency via the blended learning approach used in the study, when excluding transition costs. The sunk cost of approximately AUD $40,000 to transition to the blended model exceeds any savings from using the approach within the first year of its implementation; however, a break-even point is achieved within its third iteration and relative savings in the subsequent years. The sensitivity analysis indicates that approaches with higher transition costs, or staffing requirements over that of a traditional method, are likely to result in negative value propositions. Under the study conditions, a blended learning approach was more cost-effective to operate and resulted in improved value for the institution after the third year iteration, when compared to the traditional face-to-face model. The wider applicability of the findings are dependent on the type of blended learning utilized, staffing expertise, and educational context.

Inverting faces elicits sensitivity to race on the N170 component: a cross-cultural study.

PubMed

Vizioli, Luca; Foreman, Kay; Rousselet, Guillaume A; Caldara, Roberto

2010-01-29

Human beings are natural experts at processing faces, with some notable exceptions. Same-race faces are better recognized than other-race faces: the so-called other-race effect (ORE). Inverting faces impairs recognition more than for any other inverted visual object: the so-called face inversion effect (FIE). Interestingly, the FIE is stronger for same- compared to other-race faces. At the electrophysiological level, inverted faces elicit consistently delayed and often larger N170 compared to upright faces. However, whether the N170 component is sensitive to race is still a matter of ongoing debate. Here we investigated the N170 sensitivity to race in the framework of the FIE. We recorded EEG from Western Caucasian and East Asian observers while presented with Western Caucasian, East Asian and African American faces in upright and inverted orientations. To control for potential confounds in the EEG signal that might be evoked by the intrinsic and salient differences in the low-level properties of faces from different races, we normalized their amplitude-spectra, luminance and contrast. No differences on the N170 were observed for upright faces. Critically, inverted same-race faces lead to greater recognition impairment and elicited larger N170 amplitudes compared to inverted other-race faces. Our results indicate a finer-grained neural tuning for same-race faces at early stages of processing in both groups of observers.

The establishment of a mother-baby inpatient psychiatry unit in India: Adaptation of a Western model to meet local cultural and resource needs

PubMed Central

Chandra, Prabha S.; Desai, Geetha; Reddy, Dharma; Thippeswamy, Harish; Saraf, Gayatri

2015-01-01

Background: Several Western countries have established mother-baby psychiatric units for women with mental illness in the postpartum; similar facilities are however not available in most low and medium income countries owing to the high costs of such units and the need for specially trained personnel. Materials and Methods: The first dedicated inpatient mother-baby unit (MBU) was started in Bengaluru, India, in 2009 at the National Institute of Mental Health and Neurosciences in response to the growing needs of mothers with severe mental illness and their infants. We describe the unique challenges faced in the unit, characteristics of this patient population and clinical outcomes. Results: Two hundred and thirty-seven mother-infant pairs were admitted from July 2009 to September 2013. Bipolar disorder and acute polymorphic psychosis were the most frequent primary diagnosis (36% and 34.5%). Fifteen percent of the women had catatonic symptoms. Suicide risk was present in 36 (17%) mothers and risk to the infant by mothers in 32 (16%). Mother-infant bonding problems were seen in 98 (41%) mothers and total breastfeeding disruption in 87 (36.7%) mothers. Eighty-seven infants (37%) needed an emergency pediatric referral. Ongoing domestic violence was reported by 42 (18%). The majority of the mother infant dyads stayed for <4 weeks and were noted to have improved at discharge. However, 12 (6%) mothers had readmissions during the study period of 4 years. Disrupted breastfeeding was restituted in 75 of 87 (86%), mother infant dyads and mother infant bonding were normal in all except ten mothers at discharge. Conclusions: Starting an MBU in a low resource setting is feasible and is associated with good clinical outcomes. Addressing risks, poor infant health, breastfeeding disruption, mother infant bonding and ongoing domestic violence are the challenges during the process. PMID:26600584

Neuromechanical tuning of nonlinear postural control dynamics

NASA Astrophysics Data System (ADS)

Ting, Lena H.; van Antwerp, Keith W.; Scrivens, Jevin E.; McKay, J. Lucas; Welch, Torrence D. J.; Bingham, Jeffrey T.; DeWeerth, Stephen P.

2009-06-01

Postural control may be an ideal physiological motor task for elucidating general questions about the organization, diversity, flexibility, and variability of biological motor behaviors using nonlinear dynamical analysis techniques. Rather than presenting "problems" to the nervous system, the redundancy of biological systems and variability in their behaviors may actually be exploited to allow for the flexible achievement of multiple and concurrent task-level goals associated with movement. Such variability may reflect the constant "tuning" of neuromechanical elements and their interactions for movement control. The problem faced by researchers is that there is no one-to-one mapping between the task goal and the coordination of the underlying elements. We review recent and ongoing research in postural control with the goal of identifying common mechanisms underlying variability in postural control, coordination of multiple postural strategies, and transitions between them. We present a delayed-feedback model used to characterize the variability observed in muscle coordination patterns during postural responses to perturbation. We emphasize the significance of delays in physiological postural systems, requiring the modulation and coordination of both the instantaneous, "passive" response to perturbations as well as the delayed, "active" responses to perturbations. The challenge for future research lies in understanding the mechanisms and principles underlying neuromechanical tuning of and transitions between the diversity of postural behaviors. Here we describe some of our recent and ongoing studies aimed at understanding variability in postural control using physical robotic systems, human experiments, dimensional analysis, and computational models that could be enhanced from a nonlinear dynamics approach.

The 13th International Workshops on Opportunistic Protists (IWOP13).

PubMed

Calderon, Enrique J; Cushion, Melanie T; Xiao, Lihua; Lorenzo-Morales, Jacob; Matos, Olga; Kaneshiro, Edna S; Weiss, Louis M

2015-01-01

The 13th International Workshops on Opportunistic Protists (IWOP-13) was held November 13-15, 2014 in Seville, Spain. The objectives of the IWOP meetings are to: (1) serve as a forum for exchange of new information among active researchers concerning the basic biology, molecular genetics, immunology, biochemistry, pathogenesis, drug development, therapy, and epidemiology of these immunodeficiency-associated pathogenic eukaryotic microorganisms that are seen in patients with AIDS and; (2) to foster the entry of new and young investigators into these underserved research areas. The IWOP meeting focuses on opportunistic protists; e.g. the free-living amoebae, Pneumocystis, Cryptosporidium, Toxoplasma, the Microsporidia, and kinetoplastid flagellates. This conference represents the major conference which brings together research groups working on these opportunistic pathogens. Progress has been achieved on understanding the biology of these pathogenic organisms, their involvement in disease causation in both immune deficient and immune competent hosts and is providing important insights into these emerging and reemerging pathogens. A continuing concern of the participants is the ongoing loss of scientific expertise and diversity in this research community. This decline is due to the small size of these research communities and an ongoing lack of understanding by the broader scientific community of the challenges and limitations faced by researchers working on these organisms, which makes these research communities very sensitive to declines in research funding. © 2015 The Author(s) Journal of Eukaryotic Microbiology © 2015 International Society of Protistologists.

Adverse childhood experiences: assessing the impact on health and school engagement and the mitigating role of resilience.

PubMed

Bethell, Christina D; Newacheck, Paul; Hawes, Eva; Halfon, Neal

2014-12-01

The ongoing longitudinal Adverse Childhood Experiences Study of adults has found significant associations between chronic conditions; quality of life and life expectancy in adulthood; and the trauma and stress associated with adverse childhood experiences, including physical or emotional abuse or neglect, deprivation, or exposure to violence. Less is known about the population-based epidemiology of adverse childhood experiences among US children. Using the 2011-12 National Survey of Children's Health, we assessed the prevalence of adverse childhood experiences and associations between them and factors affecting children's development and lifelong health. After we adjusted for confounding factors, we found lower rates of school engagement and higher rates of chronic disease among children with adverse childhood experiences. Our findings suggest that building resilience-defined in the survey as "staying calm and in control when faced with a challenge," for children ages 6-17-can ameliorate the negative impact of adverse childhood experiences. We found higher rates of school engagement among children with adverse childhood experiences who demonstrated resilience, as well as higher rates of resilience among children with such experiences who received care in a family-centered medical home. We recommend a coordinated effort to fill knowledge gaps and translate existing knowledge about adverse childhood experiences and resilience into national, state, and local policies, with a focus on addressing childhood trauma in health systems as they evolve during ongoing reform. Project HOPE—The People-to-People Health Foundation, Inc.

Gender Dysphoria in the Military.

PubMed

Ford, Shannon; Schnitzlein, Carla

2017-11-07

With the announcement that members of the military who identify as transgender are allowed to serve openly, the need for Department of Defense behavioral health providers to be comfortable in the assessment, diagnosis, and treatment of this population becomes quickly evident. This population has been seeking care in the community and standards have been developed to help guide decision-making, but a comparable document does not exist for the military population. Previously published papers were written in anticipation of the policy allowing for open service. The civilian sector has treatment guidelines and evidence supporting the same for reference. There is no similar document for the military population, likely due to the recent change and ongoing development. This paper attempts to provide an overview of the recent Department of Defense policy and walks the reader through key considerations when providing care to a transgender member of the military as it relates to those who are currently serving in the military through the use of a case example. The military transgender population faces some unique challenges due to the need to balance readiness and deployability with medically necessary health care. Also complicating patient care is that policy development is ongoing-as of this publication, the decision has not yet been made regarding how people who identify as transgender will access into the military nor is there final approval regarding coverage for surgical procedures. Unique circumstances of this population are brought up to generate more discussion and encourage further evaluation and refinement of the process.

Robotic System for Condition Assessment of Concrete Bridge Decks : Data Driven Decisions [Tech Brief

DOT National Transportation Integrated Search

2012-12-11

In the United States, the stewardship and management of approximately 599,000 bridges present ongoing planning, operational, maintenance, and economic challenges for Federal, State, and local transportation agencies. To help overcome these challenges...

Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments.

PubMed

Dougherty, Scott; Beaton, Andrea; Nascimento, Bruno R; Zühlke, Liesl J; Khorsandi, Maziar; Wilson, Nigel

2018-01-01

Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs.

Prevention and control of rheumatic heart disease: Overcoming core challenges in resource-poor environments

PubMed Central

Dougherty, Scott; Beaton, Andrea; Nascimento, Bruno R; Zühlke, Liesl J; Khorsandi, Maziar; Wilson, Nigel

2018-01-01

Rheumatic heart disease (RHD) has long receded as a significant threat to public health in high-income countries. In low-resource settings, however, the specter of RHD remains unabated, as exemplified by recent data from the Global Burden of Diseases Study. There are many complex reasons for this ongoing global disparity, including inadequate data on disease burden, challenges in effective advocacy, ongoing poverty and inequality, and weak health systems, most of which predominantly affect developing nations. In this review, we discuss how each of these acts as a core challenge in RHD prevention and control. We then examine key lessons learnt from successful control programs in the past and highlight resources that have been developed to help create strong national RHD control programs. PMID:29440834

Examining the Roles of the Facilitator in Online and Face-to-Face PD Contexts

ERIC Educational Resources Information Center

Park, Gina; Johnson, Heather; Vath, Richard; Kubitskey, Beth; Fishman, Barry

2013-01-01

Online teacher professional development has become an alternative to face-to-face professional development. Such a shift from face-to-face to online professional development, however, brings new challenges for professional development facilitators, whose roles are crucial in orchestrating teacher learning. This paper is motivated by the need to…

Counseling the Young Adult Lesbian.

ERIC Educational Resources Information Center

Miller, Rhoda

1980-01-01

Focuses on problems faced by young adult lesbians. Suggests counselors should: (1) encourage the counselee to "dump"; (2) guide her in a decision on coming out; (3) explain the legal rights and restrictions; (4) provide ongoing support for those who socialize openly; and (5) publicly promote gay rights. (Author)

Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

PubMed

Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

2018-05-09

The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to communicate and advocate more effectively. Rehabilitation professionals can support people with scleroderma by providing them with information on connecting with scleroderma patient organizations or by facilitating local patient support networks.

Challenges newly-arrived migrant women in Montreal face when needing maternity care: Health care professionals' perspectives.

PubMed

Peláez, Sandra; Hendricks, Kristin N; Merry, Lisa A; Gagnon, Anita J

2017-01-25

People who leave their country of origin, or the country of habitual residence, to establish themselves permanently in another country are usually referred to as migrants. Over half of all births in Montreal, Canada are to migrant women. To understand healthcare professionals' attitudes towards migrants that could influence their delivery of care, our objective was to explore their perspectives of challenges newly-arrived migrant women from non-Western countries face when needing maternity care. In this qualitative multiple case study, we conducted face-to-face interviews with 63 health care professionals from four teaching hospitals in Montreal, known for providing maternity care to a high volume of migrant women. Interviews were transcribed and thematically analysed. Physicians, nurses, social workers, and therapists participated; 90% were female; and 17% were themselves migrants from non-Western countries. According to participants, newly-arrived migrant women face challenges at two levels: (a) direct care (e.g., understanding Canadian health care professionals' expectations, communicating effectively with health care professionals), and (b) organizational (e.g., access to appropriate health care). Challenges women face are strongly influenced by the migrant woman's background as well as social position (e.g., general education, health literacy, socio-cultural integration) and by how health care professionals balance women's needs with perceived requirement to adhere to standard procedures and regulations. Health care professionals across institutions agreed that maternity care-related challenges faced by newly-arrived migrant women often are complex in that they are simultaneously driven by conflicting values: those based on migrant women's sociocultural backgrounds versus those related to the implementation of Canadian guidelines for maternity care in which consideration of migrant women's particular needs are not priority.

Scotland: Education, Curriculum and Learning. the Strengths, Challenges and Solutions in Lifelong Learning. IBE Working Papers on Curriculum Issues No. 13

ERIC Educational Resources Information Center

Armstrong, Alan

2014-01-01

This paper brings together the main strengths and challenges currently facing Scottish education and outlines approaches to the ways forward. Knowledge about how to improve education systems has grown rapidly over the last two decades. One key challenge facing Scotland, and no doubt many other countries, is in ensuring a smooth "learner…

Threat Control through Arms Control. Report to Congress 1994

DTIC Science & Technology

1994-07-13

reduction, chemical weapons’ elimination, or any of the other growing arms control and nonproliferation challenges America faces, ACDA is an essential...nuclear missile reduction, chemical weapons elimination, or any of. the other growing arms control and nonproliferation challenges America faces... challenging . Nonprolif eration agreements are our first line of defense against the creation of a far more unstable and hazardous world than we have ever

Supporting the Thesis Writing Process of International Research Students through an Ongoing Writing Group

ERIC Educational Resources Information Center

Li, Linda Y.; Vandermensbrugghe, Joelle

2011-01-01

Evidence from research suggests writing support is particularly needed for international research students who have to tackle the challenges of thesis writing in English as their second language in Western academic settings. This article reports the development of an ongoing writing group to support the thesis writing process of international…

Landscape Conservation Cooperatives: Creating a Collaborative Conservation Vision in the Face of Climate Change Uncertainty

NASA Astrophysics Data System (ADS)

Athearn, N.; Schlafmann, D.

2015-12-01

The 22 Landscape Conservation Cooperatives (LCCs) form a "network of networks," each defined by the characteristics of its ecoregion and its unique community of conservation managers, practitioners, and scientists. As self-directed partnerships, LCCs are strongly influenced not only by the landscape but by the evolving cultures and values that define the multi-faceted relationships between people and place. LCCs maintain an ecologically connected network across these diverse landscapes by transcending borders and leveraging resources. Natural resource managers are challenged to make decisions in the face of multiple uncertainties, and several partners across the network have recognized that climate change is one important uncertainty that spans boundaries - both across the conservation community and beyond. The impacts of climate change across the LCC Network are likely to be as diverse as the network itself - manifesting as, for example, sea level rise, ocean acidification, loss of sea ice, and shifts in climate patterns and timing - but synergies are being leveraged within and between LCCs and national climate-focused programs to systematically address the needs of the network to support a collaborative conservation vision that addresses multiple landscape-scale stressors in the face of climate uncertainties. This vision is being achieved by leveraging the convening power of the LCCs and collaborating with DOI Climate Science Centers and others. Selected case studies will demonstrate how the network finds strength in its differences, but also reveals powerful collaborative opportunities through integrated science, shared conservation strategies, and strategic approaches for translating targeted science to conservation action. These examples exemplify past successes as well as ongoing efforts as the network continues to bring about effective application of climate science to achieve conservation outcomes across the LCC Network in an uncertain future climate.

The Future of General Internal Medicine

PubMed Central

Larson, Eric B; Fihn, Stephan D; Kirk, Lynne M; Levin, Wendy; Loge, Ronald V; Reynolds, Eileen; Sandy, Lewis; Schroeder, Steven; Wenger, Neil; Williams, Mark

2004-01-01

The Society of General Internal Medicine asked a task force to redefine the domain of general internal medicine. The task force believes that the chaos and dysfunction that characterize today's medical care, and the challenges facing general internal medicine, should spur innovation. These are our recommendations: while remaining true to its core values and competencies, general internal medicine should stay both broad and deep—ranging from uncomplicated primary care to continuous care of patients with multiple, complex, chronic diseases. Postgraduate and continuing education should develop mastery. Wherever they practice, general internists should be able to lead teams and be responsible for the care their teams give, embrace changes in information systems, and aim to provide most of the care their patients require. Current financing of physician services, especially fee-for-service, must be changed to recognize the value of services performed outside the traditional face-to-face visit and give practitioners incentives to improve quality and efficiency, and provide comprehensive, ongoing care. General internal medicine residency training should be reformed to provide both broad and deep medical knowledge, as well as mastery of informatics, management, and team leadership. General internal medicine residents should have options to tailor their final 1 to 2 years to fit their practice goals, often earning a certificate of added qualification (CAQ) in special generalist fields. Research will expand to include practice and operations management, developing more effective shared decision making and transparent medical records, and promoting the close personal connection that both doctors and patients want. We believe these changes constitute a paradigm shift that can benefit patients and the public and reenergize general internal medicine. PMID:14748863

School Supplies on a Budget

ERIC Educational Resources Information Center

Dyrli, Kurt O.

2008-01-01

This article reports on the challenge that parents, teachers, and district administrators face in continuing to provide essential school supplies to their students despite budget cuts. At the Verona Area (Wisconsin) School District, administrators, teachers, and parents have recently faced this common challenge. Increasingly dependent on funding…

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;…

Supporting Children with Developmental Challenges.

ERIC Educational Resources Information Center

Brand, Marie

1998-01-01

Examines strategies for developing challenging but appropriate programs for children with disabilities. Discusses the importance of identifying and understanding the particular needs of individual children; developing appropriate routines; maintaining ongoing communication with, and the involvement of, family members; and playing an active support…

Evolving career choice narratives of new graduate nurses.

PubMed

Price, Sheri L; McGillis Hall, Linda; Murphy, Gail Tomblin; Pierce, Bridget

2018-01-01

This article describes findings from one stage of a longitudinal study of the professional socialization experiences of Millennial nurses as they prepared for graduation and transition to practice. This study employed an interpretive narrative methodology guided by Polkinghorne's theory of narrative identity. Analysis of face-to-face interviews and journal entries by Millennial nursing students uncovered the formal professional socialization experiences over four years of nursing education. Participants include six Millennial nursing student participants (born after 1980) interviewed approximately one-month aftergraduation. These six participants are a voluntary subset of twelve who were interviewed prior to beginning their nursing studies, the analysis of which is captured in Price et al. (2013a) and Price et al. (2013b). Narrative analysis of the post-graduation interviews resulted in three main themes: 'Real Nursing: Making a Difference', 'The Good Nurse: Defined by Practice' and 'Creating Career Life Balance'. Graduate nurses strive to provide excellent nursing care as they transition into the workforce and identify a need for ongoing peer and professional supports to assist their ongoing professional socialization. Ongoing formal socialization and professional development is required to support the transition and retention of new nurse graduates in the workplace and the profession. Millenial generation nurses seek opportunities for career mapping, goal setting and formal mentorship by role models and peers to actualize their professional aspirations. Copyright © 2017. Published by Elsevier Ltd.

Using International Classification of Functioning, Disability and Health to understand challenges in community reintegration of injured veterans.

PubMed

Resnik, Linda J; Allen, Susan M

2007-01-01

This pilot study used the framework of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) to understand the challenges faced by Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans as they reintegrate into the community. We conducted semistructured interviews with 14 injured veterans, 12 caregivers, and 14 clinicians. We used ICF taxonomy to code data and identify issues. We identified challenges in the following ICF domains: learning and applying knowledge; general tasks and demands; communication; mobility; self-care; domestic life; interpersonal interactions, major life areas; and community, social, and civic life. We found many similarities between the challenges faced by veterans with and without polytraumatic injuries, although veterans with polytraumatic injuries faced challenges of greater magnitude. Identifying community reintegration challenges early and promoting reintegration are important mandates for the Department of Veterans Affairs. The findings of this study are useful in understanding the needs of OEF/OIF veterans.

Tribal Science 2017 Webinar Series: Arctic Research, One Health and the Local Environmental Observer (LEO) Network: Ongoing Activities and Expansion to Lower 48

EPA Pesticide Factsheets

The U.S. EPA Sustainable and Healthy Communities Seminar Series presents the Tribal Science Webinar Series that will look to develop a forum for discussion of the complex environmental issues facing many tribal and indigenous communities.

Integrating Social Neuroscience and Social Work: Innovations for Advancing Practice-Based Research

ERIC Educational Resources Information Center

Matto, Holly C.; Strolin-Goltzman, Jessica

2010-01-01

Throughout the social work profession, there is ongoing interest in building a social science agenda that can address the complex practice-based questions faced by social work professionals today. Methodological innovations and unique funding opportunities have already significantly advanced research on social work practice. Still, there is…

Blended Learning in Medical Education

ERIC Educational Resources Information Center

Zayapragassarazan, Z.; Kumar, Santosh

2012-01-01

The ongoing pedagogical advancements in medical education across the globe have gained the attention of academicians for the preparation of well-educated and competent physicians to address the healthcare issues facing today. The integration of technology into medical pedagogy has proved effective in many ways. This has made the medical education…

Aid, Development, and Education

ERIC Educational Resources Information Center

Klees, Steven J.

2010-01-01

The world faces pervasive poverty and inequality. Hundreds of billions of dollars in international aid have been given or loaned to developing countries though bilateral and multilateral mechanisms, at least, ostensibly, in order to do something about these problems. Has such aid helped? Debates around this question have been ongoing for decades,…

Supporting Early Childhood Teachers in Guinea-Bissau

ERIC Educational Resources Information Center

Portugal, Maria Gabriela; Aveleira, Ana Paula

2009-01-01

This article presents a reflective report on a project aiming to strengthen educators and improve early childhood education in Guinea-Bissau--one of the poorest countries on the African continent, where preschool teachers have no training and have to face several ongoing difficulties. Helping these Guinea-Bissau teachers to focus on curriculum…

Wonder as a Tool to Engage Preservice Elementary Teachers in Science Learning and Teaching

ERIC Educational Resources Information Center

Gilbert, Andrew; Byers, Christie C.

2017-01-01

This exploratory project considers the use of "wonder" as a pedagogical tool with preservice elementary teachers (PSETs). An ongoing vexation facing science teacher educators is helping future elementary teachers overcome anxiety and negative associations with science due to their own school science experiences, while simultaneously…

It Takes a Community

ERIC Educational Resources Information Center

Weasmer, Jerie; Woods, Amelia Mays

2010-01-01

Modifying course plans to accommodate diverse learners seems simple in theory. However, when faced with specific applications, many teachers feel lost. In a school community, they need not feel alone. General classroom teachers have several sources of ongoing support available to help them extend their teaching repertoire to meet their students'…

The Role of Learner-Centred Assessment in Postsecondary Organisational Change

ERIC Educational Resources Information Center

Webber, Karen L.; Tschepikow, Kyle

2013-01-01

For postsecondary institutions, organisational change is an inevitable and ongoing process. Institutions face a growing need to assess student learning assessment as part of an institution's comprehensive assessment plan. While a growing body of literature suggests that learner-centred assessment is a best practice in higher education pedagogy, it…

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology

PubMed Central

Magalhães-Sant'Ana, M.; More, S. J.; Morton, D. B.; Hanlon, A.

2016-01-01

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. PMID:27613779

Examining the Challenging Hindrances facing in the Construction Projects: South India’s Perspective

NASA Astrophysics Data System (ADS)

Subramanyam, K.; Haridharan, M. K.

2017-07-01

Developing countries like India require a huge infrastructure to facilitate needs of the people. Construction industry provides several opportunities to the individuals. Construction manager work is to supervise and organize the construction activities in construction projects. Now a day construction manager facing challenges. This paper aimed to study the challenges facing by the construction manager in the perception of construction professionals. 39 variables were taken from the literature review which found to be severe impact on construction managers’ performance. Construction manager, project manager and site engineers are the respondents for this survey. Using SPSS, regression analysis was done and recognized significant challenges. These challenges were classified into 5 domains. In management challenges, resource availability and allocation, risks and uncertainties existing in the project onsite, top management support and cost constraints are the most significant variables. In skills requirement of a construction manager challenges, technical skills required to learn and adapt new technology in the project, decision making and planning according to the situation in site are the most significant variables. In performance challenges, implementation of tasks according to the plan is the important variable whereas in onsite challenges, manage project risks, develop project policies and procedures are the most important.

Ethical challenges facing veterinary professionals in Ireland: results from Policy Delphi with vignette methodology.

PubMed

Magalhães-Sant'Ana, M; More, S J; Morton, D B; Hanlon, A

2016-10-29

Ethics is key to the integrity of the veterinary profession. Despite its importance, there is a lack of applied research on the range of ethical challenges faced by veterinarians. A three round Policy Delphi with vignette methodology was used to record the diversity of views on ethical challenges faced by veterinary professionals in Ireland. Forty experts, comprising veterinary practitioners, inspectors and nurses, accepted to participate. In round 1, twenty vignettes describing a variety of ethically challenging veterinary scenarios were ranked in terms of ethical acceptability, reputational risk and perceived standards of practice. Round 2 aimed at characterising challenges where future policy development or professional guidance was deemed to be needed. In round 3, possible solutions to key challenges were explored. Results suggest that current rules and regulations are insufficient to ensure best veterinary practices and that a collective approach is needed to harness workable solutions for the identified ethical challenges. Challenges pertaining mostly to the food chain seem to require enforcement measures whereas softer measures that promote professional discretion were preferred to address challenges dealing with veterinary clinical services. These findings can support veterinary representative bodies, advisory committees and regulatory authorities in their decision making, policy and regulation. British Veterinary Association.

Challenges facing developers of CAD/CAM models that seek to predict human working postures

NASA Astrophysics Data System (ADS)

Wiker, Steven F.

2005-11-01

This paper outlines the need for development of human posture prediction models for Computer Aided Design (CAD) and Computer Aided Manufacturing (CAM) design applications in product, facility and work design. Challenges facing developers of posture prediction algorithms are presented and discussed.

Challenges Facing Early Childhood Programs Worldwide

ERIC Educational Resources Information Center

Neugebauer, Roger

2008-01-01

In this article, the author presents the challenges faced by early childhood education in 29 countries, according to the World Forum National Representatives and Global Leaders for Young Children. The countries represented in these responses include: Azerbaijan, Bangladesh, Bolivia, Brazil, Canada, Denmark, Egypt, Fiji, India, Iran, Iraq, Japan,…

Exploring Biotechnology Using Case-Based Multimedia

ERIC Educational Resources Information Center

Bergland, Mark; Lundeberg, Mary; Klyczek, Karen; Sweet, Jennifer; Emmons, Jean; Martin, Christine; Marsh, Katherine; Werner, Joy; Jarvis-Uetz, Michelle

2006-01-01

Today, teachers face more challenges than ever, and biology teachers face a special challenge. As technology continues to expand, biology teachers have a responsibility to keep students informed of technological and scientific advances. Biology teachers must also address ethical issues associated with these advances. In this paper, the authors…

Improving accountability through alignment: the role of academic health science centres and networks in England.

PubMed

Ovseiko, Pavel V; Heitmueller, Axel; Allen, Pauline; Davies, Stephen M; Wells, Glenn; Ford, Gary A; Darzi, Ara; Buchan, Alastair M

2014-01-20

As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the "unlinked partners" model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from the bottom up. It remains to be seen which alignment mechanisms are most effective, and whether they are strong enough to counter the separation of accountabilities for the tripartite mission at the national level, the on-going structural fragmentation of the health system in England, and the unprecedented financial challenges that it faces. Future research should focus on determining the comparative effectiveness of different alignment mechanisms, developing standardised metrics and key performance indicators, evaluating and assessing academic health science centres and networks, and empirically addressing leadership issues.

Improving accountability through alignment: the role of academic health science centres and networks in England

PubMed Central

2014-01-01

Background As in many countries around the world, there are high expectations on academic health science centres and networks in England to provide high-quality care, innovative research, and world-class education, while also supporting wealth creation and economic growth. Meeting these expectations increasingly depends on partnership working between university medical schools and teaching hospitals, as well as other healthcare providers. However, academic-clinical relationships in England are still characterised by the “unlinked partners” model, whereby universities and their partner teaching hospitals are neither fiscally nor structurally linked, creating bifurcating accountabilities to various government and public agencies. Discussion This article focuses on accountability relationships in universities and teaching hospitals, as well as other healthcare providers that form core constituent parts of academic health science centres and networks. The authors analyse accountability for the tripartite mission of patient care, research, and education, using a four-fold typology of accountability relationships, which distinguishes between hierarchical (bureaucratic) accountability, legal accountability, professional accountability, and political accountability. Examples from North West London suggest that a number of mechanisms can be used to improve accountability for the tripartite mission through alignment, but that the simple creation of academic health science centres and networks is probably not sufficient. Summary At the heart of the challenge for academic health science centres and networks is the separation of accountabilities for patient care, research, and education in different government departments. Given that a fundamental top-down system redesign is now extremely unlikely, local academic and clinical leaders face the challenge of aligning their institutions as a matter of priority in order to improve accountability for the tripartite mission from the bottom up. It remains to be seen which alignment mechanisms are most effective, and whether they are strong enough to counter the separation of accountabilities for the tripartite mission at the national level, the on-going structural fragmentation of the health system in England, and the unprecedented financial challenges that it faces. Future research should focus on determining the comparative effectiveness of different alignment mechanisms, developing standardised metrics and key performance indicators, evaluating and assessing academic health science centres and networks, and empirically addressing leadership issues. PMID:24438592

A qualitative process evaluation of training for non-physician clinicians/associate clinicians (NPCs/ACs) in emergency maternal, neonatal care and clinical leadership, impact on clinical services improvements in rural Tanzania: the ETATMBA project.

PubMed

Ellard, David R; Shemdoe, Aloisia; Mazuguni, Festo; Mbaruku, Godfrey; Davies, David; Kihaile, Paul; Pemba, Senga; Bergström, Staffan; Nyamtema, Angelo; Mohamed, Hamed-Mahfoudh; O'Hare, Joseph Paul

2016-02-12

The Enhancing Human Resources and Use of Appropriate Training for Maternal and Perinatal Survival in sub-Saharan Africa (ETATMBA) project is training non-physician clinicians as advanced clinical leaders in emergency maternal and newborn care in Tanzania and Malawi. The main aims of this process evaluation were to explore the implementation of the programme of training in Tanzania, how it was received, how or if the training has been implemented into practice and the challenges faced along the way. Qualitative interviews with trainees, trainers, district officers and others exploring the application of the training into practice. During late 2010 and 2011, 36 trainees including 19 assistant medical officers one senior clinical officer and 16 nurse midwives/nurses (anaesthesia) were recruited from districts across rural Tanzania and invited to join the ETATMBA training programme. Trainees (n=36) completed the training returning to 17 facilities, two left and one died shortly after training. Of the remaining trainees, 27 were interviewed at their health facility. Training was well received and knowledge and skills were increased. There were a number of challenges faced by trainees, not least that their new skills could not be practised because the facilities they returned to were not upgraded. Nonetheless, there is evidence that the training is having an effect locally on health outcomes, like maternal and neonatal mortality, and the trainees are sharing their new knowledge and skills with others. The outcome of this evaluation is encouraging but highlights that there are many ongoing challenges relating to infrastructure (including appropriate facilities, electricity and water) and the availability of basic supplies and drugs. This cadre of workers is a dedicated and valuable resource that can make a difference, which with better support could make a greater contribution to healthcare in the country. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Development of Critical Thinking Skills through Writing Tasks: Challenges Facing Maritime English Students at Aqaba College, AlBalqa Applied University, Jordan

ERIC Educational Resources Information Center

Alidmat, Ali Odeh Hammoud; Ayassrah, Mohamed Ayed

2017-01-01

Teaching English for Special Purposes (ESP) in a context where English is taught as a Foreign Language (EFL) is no easy task. There is in fact extensive research reporting on challenges facing both teacher and student in the Foreign Language classroom where language skills must be learnt outside their usual context. Even more challenging is…

Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana.

PubMed

Atuoye, Kilian Nasung; Vercillo, Siera; Antabe, Roger; Galaa, Sylvester Zackaria; Luginaah, Isaac

2016-11-01

Policy makers in low and middle-income countries are frequently confronted with challenges of increasing health access for poor populations in a sustainable manner. After several years of trying out different health financing mechanisms, health insurance has recently emerged as a pro-poor health financing policy. Capitation, a fixed fee periodically paid to health service providers for anticipated services, is one of the payment policies in health insurance. This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana's National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the policy debate advance arguments to legitimize their claims about the contested capitation payment system. In addition, we found that the health of poor communities, women and children are being used as surrogates for political and individual arguments in the policy debate. The article recommends a more holistic and participatory approach through persuasion and negotiation to join interests and core evidence together in the capitation policy making in Ghana and elsewhere with similar contexts. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Plant genetic resources for food and agriculture: opportunities and challenges emerging from the science and information technology revolution.

PubMed

Halewood, Michael; Chiurugwi, Tinashe; Sackville Hamilton, Ruaraidh; Kurtz, Brad; Marden, Emily; Welch, Eric; Michiels, Frank; Mozafari, Javad; Sabran, Muhamad; Patron, Nicola; Kersey, Paul; Bastow, Ruth; Dorius, Shawn; Dias, Sonia; McCouch, Susan; Powell, Wayne

2018-03-01

Contents Summary 1407 I. Introduction 1408 II. Technological advances and their utility for gene banks and breeding, and longer-term contributions to SDGs 1408 III. The challenges that must be overcome to realise emerging R&D opportunities 1410 IV. Renewed governance structures for PGR (and related big data) 1413 V. Access and benefit sharing and big data 1416 VI. Conclusion 1417 Acknowledgements 1417 ORCID 1417 References 1417 SUMMARY: Over the last decade, there has been an ongoing revolution in the exploration, manipulation and synthesis of biological systems, through the development of new technologies that generate, analyse and exploit big data. Users of Plant Genetic Resources (PGR) can potentially leverage these capacities to significantly increase the efficiency and effectiveness of their efforts to conserve, discover and utilise novel qualities in PGR, and help achieve the Sustainable Development Goals (SDGs). This review advances the discussion on these emerging opportunities and discusses how taking advantage of them will require data integration and synthesis across disciplinary, organisational and international boundaries, and the formation of multi-disciplinary, international partnerships. We explore some of the institutional and policy challenges that these efforts will face, particularly how these new technologies may influence the structure and role of research for sustainable development, ownership of resources, and access and benefit sharing. We discuss potential responses to political and institutional challenges, ranging from options for enhanced structure and governance of research discovery platforms to internationally brokered benefit-sharing agreements, and identify a set of broad principles that could guide the global community as it seeks or considers solutions. © 2018 The Authors. New Phytologist © 2018 New Phytologist Trust.

Researchers' perspectives on pediatric obesity research participant recruitment.

PubMed

Parikh, Yasha; Mason, Maryann; Williams, Karen

2016-12-01

Childhood obesity prevalence has tripled over the last three decades. Pediatric obesity has important implications for both adult health as well as the United States economy. In order to combat pediatric obesity, exploratory studies are necessary to create effective interventions. Recruitment is an essential part of any study, and it has been challenging for all studies, especially pediatric obesity studies. The objective of this study was to understand barriers to pediatric obesity study recruitment and review facilitators to overcome recruitment difficulties. Twenty four childhood obesity researchers were contacted. Complete data for 11 researchers were obtained. Interviews were transcribed and analyzed using content analysis. Grounded Theory methodological approach was used, as this was an exploratory study. Investigators YP and MM coded the interviews using 28 codes. Barriers to recruitment included: family and study logistics, family economics, lack of provider interest, invasive protocols, stigma, time restraints of clinicians, lack of patient motivation/interest, groupthink of students in a classroom, and participants who do not accept his or her own weight status. Facilitators to enhance recruitment practices included accommodating participants outside of regular clinic hours, incentivizing participants, cultivating relationships with communities, schools and clinics prior to study recruitment, emphasizing benefits of a study for the patient, and shifting language to focus on health rather than obesity. Pediatric obesity researchers face many standard and some unique challenges to recruitment, reflecting challenges common to clinical research as well as some specific to pediatrics and some specific to obesity research. Both pediatric studies as well as obesity studies are an added challenge to the already-difficult task of general study recruitment. Our findings can be used to make researchers more aware of potential difficulties, approaches and on-going needs for enhancing recruitment and enrollment practices, and in turn if applied, may result in increased study efficiency.

Exploring strategies to overcome extra-organisational challenges faced by community pharmacies in Sarawak, Malaysia.

PubMed

Kho, Boon Phiaw; Hassali, Mohamed Azmi; Lim, Ching Jou; Saleem, Fahad

2018-03-15

The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations. Items were constructed based on the findings of a prior qualitative research supplemented with relevant literature about these issues. High levels of homogeneity in responses were recorded on various extra-organisational challenges faced, particularly those economy-oriented. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than services provision. Highly rated strategies included increasing discounts for customers (n = 54; 68%) and finding cheaper suppliers (n = 70; 88%). Legislative changes proposed that might increase their share of the pharmaceutical market were strongly supported by respondents, particularly about making it compulsory for general practitioners to provide patients the option to have their medicines dispensed in community pharmacies (n = 72; 90%). Current legislative conditions and Malaysian consumer mindset may have constrained the strategic choices of community pharmacies to deal with the strong extra-organisational challenges. A long-term multipronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change. © 2018 Royal Pharmaceutical Society.

The Impact of Evidence-Based Practice Implementation and Fidelity Monitoring on Staff Turnover: Evidence for a Protective Effect

ERIC Educational Resources Information Center

Aarons, Gregory A.; Sommerfeld, David H.; Hecht, Debra B.; Silovsky, Jane F.; Chaffin, Mark J.

2009-01-01

Staff retention is an ongoing challenge in mental health and community-based service organizations. Little is known about the impact of evidence-based practice implementation on the mental health and social service workforce. The present study examined the effect of evidence-based practice implementation and ongoing fidelity monitoring on staff…

The MOOC and Learning Analytics Innovation Cycle (MOLAC): A Reflective Summary of Ongoing Research and Its Challenges

ERIC Educational Resources Information Center

Drachsler, H.; Kalz, M.

2016-01-01

The article deals with the interplay between learning analytics and massive open online courses (MOOCs) and provides a conceptual framework to situate ongoing research in the MOOC and learning analytics innovation cycle (MOLAC framework). The MOLAC framework is organized on three levels: On the micro-level, the data collection and analytics…

Multi-Institution Research Centers: Planning and Management Challenges

ERIC Educational Resources Information Center

Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

2016-01-01

Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

Internationalising Teacher Education for a "Glocal" Curriculum: South Koreans Learning to Teach Hong Kong Liberal Studies

ERIC Educational Resources Information Center

Jackson, Liz; Han, Ana Yoon Jin

2016-01-01

Internationalisation in education facilitates student and teacher mobility. Though Hong Kong has embraced internationalisation in education, international university students can face challenges related to cultural difference. In teacher education, these challenges can be amplified, as student-teachers face expectations to teach schoolchildren…

Anger and Globalization among Young People in India

ERIC Educational Resources Information Center

Suchday, Sonia

2015-01-01

This article addresses the challenges faced by youth in developing countries. Using India as an example of a fast-globalizing country, this article highlights the experience and challenges faced by adolescents and emerging adults as they search for their interpersonal and professional identities. The difficulties of defining identity in the…

The Challenges Facing Catholic Education in France Today

ERIC Educational Resources Information Center

Moog, François

2016-01-01

The effects of secularisation on society demand a rethinking of the identity and mission of Catholic schools in France. In 2013, the French bishops published a new directory which offers new approaches, described here, based on the three challenges facing Catholic education in France: linking social responsibility and evangelisation, setting up…

An Inventory and Use Analysis of Information Systems on Small Farms in Pennsylvania

ERIC Educational Resources Information Center

Adams, Jean S.

2007-01-01

Across the United States, today's farm operators face continuing challenges from global competition, increasing production costs, changing technology, increased regulations, scarce resources, and lower profit margins. To face these challenges, farm operators need to gather and utilize information allowing them to make informed decisions. Several…

Anatomy Education Faces Challenges in Pakistan

ERIC Educational Resources Information Center

Memon, Ismail K.

2009-01-01

Anatomy education in Pakistan is facing many of the same challenges as in other parts of the world. Roughly, a decade ago, all medical and dental colleges in Pakistan emphasized anatomy as a core basic discipline within a traditional medical science curriculum. Now institutions are adopting problem based learning (PBL) teaching philosophies, and…

Many Faces Have I.

ERIC Educational Resources Information Center

Zilliox, Joseph T.; Lowery, Shannon G.

1997-01-01

Describes an extended investigation of polygons and polyhedra which was conducted in response to a challenge posed in Focus, a newsletter from the Mathematical Association of America (MAA). Students were challenged to construct a polyhedron with faces that measure more than 13 inches to a side. Outlines the process, including the questions posed…

Women Superintendents in Illinois: Gender Barriers and Challenges

ERIC Educational Resources Information Center

VanTuyle, Vicki; Watkins, Sandra G.

2009-01-01

Women face unique challenges as superintendents. This study determined barriers women face as superintendents and elicited reasons why these women would consider leaving the superintendent's position. Thirty-nine PreK-12 women superintendents in Illinois participated in a web-based survey in January 2008. Survey items included information…

Plural Societies and the Possibility of Shared Citizenship

ERIC Educational Resources Information Center

Merry, Michael S.

2012-01-01

As civilization pushes headlong into the twenty-first century, increasingly stringent demands for citizenship issue forth from governments around the world faced with a formidable assortment of challenges. Faced with these challenges, states are exploring ways to elicit civic attachments from their heterogeneous populations, but doing so is…

Challenges Facing Principals in the First Year at Their Schools

ERIC Educational Resources Information Center

Bayar, Adem

2016-01-01

The aim of this study is to identify key challenges of practice that principals face. In line with this purpose, the researcher has employed a qualitative research methodology, interviewing principals working in Amasya district, over and above doing document analysis to collect detailed information concerning leadership and administration…

Perspectives on Urban Geography in Advanced Placement® Human Geography

ERIC Educational Resources Information Center

Benton-Short, Lisa; Monk, Liliana

2016-01-01

"Perspectives on Urban Geography" constitutes a major part of the AP Human Geography course outline. In this article, urban core revitalization and rising suburban poverty are considered as two challenges facing cities in developed countries; and industrialization and the growth of megacities as two challenges facing cities in developing…

Homeless Children: Meeting the Educational Challenges. ERIC Digest.

ERIC Educational Resources Information Center

Goins, Brad; Cesarone, Bernard

Difficulties faced by homeless children include depression, low self-esteem, lack of sleep and nutrition, and feelings of shame and embarrassment. Challenges faced by schools in providing education to homeless children include: (1) keeping children in one school despite frequent family moves; (2) ensuring that children's health records are…

The Big Picture and Specifics of College General Education

ERIC Educational Resources Information Center

Gan, Yang

2018-01-01

In recent years, general education has developed considerably in Chinese universities, but it still faces many challenges and problems. Among the various negative factors, four problems may be the greatest challenges currently faced by Chinese university general education and ordinary undergraduate education: (1) In the era of massified higher…

Autism and Reading: Teaching a Sudanese Refugee Boy

ERIC Educational Resources Information Center

Walker-Dalhouse, Doris; Dalhouse, A. Derick

2015-01-01

Refugee families in the United States face numerous challenges in becoming acculturated. School-age children of refugees face the additional challenges of acquiring academic language and meeting school expectations for behavior and social interactions while attempting to navigate the school curriculum. This case study examines the school and home…

Missed Opportunities for Science Learning: Unacknowledged Unscientific Arguments in Asynchronous Online and Face-to-Face Discussions

NASA Astrophysics Data System (ADS)

Callis-Duehl, Kristine; Idsardi, Robert; Humphrey, Eve A.; Gougis, Rebekka Darner

2018-02-01

We explored the scientific argumentation that occurs among university biology students during an argumentation task implemented in two environments: face-to-face in a classroom and online in an asynchronous discussion. We observed 10 student groups, each composed of three students. Our analysis focused on how students respond to their peers' unscientific arguments, which we define as assertions, hypotheses, propositions, or explanations that are inaccurate or incomplete from a scientific perspective. Unscientific arguments provide opportunities for productive dissent, scientific argumentation, and conceptual development of scientifically desirable conceptions. We found that students did not respond to the majority of unscientific arguments in both environments. Challenges to unscientific arguments were expressed as a question or through explanation, although the latter was more common online than face-to-face. Students demonstrated significantly more epistemic distancing in the face-to-face environment than the online environment. We discuss the differences in discourse observed in both environments and teaching implications. We also provide direction for future research seeking to address the challenges of engaging students in productive scientific argumentation in both face-to-face and online environments.

Is There a Role for Social Networking Sites in Education?

NASA Astrophysics Data System (ADS)

Santos, Ieda M.; Hammond, Michael; Durli, Zenilde; Chou, Shiao-Yuh

Social networking sites such as Facebook and MySpace have become popular among millions of users including students of all ages. There are ongoing discussions over the potential of these sites to support teaching and learning, particularly to complement traditional or online classroom activities. This paper explores whether social networking have a place in teaching and learning by investigating how students use these sites and whether they find opportunities to discuss study related activities with their peers. Two small scale studies were carried out in a face-to-face undergraduate course in Singapore and students enrolled in a face-to-face Master’s programme in Brazil. Data were collected using surveys and interviews; findings were mixed. Many of the Brazilian students used social networking sites to both socialize and discuss their studies while the Singaporean students used such sites for social interactions only. The paper discusses these differences and offers suggestions for further research.

Real-time camera-based face detection using a modified LAMSTAR neural network system

NASA Astrophysics Data System (ADS)

Girado, Javier I.; Sandin, Daniel J.; DeFanti, Thomas A.; Wolf, Laura K.

2003-03-01

This paper describes a cost-effective, real-time (640x480 at 30Hz) upright frontal face detector as part of an ongoing project to develop a video-based, tetherless 3D head position and orientation tracking system. The work is specifically targeted for auto-stereoscopic displays and projection-based virtual reality systems. The proposed face detector is based on a modified LAMSTAR neural network system. At the input stage, after achieving image normalization and equalization, a sub-window analyzes facial features using a neural network. The sub-window is segmented, and each part is fed to a neural network layer consisting of a Kohonen Self-Organizing Map (SOM). The output of the SOM neural networks are interconnected and related by correlation-links, and can hence determine the presence of a face with enough redundancy to provide a high detection rate. To avoid tracking multiple faces simultaneously, the system is initially trained to track only the face centered in a box superimposed on the display. The system is also rotationally and size invariant to a certain degree.

Voicing the Challenges Faced by an Innovative Teacher Community

ERIC Educational Resources Information Center

Moate, Josephine

2011-01-01

This research draws on sociocultural theories of learning and activity theory to explore the challenges faced by an innovative community of teachers in Central Finland. The aim of the teacher community was to develop a stream of foreign-language (FL)-mediated teaching and learning in the locality from kindergarten to upper secondary level. To…

Oral Academic Discourse Socialisation: Challenges Faced by International Undergraduate Students in a Malaysian Public University

ERIC Educational Resources Information Center

Mahfoodh, Omer Hassan Ali

2014-01-01

This paper reports a qualitative study which examines the challenges faced by six international undergraduate students in their socialisation of oral academic discourse in a Malaysian public university. Data were collected employing interviews. Students' presentations were also collected. Semi-structured interviews were transcribed verbatim and…

Connecting Pre-Service Teachers with Contemporary Mathematics Practices: Selecting and Sequencing Students' Work Samples

ERIC Educational Resources Information Center

Livy, Sharyn; Muir, Tracey; Downton, Ann

2017-01-01

One of the challenges facing teacher educators is providing our pre-service teachers (PSTs) with authentic experiences that cross the boundaries between Initial Teacher Education (ITE) and the classroom. An additional challenge facing the mathematics teacher educator, is addressing and deepening PSTs' mathematical content knowledge (MCK), which…

Information Technology Challenges Facing the Strategic Leaders of Homeland Security in the 21st Century

DTIC Science & Technology

2004-05-03

A special thanks to all of these folks (Glenn Starnes, Lee Gutierrez, Bill Rapp, Joel Hillison, Carlos Gomez, Steve Fraunfelter, Janie Hopkins, Dave ...DiClemente, Joe Nunez, John Bonin , and Steve Nerheim). viii INFORMATION TECHNOLOGY CHALLENGES FACING THE STRATEGIC LEADERS OF HOMELAND SECURITY IN THE 21ST

Strategies for the Challenges Facing Women in Higher Education Administration.

ERIC Educational Resources Information Center

Rehnke, Mary Ann

Women administrators in higher education must deal not only with the usual challenges facing administrators (decision-making, resolving conflict, and advancing professionally), but also with the effects of sex stereotyping. Women are not seen as decision-makers, nor as conflict-resolvers, and are often viewed as supporting personnel rather than…

Tenured Women Counselor Educators at Research Universities: Navigating Multiple Roles and Personal Well-Being

ERIC Educational Resources Information Center

Rosenberg, Melissa A.

2013-01-01

Women in academia navigate multiple professional and personal roles, and may face unique challenges to integrate their intellectual, emotional, physical, and spiritual selves. The narrative of constraint underscores the disadvantages, challenges, and inequities that women who are mothers and academics face in their lives. This lack of privilege…

Integration and Career Challenges of Newcomer Youth in Newfoundland in Canada

ERIC Educational Resources Information Center

Li, Xuemei; Que, Hua

2016-01-01

Faced with a labor shortage and low profile of diversity, the province of Newfoundland and Labrador in Canada has been making an effort to attract and retain newcomers. Guided by Bronfenbrenner's (1979) ecological systems theory, this qualitative study investigates the challenges faced by newcomer youth, including permanent residents coming as…

"Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia"

ERIC Educational Resources Information Center

de Lange, Paul; Watty, Kim

2011-01-01

Of the various reports released in 2010, two purport to examine the state of accounting education in Australia. These are "Accounting Education at a Crossroad in 2010" and "Challenges Facing Accounting Education in Australia". Both were released as collaborations of the leading academic organisation, the Accounting and Finance…

A Business Intelligence Framework for Sustainability Information Management in Higher Education

ERIC Educational Resources Information Center

Scholtz, Brenda; Calitz, Andre; Haupt, Ross

2018-01-01

Purpose: Higher education institutions (HEIs) face a number of challenges in effectively managing and reporting on sustainability information, such as siloes of data and a limited distribution of information. Business intelligence (BI) can assist in addressing the challenges faced by organisations. The purpose of this study was to propose a BI…

Active Learning: Engaging Students to Maximize Learning in an Online Course

ERIC Educational Resources Information Center

Khan, Arshia; Egbue, Ona; Palkie, Brooke; Madden, Janna

2017-01-01

Student engagement is key to successful teaching and learning, irrespective of the content and format of the content delivery mechanism. However, engaging students presents a particular challenge in online learning environments. Unlike face-to-face courses, online courses present a unique challenge as the only social presence between the faculty…

Can Free-Range Students Save Some Schools? A Case Study on a Hybrid Classroom

ERIC Educational Resources Information Center

White, Christopher Francis

2013-01-01

In the face of budgetary constraints, new marketplace competition, digital innovation and an emerging generation of students with new demands and new needs, higher education in America is challenged as never before. This paper reviews the various challenges facing traditional non-profit educational institutions, considers the potential of an…

Calculus Challenges: An Active Learning Approach

ERIC Educational Resources Information Center

Crawford, Pam; Moseley, Daniel; Nancarrow, Mike; Ward, Erika

2018-01-01

One of the greatest challenges facing students new to calculus is the ability to persevere in the face of failure. Whether the student is choosing an integration technique or a series test, calculus is often the first course in mathematics where the path to the solution is not prescribed in an algorithmic way. At Jacksonville University we…

Challenges Faced by Institutions of Higher Education in Migrating to Distance Learning.

ERIC Educational Resources Information Center

Broskoske, Stephen L.; Harvey, Francis A.

This paper presents the results of a research study conducted in fall 1999 to examine the challenges facing higher educational institutions in migrating to distance learning. The study consisted of five case studies conducted at higher educational institutions in Pennsylvania. At each institution the researchers interviewed the president and other…

The Complexity of Substantive Reform: A Call for Interdependence among Key Stakeholders.

ERIC Educational Resources Information Center

Young, Michelle D.; Petersen, George J.; Short, Paula M.

The field of educational leadership faces serious challenges in the 21st century, such as the shortage of principals and superintendents, the growing demands for leadership positions, and the struggle for adequate resources. This paper explores the challenges facing this field from the position of university educational leadership preparation. The…

Meeting the Needs of Children and Families: Opportunities and Challenges for School Psychology Training Programs.

ERIC Educational Resources Information Center

Curtis, Michael J.; Batsche, George M.

1991-01-01

Notes that graduate training programs face challenges, as well as opportunities, in fulfillment of their responsibilities to prepare school psychologists for entry into professional practice. Examines nature and origins of potential changes facing school psychology and discusses adequacy of current training programs. Discusses future implications…

Community Violence Exposure of Southeast Asian American Adolescents

ERIC Educational Resources Information Center

Ho, Joyce

2008-01-01

Southeast Asian adolescents in the United States face the daily challenge of adjusting to the American culture and their culture of origin. However, little is known about how the patterns of their bicultural adjustment influence psychological symptoms, especially when faced with other challenges such as community violence and negative life events.…

Preserving Guam's Culture with Culturally Responsive Children's Stories

ERIC Educational Resources Information Center

Jackson, Marilyn Malloy; Heath, Melissa Allen

2017-01-01

Regardless of where schools are located, teachers face the challenge of teaching and mentoring children, not only in academic achievement but in social emotional development. When faced with challenges, young children are especially vulnerable because they lack the life experience and developmental maturity to adequately cope. Relying on the lead…

New Challenges Facing Universities in the Internet-Driven Global Environment

ERIC Educational Resources Information Center

Rajasingham, Lalita

2011-01-01

This paper explores some new challenges facing universities in a global multimediated Internet-based environment, as they seek alternative paradigms and options to remain true to their core business. At a time of rapid technological change, and contested, complex concepts associated with globalisation, knowledge is becoming a primary factor of…

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Career Development with Transgender College Students: Implications for Career and Employment Counselors

ERIC Educational Resources Information Center

Scott, David A.; Belke, Stephanie L.; Barfield, Hannah G.

2011-01-01

The number of transgender college students continues to increase every year. These students face unique challenges that many college and university career centers are not prepared to handle. This article describes some of the challenges facing transgender students and college career centers. A professional development design is proposed to assist…

Quality Assurance Challenges and Opportunities Faced by Private Universities in Zimbabwe

ERIC Educational Resources Information Center

Garwe, Evelyn Chiyevo

2014-01-01

The study sought to provide an understanding of the quality assurance challenges and opportunities faced by private universities in Zimbabwe. The study analyzed the factors determining provision of quality higher education in private universities and the resultant effects of failing to achieve the minimum acceptable standards. The author employed…

Challenges and Opportunities Facing Technology Education in Taiwan

ERIC Educational Resources Information Center

Lee, Lung-Sheng Steven

2009-01-01

The technology education in Taiwan is prescribed in the national curriculum and provided to all students in grades 1-12. However, it faces the following challenges: (1) Lack of worthy image, (2) Inadequate teachers in elementary schools, (3) Deficient teaching vitality in secondary schools, and (4) Diluted technology teacher education programs. In…

Challenges Faced by Teachers Implementing Socio-Scientific Issues as Core Elements in Their Classroom Practices

ERIC Educational Resources Information Center

Bossér, Ulrika; Lundin, Mattias; Lindahl, Mats; Linder, Cedric

2015-01-01

Teachers may face considerable challenges when implementing socio-scientific issues (SSI) in their classroom practices, such as incorporating student-centred teaching practices and exploring knowledge and values in the context of socioscientific issues. This year-long study explores teachers' reflections on the process of developing their…

Challenges Facing Women Academic Leadership in Secondary Schools of Irbid Educational Area

ERIC Educational Resources Information Center

Al-Jaradat, Mahmoud Khaled Mohammad

2014-01-01

This study aimed at identifying the challenges facing women academic leadership in secondary schools of Irbid Educational Area. A random sample of 187 female leaders were chosen. They responded to a 49-item questionnaire prepared by the researcher. The items were distributed into four domains: organizational, personal, social and physical…

Executive Leadership: Another Lever in the System?

ERIC Educational Resources Information Center

Harris, Alma; Brown, David; Abbott, Ian

2006-01-01

The leadership challenges facing most head teachers can at times be daunting but for those leading schools in difficulty, the challenges are acute. This article draws upon the personal experience of an executive leader in a school facing difficult circumstances. It will firstly, outline and analyse this model of leadership and secondly, look at…

TQM in a Multi-Campus Public University.

ERIC Educational Resources Information Center

Zargar, Ali M.

Running a university is fast becoming more challenging than managing a large corporation, in part due to greater quality demands by more groups in the face of shrinking resources and budget cuts. This paper argues against universities conducting business as usual in the face of societal change and increasingly greater challenges, and presents…

Challenges in healthcare delivery in an economic downturn, in the Republic of Ireland.

PubMed

Carney, Marie

2010-07-01

The purpose of the present study was to discuss some of effects of the downturn in the Irish economy and to demonstrate that in the face of economic difficulties innovation in health care is still occurring. Staff that are managing and delivering healthcare need to know the challenges facing them and have an awareness of the importance of maintaining interest in innovative practice in turbulent times. Information obtained from several sources including government papers, the nursing regulatory board and quality authority documents and current best practice articles. Information was evaluated based on the study's aim. Issues emerging were that current challenges facing Irish health care delivery relate mainly to economic, clinical management, education and information technology factors and further reductions in the cost base of health care delivery remains focused on value for money. In the face of the economic downturn Ireland is achieving health targets and is now sitting in 13th place on the European health index, down from number 28 in 2008. This improvement in position has resulted from several new innovative work practices. As a result of cost reduction measures in place nurse managers will face greater challenges than ever before in meeting the objectives of the healthcare transformation programme.

Web-Based vs. Face-to-Face MBA Classes: A Comparative Assessment Study

ERIC Educational Resources Information Center

Brownstein, Barry; Brownstein, Deborah; Gerlowski, Daniel A.

2008-01-01

The challenges of online learning include ensuring that the learning outcomes are at least as robust as in the face-to-face sections of the same course. At the University of Baltimore, both online sections and face-to-face sections of core MBA courses are offered. Once admitted to the MBA, students are free to enroll in any combination of…

Preventing Bullying and Harassment of Sexual Minority Students in Schools

ERIC Educational Resources Information Center

Bishop, Holly N.; Casida, Heather

2011-01-01

Sexual minority students (most often gay, lesbian, or bisexual, but including anyone who does not or is perceived to not fit the common heterosexual stereotype) often face ongoing bullying and harassment in schools that goes unstopped by faculty or administration. These students suffer academically, emotionally, and physically as a direct result…

Developing a Leadership Brand: The Heart of Effective School Leadership in Turbulent Times

ERIC Educational Resources Information Center

Davis, Stephen H.; Leon, Ronald J.

2014-01-01

Faced with scarce resources and high expectations, school principals must increasingly rely upon the power of persuasion to promote ongoing school improvement. We maintain that the development of a vibrant and tangible leadership brand constructed upon a principal's core values and noble character can motivate stakeholders and stimulate school…

Hard Choices in School Consolidation: Providing Education in the Best Interests of Students or Preserving Community Identity

ERIC Educational Resources Information Center

Warner, Wanda; Lindle, Jane Clark

2009-01-01

Educational leaders face difficult decisions in ensuring that all students learn despite ongoing scarcity of resources. School communities play an important role in establishing positive learning environments and supplying the resources for student learning. Declining community conditions often present school leaders with tough choices between…

A Dynamic Capabilities View of Employability: Exploring the Drivers of Competitive Advantage for University Graduates

ERIC Educational Resources Information Center

Finch, David J.; Peacock, Melanie; Levallet, Nadege; Foster, William

2016-01-01

Purpose: The increasing demand for post-secondary education, and the ongoing difficulty students' face in securing appropriate work upon program completion, highlight the importance of an enhanced understanding of employability resources for university graduates. Just as organizations achieve a strategic advantage from resources and dynamic…

Teaching and Leading for Human Flourishing: Creating a Liberal Arts Framework for Teacher Preparation

ERIC Educational Resources Information Center

Lederhouse, Jillian N.

2014-01-01

To satisfy the ongoing demands of external communities, education faculty at liberal arts colleges often make curricular and instructional compromises within their programs which can adversely affect the developmental goals of liberal education. This article highlights several of the complex tensions faculty members face in offering their…

Partnership as Cultural Practice in the Face of Neoliberal Reform

ERIC Educational Resources Information Center

Smith, Rob; O'Leary, Matt

2015-01-01

This article examines the nature of an on-going educational partnership between a Higher Education institution and a number of Further Education (FE) colleges in the West Midlands region of England, forged against the backdrop of sectoral marketisation and neoliberal reform. The partnership originates in the organisation and administration of…

Facing Fears: The Feasibility of Anxiety Universal Prevention Efforts with Children and Adolescents

ERIC Educational Resources Information Center

Miller, Lynn D.

2008-01-01

A few comprehensive reviews of the effectiveness of prevention programs of mental disorders in school-age children ((Greenberg et al., 2003) and (Weisz et al., 2005)) conclude that while several well-designed studies demonstrate the potential of preventive intervention, greater attention and ongoing rigorous research is critical. The benefits and…

What Happens When Induction Goes Wrong: Case Studies from the Field

ERIC Educational Resources Information Center

Kearney, Sean

2016-01-01

Although induction programmes are widely held to alleviate the pressures beginning teachers face early in their careers, what happens when beginning teachers do not receive adequate induction? While the research advocates effective and ongoing induction to acculturate new teachers to their careers, there is little research on the effects of…

Multigenerational Households and the School Readiness of Children Born to Unmarried Mothers

ERIC Educational Resources Information Center

Augustine, Jennifer March; Raley, R. Kelly

2013-01-01

Following the ongoing increase in nonmarital fertility, policy makers have looked for ways to limit the disadvantages faced by children of unmarried mothers. Recent initiatives included marriage promotion and welfare-to-work programs. Yet policy might also consider the promotion of three generational households. We know little about whether…

Responding to Children's Drawings

ERIC Educational Resources Information Center

Watts, Robert

2010-01-01

This article aims to explore the issues that face primary school teachers when responding to children's drawings. Assessment in art and design is an ongoing concern for teachers with limited experience and confidence in the area and, although children's drawings continue to be a focus of much research, the question of what it is that teachers say…

The health benefits following regular ongoing exercise lifestyle in independent community-dwelling older Taiwanese adults.

PubMed

Wang, Ching-Yi; Yeh, Chih-Jung; Wang, Chia-Wei; Wang, Chun-Feng; Lin, Yen-Ling

2011-03-01

To examine the effect of regular ongoing exercise lifestyle on mental and physical health in a group of independent community-dwelling Taiwanese older adults over a 2-year period. 197 older adults (mean age 72.5 years; 106 men and 91 women) who were independent in walking, instrumental and basic activities of daily living completed the baseline and a 2-year follow-up assessment. Older adults regularly performing exercises during the 2-year study period were grouped into regular exercise group; otherwise in the irregular exercise group. Baseline and follow-up assessments included a face-to-face interview and a battery of performance tests. The regular exercise group showed significantly less depression (P = 0.03) and tended to regress less on the performance tests (P = 0.025-0.410) across 2 years compared to the irregular exercise group. Regular exercise is important for maintaining or even improving mental and functional health, even for independent community-dwelling older adults. © 2010 The Authors. Australasian Journal on Ageing © 2010 ACOTA.

DEVELOPMENT OF CFD SIMULATION APPLICATIONS FOR LOCAL-SCALE AREAS AND POTENTIAL INTERFACE WITH MESOSCALE MODELS

EPA Science Inventory

The presentation summarizes developments of ongoing applications of fine-scale (geometry specific) CFD simulations to urban areas within atmospheric boundary layers. Enabling technology today and challenges for the future are discussed. There is a challenging need to develop a ...

Community-Based Research Assessments: Some Principles and Practices.

ERIC Educational Resources Information Center

Marullo, Sam; Cooke, Deanna; Willis, Jason; Rollins, Alexandra; Burke, Jacqueline; Bonilla, Paul; Waldref, Vanessa

2003-01-01

Examines benefits and challenges of undertaking assessments in community-based research (CBR). Such assessments are compared and contrasted to more traditional research processes. Further, the challenges of integrating CBR assessments into an ongoing social change initiative are analyzed. Five principles to guide CBR assessments are articulated. A…

People with Learning Disabilities and "Active Ageing"

ERIC Educational Resources Information Center

Foster, Liam; Boxall, Kathy

2015-01-01

Background: People (with and without learning disabilities) are living longer. Demographic ageing creates challenges and the leading policy response to these challenges is "active ageing". "Active" does not just refer to the ability to be physically and economically active, but also includes ongoing social and civic engagement…

Identifying pathways for improving household food self-sufficiency outcomes in the hills of Nepal

USDA-ARS?s Scientific Manuscript database

Maintaining and improving food security in mountain regions is an ongoing challenge. There are many facets to the problem, including comparatively high levels of system diversity and crop-livestock integration, challenging terrain and transportation bottlenecks, declining labor availability due to o...

Neuropsychology in South Africa: confronting the challenges of specialist practice in a culturally diverse developing country.

PubMed

Watts, Ann D; Shuttleworth-Edwards, Ann B

2016-11-01

This was an invited paper on the history and current status of neuropsychology in South Africa. Information was gathered from literature searches, personal communication, and the authors' experiences while occupying relevant professional and academic positions for over 30 years. Since its origins in the 1950s, the development of neuropsychology in South Africa has faced numerous challenges, against a background of extreme sociocultural and socioeconomic disparity in the country that is on-going. The creation of the South African Clinical Neuropsychological Society in the 1980s, a credentialing and training body, gave impetus to the discipline. In the absence of a neuropsychology category within the South African professional framework, university instruction has been ad hoc with vastly different levels of competency depending on the institution involved. The small number of practitioners and/or academics involved in neuropsychology includes mainly masters, and some doctoral level psychologists registered in clinical, counseling or educational categories. A prime emphasis of neuropsychological research has been local norming of psychometric tests to facilitate valid assessment practices in the country. South Africa is on the cusp of achieving a hard-won neuropsychology professional register. It is anticipated that this development will provide impetus to the discipline by promoting training programs, the creation of neuropsychology posts, wider service delivery, and increased research funding. Despite significant challenges in a culturally diverse, developing country, neuropsychology has evolved sufficiently to warrant the creation of a separate category in the professional framework. This development will facilitate training, research, and services in the country.

The Brotherhood Medical Center: Collaborative Foundation of Maternity and Children’s Healthcare Facility for Displaced Syrians

PubMed Central

Aburas, Rahma; Najeeb, Amina; Baageel, Laila; Mackey, Tim K.

2018-01-01

The United Nations has declared the Syrian conflict, with more than 50% of Syria’s population currently displaced, as the worst humanitarian crisis of the twenty-first century. The Syrian conflict has led to a collapse of infrastructure, including access to critical and lifesaving healthcare services. Women and children account for approximately 75% of internally displaced Syrians and refugees. This population is also particularly vulnerable to poor health outcomes, a condition worsened by lack of access to maternal and child health services. In response to this crisis, a partnership of Saudi and Syrian physicians established a non-profit healthcare facility named the Brotherhood Medical Center (BMC) to serve women and children within a safe area near the Syrian–Turkish border. The project began in September 2014 and was implemented in three phases of establishment, phased construction and formal launch and operation. Currently, the BMC is working at about 70% of its capacity and is run in partnership with the Syrian Expatriate Medical Association. Although there was strong initial support from donors, the BMC continues to face many financial and operational challenges, including difficulties in transferring money to Syria, shortage of medical supplies, and lack of qualified medical personnel. Despite these challenges, the BMC represents a critical model and an important case study of the challenges of delivering healthcare services to underserved populations during an ongoing conflict. However, more robust support from the international community is needed to ensure it continues its important health and humanitarian mission. PMID:29721489

Adult congenital heart disease in Greece: Preliminary data from the CHALLENGE registry.

PubMed

Giannakoulas, G; Vasiliadis, K; Frogoudaki, A; Ntellos, C; Tzifa, A; Brili, S; Manginas, A; Papaphylactou, M; Parcharidou, D; Kampouridis, N; Pitsis, A; Chamaidi, A; Kolios, M; Papadopoulos, G; Douras, A; Davlouros, P; Ntiloudi, D; Karvounis, H; Kalangos, A; Tsioufis, C; Rammos, S

2017-10-15

The majority of patients with congenital heart disease (CHD), nowadays, survives into adulthood and is faced with long-term complications. We aimed to study the basic demographic and clinical characteristics of adult patients with congenital heart disease (ACHD) in Greece. A registry named CHALLENGE (Adult Congenital Heart Disease Registry. A registry from Hellenic Cardiology Society) was initiated in January 2012. Patients with structural CHD older than 16years old were enrolled by 16 specialized centers nationwide. Out of a population of 2115 patients with ACHD, who have been registered, (mean age 38years (SD 16), 52% women), 47% were classified as suffering from mild, 37% from moderate and 15% from severe ACHD. Atrial septal defect (ASD) was the most prevalent diagnosis (33%). The vast majority of ACHD patients (92%) was asymptomatic or mildly symptomatic (NYHA class I/II). The most symptomatic patients were suffering from an ASD, most often the elderly or those under targeted therapy for pulmonary arterial hypertension. Elderly patients (>60years old) accounted for 12% of the ACHD population. Half of patients had undergone at least one open-heart surgery, while 39% were under cardiac medications (15% under antiarrhythmic drugs, 16% under anticoagulants, 16% under medications for heart failure and 4% under targeted therapy for pulmonary arterial hypertension). ACHD patients are an emerging patient population and national prospective registries such as CHALLENGE are of unique importance in order to identify the ongoing needs of these patients and match them with the appropriate resource allocation. Copyright © 2017 Elsevier B.V. All rights reserved.

A Cost-Effectiveness Analysis of Blended Versus Face-to-Face Delivery of Evidence-Based Medicine to Medical Students

PubMed Central

Nicklen, Peter; Rivers, George; Foo, Jonathan; Ooi, Ying Ying; Reeves, Scott; Walsh, Kieran; Ilic, Dragan

2015-01-01

Background Blended learning describes a combination of teaching methods, often utilizing digital technologies. Research suggests that learner outcomes can be improved through some blended learning formats. However, the cost-effectiveness of delivering blended learning is unclear. Objective This study aimed to determine the cost-effectiveness of a face-to-face learning and blended learning approach for evidence-based medicine training within a medical program. Methods The economic evaluation was conducted as part of a randomized controlled trial (RCT) comparing the evidence-based medicine (EBM) competency of medical students who participated in two different modes of education delivery. In the traditional face-to-face method, students received ten 2-hour classes. In the blended learning approach, students received the same total face-to-face hours but with different activities and additional online and mobile learning. Online activities utilized YouTube and a library guide indexing electronic databases, guides, and books. Mobile learning involved self-directed interactions with patients in their regular clinical placements. The attribution and differentiation of costs between the interventions within the RCT was measured in conjunction with measured outcomes of effectiveness. An incremental cost-effectiveness ratio was calculated comparing the ongoing operation costs of each method with the level of EBM proficiency achieved. Present value analysis was used to calculate the break-even point considering the transition cost and the difference in ongoing operation cost. Results The incremental cost-effectiveness ratio indicated that it costs 24% less to educate a student to the same level of EBM competency via the blended learning approach used in the study, when excluding transition costs. The sunk cost of approximately AUD $40,000 to transition to the blended model exceeds any savings from using the approach within the first year of its implementation; however, a break-even point is achieved within its third iteration and relative savings in the subsequent years. The sensitivity analysis indicates that approaches with higher transition costs, or staffing requirements over that of a traditional method, are likely to result in negative value propositions. Conclusions Under the study conditions, a blended learning approach was more cost-effective to operate and resulted in improved value for the institution after the third year iteration, when compared to the traditional face-to-face model. The wider applicability of the findings are dependent on the type of blended learning utilized, staffing expertise, and educational context. PMID:26197801

Challenges in integrative approaches to modelling the marine ecosystems of the North Atlantic: Physics to fish and coasts to ocean

NASA Astrophysics Data System (ADS)

Holt, Jason; Icarus Allen, J.; Anderson, Thomas R.; Brewin, Robert; Butenschön, Momme; Harle, James; Huse, Geir; Lehodey, Patrick; Lindemann, Christian; Memery, Laurent; Salihoglu, Baris; Senina, Inna; Yool, Andrew

2014-12-01

It has long been recognised that there are strong interactions and feedbacks between climate, upper ocean biogeochemistry and marine food webs, and also that food web structure and phytoplankton community distribution are important determinants of variability in carbon production and export from the euphotic zone. Numerical models provide a vital tool to explore these interactions, given their capability to investigate multiple connected components of the system and the sensitivity to multiple drivers, including potential future conditions. A major driver for ecosystem model development is the demand for quantitative tools to support ecosystem-based management initiatives. The purpose of this paper is to review approaches to the modelling of marine ecosystems with a focus on the North Atlantic Ocean and its adjacent shelf seas, and to highlight the challenges they face and suggest ways forward. We consider the state of the art in simulating oceans and shelf sea physics, planktonic and higher trophic level ecosystems, and look towards building an integrative approach with these existing tools. We note how the different approaches have evolved historically and that many of the previous obstacles to harmonisation may no longer be present. We illustrate this with examples from the on-going and planned modelling effort in the Integrative Modelling Work Package of the EURO-BASIN programme.

Dua sakit (double sick): trauma and the settlement experiences of West Papuan refugees living in North Queensland.

PubMed

Rees, Susan; Silove, Derrick; Kareth, Moses

2009-08-01

There is mounting evidence of systematic abuses, including torture, rape and extrajudicial killings directed against independence activists as well as the civilian population in Indonesian occupied West Papua. Refugees from West Papua have sought safety in neighbouring Australia, experiencing hazardous journeys during their flight. We report early observations from a mental health study among West Papuan refugees living in North Queensland, Australia. The project includes qualitative methods aimed at gathering histories of trauma and human rights violations as well as standard mental health assessments and indices of acculturation and resettlement stresses. We consider the emerging data from the vantage point of the Adaptation and Development After Persecution and Trauma model that identifies five psychosocial domains that require repair following exposure to gross human rights violations and refugee trauma. The model emphasizes the inter-relatedness of key challenges, the compounding of adversity, and the bivalent effects of complex experiences, with both positive and negative elements shaping the adaptive trajectory of displaced persons. Refugee groups have their own approaches to conceptualizing the complexity of their problems, with the term dua sakit representing the expression used by West Papuans to identify the multiple challenges they face. The study highlights the importance of assessing each refugee group within its unique social and cultural context, taking into account such diverse factors as geographical location, employment, and ongoing conflict in the homeland in designing appropriate interventions.

Human exposure monitoring and evaluation in the Arctic: the importance of understanding exposures to the development of public health policy.

PubMed Central

Suk, William A; Avakian, Maureen D; Carpenter, David; Groopman, John D; Scammell, Madeleine; Wild, Christopher P

2004-01-01

Arctic indigenous peoples face significant challenges resulting from the contamination of Arctic air, water, and soil by persistent organic pollutants, heavy metals, and radionuclides. International cooperative efforts among governments and research institutions are under way to collect the information needed by environmental health scientists and public health officials to address environmental contamination in the Arctic. However, the climatic, political, and cultural conditions of the land and its native populations combine to present a unique set of scientific and logistic challenges to addressing this important public health issue. Public health officials have the responsibility to respect the cultural traditions of indigenous communities, while simultaneously designing strategies that will reduce their exposure to environmental contaminants and rates of disease and dysfunction. Researchers can better understand the link between environmental exposures and disease through monitoring programs for both the subsistence diets and health status of the indigenous populations. We suggest that the incorporation of community-based participatory research methods into programs designed to assess biomarkers of contaminant exposure in children and adults may be a valuable addition to ongoing and newly developed research programs. This approach could serve as a model for international environmental health initiatives, because it involves the participation of the local communities and seeks to builds trust between all stakeholders. PMID:14757538

Managed aquifer recharge through off-season irrigation in agricultural regions

USGS Publications Warehouse

Niswonger, Richard; Morway, Eric D.; Triana, Enrique; Huntington, Justin L.

2017-01-01

Options for increasing reservoir storage in developed regions are limited and prohibitively expensive. Projected increases in demand call for new long-term water storage to help sustain agriculture, municipalities, industry, and ecological services. Managed aquifer recharge (MAR) is becoming an integral component of water resources around the world. However, MAR faces challenges, including infrastructure costs, difficulty in enhancing recharge, water quality issues, and lack of available water supplies. Here we examine, through simulation modeling of a hypothetical agricultural subbasin in the western U.S., the potential of agricultural managed aquifer recharge (Ag-MAR) via canal seepage and off-season field irrigation. Weather phenomenon in many regions around the world exhibit decadal and other multiyear cycles of extreme precipitation. An ongoing challenge is to develop approaches to store greater amounts of water during these events. Simulations presented herein incorporate Ag-MAR programs and demonstrate that there is potential to enhance regional recharge by 7–13%, increase crop consumptive use by 9–12%, and increase natural vegetation consumption by 20–30%, where larger relative increases occur for lower aquifer hydraulic conductivity and higher specific yield values. Annual increases in groundwater levels were 7 m, and sustained levels following several years of drought were greater than 2 m. Results demonstrate that Ag-MAR has great potential to enhance long-term sustainability of water resources in agricultural basins.

Transition to family practice in Turkey.

PubMed

Güneş, Evrim Didem; Yaman, Hakan

2008-01-01

Turkey's primary health care (PHC) system was established in the beginning of the 1960s and provides preventive and curative basic medical services to the population. This article describes the experience of the Turkish health system, as it tries to adapt to the European health system. It describes the current organization of primary health care and the family medicine model that is in the process of implementation and discusses implications of the transition for family physicians and the challenges faced in meeting the needs for health care staff. In Turkey a trend toward urbanization is evident and more staff positions in rural PHC centers are vacant. Shortages of physicians and an ineffective distribution of doctors are seen as a major problem. Family medicine gained popularity at the beginning of the 1990s, as a specialty with a 3-year postgraduate training program. Medical practitioners who are graduates of a 6-year medical training program and are already working in the PHC system are offered retraining courses. Better working conditions and higher salaries may be important incentives for medical practitioners to sign a contract with the social security institution of Turkey. The lack of well-trained primary care staff is an ongoing challenge. Attempts to retrain medical practitioners to act as family physicians show promising results. Shortness of physician and health professionals and lack of time and resources in primary health care are problems to overcome during this process.

The potential of open learning in animal breeding.

PubMed

Lohuis, M M; Lohuis, C T; Petrongolo, R A

1999-07-01

Animal breeding education is presently facing many challenges. These include rapid changes in breeding knowledge and technology, resource and funding restrictions, and altering demographics of the learner and the animal breeding industry. These challenges can be met via an open learning educational format. This nontraditional approach is based on the needs of individual learners, not the interests of the teacher or the institution. An important feature of open learning is its appropriateness for the professional development audience. Delivery methods include interactive distance courses on the Web, computer-assisted learning, and team-based study. The Canadian dairy breeding industry has expressed the need for ongoing professional development to understand and adopt new animal breeding technologies. The University of Guelph responded by delivering a series of animal breeding short courses (Executive Certificate Program in Animal Breeding) to industry decision makers in 1997. A version modified specifically for farmers and breeding industry personnel was offered in 1998. Through the collaboration of experts from various agricultural institutions and the use of a learner-centered format, this professional development initiative was a pedagogical and financial success. This paper describes how the open learning approach differs from traditional university teaching. Using the University of Guelph example in animal breeding professional development, the framework for a successful open learning program will be examined. The best practices for effective adult education will also be identified and discussed within this case study.

Automated collection of medical images for research from heterogeneous systems: trials and tribulations

NASA Astrophysics Data System (ADS)

Patel, M. N.; Looney, P.; Young, K.; Halling-Brown, M. D.

2014-03-01

Radiological imaging is fundamental within the healthcare industry and has become routinely adopted for diagnosis, disease monitoring and treatment planning. Over the past two decades both diagnostic and therapeutic imaging have undergone a rapid growth, the ability to be able to harness this large influx of medical images can provide an essential resource for research and training. Traditionally, the systematic collection of medical images for research from heterogeneous sites has not been commonplace within the NHS and is fraught with challenges including; data acquisition, storage, secure transfer and correct anonymisation. Here, we describe a semi-automated system, which comprehensively oversees the collection of both unprocessed and processed medical images from acquisition to a centralised database. The provision of unprocessed images within our repository enables a multitude of potential research possibilities that utilise the images. Furthermore, we have developed systems and software to integrate these data with their associated clinical data and annotations providing a centralised dataset for research. Currently we regularly collect digital mammography images from two sites and partially collect from a further three, with efforts to expand into other modalities and sites currently ongoing. At present we have collected 34,014 2D images from 2623 individuals. In this paper we describe our medical image collection system for research and discuss the wide spectrum of challenges faced during the design and implementation of such systems.

Multimodeling: new approaches for linking ecological models

USGS Publications Warehouse

Gross, Louis J.; DeAngelis, Donald L.; Scott, J. Michael; Heglund, Patricia J.; Morrison, Michael L.

2006-01-01

The Everglades region of South Florida presents one of the major natural system management challenges facing the United States. With its assortment of alligators, crocodiles, manatees, panthers, large mixed flocks of wading birds, highly diverse subtropical flora, and sea of sawgrass, the ecosystem is unique in this country (Davis and Ogden 1994). The region is also perhaps the largest human-controlled system on the planet in that the major environmental factor influencing the region is water, and water flows are managed on a daily basis--subject to the vagaries of rainfall--by a massive system of locks, pumps, canals, and levees constructed over the past century. The changes brought about by such control have led to extensive modifications of historical patterns and magnitudes of flow, causing large declines in many native species, extensive changes in nutrient cycling and vegetation across south Florida, and great increases in pollutants such as mercury. Constrained by the conflicting demands of agriculture, urban human populations, and wildlife for control of water resources, and the varying agendas of hosts of government agencies and nongovernmental organizations, there is now an ongoing effort to plan for major changes to the system with expenditure estimates of eight billion dollars or more over the next several decades (USACOE 1999). Carrying out such planning, particularly as it impacts the natural systems of the region, provides one of the major challenges to the new field of computational ecology.

A Case of Attempted Suicide in Huntington's Disease: Ethical and Moral Considerations.

PubMed

Furfari, Kristin; Zehnder, Nichole; Abbott, Jean

2016-01-01

A 62-year-old female with Huntington's disease presented after a suicide attempt. Her advance directive stated that she did not want intubation or resuscitation, which her family acknowledged and supported. Despite these directives, she was resuscitated in the emergency department and continued to state that she would attempt suicide again. Her suicidality in the face of a chronic and advancing illness, and her prolonged consistency in her desire to take her own life, left careproviders wondering how to provide ethical, respectful care to this patient. Tension between the ethical principles of autonomy and beneficence is central in this case. The patient's narrative demonstrated that her suicide was an autonomous decision, free from coercion or disordered thinking from mental illness. Beneficence then would seem to necessitate care aligned with the patient's desire to end her life, which created ethical uneasiness for her family and careproviders. The case highlights several end-of-life ethical considerations that have received much recent attention. With ongoing discussions about the legalization of aid in dying across the country, caregivers are challenged to understand what beneficence means in people with terminal illnesses who want a say in their death. This case also highlights the profound moral distress of families and careproviders that arises in such ethically challenging scenarios. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Stakeholder engagement opportunities in systematic reviews: knowledge transfer for policy and practice.

PubMed

Keown, Kiera; Van Eerd, Dwayne; Irvin, Emma

2008-01-01

Knowledge transfer and exchange is the process of increasing the awareness and use of research evidence in policy or practice decision making by nonresearch audiences or stakeholders. One way to accomplish this end is through ongoing interaction between researchers and interested nonresearch audiences, which provides an opportunity for the two groups to learn more about one another. The purpose of this article is to describe and discuss various stakeholder engagement opportunities that we employ throughout the stages of conducting a systematic review, to increase knowledge utilization within these audiences. Systematic reviews of the literature on a particular topic can provide an unbiased overview of the state of the literature. The engagement opportunities we have identified are topic consultation, feedback meetings during the review, member of review team, and involvement in dissemination. The potential benefits of including stakeholders in the process of a systematic review include increased relevance, clarity, and awareness of systematic review findings. A further benefit is the potential for increased dissemination of the findings. Challenges that researchers face are that stakeholder interactions can be time- and resource-intensive, it can be difficult balancing stakeholder desires with scientific rigor, and stakeholders may have difficulties accepting findings with which they do not agree. Despite these challenges we have included stakeholder involvement as a permanent step in the procedure of conducting a systematic review.

Operating room metrics score card-creating a prototype for individualized feedback.

PubMed

Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Urman, Richard D

2014-11-01

The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers.

Common Origins of Diverse Misconceptions: Cognitive Principles and the Development of Biology Thinking

PubMed Central

Coley, John D.; Tanner, Kimberly D.

2012-01-01

Many ideas in the biological sciences seem especially difficult to understand, learn, and teach successfully. Our goal in this feature is to explore how these difficulties may stem not from the complexity or opacity of the concepts themselves, but from the fact that they may clash with informal, intuitive, and deeply held ways of understanding the world that have been studied for decades by psychologists. We give a brief overview of the field of developmental cognitive psychology. Then, in each of the following sections, we present a number of common challenges faced by students in the biological sciences. These may be in the form of misconceptions, biases, or simply concepts that are difficult to learn and teach, and they occur at all levels of biological analysis (molecular, cellular, organismal, population, and ecosystem). We then introduce the notion of a cognitive construal and discuss specific examples of how these cognitive principles may explain what makes some misconceptions so alluring and some biological concepts so challenging for undergraduates. We will argue that seemingly unrelated misconceptions may have common origins in a single underlying cognitive construal. These ideas emerge from our own ongoing cross-disciplinary conversation, and we think that expanding this conversation to include other biological scientists and educators, as well as other cognitive scientists, could have significant utility in improving biology teaching and learning. PMID:22949417

Managed aquifer recharge through off-season irrigation in agricultural regions

NASA Astrophysics Data System (ADS)

Niswonger, Richard G.; Morway, Eric D.; Triana, Enrique; Huntington, Justin L.

2017-08-01

Options for increasing reservoir storage in developed regions are limited and prohibitively expensive. Projected increases in demand call for new long-term water storage to help sustain agriculture, municipalities, industry, and ecological services. Managed aquifer recharge (MAR) is becoming an integral component of water resources around the world. However, MAR faces challenges, including infrastructure costs, difficulty in enhancing recharge, water quality issues, and lack of available water supplies. Here we examine, through simulation modeling of a hypothetical agricultural subbasin in the western U.S., the potential of agricultural managed aquifer recharge (Ag-MAR) via canal seepage and off-season field irrigation. Weather phenomenon in many regions around the world exhibit decadal and other multiyear cycles of extreme precipitation. An ongoing challenge is to develop approaches to store greater amounts of water during these events. Simulations presented herein incorporate Ag-MAR programs and demonstrate that there is potential to enhance regional recharge by 7-13%, increase crop consumptive use by 9-12%, and increase natural vegetation consumption by 20-30%, where larger relative increases occur for lower aquifer hydraulic conductivity and higher specific yield values. Annual increases in groundwater levels were 7 m, and sustained levels following several years of drought were greater than 2 m. Results demonstrate that Ag-MAR has great potential to enhance long-term sustainability of water resources in agricultural basins.

Common origins of diverse misconceptions: cognitive principles and the development of biology thinking.

PubMed

Coley, John D; Tanner, Kimberly D

2012-01-01

Many ideas in the biological sciences seem especially difficult to understand, learn, and teach successfully. Our goal in this feature is to explore how these difficulties may stem not from the complexity or opacity of the concepts themselves, but from the fact that they may clash with informal, intuitive, and deeply held ways of understanding the world that have been studied for decades by psychologists. We give a brief overview of the field of developmental cognitive psychology. Then, in each of the following sections, we present a number of common challenges faced by students in the biological sciences. These may be in the form of misconceptions, biases, or simply concepts that are difficult to learn and teach, and they occur at all levels of biological analysis (molecular, cellular, organismal, population, and ecosystem). We then introduce the notion of a cognitive construal and discuss specific examples of how these cognitive principles may explain what makes some misconceptions so alluring and some biological concepts so challenging for undergraduates. We will argue that seemingly unrelated misconceptions may have common origins in a single underlying cognitive construal. These ideas emerge from our own ongoing cross-disciplinary conversation, and we think that expanding this conversation to include other biological scientists and educators, as well as other cognitive scientists, could have significant utility in improving biology teaching and learning.

Security and SCADA protocols

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

Igure, V. M.; Williams, R. D.

2006-07-01

Supervisory control and data acquisition (SCADA) networks have replaced discrete wiring for many industrial processes, and the efficiency of the network alternative suggests a trend toward more SCADA networks in the future. This paper broadly considers SCADA to include distributed control systems (DCS) and digital control systems. These networks offer many advantages, but they also introduce potential vulnerabilities that can be exploited by adversaries. Inter-connectivity exposes SCADA networks to many of the same threats that face the public internet and many of the established defenses therefore show promise if adapted to the SCADA differences. This paper provides an overview ofmore » security issues in SCADA networks and ongoing efforts to improve the security of these networks. Initially, a few samples from the range of threats to SCADA network security are offered. Next, attention is focused on security assessment of SCADA communication protocols. Three challenges must be addressed to strengthen SCADA networks. Access control mechanisms need to be introduced or strengthened, improvements are needed inside of the network to enhance security and network monitoring, and SCADA security management improvements and policies are needed. This paper discusses each of these challenges. This paper uses the Profibus protocol as an example to illustrate some of the vulnerabilities that arise within SCADA networks. The example Profibus security assessment establishes a network model and an attacker model before proceeding to a list of example attacks. (authors)« less

Game Face

ERIC Educational Resources Information Center

Weiner, Jill

2005-01-01

In this article, the author discusses "Game Face: Life Lessons Across the Curriculum", a teaching kit that challenges assumptions and builds confidence. Game Face, which is derived from a book and art exhibition, "Game Face: What Does a Female Athlete Look Like?", uses layered and powerful images of women and girls participating in sports to teach…

Impact of conflict on medical education: a cross-sectional survey of students and institutions in Iraq.

PubMed

Barnett-Vanes, Ashton; Hassounah, Sondus; Shawki, Marwan; Ismail, Omar Abdulkadir; Fung, Chi; Kedia, Tara; Rawaf, Salman; Majeed, Azeem

2016-02-16

This study surveyed all Iraqi medical schools and a cross-section of Iraqi medical students regarding their institutional and student experiences of medical education amidst ongoing conflict. The objective was to better understand the current resources and challenges facing medical schools, and the impacts of conflict on the training landscape and student experience, to provide evidence for further research and policy development. Deans of all Iraqi medical schools registered in the World Directory of Medical Schools were invited to participate in a survey electronically. Medical students from three Iraqi medical schools were invited to participate in a survey electronically. Primary: Student enrolment and graduation statistics; human resources of medical schools; dean perspectives on impact of conflict. Secondary: Medical student perspectives on quality of teaching, welfare and future career intentions. Of 24 medical schools listed in the World Directory of Medical Schools, 15 replied to an initial email sent to confirm their contact details, and 8 medical schools responded to our survey, giving a response rate from contactable medical schools of 53% and overall of 33%. Five (63%) medical schools reported medical student educational attainment being impaired or significantly impaired; 4 (50%) felt the quality of training medical schools could offer had been impaired or significantly impaired due to conflict. A total of 197 medical students responded, 62% of whom felt their safety had been threatened due to violent insecurity. The majority (56%) of medical students intended to leave Iraq after graduating. Medical schools are facing challenges in staff recruitment and adequate resource provision; the majority believe quality of training has suffered as a result. Medical students are experiencing added psychological stress and lower quality of teaching; the majority intend to leave Iraq after graduation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Towards operational hydrology for a thorough spatio-temporal exploration of the Critical Zone

NASA Astrophysics Data System (ADS)

Chatton, Eliot; Labasque, Thierry; Guillou, Aurélie; Aquilina, Luc; Bour, Olivier; Le Borgne, Tanguy; Longuevergne, Laurent

2017-04-01

Over the last century, the Critical Zone faced remarkable climate and land use changes increasing the pressures on the Hydrosphere and giving rise to numerous environmental consequences in terms of water quantity and quality. From now on, the Critical Zone must face the challenge to supply 9 billion people with quality food and safe drinking water in a context of global warming. For the Hydrosphere, this challenge could be addressed with a better understanding of the dynamics and resilience of aquatic environments (rivers, lakes, groundwaters, oceans). In view of the spatial and temporal variety and variability of flow dynamics and biogeochemical reactions occurring in the Hydrosphere a new investigation method is needed. This study approaches the concept of "operational hydrology" aiming to enhance either the spatio-temporal distribution and the quality of environmental data for a thorough exploration of the Hydrosphere. To illustrate our approach, we present natural and anthropogenic dissolved gas data (He, Ne, Ar, Kr, Xe, N2, O2, CO2, CH4, N2O, H2, BTEX, and some VOCs) measured in situ with a CF-MIMS (Chatton et al, 2016) installed in a mobile laboratory arranged in an all-terrain truck (CRITEX-Lab). This ongoing work focuses on groundwater and the field investigation of residence time distributions, recharge processes (origins), water flow paths and mixing, biogeochemical reactivity and contamination (sources). The rationale behind "operational hydrology" could be applied to the field measurement at high-frequency of many other environmental parameters (temperature, cations, anions, isotopes, micro-organisms) not only for the investigation of groundwaters but also rivers, lakes and oceans. Eliot Chatton, Thierry Labasque, Jérôme de La Bernardie, Nicolas Guihéneuf, Olivier Bour and Luc Aquilina; Field Continuous Measurement of Dissolved Gases with a CF-MIMS: Applications to the Physics and Biogeochemistry of Groundwater Flow; Environmental Science & Technology, in press, 2016.

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

PubMed Central

Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

2017-01-01

Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a number of legal, policy and fiscal milestones, thereby presenting a unique and fertile environment for the expansion of mental health services PMID:28949462

NASA Earth Observations Informing Energy Management Decision Making

NASA Technical Reports Server (NTRS)

Eckman, Richard; Stackhouse, Paul

2017-01-01

The Energy Sector is experiencing increasing impacts from severe weather and shifting climatic trends, as well as facing a changing political climate, adding uncertainty for stakeholders as they make short- and long-term planning investments. Climate changes such as prolonged extreme heat and drought (leading to wildfire spread, for example), sea level rise, and extreme storms are changing the ways that utilities operate. Energy infrastructure located in coastal or flood-prone areas faces inundation risks, such as damage to energy facilities. The use of renewable energy resources is increasing, requiring more information about their intermittency and spatial patterns. In light of these challenges, public and private stakeholders have collaborated to identify potential data sources, tools, and programmatic ideas. For example, utilities across the country are using cutting-edge technology and data to plan for and adapt to these changes. In the Federal Government, NASA has invested in preliminary work to identify needs and opportunities for satellite data in energy sector application, and the Department of Energy has similarly brought together stakeholders to understand the landscape of climate vulnerability and resilience for utilities and others. However, have these efforts improved community-scale resilience and adaptation efforts? Further, some communities are more vulnerable to climate change and infrastructure impacts than others. This session has two goals. First, panelists seek to share existing and ongoing efforts related to energy management. Second, the session seeks to engage with attendees via group knowledge exchange to connect national energy management efforts to local practice for increased community resilience.

Thermal-to-visible face recognition using partial least squares.

PubMed

Hu, Shuowen; Choi, Jonghyun; Chan, Alex L; Schwartz, William Robson

2015-03-01

Although visible face recognition has been an active area of research for several decades, cross-modal face recognition has only been explored by the biometrics community relatively recently. Thermal-to-visible face recognition is one of the most difficult cross-modal face recognition challenges, because of the difference in phenomenology between the thermal and visible imaging modalities. We address the cross-modal recognition problem using a partial least squares (PLS) regression-based approach consisting of preprocessing, feature extraction, and PLS model building. The preprocessing and feature extraction stages are designed to reduce the modality gap between the thermal and visible facial signatures, and facilitate the subsequent one-vs-all PLS-based model building. We incorporate multi-modal information into the PLS model building stage to enhance cross-modal recognition. The performance of the proposed recognition algorithm is evaluated on three challenging datasets containing visible and thermal imagery acquired under different experimental scenarios: time-lapse, physical tasks, mental tasks, and subject-to-camera range. These scenarios represent difficult challenges relevant to real-world applications. We demonstrate that the proposed method performs robustly for the examined scenarios.

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

PubMed

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

2005-01-01

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

The organisational and human resource challenges facing primary care trusts: protocol of a multiple case study

PubMed Central

2001-01-01

Background The study is designed to assess the organisational and human resource challenges faced by Primary Care Trusts (PCTs). Its objectives are to: specify the organisational and human resources challenges faced by PCTs in fulfilling the roles envisaged in government and local policy; examine how PCTs are addressing these challenges, in particular, to describe the organisational forms they have adopted, and the OD/HR strategies and initiatives they have planned or in place; assess how effective these structures, strategies and initiatives have been in enabling the PCTs to meet the organisational and human resources challenges they face; identify the factors, both internal to the PCT and in the wider health community, which have contributed to the success or failure of different structures, strategies and initiatives. Methods The study will be undertaken in three stages. In Stage 1 the key literature on public sector and NHS organisational development and human resources management will be reviewed, and discussions will be held with key researchers and policy makers working in this area. Stage 2 will focus on detailed case studies in six PCTs designed to examine the organisational and human resources challenges they face. Data will be collected using semi-structured interviews, group discussion, site visits, observation of key meetings and examination of local documentation. The findings from the case study PCTs will be cross checked with a Reference Group of up to 20 other PCG/Ts, and key officers working in organisational development or primary care at local, regional and national level. In Stage 3 analysis of findings from the preparatory work, the case studies and the feedback from the Reference Group will be used to identify practical lessons for PCTs, key messages for policy makers, and contributions to further theoretical development. PMID:11737883

Reflections of Malaysian parents of children with developmental disabilities on their experiences with AAC.

PubMed

Joginder Singh, Susheel; Hussein, Nur Hazirah; Mustaffa Kamal, Rahayu; Hassan, Fatimah Hani

2017-06-01

Parents play an important role in the successful implementation of AAC. Previous research has indicated that parents in different countries have varying perceptions about the use of AAC and face different challenges in its implementation. To date, there is limited information about the use of AAC by children in Malaysia or parents' views about its use. The aim of this study was to explore Malaysian parents' perception of AAC and their experience when supporting their children who use AAC. For this study, 12 parents of children with autism spectrum disorder and cerebral palsy were involved in semi-structured individual interviews. Qualitative content analysis was used to analyze interview data. Following analysis, three themes were identified: (a) impact of the use of AAC, (b) challenges faced, and (c) hopes and expectations. Participants reported that the use of AAC had a positive impact on their children, but that they faced challenges related to the child, the settings, and the system itself, as well as a lack of time and support. Findings from this study provide an insight for Malaysian speech therapists about the challenges faced by parents when supporting their children who use AAC, and how important it is to overcome these challenges to ensure successful implementation of AAC.

Searching for Grey Literature for Systematic Reviews: Challenges and Benefits

ERIC Educational Resources Information Center

Mahood, Quenby; Van Eerd, Dwayne; Irvin, Emma

2014-01-01

There is ongoing interest in including grey literature in systematic reviews. Including grey literature can broaden the scope to more relevant studies, thereby providing a more complete view of available evidence. Searching for grey literature can be challenging despite greater access through the Internet, search engines and online bibliographic…

Applied Linguistics: The Challenge of Theory

ERIC Educational Resources Information Center

McNamara, Tim

2015-01-01

Language has featured prominently in contemporary social theory, but the relevance of this fact to the concerns of Applied Linguistics, with its necessary orientation to practical issues of language in context, represents an ongoing challenge. This article supports the need for a greater engagement with theory in Applied Linguistics. It considers…

Committed to Conservation

ERIC Educational Resources Information Center

Boulard, Garry

2009-01-01

Addressing ongoing and costly deferred-maintenance needs is a challenge for any two- or four-year school. During an economically challenging time, many HBCUs have put energy efficiency and other green projects on the back burner. However, some are finding that deferred maintenance does not have to be a barrier to becoming green. Despite budget…

Playing on Reality: Do Geomodels Improve the Perception of Geographical Terms?

ERIC Educational Resources Information Center

Czigány, Szabolcs; Császár, Zsuzsa; Kiss, Kinga; Halmai, Ákos; Lóczy, Dénes; Nagyváradi, László; Pirkhoffer, Ervin

2018-01-01

Remodeling of geography education has been an ongoing challenge recently. Constructivist pedagogy, employing tools of problem and model-based learning, offers new opportunities to meet these challenges. Geomodels, flumes and stream tables may ease the understanding of geographic processes through hand-on-experience for students. With a…

Researching across Boundaries and Borders: The Challenges for Research

ERIC Educational Resources Information Center

Bowl, Marion; Cooke, Sandra; Hockings, Christine

2008-01-01

This article explores some of the challenges of conducting action research in higher education. It arises from an ongoing research project funded by the Economic and Social Research Council's Teaching and Learning Research Programme (ESRC/TLRP), "Learning and Teaching for Social Diversity and Difference", which examines the dynamics of…

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

ERIC Educational Resources Information Center

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

2017-01-01

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

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

PubMed

Abou-Gharbia, Magid; Childers, Wayne E

2013-07-25

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

With Geospatial in Path of Smart City

NASA Astrophysics Data System (ADS)

Homainejad, A. S.

2015-04-01

With growth of urbanisation, there is a requirement for using the leverage of smart city in city management. The core of smart city is Information and Communication Technologies (ICT), and one of its elements is smart transport which includes sustainable transport and Intelligent Transport Systems (ITS). Cities and especially megacities are facing urgent transport challenge in traffic management. Geospatial can provide reliable tools for monitoring and coordinating traffic. In this paper a method for monitoring and managing the ongoing traffic in roads using aerial images and CCTV will be addressed. In this method, the road network was initially extracted and geo-referenced and captured in a 3D model. The aim is to detect and geo-referenced any vehicles on the road from images in order to assess the density and the volume of vehicles on the roads. If a traffic jam was recognised from the images, an alternative route would be suggested for easing the traffic jam. In a separate test, a road network was replicated in the computer and a simulated traffic was implemented in order to assess the traffic management during a pick time using this method.

Exploring the Lived Experience of Women Immediately Following Mastectomy: A Phenomenological Study.

PubMed

Davies, Claire C; Brockopp, Dorothy; Moe, Krista; Wheeler, Peggy; Abner, Jean; Lengerich, Alexander

In 2014, it is estimated that 232,670 new cases of breast cancer occurred in the United States. Unilateral or bilateral mastectomy is a frequently chosen option for treating this disease. The purpose of this study was to explore, through an in-depth interview process, the lived experience of women immediately following mastectomy when they see their scars for the first time. Purposeful sampling was used until saturation was reached. In-depth interviews were conducted with 10 women related to their mastectomy experience. The data were analyzed using a phenomenological approach. The following 8 themes emerged from the data; lasting impact, personal impact, relational impact, gratitude, support system, coping strategies, timing, and discomfort. The results of the study provide evidence that women face ongoing challenges following seeing their mastectomy scars for the first time that is not adequately addressed by healthcare professionals. Nurses and other healthcare professionals need to gain a better understanding of the difficulties perceived by women following seeing the scars from mastectomy and implement strategies to assist in successful adaptation to the experience.

LiDAR in extreme environment: surveying in Antarctica

NASA Astrophysics Data System (ADS)

Abate, D.; Pierattini, S.; Bianchi Fasani, G.

2013-10-01

This study was performed under the patronage of the Italian National Research Programme in Antarctica (PNRA) with the aim to realize a high resolution Digital Elevation Model (DEM) of the moraine named "Boulder Clay" which insists approximately 7 km far from the Italian Research Base "Mario Zucchelli Station" in the Terra Nova Bay area. The DEM will be included in the project for the construction of two runways to be used as support facilities for the scientific research campaigns which take place on regular basis each year. Although the research efforts to realize a detailed cartography of the area is on-going, for the specific aim and urgency of this project it was decided to perform a laser scanning survey in this extreme environment in order to obtain contour lines describing the terrain elevation each 50 cm and volume analysis. The final result will be super imposed on a photogrammetric DEM with contour lines each 2.5 m and satellite images. This paper focus both on the final scientific data and on all the challenges have to be faced in such extreme and particular environment during the laser scanning survey.

Packing of Fruit Fly Parasitoids for Augmentative Releases

PubMed Central

Montoya, Pablo; Cancino, Jorge; Ruiz, Lía

2012-01-01

The successful application of Augmentative Biological Control (ABC) to control pest fruit flies (Diptera: Tephritidae) confronts two fundamental requirements: (1) the establishment of efficient mass rearing procedures for the species to be released, and (2) the development of methodologies for the packing and release of parasitoids that permit a uniform distribution and their optimal field performance under an area-wide approach. Parasitoid distributions have been performed by ground and by air with moderate results; both options face challenges that remain to be addressed. Different devices and strategies have been used for these purposes, including paper bags and the chilled adult technique, both of which are commonly used when releasing sterile flies. However, insect parasitoids have morphological and behavioral characteristics that render the application of such methodologies suboptimal. In this paper, we discuss an alternate strategy for the augmentative release of parasitoids and describe packing conditions that favor the rearing and emergence of adult parasitoids for increased field performance. We conclude that the use of ABC, including the packaging of parasitoids, requires ongoing development to ensure that this technology remains a viable and effective control technique for pest fruit flies. PMID:26466634

Human Response to Emergency Warning

NASA Astrophysics Data System (ADS)

Sorensen, J.

2009-12-01

Almost every day people evacuate from their homes, businesses or other sites, even ships, in response to actual or predicted threats or hazards. Evacuation is the primary protective action utilized in large-scale emergencies such as hurricanes, floods, tornados, tsunamis, volcanic eruptions, or wildfires. Although often precautionary, protecting human lives by temporally relocating populations before or during times of threat remains a major emergency management strategy. One of the most formidable challenges facing emergency officials is evacuating residents for a fast-moving and largely unpredictable event such as a wildfire or a local tsunami. How to issue effective warnings to those at risk in time for residents to take appropriate action is an on-going problem. To do so, some communities have instituted advanced communications systems that include reverse telephone call-down systems or other alerting systems to notify at-risk residents of imminent threats. This presentation examines the effectiveness of using reverse telephone call-down systems for warning San Diego residents of wildfires in the October of 2007. This is the first systematic study conducted on this topic and is based on interviews with 1200 households in the evacuation areas.

Review on recent developments on pulp and paper mill wastewater treatment.

PubMed

Kamali, Mohammadreza; Khodaparast, Zahra

2015-04-01

Economic benefits of the pulp and paper industry have led it to be one of the most important industrial sections in the world. Nevertheless, in recent years, pulp and paper mills are facing challenges with the energy efficiency mechanisms and management of the resulting pollutants, considering the environmental feedbacks and ongoing legal requirements. This study reviews and discusses the recent developments of affordable methods dealing with pulp and paper mill wastewaters. To this end, the current state of the various processes used for pulp and paper production from virgin or recovered fibers has been briefly reviewed. Also, the relevant contaminants have been investigated, considering the used raw materials and applied techniques as the subject for further discussion about the relevant suitable wastewater treatment methods. The results of the present study indicated that adopting the integrated methods, alongside a combination of biological (e.g., anaerobic digestion) and physicochemical (e.g., novel Fenton reactions) treatment methods, can be environmentally and economically preferable to minimize environmental contaminants and energy recycling. Copyright © 2014 Elsevier Inc. All rights reserved.

PPDB - A tool for investigation of plants physiology based on gene ontology.

PubMed

Sharma, Ajay Shiv; Gupta, Hari Om; Prasad, Rajendra

2014-09-02

Representing the way forward, from functional genomics and its ontology to functional understanding and physiological model, in a computationally tractable fashion is one of the ongoing challenges faced by computational biology. To tackle the standpoint, we herein feature the applications of contemporary database management to the development of PPDB, a searching and browsing tool for the Plants Physiology Database that is based upon the mining of a large amount of gene ontology data currently available. The working principles and search options associated with the PPDB are publicly available and freely accessible on-line ( http://www.iitr.ernet.in/ajayshiv/ ) through a user friendly environment generated by means of Drupal-6.24. By knowing that genes are expressed in temporally and spatially characteristic patterns and that their functionally distinct products often reside in specific cellular compartments and may be part of one or more multi-component complexes, this sort of work is intended to be relevant for investigating the functional relationships of gene products at a system level and, thus, helps us approach to the full physiology.

PPDB: A Tool for Investigation of Plants Physiology Based on Gene Ontology.

PubMed

Sharma, Ajay Shiv; Gupta, Hari Om; Prasad, Rajendra

2015-09-01

Representing the way forward, from functional genomics and its ontology to functional understanding and physiological model, in a computationally tractable fashion is one of the ongoing challenges faced by computational biology. To tackle the standpoint, we herein feature the applications of contemporary database management to the development of PPDB, a searching and browsing tool for the Plants Physiology Database that is based upon the mining of a large amount of gene ontology data currently available. The working principles and search options associated with the PPDB are publicly available and freely accessible online ( http://www.iitr.ac.in/ajayshiv/ ) through a user-friendly environment generated by means of Drupal-6.24. By knowing that genes are expressed in temporally and spatially characteristic patterns and that their functionally distinct products often reside in specific cellular compartments and may be part of one or more multicomponent complexes, this sort of work is intended to be relevant for investigating the functional relationships of gene products at a system level and, thus, helps us approach to the full physiology.

Political experiences of changing the focus in elderly care in one municipality.

PubMed

Evertsson, Paula; Rosengren, Kristina

2015-11-01

To describe local politicians' experiences of an ongoing planning process for elderly care for the future in a medium-sized municipality in western Sweden. Elderly care is facing challenges because of an ageing population. The study comprised a total of eight semi-structured interviews with politicians. The interviews were analysed using manifest qualitative content analysis. One category (political consensus) and three subcategories (involvement generates security, trust in change management and confidence to create visions) were identified. Political consensus across elderly care organisations could establish a sense of security for old people, their relatives and the staff in particular. Continuous information and support from different managerial levels is one way of implementing changes within large organisations. However, further research is needed to describe how to develop future elderly care. An ageing population requires cooperation across provider boundaries to further develop high-quality elderly care services. Nursing leadership during a change process is crucial to implement political decisions in care organisations. Furthermore, active marketing of the health care profession for elderly care is needed as well as new knowledge regarding old people. © 2014 John Wiley & Sons Ltd.

Beyond Disaster Preparedness: Building a Resilience-Oriented Workforce for the Future

PubMed Central

Madrigano, Jaime; Chandra, Anita; Costigan, Tracy; Acosta, Joie D.

2017-01-01

Enhancing citizens’ and communities’ resilience is critical to adapt successfully to ongoing challenges faced by communities, as well as acute shocks resulting from disasters. While significant progress has been made in this area, several research and practice gaps remain. A crucial next step to advance resilience is the development of a resilience-oriented workforce. This narrative review examines existing literature to determine key components of a resilience-oriented workforce, with a focus on organizational structures, training and education, and leadership models. Reviewed articles spanned a variety of study types, including needs assessments of existing workforce, program evaluations, and reviews/commentaries. A resilience-oriented workforce spans many disciplines and training programs will need to reflect that. It requires a collaborative organizational model that promotes information sharing structures. Leadership models should foster a balance between workforce autonomy and operation as a collective entity. Optimal strategies to develop a resilience-oriented workforce have yet to be realized and future research will need to collect and synthesize data to promote and evaluate the growth of this field. PMID:29236028

Partnerships in health care: creating a strong value chain.

PubMed

Steinhart, C M; Alsup, R G

2001-01-01

The health care climate is one of stormy relations between various entities. Employers, managed care organizations, hospitals, and physicians battle over premiums, inpatient rates, fee schedules, and percent of premium dollars. Patients are angry at health plans over problems with access, choice, and quality of care. Employers dicker with managed care organizations over prices, benefits, and access. Hospitals struggle to maintain operations, as occupancy rates decline and the shift to ambulatory care continues. Physicians strive to assure their patients get quality care while they try to maintain stable incomes. Businesses, faced with similar challenges in the competitive marketplace, have formed partnerships for mutual benefit. Successful partnerships are based upon trust and the concept of "win-win." Communication, ongoing evaluation, long-term relations, and shared values are also essential. In Japan, the keiretsu contains the elements of a bonafide partnership. Examples in U.S. businesses abound. In health care, partnerships will improve quality and access. When health care purchasers and providers link together, these partnerships create a new value chain that has patients as the focal point.

Beyond Disaster Preparedness: Building a Resilience-Oriented Workforce for the Future.

PubMed

Madrigano, Jaime; Chandra, Anita; Costigan, Tracy; Acosta, Joie D

2017-12-13

Enhancing citizens' and communities' resilience is critical to adapt successfully to ongoing challenges faced by communities, as well as acute shocks resulting from disasters. While significant progress has been made in this area, several research and practice gaps remain. A crucial next step to advance resilience is the development of a resilience-oriented workforce. This narrative review examines existing literature to determine key components of a resilience-oriented workforce, with a focus on organizational structures, training and education, and leadership models. Reviewed articles spanned a variety of study types, including needs assessments of existing workforce, program evaluations, and reviews/commentaries. A resilience-oriented workforce spans many disciplines and training programs will need to reflect that. It requires a collaborative organizational model that promotes information sharing structures. Leadership models should foster a balance between workforce autonomy and operation as a collective entity. Optimal strategies to develop a resilience-oriented workforce have yet to be realized and future research will need to collect and synthesize data to promote and evaluate the growth of this field.