Thomas Kuhn's impact on science education: What lessons can be learned?

NASA Astrophysics Data System (ADS)

Matthews, Michael R.

2004-01-01

Thomas Kuhn has had an impact in all academic fields. In science education, Kuhnian themes are especially noticeable in conceptual change research, constructivist theorizing, and multicultural education debates. Unfortunately the influence is frequently compromised by researchers having a limited understanding of Kuhn's original ideas, little exposure to the tradition of philosophical opposition to Kuhn's theories, and minimal appreciation of how Kuhn progressively qualified his initial irrationalist'' views of scientific development. One lesson to be learnt is that the science education community should more seriously and effectively engage with on-going debates and analysis in the history and philosophy of science. This is the same lesson that was learnt from the science education community's wholesale embrace of logical empiricism during the 1950s and 1960s. Another lesson is that there are powerful disciplinary, institutional, and subcultural barriers that mitigate against science educators seriously engaging with historical and philosophical scholarship.

Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia.

PubMed

Chim, Harvey; Yew, Woon Si; Song, Colin

2007-01-01

Terror attacks in Southeast Asia were almost nonexistent until the 2002 Bali bomb blast, considered the deadliest attack in Indonesian history. Further attacks in 2003 (Jakarta), 2004 (Jakarta), and 2005 (Bali) have turned terrorist attacks into an ever-present reality. The authors reviewed medical charts of victims evacuated to the Singapore General Hospital (SGH) Burns Centre during three suicide attacks involving Bali (2002 and 2005) and the Jakarta Marriott hotel (2003). Problems faced, lessons learnt, and costs incurred are discussed. A burns disaster plan drawing on lessons learnt from these attacks is presented. Thirty-one patients were treated at the SGH Burns Centre in three attacks (2002 Bali attack [n = 15], 2003 Jakarta attack [n = 14], and 2005 Bali attack [n = 2]). For the 2002 Bali attack, median age was 29 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 9). A large number of patients had other injuries. Problems faced included manpower issues, lack of bed space, shortage of blood products, and lack of cadaver skin. The changing nature of terror attacks mandates continued vigilance and disaster preparedness. The multidimensional burns patient, complicated by other injuries, is likely to become increasingly common. A burns disaster plan with emphasis on effective command, control, and communication as well as organisation of health care personnel following a 'team concept' will do much to ensure that the sudden onset of a crisis situation at an unexpected time does not overwhelm hospital manpower and resources.

Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia

PubMed Central

Saint, Victoria; Floranita, Rustini; Koemara Sakti, Gita Maya; Pambudi, Imran; Hermawan, Lukas; Villar, Eugenio; Magar, Veronica

2018-01-01

ABSTRACT The World Health Organization’s Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals’ commitment to ‘leave no one behind’. In 2014–2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This ‘methods forum’ article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a ‘leave no one behind’ approach. As follow-up during 2015–2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs’ commitment to leave no one behind, in particular in relation to influencing programming and monitoring and evaluation. PMID:29569529

Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia.

PubMed

Koller, Theadora Swift; Saint, Victoria; Floranita, Rustini; Koemara Sakti, Gita Maya; Pambudi, Imran; Hermawan, Lukas; Briot, Benedicte; Frenz, Patricia; Solar, Orielle; Campos, Pilar; Villar, Eugenio; Magar, Veronica

The World Health Organization's Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals' commitment to 'leave no one behind'. In 2014-2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This 'methods forum' article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a 'leave no one behind' approach. As follow-up during 2015-2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs' commitment to leave no one behind, in particular in relation to influencing programming and monitoring and evaluation.

Managing burn victims of suicide bombing attacks: outcomes, lessons learnt, and changes made from three attacks in Indonesia

PubMed Central

Chim, Harvey; Yew, Woon Si; Song, Colin

2007-01-01

Introduction Terror attacks in Southeast Asia were almost nonexistent until the 2002 Bali bomb blast, considered the deadliest attack in Indonesian history. Further attacks in 2003 (Jakarta), 2004 (Jakarta), and 2005 (Bali) have turned terrorist attacks into an ever-present reality. Methods The authors reviewed medical charts of victims evacuated to the Singapore General Hospital (SGH) Burns Centre during three suicide attacks involving Bali (2002 and 2005) and the Jakarta Marriott hotel (2003). Problems faced, lessons learnt, and costs incurred are discussed. A burns disaster plan drawing on lessons learnt from these attacks is presented. Results Thirty-one patients were treated at the SGH Burns Centre in three attacks (2002 Bali attack [n = 15], 2003 Jakarta attack [n = 14], and 2005 Bali attack [n = 2]). For the 2002 Bali attack, median age was 29 years (range 20 to 50 years), median percentage of total burn surface area (TBSA) was 29% (range 5% to 55%), and median abbreviated burn severity index (ABSI) was 6 (range 3 to 10). Eight of 15 patients were admitted to the intensive care unit. For the 2003 Jakarta attack, median age was 35 years (range 24 to 56 years), median percentage of TBSA was 10% (range 2% to 46%), and median ABSI was 4 (range 3 to 9). A large number of patients had other injuries. Problems faced included manpower issues, lack of bed space, shortage of blood products, and lack of cadaver skin. Conclusion The changing nature of terror attacks mandates continued vigilance and disaster preparedness. The multidimensional burns patient, complicated by other injuries, is likely to become increasingly common. A burns disaster plan with emphasis on effective command, control, and communication as well as organisation of health care personnel following a 'team concept' will do much to ensure that the sudden onset of a crisis situation at an unexpected time does not overwhelm hospital manpower and resources. PMID:17274813

Lessons Learnt from Past Incidents and Accidents in Radiation Oncology.

PubMed

Knöös, T

2017-09-01

The purpose of this report is to review and compile what have been and can be learnt from incidents and accidents in radiation oncology, especially in external beam and brachytherapy. Some major accidents from the last 20 years will be discussed. The relationship between major events and minor or so-called near misses is mentioned, leading to the next topic of exploring the knowledge hidden among them. The main lessons learnt from the discussion here and elsewhere are that a well-functioning and safe radiotherapy department should help staff to work with awareness and alertness and that documentation and procedures should be in place and known by everyone. It also requires that trained and educated staff with the required competences are in place and, finally, functions and responsibilities are defined and well known. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Coping with Natural Disasters: Lessons Learnt by a Head of Department

ERIC Educational Resources Information Center

Lord, Beverley

2011-01-01

Since the first of the 29 significant earthquakes and thousands of aftershocks that the University of Canterbury (New Zealand) community has endured in the last year, Beverly Lord has learned a few lessons as a departmental head in a university during a time of natural disaster. Herein, she organizes and describes these lessons under five…

The early identification of psychosis: Can lessons be learnt from Cardiac Stress Testing?

PubMed Central

Gupta, Swapnil; Ranganathan, Mohini; D’Souza, Deepak Cyril

2015-01-01

Psychotic disorders including schizophrenia are amongst the most debilitating psychiatric disorders. There is an urgent need to develop methods to identify individuals at risk with greater precision and as early as possible. At present, a prerequisite for a diagnosis of schizophrenia is the occurrence of a psychotic episode. Therefore, attempting to detect schizophrenia on the basis of psychosis is analogous to diagnosing coronary artery disease (CAD) after the occurrence of a myocardial infarction (MI). The introduction of cardiac stress testing (CST) has revolutionized the detection of CAD and the prevention and management of angina and MI. In this paper we attempt to apply lessons learnt from cardiac stress testing to the early detection of psychosis by proposing the development of an analogous psychosis stress test. We discuss in detail the various parameters of a proposed psychosis stress test including the choice of a suitable psychological or psychopharmacological “stressor”, target population, outcome measures, safety of the approach and the necessary evolution of test to become clinically informative. The history of evolution of CST may guide the development of a similar approach for the detection and management of psychotic disorders. The initial development of a test to unmask latent risk for schizophrenia will require the selection of a suitable and safe stimulus and the development of outcome measures as a prelude to testing in populations with a range of risk to determine predictive value. The use of cardiac stress testing in coronary artery disease offers the intriguing possibility that a similar approach may be applied to the detection and management of schizophrenia. PMID:26566609

Integrated Basin-Scale Modelling and Assessment: Lessons and Challenges in Linking Biophysical and Socioeconomic Sciences for Enhancing Sustainability Outcomes

NASA Astrophysics Data System (ADS)

Jakeman, A. J.; Croke, B. F.; Letcher, R. A.; Newham, L. T.; Norton, J. P.

2004-12-01

Integrated Assessment (IA) and Integrated Scenario Modelling (ISM) are being increasingly used to assess sustainability options and, in particular, the effects of policy changes, land use management, climate forcing and other uncontrollable drivers on a wide range of river basin outcomes. IA and ISM are processes that invoke the necessary range of biophysical and socioeconomic disciplines and embrace stakeholder involvement as an essential ingredient. The authors report on their IA studies in Australian and Asian river basins. They illustrate a range of modelling frameworks and tools that were used to perform the assessments, engage the relevant interest groups and promote systems understanding and social learning. The studies cover a range of issues and policies including poverty alleviation, industrial investments, infrastructure provision, erosion and sedimentation, water supply allocation, and ecological protection. The positive impacts of these studies are presented, as well as the lessons learnt and the challenges for modellers and disciplinary experts in advancing the reputation and performance of integrated assessment exercises.

Lessons learnt from a three-year pilot field epidemiology training programme

PubMed Central

Durand, A Mark; Hancock, Thane; Cash, Haley L; Hardie, Kate; Paterson, Beverley; Paulino, Yvette; White, Paul; Merritt, Tony; Fitzgibbons, Dawn; Gopalani, Sameer Vali; Flint, James; Edwin A Merilles, Onofre; Kashiwabara, Mina; Biaukula, Viema; Lepers, Christelle; Souares, Yvan; Nilles, Eric; Batikawai, Anaseini; Huseynova, Sevil; Patel, Mahomed; Saketa, Salanieta T; Durrheim, David; Henderson, Alden; Roth, Adam

2017-01-01

Problem The Pacific region has widely dispersed populations, limited financial and human resources and a high burden of disease. There is an urgent need to improve the availability, reliability and timeliness of useable health data. Context The purpose of this paper is to share lessons learnt from a three-year pilot field epidemiology training programme that was designed to respond to these Pacific health challenges. The pilot programme built on and further developed an existing field epidemiology training programme for Pacific health staff. Action The programme was delivered in country by epidemiologists working for Pacific Public Health Surveillance Network partners. The programme consisted of five courses: four one-week classroom-based courses and one field epidemiology project. Sessions were structured so that theoretical understanding was achieved through interaction and reinforced through practical hands-on group activities, case studies and other interactive practical learning methods. Outcome As of September 2016, 258 students had commenced the programme. Twenty-six course workshops were delivered and one cohort of students had completed the full five-course programme. The programme proved popular and gained a high level of student engagement. Discussion Face-to-face delivery, a low student-to-facilitator ratio, substantial group work and practical exercises were identified as key factors that contributed to the students developing skills and confidence. Close engagement of leaders and the need to quickly evaluate and adapt the curriculum were important lessons, and the collaboration between external partners was considered important for promoting a harmonized approach to health needs in the Pacific. PMID:29051838

Reflections on Pedagogy: A Journey of Collaboration

ERIC Educational Resources Information Center

Woods, Christine

2011-01-01

One of the goals of autoethnography is to "offer lessons for further conversation". In this article, the author reflects on several lessons that were learnt along a journey in management education in the area of indigenous entrepreneurship. In particular, the author outlines her pedagogical practice as an academic engaged in teaching…

Learning from Hong Kong Alumni: Lessons for School Leadership

ERIC Educational Resources Information Center

Jabal, Eric

2006-01-01

A secondary analysis of interview and survey data was undertaken to explore what could be learnt about school leadership from international schools alumni. Using a framework of "values-led contingency" leadership, three features of effective principalship guide the analysis. The results highlight three salutary lessons for school…

Lessons learnt from developing a Health Impact Assessment guide in Iran.

PubMed

Fakhri, Ali; Harris, Patrick; Maleki, Mohammadreza

2016-12-01

For others wishing to develop Health Impact Assessment (HIA) guides (manuals) and to adjust them to conditions in their countries, we draw lessons from developing an HIA guide in Iran. We derive the lessons from our research comparing HIA guides found in the international literature and our experiences in adapting international experience to an HIA model for Iran that incorporates Iranian experts' opinions.

Lessons learnt from past Flash Floods and Debris Flow events to propose future strategies on risk management

NASA Astrophysics Data System (ADS)

Cabello, Angels; Velasco, Marc; Escaler, Isabel

2010-05-01

Floods, including flash floods and debris flow events, are one of the most important hazards in Europe regarding both economic and life loss. Moreover, changes in precipitation patterns and intensity are very likely to increase due to the observed and predicted global warming, rising the risk in areas that are already vulnerable to floods. Therefore, it is very important to carry out new strategies to improve flood protection, but it is also crucial to take into account historical data to identify high risk areas. The main objective of this paper is to show a comparative analysis of the flood risk management information compiled in four test-bed basins (Llobregat, Guadalhorce, Gardon d'Anduze and Linth basins) from three different European countries (Spain, France and Switzerland) and to identify which are the lessons learnt from their past experiences in order to propose future strategies on risk management. This work is part of the EU 7th FP project IMPRINTS which aims at reducing loss of life and economic damage through the improvement of the preparedness and the operational risk management of flash flood and debris flow (FF & DF) events. The methodology followed includes the following steps: o Specific survey on the effectivity of the implemented emergency plans and risk management procedures sent to the test-bed basin authorities that participate in the project o Analysis of the answers from the questionnaire and further research on their methodologies for risk evaluation o Compilation of available follow-up studies carried out after major flood events in the four test-bed basins analyzed o Collection of the lessons learnt through a comparative analysis of the previous information o Recommendations for future strategies on risk management based on lessons learnt and management gaps detected through the process As the Floods Directive (FD) already states, the flood risks associated to FF & DF events should be assessed through the elaboration of Flood Risk Management Plans (FRMP) with tailored solutions for each basin, evaluating their flood mitigation potential, promoting environmental objectives and increasing the efficiency of the already adopted measures. The FRMP should focus on prevention (and protection), preparedness and response, and these have been the three main risk management phases of a flood crisis that have been assessed when extracting the lessons learnt from past events. Lessons learnt concerning dissemination through the three previously mentioned phases and also related to education initiatives have also been included. A common response to most of the events described in this paper was to upgrade the meteorological and hydrological forecasting systems, making the forecasting lead-time as large as possible. Another common recommendation from the test-beds was the need to implement and accomplish the land use regulations. All the basins also detected that structural measures are necessary to increase the population's protection level, but replacing the traditional safety mentality by a risk culture based on a comprehensive analysis of the flood risk. The four basins studied have also highlighted the importance of collecting information when FF & DF events occur and creating historic databases that will provide extremely useful information in the future.

Taking Stock

ERIC Educational Resources Information Center

Wykes, James

1970-01-01

The Director of Television for the Inner London Education Authority discusses the experience gained and lessons learnt after eighteen months of transmission on the Authority's educational television network." (Editor)

Lessons learnt from the introduction of the contraceptive implant in South Africa

PubMed

Pleaner, M; Morroni, C; Smit, J; Lince-Deroche, N; Chersich, M; Mullick, S; Pillay, D; Makua, M; Rees, H

2017-10-01

In 2014, South Africa (SA) introduced the subdermal contraceptive implant with the aim of expanding the contraceptive method mix and availability of long-acting reversible methods in the public sector. Three years on, concerns have been raised about the decline in uptake, early implant removals and challenges in service delivery. This article explores the lessons learnt from the introduction of contraceptive technologies elsewhere and applies these to the SA context. Drawing on the World Health Organization’s conceptual framework for the introduction of new contraceptive methods, and subsequent literature on the topic, lessons are classified into six cross-cutting themes. Recommendations highlight the need for SA to review and explore strategies to strengthen current implant services, including the provision of improved provider training aimed at sensitive, client-centred approaches; increased community engagement; and improved systems for programmatic monitoring and evaluation. With implementation of these recommendations, worrying trends in the provision of implants could be reversed. Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0)

The RAFT Telemedicine Network: Lessons Learnt and Perspectives from a Decade of Educational and Clinical Services in Low- and Middle-Incomes Countries.

PubMed

Bediang, Georges; Perrin, Caroline; Ruiz de Castañeda, Rafael; Kamga, Yannick; Sawadogo, Alexandre; Bagayoko, Cheick Oumar; Geissbuhler, Antoine

2014-01-01

The objectives of this paper are to (i) provide an overview of the educational and clinical experiences of the Réseau en Afrique Francophone pour la Télémédecine (RAFT) network, (ii) analyze key challenges and lessons learnt throughout a decade of activity, and (iii) draw a vision and perspectives of its sustainability. The study was carried out following three main stages: (i) a literature review, (ii) the analysis of key documents, and (iii) discussions with key collaborators of the RAFT. Réseau en Afrique Francophone pour la Télémédecine has been offering an important quantity of educational, clinical, and public health activities during the last decade. The educational activities include the weekly delivery of video-lectures for continuing and post-graduate medical education, the use of virtual patients for training in clinical decision making, research training activities using ICTs and other e-learning activities. The clinical and public health activities include tele-expertise to support health professionals in the management of difficult clinical cases, the implementation of clinical information systems in African hospitals, the deployment of mHealth projects, etc. Since 2010, the RAFT has been extended to the Altiplano in Bolivia and Nepal (in progress). Lessons Learnt and Perspectives: Important lessons have been learnt from the accumulated experiences throughout these years. These lessons concern: social and organization, human resources, technologies and data security, policy and legislation, and economy and financing. Also, given the increase of the activities and the integration of eHealth and telemedicine in the health system of most of the countries, the RAFT network faces many other challenges and perspectives such as learning throughout life, recognition, and valorization of teaching or learning activities, the impact evaluation of interventions, and the scaling up and transferability out of Africa of RAFT activities. Based on the RAFT experience, effective integration and optimum use of eHealth and telemedicine in low- and middle-income countries (LMICs) health systems should take into account the context (resources, infrastructure, and funding), the needs of key stakeholders, and the results derived from theoretical and practical experience. The relevant items highlighted to illustrate the sustainability of the RAFT network and the analyses performed in this study, should serve as discussion basis for the development of eHealth and telemedicine in LMICs.

Flipped Learning, MOOCs and Learning Analytics: Lessons learnt from a Web Map Design course redesign

NASA Astrophysics Data System (ADS)

Treves, R.

2013-12-01

Five weeks content of a 12 week course in web map design were converted to 'flipped learning': Lecture sessions were replaced by online short video lectures and multiple choice questions to be completed outside class. Class time was taken up with activities and exercises linked to the online learning. Students use of the online content was carefully tracked and detailed student feedback gathered. The response from students was good, 90% of them completed all the out of class activities and their feedback was very positive. The format has the advantage of being easily repurposed as a MOOC or scaled up in other ways. Lessons learnt from the implementation of the materials and the analysis of the VLE logs will be discussed as will ongoing efforts to reuse the materials in a MOOC.

Video Relay Service for Signing Deaf - Lessons Learnt from a Pilot Study

NASA Astrophysics Data System (ADS)

Ponsard, Christophe; Sutera, Joelle; Henin, Michael

The generalization of high speed Internet, efficient compression techniques and low cost hardware have resulted in low cost video communication since the year 2000. For the Deaf community, this enables native communication in sign language and a better communication with hearing people over the phone. This implies that Video Relay Service can take over the old Text Relay Service which is less natural and requires mastering written language. A number of such services have developed throughout the world. The objectives of this paper are to present the experience gained in the Walloon Region of Belgium, to share a number of lessons learnt, and to provide recommendations at the technical, user adoption and political levels. A survey of video relay services around the world is presented together with the feedback from users both before and after using the pilot service.

Incidence of trampoline related pediatric fractures in a large district general hospital in the United Kingdom: lessons to be learnt.

PubMed

Bhangal, K K; Neen, D; Dodds, R

2006-04-01

To test the observation that the incidence of trampoline related pediatric fractures is increasing-both nationally and in a large district general hospital. A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000-03. Theatre records of fractures treated operatively were used as the initial data source. A statistically significant increase in trampoline related injuries was discovered. This reflects the rising incidence of injuries from national data and furthermore corresponds to the growing popularity of domestic use trampolines in the UK. The incidence of injuries is increasing. There are lessons to be learnt from existing work from countries where trampoline prevalence has been greater for longer. The authors recommend various safety measures that may reduce children's injuries.

Dengue outbreak in a large military station: Have we learnt any lesson?

PubMed

Kunwar, R; Prakash, R

2015-01-01

An outbreak was reported from a large military station located in South India in 2013. In spite of instituting the preventive measures early, it took more than 2 months to bring the outbreak under control. This paper brings out lessons learnt and suggests strategy for controlling similar outbreak in future. The Military station comprises of 6 large Regimental Centres and many smaller units. The approximate strength of the serving personnel and their families is 25,000. Besides the unit Regimental Medical Officers, a large tertiary care hospital and a Station Health Organization is available to provide health care. A total of 266 patients including 192 serving personnel and 74 of their dependents were hospitalized for dengue between 15 May 2013 and 28 Jul 2013. Many dependents not having severe symptoms, were not hospitalized and treated on outpatient basis. Health advisories and instructions for constituting Dengue Task Force (DTF) were issued well in advance. Preventive measures were instituted early. But the outbreak was controlled only after intervention from higher administrative authorities. Lessons learnt included correct and timely perception of threat is essential; behavioural change of individuals is desired; availability of adequate health functionaries is mandatory; and complete dataset helps correct perception. Future strategy for control of dengue outbreak should include repeated and timely survey of entire area for correct risk perception, assessment of behavioural change among individuals; operational research to assess the impact of ongoing public health campaign.

Lessons Learnt from the Fukushima Accident-A Swedish Medical Preparedness Perspective.

PubMed

Stenke, L; von Schreeb, J; Simonsson, M; Johansson, J; Postgård, P; Sigurdsson, S; Ljungquist, Å; Lagergren Lindberg, M

2016-09-01

The triple disaster in March 2011 tragically and severely affected the Japanese society, in spite of its well-developed infrastructure and good access to resources. A multitude of Japanese and international reports have since described the chain of events and actions taken in connection with the earthquake, the tsunami and the power plant failure in Fukushima. In order to further evaluate Japanese experiences of the disaster, and to bring home 'lessons-learnt' of relevance for continued emergency preparedness planning, a group from the National Board of Health and Welfare and other Swedish agencies performed an observer visit to Japan in 2012. A report from the group was recently published. Its main conclusions, and implications focusing on a strengthened national medical preparedness for radionuclear events in Sweden (and possibly elsewhere), are presented here. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

North-South Partnership in Water Resource Education and Research - Lessons learnt from U.S.-Ethiopia Partnership

NASA Astrophysics Data System (ADS)

Gebremichael, M.

2015-12-01

In 2010, Ethiopian and U.S. universities formed partnership to train critical mass of Ethiopians in modern water resources tools, techniques, skills and knowledge, and to strengthen the institutional capacity of Ethiopian universities to establish graduate-level programs in Ethiopia. The partnership established Ethiopia's first water resource research institute, two graduate-level programs (water resource engineering and management, water and health) that are currently training about 100 students at M.S. and Ph.D. levels, summer undergraduate outreach program that provided community-based research experience in water resource for undergraduate students, and short-term trainings to practitioners and policy makers. The design, implementation and impact of these programs have had limitations and successes. In this presentation, I will provide lessons learnt from this partnership, and suggestions of elements required for successful North-South partnership in higher education and research.

The Development of Computational Biology in South Africa: Successes Achieved and Lessons Learnt

PubMed Central

Mulder, Nicola J.; Christoffels, Alan; de Oliveira, Tulio; Gamieldien, Junaid; Hazelhurst, Scott; Joubert, Fourie; Kumuthini, Judit; Pillay, Ché S.; Snoep, Jacky L.; Tastan Bishop, Özlem; Tiffin, Nicki

2016-01-01

Bioinformatics is now a critical skill in many research and commercial environments as biological data are increasing in both size and complexity. South African researchers recognized this need in the mid-1990s and responded by working with the government as well as international bodies to develop initiatives to build bioinformatics capacity in the country. Significant injections of support from these bodies provided a springboard for the establishment of computational biology units at multiple universities throughout the country, which took on teaching, basic research and support roles. Several challenges were encountered, for example with unreliability of funding, lack of skills, and lack of infrastructure. However, the bioinformatics community worked together to overcome these, and South Africa is now arguably the leading country in bioinformatics on the African continent. Here we discuss how the discipline developed in the country, highlighting the challenges, successes, and lessons learnt. PMID:26845152

The Development of Computational Biology in South Africa: Successes Achieved and Lessons Learnt.

PubMed

Mulder, Nicola J; Christoffels, Alan; de Oliveira, Tulio; Gamieldien, Junaid; Hazelhurst, Scott; Joubert, Fourie; Kumuthini, Judit; Pillay, Ché S; Snoep, Jacky L; Tastan Bishop, Özlem; Tiffin, Nicki

2016-02-01

Bioinformatics is now a critical skill in many research and commercial environments as biological data are increasing in both size and complexity. South African researchers recognized this need in the mid-1990s and responded by working with the government as well as international bodies to develop initiatives to build bioinformatics capacity in the country. Significant injections of support from these bodies provided a springboard for the establishment of computational biology units at multiple universities throughout the country, which took on teaching, basic research and support roles. Several challenges were encountered, for example with unreliability of funding, lack of skills, and lack of infrastructure. However, the bioinformatics community worked together to overcome these, and South Africa is now arguably the leading country in bioinformatics on the African continent. Here we discuss how the discipline developed in the country, highlighting the challenges, successes, and lessons learnt.

Incidence of trampoline related pediatric fractures in a large district general hospital in the United Kingdom: lessons to be learnt

PubMed Central

Bhangal, K K; Neen, D; Dodds, R

2006-01-01

Aim To test the observation that the incidence of trampoline related pediatric fractures is increasing—both nationally and in a large district general hospital. Method A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000–03. Theatre records of fractures treated operatively were used as the initial data source. Results A statistically significant increase in trampoline related injuries was discovered. This reflects the rising incidence of injuries from national data and furthermore corresponds to the growing popularity of domestic use trampolines in the UK. Conclusion The incidence of injuries is increasing. There are lessons to be learnt from existing work from countries where trampoline prevalence has been greater for longer. The authors recommend various safety measures that may reduce children's injuries. PMID:16595431

Influenza A (H1N1-2009) pandemic in Singapore--public health control measures implemented and lessons learnt.

PubMed

Tay, Joanne; Ng, Yeuk Fan; Cutter, Jeffery L; James, Lyn

2010-04-01

We describe the public health control measures implemented in Singapore to limit the spread of influenza A (H1N1-2009) and mitigate its social effects. We also discuss the key learning points from this experience. Singapore's public health control measures were broadly divided into 2 phases: containment and mitigation. Containment strategies included the triage of febrile patients at frontline healthcare settings, admission and isolation of confirmed cases, mandatory Quarantine Orders (QO) for close contacts, and temperature screening at border entry points. After sustained community transmission became established, containment shifted to mitigation. Hospitals only admitted H1N1-2009 cases based on clinical indications, not for isolation. Mild cases were managed in the community. Contact tracing and QOs tapered off, and border temperature screening ended. The 5 key lessons learnt were: (1) Be prepared, but retain flexibility in implementing control measures; (2) Surveillance, good scientific information and operational research can increase a system's ability to manage risk during a public health crisis; (3) Integrated systems-level responses are essential for a coherent public health response; (4) Effective handling of manpower surges requires creative strategies; and (5) Communication must be strategic, timely, concise and clear. Singapore's effective response to the H1N1-2009 pandemic, founded on experience in managing the 2003 SARS epidemic, was a whole-of-government approach towards pandemic preparedness planning. Documenting the measures taken and lessons learnt provides a learning opportunity for both doctors and policy makers, and can help fortify Singapore's ability to respond to future major disease outbreaks.

Developing Written Information for Cancer Survivors from Culturally and Linguistically Diverse Backgrounds: Lessons Learnt.

PubMed

Wiley, Georgina; Piper, Amanda; Phyllis Butow, A M; Schofield, Penny; Douglas, Fiona; Roy, Jane; Nolte, Linda; Jefford, Michael

2018-01-01

Australia is a multicultural nation with a large migrant population. Migrants with cancer report inferior quality of life and the need for more information in their own language. This paper describes lessons learnt from developing culturally appropriate written information resources with and for Arabic, Italian, and Vietnamese cancer survivors and carers. The information needs of survivors from these language groups as well as guidelines for the development of written resources for culturally diverse populations were identified through literature review. Community consultation was undertaken with focus groups. The content was developed and tested with health professionals who spoke the appropriate language and focus group participants, ensuring relevance and appropriateness. Resource design and dissemination were informed through community consultation. A number of key tasks for developing resources were identified as follows: (1) community engagement and consultation; (2) culturally sensitive data collection; (3) focus group facilitators (recruitment and training); (4) content development; (5) translation and review process; (6) design; and (7) sustainability. This project reinforced literature review findings on the importance of cultural sensitivity in the development of resources. Engaging with community groups and incorporating culturally appropriate recruitment strategies optimises recruitment to focus groups and facilitates content development. Stakeholders and lay persons from the intended ethnic-minority communities should be involved in the development and formative evaluation of resources to ensure appropriateness and relevance and in the dissemination strategy to optimize penetration. We believe the lessons we have learnt will be relevant to any group intending to develop health information for culturally and linguistic diverse groups.

Developing Written Information for Cancer Survivors from Culturally and Linguistically Diverse Backgrounds: Lessons Learnt

PubMed Central

Wiley, Georgina; Piper, Amanda; Phyllis Butow, AM; Schofield, Penny; Douglas, Fiona; Roy, Jane; Nolte, Linda; Jefford, Michael

2018-01-01

Australia is a multicultural nation with a large migrant population. Migrants with cancer report inferior quality of life and the need for more information in their own language. This paper describes lessons learnt from developing culturally appropriate written information resources with and for Arabic, Italian, and Vietnamese cancer survivors and carers. The information needs of survivors from these language groups as well as guidelines for the development of written resources for culturally diverse populations were identified through literature review. Community consultation was undertaken with focus groups. The content was developed and tested with health professionals who spoke the appropriate language and focus group participants, ensuring relevance and appropriateness. Resource design and dissemination were informed through community consultation. A number of key tasks for developing resources were identified as follows: (1) community engagement and consultation; (2) culturally sensitive data collection; (3) focus group facilitators (recruitment and training); (4) content development; (5) translation and review process; (6) design; and (7) sustainability. This project reinforced literature review findings on the importance of cultural sensitivity in the development of resources. Engaging with community groups and incorporating culturally appropriate recruitment strategies optimises recruitment to focus groups and facilitates content development. Stakeholders and lay persons from the intended ethnic-minority communities should be involved in the development and formative evaluation of resources to ensure appropriateness and relevance and in the dissemination strategy to optimize penetration. We believe the lessons we have learnt will be relevant to any group intending to develop health information for culturally and linguistic diverse groups. PMID:29379844

Central collecting and evaluating of major accidents and near-miss-events in the Federal Republic of Germany--results, experiences, perspectives.

PubMed

Uth, Hans-Joachim; Wiese, Norbert

2004-07-26

Lessons learnt from accidents are essential sources for updating state of the art requirements in process safety. To improve this input by a systematic way in the FRG, a central body for collecting and evaluating major accident (ZEMA) was established in 1993. ZEMA is part of the Federal Environmental Agency. All events which are to be notified due to the German Regulation on Major Accidents (Störfall-Verordnung) are centrally collected, analysed (deducing lessons learnt) and documented by ZEMA. The bureau is also responsible for the dissemination of the lessons learnt to all stake holders. This work is done in co-operation with the German Major-Accident Hazard Commission (Störfallkommission) and other international bodies like European MAHB. At the time being, over 375 events from 1980 to 2002 are registered in Germany. For each event, a separate data sheet is published in annual reports, first started in 1993. All information is also available at. A summary evaluation on the events from 1993 to 1999 is presented and some basic lessons learnt are shown. The results from root cause analysis underline the importance of maintenance, detailed knowledge of chemical properties, human factor issues and the role of safety organisation especially connected with subcontractors. The German notification system is described in detail and some experience with the system is reported. Keeping in mind that collecting reports from notified major accidents is only a small amount compared with all the events which might be interesting to learn from, the German Major-Accident Hazard Commission has established a separate body, the subcommittee "Incident Evaluation", which is in charge with collecting and evaluating of minor and near-miss events. Since 1994, a concept for the registration and evaluation of those non-notifiable events was developed. From 2000 on, the concept has been put into operation. Its main elements are; 1. reporting of the incident by the plant operator to an information collecting point of its trust, 2. passing the anonymous report to the "Incident Evaluation" subcommittee, 3. evaluation and classification whether the incident is safety relevant or not and, 4. publishing the relevant information to all interested stake holders, preparing of summary evaluation results in certain areas. Up to now, two brochures on "waste gas pipes" and "obstructions of pipes" were published.

Developing children’s palliative care in Africa through beacon centres: lessons learnt

PubMed Central

2013-01-01

Much progress has been made in the provision of palliative care across sub-Saharan Africa, however much still remains to be done, particularly in the area of children’s palliative care (CPC). The Beacon Centres programme was set up in 2009, aimed at improving access to CPC in South Africa, Uganda and Tanzania through more and better-trained health professionals and CPC clinical services of a high standard. Having identified sites in each country to develop into CPC Beacon Centres, Navigators were identified who would be the ‘champions’ for CPC in those sites and lead a programme of training, mentorship and support. Five navigators (2 in Uganda and Tanzania and 1 in South Africa) were trained between September and December 2009. Following this they undertook CPC needs assessments at the 3 centres and set up and delivered a six-month CPC training programme, providing mentorship and support to students to enable them to integrate CPC into their workplaces. To date, 188 participants have commenced the six-month course, with 80 having completed it. CPC has been integrated into the activities of the centres and a CPC virtual resource centre set up in South Africa. The achievements from the Beacon project have been great and the work of the navigators immense, but as in all projects it has not been without its challenges. Lessons learnt include issues around: the focus of the project; the length and nature of the training; assessment; accreditation; the choice of navigators; mentoring; administrative support; co-ordination; the choice of project sites; and the integration of CPC into services. The need for CPC is not going to go away and it is therefore important that models of scaling-up are found that are not only practical, feasible, affordable and sustainable, but that focus on the outcome of improved CPC for all those who need it. It is hoped that the lessons shared from the Beacon Project will help in developing and implementing such models. PMID:23419095

Mapping infectious disease hospital surge threats to lessons learnt in Singapore: a systems analysis and development of a framework to inform how to DECIDE on planning and response strategies.

PubMed

Singh, Shweta R; Coker, Richard; Vrijhoef, Hubertus J-M; Leo, Yee Sin; Chow, Angela; Lim, Poh Lian; Tan, Qinghui; Chen, Mark I-Cheng; Hildon, Zoe Jane-Lara

2017-09-04

Hospital usage and service demand during an Infectious Disease (ID) outbreak can tax the health system in different ways. Herein we conceptualize hospital surge elements, and lessons learnt from such events, to help build appropriately matched responses to future ID surge threats. We used the Interpretive Descriptive qualitative approach. Interviews (n = 35) were conducted with governance and public health specialists; hospital based staff; and General Practitioners. Key policy literature in tandem with the interview data were used to iteratively generate a Hospital ID Surge framework. We anchored our narrative account within this framework, which is used to structure our analysis. A spectrum of surge threats from combinations of capacity (for crowding) and capability (for treatment complexity) demands were identified. Starting with the Pyramid scenario, or an influx of high screening rates flooding Emergency Departments, alongside fewer and manageable admissions; the Reverse-Pyramid occurs when few cases are screened and admitted but those that are, are complex; during a 'Black' scenario, the system is overburdened by both crowding and complexity. The Singapore hospital system is highly adapted to crowding, functioning remarkably well at constant near-full capacity in Peacetime and resilient to Endemic surges. We catalogue 26 strategies from lessons learnt relating to staffing, space, supplies and systems, crystalizing institutional memory. The DECIDE model advocates linking these strategies to types of surge threats and offers a step-by-step guide for coordinating outbreak planning and response. Lack of a shared definition and decision making of surge threats had rendered the procedures somewhat duplicative. This burden was paradoxically exacerbated by a health system that highly prizes planning and forward thinking, but worked largely in silo until an ID crisis hit. Many such lessons can be put into play to further strengthen our current hospital governance and adapted to more diverse settings.

Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt.

PubMed

Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

2013-08-13

A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome.

Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt

PubMed Central

Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

2013-01-01

A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome. PMID:23946511

Preparing for Citizenship: Bring Back John Dewey

ERIC Educational Resources Information Center

Pring, Richard

2016-01-01

The paper traces the development of citizenship in the curriculum in England since the 1960s, emerging particularly from the Crick report. It argues for lessons to be learnt from John Dewey's "Democracy and education", the centenary of which is being celebrated this year.

A MAPPING BASED ON PHYSICO-CHEMICAL FEATURES: LESSONS LEARNT

EPA Science Inventory

The ban on animal testing of cosmetic products for systemic toxicity in Europe is foreseen in 2013. Several research programs involving the public and private sectors have been initiated with the aim of fulfilling regulatory requirements and complying with this transformative shi...

Undertaking clinical audit, with reference to a Prescribing Observatory for Mental Health audit of lithium monitoring.

PubMed

Paton, Carol; Barnes, Thomas R E

2014-06-01

Audit is an important tool for quality improvement. The collection of data on clinical performance against evidence-based and clinically relevant standards, which are considered by clinicians to be realistic in routine practice, can usefully prompt reflective practice and the implementation of change. Evidence of participation in clinical audit is required to achieve intended learning outcomes for trainees in psychiatry and revalidation for those who are members of the Royal College of Psychiatrists. This article addresses some of the practical steps involved in conducting an audit project, and, to illustrate key points, draws on lessons learnt from a national, audit-based, quality improvement programme of lithium prescribing and monitoring conducted through the Prescribing Observatory for Mental Health.

Data science for mental health: a UK perspective on a global challenge.

PubMed

McIntosh, Andrew M; Stewart, Robert; John, Ann; Smith, Daniel J; Davis, Katrina; Sudlow, Cathie; Corvin, Aiden; Nicodemus, Kristin K; Kingdon, David; Hassan, Lamiece; Hotopf, Matthew; Lawrie, Stephen M; Russ, Tom C; Geddes, John R; Wolpert, Miranda; Wölbert, Eva; Porteous, David J

2016-10-01

Data science uses computer science and statistics to extract new knowledge from high-dimensional datasets (ie, those with many different variables and data types). Mental health research, diagnosis, and treatment could benefit from data science that uses cohort studies, genomics, and routine health-care and administrative data. The UK is well placed to trial these approaches through robust NHS-linked data science projects, such as the UK Biobank, Generation Scotland, and the Clinical Record Interactive Search (CRIS) programme. Data science has great potential as a low-cost, high-return catalyst for improved mental health recognition, understanding, support, and outcomes. Lessons learnt from such studies could have global implications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Environmental implications for disaster preparedness: lessons learnt from the Indian Ocean Tsunami.

PubMed

Srinivas, Hari; Nakagawa, Yuko

2008-10-01

The impact of disasters, whether natural or man-made, not only has human dimensions, but environmental ones as well. Environmental conditions may exacerbate the impact of a disaster, and vice versa, disasters tend to have an impact on the environment. Deforestation, forest management practices, or agriculture systems can worsen the negative environmental impacts of a storm or typhoon, leading to landslides, flooding, silting, and ground/surface water contamination. We have only now come to understand these cyclical causes and impacts and realize that taking care of our natural resources and managing them wisely not only assures that future generations will be able to live in sustainable ways, but also reduces the risks that natural and man-made hazards pose to people living today. Emphasizing and reinforcing the centrality of environmental concerns in disaster management has become a critical priority, requiring the sound management of natural resources as a tool to prevent disasters and lessen their impacts on people, their homes, and livelihoods. As the horrors of the Asian tsunami of December 2004 continue to be evaluated, and people in the region slowly attempt to build a semblance of normalcy, we have to look to the lessons learnt from the tsunami disaster as an opportunity to prepare ourselves better for future disasters. This article focuses on findings and lessons learnt on the environmental aspects of the tsunami, and its implications on disaster preparedness plans. This article essentially emphasizes the cyclical interrelations between environments and disasters, by studying the findings and assessments of the recent Indian Ocean earthquake and tsunami that struck on 26 December 2004. It specifically looks at four key affected countries--Maldives, Sri Lanka, Indonesia, and Thailand.

Lessons learnt from a factory fire with asbestos-containing fallout.

PubMed

Bridgman, S A

1999-06-01

Fallout containing asbestos from a factory fire at Tranmere, Wirral, England, landed on a highly populated urban area with an estimated 16000 people living in the area worst affected, which included a shipbuilding community. There was considerable public concern over the health impact of the acute environmental incident, and great media interest. A descriptive study was carried out of the acute environmental incident and its management, and the difficulties encountered. Practical lessons learnt include need for: increased fire-fighter awareness of potential adverse health effects from asbestos in the structure of buildings; early involvement of both Local Authority environmental health and National Health Service public health departments; creation of a systematic local database of potential environmental health hazards in the structure of buildings as well as their contents; 24 hour on-call arrangements with laboratories expert in analyses of fire fallout; rapid quantitative analyses of multiple environmental samples; district written policy on handling asbestos incidents; systematic assessment of fright and media factors in public impact of an incident; dedicated public help-lines open long hours; consistent evidence-based public messages from all those communicating with the public; measurement of asbestos levels in the street and homes for public reassurance; local and health authorities' subscription to an environmental incident support service; formation of an acute environmental incident team to jointly manage and publicly report on airborne acute environmental incidents; clear government definition of responsibilities of different agencies. This paper provides a description of important lessons learnt during an acute environmental incident with asbestos-containing fallout. It will be helpful to those involved in the practical planning for and management of future incidents.

Implementing Community Engagement for Combination Prevention: Lessons Learnt From the First Year of the HPTN 071 (PopART) Community-Randomized Study.

PubMed

Simwinga, Musonda; Bond, Virginia; Makola, Nozizwe; Hoddinott, Graeme; Belemu, Steve; White, Rhonda; Shanaube, Kwame; Seeley, Janet; Moore, Ayana

2016-08-01

Key to the success of a HIV combination prevention strategy, including galvanizing the current push to roll out universal test and treat (UTT), is the involvement and buy-in of the populations that the strategy aims to reach. Drawing on the experiences of engaging with 21 communities in Zambia and South Africa in the design and implementation of a community-randomized study of combination HIV prevention including UTT, this paper reflects on the commitment to, approaches for and benefits of involving communities. Key lessons learnt include that all communities require continuous community engagement (CE) and engagement needs to be adapted to diverse local contexts. Intrinsic goals of CE, such as building trusting relationships between study stakeholders, are necessary precursors to instrumental goals which strengthen the research quality. Engaging the community for combination prevention requires that CE successfully bridges science and real life, paying attention to influences in the wider social landscape.

Design-Based Research Principles for Student Orientation to Online Study: Capturing the Lessons Learnt

ERIC Educational Resources Information Center

Wozniak, Helen; Pizzica, Jenny; Mahony, Mary Jane

2012-01-01

Few institutions have reported research on students' "use" of orientation programs designed for mature students returning to study in contemporary learning environments now regularly amalgamating distance and online strategies. We report within a design-based research framework the student experience of "GetLearning," the third…

Research Reports into Professional Development.

ERIC Educational Resources Information Center

Australian National Training Authority, Brisbane.

Five reports present findings of research into professional development (PD) issues in vocational education and training (VET) in Australia. "Lessons Learnt: An Analysis of Findings of Recent Evaluation Reports on PD in VET" (Kate Perkins) provides an overview of issues, insights, and ideas emerging from past PD experience that may be…

Estimating the size of key populations at higher risk of HIV infection: a summary of experiences and lessons presented during a technical meeting on size estimation among key populations in Asian countries

PubMed Central

Calleja, Jesus Maria Garcia; Zhao, Jinkou; Reddy, Amala; Seguy, Nicole

2014-01-01

Problem Size estimates of key populations at higher risk of HIV exposure are recognized as critical for understanding the trajectory of the HIV epidemic and planning and monitoring an effective response, especially for countries with concentrated and low epidemics such as those in Asia. Context To help countries estimate population sizes of key populations, global guidelines were updated in 2011 to reflect new technical developments and recent field experiences in applying these methods. Action In September 2013, a meeting of programme managers and experts experienced with population size estimates (PSE) for key populations was held for 13 Asian countries. This article summarizes the key results presented, shares practical lessons learnt and reviews the methodological approaches from implementing PSE in 13 countries. Lessons learnt It is important to build capacity to collect, analyse and use PSE data; establish a technical review group; and implement a transparent, well documented process. Countries should adapt global PSE guidelines and maintain operational definitions that are more relevant and useable for country programmes. Development of methods for non-venue-based key populations requires more investment and collaborative efforts between countries and among partners. PMID:25320676

Why should I care? Engaging students in conceptual understanding using global context to develop social attitudes.

NASA Astrophysics Data System (ADS)

Forder, S. E.; Welstead, C.; Pritchard, M.

2014-12-01

A glance through the Harvard Business Review reveals many suggestions and research pieces reviewing sales and marketing techniques. Most educators will be familiar with the notion that making accurate first impressions and being responsive, whilst maintaining pace is critical to engaging an audience. There are lessons to be learnt from industry that can significantly impact upon our teaching. Eisenkraft, in his address to the NSTA, proposed four essential questions. This presentation explores one of those questions: 'Why should I care?', and discusses why this question is crucial for engaging students by giving a clear purpose for developing their scientific understanding. Additionally, this presentation explores how The ISF Academy has adapted the NGSS, using the 14 Grand Engineering Challenges and the IB MYP, to provide current, authentic global contexts, in order to give credibility to the concepts, understandings and skills being learnt. The provision of global contexts across units and within lessons supports a platform for students to have the freedom to explore their own sense of social responsibility. The Science Department believes that planning lessons with tasks that elaborate on the student's new conceptualisations, has helped to transfer the student's new understanding into social behavior beyond the classroom. Furthermore, extension tasks have been used to transfer conceptual understanding between different global contexts.

Generating a city's first report on bicyclist safety: lessons from the field.

PubMed

Lopez, Dahianna S; Hemenway, David

2017-08-03

For cities aiming to create a useful surveillance system for bicycle injuries, a common challenge is that city crash reporting is scattered, faulty or non-existent. We document some of the lessons we learnt in helping the city of Boston, Massachusetts, USA, do the following: (1) Create a prototype for a comprehensive police crash data set (2) Produce the city's first cyclist safety report, (3) Make crash data available to the public and (4) Generate policy recommendations for both specific roadside improvements and for sustainable changes to the police department's crash reporting database. We provided research and technical assistance to government partners to generate the report and used participant-observation field notes to generate the list of learnt lessons. After the release of the report, the city implemented immediate activities aimed at making an effort to prevent injuries, including: (1) Furnishing over 1800 taxis with stickers to prevent 'dooring,' (2) Adding pavement markings at trolley tracks to decrease the likelihood that cyclists would fall from getting their wheels lodged in the tracks, (3) Conducting targeted enforcement of traffic laws and (4) Working directly with state and federal agencies to fund a more comprehensive surveillance system. As of January of 2017, nearly 4 years after its public release, 19 170 users have viewed the crash data set 23 247 times. Some of the lessons include finding and using committed champions, prioritising the use of existing data, creating opportunities to bridge divisions between stakeholders, partnering with local universities for assistance with advanced analytics and using deliverables, such as a cyclist safety report, to advocate for sustainability. Providing an initial report on bicycle crashes in Boston served to identify specific problems, showed the value of a data system, and provided a blueprint for an improved data system. Building a useful surveillance system depends in no small part on the wise use of advocacy, group dynamics, and politics. Our hope is that the lessons learnt from our experience in Boston can help others do even better. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Challenging Ties between State and Tobacco Industry: Advocacy Lessons from India

PubMed Central

Bhojani, Upendra; Venkataraman, Vidya; Manganawar, Bheemaray

2013-01-01

Background: Globally, tobacco use is a major public health concern given its huge morbidity and mortality burden that is inequitably high in low- and middle-income countries. The World Health Organization has suggested banning the advertisement, promotion and sponsorship of tobacco. However, governments in some countries, including India, are either directly engaged in tobacco industry operations or have a mandate to promote tobacco industry development. This paper analyses a short-term advocacy campaign that challenged the state-tobacco industry ties to draw lessons for effective public health advocacy. Method: This paper uses a case study method to analyze advocacy efforts in India to thwart the state-tobacco industry partnership: the Indian government’s sponsorship and support to a global tobacco industry event. The paper explores multiple strategies employed in the five-month advocacy campaign (May to October 2010) to challenge this state-industry tie. In doing so, we describe the challenges faced and the lessons learnt for effective advocacy. Results: Government withdrew participation and financial sponsorship from the tobacco industry event. Use of multiple strategies including engaging all concerned government agencies from the beginning, strategic use of media, presence and mobilization of civil society, and use of legal tools to gain information and judicial action, were complementary in bringing desired outcomes. Conclusion: Use of multiple and complementary advocacy strategies could lead to positive outcomes in a short-time campaign. The Framework Convention on Tobacco Control could form an important advocacy tool, especially in countries that have ratified it, to advocate for improvements in national tobacco control regulations. PMID:24688958

The experience of implementing a 'TB village' for a pastoralist population in Cherrati, Ethiopia.

PubMed

Tayler-Smith, K; Khogali, M; Keiluhu, K; Jemmy, J-P; Ayada, L; Weyeyso, T; Issa, A M; De Maio, G; Harries, A D; Zachariah, R

2011-10-01

In Cherrati District, Somali Regional State (SRS), Ethiopia, despite a high burden of tuberculosis (TB), TB control activities are virtually absent. The majority of the population is pastoralist with a mobile lifestyle. TB care and treatment were offered using a 'TB village' approach that included traditional style residential care, community empowerment and awareness raising, provision of essential social amenities and essential food and non-food items. To describe 1) key aspects of the implementation of the TB village approach, 2) TB treatment outcomes and 3) the lessons learnt during implementation. Descriptive study. A total of 297 patients entered the TB village between September 2006 and October 2008; 271 (91%) patients were treated successfully, nine (3%) defaulted and 13 (4%) died. For pastoralist populations, a TB village approach may be effective for improving access to TB care, ensuring proper adherence to treatment and achieving good overall TB outcomes. The successes and challenges of this approach are discussed.

Active Citizenship in University Education: Lessons Learnt in Times of Crisis

ERIC Educational Resources Information Center

Papadiamantaki, Yiouli

2014-01-01

Despite the fact that historically the university has been the par excellence locus for the discussion of public issues and the formation of citizens, current European Union education policies promote and foster citizenship in secondary education, while the civic dimension of higher education is less prominent. This paper presents the case study…

ENTEL: A Case Study on Knowledge Networks and the Impact of Web 2.0 Technologies

ERIC Educational Resources Information Center

Griffiths, Paul; Arenas, Teresita

2014-01-01

This study re-visits an organisation that defined its knowledge-management strategy in 2008-9 applying an established strategy-intellectual capital alignment framework. It addresses questions "How has knowledge management evolved at ENTEL, and what lessons can be learnt? Does the strategy-knowledge management alignment framework applied at…

Engaging Students in Higher Education through Mobile Learning: Lessons Learnt in a Chinese Entrepreneurship Course

ERIC Educational Resources Information Center

Menkhoff, Thomas; Bengtsson, Magnus Lars

2012-01-01

This evaluative-exploratory case study reports pedagogical experiences with using mobiles phones, wikis, and other mobile learning approaches such as podcasts and walking tours as educational tools in the context of an undergraduate course on Chinese Entrepreneurship and Asian Business Networks taught at a university in Singapore. Conceptualized…

Recognising the Effects of Costing Assumptions in Educational Business Simulation Games

ERIC Educational Resources Information Center

Eckardt, Gordon; Selen, Willem; Wynder, Monte

2015-01-01

Business simulations are a powerful way to provide experiential learning that is focussed, controlled, and concentrated. Inherent in any simulation, however, are numerous assumptions that determine feedback, and hence the lessons learnt. In this conceptual paper we describe some common cost assumptions that are implicit in simulation design and…

Higher Education Institutions and Regional Mission: Lessons Learnt from the OECD Review Project

ERIC Educational Resources Information Center

Puukka, Jaana; Marmolejo, Francisco

2008-01-01

With the processes of globalization and localization, the local availability of knowledge and skills, and the transfer of technology and innovation to industry, small and medium-sized enterprises and the wider society have become increasingly important. In recent years, there have been many initiatives across Organization for Economic Cooperation…

An Institution in Search of Excellence: Lessons Learnt

ERIC Educational Resources Information Center

Hashim, Fatimah; Awang, Halimah

2005-01-01

This is a report of the strategies adopted by the University of Malaya (UM), Malaysia, to address the issues and complexities involved in its search for excellence in teaching and learning, research and service. The story is told how the university sought accreditation through the International Standards Organisation (ISO) and how by uniting their…

Developing a MOOC Initiative: Lessons Learnt from the Universitat Politecnica de Valencia Experience

ERIC Educational Resources Information Center

Despujol, Ignacio; Castaneda, Linda; Turro, Carlos

2018-01-01

Universitat Politecnica de Valencia (UPV) was the European institution with more MOOC course runs done by December 2016. This paper describes and analyses the decisionmaking process, and rationale of the development of this low budget real MOOC institutional initiative carried out by a traditional higher educational medium sized institution. This…

The Effect of Chemistry Laboratory Activities on Students' Chemistry Perception and Laboratory Anxiety Levels

ERIC Educational Resources Information Center

Aydogdu, Cemil

2017-01-01

Chemistry lesson should be supported with experiments to understand the lecture effectively. For safety laboratory environment and to prevent laboratory accidents; chemical substances' properties, working principles for chemical substances' usage should be learnt. Aim of the present study was to analyze the effect of experiments which depend on…

Student Reflection and Learning through Peer Reviews

ERIC Educational Resources Information Center

Boase-Jelinek, Daniel; Parker, Jenni; Herrington, Jan

2013-01-01

This paper describes lessons learnt whilst using an online peer review system in an undergraduate unit for pre-service teachers. In this unit, students learn to use information technologies as part of their future teaching practice. The unit aims to foster graduates who become lifelong reflective educators by providing opportunities to explore and…

Piecing the Puzzle: A Framework for Developing Intercultural Online Communication Projects in Business Education

ERIC Educational Resources Information Center

Crossman, Joanna; Bordia, Sarbari

2012-01-01

Purpose: The purpose of this paper is to present a framework based on lessons learnt from a recently completed project aimed at developing intercultural online communication competencies in business students. Design/methodology/approach: The project entailed collaboration between students and staff in business communication courses from an…

ESD as a Means to Strengthen the Sustainable Management of Marginal Drylands in Egypt

ERIC Educational Resources Information Center

Salem, Boshra B.

2012-01-01

The objective of this article is to present results of and lessons learnt from implementing education for sustainable development (ESD) in marginal drylands, based on experiences from the TEMPUS IV project, Education for Sustainable Development beyond the Campus (EDUCAMP), in Egypt and the multinational project, Sustainable Development of Marginal…

The history of mast cell and basophil research - some lessons learnt from the last century.

PubMed

Blank, U; Falcone, F H; Nilsson, G

2013-09-01

This year (2013) marks the 50th anniversary of death of Otto Carl Willy Prausnitz (1876-1963) and Heinz Küstner (1897-1963). The two physicians, when working at the Hygiene Institute at the University of Breslau, Germany (Prausnitz was the Head of the Institute), described in 1921 what is still called today the Prausnitz-Küstner or PK reaction showing that allergy could be transferred from the allergic person by transferring serum to a healthy person. Their discovery ended the belief that an anaphylactic/allergic reaction was caused by poisons, but to the contrary showed that the presence of the hypersensitivity factor could be transferred to other people. We know now that this factor is immunoglobulin E (IgE), sensitizing mast cells and basophils to respond to an allergic stimulus. We take this occasion to retrace some of the important discoveries and lessons learnt from the last century relating to the function of these two cell types as effectors of the IgE system and the mediators they produce. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Strategies adopted and lessons learnt during the severe acute respiratory syndrome crisis in Singapore.

PubMed

2005-01-01

In Singapore, the military was actively involved in the containment of the outbreak of severe acute respiratory syndrome (SARS) last year. The outbreak started in February 2003 with three Singapore travellers to Hong Kong. At that time, nothing was known about the aetiological agent of the atypical pneumonia that was termed SARS. Unfortunately one of the travellers was a super-spreader, defined as a person with high efficiency for virus transmission, and was responsible for the expansion of the national outbreak. Not only was the Singapore military involved in contact tracing of personnel and enforcement of home quarantine, military-affiliated research institutes were also involved in providing diagnostic support. This review reconstructs the events that took place during the SARS outbreak, focusing on the special support arising from complementing the military-affiliated laboratory with the public health laboratory. A description of the diagnostic findings is provided in chronological order. The review ends with lessons Singapore learnt from the SARS crisis, stressing the importance of national preparedness for future outbreaks. 2004 John Wiley & Sons, Ltd.

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

Agol, Dorice, E-mail: d.agol@uea.a.c.uk; Latawiec, Agnieszka E., E-mail: a.latawiec@iis-rio.org; Opole University of Technology, Department of Production Engineering and Logistics, Luboszycka 5, 45-036 Opole

There has been an increased interest in using sustainability indicators for evaluating the impacts of development and conservation projects. Past and recent experiences have shown that sustainability indicators can be powerful tools for measuring the outcomes of various interventions, when used appropriately and adequately. Currently, there is a range of methods for applying sustainability indicators for project impact evaluation at the environment–development interface. At the same time, a number of challenges persist which have implication for impact evaluation processes especially in developing countries. We highlight some key and recurrent challenges, using three cases from Kenya, Indonesia and Brazil. In thismore » study, we have conducted a comparative analysis across multiple projects from the three countries, which aimed to conserve biodiversity and improve livelihoods. The assessments of these projects were designed to evaluate their positive, negative, short-term, long term, direct and indirect impacts. We have identified a set of commonly used sustainability indicators to evaluate the projects and have discussed opportunities and challenges associated with their application. Our analysis shows that impact evaluation processes present good opportunities for applying sustainability indicators. On the other hand, we find that project proponents (e.g. managers, evaluators, donors/funders) face challenges with establishing full impacts of interventions and that these are rooted in monitoring and evaluation processes, lack of evidence-based impacts, difficulties of measuring certain outcomes and concerns over scale of a range of impacts. We outline key lessons learnt from the multiple cases and propose ways to overcome common problems. Results from our analysis demonstrate practical experiences of applying sustainability indicators in developing countries context where there are different prevailing socio-economic, cultural and environmental conditions. The knowledge derived from this study may therefore be useful to a wider range of audience who are concerned with sustainable integration of development and environmental conservation. - Highlights: • Sustainability indicators are increasingly used for evaluating project impacts. • Lessons learnt are based on case studies from Africa, Asia and South America. • Similar challenges when assessing impacts of development and conservation projects • Need for pragmatic solutions to overcome challenges when assessing project impacts.« less

Vaccine trials in the developing world: operational lessons learnt from a phase IV poliomyelitis vaccine trial in South Africa.

PubMed

Geldenhuys, H; Waggie, Z; Jacks, M; Geldenhuys, M; Traut, L; Tameris, M; Hatherill, M; Hanekom, W A; Sutter, R; Hussey, G; Mahomed, H

2012-08-31

Conducting vaccine trials in developing nations is necessary but operationally complex. We describe operational lessons learnt from a phase IV poliomyelitis vaccine trial in a semi-rural region of South Africa. We reviewed operational data collected over the duration of the trial with respect to staff recruitment and training, participant recruitment and retention, and cold chain maintenance. RESULTS-LESSONS LEARNT: The recruitment model we used that relied on the 24h physical presence of a team member in the birthing unit was expensive and challenging to manage. Forecasting of enrolment rates was complicated by incomplete baseline data and by the linear nature of forecasts that do not take into account changing variables. We found that analyzing key operational data to monitor progress of the trial enabled us to identify problem areas timeously, and to facilitate a collegial problem-solving process by the extended trial team. Pro-actively nurturing a working relationship with the public sector health care system and the community was critical to our success. Despite the wide geographical area and lack of fixed addresses, we maintained an excellent retention rate through community assistance and the use of descriptive residential information. Training needs of team members were ongoing and dynamic and we discovered that these needs that were best met by an in-house, targeted and systemized training programme. The use of vaccine refrigerators instead of standard frost-free refrigerators is cost-effective and necessary to maintain the cold-chain. Operational challenges of a vaccine trial in developing world populations include inexperienced staff, the close liaison required between researchers and public health care services, impoverished participants that require complex recruitment and retention strategies, and challenges of distance and access. These challenges can be overcome by innovative strategies that allow for the unique characteristics of the setting, trial population, and trial team. Copyright © 2012 Elsevier Ltd. All rights reserved.

Implementing interprofessional education and practice: Lessons from a resource-constrained university.

PubMed

Frantz, J M; Rhoda, A J

2017-03-01

Interprofessional education is seen as a vehicle to facilitate collaborative practice and, therefore, address the complex health needs of populations. A number of concerns have, however, been raised with the implementation of interprofessional education. The three core concerns raised in the literature and addressed in the article include the lack of an explicit framework, challenges operationalising interprofessional education and practice, and the lack of critical mass in terms of human resources to drive activities related to interprofessional education and practice. This article aims to present lessons learnt when attempting to overcome the main challenges and implementing interprofessional education activities in a resource-constrained higher education setting in South Africa. Boyer's model of scholarship, which incorporates research, teaching integration, and application, was used to address the challenge of a lack of a framework in which to conceptualise the activities of interprofressional education. In addition, a scaffolding approach to teaching activities within a curriculum was used to operationalise interprofessional education and practice. Faculty development initiatives were additionally used to develop a critical mass that focused on driving interprofessional education. Lessons learnt highlighted that if a conceptual model is agreed upon by all, it allows for a more focused approach, and both human and financial resources may be channelled towards a common goal which may assist resource-constrained institutions in successfully implementing interprofessional activities.

AskNow!--Evaluating an Australian Collaborative Chat Reference Service: A Project Manager's Perspective

ERIC Educational Resources Information Center

Wilson, Fran; Keys, Jacki

2004-01-01

AskNow! online answers Australia-wide, the first nation-wide chat reference service, has been a successful exercise in collaboration and cooperation. This article examines some of the lessons learnt, the challenges of collaboration and possible future directions. AskNow!, an initiative of the Council of Australian State Libraries (CASL), commenced…

Exploring the Usage of a Video Application Tool: Experiences in Film Studies

ERIC Educational Resources Information Center

Ali, Nazlena Mohamad; Smeaton, Alan F.

2011-01-01

This paper explores our experiences in deploying a video application tool in film studies, and its evaluation in terms of realistic contextual end-users who have real tasks to perform in a real environment. We demonstrate our experiences and core lesson learnt in deploying our novel movie browser application with undergraduate and graduate…

Developing a Multimedia Package for University Teaching and Learning--Lessons Learnt

ERIC Educational Resources Information Center

Maheshwari, B.

2011-01-01

A team of staff at the University of Western Sydney (UWS) were involved in developing a multimedia package, called Sustainable Water Use in Agriculture (SWAG), to assist the first and second year students to learn about the use, management and conservation of water in agriculture. A range of media techniques including text, sound, diagrams,…

Competence-Based Quality Assurance of University Education Lessons Learnt from the OECD-AHELO Feasibility Study

ERIC Educational Resources Information Center

Fukahori, Satoko

2014-01-01

The discourse that an educated workforce is essential for a prosperous and sustainable economy in a knowledge-based society has invited heightened policy interest in higher education. In effect, many industrialized countries are approaching, or have already reached universal access, with the majority of their age cohorts enrolling in higher…

Different measles outbreaks in Belgium, January to June 2016 – a challenge for public health

PubMed Central

Grammens, Tine; Maes, Virginie; Hutse, Veronik; Laisnez, Valeska; Schirvel, Carole; Trémérie, Jean Marie; Sabbe, Martine

2016-01-01

During the first half of 2016, several outbreaks of measles were reported in the three regions of Belgium. Main challenges for public health were severe complications occurring in adults, nosocomial transmission and infection in healthcare workers. Here, we describe those outbreaks and lessons learnt for public health. PMID:27541858

Global governance approaches to addressing illegal logging: uptake and lessons learnt

Treesearch

B. Cashore; K. McGinley; S. Leipold; P.O. Cerutti; G. Bueno; S. et al. Carodenuto

2016-01-01

This report presents the results of the fifth global scientific assessment undertaken by the GFEP initiative. The report set out to gain deeper understanding of the meaning of illegal logging and related timber trade, its scale, drivers and consequences. It provides a structured synthesis of available scientific and expert knowledge on illegal logging and associated...

Lessons Learnt from a Secondary School Sex Education Program in Portugal

ERIC Educational Resources Information Center

Sousa, Ana Paula; Soares, Isabel; Vilar, Duarte

2007-01-01

Based on a developmental framework, a study was conducted in Portugal in two groups of youth in terms of relevant aspects related to adolescent psychosexual development: one group participated in an Experimental Project of Sex Education and Health Promotion during high school, whereas the other did not receive any formal sex education in school.…

Examining High-Performing Education Systems in Terms of Teacher Training: Lessons Learnt for Low-Performers

ERIC Educational Resources Information Center

Çer, Erkan; Solak, Ekrem

2018-01-01

The quality of a teacher plays one of the most important roles in the achievement of an education system. Teacher training is a multi-dimensional process which comprises the selection of teacher candidates, pre-service training, appointment, in-service training and teaching practices. Therefore, this study focuses on teacher training processes in…

Stroke Units: The Implementation of a Complex Intervention

ERIC Educational Resources Information Center

Kilbride, Cherry; Meyer, Julienne; Flatley, Mary; Perry, Lin

2005-01-01

This article reports on selected findings from an action research study that looked at the lessons learnt from setting up a new in-patient stroke service in a London teaching hospital. Key participants in the design and evaluation of this 2-year study included members of the multi-professional stroke team and support staff within the unit, the…

Introducing E-Portfolios to Pre-Service Teachers as Tools for Reflection and Growth: Lessons Learnt

ERIC Educational Resources Information Center

Oakley, Grace; Pegrum, Mark; Johnston, Shannon

2014-01-01

E-portfolios are being introduced into initial teacher education programmes internationally to help pre-service teachers build records of their learning journeys and develop into reflective practitioners; to allow them to assemble collections of evidence of their achievements against graduate standards, which can function as digital CVs; and to…

Rationality and Emotion in Primary School Leadership: An Exploration of Key Themes

ERIC Educational Resources Information Center

Crawford, Megan

2007-01-01

This article discusses the symbiotic relationship between emotion and rationality in leadership in primary schools. It uses the literature of both emotion and leadership to ask whether school leadership has learnt some of the lessons from the recent interest in emotion and leadership. Drawing on recent research into the lives of primary school…

Investigating Students' Use and Adoption of "With-Video Assignments": Lessons Learnt for Video-Based Open Educational Resources

ERIC Educational Resources Information Center

Pappas, Ilias O.; Giannakos, Michail N.; Mikalef, Patrick

2017-01-01

The use of video-based open educational resources is widespread, and includes multiple approaches to implementation. In this paper, the term "with-video assignments" is introduced to portray video learning resources enhanced with assignments. The goal of this study is to examine the factors that influence students' intention to adopt…

Developing Government Policies for Distance Education: Lessons Learnt from Two Sri Lankan Case Studies

ERIC Educational Resources Information Center

Liyanagunawardena, Tharindu Rekha; Adams, Andrew A.; Rassool, Naz; Williams, Shirley A.

2014-01-01

Education, especially higher education, is considered vital for maintaining national and individual competitiveness in the global knowledge economy. Following the introduction of its "Free Education Policy" as early as 1947, Sri Lanka is now the best performer in basic education in the South Asian region, with a remarkable record in…

Lessons Learnt from Teachers' Perspectives on Mobile Learning in South Africa with Cultural and Linguistic Constraints

ERIC Educational Resources Information Center

Jantjies, Mmaki; Joy, Mike

2016-01-01

South Africa's classrooms are characterised by a wide variety of cultural and linguistic differences, providing teachers with educational challenges, particularly in mathematics and science subjects. In response, various mobile learning systems have been developed and piloted in the North West and Gauteng Provinces of South Africa. A framework has…

Modern military surgery: lessons from Iraq and Afghanistan.

PubMed

Brown, K V; Guthrie, H C; Ramasamy, A; Kendrew, J M; Clasper, J

2012-04-01

The types of explosive devices used in warfare and the pattern of war wounds have changed in recent years. There has, for instance, been a considerable increase in high amputation of the lower limb and unsalvageable leg injuries combined with pelvic trauma. The conflicts in Iraq and Afghanistan prompted the Department of Military Surgery and Trauma in the United Kingdom to establish working groups to promote the development of best practice and act as a focus for research. In this review, we present lessons learnt in the initial care of military personnel sustaining major orthopaedic trauma in the Middle East.

Intra-tumor heterogeneity: lessons from microbial evolution and clinical implications

PubMed Central

2013-01-01

Multiple subclonal populations of tumor cells can coexist within the same tumor. This intra-tumor heterogeneity will have clinical implications and it is therefore important to identify factors that drive or suppress such heterogeneous tumor progression. Evolutionary biology can provide important insights into this process. In particular, experimental evolution studies of microbial populations, which exist as clonal populations that can diversify into multiple subclones, have revealed important evolutionary processes driving heterogeneity within a population. There are transferrable lessons that can be learnt from these studies that will help us to understand the process of intra-tumor heterogeneity in the clinical setting. In this review, we summarize drivers of microbial diversity that have been identified, such as mutation rate and environmental influences, and discuss how knowledge gained from microbial experimental evolution studies may guide us to identify and understand important selective factors that promote intra-tumor heterogeneity. Furthermore, we discuss how these factors could be used to direct and optimize research efforts to improve patient care, focusing on therapeutic resistance. Finally, we emphasize the need for longitudinal studies to address the impact of these potential tumor heterogeneity-promoting factors on drug resistance, metastatic potential and clinical outcome. PMID:24267946

A Blended Approach to Learning: Added Value and Lessons Learnt from Students' Use of Computer-Based Materials for Neurological Analysis

ERIC Educational Resources Information Center

Davies, Alison; Ramsay, Jill; Lindfield, Helen; Couperthwaite, John

2005-01-01

This paper examines BSc Physiotherapy students' experiences of developing their neurological observational and analytical skills using a blend of traditional classroom activities and computer-based materials at the University of Birmingham. New teaching and learning resources were developed and supported in the School of Health Sciences using Web…

How to Assess Children's Virtue Literacy: Methodological Lessons Learnt from the Knightly Virtues Programme

ERIC Educational Resources Information Center

Davison, Ian; Harrison, Tom; Hayes, Dan; Higgins, Jenny

2016-01-01

Character education is of growing importance in educational discourse. The Knightly Virtues programme draws on selected classic stories to teach eight moral virtues to nine- to 11-year-olds; it has proved to be hugely popular with UK schools. A finding of the trial was the different levels of "virtue literacy" in faith and non-faith…

Ecological Education: What Resources Are There in Confucian Ethics?

ERIC Educational Resources Information Center

Nuyen, Anh Tuan

2008-01-01

Given the fact that ecological issues are global and the fact that a large part of humanity is rooted in the Confucian tradition, it is pertinent to ask what lessons can be learnt from Confucianism, in terms of both ecological education and the current debate in environmental ethics. In this paper I argue that while Confucian ethics cannot,…

Learning from a Lived Experience of a PhD: A Reflexive Ethnography of Two Journeys

ERIC Educational Resources Information Center

Aziato, Lydia

2015-01-01

Introduction: Nurses globally have strived to obtain a Doctor of Philosophy Degree (PhD) especially those in academia. Few publications have focused on lived experiences of nurses especially those reporting failed attempts. Thus, this paper presents how lessons learnt from a failed attempt of a PhD in Nursing was used to achieve an outstanding…

Lessons Learnt from and Sustainability of Adopting a Personal Learning Environment & Network (Ple&N)

ERIC Educational Resources Information Center

Tsui, Eric; Sabetzadeh, Farzad

2014-01-01

This paper describes the feedback from the configuration and deployment of a Personal Learning Environment & Network (PLE&N) tool to support peer-based social learning for university students and graduates. An extension of an earlier project in which a generic and PLE&N was deployed for all learners, the current PLE&N is a…

Applying Real-Time UML: Real-World Experiences

NASA Astrophysics Data System (ADS)

Cooling, Niall; Pachschwoell, Stefan

2004-06-01

This paper presents Austrian Aerospace's experiences of applying UML for the design of an embedded real-time avionics system based on Feabhas' "Pragma Process". It describes the complete lifecycle from adoption of UML, through training, CASE-tool selection, system analysis, and software design and development of the project itself. It concludes by reflecting on the experiences obtained and some lessons learnt.

PICs, TECs and LECs: Lessons to Be Learnt from the Differences between the USA Private Industry Councils and Britain's Training and Enterprise Councils.

ERIC Educational Resources Information Center

Bennett, Robert J.

1994-01-01

Comparison of Britain's Training and Enterprise Councils/Local Enterprise Companies with the United States' Private Industry Councils (PICs) shows common problems: inadequate financing, labor market fragmentation, staff turnover, and lack of national strategy. PICs have a clearer mission and greater success in developing partnerships with local…

A Multi-Year Study of Teaching an Online Computer Literacy Course in a Medical University: A Lesson Learnt

ERIC Educational Resources Information Center

Wan, Hsu-Tien; Hsu, Kuang-Yang; Sheu, Shiow-Yunn

2016-01-01

In this research, we aim to understand the effectiveness of adopting educational technologies in a computer literacy course to students in a medical university. The course was organized with three core components: Open Education Resources (OER) reading, a book club, and online game competition. These components were delivered by a learning…

Roles of Regional Centres of Expertise on Education for Sustainable Development: Lessons Learnt in the First Half of the UNDESD

ERIC Educational Resources Information Center

Fadeeva, Zinaida; Mochizuki, Yoko

2010-01-01

As its major contribution to the United Nations Decade of Education for Sustainable Development (UN DESD, 2005-2014), the United Nations University (UNU) has promoted the establishment of Regional Centres of Expertise on education for sustainable development (RCEs) and their net-working to build innovative multistakeholder platforms for ESD…

Managing International Branch Campuses: Lessons Learnt from Eight Years on a Branch Campus in Malaysia

ERIC Educational Resources Information Center

Hill, Christopher; Thabet, Rawy Abdelrahman

2018-01-01

Purpose: International branch campuses (IBCs) are complex entities and while much has been written about their expansion and development, the literature is largely from an external perspective. There have been few longitudinal studies examining the development of an IBC over time. The purpose of this paper is to review the development of one IBC…

Nutrition Health Promotion in Schools in the UK: Learning from Food Standards Agency Funded Schools Research

ERIC Educational Resources Information Center

Woolfe, Jennifer; Stockley, Lynn

2005-01-01

Objective: To test the feasibility and effectiveness of dietary change interventions in UK school-based settings. This overview draws out the main lessons that were learnt from these studies, for both practitioners and researchers. Design: A review and analysis of the final reports from five studies commissioned by the Food Standards Agency.…

Leadership, management and technical lessons learnt from a successful public-private partnership for TB control in Nepal.

PubMed

Newell, J N; Pande, S B; Baral, S C; Bam, D S; Malla, P

2005-09-01

There is considerable interest in involving private practitioners (PPs) in tuberculosis (TB) control, but little experience. To describe and discuss leadership, management and technical lessons learnt from the successful implementation of a public-private partnership (PPP) for TB control in Nepal. Description and discussion of implementation of the PPP is based on feedback from the working group charged with developing the PPP, PPs involved in diagnosis and referral, NGOs providing direct observation of treatment and tracing of late patients, and members of the Nepal National TB Programme. The process of building the partnership was slow and demoralising, yet with perseverance partners gradually increased their involvement and commitment to the PPP. Leadership was needed to foster communication and openness between partners. It was not necessary to involve all PPs: many patients bypassed PPs and went directly to the free DOTS centres. An understanding of issues that arose during development of the Lalitpur PPP may assist assessment of the feasibility of PPPs in other settings, and increase the likelihood of successful implementation. The wider literature on partnerships may be useful to further inform the development of PPPs for health in developing countries.

Art and theatre for health in rural Cambodia.

PubMed

Nguon, Chea; Dysoley, Lek; Davoeung, Chan; Sovann, Yok; Sanann, Nou; Sareth, Ma; Kunthea, Pich; Vuth, San; Sovann, Kem; Kol, Kayna; Heng, Chhouen; Sary, Rouen; Peto, Thomas J; Tripura, Rupam; Lim, Renly; Cheah, Phaik Yeong

2018-01-01

This article describes our experience using art and theatre to engage rural communities in western Cambodia to understand malaria and support malaria control and elimination. The project was a pilot science-arts initiative to supplement existing engagement activities conducted by local authorities. In 2016, the project was conducted in 20 villages, involved 300 community members and was attended by more than 8000 people. Key health messages were to use insecticide-treated bed-nets and repellents, febrile people should attend village malaria workers, and to raise awareness about the risk of forest-acquired malaria. Building on the experience and lessons learnt in the year prior, the 2017 project which was conducted in 15 villages involved 600 community members and attracted more than 12,000 people. In addition to the malaria theme, upon discussion with local health authorities, secondary theme (infant vaccination) was added to the 2017 project. We learnt the following lessons from our experience in Cambodia: involving local people including children from the beginning of the project and throughout the process is important; messages should be kept simple; it is necessary to take into consideration practical issues such as location and timing of the activities; and that the project should offer something unique to communities.

Lessons learnt from human papillomavirus (HPV) vaccination in 45 low- and middle-income countries.

PubMed

Gallagher, Katherine E; Howard, Natasha; Kabakama, Severin; Mounier-Jack, Sandra; Griffiths, Ulla K; Feletto, Marta; Burchett, Helen E D; LaMontagne, D Scott; Watson-Jones, Deborah

2017-01-01

To synthesise lessons learnt and determinants of success from human papillomavirus (HPV) vaccine demonstration projects and national programmes in low- and middle-income countries (LAMICs). Interviews were conducted with 56 key informants. A systematic literature review identified 2936 abstracts from five databases; after screening 61 full texts were included. Unpublished literature, including evaluation reports, was solicited from country representatives; 188 documents were received. A data extraction tool and interview topic guide outlining key areas of inquiry were informed by World Health Organization guidelines for new vaccine introduction. Results were synthesised thematically. Data were analysed from 12 national programmes and 66 demonstration projects in 46 countries. Among demonstration projects, 30 were supported by the GARDASIL® Access Program, 20 by Gavi, four by PATH and 12 by other means. School-based vaccine delivery supplemented with health facility-based delivery for out-of-school girls attained high coverage. There were limited data on facility-only strategies and little evaluation of strategies to reach out-of-school girls. Early engagement of teachers as partners in social mobilisation, consent, vaccination day coordination, follow-up of non-completers and adverse events was considered invaluable. Micro-planning using school/ facility registers most effectively enumerated target populations; other estimates proved inaccurate, leading to vaccine under- or over-estimation. Refresher training on adverse events and safe injection procedures was usually necessary. Considerable experience in HPV vaccine delivery in LAMICs is available. Lessons are generally consistent across countries and dissemination of these could improve HPV vaccine introduction.

Lessons learnt from a three-year pilot field epidemiology training programme.

PubMed

Hoy, Damian; Durand, A Mark; Hancock, Thane; Cash, Haley L; Hardie, Kate; Paterson, Beverley; Paulino, Yvette; White, Paul; Merritt, Tony; Fitzgibbons, Dawn; Gopalani, Sameer Vali; Flint, James; Edwin A Merilles, Onofre; Kashiwabara, Mina; Biaukula, Viema; Lepers, Christelle; Souares, Yvan; Nilles, Eric; Batikawai, Anaseini; Huseynova, Sevil; Patel, Mahomed; Saketa, Salanieta T; Durrheim, David; Henderson, Alden; Roth, Adam

2017-01-01

The Pacific region has widely dispersed populations, limited financial and human resources and a high burden of disease. There is an urgent need to improve the availability, reliability and timeliness of useable health data. The purpose of this paper is to share lessons learnt from a three-year pilot field epidemiology training programme that was designed to respond to these Pacific health challenges. The pilot programme built on and further developed an existing field epidemiology training programme for Pacific health staff. The programme was delivered in country by epidemiologists working for Pacific Public Health Surveillance Network partners. The programme consisted of five courses: four one-week classroom-based courses and one field epidemiology project. Sessions were structured so that theoretical understanding was achieved through interaction and reinforced through practical hands-on group activities, case studies and other interactive practical learning methods. As of September 2016, 258 students had commenced the programme. Twenty-six course workshops were delivered and one cohort of students had completed the full five-course programme. The programme proved popular and gained a high level of student engagement. Face-to-face delivery, a low student-to-facilitator ratio, substantial group work and practical exercises were identified as key factors that contributed to the students developing skills and confidence. Close engagement of leaders and the need to quickly evaluate and adapt the curriculum were important lessons, and the collaboration between external partners was considered important for promoting a harmonized approach to health needs in the Pacific.

Closing the (service) gap: exploring partnerships between Aboriginal and mainstream health services.

PubMed

Taylor, Kate P; Thompson, Sandra C

2011-08-01

Although effective partnerships between Aboriginal and mainstream health services are critical to improve Aboriginal health outcomes, many factors can cause these partnerships to be tenuous and unproductive. Understanding the elements of best practice for successful partnerships is essential. A literature review was conducted in 2009 using keyword searches of electronic databases. Sourced literature was assessed for relevance regarding the benefits, challenges, lessons learnt and factors contributing to successful Aboriginal and mainstream partnerships. Key themes were collated. Although there is much literature regarding general partnerships generally, few specifically examine Aboriginal and mainstream health service partnerships. Twenty-four sources were reviewed in detail. Benefits include broadening service capacity and improving the cultural security of healthcare. Challenges include the legacy of Australia's colonial history, different approaches to servicing clients and resource limitations. Recommendations for success include workshopping tensions early, building trust and leadership. Although successful partnerships are crucial to optimise Aboriginal health outcomes, failed collaborations risk inflaming sensitive Aboriginal-non-Aboriginal relationships. Factors supporting successful partnerships remind us to develop genuine, trusting relationships that are tangibly linked to the Aboriginal community. Failure to invest in this relational process and push forward with 'business as usual' can ultimately have negative ramifications on client outcomes.

The Evolution of the Stem Cell Theory for Heart Failure.

PubMed

Silvestre, Jean-Sébastien; Menasché, Philippe

2015-12-01

Various stem cell-based approaches for cardiac repair have achieved encouraging results in animal experiments, often leading to their rapid proceeding to clinical testing. However, freewheeling evolutionary developments of the stem cell theory might lead to dystopian scenarios where heterogeneous sources of therapeutic cells could promote mixed clinical outcomes in un-stratified patient populations. This review focuses on the lessons that should be learnt from the first generation of stem cell-based strategies and emphasizes the absolute requirement to better understand the basic mechanisms of stem cell biology and cardiogenesis. We will also discuss about the unexpected "big bang" in the stem cell theory, "blasting" the therapeutic cells to their unchallenged ability to release paracrine factors such as extracellular membrane vesicles. Paradoxically, the natural evolution of the stem cell theory for cardiac regeneration may end with the development of cell-free strategies with multiple cellular targets including cardiomyocytes but also other infiltrating or resident cardiac cells.

Predicting Defects Using Information Intelligence Process Models in the Software Technology Project

PubMed Central

Selvaraj, Manjula Gandhi; Jayabal, Devi Shree; Srinivasan, Thenmozhi; Balasubramanie, Palanisamy

2015-01-01

A key differentiator in a competitive market place is customer satisfaction. As per Gartner 2012 report, only 75%–80% of IT projects are successful. Customer satisfaction should be considered as a part of business strategy. The associated project parameters should be proactively managed and the project outcome needs to be predicted by a technical manager. There is lot of focus on the end state and on minimizing defect leakage as much as possible. Focus should be on proactively managing and shifting left in the software life cycle engineering model. Identify the problem upfront in the project cycle and do not wait for lessons to be learnt and take reactive steps. This paper gives the practical applicability of using predictive models and illustrates use of these models in a project to predict system testing defects thus helping to reduce residual defects. PMID:26495427

Predicting Defects Using Information Intelligence Process Models in the Software Technology Project.

PubMed

Selvaraj, Manjula Gandhi; Jayabal, Devi Shree; Srinivasan, Thenmozhi; Balasubramanie, Palanisamy

2015-01-01

A key differentiator in a competitive market place is customer satisfaction. As per Gartner 2012 report, only 75%-80% of IT projects are successful. Customer satisfaction should be considered as a part of business strategy. The associated project parameters should be proactively managed and the project outcome needs to be predicted by a technical manager. There is lot of focus on the end state and on minimizing defect leakage as much as possible. Focus should be on proactively managing and shifting left in the software life cycle engineering model. Identify the problem upfront in the project cycle and do not wait for lessons to be learnt and take reactive steps. This paper gives the practical applicability of using predictive models and illustrates use of these models in a project to predict system testing defects thus helping to reduce residual defects.

[Lessons from a heart valve prosthesis controversy].

PubMed

Vandenbroucke, J P; Grobbee, D E

1998-07-18

Two lessons are to be learnt from the Björk-Shiley heart valve prosthesis tragedy. In the first place pharmacoepidemiologic studies are seriously hampered by recent privacy legislation. Individual patients carrying such a prosthesis cannot be traced and advised as to their health risks any more, because their legal autonomy has to be respected. This is clearly not to their advantage. In the second place the atmosphere of marketing and litigation and the increasing dependency of researchers on money from sources with conflicting interests is not conducive to a well-informed and balanced judgement of the epidemiological evidence of safety and efficacy of medical treatments.

Using Argumentation as a Strategy of Promotion of Talking Science in a Physics Classroom: What Are Some of the Challenges?

ERIC Educational Resources Information Center

Qhobela, Makomosela

2012-01-01

This paper discusses lessons learnt from a bigger study which investigates teaching approaches that could be employed to address the problem of classrooms that are dominated by teacher-centered approaches with minimal students' talk. The purpose of this paper is to establish the feasibility of success when argumentation is introduced as a part of…

Regime Changes and Uprisings in the Middle East and Parts of North Africa: Some Lessons to Be Learnt

ERIC Educational Resources Information Center

Muftau, Rufai

2016-01-01

The event leading to the death of Mohammed Bouzazi in Tunisia in 2009 brought to light the dehumanized conditions which an average Tunis had been subjected to at the hands of the Tunisian government. The death of Bouzazi lead to street protests and demonstrations by thousands of demonstrators, calling for political reforms, free speech, improved…

The Challenges of Implementing Group Work in Primary School Classrooms and Including Pupils with Special Educational Needs

ERIC Educational Resources Information Center

Baines, Ed; Blatchford, Peter; Webster, Rob

2015-01-01

Findings from two studies are discussed in relation to the experiences and challenges faced by teachers trying to implement effective group work in schools and classrooms and to reflect on the lessons learnt about how to involve pupils with special educational needs (SEN). The first study reports on UK primary school teachers' experiences of…

Effectiveness of the Forum Method for the Self Development Course in UKM and Its Link with Student Interest

ERIC Educational Resources Information Center

Wan Hassan, Wan Zulkifli; Jamsari, Ezad Azraai; Taha, Mohamad; Basir @ Ahmad, Aminudin; Alias, Jamsari; Muslim, Nazri

2015-01-01

Student inability to explain concepts learnt in lessons using their own words academically and intellectually and their lack of interest in learning the subject are a cause of their incompetence in the development of their personality. This presents a challenge to lecturers that they should not rely entirely on conventional lectures and tutorials.…

Internal Branding in Universities and the Lessons Learnt from the Past: The Significance of Employee Brand Support and Transformational Leadership

ERIC Educational Resources Information Center

Sujchaphong, Narissara; Nguyen, Bang; Melewar, T. C.

2015-01-01

The paper reviews the literature on the concept of internal branding and its effects in the service sector in general, as well as in UK universities. In addition, the concept of employee brand support is reviewed, discussing the influence of leadership characteristics on internal branding in universities. Employee brand support is a crucial…

Lessons Learnt from Applying Action Research to Support Strategy Formation Processes in Long-Term Care Networks

ERIC Educational Resources Information Center

Cramer, Hendrik; Dewulf, Geert; Voordijk, Hans

2015-01-01

This study demonstrates how action research (AR) that is aimed at scaling-up experiments can be applied to support a strategy formation process (SFP) in a subsidized long-term care network. Previous research has developed numerous AR frameworks to support experiments in various domains, but has failed to explain how to apply AR and action learning…

Reconceptualised Life Skills in Secondary Education in the African Context: Lessons Learnt from Reforms in Ghana

ERIC Educational Resources Information Center

Akyeampong, Kwame

2014-01-01

Early notions of life skills in Africa did not take into account the importance of a flexible and portable set of skills that would enable youth to adapt to changes in the world of work and lay the foundations for productive well-being and behaviour. Rather, life skills education in many secondary education curricula in Africa started with an…

Lessons Learnt from Employing van Hiele Theory Based Instruction in Senior Secondary School Geometry Classrooms

ERIC Educational Resources Information Center

Alex, Jogymol Kalariparambil; Mammen, Kuttickattu John

2016-01-01

This paper reports on a part of a study which was conducted to determine the effect of van Hiele theory based instruction in the teaching of geometry to Grade 10 learners. The sample consisted of 359 participants from five conveniently selected schools from Mthatha District in the Eastern Cape Province in South Africa. There were 195 learners in…

An Architecture for Network Centric Operations in Unconventional Crisis: Lessons Learnt from Singapore’s SARS Experience

DTIC Science & Technology

2004-12-01

Tan Tock Seng Hospital (TTSH) to Singapore General...critical information, the Alert Manager of other hospitals will use the event defined in the Event Manager at Tan Tock Seng Hospital to automatically...events defined at Tan Tock Seng hospital can be monitored by the Alert Manager operated at the immigration department to ensure that the

Winds of Change: Reflections on Community Based Child Development in Nepal. Lessons Learnt No. 6.

ERIC Educational Resources Information Center

Wright, Chris

In March 1989, a new program was started in the middle hills area of Nepal. A community-based child development project entered the community by concentrating first on the children, and starting in one small area, and extending to new village areas in subsequent years. As of March 1993, there were four Village Development Areas participating in…

Accreditation of Prior Learning as a Lever for Lifelong Learning: Lessons Learnt from the New Opportunities Initiative, Portugal

ERIC Educational Resources Information Center

Carneiro, Roberto, Ed.

2011-01-01

The New Opportunities Initiative (NOI) is a Portuguese flagship programme to recognise and accredit prior learning (RPL, APL) and to endow low-skilled adults with upper secondary qualifications, which is defined as the minimum entry threshold to the exercise of a full citizenship in a knowledge-rich society. NOI's major achievement has been its…

Twenty-Five Years After--Rebuilding the Lifelong Learning System in the Czech and Slovak Republic: Progress, Challenges and Lessons Learnt from a Narrative Research

ERIC Educational Resources Information Center

Sprlak, Tomas

2016-01-01

The lifelong learning system in the Czech Republic and Slovakia share some common traits: traditional model with the dominant role of the initial education, low participation rates, lack of incentives and fragmentation. The results of the narrative research on 15 low-skilled persons demonstrated that negative attitudes towards education are often…

Social Return on Investment (SROI) methodology to account for value for money of public health interventions: a systematic review.

PubMed

Banke-Thomas, Aduragbemi Oluwabusayo; Madaj, Barbara; Charles, Ameh; van den Broek, Nynke

2015-06-24

Increased scarcity of public resources has led to a concomitant drive to account for value-for-money of interventions. Traditionally, cost-effectiveness, cost-utility and cost-benefit analyses have been used to assess value-for-money of public health interventions. The social return on investment (SROI) methodology has capacity to measure broader socio-economic outcomes, analysing and computing views of multiple stakeholders in a singular monetary ratio. This review provides an overview of SROI application in public health, explores lessons learnt from previous studies and makes recommendations for future SROI application in public health. A systematic review of peer-reviewed and grey literature to identify SROI studies published between January 1996 and December 2014 was conducted. All articles describing conduct of public health SROI studies and which reported a SROI ratio were included. An existing 12-point framework was used to assess study quality. Data were extracted using pre-developed codes: SROI type, type of commissioning organisation, study country, public health area in which SROI was conducted, stakeholders included in study, discount rate used, SROI ratio obtained, time horizon of analysis and reported lessons learnt. 40 SROI studies, of varying quality, including 33 from high-income countries and 7 from low middle-income countries, met the inclusion criteria. SROI application increased since its first use in 2005 until 2011, declining afterwards. SROI has been applied across different public health areas including health promotion (12 studies), mental health (11), sexual and reproductive health (6), child health (4), nutrition (3), healthcare management (2), health education and environmental health (1 each). Qualitative and quantitative methods have been used to gather information for public health SROI studies. However, there remains a lack of consensus on who to include as beneficiaries, how to account for counterfactual and appropriate study-time horizon. Reported SROI ratios vary widely (1.1:1 to 65:1). SROI can be applied across healthcare settings. Best practices such as analysis involving only beneficiaries (not all stakeholders), providing justification for discount rates used in models, using purchasing power parity equivalents for monetary valuations and incorporating objective designs such as case-control or before-and-after designs for accounting for outcomes will improve robustness of public health SROI studies.

Seeing Eye-to-Eye on ICT: Science Student and Teacher Perceptions of Laptop Use across 14 Australian Schools

ERIC Educational Resources Information Center

Crook, Simon J.; Sharma, Manjula D.; Wilson, Rachel; Muller, Derek A.

2013-01-01

As schools start investigating and investing in the idea of 1:1 iPads and tablets, are there any lessons that can be learnt from recent 1:1 laptop deployments? In Australia, since 2008, 1:1 laptops have been introduced into every secondary school. This study reports on a survey designed to investigate frequency and type of laptop use, and the…

Early interventions and lessons from Harvard Business Review.

PubMed

Chong, Siow-Ann

2007-11-01

To describe the establishment and development of an Early Psychosis Intervention Programme in Singapore that is based on a business model and with concepts drawn from the corporate world. The author who directed this programme describes the circumstances that led to this initiative, the ideas borrowed and adapted from the corporate world, and the lessons learnt in setting up this intervention programme. The modus operandi of the programme is based on the Balanced Scorecard - a model which stresses four equally important components: customers, internal processes, financial health and learning and innovation. Other complementary actions like creating a sense of urgency, forging a vision with a core ideology, empowerment of team members, creating short-term wins, anchoring the changes and finding meaning in the work are vital for the programme to thrive. This model also emphasizes the importance of accountability through the measurability of indicators. These indicators included a significant reduction in the duration of untreated psychosis, a positive change in the referral patterns with better engagement of the primary health-care sector and an improvement in the quality of care for the patients. Much can be learnt from the business world in building and maintaining a public mental health programme. Effective change also requires effective leadership, and the successful implementation of certain strategic steps.

Lessons learnt from human papillomavirus (HPV) vaccination in 45 low- and middle-income countries

PubMed Central

Howard, Natasha; Kabakama, Severin; Mounier-Jack, Sandra; Griffiths, Ulla K.; Feletto, Marta; Burchett, Helen E. D.; LaMontagne, D. Scott; Watson-Jones, Deborah

2017-01-01

Objective To synthesise lessons learnt and determinants of success from human papillomavirus (HPV) vaccine demonstration projects and national programmes in low- and middle-income countries (LAMICs). Methods Interviews were conducted with 56 key informants. A systematic literature review identified 2936 abstracts from five databases; after screening 61 full texts were included. Unpublished literature, including evaluation reports, was solicited from country representatives; 188 documents were received. A data extraction tool and interview topic guide outlining key areas of inquiry were informed by World Health Organization guidelines for new vaccine introduction. Results were synthesised thematically. Results Data were analysed from 12 national programmes and 66 demonstration projects in 46 countries. Among demonstration projects, 30 were supported by the GARDASIL® Access Program, 20 by Gavi, four by PATH and 12 by other means. School-based vaccine delivery supplemented with health facility-based delivery for out-of-school girls attained high coverage. There were limited data on facility-only strategies and little evaluation of strategies to reach out-of-school girls. Early engagement of teachers as partners in social mobilisation, consent, vaccination day coordination, follow-up of non-completers and adverse events was considered invaluable. Micro-planning using school/ facility registers most effectively enumerated target populations; other estimates proved inaccurate, leading to vaccine under- or over-estimation. Refresher training on adverse events and safe injection procedures was usually necessary. Conclusion Considerable experience in HPV vaccine delivery in LAMICs is available. Lessons are generally consistent across countries and dissemination of these could improve HPV vaccine introduction. PMID:28575074

Boosting innovation in the water sector--the role and lessons learned from collaborative projects.

PubMed

Alegre, H; Coelho, S T; Feliciano, J F; Matos, R

2015-01-01

A key worldwide challenge in most sectors is to boost the effective adoption of innovation, as underpinned by the new European Union research programme Horizon 2020, which focuses on increasing innovation in Europe from 2014 to 2020. This is particularly relevant in the water sector, often perceived as conservative and averse to change. This paper discusses the role that collaborative knowledge-transfer projects can play in effectively rolling out R&D in the water industry. LNEC (Laboratório Nacional de Engenharia Civil) has designed a structured model based on a phased programme and a network of utilities and researchers. The paper presents the core principles, the rationale, the model and methods used, and the theoretical background, as well as the project's impact, outcomes and products. The discussion highlights the lessons learnt and provides a formal analysis of the advantages of focusing on middle management as an effective entry point, even if innovation is needed across the organization. Making training materials, guidelines, use cases, data and software publicly available after the project's end has proven to have a decisive multiplying effect. The paper also argues in favour of the collaborative model as a basis for R&D sustainability, and details on-going and planned developments.

Taxing soft drinks in the Pacific: implementation lessons for improving health.

PubMed

Thow, Anne Marie; Quested, Christine; Juventin, Lisa; Kun, Russ; Khan, A Nisha; Swinburn, Boyd

2011-03-01

A tax on soft drinks is often proposed as a health promotion strategy for reducing their consumption and improving health outcomes. However, little is known about the processes and politics of implementing such taxes. We analysed four different soft drink taxes in Pacific countries and documented the lessons learnt regarding the process of policy agenda-setting and implementation. While local social and political context is critically important in determining policy uptake, these case studies suggest strategies for health promotion practitioners that can help to improve policy uptake and implementation. The case studies reveal interaction between the Ministries of Health, Finance and Revenue at every stage of the policy making process. In regard to agenda-setting, relevance to government fiscal priorities was important in gaining support for soft drink taxes. The active involvement of health policy makers was also important in initiating the policies, and the use of existing taxation mechanisms enabled successful policy implementation. While the earmarking of taxes for health has been widely recommended, the revenue may be redirected as government priorities change. Health promotion practitioners must strategically plan for agenda-setting, development and implementation of intersectoral health-promoting policies by engaging with stakeholders in finance at an early stage to identify priorities and synergies, developing cross-sectoral advocacy coalitions, and basing proposals on existing legislative mechanisms where possible.

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

PubMed

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

2017-03-01

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

Preparing pre-service teachers to integrate technology into inquiry-based science education: Three case studies in The Netherlands

NASA Astrophysics Data System (ADS)

Tran, Trinh-Ba; van den Berg, Ed; Ellermeijer, Ton; Beishuizen, Jos

2016-05-01

Integration of technology ( e.g. measuring with sensors, video measurement, and modeling) into secondary-school science teaching is a need globally recognized. A central issue of incorporating these technologies in teaching is how to turn manipulations of equipment and software into manipulations of ideas. Therefore, preparation for pre-service teachers to apply ICT tools should be combined with the issues of minds-on inquiring and meaning-making. From this perspective, we developed a course within the post-graduate teacher-education program in the Netherlands. During the course, pre-service teachers learnt not only to master ICT skills but also to design, teach, and evaluate an inquiry-based lesson in which the ICT tool was integrated. Besides three life sessions, teachers' learning scenario also consisted of individual tasks which teachers could carry out mostly in the school or at home with support materials and online assistance. We taught three iterations of the course within a design-research framework in 2013, 2014 and collected data on the teacher learning processes and outcomes. The analyses of these data from observation, interviews, questionnaires, and documents were to evaluate implementation of the course, then suggest for revisions of the course set-up, which was executed and then assessed again in a subsequent case study. Main outcomes of the three case studies can be summarized as follows: within a limited time (3 life sessions spread over 2-3 months), the heterogeneous groups of pre-service teachers achieved a reasonable level of competence regarding the use of ICT tools in inquiry-based lessons. The blended set-up with support materials, especially the Coach activities and the lesson-plan form for an ICT-integrated inquiry-based lesson, contributed to this result under the condition that the course participants really spent considerable time outside the life sessions. There was a need for more time for hands-on, in-group activities in life sessions and more detailed feedback on individual reports of pre-service teachers. The majority of the pre-service teachers were able to design a lesson plan aimed at a certain inquiry level with integration of ICT, but just a few could implement it faithfully in the classroom. There was still a considerable difference between intended inquiry activities and actual realized inquiry which parallels results from the literature for experienced teachers. The participants had to struggle with science --ICT conceptual issues as well as getting their students to focus on inquiry and concept learning in the classroom. Each evaluation guided iteration of the course resulted in better learning outcomes.

Minimally invasive surgical techniques for stress incontinence surgery.

PubMed

Morley, Roland; Nethercliffe, Janine

2005-12-01

Minimally invasive techniques for surgical correction of stress incontinence date back to the late 1950s. Since that time there have been many developments to attempt to emulate the good results achieved by open surgery with less surgical morbidity. Needle suspensions have attempted to reposition the bladder neck in the same way as a colposuspension. However, although numerous variations have been described, they do not have the long-term outcomes of colposuspension. These variations, their complications and long-term outcome are discussed. Sling surgery, especially the tension-free vaginal tape (TVT), has probably had the largest impact on incontinence surgery in recent years, offering a procedure with low morbidity and, thus far in the medium term, outcomes comparable with those of more invasive procedures. This has led the TVT procedure to become the most common procedure performed worldwide for stress incontinence. With the benefit of lessons learnt from the use of synthetic material in the genitourinary tract, some worries remain with regard to the long-term complications of TVT. Other non-synthetic material should not be forgotten, and the advantages and disadvantages of various sling materials are compared. Injectables have an established place in the treatment of sphincter deficiency, though long-term results are poor compared to those of other procedures. Various materials used and the technique for their injection are discussed.

What's D&T For? Gathering and Comparing the Values of Design and Technology Academics and Trainee Teachers

ERIC Educational Resources Information Center

Hardy, Alison

2015-01-01

Some who read and research about Design & Technology (D&T) would say that the concept of value is key to understanding and defining D&T. Closer inspection reveals though that there are two ways in which values are defined in D&T: how values are taught and learnt about in D&T to use them to make judgments in D&T lessons, and…

Moral dilemmas and abortion decision-making: Lessons learnt from abortion research in England and Wales.

PubMed

Hoggart, Lesley

2018-05-21

This paper scrutinises the concepts of moral reasoning and personal reasoning, problematising the binary model by looking at young women's pregnancy decision-making. Data from two UK empirical studies are subjected to theoretically driven qualitative secondary analysis, and illustrative cases show how complex decision-making is characterised by an intertwining of the personal and the moral, and is thus best understood by drawing on moral relativism.

Health care – an everlasting challenge in temporal and spatial domains

PubMed Central

Chen, Wenxi

2010-01-01

Health care is an everlasting challenge that requires effort at all levels, from national and organizational to individual domains, over a long-term period. This article reviews the historical development of health care-related issues worldwide and accentuates the necessity of health care in the current era. Through investigating the historical background in both the occidental and the oriental worlds and the latest achievements from academic and industrial endeavors, many lessons can be learnt, and as a result, an integrative strategy is proposed to meet today’s pressing needs. A government-funded project, “Challenge to 100 years of age”, which involved more than 600 residents in west Aizu village, lasted over 15 years. After reviewing its outcomes, a metrology of health based upon the three-dimensional phase space, which integrates with social well-being, mental status, and physical condition for a lifelong span, is advocated as a measure of the holistic view of health state. PMID:21197368

Action Stations! 100 years of trauma care on maritime and amphibious operations in the Royal Navy.

PubMed

Osborne, M; Smith, J E

2015-01-01

Over the past century trauma care within the Royal Navy (RN) has evolved; wartime experiences and military medical research have combined to allow significant improvement in the care of casualties. This article describes the key maritime and amphibious operations that have seen the Royal Navy Medical Service (RNMS) deliver high levels of support to wherever the Naval Service has deployed in the last 100 years. Key advancements in which progress has led to improved outcomes for injured personnel are highlighted--the control and treatment of blood loss, wound care, and the prevention and management of organ failure with optimal resuscitation. Historians often point out how slowly military medicine progressed for the first few thousand years of its recorded history, and how quickly it has progressed in the last century. This reflective article will show how the RNMS has been an integral part of that story, and how the lessons learnt by our predecessors have shaped our modern day doctrine surrounding trauma care.

The Evolution of the Stem Cell Theory for Heart Failure

PubMed Central

Silvestre, Jean-Sébastien; Menasché, Philippe

2015-01-01

Various stem cell-based approaches for cardiac repair have achieved encouraging results in animal experiments, often leading to their rapid proceeding to clinical testing. However, freewheeling evolutionary developments of the stem cell theory might lead to dystopian scenarios where heterogeneous sources of therapeutic cells could promote mixed clinical outcomes in un-stratified patient populations. This review focuses on the lessons that should be learnt from the first generation of stem cell-based strategies and emphasizes the absolute requirement to better understand the basic mechanisms of stem cell biology and cardiogenesis. We will also discuss about the unexpected “big bang” in the stem cell theory, “blasting” the therapeutic cells to their unchallenged ability to release paracrine factors such as extracellular membrane vesicles. Paradoxically, the natural evolution of the stem cell theory for cardiac regeneration may end with the development of cell-free strategies with multiple cellular targets including cardiomyocytes but also other infiltrating or resident cardiac cells. PMID:26844266

Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce

PubMed Central

Dussault, Gilles; Franceschini, Maria Cristina

2006-01-01

Access to good-quality health services is crucial for the improvement of many health outcomes, such as those targeted by the Millennium Development Goals (MDGs) adopted by the international community in 2000. The health-related MDGs cannot be achieved if vulnerable populations do not have access to skilled personnel and to other necessary inputs. This paper focuses on the geographical dimension of access and on one of its critical determinants: the availability of qualified personnel. The objective of this paper is to offer a better understanding of the determinants of geographical imbalances in the distribution of health personnel, and to identify and assess the strategies developed to correct them. It reviews the recent literature on determinants, barriers and the effects of strategies that attempted to correct geographical imbalances, with a focus on empirical studies from developing and developed countries. An analysis of determinants of success and failures of strategies implemented, and a summary of lessons learnt, is included. PMID:16729892

Application of system thinking concepts in health system strengthening in low-income settings: a proposed conceptual framework for the evaluation of a complex health system intervention: the case of the BHOMA intervention in Zambia.

PubMed

Mutale, Wilbroad; Balabanova, Dina; Chintu, Namwinga; Mwanamwenge, Margaret Tembo; Ayles, Helen

2016-02-01

The current drive to strengthen health systems provides an opportunity to develop new strategies that will enable countries to achieve targets for millennium development goals. In this paper, we present a proposed framework for evaluating a new health system strengthening intervention in Zambia known as Better Health Outcomes through Mentoring and Assessment. We briefly describe the intervention design and focus on the proposed evaluation approach through the lens of systems thinking. In this paper, we present a proposed framework to evaluate a complex health system intervention applying systems thinking concepts. We hope that lessons learnt from this process will help to adapt the intervention and limit unintended negative consequences while promoting positive effects. Emphasis will be paid to interaction and interdependence between health system building blocks, context and the community. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Insights into interventions in managing COPD patients: lessons from the TORCH and UPLIFT® studies

PubMed Central

Miravitlles, Marc; Anzueto, Antonio

2009-01-01

Influencing the progression of COPD has long been an elusive goal of drug therapy. Directly or indirectly, this has again been investigated in two of the largest, long-term drug trials in COPD: Towards a Revolution in COPD Health (TORCH) and Understanding Potential Long-Term Impacts on Function with Tiotropium (UPLIFT®). Neither trial achieved statistical significance in their respective primary outcomes; however, both make considerable contributions to understanding of how the progression of COPD may be influenced. The objective of this article is to review the data from these different trials with a view to what can be learnt about the management of COPD. The long-term improvements in lung function, health-related quality of life, and possibly survival from the use of long-acting bronchodilators in these trials suggest an influence on progression of the disease. With the more optimistic view of benefits from drug treatment of COPD that these trials provide, a review of prescribing practices is warranted. PMID:19516917

Improving policy and practice to promote equity and social justice - a qualitative comparative analysis building on key learnings from a twinning exchange between England and the US.

PubMed

Blanchard, Claire; Narle, Ginder; Gibbs, Martin; Ruddock, Charmaine; Grady, Michael; Brookes, Chris; Hopkins, Trevor; Norwood, Jayne

2013-12-01

Community health promotion interventions, targeted at marginalised populations and focusing on addressing the social determinants of health (SDH) to reduce health inequalities and addressing the processes of exclusion, are an important strategy to prevent and control non-communicable diseases (NCDs) and promote the health of underprivileged and under-resourced groups. This article builds on key lessons learnt from a learning exchange between Communities for Health in England and the Racial and Ethnic Approaches to Community Health across the US (REACH US) communities that are tackling health inequities. It presents a qualitative analysis further capturing information about specific community interventions involved in the exchange and identifying lessons learnt. This exchange was led by a partnership between the US Centers for Disease Control and Prevention, the International Union for Health Promotion and Education, the Department of Health of England, Health Action Partnership International, and Learning for Public Health West Midlands. These efforts provide interesting insights for further research, priority areas of action for policy and practice to address the SDH and to promote and sustain equity and social justice globally. The article highlights some key lessons about the use of data, assets-based community interventions and the importance of good leadership in times of crisis and adversity. Whilst complex and time-consuming to arrange, such programmes have the potential to offer other countries including the global south new insights and perspectives that will in turn contribute to the SDH field and provide concrete strategies and actions that effectively reduce inequities and promote the health of our societies. The key learnings have the potential to contribute to the global community and growing documentation on evidence of effective efforts in the reduction of health inequities.

Radioguided localisation of impalpable breast lesions using 99m-Technetium macroaggregated albumin: Lessons learnt during introduction of a new technique to guide preoperative localisation

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

Landman, Joanne; Kulawansa, Sagarika; McCarthy, Michael

2015-03-15

Preoperative wire-guided localisation (WGL) of impalpable breast lesions is widely used but can be technically difficult. Risks include wire migration, inaccurate placement, and inadequate surgical margins. Research shows that radioguided occult lesion localisation (ROLL) is quicker, easier, and can improve surgical and cosmetic outcomes. An audited introduction of ROLL was conducted to validate the technique as a feasible alternative to WGL. Fifty patients with single impalpable lesions and biopsy proven malignancy or indeterminate histology underwent WGL followed by intralesional radiopharmaceutical injection of 99m-Technetium macroaggregated albumin. Postprocedural mammography was performed to demonstrate wire position, and scintigraphy to evaluate radiopharmaceutical migration. Lymphoscintigraphymore » and intraoperative sentinel node biopsy were performed if indicated, followed by lesion localisation and excision using a gamma probe. Specimen imaging was performed, with immediate reexcision for visibly inadequate margins. Accurate localisation was achieved in 86% of patients with ROLL compared to 72% with WGL. All lesions were successfully removed, with clear margins in 71.8% of malignant lesions. Reexcision and intraoperative sentinel node localisation rates were equivalent to preaudit figures for WGL. ROLL was easy to perform and problems were infrequent. Inaccurate radiopharmaceutical placement necessitating WGL occurred in four patients. Minor radiopharmaceutical migration was common, but precluded using ROLL in only two cases. ROLL is effective, simple, inexpensive, and easily learnt; however, preoperative confirmation of correct radiopharmaceutical placement using mammography and the gamma probe is important to help ensure successful lesion removal. Insertion of a backup hookwire is recommended during the initial introduction of ROLL.« less

Advanced Thermoplastic Polymers and Additive Manufacturing Applied to ISS Columbus Toolbox: Lessons Learnt and Results

NASA Astrophysics Data System (ADS)

Ferrino, Marinella; Secondo, Ottaviano; Sabbagh, Amir; Della Sala, Emilio

2014-06-01

In the frame of the International Space Station (ISS) Exploitation Program a new toolbox has been realized by TAS-I to accommodate the tools currently in use on the ISS Columbus Module utilizing full-scale prototypes obtained with 3D rapid prototyping. The manufacturing of the flight hardware by means of advanced thermoplastic polymer UL TEM 9085 and additive manufacturing Fused Deposition Modelling (FDM) technology represent innovative elements. In this paper, the results achieved and the lessons learned are analyzed to promote future technology know-how. The acquired experience confirmed that the additive manufacturing process allows to save time/cost and to realize new shapes/features to introduce innovation in products and future design processes for space applications.

Measuring laboratory-based influenza surveillance capacity: development of the 'International Influenza Laboratory Capacity Review' Tool.

PubMed

Muir-Paulik, S A; Johnson, L E A; Kennedy, P; Aden, T; Villanueva, J; Reisdorf, E; Humes, R; Moen, A C

2016-01-01

The 2005 International Health Regulations (IHR 2005) emphasized the importance of laboratory capacity to detect emerging diseases including novel influenza viruses. To support IHR 2005 requirements and the need to enhance influenza laboratory surveillance capacity, the Association of Public Health Laboratories (APHL) and the Centers for Disease Control and Prevention (CDC) Influenza Division developed the International Influenza Laboratory Capacity Review (Tool). Data from 37 assessments were reviewed and analyzed to verify that the quantitative analysis results accurately depicted a laboratory's capacity and capabilities. Subject matter experts in influenza and laboratory practice used an iterative approach to develop the Tool incorporating feedback and lessons learnt through piloting and implementation. To systematically analyze assessment data, a quantitative framework for analysis was added to the Tool. The review indicated that changes in scores consistently reflected enhanced or decreased capacity. The review process also validated the utility of adding a quantitative analysis component to the assessments and the benefit of establishing a baseline from which to compare future assessments in a standardized way. Use of the Tool has provided APHL, CDC and each assessed laboratory with a standardized analysis of the laboratory's capacity. The information generated is used to improve laboratory systems for laboratory testing and enhance influenza surveillance globally. We describe the development of the Tool and lessons learnt. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Overcoming challenges in implementing the WHO Surgical Safety Checklist: lessons learnt from using a checklist training course to facilitate rapid scale up in Madagascar

PubMed Central

Close, Kristin L; Baxter, Linden S; Ravelojaona, Vaonandianina A; Rakotoarison, Hasiniaina N; Bruno, Emily; Herbert, Alison; Andean, Vanessa; Callahan, James; Andriamanjato, Hery H

2017-01-01

The WHO Surgical Safety Checklist was launched in 2009, and appropriate use reduces mortality, surgical site infections and complications after surgery by up to 50%. Implementation across low-income and middle-income countries has been slow; published evidence is restricted to reports from a few single institutions, and significant challenges to successful implementation have been identified and presented. The Mercy Ships Medical Capacity Building team developed a multidisciplinary 3-day Surgical Safety Checklist training programme designed for rapid wide-scale implementation in all regional referral hospitals in Madagascar. Particular attention was given to addressing previously reported challenges to implementation. We taught 427 participants in 21 hospitals; at 3–4 months postcourse, we collected surveys from 183 participants in 20 hospitals and conducted one focus group per hospital. We used a concurrent embedded approach in this mixed-methods design to evaluate participants’ experiences and behavioural change as a result of the training programme. Quantitative and qualitative data were analysed using descriptive statistics and inductive thematic analysis, respectively. This analysis paper describes our field experiences and aims to report participants’ responses to the training course, identify further challenges to implementation and describe the lessons learnt. Recommendations are given for stakeholders seeking widespread rapid scale up of quality improvement initiatives to promote surgical safety worldwide. PMID:29225958

Capacity-building of the allied health workforce to prevent and control diabetes: Lessons learnt from the National Initiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGI Lanka) project.

PubMed

Wijeyaratne, Chandrika; Arambepola, Carukshi; Karunapema, Palitha; Periyasamy, Kayathri; Hemachandra, Nilmini; Ponnamperuma, Gominda; Beneragama, Hemantha; de Alwis, Sunil

2016-04-01

In 2008, to tackle the exponential rise in the clinical burden of diabetes that was challenging the health systems in Sri Lanka, a shift in focus towards patient-centred care linked with community health promotion was initiated by the National Initiative to Reinforce and Organize General Diabetes Care in Sri Lanka (NIROGI Lanka) project of the Sri Lanka Medical Association. Specific training of "diabetes educator nursing officers" (DENOs), field staff in maternal and child health, footwear technicians, and health promoters from the community, was instituted to improve knowledge, skills and attitudes in the area of control and prevention of diabetes. This article highlights some of the activities carried out to date with the allied health workforce and volunteer community. Specifically, it describes experiences with the DENO programme: the educational and administrative processes adopted, challenges faced and lessons learnt. It also highlights an approach to prevention and management of complications of chronic diabetic foot through training a cohort of prosthetics and orthotics technicians, in the absence of podiatrists, and an initiative to provide low-cost protective footwear. Harnessing the enthusiasm of volunteers - adults and schoolchildren - to address behavioural risk factors in a culturally appropriate fashion has also been a key part of the NIROGI Lanka strategy.

Public health in transition: views of the specialist workforce.

PubMed

Griffiths, Sian; Thorpe, Allison

2007-09-01

The constant structural changes to the NHS in England have created instability and lack of job security within the public health workforce in the U.K. Since posts are linked to structures which keep changing, recent years have seen constant changes in titles, responsibilities and expectations. Effective public health practice involves teamwork across sectors and strong relationships with local communities, and this constant change has posed professional challenges. The changes in 2002 offered the Faculty of Public Health the opportunity to work with the Department of Health to consult with specialists, the main objective being to reach agreement on future roles and ways of working. The lessons learnt from this exercise are described here as they remain relevant as the structural changes continue. Key messages are that if the many opportunities of the current policy agenda are to be realized, the public health profession needs to be supported to play its full role in the three domains of practice: health improvement, health protection and developing better health services. This challenge needs professional bodies to be clear on expected competence of their members; employers to be clear on the potential contribution of public health specialists not only in promoting and protecting health in communities but also within the acute sector; organizational arrangements to be in place to sustain the capacity of the workforce whatever the structural changes occurring. This lesson has yet to be learnt.

Violence and HIV/AIDS prevention among female out-of-school youths in southwestern Nigeria: lessons learnt from interventions targeted at hawkers and apprentices.

PubMed

Fawole, O I; Ajuwon, A J; Osungbade, K O

2004-12-01

Between 1997 and 2003, four studies on hawkers and apprentices in motor parks and work shops in south west, Nigeria were carried out to evaluate the effectiveness of interventions aimed at preventing HIV infection and gender based violence (GBV). The studies were in 3 phases namely baseline survey, intervention and end line survey. Interventions consisting of:--development and distribution of education materials and training programmes for the police, judiciary, instructors, drivers, traders and apprentices/hawkers, including micro-credit facilities were implemented in some of the studies. The major lessons learnt were that: Young girls working in the informal sector of the Nigerian economy face dual risks of HIV infection and GBV and yet they are seldom targets of intervention; Many had been victims of GBV and did not seek redress either because they accept it is their lot, are afraid of being stigmatized or are put off the prolonged legal system; Perpetrators tend to deny their involvement in violence; Despite the challenges involved, interventions implemented among female apprentices and hawkers, especially those that involve multiple stakeholders, made a difference in protecting this group from dual risks of GBV and HIV/AIDS infection. We recommend more intervention programmes for this population, and regulation of activities in the informal sector of the Nigerian economy.

The effect of 5E-SWH learning model on students' view of nature of science

NASA Astrophysics Data System (ADS)

Sinthuwa, Waralee; Sangpradit, Theerapong

2018-01-01

View of Nature of Science (NOS) is one of key factors to support students' scientific literacy. So, it includes in scientific learning goals internationally. As in the literature, the many potential benefits associated with appropriate view of NOS. For instance, it influences students' learning achievement in science and lets students see how science connected to their real world. The aim of this study was to develop the 5E-SWH learning model to enhance 12th grade students' view of NOS. Eighty-eight students participated in this study. They were separated into two groups. Forty-four students had learnt biology by using 5E-SWH learning unit, but another group had learnt by using traditional 5E. View of NOS questionnaire that was adapted from the Views of NOS Questionnaire (VNOS-C) was applied with the both groups as pretest and posttest. The questionnaire consisted of ten open-ended items. The semi-structured interview protocol was also used with thirty students and feedback on the lesson record was provided in order to triangulate students' view of NOS. The analyzed results were approved by peer review. In addition, the during the implementation, data from voice recorder was transcribed and used discourse analysis to show students' NOS views. There were three aspects that relate to genetics technology content. These aspects included the subjective, empirical, and social and culture. Students' responses were categorized into 3 groups including informed, adequate and inadequate view. The results showed that the majority of participants held inadequate views of the subjective and empirical aspect at the beginning of the study. In addition, almost student as well as held adequate view of the social and culture aspect and they had misconception in some target NOS aspects. After that, they had learnt genetics technology content by using 5E-SWH learning model for 15 periods (50 min/ period). Both student groups' view of NOS was compared with each other. The study showed that the group that using 5E-SWH learning model develop their NOS view more than the control group that learnt through on 5E. The experimental group improved to informed view as following 45.46% subjective, 31.82% empirical and 59.09% social and culture. In addition, more than 50% of students shifted their view of NOS to better group in all target aspects. 25.76% of students shifted their view of NOS from inadequate to adequate view and 27.27% of students shifted their view of NOS from inadequate to informed view. 21.21% of students shifted their view of NOS from adequate to informed view. Furthermore, it showed their view of NOS improvement by conversation in class. The feedback on the lesson record was also support that students' view of NOS were improved by engaging in 5E-SWH learning unit. However, some students' comment on the lesson showed that they were still familiar with lecture. Therefore, it was the factor that we should concern in view of NOS development. The implications of this research for teachers were that the learning model could use to be the guideline to teach NOS integrate content in the classroom and they can use this learning model to design lesson plan in science.

Brucellosis in a refugee who migrated from Syria to Germany and lessons learnt, 2016

PubMed Central

Grunow, Roland; Jacob, Daniela; Klee, Silke; Schlembach, Dietmar; Jackowski-Dohrmann, Sabine; Loenning-Baucke, Vera; Eberspächer, Bettina; Swidsinski, Sonja

2016-01-01

A teenage woman migrating from Syria arrived in May 2015 in Germany. She gave birth to a healthy child in early 2016, but became febrile shortly after delivery. Blood cultures revealed Brucella melitensis. In retrospect, she reported contact with sheep in Syria and recurrent pain in the hip joints over about five months before diagnosis of brucellosis. We discuss consequences for adequate treatment of mother and child as well as for clinical and laboratory management. PMID:27525454

Measles outbreak linked to European B3 outbreaks, Wales, United Kingdom, 2017.

PubMed

Currie, Jonny; Davies, Llion; McCarthy, Joanne; Perry, Malorie; Moore, Catherine; Cottrell, Simon; Bowley, Mererid; Williams, Chris; Shankar, Ananda Giri; Stiff, Rhianwen

2017-10-01

The United Kingdom achieved interrupted endemic measles transmission for 36 months in 2016. Despite this, ongoing challenges from sporadic measles cases typically imported from abroad remain. We summarise a B3 measles genotype outbreak in south-east Wales occurring between May and September 2017, linked with other European outbreaks, and lessons learnt. Seventeen confirmed cases and one probable case occurred principally in education and healthcare-settings. Six confirmed cases attended healthcare settings when infectious, without being isolated.

Eradicating Organized Criminal Gangs in Jamaica: Can Lessons be Learnt From a Successful Counterinsurgency

DTIC Science & Technology

2008-01-01

34’Sa’tanrrlCl-I’o • ;S0.t..rUt 1\\1ar ,,’ FrankJ’ield" !I; E’ort Antoa"io ~*I~$~’ ’~t:.;:;: "::f;i’I’,":; . ’.. ......... [ilu’c’ 7" IOt ;.s:uc/i’ CaL"es...dissemination), Crime Management Unit, Fraud Squad, Forensic Laboratory, Bureau of Special Investigation, Canine Division, Protective Services, and the National

Interleukin-5 Inhibitors for Severe Asthma: Rationale and Future Outlook.

PubMed

Shrimanker, Rahul; Pavord, Ian D

2017-04-01

In this review, we outline the pathophysiology of severe asthma and discuss the role of anti-interleukin (IL)-5 inhibitors for the treatment of asthma. Anti-IL-5 treatments have shown efficacy in reducing the rate of severe asthma attacks in eosinophilic asthma. We review the history of the development of these agents, lessons learnt about severe asthma along the way and key clinical trials supporting efficacy of the three anti-IL-5 treatments that are clinically available or undergoing clinical trials in asthma.

Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg – a project report

PubMed Central

Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik

2016-01-01

Introduction: This project report describes the development, “piloting” and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. Project Description: A five-member interprofessional team collaborated together on this project. Kolb’s experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). Results: The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Conclusions: Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes. PMID:27280133

Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg - a project report.

PubMed

Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik

2016-01-01

This project report describes the development, "piloting" and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. A five-member interprofessional team collaborated together on this project. Kolb's experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes.

Crusted scabies in remote Australia, a new way forward: lessons and outcomes from the East Arnhem Scabies Control Program.

PubMed

Lokuge, Buddhi; Kopczynski, Alex; Woltmann, Angela; Alvoen, Faye; Connors, Christine; Guyula, Terrence; Mulholland, Eddie; Cran, Samantha; Foster, Tim; Lokuge, Kamalini; Burke, Tanya; Prince, Sam

2014-06-16

Crusted scabies is a highly infectious, debilitating and disfiguring disease, and remote Aboriginal communities of northern Australia have the highest reported rates of the condition in the world. We draw on monitoring data of the East Arnhem Scabies Control Program to discuss outcomes and lessons learnt through managing the condition in remote communities. Using active case finding, we identified seven patients with crusted scabies in three communities and found most had not presented to health services despite active disease. We compared presentations and hospitalisations for a cumulative total of 99 months during a novel preventive program with 99 months immediately before the program for the seven cases and seven sentinel household contacts. Our preventive long-term case management approach was associated with a significant 44% reduction in episodes of recurrent crusted scabies (from 36 to 20; P = 0.025) in the seven cases, and a non-significant 80% reduction in days spent in hospital (from 173 to 35; P = 0.09). It was also associated with a significant 75% reduction in scabies-related presentations (from 28 to 7; P = 0.017) for the seven sentinel household contacts. We recommend active surveillance and wider adoption of this preventive case management approach, with ongoing evaluation to refine protocols and improve efficiency. Contacts of children presenting with recurrent scabies should be examined to exclude crusted scabies. In households where crusted scabies is present, a diagnosis of parental neglect due to recurrent scabies and weight loss in children should be made with extreme caution. Improved coordination of care by health services, and research and development of new therapies including immunotherapies for crusted scabies, must be a priority.

Protocol: a realist review of user fee exemption policies for health services in Africa.

PubMed

Robert, Emilie; Ridde, Valéry; Marchal, Bruno; Fournier, Pierre

2012-01-01

Background Four years prior to the Millenium Development Goals (MDGs) deadline, low- and middle-income countries and international stakeholders are looking for evidence-based policies to improve access to healthcare for the most vulnerable populations. User fee exemption policies are one of the potential solutions. However, the evidence is disparate, and systematic reviews have failed to provide valuable lessons. The authors propose to produce an innovative synthesis of the available evidence on user fee exemption policies in Africa to feed the policy-making process. Methods The authors will carry out a realist review to answer the following research question: what are the outcomes of user fee exemption policies implemented in Africa? why do they produce such outcomes? and what contextual elements come into play? This type of review aims to understand how contextual elements influence the production of outcomes through the activation of specific mechanisms, in the form of context-mechanism-outcome configurations. The review will be conducted in five steps: (1) identifying with key stakeholders the mechanisms underlying user fee exemption policies to develop the analytical framework, (2) searching for and selecting primary data, (3) assessing the quality of evidence using the Mixed-Method Appraisal Tool, (4) extracting the data using the analytical framework and (5) synthesising the data in the form of context-mechanism-outcomes configurations. The output will be a middle-range theory specifying how user fee exemption policies work, for what populations and under what circumstances. Ethics and dissemination The two main target audiences are researchers who are looking for examples to implement a realist review, and policy-makers and international stakeholders looking for lessons learnt on user fee exemption. For the latter, a knowledge-sharing strategy involving local scientific and policy networks will be implemented. The study has been approved by the ethics committee of the CHUM Research Centre (CR-CHUM). It received funding from the Canadian Institutes of Health Research. The funders will not have any role in study design; collection, management, analysis, and interpretation of data; writing of the report and the decision to submit the report for publication, including who will have ultimate authority over each of these activities.

Which lesson can be learnt from a historical contamination analysis of the most polluted river in Europe?

PubMed

Lofrano, Giusy; Libralato, Giovanni; Acanfora, Floriana Giuseppina; Pucci, Luca; Carotenuto, Maurizio

2015-08-15

The Sarno River trend analysis during the last 60 years was traced focusing on the socio-economic and environmental issues. The river, originally worshiped as a god by Romans, is affected by an extreme level of environmental degradation, being sadly reputed as the most polluted river in Europe. This is the "not to be followed" example of the worst way a European river can be managed. Data about water, sediment, soil, biota and air contamination were collected from scientific papers, monitoring surveys, and technical reports depicting a sick river. Originally, the river was reputed as a source of livelihood, now it is considered a direct threat for human health. Wastewater can still flow through the river partially or completely untreated, waste production associated with the manufacture of metal products and leather tanning continues to suffer from the historical inadequacy of regional wastewater treatment plants (WWTPs), associated with the partial or no reuse of effluents. All efforts should be devoted to solving the lack of wastewater and waste management, the gap in land planning, improving the capacity of existing WWTPs also via the construction of new sewer sections, restoring Sarno River minimum vital-flow, keeping to a minimum uncontrolled discharges as well as supporting river contracts. The 2015 goal stated by the Water Framework Directive (2000/60/EC) is still far to be reached. The lesson has not been learnt yet. Copyright © 2015 Elsevier B.V. All rights reserved.

Mobile clinics for antiretroviral therapy in rural Mozambique

PubMed Central

Jequicene, Tito; Blevins, Meridith; José, Eurico; Lankford, Julie R; Wester, C William; Fuchs, Martina C; Vermund, Sten H

2014-01-01

Abstract Problem Despite seven years of investment from the President's Emergency Plan For AIDS Relief (PEPFAR), the expansion of human immunodeficiency virus (HIV)-related services continues to challenge Mozambique’s health-care infrastructure, especially in the country’s rural regions. Approach In 2012, as part of a national acceleration plan for HIV care and treatment, Namacurra district employed a mobile clinic strategy to provide temporary manpower and physical space to expand services at four rural peripheral clinics. This paper describes the strategy deployed, the uptake of services and the key lessons learnt in the first 18 months of implementation. Local setting In 2012, Namacurra´s adult population was estimated to be 125 425, and of those 15 803 were estimated to be HIV infected. Although there is consistent government support of antiretroviral therapy (ART) programmes, national coverage remains low, with less than 15% of those eligible having received ART by December 2012. Relevant changes Between April 2012 and September 2013, Namacurra district enrolled 4832 new patients into HIV care and treatment. By using the mobile clinic strategy for ART expansion, the district was able to expand provision of ART from two to six (of a desired seven) clinics by September 2013. Lessons learnt Mobile clinic strategies could rapidly expand HIV care and treatment in under-funded settings in ways that both build local capacity and are sustainable for local health systems. The clinics best serve as a transition to improved capacity at fixed-site services. PMID:25378759

Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center.

PubMed

Mudumbai, Seshadri C

2016-01-01

Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

Restoring Forest Landscapes: Important Lessons Learnt

NASA Astrophysics Data System (ADS)

Mansourian, Stephanie; Vallauri, Daniel

2014-02-01

Forest restoration at large scales, or landscapes, is an approach that is increasingly relevant to the practice of environmental conservation. However, implementation remains a challenge; poor monitoring and lesson learning lead to similar mistakes being repeated. The World Wildlife Fund (WWF), the global conservation organization, recently took stock of its 10 years of implementation of forest landscape restoration. A significant body of knowledge has emerged from the work of the WWF and its partners in the different countries, which can be of use to the wider conservation community, but for this to happen, lessons need to be systematically collected and disseminated in a coherent manner to the broader conservation and development communities and, importantly, to policy makers. We use this review of the WWF's experiences and compare and contrast it with other relevant and recent literature to highlight 11 important lessons for future large-scale forest restoration interventions. These lessons are presented using a stepwise approach to the restoration of forested landscapes. We identify the need for long-term commitment and funding, and a concerted and collaborative effort for successful forest landscape restoration. Our review highlights that monitoring impact within landscape-scale forest restoration remains inadequate. We conclude that forest restoration within landscapes is a challenging yet important proposition that has a real but undervalued place in environmental conservation in the twenty-first century.

Building a sustainable clinical academic workforce to meet the future healthcare needs of Australia and New Zealand: report from the first summit meeting.

PubMed

Windsor, J; Searle, J; Hanney, R; Chapman, A; Grigg, M; Choong, P; Mackay, A; Smithers, B M; Churchill, J A; Carney, S; Smith, J A; Wainer, Z; Talley, N J; Gladman, M A

2015-09-01

The delivery of healthcare that meets the requirements for quality, safety and cost-effectiveness relies on a well-trained medical workforce, including clinical academics whose career includes a specific commitment to research, education and/or leadership. In 2011, the Medical Deans of Australia and New Zealand published a review on the clinical academic workforce and recommended the development of an integrated training pathway for clinical academics. A bi-national Summit on Clinical Academic Training was recently convened to bring together all relevant stakeholders to determine how best to do this. An important part understood the lessons learnt from the UK experience after 10 years since the introduction of an integrated training pathway. The outcome of the summit was to endorse strongly the recommendations of the medical deans. A steering committee has been established to identify further stakeholders, solicit more information from stakeholder organisations, convene a follow-up summit meeting in late 2015, recruit pilot host institutions and engage the government and future funders. © 2015 Royal Australasian College of Physicians.

'Treat to Target' - Lessons Learnt.

PubMed

Kurti, Zsuzsanna; Vegh, Zsuzsanna; Golovics, Petra Anna; Lakatos, Peter Laszlo

2016-01-01

Therapeutic management in inflammatory bowel diseases (IBD) has significantly changed in the last decades with the advent of biological therapy resulting in new treatment targets other than clinical symptoms. Patient stratification in the early stage of the disease is an important step to identify patients with poor prognosis, who might benefit from early aggressive treatment to avoid complications in the later disease course. Recent randomized and hypothesis driven (e.g., Randomized Evaluation of an Algorithm for Crohn's Treatment, Post-Operative Crohn's Endoscopic Recurrence) clinical trials conducted in the biological era underscore the need of objective disease monitoring including assessment of biomarkers (e.g., C-reactive protein and calprotectin), mucosal healing and, for biologically treated patients, therapeutic drug monitoring beside clinical symptom assessment in both Crohn's disease and ulcerative colitis. Assessing the treatment efficacy objectively has become an important element of patient monitoring besides clinical symptom assessment. Further clinical studies are needed to assess whether implementation of new therapeutic algorithms based on these targets and tight monitoring in clinical practice have the potential to further improve long-term disease outcomes in IBD. © 2016 S. Karger AG, Basel.

Drug treatment for obesity in the post-sibutramine era.

PubMed

Cheung, Bernard M Y

2011-08-01

Obesity is a major health problem worldwide. It is associated with cardiovascular diseases, diabetes mellitus and decreased longevity. In managing obesity, diet and exercise are essential; pharmacological therapy may be added for obese patients or overweight patients with cardiovascular risk factors. Sibutramine is a serotonergic and adrenergic drug that reduces food intake and increases thermogenesis. It reduces bodyweight by about 4.2 kg after 12 months, and improves blood glucose and lipids; however, it can increase heart rate and blood pressure. In the SCOUT (Sibutramine Cardiovascular OUTcomes) study, sibutramine increased serious cardiovascular events, such as stroke or myocardial infarction, compared with placebo, and was consequently withdrawn from the market. The lesson learnt from this is the importance of patient selection, limiting the duration of treatment and stopping treatment in non-responders. Currently, phentermine and amfepramone (diethylpropion) are approved for short-term treatment of obesity (up to 3 months) and orlistat is approved for longer-term treatment; however, the gastrointestinal adverse effects of orlistat may be intolerable for some patients. There is now a clear need to find anti-obesity drugs that are effective and safe in the long term.

Surfing pathogens and the lessons learned for actin polymerization.

PubMed

Frischknecht, F; Way, M

2001-01-01

A number of unrelated bacterial species as well as vaccinia virus (ab)use the process of actin polymerization to facilitate and enhance their infection cycle. Studies into the mechanism by which these pathogens hijack and control the actin cytoskeleton have provided many interesting insights into the regulation of actin polymerization in migrating cells. This review focuses on what we have learnt from the actin-based motilities of Listeria, Shigella and vaccinia and discusses what we would still like to learn from our nasty friends, including enteropathogenic Escherichia coli and Rickettsia

Holding a country countdown to 2015 conference on Millennium Development Goals (MDGs) - the Zambian experience.

PubMed

Mukonka, Victor M; Malumo, Sarai; Kalesha, Penelope; Nambao, Mary; Mwale, Rodgers; Mwinga, Kasonde; Katepa-Bwalya, Mary; Babaniyi, Olusegan; Mason, Elizabeth; Phiri, Caroline; Wamulume, Pauline K

2014-01-21

Initiatives such as the Country Countdown to 2015 Conference on Millennium Development Goals (MDGs) have provided countries with high maternal and child deaths like Zambia a platform to assess progress, discuss challenges and share lessons learnt as a conduit for national commitment to reaching and attaining the MDGs four and five. This paper discusses and highlights the process of holding a successful country countdown conference and shares Zambia's experience with other countries planning to organise country countdown to 2015 Conferences on MDGs.

From LPF to eLISA: new approach in payload software

NASA Astrophysics Data System (ADS)

Gesa, Ll.; Martin, V.; Conchillo, A.; Ortega, J. A.; Mateos, I.; Torrents, A.; Lopez-Zaragoza, J. P.; Rivas, F.; Lloro, I.; Nofrarias, M.; Sopuerta, CF.

2017-05-01

eLISA will be the first observatory in space to explore the Gravitational Universe. It will gather revolutionary information about the dark universe. This implies a robust and reliable embedded control software and hardware working together. With the lessons learnt with the LISA Pathfinder payload software as baseline, we will introduce in this short article the key concepts and new approaches that our group is working on in terms of software: multiprocessor, self-modifying-code strategies, 100% hardware and software monitoring, embedded scripting, Time and Space Partition among others.

Brucellosis in a refugee who migrated from Syria to Germany and lessons learnt, 2016.

PubMed

Grunow, Roland; Jacob, Daniela; Klee, Silke; Schlembach, Dietmar; Jackowski-Dohrmann, Sabine; Loenning-Baucke, Vera; Eberspächer, Bettina; Swidsinski, Sonja

2016-08-04

A teenage woman migrating from Syria arrived in May 2015 in Germany. She gave birth to a healthy child in early 2016, but became febrile shortly after delivery. Blood cultures revealed Brucella melitensis. In retrospect, she reported contact with sheep in Syria and recurrent pain in the hip joints over about five months before diagnosis of brucellosis. We discuss consequences for adequate treatment of mother and child as well as for clinical and laboratory management. This article is copyright of The Authors, 2016.

Design of the compact high-resolution imaging spectrometer (CHRIS), and future developments

NASA Astrophysics Data System (ADS)

Cutter, Mike; Lobb, Dan

2017-11-01

The CHRIS instrument was launched on ESA's PROBA platform in October 2001, and is providing hyperspectral images of selected ground areas at 17m ground sampling distance, in the spectral range 415nm to 1050nm. Platform agility allows image sets to be taken at multiple view angles in each overpass. The design of the instrument is briefly outlined, including design of optics, structures, detection and in-flight calibration system. Lessons learnt from construction and operation of the experimental system, and possible design directions for future hyperspectral systems, are discussed.

Pandemic planning in the shipping industry--lessons learnt from the 2009 Influenza Pandemic.

PubMed

Bunyan, Kate

2011-01-01

The events around the 2009 A/H1N1 Influenza Pandemic highlighted the need for better planning to ensure protection of those on vessels, protection for ports of call, and protection of business assets (business continuity). The variety of stakeholders involved in the management of a pandemic made it difficult to achieve a cohesive plan during the event itself. By considering the actions during the last pandemic, and the literature available for the shipping industry on pandemic planning, a pathway to better preparation is suggested.

Strengthening monitoring and evaluation (M&E) and building sustainable health information systems in resource limited countries: lessons learned from an M&E task-shifting initiative in Botswana.

PubMed

Mpofu, Mulamuli; Semo, Bazghina-Werq; Grignon, Jessica; Lebelonyane, Refeletswe; Ludick, Steven; Matshediso, Ellah; Sento, Baraedi; Ledikwe, Jenny H

2014-10-03

The demand for quality data and the interest in health information systems has increased due to the need for country-level progress reporting towards attainment of the United Nations Millennium Development Goals and global health initiatives. To improve monitoring and evaluation (M&E) of health programs in Botswana, 51 recent university graduates with no experience in M&E were recruited and provided with on-the-job training and mentoring to develop a new cadre of health worker: the district M&E officer. Three years after establishment of the cadre, an assessment was conducted to document achievements and lessons learnt. This qualitative assessment included in-depth interviews at the national level (n = 12) with officers from government institutions, donor agencies, and technical organizations; and six focus group discussions separately with district M&E officers, district managers, and program officers coordinating different district health programs. Reported achievements of the cadre included improved health worker capacity to monitor and evaluate programs within the districts; improved data quality, management, and reporting; increased use of health data for disease surveillance, operational research, and planning purposes; and increased availability of time for nurses and other health workers to concentrate on core clinical duties. Lessons learnt from the assessment included: the importance of clarifying roles for newly established cadres, aligning resources and equipment to expectations, importance of stakeholder collaboration in implementation of sustainable programs, and ensuring retention of new cadres. The development of a dedicated M&E cadre at the district level contributed positively to health information systems in Botswana by helping build M&E capacity and improving data quality, management, and data use. This assessment has shown that such cadres can be developed sustainably if the initiative is country-led, focusing on recruitment and capacity-development of local counterparts, with a clear government retention plan.

Combined structural interventions for gender equality and livelihood security: a critical review of the evidence from southern and eastern Africa and the implications for young people.

PubMed

Gibbs, Andrew; Willan, Samantha; Misselhorn, Alison; Mangoma, Jaqualine

2012-06-14

Young people in southern and eastern Africa remain disproportionately vulnerable to HIV with gender inequalities and livelihood insecurities being key drivers of this. Behavioural HIV prevention interventions have had weak outcomes and a new generation of structural interventions have emerged seeking to challenge the wider drivers of the HIV epidemic, including gender inequalities and livelihood insecurities. We searched key academic data bases to identify interventions that simultaneously sought to strengthen people's livelihoods and transform gender relationships that had been evaluated in southern and eastern Africa. Our initial search identified 468 articles. We manually reviewed these and identified nine interventions that met our criteria for inclusion. We clustered the nine interventions into three groups: microfinance and gender empowerment interventions; supporting greater participation of women and girls in primary and secondary education; and gender empowerment and financial literacy interventions. We summarise the strengths and limitations of these interventions, with a particular focus on what lessons may be learnt for young people (18-24). Our review identified three major lessons for structural interventions that sought to transform gender relationships and strengthen livelihoods: 1) interventions have a narrow conceptualisation of livelihoods, 2) there is limited involvement of men and boys in such interventions, 3) studies have typically been done in stable populations. We discuss what this means for future interventions that target young people through these methods.

Combined structural interventions for gender equality and livelihood security: a critical review of the evidence from southern and eastern Africa and the implications for young people

PubMed Central

Gibbs, Andrew; Willan, Samantha; Misselhorn, Alison; Mangoma, Jaqualine

2012-01-01

Background Young people in southern and eastern Africa remain disproportionately vulnerable to HIV with gender inequalities and livelihood insecurities being key drivers of this. Behavioural HIV prevention interventions have had weak outcomes and a new generation of structural interventions have emerged seeking to challenge the wider drivers of the HIV epidemic, including gender inequalities and livelihood insecurities. Methods We searched key academic data bases to identify interventions that simultaneously sought to strengthen people's livelihoods and transform gender relationships that had been evaluated in southern and eastern Africa. Our initial search identified 468 articles. We manually reviewed these and identified nine interventions that met our criteria for inclusion. Results We clustered the nine interventions into three groups: microfinance and gender empowerment interventions; supporting greater participation of women and girls in primary and secondary education; and gender empowerment and financial literacy interventions. We summarise the strengths and limitations of these interventions, with a particular focus on what lessons may be learnt for young people (18–24). Conclusions Our review identified three major lessons for structural interventions that sought to transform gender relationships and strengthen livelihoods: 1) interventions have a narrow conceptualisation of livelihoods, 2) there is limited involvement of men and boys in such interventions, 3) studies have typically been done in stable populations. We discuss what this means for future interventions that target young people through these methods. PMID:22713350

Optimistic Biases in Observational Learning of Value

ERIC Educational Resources Information Center

Nicolle, A.; Symmonds, M.; Dolan, R. J.

2011-01-01

Action-outcome contingencies can be learnt either by active trial-and-error, or vicariously, by observing the outcomes of actions performed by others. The extant literature is ambiguous as to which of these modes of learning is more effective, as controlled comparisons of operant and observational learning are rare. Here, we contrasted human…

Implementation of an education development project in pathology to improve student competency-lessons learnt.

PubMed

Negi, Gita; Harsh, Meena; Chauhan, Vijendra D; Kalra, Vinita; Agarwal, Pradeep; Kusum, Anuradha

2015-08-01

Basic medical sciences and clinical teachings are not coordinated in the present medical education system. They are not taught keeping in mind the outcomes required at the time of actual handling of patients in the community. An educational development project was implemented in the Department of Pathology with the aim that it will result in the student learning to link the pathophysiology of the disease to clinical scenarios and become fully competent for lifelong medical practice. The pathology teaching of the second professional batch was modified by starting with defining the desired outcomes/competencies in the student's knowledge, skills, and attitude which were then addressed by lectures, demonstrations, practical classes and small group activities where case scenarios and laboratory reports were included. The outcome was assessed by Objectively Structured Clinical/Practical Examination and multiple choice questions. Force field analysis, faculty and student interviews, and questionnaires were used to assess the factors affecting its implementation and impact. Totally 80 students of the 2(nd) Professional MBBS were exposed to a competency-based education development project. It was found that the system was appreciated by faculty and students, especially the integration with clinical scenarios. There were many factors which influenced the execution of this program, including motivation level of students and faculty, time, logistics and meticulous planning. There was a significant improvement in student's performance and satisfaction. Many factors including prior planning were a major determinant for the success of this education development project.

Outcomes of antiretroviral therapy in a northern Indian urban clinic

PubMed Central

Dhooria, Sahajal; Prasad, KT; George, Ninoo; Ranjan, Sanjay; Gupta, Deepak; Sreenivas, Vishnubhatla; Kadhiravan, Tamilarasu; Miglani, Sunita; Sinha, Sanjeev; Wig, Naveet; Biswas, Ashutosh; Vajpayee, Madhu

2010-01-01

Abstract Problem Antiretroviral therapy (ART) programmes have been successful in several countries. However, whether they would succeed as part of a national programme in a resource-constrained setting such as India is not clear. The outcomes and specific problems encountered in such a setting have not been adequately studied. Approach We assessed the efficacy and functioning of India’s national ART programme in a tertiary care centre in northern India. All ART-naive patients started on ART between May 2005 and October 2006 were included in the study and were followed until 31 April 2008. Periodic clinical and laboratory evaluations were carried out in accordance with national guidelines. Changes in CD4+ lymphocyte count, body weight and body mass index were assessed at follow-up, and the operational problems analysed. Local setting The setting was a tertiary care centre in northern India with a mixed population of patients, mostly of low socioeconomic status. The centre is reasonably well resourced but faces constraints in health-care delivery, such as lack of adequate human resources and a high patient load. Relevant changes The response to ART in the cohort studied was comparable to that reported from other countries. However, the programme had a high attrition rate, possibly due to patient-related factors and operational constraints. Lessons learnt A high rate of attrition can affect the overall efficacy and functioning of an ART programme. Addressing the issues causing attrition might improve patient outcomes in India and in other resource-constrained countries. PMID:20428391

The severe acute respiratory syndrome: impact on travel and tourism.

PubMed

Wilder-Smith, Annelies

2006-03-01

SARS and travel are intricately interlinked. Travelers belonged to those primarily affected in the early stages of the outbreak, travelers became vectors of the disease, and finally, travel and tourism themselves became the victims. The outbreak of SARS created international anxiety because of its novelty, its ease of transmission in certain settings, and the speed of its spread through jet travel, combined with extensive media coverage. The psychological impacts of SARS, coupled with travel restrictions imposed by various national and international authorities, have diminished international travel in 2003, far beyond the limitations to truly SARS hit areas. Governments and press, especially in non SARS affected areas, have been slow to strike the right balance between timely and frequent risk communication and placing risk in the proper context. Screening at airport entry points is costly, has a low yield and is not sufficient in itself. The low yield in detecting SARS is most likely due to a combination of factors, such as travel advisories which resulted in reduced travel to and from SARS affected areas, implementation of effective pre-departure screening at airports in SARS-hit countries, and a rapid decline in new cases at the time when screening was finally introduced. Rather than investing in airport screening measures to detect rare infectious diseases, investments should be used to strengthen screening and infection control capacities at points of entry into the healthcare system. If SARS reoccurs, the subsequent outbreak will be smaller and more easily contained if the lessons learnt from the recent epidemic are applied. Lessons learnt during the outbreak in relation to international travel will be discussed.

Lay and peer counsellors to reduce leprosy-related stigma--lessons learnt in Cirebon, Indonesia.

PubMed

Lusli, Mimi; Peters, Ruth M H; Zweekhorst, Marjolein B M; Van Brakel, Wim H; Seda, Francisia S S E; Bunders, Joske F G; Irwanto

2015-03-01

Counselling has been identified as a promising strategy to reduce stigma. Lay and peer counsellors have provided counselling in various fields, but this has not yet been studied in the field of leprosy. The Stigma Assessment and Reduction of Impact (SARI) project in Cirebon District, Indonesia took up this endeavour. This paper describes the initial experiences based on the perspectives of the lay and peer counsellors and aims to provide lessons learnt for future initiatives. The selection of lay and peer counsellors was based upon pre-defined criteria such as completed junior high school and level of confidence. This study draws on the notes of seven monitoring and evaluation meetings and 21 group discussions the main researcher facilitated with the lay and peer counsellors and the notes written by the lay and peer counsellors on the sessions with their clients. In total, 198 people affected by leprosy were offered counselling by the 11 lay and 12 peer counsellors; 145 accepted this offer. The other 53 either did not need counselling or did not want to participate for example due to worries about disclosure. Effective communication skills such as listening and asking effective questions were important, but also difficult to acquire for the lay and peer counsellors. Sharing personal experiences was highly appreciated by clients and stimulated a deepened reflection. Challenges related to concealment and effective skills exist, but some people affected by leprosy and others can become effective counsellors making it at the outset a challenging but nevertheless promising intervention.

Preparing medical students for clinical practice: easing the transition.

PubMed

Teagle, Alexandra R; George, Maria; Gainsborough, Nicola; Haq, Inam; Okorie, Michael

2017-08-01

The transition from medical student to junior doctor is a challenge; the UK General Medical Council has issued guidance emphasizing the importance of adequate preparation of medical students for clinical practice. This study aimed to determine whether a junior doctor-led simulation-based course is an effective way of preparing final year medical students for practice as a junior doctor.We piloted a new 'preparation for practice' course for final year medical students prior to beginning as Foundation Year 1 (first year of practice) doctors. The course ran over three days and consisted of four simulated stations: ward round, prescribing, handover, and lessons learnt. Quantitative and qualitative feedback was obtained.A total of 120 students attended (40 on each day) and feedback was collected from 95 of them. Using a scale of 1 (lowest) to 5 (highest), feedback was positive, with 99% and 96% rating 4 or 5 for the overall quality of the program and the relevance of the program content, respectively. A score of 5 was awarded by 67% of students for the ward round station; 58% for the handover station; 71% for the prescribing station, and 35% for the lessons learnt station. Following the prescribing station, students reported increased confidence in their prescribing.Preparation for practice courses and simulation are an effective and enjoyable way of easing the transition from medical student to junior doctor. Together with 'on-the-job' shadowing time, such programs can be used to improve students' confidence, competence, and ultimately patient safety and quality of care.

Strategies for recruiting South Asian women to cancer screening research and the lessons learnt.

PubMed

Chan, Dorothy N S; So, Winnie K W

2016-11-01

The aim of this study was to describe and discuss the recruitment strategies used in a research study of cervical cancer screening among South Asian women, the challenges encountered and the lessons learnt from the experience. Ethnic minority populations face different barriers to participating in research studies. Strategies have been developed to recruit this population to health-related research in Western countries, but there is little information about such research in the Asian region. Discussion paper. The discussion is based on our previous experience. The source of this experience is the recruitment strategies used, their results and the challenges encountered during the process. Culturally, relevant strategies and maintaining good relationships with stakeholders improved participant recruitment. Familiarity with South Asians' traditional calendar - when cultural and religious festivals are held every year - would aid the setting up of appropriate schedules for participant recruitment, either before or after the periods when they cannot be reached, such as Ramadan. South Asian women are often busy with childcare and housework. This is their major responsibility in the family and any failure to fulfil such duties is a source of stress and may foster feelings of guilt. A better understanding of their daily routines is therefore important. Such information enables the establishment of daily meeting schedules to increase the success rate of recruitment. Recruitment is a tedious process, but appropriate planning and taking account of cultural and religious practices and daily schedules will help to improve its rate of success. © 2016 John Wiley & Sons Ltd.

Consistency across missions of long time series of global biophysical variables: challenges and lessons learnt

NASA Astrophysics Data System (ADS)

Lacaze, Roselyne; Smets, Bruno; Calvet, Jean-Christophe; Camacho, Fernando; Swinnen, Else; Verger, Aleixandre

2017-04-01

The Global component of the Copernicus Land Monitoring Service (CGLS) provides continuously a set of bio-geophysical variables describing the dynamics of vegetation, the energy budget at the continental surface, the water cycle and the cryosphere. Products are generated on a reliable and automatic basis from Earth Observation satellite data, at a frequency ranging from one hour to 10 days. They are accessible free of charge through the GCLS website (http://land.copernicus.eu/global/), associated with documentation describing the physical methodologies, the technical properties of products, and the quality of variables based on the results of validation exercises. The portfolio of the CGLS contains some Essential Climate Variables (ECV) like the Leaf Area Index (LAI), the Fraction of PAR absorbed by the vegetation (FAPAR), the surface albedo, and additional vegetation indices. These products were derived from SPOT/VEGETATION sensor data till December 2013, are currently derived from PROBA-V sensor data, and will be derived in the future from Sentinel-3 data. This talk will show how challenging is the transition between sensors to ensure the sustainability of the production while keeping the consistency of the time series. We will discuss the various sources of differences from input data, the impact of these differences on the biophysical variables and, in turn, on some final users' applications as such those based upon anomalies or assimilation of time series. We will present the mitigation measures taken to reduce as much as possible this impact. We will conclude with the lessons learnt and how this experience will be exploited to manage the transition towards Sentinel-3.

Lessons learnt from the Climate Dialogue initiative

NASA Astrophysics Data System (ADS)

Crok, Marcel; Strengers, Bart; Vasileiadou, Eleftheria

2015-04-01

The weblog Climate Dialogue (climatedialogue.org) has been an experimental climate change communication project. It was the result of a motion in the Dutch parliament, which asked the Dutch government "to also involve climate sceptics in future studies on climate change". Climate Dialogue was set up by the Royal Netherlands Meteorological Institute (KNMI), the Netherlands Environmental Assessment Agency (PBL), and Dutch science journalist Marcel Crok. It operated for slightly more than two years (From November 2012 till December 2014). Around 20 climate scientists from all over the world, many of them leading in their respective fields, participated in six dialogues. Climate Dialogue was a moderated blog on controversial climate science topics introducing a combination of several novel elements: a) bringing together scientists with widely separated viewpoints b) strict moderation of the discussion and c) compilation of executive and extended summaries of the discussions that were approved by the invited scientists. In our talk, we will discuss the operation and results of the Climate Dialogue project, focusing more explicitly on the lessons learnt with respect to online climate change communication addressing the question: "To what extent can online climate change communication bring together climate scientists with widely separated viewpoints, and what would be the advantage of such communication practice?" We identify how Climate Dialogue was received and perceived by the participating scientists, but also by different scientific and online communities. Finally, we present our ideas on how Climate Dialogue could evolve in a novel way of contributing to (climate) science and what steps would be necessary and/or beneficial for such a platform to survive and succeed.

Nursing shaping and influencing health and social care policy.

PubMed

Fyffe, Theresa

2009-09-01

This paper seeks to consider how nursing as a profession in the United Kingdom is developing its role in shaping and influencing policy using lessons learnt from a policy study tour undertaken in the United States of America and extensive experience as a senior nurse within the government, the health service and more recently within a Professional Organization. The nursing profession faces major changes in health and health care and nurses need to be visible in the public debate about future models of health and health care. This paper critically reviews recent UK and USA literature and policy with relevance to nursing. Strategies that support nurses and nursing to influence policy are in place but more needs to be done to address all levels of nursing in order to find creative solutions that promote and increase the participation of nurses in the political process and health policy. There are lessons to be learnt in the UK from the US nursing experience. These need to be considered in the context of the UK and devolution. Although much has been achieved in positioning nurses and nursing as an influencer in the arena of policy and political decision-making, there is a need for greater co-ordination of action to ensure that nursing is actively supported in influencing and shaping health and health care policy. All leaders and other stakeholders require to play their part in considering how the actions set out in this article can be taken forward and how gaps such as education, fellowship experience and media engagement can be addressed in the future.

Species coexistence in a changing world

PubMed Central

Valladares, Fernando; Bastias, Cristina C.; Godoy, Oscar; Granda, Elena; Escudero, Adrián

2015-01-01

The consequences of global change for the maintenance of species diversity will depend on the sum of each species responses to the environment and on the interactions among them. A wide ecological literature supports that these species-specific responses can arise from factors related to life strategies, evolutionary history and intraspecific variation, and also from environmental variation in space and time. In the light of recent advances from coexistence theory combined with mechanistic explanations of diversity maintenance, we discuss how global change drivers can influence species coexistence. We revise the importance of both competition and facilitation for understanding coexistence in different ecosystems, address the influence of phylogenetic relatedness, functional traits, phenotypic plasticity and intraspecific variability, and discuss lessons learnt from invasion ecology. While most previous studies have focused their efforts on disentangling the mechanisms that maintain the biological diversity in species-rich ecosystems such as tropical forests, grasslands and coral reefs, we argue that much can be learnt from pauci-specific communities where functional variability within each species, together with demographic and stochastic processes becomes key to understand species interactions and eventually community responses to global change. PMID:26528323

Species coexistence in a changing world.

PubMed

Valladares, Fernando; Bastias, Cristina C; Godoy, Oscar; Granda, Elena; Escudero, Adrián

2015-01-01

The consequences of global change for the maintenance of species diversity will depend on the sum of each species responses to the environment and on the interactions among them. A wide ecological literature supports that these species-specific responses can arise from factors related to life strategies, evolutionary history and intraspecific variation, and also from environmental variation in space and time. In the light of recent advances from coexistence theory combined with mechanistic explanations of diversity maintenance, we discuss how global change drivers can influence species coexistence. We revise the importance of both competition and facilitation for understanding coexistence in different ecosystems, address the influence of phylogenetic relatedness, functional traits, phenotypic plasticity and intraspecific variability, and discuss lessons learnt from invasion ecology. While most previous studies have focused their efforts on disentangling the mechanisms that maintain the biological diversity in species-rich ecosystems such as tropical forests, grasslands and coral reefs, we argue that much can be learnt from pauci-specific communities where functional variability within each species, together with demographic and stochastic processes becomes key to understand species interactions and eventually community responses to global change.

Benchmarking neuromorphic vision: lessons learnt from computer vision

PubMed Central

Tan, Cheston; Lallee, Stephane; Orchard, Garrick

2015-01-01

Neuromorphic Vision sensors have improved greatly since the first silicon retina was presented almost three decades ago. They have recently matured to the point where they are commercially available and can be operated by laymen. However, despite improved availability of sensors, there remains a lack of good datasets, while algorithms for processing spike-based visual data are still in their infancy. On the other hand, frame-based computer vision algorithms are far more mature, thanks in part to widely accepted datasets which allow direct comparison between algorithms and encourage competition. We are presented with a unique opportunity to shape the development of Neuromorphic Vision benchmarks and challenges by leveraging what has been learnt from the use of datasets in frame-based computer vision. Taking advantage of this opportunity, in this paper we review the role that benchmarks and challenges have played in the advancement of frame-based computer vision, and suggest guidelines for the creation of Neuromorphic Vision benchmarks and challenges. We also discuss the unique challenges faced when benchmarking Neuromorphic Vision algorithms, particularly when attempting to provide direct comparison with frame-based computer vision. PMID:26528120

Carcinogenicity of ambient air pollution: use of biomarkers, lessons learnt and future directions

PubMed Central

Vineis, Paolo

2015-01-01

The association between ambient air pollution (AAP) exposure and lung cancer risk has been investigated in prospective studies and the results are generally consistent, indicating that long-term exposure to air pollution can cause lung cancer. Biomarkers can enhance research on the health effects of air pollution by improving exposure assessment, increasing the understanding of mechanisms, and enabling the investigation of individual susceptibility. In this review, we assess DNA adducts as biomarkers of exposure to AAP and early biological effect, and DNA methylation as biomarker of early biological change and discuss critical issues arising from their incorporation in AAP health impact evaluations, such as confounding, individual susceptibilities, timing, intensity and duration of exposure, and investigated tissue. DNA adducts and DNA methylation are treated as paradigms. However, the lessons, learned from their use in the examination of AAP carcinogenicity, can be applied to investigations of other biomarkers involved in AAP carcinogenicity. PMID:25694819

The lessons of SARS in Hong Kong.

PubMed

Lai, Thomas Sik To; Yu, Wai Cho

2010-02-01

Severe acute respiratory syndrome (SARS) is a novel coronavirus infection which broke out in Hong Kong in March 2003. Princess Margaret Hospital was designated to manage this new, mysterious and serious disease. Healthcare workers had to work under extremely stressful and often risky conditions to care for patients. Despite manpower and equipment reinforcements, staff infection occurred as a result of bodily exhaustion, working in an unfamiliar environment and lapses in infection control. Patients suffered even more, not only due to physical discomfort, but also because of the fear of isolation and death away from family and friends. Health authorities learnt their lessons in the outbreak and formulated emergency plans for future infectious disease epidemics. The healthcare infrastructure has been examined and upgraded with regard to intensive care capacity, infection control measures, professional training, manpower deployment, staff facilities, and stockpiling of drugs and personal protective equipment.

Audit of prostate cancer: lessons learnt for current clinical practice, surrogates for quality of care and standardisation and quality assurance.

PubMed

Silcocks, P; Needham, P; Hemsley, F

1999-07-01

Two-hundred and fifty-one prostate cancer patients first registered during 1994 were sampled from a Regional Cancer Registry. In the six months after diagnosis, 39% received drug treatment alone, while 37% had no active treatment. Eighty-one percent of cases were histologically proven. Seventy-six percent had a prostate specific antigen (PSA) test and in 3% the PSA test was the basis for diagnosis. Of histologically proven cases 29% had a Gleason grade. None were staged by clinicians. Key lessons were: The result was a snapshot of current clinical practice which suggested other possible surrogates for quality of care, such as basis of stage and timing of investigations; There is a need for standardisation and quality assurance of the content of pathology reports; Standard treatment protocols would aid recording and comparison of treatments.

Lessons to be Learned from Recent Biosafety Incidents in the United States.

PubMed

Weiss, Shay; Yitzhaki, Shmuel; Shapira, Shmuel C

2015-05-01

During recent months, the Centers for Disease Control and Prevention (CDC) announced the occurrence of three major biosafety incidents, raising serious concern about biosafety and biosecurity guideline implementation in the most prestigious agencies in the United States: the CDC, the National Institutes of Health (NIH) and the Federal Drug Administration (FDA). These lapses included: a) the mishandling of Bacillus anthracis spores potentially exposing dozens of employees to anthrax; b) the shipment of low pathogenic influenza virus unknowingly cross-contaminated with a highly pathogenic strain; and c) an inventory lapse of hundreds of samples of biological agents, including six vials of variola virus kept in a cold storage room for decades, unnoticed. In this review we present the published data on these events, report the CDC inquiry's main findings, and discuss the key lessons to be learnt to ensure safer scientific practice in biomedical and microbiological service and research laboratories.

Nigerian response to the 2014 Ebola viral disease outbreak: lessons and cautions

PubMed Central

Oleribe, Obinna Ositadimma; Crossey, Mary Margaret Elizabeth; Taylor-Robinson, Simon David

2015-01-01

The Ebola virus disease outbreak that initially hit Guinea, Liberia and Senegal in 2014 was projected to affect Nigeria very badly when the first case was reported in July 2014. However, the outbreak was effectively and swiftly contained with only eight deaths out of 20 cases, confounding even the most optimistic predictions of the disease modelers. A combination of health worker and public education, a coordinated field epidemiology and laboratory training program (with prior experience in disease outbreak control in other diseases) and effective set-up of emergency operations centers were some of the measures that helped to confound the critics and contain what would have been an otherwise deadly outbreak in a densely populated country with a highly mobile population. This article highlights the measures taken in Nigeria and looks to the translatable lessons learnt for future disease outbreaks, whether that be from the Ebola virus or other infectious agents. PMID:26740841

Drug discovery: lessons from evolution

PubMed Central

Warren, John

2011-01-01

A common view within the pharmaceutical industry is that there is a problem with drug discovery and we should do something about it. There is much sympathy for this from academics, regulators and politicians. In this article I propose that lessons learnt from evolution help identify those factors that favour successful drug discovery. This personal view is influenced by a decade spent reviewing drug development programmes submitted for European regulatory approval. During the prolonged gestation of a new medicine few candidate molecules survive. This process of elimination of many variants and the survival of so few has much in common with evolution, an analogy that encourages discussion of the forces that favour, and those that hinder, successful drug discovery. Imagining a world without vaccines, anaesthetics, contraception and anti-infectives reveals how medicines revolutionized humanity. How to manipulate conditions that favour such discoveries is worth consideration. PMID:21395642

Inquiries into Malaysia's socio-technical disasters: recommendations and lessons learnt.

PubMed

Said, Aini Mat; Ahmadun, Fakhru'l-Razi; Abdul Kadir, Razali; Daud, Mohamed

2009-04-01

Most democratic countries hold inquiries into disasters. One of their key functions is to establish the cause of an event and to learn lessons in order to prevent a recurrence. In addition, they offer an opportunity for communal catharsis, permitting the public to vent anger, distress and frustration and to exert pressure for policy changes. Malaysia has experienced six landmark socio-technical disasters since 1968, which resulted in the proposal or amendment of various safety/emergency acts and regulations. The authors used a grounded theory approach utilising a constant comparative method to analyse the recommendations made by the inquiries into these events. Data indicate that social and technical recommendations comprise 85 and 15 per cent, respectively, of the total recommendations made by the inquiry committees. This paper offers suggestions for improving the management of inquiry tribunals, as they will remain a valuable source of information for society and corporations to learn from past incidents.

Doing Projects in a Foreign Language — Communications Management, Issues and Strategies

NASA Astrophysics Data System (ADS)

Xian, Deling

The Qinghai Salt Lake Industry Co. Ltd. (QSLIC) smelter project involves a Chinese state-owned client, a Canadian engineering company, their American technology partner, several Chinese design institutes and international vendors. Proper technical communication plays an important role during the development of a project in a foreign language and across cultures. Using the QSLIC project as an example, this paper presents the role of Communications Manager and personal qualifications required, as well as technical communications management, issues and strategies, lessons learnt while doing smelter projects in China and Chinese business culture and etiquette.

Helium refrigerator maintenance and reliability at the OPAL cold neutron source

NASA Astrophysics Data System (ADS)

Thiering, Russell; Taylor, David; Lu, Weijian

2012-06-01

Australia's first Cold Neutron Source (CNS) is a major asset to its nuclear research program. The CNS, and associated helium refrigerator, was commissioned in 2006 and is operated at the Open Pool Light Water nuclear Reactor (OPAL). The OPAL CNS operates a 20K, 5 kW Brayton cycle helium refrigerator. In this paper relevant experiences from helium refrigerator operation, maintenance and repair are presented along with the lessons learnt from a series of technical investigations. Turbine failure, due to volatile organic species, is discussed along with the related compressor oil degradation and oil separation efficiency.

Social and ethical issues in environmental risk management.

PubMed

Oughton, Deborah H

2011-07-01

The recognition of the social and ethical aspects of radiation risk management has been an important part of international projects following the Chernobyl accident of 1986. This study comments on the science and policy issues in environmental risk assessment, including the social and ethical dimensions of emergency preparedness and remediation experiences gained from the Chernobyl accident. While the unique situation of Fukushima, combined with an earthquake and tsunami, raises its own social and political challenges, it is hoped that some of the lessons learnt from Chernobyl will be relevant to long-term management of the Fukushima site. Copyright © 2011 SETAC.

Development of technology for lightweight Beryllium Cassegrain Telescope for space applications and lessons learnt

NASA Astrophysics Data System (ADS)

Greger, R.; Rugi, E.; Hausner, Th.; Jahnen, W.; Frei, S.; Pellaton, D.; Mueller, P.; Hollenbach, I.

2017-11-01

This paper gives an overview on the development of a light weighted Cassegrain telescope with a 200 mm optical aperture as one key element of the Laser Altimeter which will fly on the BepiColombo mission to Mercury (BELA).The Receiver Telescope (RTL) collects the light pulse transmitted to Mercury and reflected from the planet's surface. Mercury's challenging thermal environment, the thermo-mechanical stability of the telescope and the stringent instrument's mass budget require the implementation of an innovative design solution to achieve the requested optical performance over an extended temperature range.

The ALMA OT in early science: supporting multiple customers

NASA Astrophysics Data System (ADS)

Bridger, Alan; Williams, Stewart; McLay, Stewart; Yatagai, Hiroshi; Schilling, Marcus; Biggs, Andrew; Tobar, Rodrigo; Warmels, Rein H.

2012-09-01

The ALMA Observatory is currently operating 'Early Science' observing. The Cycle0 and Cycle1 Calls for Proposals are part of this Early Science, and in both the ALMA Observing Tool plays a crucial role. This paper describes how the ALMA OT tackles the problem of making millimeter/sub-millimeter interferometry accessible to the wider community, while allowing "experts" the power and flexibility they need. We will also describe our approach to the challenges of supporting multiple customers, and explore the lessons learnt from the Early Science experiences. Finally we look ahead to the challenges presented by future observing cycles.

The evolution of the simulation environment in the ALMA Observatory

NASA Astrophysics Data System (ADS)

Shen, Tzu-Chiang; Soto, Ruben; Saez, Norman; Velez, Gaston; Staig, Tomas; Sepulveda, Jorge; Saez, Alejandro; Ovando, Nicolas; Ibsen, Jorge

2016-07-01

The Atacama Large Millimeter /submillimeter Array (ALMA) has entered into operation phase since 2013. This transition changed the priorities within the observatory, in which, most of the available time will be dedicated to science observations at the expense of technical time. Therefore, it was planned to design and implement a new simulation environment, which must be comparable - or at least- be representative of the production environment. Concepts of model in the loop and hardware in the loop were explored. In this paper we review experiences gained and lessons learnt during the design and implementation of the new simulation environment.

Many diseases, one model of care?

PubMed Central

Albreht, Tit; Dyakova, Mariana; Schellevis, François G.

2016-01-01

Patients with multiple chronic conditions (multimorbidity) have complex and extensive health and social care needs that are not well served by current silo-based models of care. A lack of integration between care providers often leads to fragmented, incomplete, and ineffective care, leaving many patients overwhelmed and unable to navigate their way towards better health outcomes. In planning for the future, healthcare policies and models of care are required that cater for the complex needs of patients with multimorbidity and that deliver coordinated care that is patient-centred and focused on disease prevention, multidisciplinary teamwork and shared decision-making, and on empowering patients to self-manage. Salient lessons can be learnt from the work undertaken at a European and national level to develop care models in cancer and diabetes – two complex and often co-occurring conditions requiring coordinated long-term care. Innovative work is also underway in many European countries aimed at improving the integration of care for people with multimorbidity, resulting in more efficient and cost-effective health outcomes. This article reviews some of the most innovative programmes that have been initiated across and within Europe with the aim of improving the way care is delivered to people with complex and multiple long-term conditions. This work provides a foundation upon which to build better, more effective models of care for people with multimorbidity. PMID:29090167

Strengthening Indonesia’s Field Epidemiology Training Programme to address International Health Regulations requirements

PubMed Central

Samaan, Gina; Santoso, Hari; Kushadiwijaya, Haripurnomo; Juwita, Ratna; Mohadir, Andi; Aditama, Tjandra

2010-01-01

Abstract Problem According to the International Health Regulations (IHR), countries need to strengthen core capacity for disease surveillance and response systems. Many countries are establishing or enhancing their field epidemiology training programmes (FETPs) to meet human resource needs but face challenges in sustainability and training quality. Indonesia is facing these challenges, which include limited resources for field training and limited coordination in a newly decentralized health system. Approach A national FETP workplan was developed based on an evaluation of the existing programme and projected human resource needs. A Ministry of Health Secretariat linking universities, national and international partners was established to oversee revision and implementation of the FETP. Local setting The FETP is integrated into the curriculum of Indonesian universities and field training is conducted in district and provincial health offices under the coordination of the universities and the FETP Secretariat. Relevant changes The FETP was included in the Ministry of Health workforce development strategy through governmental decree. Curricula have been enhanced and field placements strengthened to provide trainees with better learning experiences. To improve sustainability of the FETP, links were established with the Indonesian Epidemiologists’ Association, local governments and donors to cultivate future FETP champions and maintain funding. Courses, competitions and discussion forums were established for field supervisors and alumni. These changes have increased the geographic distribution of students, intersectoral and international participation and the quality of student performance. Lessons learnt The main lesson learnt is that linkages with universities, ministries and international agencies such as the World Health Organization are critical for building a sustainable high-quality programme. The most critical factors were development of trusting relationships and clear definitions of the responsibilities of each stakeholder. PMID:20428389

Lessons learnt on recruitment and fieldwork from a pilot European human biomonitoring survey.

PubMed

Fiddicke, Ulrike; Becker, Kerstin; Schwedler, Gerda; Seiwert, Margarete; Joas, Reinhard; Joas, Anke; Biot, Pierre; Aerts, Dominique; Casteleyn, Ludwine; Dumez, Birgit; Castaño, Argelia; Esteban, Marta; Angerer, Jürgen; Koch, Holger M; Schoeters, Greet; Den Hond, Elly; Sepai, Ovnair; Exley, Karen; Knudsen, Lisbeth E; Horvat, Milena; Bloemen, Louis; Katsonouri, Andromachi; Hadjipanayis, Adamos; Cerna, Milena; Krsková, Andrea; Jensen, Janne Fangel; Nielsen, Jeanette K S; Rudnai, Peter; Közepésy, Szilvia; Gutleb, Arno C; Fischer, Marc E; Ligocka, Danuta; Kamińska, Joanna; Reis, M Fátima; Namorado, Sónia; Lupsa, Ioana-Rodica; Gurzau, Anca E; Halzlová, Katarína; Mazej, Darja; Tratnik, Janja Snoj; Rivas, Teresa C; Gómez, Silvia; Berglund, Marika; Larsson, Kristin; Lehmann, Andrea; Crettaz, Pierre; Dewolf, Marie-Christine; Burns, Damien; Kellegher, Anne; Kolossa-Gehring, Marike

2015-08-01

Within the European Environment and Health Action Plan an initiative to establish a coherent human biomonitoring approach in Europe was started. The project COPHES (COnsortium to Perform Human biomonitoring on a European Scale ) developed recommendations for a harmonized conduct of a human biomonitoring (HBM) survey which came into action as the pilot study DEMOCOPHES (DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale). Seventeen European countries conducted a survey with harmonized instruments for, inter alia, recruitment, fieldwork and sampling, in autumn/winter 2011/2012. Based on the countries' experiences of conducting the pilot study, following lessons learnt were compiled: the harmonized fieldwork instruments (basic questionnaire, urine and hair sampling) turned out to be very valuable for future HBM surveys on the European scale. A school approach was favoured by most of the countries to recruit school-aged children according to the established guidelines and country specific experiences. To avoid a low participation rate, intensive communication with the involved institutions and possible participants proved to be necessary. The communication material should also include information on exclusion criteria and offered incentives. Telephone contact to the participants the day before fieldwork during the survey can prevent the forgetting of appointments and first morning urine samples. To achieve comparable results on the European scale, training of interviewers in all issues of recruitment, fieldwork and sampling through information material and training sessions is crucial. A survey involving many European countries needs time for preparation and conduct. Materials for quality control prepared for all steps of recruitment, fieldwork and sampling proved to be important to warrant reliable results. Copyright © 2014 Elsevier Inc. All rights reserved.

Health impact assessment of agriculture and food policies: lessons learnt from the Republic of Slovenia.

PubMed

Lock, Karen; Gabrijelcic-Blenkus, Mojca; Martuzzi, Marco; Otorepec, Peter; Wallace, Paul; Dora, Carlos; Robertson, Aileen; Zakotnic, Jozica Maucec

2003-01-01

The most important public health priority in agricultural policy-making is currently food safety, despite the relatively higher importance of food security, nutrition, and other agricultural-related health issues in terms of global burden of disease. There is limited experience worldwide of using health impact assessment (HIA) during the development of agriculture and food policies, which perhaps reflects the complex nature of this policy sector. This paper presents methods of HIA used in the Republic of Slovenia, which is conducting a HIA of proposed agricultural and food policies due to its accession to the European Union. It is the first time that any government has attempted to assess the health effects of agricultural policy at a national level. The HIA has basically followed a six-stage process: policy analysis; rapid appraisal workshops with stakeholders from a range of backgrounds; review of research evidence relevant to the agricultural policy; analysis of Slovenian data for key health-related indicators; a report on the findings to a key cross-government group; and evaluation. The experience in Slovenia shows that the HIA process has been a useful mechanism for raising broader public health issues on the agricultural policy agenda, and it has already had positive results for policy formation. HIA is one useful approach to more integrated policy-making across sectors, but clearly it is not the only mechanism to achieve this. A comparison of the approach used in Slovenia with HIA methods in other countries and policy contexts shows that there are still many limitations with HIA application at a government level. Lessons can be learnt from these case studies for future development and application of HIA that is more relevant to policy-makers, and assists them in making more healthy policy choices.

Health impact assessment of agriculture and food policies: lessons learnt from the Republic of Slovenia.

PubMed Central

Lock, Karen; Gabrijelcic-Blenkus, Mojca; Martuzzi, Marco; Otorepec, Peter; Wallace, Paul; Dora, Carlos; Robertson, Aileen; Zakotnic, Jozica Maucec

2003-01-01

The most important public health priority in agricultural policy-making is currently food safety, despite the relatively higher importance of food security, nutrition, and other agricultural-related health issues in terms of global burden of disease. There is limited experience worldwide of using health impact assessment (HIA) during the development of agriculture and food policies, which perhaps reflects the complex nature of this policy sector. This paper presents methods of HIA used in the Republic of Slovenia, which is conducting a HIA of proposed agricultural and food policies due to its accession to the European Union. It is the first time that any government has attempted to assess the health effects of agricultural policy at a national level. The HIA has basically followed a six-stage process: policy analysis; rapid appraisal workshops with stakeholders from a range of backgrounds; review of research evidence relevant to the agricultural policy; analysis of Slovenian data for key health-related indicators; a report on the findings to a key cross-government group; and evaluation. The experience in Slovenia shows that the HIA process has been a useful mechanism for raising broader public health issues on the agricultural policy agenda, and it has already had positive results for policy formation. HIA is one useful approach to more integrated policy-making across sectors, but clearly it is not the only mechanism to achieve this. A comparison of the approach used in Slovenia with HIA methods in other countries and policy contexts shows that there are still many limitations with HIA application at a government level. Lessons can be learnt from these case studies for future development and application of HIA that is more relevant to policy-makers, and assists them in making more healthy policy choices. PMID:12894321

Infection surveillance after a natural disaster: lessons learnt from the Great East Japan Earthquake of 2011

PubMed Central

Oki, Tomoharu; Ishiki, Aiko; Shimanuki, Masaaki; Fuchimukai, Toru; Chosa, Toru; Chida, Shoichi; Nakamura, Yasuhide; Shima, Hiroji; Kanno, Michihiro; Matsuishi, Toyojiro; Ishiki, Mikihito; Urabe, Daisaku

2013-01-01

Abstract Problem On 11 March 2011, the Great East Japan Earthquake produced a catastrophic tsunami that devastated the city of Rikuzen-Takata and left it without an effective health infrastructure and at increased risk of outbreaks of disease. Approach On 2 May 2011, a disease-surveillance team was formed of volunteers who were clinicians or members of Rikuzen-Takata’s municipal government. The team’s main goal was to detect the early signs of disease outbreaks. Local setting Seven weeks after the tsunami, 16 support teams were providing primary health care in Rikuzen-Takata but the chain of command between them was poor and 70% of the city’s surviving citizens remained in evacuation centres. The communication tools that were available were generally inadequate. Relevant changes The surveillance team collected data from the city’s clinics by using a simple reporting form that could be completed without adding greatly to the workloads of clinicians. The summary findings were reported daily to clinics. The team also collaborated with public health nurses in rebuilding communication networks. Public health nurses alerted evacuation centres to epidemics of communicable disease. Lessons learnt Modern health-care systems are highly vulnerable to the loss of advanced technological tools. The initiation – or re-establishment – of disease surveillance following a natural disaster can therefore prove challenging even in a developed country. Surveillance should be promptly initiated after a disaster by (i) developing a surveillance system that is tailored to the local setting, (ii) establishing a support team network, and (iii) integrating the resources that remain – or soon become – locally available. PMID:24115802

Avoiding bias in medical ethical decision-making. Lessons to be learnt from psychology research.

PubMed

Albisser Schleger, Heidi; Oehninger, Nicole R; Reiter-Theil, Stella

2011-05-01

When ethical decisions have to be taken in critical, complex medical situations, they often involve decisions that set the course for or against life-sustaining treatments. Therefore the decisions have far-reaching consequences for the patients, their relatives, and often for the clinical staff. Although the rich psychology literature provides evidence that reasoning may be affected by undesired influences that may undermine the quality of the decision outcome, not much attention has been given to this phenomenon in health care or ethics consultation. In this paper, we aim to contribute to the sensitization of the problem of systematic reasoning biases by showing how exemplary individual and group biases can affect the quality of decision-making on an individual and group level. We are addressing clinical ethicists as well as clinicians who guide complex decision-making processes of ethical significance. Knowledge regarding exemplary group psychological biases (e.g. conformity bias), and individual biases (e.g. stereotypes), will be taken from the disciplines of social psychology and cognitive decision science and considered in the field of ethical decision-making. Finally we discuss the influence of intuitive versus analytical (systematical) reasoning on the validity of ethical decision-making.

Human transgenerational responses to early-life experience: potential impact on development, health and biomedical research

PubMed Central

Pembrey, Marcus; Saffery, Richard; Bygren, Lars Olov

2014-01-01

Mammalian experiments provide clear evidence of male line transgenerational effects on health and development from paternal or ancestral early-life exposures such as diet or stress. The few human observational studies to date suggest (male line) transgenerational effects exist that cannot easily be attributed to cultural and/or genetic inheritance. Here we summarise relevant studies, drawing attention to exposure sensitive periods in early life and sex differences in transmission and offspring outcomes. Thus, variation, or changes, in the parental/ancestral environment may influence phenotypic variation for better or worse in the next generation(s), and so contribute to common, non-communicable disease risk including sex differences. We argue that life-course epidemiology should be reframed to include exposures from previous generations, keeping an open mind as to the mechanisms that transmit this information to offspring. Finally, we discuss animal experiments, including the role of epigenetic inheritance and non-coding RNAs, in terms of what lessons can be learnt for designing and interpreting human studies. This review was developed initially as a position paper by the multidisciplinary Network in Epigenetic Epidemiology to encourage transgenerational research in human cohorts. PMID:25062846

Academic drug discovery: current status and prospects.

PubMed

Everett, Jeremy R

2015-01-01

The contraction in pharmaceutical drug discovery operations in the past decade has been counter-balanced by a significant rise in the number of academic drug discovery groups. In addition, pharmaceutical companies that used to operate in completely independent, vertically integrated operations for drug discovery, are now collaborating more with each other, and with academic groups. We are in a new era of drug discovery. This review provides an overview of the current status of academic drug discovery groups, their achievements and the challenges they face, together with perspectives on ways to achieve improved outcomes. Academic groups have made important contributions to drug discovery, from its earliest days and continue to do so today. However, modern drug discovery and development is exceedingly complex, and has high failure rates, principally because human biology is complex and poorly understood. Academic drug discovery groups need to play to their strengths and not just copy what has gone before. However, there are lessons to be learnt from the experiences of the industrial drug discoverers and four areas are highlighted for attention: i) increased validation of targets; ii) elimination of false hits from high throughput screening (HTS); iii) increasing the quality of molecular probes; and iv) investing in a high-quality informatics infrastructure.

Surrogacy in antiviral drug development

PubMed Central

Shaunak, Sunil; Davies, Donald S

2002-01-01

The coming of age of molecular biology has resulted in an explosion in our understanding of the pathogenesis of virus related diseases. New pathogens have been identified and characterized as being responsible for old diseases. Empirical clinical evaluation of morbidity and mortality as outcome measures after a therapeutic intervention have started to give way to the use of an increasing number of surrogate markers. Using a combination of these markers, it is now possible to measure and monitor the pathogen as well as the host's response. Nowhere is this better exemplified in virology than in the field of AIDS. We have utilized the advances in pathogenesis and new antiretroviral drug development to: develop a new class of drugs which block the entry of HIV-1 into cells.develop a new approach for effectively delivering these drugs to those tissues in which most viral replication takes place. Over the last 10 years, our work has progressed from concept to clinical trial. Our laboratory based evaluation of the new molecules developed as well as our clinical evaluation of their safety and efficacy have had to respond and adapt to the rapid changes taking place in AIDS research. This paper discusses the problems encountered and the lessons learnt. PMID:12100230

Rebuilding self-confidence after cancer: a feasibility study of life-coaching.

PubMed

Wagland, Richard; Fenlon, Deborah; Tarrant, Ruth; Howard-Jones, Gilly; Richardson, Alison

2015-03-01

Cancer survivors often experience decreased self-confidence which impacts negatively on their ability to self-manage the practical, social and emotional problems frequently faced as they emerge from end of treatment. This was a feasibility study of a life-coaching intervention, designed to rebuild confidence of survivors and support transition to life after cancer treatment. A one group pre-test, post-test design was used, recruiting participants from community organisations. Eligibility criteria are as follows: <1 year of completion of primary cancer treatment, aged >18, no metastases, and no mental health problems. Participants received one individualised face-to-face and five telephone coaching sessions over 3 months. Outcome measures are as follows: New General Self-Efficacy Scale, Hope Scale, Personal Well-being Index, Assessment of Survivorship Concerns, Quality of Life in Adult Cancer Survivors, Hospital Anxiety and Depression Scale, Social Difficulties Index, and a goal attainment score. Interviews explored feasibility, acceptability and impact of life-coaching and research design. Nine women and two men were recruited, representing varying cancer diagnoses. All outcome measures were sensitive to change and indicated positive trends post-intervention. Participant interviews indicated the intervention was well received and had a positive impact. Lessons were learnt about study design, recruitment and intervention delivery. Life-coaching has a potential to enable cancer survivors to manage the transition to life beyond cancer and effect change on a range of outcomes. The intervention was feasible to deliver and acceptable to survivors at a time when many struggle to make sense of life. It merits further evaluation through a randomised controlled trial.

Redesign and commissioning of sexual health services in England - a qualitative study.

PubMed

Walker, I F; Leigh-Hunt, N; Lee, A C K

2016-10-01

Responsibility for the commissioning of sexual and reproductive health (SRH) services transferred from the National Health Service to local authorities in England in 2013. This transfer prompted many local authorities to undertake new procurements of these SRH services. This study was undertaken to capture some of the lessons learnt in order to inform future commissioning and system redesign. A qualitative study was carried out involving semi-structured interviews. Interviews were conducted with 13 local authority sexual health commissioners in Yorkshire and the Humber from 11 interviews. Thematic analysis was used to identify themes from transcripts of the interviews with the 13 participants. Key themes identified were as follows: the challenge and complexity to those new to clinical commissioning; the prerequisites of robust infrastructural inputs to undertake the process, including technical expertise, a dependable project team, with clarity over the timescales and the budget; the requirement for good governance, stakeholder engagement and successful management of relationships with the latter; and the need to focus on the outcomes, aiming for value for money and improved system performance. Several key issues emerged from our study that significantly influenced the outcome of the redesign and commissioning process for sexual health services. An adapted model of the Donabedian evaluation framework was developed to provide a tool to inform future system redesign. Our model helps identify the key determinants for successful redesign in this context which is essential to both mitigate potential risks and maximize the likelihood of successful outcomes. Our model may have wider applications. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Polio Eradication–Lessons from the Past and Future Perspective

PubMed Central

P, Basavaraj; Singh, Shilpi; Singla, Ashish; Kundu, Hansa; Singh, Khushboo

2014-01-01

Background: India has recently achieved the “Polio free status” by WHO with stringent efforts of the Health Ministry to control its spread. However, we should not forget the lessons learnt from the failure of National malaria eradication Programme and National Tuberculosis control Programme which creates a need to assess the probable barriers for the various National Health Programmes. The present article presents an overview of the Polio Eradication programme in India highlighting the lessons learnt from the past. Also, it evaluates the reality behind full participation of Pulse Polio Programme. Materials and Methods: The study results of a cross-sectional survey conducted with an aim to assess the probable reasons and barriers behind non compliance of Pulse Polio Programme among parents of children (1-5 yr of age) of Modinagar area have also been discussed. The survey instrument was a structured, 10 item, closed ended questionnaire. Statistical analysis used: Chi-square test was used to analyze the difference between proportions of individual responses for each question and multiple logistic regression was used to assess relation between socio demographic parameter and absence from Polio Ravivaar. Results: The study reveals a surprising 68% attendance of Pulse Polio programme which is far behind the desired goal. Most of the parents who did not attend polio ravivaar considered that there was no need for the repetition of Polio vaccine (76.9%) followed by their fear that the vaccine might get contaminated during transportation (74.5%). A significant positive association was found between older age group of the eligible children (4-5 yr, O.R.1.52), female gender, illiterate parents, distance of more than one km from residence to vaccination and lack of source of information (O.R. 1.47). Conclusion: Efforts should be done to investigate the probable reasons behind non compliance for various immunization programmes to analyse the current situation in detail and formulate appropriate programs for coming years so that the efforts so far don’t go in vain and we secure a healthy Polio free nation for our future generations. PMID:25177640

Debate on MERS-CoV respiratory precautions: surgical mask or N95 respirators?

PubMed Central

Chung, Jasmine Shimin; Ling, Moi Lin; Seto, Wing Hong; Ang, Brenda Sze Peng; Tambyah, Paul Anantharajah

2014-01-01

Since the emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in mid-2012, there has been controversy over the respiratory precaution recommendations in different guidelines from various international bodies. Our understanding of MERS-CoV is still evolving. Current recommendations on infection control practices are heavily influenced by the lessons learnt from severe acute respiratory syndrome. A debate on respiratory precautions for MERS-CoV was organised by Infection Control Association (Singapore) and the Society of Infectious Disease (Singapore). We herein discuss and present the evidence for surgical masks for the protection of healthcare workers from MERS-CoV. PMID:25017402

Conservation of cultural heritage in minority ethnic regions in northwestern china—an exploration at Kuqa, Xinjiang

NASA Astrophysics Data System (ADS)

Wu, N.; Zhang, X.

2015-08-01

Kuqa, Xinjiang, is located at northwestern inland china. Traditionally a bridge between eastern and western civilizations, Kuqa had a history of cultural fusion and was left with abundant cultural heritage. As population increase, economic growth and social changes occurred, spontaneous renovation of the old city was affected, in which street fabric and scenes underwent damages. The paper demonstrates attempts made in various projects to achieve conservation of cultural heritage in agreement with economic development and improvement of living condition. The lessons learnt in these projects will be of value to development of other historic cities, especially in minority ethnic regions in China.

An educational partnership in health promotion for pre-registration nurses and further education college students.

PubMed

Abbott, Stephen; Thomas, Nicki; Apau, Daniel; Benato, Rosa; Hicks, Siobhan; MacKenzie, Karin

2012-07-01

This paper describes a partnership between a university and a college of further education, whereby first-year nursing students administered health checks to college students. Despite many challenges, the experience was positive for both sets of students and has been mainstreamed. Many lessons were learnt about how best to support nursing students to ensure a good quality experience for both student groups. Data gained from the health checks are also presented, and the programme is compared with the brief community placement that previous nursing students had undertaken at this stage of their training. Theoretical underpinnings for the programme are discussed.

Establishing and running a trauma and dissociation unit: a contemporary experience.

PubMed

Middleton, Warwick; Higson, David

2004-12-01

To evaluate the functioning of a trauma and dissociation unit that has run for the past 8 years in a private hospital, with particular regard to operating philosophy, operating parameters, challenges encountered, research and educational initiatives, and the applicability of the treatment model to other settings. Despite the challenges associated with significant difficulties in the corporate management of a private health-care system, it has been possible to operate an inpatient and day hospital programme tailored to the needs of patients in the dissociative spectrum, and the lessons learnt from this experience are valid considerations in the future planning of mental health services overall.

Lessons from natural and artificial polyploids in higher plants.

PubMed

Hegarty, M; Coate, J; Sherman-Broyles, S; Abbott, R; Hiscock, S; Doyle, J

2013-01-01

Polyploidy in higher plants is a major source of genetic novelty upon which selection may act to drive evolution, as evidenced by the widespread success of polyploid species in the wild. However, research into the effects of polyploidy can be confounded by the entanglement of several processes: genome duplication, hybridisation (allopolyploidy is frequent in plants) and subsequent evolution. The discovery of the chemical agent colchicine, which can be used to produce artificial polyploids on demand, has enabled scientists to unravel these threads and understand the complex genomic changes involved in each. We present here an overview of lessons learnt from studies of natural and artificial polyploids, and from comparisons between the 2, covering basic cellular and metabolic consequences through to alterations in epigenetic gene regulation, together with 2 in-depth case studies in Senecio and Glycine. See also the sister article focusing on animals by Arai and Fujimoto in this themed issue. Copyright © 2013 S. Karger AG, Basel.

Detection of spectroscopic binaries: lessons from the Gaia-ESO survey

NASA Astrophysics Data System (ADS)

van der Swaelmen, Mathieu; Merle, Thibault; van Eck, Sophie; Jorissen, Alain; Zwitter, Tomaž

2018-04-01

The Gaia-ESO survey (GES; Gilmore et al. (2012), Randich et al. (2013)) is a spectroscopic survey complementing the Gaia mission to bring accurate radial velocities and chemical abundances for 105 stars. Merle et al. (submitted to A&A see also this volume) developped a tool (DOE) to detect multiple peaks in the cross-correlation functions (CCFs) of GES spectra. Using the GIRAFFE HR10 and HR21 settings, we were able to compare the efficiency of our SB detection tool depending on the wavelength range and resolution. We show that a careful design of CCF masks can improve the detection rate in the HR21 settings. HR21 spectra are similar to the ones produced by the RVS spectrograph of the Gaia mission, though the lower resolution of RVS spectra may result in a lower detection efficiency than the case of HR21. Analysis of RVS spectra in the context of spectroscopic binaries can take advantage of the lessons learnt from the GES to maximize the detection rate.

Results and lessons from the GMOS survey of transiting exoplanet atmospheres

NASA Astrophysics Data System (ADS)

Todorov, Kamen; Desert, Jean-Michel; Huitson, Catherine; Bean, Jacob; Fortney, Jonathan; Bergmann, Marcel; Stevenson, Kevin

2018-01-01

We present results from the first comprehensive survey program dedicated to probing transiting exoplanet atmospheres using transmission spectroscopy with a multi-object spectrograph (MOS). Our four-years survey focussed on ten close-in giant planets for which the wavelength dependent transit depths in the visible were measured with Gemini/GMOS. We present the complete analysis of all the targets observed (50 transits, 300 hours), and the challenges to overcome to achieve the best spectrophotometric precision (200-500 ppm / 10 nm). We also present the main results and conclusions from this survey. We show that the precision achieved by this survey permits to distinguish hazy atmospheres from cloud-free ones. We discuss the challenges faced by such an experiment, and the lessons learnt for future MOS survey. We lay out the challenges facing future ground based MOS transit surveys aiming for the atmospheric characterization of habitable worlds, and utilizing the next generation of multi-object spectrographs mounted on extremely large ground based telescopes (ELT, TMT).

Building a model for day case hiatal surgery - Lessons learnt over a 10 year period in a high volume unit: A case series.

PubMed

Mistry, Pritesh; Zaman, Shafquat; Shapey, Iestyn; Daskalakis, Markos; Nijjar, Rajwinder; Richardson, Martin; Super, Paul; Singhal, Rishi

2018-06-01

Laparoscopic anti-reflux surgery has become the standard treatment for symptomatic gastro-oesophageal reflux disease refractory to medical therapy. Successful anti-reflux surgery involves safe, minimally invasive surgery, resulting in symptom resolution with minimal side effects. This study aims to assess the feasibility and safety of day case anti-reflux surgery focussing on peri- and post-operative outcomes as a measure of success. Data was collected from the hospital database from 2003 to 2012. Data collection included demographics, surgeon, mode of admission, length of stay and complications. Electronic records were independently scrutinised for all patients with a length of stay of more than two nights. 723 patients underwent laparoscopic fundoplication ± small hiatus hernia repair (<5 cm) with a day case rate of 67.1%. The 30 day readmission rate in these patients was 2.9% (21/723 patients). Nine patients had a failure of their initial laparoscopic fundoplication (defined as recurrence of symptoms). Three patients required a re-operation within 12 months of their initial procedure (re-operation rate = 0.41% (3/723 patients)). Laparoscopic hiatal surgery can be performed safely as a day case in high volume specialist centres with good outcomes. Raising the national standard for day case fundoplication promotes good practice and should be the model for future commissioning. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

A sustainable model for cochlear implantation in the developing world: perspectives from the Indian subcontinent.

PubMed

Sampath Kumar, Raghunandhan; Kameswaran, Mohan

2018-06-01

The overall prevalence of deafness in India is 0.2%, but the prevalence in the southern state of Tamil Nadu is much higher (around 0.6%) because of consanguinity. Especially in India, establishing cochlear implantation as a treatment modality for hearing loss has been a daunting task, but in the last decade, the cochlear implantation program has emerged as an unqualified success in many states, with over 20 000 cochlear implantations done till date. Several states are sponsoring free implants to children under the age of 6 years and below poverty line. Nearly 3000 cochlear implantations have been performed in Tamil Nadu under the Chief Minister's Comprehensive Health Insurance Scheme, with the goal to have a 'deafness free Tamil Nadu' by 2025. This scheme covers nearly 40 million people in rural areas. Valuable lessons have been learnt from this social experiment. One of the cornerstones of this scheme is the method to deliver habilitation via satellite centers in rural areas at the doorstep of the patient. The outcomes in peripheral centers were found to be statistically similar to those in the main center and correlated well with duration of habilitation. Opening up satellite centers for habilitation across the state of Tamil Nadu has greatly helped to improve the attendance and outcomes. The Indian model has been hugely successful and has helped start similar cochlear implantation programs in neighboring countries such as Nepal, Sri Lanka and Bangladesh.

Human resources for health: lessons from the cholera outbreak in Papua New Guinea

PubMed Central

Bieb, Sibauk; Clark, Geoff; Miller, Geoff; MacIntyre, Raina; Zwi, Anthony

2013-01-01

Issue Papua New Guinea is striving to achieve the minimum core requirements under the International Health Regulations in surveillance and outbreak response, and has experienced challenges in the availability and distribution of health professionals. Context Since mid-2009, a large cholera outbreak spread across lowland regions of the country and has been associated with more than 15 500 notifications at a case fatality ratio of 3.2%. The outbreak placed significant pressure on clinical and public health services. Action We describe some of the challenges to cholera preparedness and response in this human resource-limited setting, the strategies used to ensure effective cholera management and lessons learnt. Outcome Cholera task forces were useful to establish a clear system of leadership and accountability for cholera outbreak response and ensure efficiencies in each technical area. Cholera outbreak preparedness and response was strongest when human resource and health systems functioned well before the outbreak. Communication relied on coordination of existing networks and methods for empowering local leaders and villagers to modify behaviours of the population. Discussion In line with the national health emergencies plan, the successes of human resource strategies during the cholera outbreak should be built upon through emergency exercises, especially in non-affected provinces. Population needs for all public health professionals involved in health emergency preparedness and response should be mapped, and planning should be implemented to increase the numbers in relevant areas. Human resource planning should be integrated with health emergency planning. It is essential to maintain and strengthen the human resource capacities and experiences gained during the cholera outbreak to ensure a more effective response to the next health emergency. PMID:24319607

Choosing Important Health Outcomes for Comparative Effectiveness Research: An Updated Review and Identification of Gaps.

PubMed

Gorst, Sarah L; Gargon, Elizabeth; Clarke, Mike; Smith, Valerie; Williamson, Paula R

2016-01-01

The COMET (Core Outcome Measures in Effectiveness Trials) Initiative promotes the development and application of core outcome sets (COS), including relevant studies in an online database. In order to keep the database current, an annual search of the literature is undertaken. This study aimed to update a previous systematic review, in order to identify any further studies where a COS has been developed. Furthermore, no prioritization for COS development has previously been undertaken, therefore this study also aimed to identify COS relevant to the world's most prevalent health conditions. The methods used in this updated review followed the same approach used in the original review and the previous update. A survey was also sent to the corresponding authors of COS identified for inclusion in this review, to ascertain what lessons they had learnt from developing their COS. Additionally, the COMET database was searched to identify COS that might be relevant to the conditions with the highest global prevalence. Twenty-five reports relating to 22 new studies were eligible for inclusion in the review. Further improvements were identified in relation to the description of the scope of the COS, use of the Delphi technique, and the inclusion of patient participants within the development process. Additionally, 33 published and ongoing COS were identified for 13 of the world's most prevalent conditions. The development of a reporting guideline and minimum standards should contribute towards future improvements in development and reporting of COS. This study has also described a first approach to identifying gaps in existing COS, and to priority setting in this area. Important gaps have been identified, on the basis of global burden of disease, and the development and application of COS in these areas should be considered a priority.

Lessons learnt? The importance of metacognition and its implications for Cognitive Remediation in schizophrenia

PubMed Central

Cella, Matteo; Reeder, Clare; Wykes, Til

2015-01-01

The cognitive problems experienced by people with schizophrenia not only impede recovery but also interfere with treatments designed to improve overall functioning. Hence there has been a proliferation of new therapies to treat cognitive problems with the hope that improvements will benefit future intervention and recovery outcomes. Cognitive remediation therapy (CR) that relies on intensive task practice can support basic cognitive functioning but there is little evidence on how these therapies lead to transfer to real life skills. However, there is increasing evidence that CR including elements of transfer training (e.g., strategy use and problem solving schemas) produce higher functional outcomes. It is hypothesized that these therapies achieve higher transfer by improving metacognition. People with schizophrenia have metacognitive problems; these include poor self-awareness and difficulties in planning for complex tasks. This paper reviews this evidence as well as research on why metacognition needs to be explicitly taught as part of cognitive treatments. The evidence is based on research on learning spanning from neuroscience to the field of education. Learning programmes, and CRT, may be able to achieve better outcomes if they explicitly teach metacognition including metacognitive knowledge (i.e., awareness of the cognitive requirements and approaches to tasks) and metacognitive regulation (i.e., cognitive control over the different task relevant cognitive requirements). These types of metacognition are essential for successful task performance, in particular, for controlling effort, accuracy and efficient strategy use. We consider metacognition vital for the transfer of therapeutic gains to everyday life tasks making it a therapy target that may yield greater gains compared to cognition alone for recovery interventions. PMID:26388797

Fifteen years of sector-wide approach (SWAp) in Bangladesh health sector: an assessment of progress

PubMed Central

Ahsan, Karar Zunaid; Streatfield, Peter Kim; Ijdi, Rashida -E-; Escudero, Gabriela Maria; Khan, Abdul Waheed; Reza, M M

2016-01-01

The Ministry of Health and Family Welfare (MOHFW) of the Government of Bangladesh embarked on a sector-wide approach (SWAp) modality for the health, nutrition and population (HNP) sector in 1998. This programmatic shift initiated a different set of planning disciplines and practices along with institutional changes in the MOHFW. Over the years, the SWAp modality has evolved in Bangladesh as the MOHFW has learnt from its implementation and refined the program design. This article explores the progress made, both in terms of achievement of health outcomes and systems strengthening results, since the implementation of the SWAp for Bangladesh’s health sector. Secondary analyses of survey data from 1993 to 2011 as well as a literature review of published and grey literature on health SWAp in Bangladesh was conducted for this assessment. Results of the assessment indicate that the MOHFW made substantial progress in health outcomes and health systems strengthening. SWAps facilitated the alignment of funding and technical support around national priorities, and improved the government’s role in program design as well as in implementation and development partner coordination. Notable systemic improvements have taken place in the country systems with regards to monitoring and evaluation, procurement and service provision, which have improved functionality of health facilities to provide essential care. Implementation of the SWAp has, therefore, contributed to an accelerated improvement in key health outcomes in Bangladesh over the last 15 years. The health SWAp in Bangladesh offers an example of a successful adaptation of such an approach in a complex administrative structure. Based on the lessons learned from SWAp implementation in Bangladesh, the MOHFW needs to play a stronger stewardship and regulatory role to reap the full benefits of a SWAp in its subsequent programming. PMID:26582744

History of the Use of Esophageal Stent in Management of Dysphagia and Its Improvement Over the Years.

PubMed

Dua, Kulwinder S

2017-02-01

The art and science of using stents to treat dysphagia and seal fistula, leaks and perforations has been evolving. Lessons learnt from the deficiencies of previous models led to several improvements making stent deployment easier, and with some designs, it was also possible to remove the stents if needed. With these improvements, besides malignant dysphagia, newer indications for using stents emerged. Unfortunately, despite several decades of evolution, as yet, there is no perfect stent that "fits all." This article is an overview of how this evolution process happened and where we are currently with using stents to manage patients with dysphagia and with other esophageal disorders.

Preliminary Evaluation Of Commercial Supercapacitors For Space Applications

NASA Astrophysics Data System (ADS)

Gineste, Valery; Loup, Didier; Mattesco, Patrick; Neugnot, Nicolas

2011-10-01

Supercapacitors are identified since years as a new technology enabling energy storage together with high power delivery capability to the system. A recent ESA study [1] led by Astrium has demonstrated the interest of these devices for space application, providing that reliability and end of life performances are demonstrated. A realistic commercial on the shelf (COTS) approach (or with limited design modification approved by potential suppliers) has been favoured (as for batteries). This paper presents preliminary test results done by Astrium on COTS supercapacitors: accelerated life tests, calendar life tests, technology analyses. Based on these results, assessment and lessons learnt are drawn in view of future exhaustive supercapacitor validation and future qualification.

Cardiac stem cell therapy and arrhythmogenicity: prometheus and the arrows of Apollo and Artemis.

PubMed

Lyon, Alexander R; Harding, Sian E; Peters, Nicholas S

2008-09-01

Cardiac cell therapy is an expanding scientific field which is yielding new insights into the pathogenesis of cardiac disease and offers new therapeutic strategies. Inherent to both these areas of research are the electrical properties of individual cells, the electrical interplay between cardiomyocytes, and their roles in arrhythmogenesis. This review discusses the potential mechanisms by which various candidate cells for cardiac therapy may modulate the ventricular arrhythmic substrate and highlights the data and lessons learnt from the clinical cardiac cell therapy trials published to date. Pro- and antiarrhythmic mechanistic factors are discussed, and the importance of their consideration in the design of any future clinical cell therapy trials.

Biomechanical study of pelvic discontinuity in failed total hip arthroplasty. Lessons learnt from the treatment of pelvic fractures.

PubMed

Ribes-Iborra, Julio; Atienza, Carlos; Sevil-De la Torre, Jorge; Gómez Pérez, Amelia

2017-11-01

Pelvic discontinuity is a rare but serious problem in orthopedic surgery. Acetabular reconstruction in case of severe bone loss after failed total hip arthroplasty is technically difficult, especially in segmental loss type III (anterior or posterior) or pelvic discontinuity (type IV). Acetabular reinforcement devices are frequently used as load-sharing devices to allow allograft incorporation and in order to serve as support of acetabular implants. This study tries to show, by means of biomechanic work, the efficiency of reinforced plate in anterior column in a segmental pelvic loss, illustrated with a clinical case, which shows the socket stability of hip prosthesis. © 2017 Elsevier Ltd. All rights reserved.

Transonic Blunt Body Aerodynamic Coefficients Computation

NASA Astrophysics Data System (ADS)

Sancho, Jorge; Vargas, M.; Gonzalez, Ezequiel; Rodriguez, Manuel

2011-05-01

In the framework of EXPERT (European Experimental Re-entry Test-bed) accurate transonic aerodynamic coefficients are of paramount importance for the correct trajectory assessment and parachute deployment. A combined CFD (Computational Fluid Dynamics) modelling and experimental campaign strategy was selected to obtain accurate coefficients. A preliminary set of coefficients were obtained by CFD Euler inviscid computation. Then experimental campaign was performed at DNW facilities at NLR. A profound review of the CFD modelling was done lighten up by WTT results, aimed to obtain reliable values of the coefficients in the future (specially the pitching moment). Study includes different turbulence modelling and mesh sensitivity analysis. Comparison with the WTT results is explored, and lessons learnt are collected.

A United States perspective on long-term management of areas contaminated with radioactive materials.

PubMed

Jones, C Rick

2004-01-01

The US has far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. This experience base includes the Department of Energy's continued follow-up with Hiroshima and Nagasaki from the 1940s at the Radiological Effects Research Foundation in Hiroshima, Japan, the long-term management of the Marshall Islands Programme, the clean-up of the US nuclear weapons complex and the ongoing management of accident sites such as in Palomares, Spain. This paper discusses the lessons learnt and best practices gained from this far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. Copyright 2004 Oxford University Press

Aligning Technology with the Organisation Using Focus and User Groups

NASA Astrophysics Data System (ADS)

Owens, Simeon

As an IT Manager of nine years in a small healthcare organisation, which has transitioned from a minimal base of IT to fully fledged systems in place, I have discovered two structures which have helped enormously in this transition. These structures are firstly, the focus group, which looks at the IT requirements of the business, and secondly the user group, or a group of super users, which help in the day to day running of the systems. I have put together a number of lessons, which I have learnt over the years through experience of the workings of these groups, the benefits of them and the value they bring to the organisation.

Patient satisfaction questionnaire--how to do them successfully.

PubMed

Holt, Vernon P

2006-01-01

In the current consumer-orientated environment, customer surveys are widely used to assess needs and levels of satisfaction. For the dental practice to succeed, it is important to assess the needs and levels of satisfaction of the patients. The planning and execution of a Patient Satisfaction Questionnaire survey is discussed, along with the quality assurance and marketing benefits that may accrue to the practice applying the lessons learnt from the survey. A well run survey will not only reveal levels of patient satisfaction with the practice care and service--a Quality Assurance exercise--but will also enable the practitioner to assess--and even influence--patients' awareness of the levels of care and service being delivered--a marketing benefit.

Progressing MoodSwings. The upgrade and evaluation of MoodSwings 2.0: An online intervention for bipolar disorder.

PubMed

Lauder, S; Cosgrove, V E; Gliddon, E; Grimm, D; Dodd, S; Berk, L; Castle, D; Suppes, T S; Berk, M

2017-05-01

MoodSwings 2.0 is a self-guided online intervention for bipolar disorder. The intervention incorporates technological improvements on an earlier validated version of the intervention (MoodSwings 1.0). The previous MoodSwings trial provides this study with a unique opportunity to progress previous work, whilst being able to take into consideration lesson learnt, and technological enhancements. The structure and technology of MoodSwings 2.0 are described and the relevance to other online health interventions is highlighted. An international team from Australia and the US updated and improved the programs content pursuant to changes in DSM-5, added multimedia components and included larger numbers of participants in the group discussion boards. Greater methodological rigour in this trial includes an attention control condition, quarterly telephone assessments, and red flag alerts for significant clinical change. This paper outlines these improvements, including additional security and safety measures. A 3 arm RCT is currently evaluating the enhanced program to assess the efficacy of MS 2.0; the primary outcome is change in depressive and manic symptoms. To our knowledge this is the first randomized controlled online bipolar study with a discussion board attention control and meets the key methodological criteria for online interventions. Copyright © 2017. Published by Elsevier Inc.

Progressing MoodSwings. The upgrade and evaluation of MoodSwings 2.0: An online intervention for Bipolar Disorder

PubMed Central

Lauder, S.; Cosgrove, V.E.; Gliddon, E.; Grimm, D.; Dodd, S.; Berk, L.; Castle, D.; Suppes, T.S.; Berk, M.

2017-01-01

MoodSwings 2.0 is a self-guided online intervention for bipolar disorder. The intervention incorporates technological improvements on an earlier validated version of the intervention (MoodSwings 1.0). The previous MoodSwings trial provides this study with a unique opportunity to progress previous work, whilst being able to take into consideration lesson learnt, and technological enhancements. The structure and technology of MoodSwings 2.0 are described and the relevance to other online health interventions is highlighted. An international team from Australia and the US updated and improved the programs content pursuant to changes in DSM-5, added multimedia components and included larger numbers of participants in the group discussion boards. Greater methodological rigour in this trial includes an attention control condition, quarterly telephone assessments, and red flag alerts for significant clinical change. This paper outlines these improvements, including additional security and safety measures. A 3 arm RCT is currently evaluating the enhanced program to assess the efficacy of MS 2.0; the primary outcome is change in depressive and manic symptoms. To our knowledge this is the first randomised controlled online bipolar study with a discussion board attention control and meets the key methodological criteria for online interventions PMID:28257919

Understanding effects of armed conflict on health outcomes: the case of Nepal

PubMed Central

2010-01-01

Objective There is abundance of literature on adverse effects of conflict on the health of the population. In contrast to this, sporadic data in Nepal claim improvements in most of the health indicators during the decade-long armed conflict (1996-2006). However, systematic information to support or reject this claim is scant. This study reviews Nepal's key health indicators before and after the violent conflict and explores the possible factors facilitating the progress. Methods A secondary analysis has been conducted of two demographic health surveys-Nepal Family Health Survey (NFHS) 1996 and Nepal Demographic and Health Survey (NDHS) 2006; the latter was supplemented by a study carried out by the Nepal Health Research Council in 2006. Results The data show Nepal has made progress in 16 out of 19 health indicators which are part of the Millennium Development Goals whilst three indicators have remained static. Our analysis suggests a number of conflict and non-conflict factors which may have led to this success. Conclusion The lessons learnt from Nepal could be replicable elsewhere in conflict and post-conflict environments. A nationwide large-scale empirical study is needed to further assess the determinants of Nepal's success in the health sector at a time the country experienced a decade of armed conflict. PMID:21122098

Process evaluation of a tobacco prevention program in Indian schools—methods, results and lessons learnt

PubMed Central

Goenka, Shifalika; Tewari, Abha; Arora, Monika; Stigler, Melissa H.; Perry, Cheryl L.; Arnold, J. P. Saulina; Kulathinal, Sangita; Reddy, K. Srinath

2010-01-01

In India, 57% of men between 15 and 54 years and 10.8% of women between 15 and 49 years use tobacco. A wide variety of tobacco gets used and the poor and the underprivileged are the dominant victims of tobacco and its adverse consequences. Project MYTRI (Mobilizing Youth for Tobacco-Related Initiatives in India) was a tobacco prevention intervention program, a cluster-randomized trial in 32 Indian schools which aimed to decrease susceptibility to tobacco use among sixth- to ninth-grade students in urban settings in India. This culture-specific intervention, which addressed both smokeless and smoked forms of tobacco, was Indian in content and communication. We qualitatively developed indicators which would help accurately measure the dose of the intervention given, received and reached. A multi-staged process evaluation was done through both subjective and objective measures. Training the teachers critically contributed toward a rigorous implementation and also correlated with the outcomes, as did a higher proportion of students participating in the classroom discussions and better peer–leader–student communication. A sizeable proportion of subjective responses were ‘socially desirable’, making objective assessment a preferred methodology even for ‘dose received’. The peer-led health activism was successful. Teachers' manuals need to be concise. PMID:20884731

Non-attendance at counselling therapy in cocaine-using methadone-maintained patients: lessons learnt from an abandoned randomised controlled trial.

PubMed

Darker, C; Sweeney, B; El Hassan, H; Kelly, A; O' Connor, S; Smyth, B; Barry, J

2012-12-01

Recently, the authors commenced a randomised controlled trial to study the effectiveness of cognitive behavioural coping skills (CBCS) to reduce cocaine usage in methadone-maintained patients' in a clinical setting by assessing attendance at treatment sessions and outcomes in terms of cocaine use. However, recruitment into the study stopped when it became apparent that attendance at counselling sessions was poor. The aim of the current study was to determine the reasons for both non-attendance and attendance from a patient's perspective at counselling sessions. A cross-sectional design was employed whereby participants who were recruited for the original study were interviewed utilising a semi-structured interview format. Motivational inconsistencies were most frequently cited as the reason for dropping out of counselling, whereas a good relationship with staff was cited by attenders as the most important factors which aided their attendance at counselling sessions. Selecting opiate-dependent methadone-maintained cocaine abusers on the basis of their urine toxicology and offering them counselling as a way of reducing their harmful drug use did not prove efficacious. Attempting to address cocaine misuse within this cohort may need a more stepped approach including brief interventions, such as motivational interviewing, or other enhancers of motivation before we can test the effectiveness of CBCS in this population.

Ebola viral hemorrhagic disease outbreak in West Africa- lessons from Uganda.

PubMed

Mbonye, Anthony K; Wamala, Joseph F; Nanyunja, Miriam; Opio, Alex; Makumbi, Issa; Aceng, Jane Ruth

2014-09-01

There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda's experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt: The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.

Why did an effective Dutch complex psycho-social intervention for people with dementia not work in the German healthcare context? Lessons learnt from a process evaluation alongside a multicentre RCT.

PubMed

Voigt-Radloff, Sebastian; Graff, Maud; Leonhart, Rainer; Hüll, Michael; Rikkert, Marcel Olde; Vernooij-Dassen, Myrra

2011-08-09

Background The positive effects of the Dutch Community Occupational Therapy in Dementia programme on patients' daily functioning were not found in a multicentre randomised controlled trial (RCT) in Germany. Objectives To evaluate possible effect modification on the primary outcome within the German RCT with regard to (1) participant characteristics, (2) treatment performance and (3) healthcare service utilisation; and (4) to compare the design and primary outcome between the German and the original Dutch study. Methods (1) The impact of participant baseline data on the primary outcome was analysed in exploratory ANCOVA and regression analyses. (2) Therapists completed questionnaires on context and performance problems. The main problems were identified by a qualitative content analysis and focus-group discussion. Associations of the primary outcome with scores of participant adherence and treatment performance were evaluated by regression analysis. (3) Utilisation rates of healthcare services were controlled for significant group differences. (4) Differences in the Dutch and German study design were identified, and the primary outcome was contrasted at the item level. Results (1) Participant characteristics could not explain more than 5% of outcome variance. (2) The treatment performance of some active intervention components was poor but not significantly associated with the primary outcome. (3) There were no significant group differences in the utilisation of healthcare resources. (4) In contrast to the Dutch waiting-control group, the active intervention in the German control group may have reduced group differences in the current RCT. The German patients demonstrated a higher independence at baseline and less improvement in instrumental activities of daily living. Conclusion The differences in outcome may be explained by a more active control treatment, partially poor experimental treatment and less room for improvement in the German sample. Future cross-national transfers should be prepared by pilot studies assessing the applicability of the intervention and patient needs specific to the target country. Trial registration International Clinical Trials Registry Platform, DRKS00000053.

Lessons learnt from the first controlled human malaria infection study conducted in Nairobi, Kenya.

PubMed

Hodgson, Susanne H; Juma, Elizabeth; Salim, Amina; Magiri, Charles; Njenga, Daniel; Molyneux, Sassy; Njuguna, Patricia; Awuondo, Ken; Lowe, Brett; Billingsley, Peter F; Cole, Andrew O; Ogwang, Caroline; Osier, Faith; Chilengi, Roma; Hoffman, Stephen L; Draper, Simon J; Ogutu, Bernhards; Marsh, Kevin

2015-04-28

Controlled human malaria infection (CHMI) studies, in which healthy volunteers are infected with Plasmodium falciparum to assess the efficacy of novel malaria vaccines and drugs, have become a vital tool to accelerate vaccine and drug development. CHMI studies provide a cost-effective and expeditious way to circumvent the use of large-scale field efficacy studies to deselect intervention candidates. However, to date few modern CHMI studies have been performed in malaria-endemic countries. An open-label, randomized pilot CHMI study was conducted using aseptic, purified, cryopreserved, infectious P. falciparum sporozoites (SPZ) (Sanaria® PfSPZ Challenge) administered intramuscularly (IM) to healthy Kenyan adults (n = 28) with varying degrees of prior exposure to P. falciparum. The purpose of the study was to establish the PfSPZ Challenge CHMI model in a Kenyan setting with the aim of increasing the international capacity for efficacy testing of malaria vaccines and drugs, and allowing earlier assessment of efficacy in a population for which interventions are being developed. This was part of the EDCTP-funded capacity development of the CHMI platform in Africa. This paper discusses in detail lessons learnt from conducting the first CHMI study in Kenya. Issues pertinent to the African setting, including community sensitization, consent and recruitment are considered. Detailed reasoning regarding the study design (for example, dose and route of administration of PfSPZ Challenge, criteria for grouping volunteers according to prior exposure to malaria and duration of follow-up post CHMI) are given and changes other centres may want to consider for future studies are suggested. Performing CHMI studies in an African setting presents unique but surmountable challenges and offers great opportunity for acceleration of malaria vaccine and drug development. The reflections in this paper aim to aid other centres and partners intending to use the CHMI model in Africa.

Patience, Persistence and Pragmatism: Experiences and Lessons Learnt from the Implementation of Clinically Integrated Teaching and Learning of Evidence-Based Health Care – A Qualitative Study

PubMed Central

Young, Taryn; Rohwer, Anke; van Schalkwyk, Susan; Volmink, Jimmy; Clarke, Mike

2015-01-01

Background Clinically integrated teaching and learning are regarded as the best options for improving evidence-based healthcare (EBHC) knowledge, skills and attitudes. To inform implementation of such strategies, we assessed experiences and opinions on lessons learnt of those involved in such programmes. Methods and Findings We conducted semi-structured interviews with 24 EBHC programme coordinators from around the world, selected through purposive sampling. Following data transcription, a multidisciplinary group of investigators carried out analysis and data interpretation, using thematic content analysis. Successful implementation of clinically integrated teaching and learning of EBHC takes much time. Student learning needs to start in pre-clinical years with consolidation, application and assessment following in clinical years. Learning is supported through partnerships between various types of staff including the core EBHC team, clinical lecturers and clinicians working in the clinical setting. While full integration of EBHC learning into all clinical rotations is considered necessary, this was not always achieved. Critical success factors were pragmatism and readiness to use opportunities for engagement and including EBHC learning in the curriculum; patience; and a critical mass of the right teachers who have EBHC knowledge and skills and are confident in facilitating learning. Role modelling of EBHC within the clinical setting emerged as an important facilitator. The institutional context exerts an important influence; with faculty buy-in, endorsement by institutional leaders, and an EBHC-friendly culture, together with a supportive community of practice, all acting as key enablers. The most common challenges identified were lack of teaching time within the clinical curriculum, misconceptions about EBHC, resistance of staff, lack of confidence of tutors, lack of time, and negative role modelling. Conclusions Implementing clinically integrated EBHC curricula requires institutional support, a critical mass of the right teachers and role models in the clinical setting combined with patience, persistence and pragmatism on the part of teachers. PMID:26110641

Fallout radionuclide-based techniques for assessing the impact of soil conservation measures on erosion control and soil quality: an overview of the main lessons learnt under an FAO/IAEA Coordinated Research Project.

PubMed

Dercon, G; Mabit, L; Hancock, G; Nguyen, M L; Dornhofer, P; Bacchi, O O S; Benmansour, M; Bernard, C; Froehlich, W; Golosov, V N; Haciyakupoglu, S; Hai, P S; Klik, A; Li, Y; Lobb, D A; Onda, Y; Popa, N; Rafiq, M; Ritchie, J C; Schuller, P; Shakhashiro, A; Wallbrink, P; Walling, D E; Zapata, F; Zhang, X

2012-05-01

This paper summarizes key findings and identifies the main lessons learnt from a 5-year (2002-2008) coordinated research project (CRP) on "Assessing the effectiveness of soil conservation measures for sustainable watershed management and crop production using fallout radionuclides" (D1.50.08), organized and funded by the International Atomic Energy Agency through the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture. The project brought together nineteen participants, from Australia, Austria, Brazil, Canada, Chile, China, Japan, Morocco, Pakistan, Poland, Romania, Russian Federation, Turkey, United Kingdom, United States of America and Vietnam, involved in the use of nuclear techniques and, more particularly, fallout radionuclides (FRN) to assess the relative impacts of different soil conservation measures on soil erosion and land productivity. The overall objective of the CRP was to develop improved land use and management strategies for sustainable watershed management through effective soil erosion control practices, by the use of ¹³⁷Cs (half-life of 30.2 years), ²¹⁰Pb(ex) (half-life of 22.3 years) and ⁷Be (half-life of 53.4 days) for measuring soil erosion over several spatial and temporal scales. The environmental conditions under which the different research teams applied the tools based on the use of fallout radionuclides varied considerably--a variety of climates, soils, topographies and land uses. Nevertheless, the achievements of the CRP, as reflected in this overview paper, demonstrate that fallout radionuclide-based techniques are powerful tools to assess soil erosion/deposition at several spatial and temporal scales in a wide range of environments, and offer potential to monitor soil quality. The success of the CRP has stimulated an interest in many IAEA Member States in the use of these methodologies to identify factors and practices that can enhance sustainable agriculture and minimize land degradation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Australian experts' perspectives on a curriculum for psychologists working in primary health care: implication for Indonesia

PubMed Central

Setiyawati, Diana; Blashki, Grant; Wraith, Ruth; Colucci, Erminia; Minas, Harry

2014-01-01

In Indonesia there is a pressing need to scale up mental health services due to a substantial unmet need for mental health care. Integrating psychologists into primary health care can potentially deliver affordable mental health services to communities and help to close the treatment gap. Australia is one of the pioneers in integrating mental health into primary health care, and the mental health reforms in Australia may have some implications for Indonesia. The aim of this paper is to examine the Australian experience and to reflect in particular on lessons that may be learnt to inform the development of curriculum for psychologists working in primary health care in Indonesia. Data were collected through semi-structured interviews with 12 Australian experts in primary mental health care. The focus of the interview was on the roles and skills of psychologists working in primary health care with a particular focus on the appropriate curriculum for psychologists. Overall, the Australian experts agreed that psychologists' roles and training should include both clinical skills and public mental health skills. The experts also agreed that psychologists should be able to educate the community about mental health issues and be capable of undertaking research and evaluation of programs. A central theme was the need for strong collaborations with general practitioners and existing agencies in the community so that psychologists are able to make appropriate referrals and also accept referrals. The lessons learnt from the Australian experience, which are most applicable to the Indonesian setting are: (1) the importance of adequate government funding of psychologists; (2) the value of evidence-based treatments such as Cognitive Behavioural Therapy; (3) the need to specifically train psychologists for primary care; (4) the need for flexibility in the psychologist workforce (e.g. location); and (5) the value of continuing supervision for psychologists to support them in their role. PMID:25750829

Lessons learnt on biases and uncertainties in personal exposure measurement surveys of radiofrequency electromagnetic fields with exposimeters.

PubMed

Bolte, John F B

2016-09-01

Personal exposure measurements of radio frequency electromagnetic fields are important for epidemiological studies and developing prediction models. Minimizing biases and uncertainties and handling spatial and temporal variability are important aspects of these measurements. This paper reviews the lessons learnt from testing the different types of exposimeters and from personal exposure measurement surveys performed between 2005 and 2015. Applying them will improve the comparability and ranking of exposure levels for different microenvironments, activities or (groups of) people, such that epidemiological studies are better capable of finding potential weak correlations with health effects. Over 20 papers have been published on how to prevent biases and minimize uncertainties due to: mechanical errors; design of hardware and software filters; anisotropy; and influence of the body. A number of biases can be corrected for by determining multiplicative correction factors. In addition a good protocol on how to wear the exposimeter, a sufficiently small sampling interval and sufficiently long measurement duration will minimize biases. Corrections to biases are possible for: non-detects through detection limit, erroneous manufacturer calibration and temporal drift. Corrections not deemed necessary, because no significant biases have been observed, are: linearity in response and resolution. Corrections difficult to perform after measurements are for: modulation/duty cycle sensitivity; out of band response aka cross talk; temperature and humidity sensitivity. Corrections not possible to perform after measurements are for: multiple signals detection in one band; flatness of response within a frequency band; anisotropy to waves of different elevation angle. An analysis of 20 microenvironmental surveys showed that early studies using exposimeters with logarithmic detectors, overestimated exposure to signals with bursts, such as in uplink signals from mobile phones and WiFi appliances. Further, the possible corrections for biases have not been fully applied. The main findings are that if the biases are not corrected for, the actual exposure will on average be underestimated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lessons learnt from 20 years surveillance of malaria drug resistance prior to the policy change in Burkina Faso.

PubMed

Tinto, Halidou; Valea, Innocent; Ouédraogo, Jean-Bosco; Guiguemdé, Tinga Robert

2016-01-01

The history of drug resistance to the previous antimalarial drugs, and the potential for resistance to evolve to Artemisinin-based combination therapies, demonstrates the necessity to set-up a good surveillance system in order to provide early warning of the development of resistance. Here we report a review summarizing the history of the surveillance of drug resistance that led to the policy change in Burkina Faso. The first Plasmodium falciparum Chloroquine-Resistance strain identified in Burkina Faso was detected by an in vitro test carried out in Koudougou in 1983. Nevertheless, no further cases were reported until 1987, suggesting that resistant strains had been circulating at a low prevalence before the beginning of the systematic surveillance system from 1984. We observed a marked increase of Chloroquine-Resistance in 2002-2003 probably due to the length of follow-up as the follow-up duration was 7 or 14 days before 2002 and 28 days from 2002 onwards. Therefore, pre-2002 studies have probably under-estimated the real prevalence of Chloroquine-Resistance by not detecting the late recrudescence. With a rate of 8.2% treatment failure reported in 2003, Sulfadoxine-Pyrimethamine was still efficacious for the treatment of uncomplicated malaria in Burkina Faso but this rate might rapidly increase as the result of its spreading from neighboring countries and due to its current use for both the Intermittent Preventive Treatment in pregnant women and Seasonal Malaria Chemoprophylaxis. The current strategy for the surveillance of the Artemisinin-based combination treatments resistance should build on lessons learnt under the previous period of 20 years surveillance of Chloroquine and Sulfadoxine-Pyrimethamine resistance (1994-2004). The most important aspect being to extend the number of sentinel sites so that data would be less patchy and could help understanding the dynamic of the resistance.

Operational research in malawi: making a difference with cotrimoxazole preventive therapy in patients with tuberculosis and HIV

PubMed Central

2011-01-01

Background In Malawi, high case fatality rates in patients with tuberculosis, who were also co-infected with HIV, and high early death rates in people living with HIV during the initiation of antiretroviral treatment (ART) adversely impacted on treatment outcomes for the national tuberculosis and ART programmes respectively. This article i) discusses the operational research that was conducted in the country on cotrimoxazole preventive therapy, ii) outlines the steps that were taken to translate these findings into national policy and practice, iii) shows how the implementation of cotrimoxazole preventive therapy for both TB patients and HIV-infected patients starting ART was associated with reduced death rates, and iv) highlights lessons that can be learnt for other settings and interventions. Discussion District and facility-based operational research was undertaken between 1999 and 2005 to assess the effectiveness of cotrimoxazole preventive therapy in reducing death rates in TB patients and subsequently in patients starting ART under routine programme conditions. Studies demonstrated significant reductions in case fatality in HIV-infected TB patients receiving cotrimoxazole and in HIV-infected patients about to start ART. Following the completion of research, the findings were rapidly disseminated nationally at stakeholder meetings convened by the Ministry of Health and internationally through conferences and peer-reviewed scientific publications. The Ministry of Health made policy changes based on the available evidence, following which there was countrywide distribution of the updated policy and guidelines. Policy was rapidly moved to practice with the development of monitoring tools, drug procurement and training packages. National programme performance improved which showed a significant decrease in case fatality rates in TB patients as well as a reduction in early death in people with HIV starting ART. Summary Key lessons for moving this research endeavour through to policy and practice were the importance of placing operational research within the programme, defining relevant questions, obtaining "buy-in" from national programme staff at the beginning of projects and having key actors or "policy entrepreneurs" to push forward the policy-making process. Ultimately, any change in policy and practice has to benefit patients, and the ultimate judge of success is whether treatment outcomes improve or not. PMID:21794154

Emergency medical rescue efforts after a major earthquake: lessons from the 2008 Wenchuan earthquake.

PubMed

Zhang, Lulu; Liu, Xu; Li, Youping; Liu, Yuan; Liu, Zhipeng; Lin, Juncong; Shen, Ji; Tang, Xuefeng; Zhang, Yi; Liang, Wannian

2012-03-03

Major earthquakes often result in incalculable environmental damage, loss of life, and threats to health. Tremendous progress has been made in response to many medical challenges resulting from earthquakes. However, emergency medical rescue is complicated, and great emphasis should be placed on its organisation to achieve the best results. The 2008 Wenchuan earthquake was one of the most devastating disasters in the past 10 years and caused more than 370,000 casualties. The lessons learnt from the medical disaster relief effort and the subsequent knowledge gained about the regulation and capabilities of medical and military back-up teams should be widely disseminated. In this Review we summarise and analyse the emergency medical rescue efforts after the Wenchuan earthquake. Establishment of a national disaster medical response system, an active and effective commanding system, successful coordination between rescue forces and government agencies, effective treatment, a moderate, timely and correct public health response, and long-term psychological support are all crucial to reduce mortality and morbidity and promote overall effectiveness of rescue efforts after a major earthquake. Copyright © 2012 Elsevier Ltd. All rights reserved.

Developing `Butterfly Warriors': a Case Study of Science for Citizenship

NASA Astrophysics Data System (ADS)

Chen, Junjun; Cowie, Bronwen

2013-12-01

Given worldwide concern about a decline in student engagement in school science and an increasing call for science for citizenship in New Zealand Curriculum, this study focused on a butterfly unit that investigated how students in a year-4 primary classroom learnt about New Zealand butterflies through thinking, talking, and acting as citizen scientists. The butterfly unit included five lessons. The researchers observed the lessons and interviewed students and the classroom teacher. The students completed a unit evaluation survey after the unit. Findings indicate that the students enjoyed and were interested in activities such as reading about butterflies, learning and using new vocabulary, drawing butterfly life cycles, as well as hunting, tagging and releasing butterflies and publishing the data they had collected on a dedicated website. Through their participation in the unit, students had opportunities to act locally and globally, and to `see themselves' in science through `being there' experience. Units like this have the potential to develop students' interest for longer-term engagement in science, even those students who may never envision themselves as professional scientists.

Over-stimulation of insulin/IGF-1 signaling by western diet may promote diseases of civilization: lessons learnt from laron syndrome.

PubMed

Melnik, Bodo C; John, Swen Malte; Schmitz, Gerd

2011-06-24

The insulin/insulin-like growth factor-1 (IGF-1) pathway drives an evolutionarily conserved network that regulates lifespan and longevity. Individuals with Laron syndrome who carry mutations in the growth hormone receptor (GHR) gene that lead to severe congenital IGF-1 deficiency with decreased insulin/IGF-1 signaling (IIS) exhibit reduced prevalence rates of acne, diabetes and cancer. Western diet with high intake of hyperglycemic carbohydrates and insulinotropic dairy over-stimulates IIS. The reduction of IIS in Laron subjects unmasks the potential role of persistent hyperactive IIS mediated by Western diet in the development of diseases of civilization and offers a rational perspective for dietary adjustments with less insulinotropic diets like the Paleolithic diet.

Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment

PubMed Central

Trček, Denis

2016-01-01

Internet of Things (IoT) devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other) also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security. PMID:26729131

Validation & Safety Constraints: What We Want to Do… What We Can Do

NASA Astrophysics Data System (ADS)

Yepez, Amaya Atenicia; Peiro, Belen Martin; Bory, Stephane

2010-09-01

Autonomous safety critical systems require an exhaustive validation in order to guarantee robustness from different perspectives(SW, HW and algorithm design). In this paper we are presenting a performance validation approach dealing with an extensive list of difficulties, as lessons learnt from the space projects developed by GMV(e.g. within EGNOS and Galileo Programs). We will strongly recommend that the selected validation strategy is decided from the early stages of the system definition and it is carried out listening to the opinions and demands of all parties. In fact, to agree on the final solution, a trade-off will be needed in order to validate the requirements with the available means, in terms of amount of data and resources.

Source mechanisms of volcanic tsunamis.

PubMed

Paris, Raphaël

2015-10-28

Volcanic tsunamis are generated by a variety of mechanisms, including volcano-tectonic earthquakes, slope instabilities, pyroclastic flows, underwater explosions, shock waves and caldera collapse. In this review, we focus on the lessons that can be learnt from past events and address the influence of parameters such as volume flux of mass flows, explosion energy or duration of caldera collapse on tsunami generation. The diversity of waves in terms of amplitude, period, form, dispersion, etc. poses difficulties for integration and harmonization of sources to be used for numerical models and probabilistic tsunami hazard maps. In many cases, monitoring and warning of volcanic tsunamis remain challenging (further technical and scientific developments being necessary) and must be coupled with policies of population preparedness. © 2015 The Author(s).

Boosted objects and jet substructure at the LHC. Report of BOOST2012, held at IFIC Valencia, 23rd–27th of July 2012

DOE PAGES

Altheimer, A.; Arce, A.; Asquith, L.; ...

2014-03-21

This report of the BOOST2012 workshop presents the results of four working groups that studied key aspects of jet substructure. We discuss the potential of first-principle QCD calculations to yield a precise description of the substructure of jets and study the accuracy of state-of-the-art Monte Carlo tools. Limitations of the experiments’ ability to resolve substructure are evaluated, with a focus on the impact of additional (pile-up) proton proton collisions on jet substructure performance in future LHC operating scenarios. The final section summarizes the lessons learnt from jet substructure analyses in searches for new physics in the production of boosted topmore » quarks.« less

Wireless Sensors Grouping Proofs for Medical Care and Ambient Assisted-Living Deployment.

PubMed

Trček, Denis

2016-01-02

Internet of Things (IoT) devices are rapidly penetrating e-health and assisted living domains, and an increasing proportion among them goes on the account of computationally-weak devices, where security and privacy provisioning alone are demanding tasks, not to mention grouping proofs. This paper, therefore, gives an extensive analysis of such proofs and states lessons learnt to avoid possible pitfalls in future designs. It sticks with prudent engineering techniques in this field and deploys in a novel way the so called non-deterministic principle to provide not only grouping proofs, but (among other) also privacy. The developed solution is analyzed by means of a tangible metric and it is shown to be lightweight, and formally for security.

Active2Gether: A Personalized m-Health Intervention to Encourage Physical Activity.

PubMed

Klein, Michel C A; Manzoor, Adnan; Mollee, Julia S

2017-06-19

Lack of physical activity is an increasingly important health risk. Modern mobile technology, such as smartphones and digital measurement devices, provides new opportunities to tackle physical inactivity. This paper describes the design of a system that aims to encourage young adults to be more physically active. The system monitors the user's behavior, uses social comparison and provides tailored and personalized feedback based on intelligent reasoning mechanisms. As the name suggests, social processes play an important role in the Active2Gether system. The design choices and functioning of the system are described in detail. Based on the experiences with the development and deployment of the system, a number of lessons learnt are provided and suggestions are proposed for improvements in future developments.

Using Competitions to Engage the Public: Lessons Learnt from Rosetta

NASA Astrophysics Data System (ADS)

O'Flaherty, K. S.; Baldwin, E.; Mignone, C.; Homfeld, A. M.; Scuka, D.; Schepers, A.; Braun, M.; Croci, F.; Giacomini, L.; Journo, N.; Bauer, M.; McCaughrean, M.

2016-03-01

The year 2014 was an historic and challenging time for the Rosetta mission. On 20 January the spacecraft awoke from a 957-day hibernation; by August, it had arrived at Comet 67P/Churyumov-Gerasimenko; and in November, the lander Philae was deployed to the comet's surface. These milestones were communicated by traditional outreach channels -- on websites and via press events -- as well as through the extensive use of social media. To provide an opportunity for the public to participate actively in these milestones, the European Space Agency and its partners ran three competitions. In this article we outline how these competitions provided a means for the public to engage with what was to become one of the most exciting space science missions in decades.

Impact of a mental health teaching programme on adolescents.

PubMed

Naylor, Paul B; Cowie, Helen A; Walters, Stephen J; Talamelli, Lorenzo; Dawkins, Judith

2009-04-01

Child and adolescent mental health disorders are present in around 10% of the population. Research indicates that many young people possess negative attitudes towards mental health difficulties among peers. To assess the impact of a mental health teaching programme on adolescent pupils' understanding. Two-group pre-test-post-test control group study in two English secondary schools. Experimental classes (School E) received a six-lesson teaching intervention on mental health; control classes (School C) did not. Participants were 14- and 15-year-old pupils. The intervention consisted of six lessons on mental health issues common to young people: stress; depression; suicide/self-harm; eating disorders; being bullied; and intellectual disability. School C was given access to these lesson plans and materials on completion of the study. Understanding was measured at two time points, Time 1 (T(1)) and Time 2 (T(2)), 8 months apart, by a Mental Health Questionnaire. Behavioural, emotional and relationship strengths and difficulties were measured by the self-rated Strengths and Difficulties Questionnaire (SDQ) with five subscales: hyperactivity, emotional symptoms, conduct problems, peer problems and prosocial behaviour. At T(2), pupils in School E compared with those in School C showed significantly more sensitivity and empathy towards people with mental health difficulties. They also used significantly fewer pejorative expressions to describe mental health difficulties. There was a significant reduction in SDQ scores on conduct problems and a significant increase on prosocial behaviour among School E pupils compared with controls. Pupils valued the intervention highly, in particular the lessons on suicide/self-harm. Teaching 14- and 15-year-olds about mental health difficulties helps to reduce stigma by increasing knowledge and promoting positive attitudes. The intervention also reduced self-reported conduct problems and increased prosocial behaviour. Generally, participating pupils were positive about the importance of lessons on mental health, and said that they had learnt much about the lesson topics.

Lessons from SARS in an age of emerging infections.

PubMed

Ooi, Peng L I M; Lim, S; Tham, K W

2006-01-01

SARS, the first pandemic of this century, commanded the world's attention and required public health actions at the national and international levels. In an age of emerging infections, the lessons learnt from combating SARS can be used to improve our preparedness capabilities in three key areas to effectively tackle a public health emergency of international concern. The first area is in outbreak alert, which encompasses use of surveillance to detect, assess, notify and report events involving death or disease, and share information widely to enable proper risk assessment. The system must able to build up a comprehensive picture with appropriate warning for zoonotic diseases, environmental health and food safety. The second area is in public health response. In the event of an outbreak alert, the authorities must be able to quickly investigate cases/deaths and institute comprehensive control measures to break the chain of transmission. Protection of healthcare workers and reducing the opportunities for spread of infection through contact tracing and quarantine are important. The third area is in international health. This comprises health requirements for inbound and outbound travellers at the border checkpoints and global information exchange to mitigate the risks of travel abroad. Extrapolating these lessons to a wider public health context, our rapidly changing global infectious diseases situation mandates that we evaluate all available public health tools and build institutional capacity to effectively manage emerging infections.

Spaced Learning: The Design, Feasibility and Optimisation of SMART Spaces. Evaluation Report and Executive Summary

ERIC Educational Resources Information Center

O'Hare, Liam; Stark, Patrick; McGuinness, Carol; Biggart, Andy; Thurston, Allen

2017-01-01

This report describes the development and pilot evaluation of SMART Spaces. This programme aims to boost GCSE science outcomes by applying the principle that information is more easily learnt when it is repeated multiple times, with time passing between the repetitions. This approach is known as "spaced learning" and is contrasted with a…

Advance market commitment for pneumococcal vaccines: putting theory into practice.

PubMed

Cernuschi, Tania; Furrer, Eliane; Schwalbe, Nina; Jones, Andrew; Berndt, Ernst R; McAdams, Susan

2011-12-01

Markets for life-saving vaccines do not often generate the most desired outcomes from a public health perspective in terms of product quantity, quality, affordability, programmatic suitability and/or sustainability for use in the lowest income countries. The perceived risks and uncertainties about sustainably funded demand from developing countries often leads to underinvestment in development and manufacturing of appropriate products. The pilot initiative Advance Market Commitment (AMC) for pneumococcal vaccines, launched in 2009, aims to remove some of these market risks by providing a legally binding forward commitment to purchase vaccines according to predetermined terms. To date, 14 countries have already introduced pneumococcal vaccines through the AMC with a further 39 countries expected to introduce before the end of 2013.This paper describes early lessons learnt on the selection of a target disease and the core design choices for the pilot AMC. It highlights the challenges faced with tailoring the AMC design to the specific supply situation of pneumococcal vaccines. It points to the difficulty - and the AMC's apparent early success - in establishing a long-term, credible commitment in a constantly changing unpredictable environment. It highlights one of the inherent challenges of the AMC: its dependence on continuous donor funding to ensure long-term purchases of products. The paper examines alternative design choices and aims to provide a starting point to inform discussions and encourage debate about the potential application of the AMC concept to other fields.

What kind of leadership does integrated care need?

PubMed

Kelley-Patterson, Deirdre

2012-01-01

Primary care clinicians and clinical commissioners are the current focus for much leadership investment and development. In this article I propose that we need to look beyond traditional thinking about effective leader behaviour and conventional approaches to leader development based on this thinking. The paper identifies some of the lessons that can be learnt from both the current academic discussion of collaborative leadership, and from an analysis of successes and failures of leadership within the NHS. Two leadership strategies are considered: the development of communities of practice and the use of connected mini-transformations to generate wider system transformation. In a period of systems change, with potential for conflict between providers and commissioners, these strategies are helpful in encouraging the 'mindfulness' that is needed to ensure integration across the complex landscape of healthcare in London.

The data acquisition and reduction challenge at the Large Hadron Collider.

PubMed

Cittolin, Sergio

2012-02-28

The Large Hadron Collider detectors are technological marvels-which resemble, in functionality, three-dimensional digital cameras with 100 Mpixels-capable of observing proton-proton (pp) collisions at the crossing rate of 40 MHz. Data handling limitations at the recording end imply the selection of only one pp event out of each 10(5). The readout and processing of this huge amount of information, along with the selection of the best approximately 200 events every second, is carried out by a trigger and data acquisition system, supplemented by a sophisticated control and monitor system. This paper presents an overview of the challenges that the development of these systems has presented over the past 15 years. It concludes with a short historical perspective, some lessons learnt and a few thoughts on the future.

Rethinking 'academic' drug discovery: the Manchester Institute perspective.

PubMed

Jordan, Allan M; Waddell, Ian D; Ogilvie, Donald J

2015-05-01

The contraction in research within pharma has seen a renaissance in drug discovery within the academic setting. Often, groups grow organically from academic research laboratories, exploiting a particular area of novel biology or new technology. However, increasingly, new groups driven by industrial staff are emerging with demonstrable expertise in the delivery of medicines. As part of a strategic review by Cancer Research UK (CR-UK), the drug discovery team at the Manchester Institute was established to translate novel research from the Manchester cancer research community into drug discovery programmes. From a standing start, we have taken innovative approaches to solve key issues faced by similar groups, such as hit finding and target identification. Herein, we share our lessons learnt and successful strategies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hospital design for better infection control

PubMed Central

Lateef, Fatimah

2009-01-01

The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges PMID:20009307

[Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

PubMed

Boidin, B

2015-02-01

This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

Active2Gether: A Personalized m-Health Intervention to Encourage Physical Activity

PubMed Central

Klein, Michel C. A.; Manzoor, Adnan; Mollee, Julia S.

2017-01-01

Lack of physical activity is an increasingly important health risk. Modern mobile technology, such as smartphones and digital measurement devices, provides new opportunities to tackle physical inactivity. This paper describes the design of a system that aims to encourage young adults to be more physically active. The system monitors the user’s behavior, uses social comparison and provides tailored and personalized feedback based on intelligent reasoning mechanisms. As the name suggests, social processes play an important role in the Active2Gether system. The design choices and functioning of the system are described in detail. Based on the experiences with the development and deployment of the system, a number of lessons learnt are provided and suggestions are proposed for improvements in future developments. PMID:28629178

Over-stimulation of insulin/IGF-1 signaling by western diet may promote diseases of civilization: lessons learnt from laron syndrome

PubMed Central

2011-01-01

The insulin/insulin-like growth factor-1 (IGF-1) pathway drives an evolutionarily conserved network that regulates lifespan and longevity. Individuals with Laron syndrome who carry mutations in the growth hormone receptor (GHR) gene that lead to severe congenital IGF-1 deficiency with decreased insulin/IGF-1 signaling (IIS) exhibit reduced prevalence rates of acne, diabetes and cancer. Western diet with high intake of hyperglycemic carbohydrates and insulinotropic dairy over-stimulates IIS. The reduction of IIS in Laron subjects unmasks the potential role of persistent hyperactive IIS mediated by Western diet in the development of diseases of civilization and offers a rational perspective for dietary adjustments with less insulinotropic diets like the Paleolithic diet. PMID:21699736

Genetic evolution of pancreatic cancer: lessons learnt from the pancreatic cancer genome sequencing project

PubMed Central

Iacobuzio-Donahue, Christine A

2012-01-01

Pancreatic cancer is a disease caused by the accumulation of genetic alterations in specific genes. Elucidation of the human genome sequence, in conjunction with technical advances in the ability to perform whole exome sequencing, have provided new insight into the mutational spectra characteristic of this lethal tumour type. Most recently, exomic sequencing has been used to clarify the clonal evolution of pancreatic cancer as well as provide time estimates of pancreatic carcinogenesis, indicating that a long window of opportunity may exist for early detection of this disease while in the curative stage. Moving forward, these mutational analyses indicate potential targets for personalised diagnostic and therapeutic intervention as well as the optimal timing for intervention based on the natural history of pancreatic carcinogenesis and progression. PMID:21749982

[Risk of thyroid cancer occurrence by nuclear disasters and its countermeasures].

PubMed

Kumagai, Atsushi; Yamashita, Shunichi

2012-11-01

Looking back at the Great East Japan Earthquake on March 11, 2011, besides further studying the appropriateness of the initial response and post-countermeasures against the severe Fukushima nuclear accident, the importance of the epidemiological study in human health risk management and the comprehensive radiation protection standard need to be emphasized; lessons learnt from the Chernobyl accident should be also implemented. Therefore, since May 2011, Fukushima Prefecture has started the "Health Care Project (Fukushima Health Management Survey Project)" for the purpose of long-term health care administration and medical diagnosis/treatment for the prefectural residents. In this issue, risk and countermeasures of thyroid cancer occurrence by nuclear disasters, especially due to radioactive iodine will be discussed despite the difficult challenge of accurate estimation of low dose and low-dose rate radiation exposures.

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.

Project to expand diversity in the nursing workforce.

PubMed

Georges, Catherine

2012-05-01

The Bronx, one of the five boroughs of New York City, has a diverse population, but the largest ethnic group is Hispanic, or Latino. More than half (53 per cent) of the students at Lehman College of the City University of New York are from this group, reflecting the population demographic of the borough, but in 2006 Hispanic students comprised just 8 per cent of those enrolled in the department of nursing. To address this disparity, the department undertook a project to increase recruitment, retention and graduation of Hispanic nursing students. The project involved several activities in collaboration with a Bronx high school, Lehman College's baccalaureate nursing programme, and a partner hospital that serves thousands of people of Hispanic origin. This article describes the project and the lessons learnt.

Tracheal agenesis in a new born: lessons learnt.

PubMed

Naina, P; John, Mary; Kathar, Mohamed Abdul; Kumar, Manish

2018-06-17

Tracheal agenesis is a rare but fatal congenital tracheal malformation. Lack of prenatal symptom and a typical clinical presentation lead to failure to arrive at a correct diagnosis and confusion during resuscitation. We report a case of a newborn male child with type 2 tracheal agenesis. Despite a typical presentation, diagnosis was delayed after unsuccessful intubation, examination under anaesthesia and emergency tracheostomy. The embryology, diagnostic criteria and potential treatment options are discussed. This case report is valuable in increasing awareness of this rare condition and will help us in being better prepared in managing these children. Future studies should aim to find the optimal replacement for the tracheal. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Injection of a Body into a Geodesic: Lessons Learnt from the LISA Pathfinder Case

NASA Technical Reports Server (NTRS)

Bortoluzzi, Daniele; Armano, M.; Audley, H.; Auger, G.; Baird, J.; Binetruy, P.; Born, M.; Bortoluzzi, D.; Brandt, N.; Bursi, A.;

Assessing the value of real-time snow and avalanche information

NASA Astrophysics Data System (ADS)

Zeidler, Antonia; Adams, Marc; Schuster, Martin; Berner, Martin; Nagy, Wilhelm

2017-04-01

This poster presentation shows first results from a pilot study on exploring the possibilities of using existing and new information and communication technologies (ICT) for snow and avalanche assessments. Today, ICT solutions allow the utilisation of information at a high spatiotemporal resolution, due to the widespread availability of internet access, high computing power and affordable mobile devices. Therefore, there is an increasing request for up to date information on snow and avalanche decision-making. However, there are challenges that need to be addressed from different view points. These include topics in the field of technological feasibility of providing a stable network, exchanging trustworthy information and motivation of experts to participate. This contribution discusses the lessons-learnt, from the establishment of a platform to the user-experience.

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

Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda.

PubMed

Namazzi, Gertrude; Okuga, Monica; Tetui, Moses; Muhumuza Kananura, Rornald; Kakaire, Ayub; Namutamba, Sarah; Mutebi, Aloysius; Namusoke Kiwanuka, Suzanne; Ekirapa-Kiracho, Elizabeth; Waiswa, Peter

2017-08-01

Preventable maternal and newborn deaths can be averted through simple evidence-based interventions, such as the use of community health workers (CHWs), also known in Uganda as village health teams. However, the CHW strategy faces implementation challenges regarding training packages, supervision, and motivation. This paper explores knowledge levels of CHWs, describes the coverage of home visits, and shares lessons learnt from setting up and implementing the CHW strategy. The CHWs were trained to conduct four home visits: two during pregnancy and two after delivery. The aim of the visits was to promote birth preparedness and utilization of maternal and newborn health (MNH) services. Mixed methods of data collection were employed. Quantitative data were analyzed using Stata version 13.0 to determine the level and predictors of CHW knowledge of MNH. Qualitative data from 10 key informants and 15 CHW interviews were thematically analyzed to assess the implementation experiences. CHWs' knowledge of MNH improved from 41.3% to 77.4% after training, and to 79.9% 1 year post-training. However, knowledge of newborn danger signs declined from 85.5% after training to 58.9% 1 year later. The main predictors of CHW knowledge were age (≥ 35 years) and post-primary level of education. The level of coverage of at least one CHW visit to pregnant and newly delivered mothers was 57.3%. Notably, CHW reports complemented the facility-based health information. CHWs formed associations, which improved teamwork, reporting, and general performance, and thus maintained low dropout rates at 3.6%. Challenges included dissatisfaction with the quarterly transport refund of 6 USD and lack of means of transportation such as bicycles. CHWs are an important resource in community-based health information and improving demand for MNH services. However, the CHW training and supervision models require strengthening for improved performance. Local solutions regarding CHW motivation are necessary for sustainability.

Concepts and Contexts in Engineering and Technology Education: An International and Interdisciplinary Delphi Study

ERIC Educational Resources Information Center

Rossouw, Ammeret; Hacker, Michael; de Vries, Marc J.

2011-01-01

Inspired by a similar study by Osborne et al. we have conducted a Delphi study among experts to identify key concepts to be taught in engineering and technology education and relevant and meaningful contexts through which these concepts can be taught and learnt. By submitting the outcomes of the Delphi study to a panel of experts in a two-day…

Wolff-Parkinson-White syndrome: lessons learnt and lessons remaining.

PubMed

Benson, D Woodrow; Cohen, Mitchell I

2017-01-01

The Wolff-Parkinson-White pattern refers to the electrocardiographic appearance in sinus rhythm, wherein an accessory atrioventricular pathway abbreviates the P-R interval and causes a slurring of the QRS upslope - the "delta wave". It may be asymptomatic or it may be associated with orthodromic reciprocating tachycardia; however, rarely, even in children, it is associated with sudden death due to ventricular fibrillation resulting from a rapid response by the accessory pathway to atrial fibrillation, which itself seems to result from orthodromic reciprocating tachycardia. Historically, patients at risk for sudden death were characterised by the presence of symptoms and a shortest pre- excited R-R interval during induced atrial fibrillation <250 ms. Owing to the relatively high prevalence of asymptomatic Wolff-Parkinson-White pattern and availability of catheter ablation, there has been a need to identify risk among asymptomatic patients. Recent guidelines recommend invasive evaluation for such patients where pre-excitation clearly does not disappear during exercise testing. This strategy has a high negative predictive value only. The accuracy of this approach is under continued investigation, especially in light of other considerations: Patients having intermittent pre-excitation, once thought to be at minimal risk may not be, and the role of isoproterenol in risk assessment.

Borderline positive antineutrophil cytoplasmic antibodies (ANCA)-PR3/MPO detection in a large cohort tertiary center: lessons learnt from a real-life experience.

PubMed

Watad, Abdulla; Bragazzi, Nicola L; Sharif, Kassem; Gilburd, Boris; Yavne, Yarden; McGonagle, Dennis; Amital, Howard; Shoenfeld, Yehuda

2018-05-24

Enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence (IIF) are the best strategies for antineutrophil cytoplasmic antibodies (ANCA) detection. In a minority of subjects, ELISA-based ANCA testing may result in a borderline positive titre. Therefore, we assessed the clinical significance of such a result. This is a retrospective study, which included all subjects screened for ANCA subtypes (myeloperoxidase (MPO) or proteinase-3 (PR3)) with subsequent identification of borderline positive results, as determined by ELISA and retested using IIF. The demographic, clinical and laboratory data of subjects with borderline positive ANCA test results were extracted from their medical records. A total of 14,555 PR3/MPO-ANCA tests were performed with ELISA during the study period (2006-2016). Of the 14,555 PR3-ANCA antibody tests that were performed, 94 were borderline positive (titre 0.9-1.1), and of 14,555 MPO-ANCA antibody tests, 43 were borderline positive (titre 0.9-1.1). The male-to-female ratio was 1:1.08 and the mean age was 50.95±21.79 years. Four MPO-ANCA (9.30%) and 11 PR3-ANCA (11.70%) antibody borderline samples resulted positive on IIF testing. Subjects with borderline positive MPO-ANCA were found to have a poorer outcome in terms of renal failure and the requirement of dialysis. Subjects with borderline positive MPO-ANCA and positive p-ANCA (IIF) seem to have a less favorable outcome. Physicians should be aware of these findings and possibly perform a closer follow-up and routine screening for these subjects.

How to and how not to develop a theory of change to evaluate a complex intervention: reflections on an experience in the Democratic Republic of Congo.

PubMed

Maini, Rishma; Mounier-Jack, Sandra; Borghi, Josephine

2018-01-01

Theories of change (ToCs) describe how interventions can bring about long-term outcomes through a logical sequence of intermediate outcomes and have been used to design and measure the impact of public health programmes in several countries. In recognition of their capacity to provide a framework for monitoring and evaluation, they are being increasingly employed in the development sector. The construction of a ToC typically occurs through a consultative process, requiring stakeholders to reflect on how their programmes can bring about change. ToCs help make explicit any underlying assumptions, acknowledge the role of context and provide evidence to justify the chain of causal pathways. However, while much literature exists on how to develop a ToC with respect to interventions in theory, there is comparatively little reflection on applying it in practice to complex interventions in the health sector. This paper describes the initial process of developing a ToC to inform the design of an evaluation of a complex intervention aiming to improve government payments to health workers in the Democratic Republic of Congo. Lessons learnt include: the need for the ToC to understand how the intervention produces effects on the wider system and having broad stakeholder engagement at the outset to maximise chances of the intervention's success and ensure ownership. Power relationships between stakeholders may also affect the ToC discourse but can be minimised by having an independent facilitator. We hope these insights are of use to other global public health practitioners using this approach to evaluate complex interventions.

Mobile phones support adherence and retention of indigenous participants in a randomised controlled trial: strategies and lessons learnt.

PubMed

McCallum, Gabrielle B; Versteegh, Lesley A; Morris, Peter S; Mckay, Clare C; Jacobsen, Nerida J; White, Andrew V; D'Antoine, Heather A; Chang, Anne B

2014-06-18

Ensuring adherence to treatment and retention is important in clinical trials, particularly in remote areas and minority groups. We describe a novel approach to improve adherence, retention and clinical review rates of Indigenous children. This descriptive study was nested within a placebo-controlled, randomised trial (RCT) on weekly azithromycin (or placebo) for 3-weeks. Indigenous children aged ≤24-months hospitalised with acute bronchiolitis were recruited from two tertiary hospitals in northern Australia (Darwin and Townsville). Using mobile phones embedded within a culturally-sensitive approach and framework, we report our strategies used and results obtained. Our main outcome measure was rates of adherence to medications, retention in the RCT and self-presentation (with child) to clinic for a clinical review on day-21. Of 301 eligible children, 76 (21%) families declined participation and 39 (13%) did not have access to a mobile phone. 186 Indigenous children were randomised and received dose one under supervision in hospital. Subsequently, 182 (99%) children received dose two (day-7), 169 (93%) dose three (day-14) and 180 (97%) attended their clinical review (day-21). A median of 2 calls (IQR 1-3) were needed to verify adherence. Importantly, over 97% of children remained in the RCT until their clinical endpoint at day-21. In our setting, the use of mobile phones within an Indigenous-appropriate framework has been an effective strategy to support a clinical trial involving Australian Indigenous children in urban and remote Australia. Further research is required to explore other applications of this approach, including the impact on clinical outcomes. ACTRN12608000150347 (RCT component).

Setting up a clinical trial for a novel disease: a case study of the Doxycycline for the Treatment of Nodding Syndrome Trial – challenges, enablers and lessons learned

PubMed Central

Anguzu, Ronald; Akun, Pamela R; Ogwang, Rodney; Shour, Abdul Rahman; Sekibira, Rogers; Ningwa, Albert; Nakamya, Phellister; Abbo, Catherine; Mwaka, Amos D; Opar, Bernard; Idro, Richard

2018-01-01

ABSTRACT A large amount of preparation goes into setting up trials. Different challenges and lessons are experienced. Our trial, testing a treatment for nodding syndrome, an acquired neurological disorder of unknown cause affecting thousands of children in Eastern Africa, provides a unique case study. As part of a study to determine the aetiology, understand pathogenesis and develop specific treatment, we set up a clinical trial in a remote district hospital in Uganda. This paper describes our experiences and documents supportive structures (enablers), challenges faced and lessons learned during set-up of the trial. Protocol development started in September 2015 with phased recruitment of a critical study team. The team spent 12 months preparing trial documents, procurement and training on procedures. Potential recruitment sites were pre-visited, and district and local leaders met as key stakeholders. Key enablers were supportive local leadership and investment by the district and Ministry of Health. The main challenges were community fears about nodding syndrome, adverse experiences of the community during previous research and political involvement. Other challenges included the number and delays in protocol approvals and lengthy procurement processes. This hard-to-reach area has frequent power and Internet fluctuations, which may affect cold chains for study samples, communication and data management. These concerns decreased with a pilot community engagement programme. Experiences and lessons learnt can reduce the duration of processes involved in trial-site set-up. A programme of community engagement and local leader involvement may be key to the success of a trial and in reducing community opposition towards participation in research. PMID:29382251

Setting up a clinical trial for a novel disease: a case study of the Doxycycline for the Treatment of Nodding Syndrome Trial - challenges, enablers and lessons learned.

PubMed

Anguzu, Ronald; Akun, Pamela R; Ogwang, Rodney; Shour, Abdul Rahman; Sekibira, Rogers; Ningwa, Albert; Nakamya, Phellister; Abbo, Catherine; Mwaka, Amos D; Opar, Bernard; Idro, Richard

2018-01-01

A large amount of preparation goes into setting up trials. Different challenges and lessons are experienced. Our trial, testing a treatment for nodding syndrome, an acquired neurological disorder of unknown cause affecting thousands of children in Eastern Africa, provides a unique case study. As part of a study to determine the aetiology, understand pathogenesis and develop specific treatment, we set up a clinical trial in a remote district hospital in Uganda. This paper describes our experiences and documents supportive structures (enablers), challenges faced and lessons learned during set-up of the trial. Protocol development started in September 2015 with phased recruitment of a critical study team. The team spent 12 months preparing trial documents, procurement and training on procedures. Potential recruitment sites were pre-visited, and district and local leaders met as key stakeholders. Key enablers were supportive local leadership and investment by the district and Ministry of Health. The main challenges were community fears about nodding syndrome, adverse experiences of the community during previous research and political involvement. Other challenges included the number and delays in protocol approvals and lengthy procurement processes. This hard-to-reach area has frequent power and Internet fluctuations, which may affect cold chains for study samples, communication and data management. These concerns decreased with a pilot community engagement programme. Experiences and lessons learnt can reduce the duration of processes involved in trial-site set-up. A programme of community engagement and local leader involvement may be key to the success of a trial and in reducing community opposition towards participation in research.

Fifteen years of sector-wide approach (SWAp) in Bangladesh health sector: an assessment of progress.

PubMed

Ahsan, Karar Zunaid; Streatfield, Peter Kim; Ijdi, Rashida-E-; Escudero, Gabriela Maria; Khan, Abdul Waheed; Reza, M M

2016-06-01

The Ministry of Health and Family Welfare (MOHFW) of the Government of Bangladesh embarked on a sector-wide approach (SWAp) modality for the health, nutrition and population (HNP) sector in 1998. This programmatic shift initiated a different set of planning disciplines and practices along with institutional changes in the MOHFW. Over the years, the SWAp modality has evolved in Bangladesh as the MOHFW has learnt from its implementation and refined the program design. This article explores the progress made, both in terms of achievement of health outcomes and systems strengthening results, since the implementation of the SWAp for Bangladesh's health sector. Secondary analyses of survey data from 1993 to 2011 as well as a literature review of published and grey literature on health SWAp in Bangladesh was conducted for this assessment. Results of the assessment indicate that the MOHFW made substantial progress in health outcomes and health systems strengthening. SWAps facilitated the alignment of funding and technical support around national priorities, and improved the government's role in program design as well as in implementation and development partner coordination. Notable systemic improvements have taken place in the country systems with regards to monitoring and evaluation, procurement and service provision, which have improved functionality of health facilities to provide essential care. Implementation of the SWAp has, therefore, contributed to an accelerated improvement in key health outcomes in Bangladesh over the last 15 years. The health SWAp in Bangladesh offers an example of a successful adaptation of such an approach in a complex administrative structure. Based on the lessons learned from SWAp implementation in Bangladesh, the MOHFW needs to play a stronger stewardship and regulatory role to reap the full benefits of a SWAp in its subsequent programming. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Eighteen-month follow-up of a play-based intervention to improve the social play skills of children with attention deficit hyperactivity disorder.

PubMed

Wilkes-Gillan, Sarah; Bundy, Anita; Cordier, Reinie; Lincoln, Michelle

2014-10-01

There is a well-documented need for interventions to successfully address the social difficulties of children with attention deficit hyperactivity disorder. This study aimed to further the development of a previously conducted pilot of a play-based intervention. To achieve this, children's social play outcomes pre-post and 18-month following the intervention were examined by raters unaware of the study's purpose. Additionally, parents' experiences of the intervention were explored. Participants included five children with attention deficit hyperactivity disorder who had participated in a play-based intervention and their typically developing playmates; parents of children with attention deficit hyperactivity disorder also participated. Children and their playmates attended an 18-month follow-up play session and parents participated in semi-structured interviews. The Test of Playfulness was used to measure children's play outcomes in the context of social play with a peer, pre-post and 18-months following the intervention. Wilcoxon signed-ranks (Z) and Cohen's-d were used to measure effect. Thematic analysis was used to analyse reoccurring themes from parents' interviews. Children's social play outcomes improved pre-post intervention (Z = 2.02; P = 0.04; d = 1.6) and were maintained 18-month post intervention (Z = 0.14; P = 0.89; d = -0.4). Core themes included: the intervention as an enjoyable experience, a common language for talking about play/social interactions, an observable change in children's skills, transference of skills and the need for support to refresh learnt lessons over time. The intervention demonstrated preliminary and long-term efficacy in developing the social play skills of children with attention deficit hyperactivity disorder. Further research is required to optimise intervention feasibility and parent involvement prior to conducting a large-scale research. © 2014 Occupational Therapy Australia.

Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings.

PubMed

Theilen, Ulf; Fraser, Laura; Jones, Patricia; Leonard, Paul; Simpson, Dave

2017-06-01

The introduction of a paediatric Medical Emergency Team (pMET) was accompanied by weekly in-situ simulation team training. Key ward staff participated in team training, focusing on recognition of the deteriorating child, teamwork and early involvement of senior staff. Following an earlier study [1], this investigation aimed to evaluate the long-term impact of ongoing regular team training on hospital response to deteriorating ward patients, patient outcome and financial implications. Prospective cohort study of all deteriorating in-patients in a tertiary paediatric hospital requiring admission to paediatric intensive care (PICU) the year before, 1year after and 3 years after the introduction of pMET and team training. Deteriorating patients were recognised more promptly (before/1year after/3years after pMET; median time 4/1.5/0.5h, p<0.001), more often reviewed by consultants (45%/76%/81%, p<0.001) and more rapidly escalated to PICU (median time 10.5/5/3.5h, p=0.02). There was a significant reduction in associated PICU admissions (56/51/32, p=0.02) and PICU bed days (527/336/193, p<0.001). The total annual cost of training (£74,250) was more than offset by savings from reduced PICU bed days (£801,600 per annum). Introduction of pMET coincided with significantly reduced hospital mortality (p<0.001). These results indicate that lessons learnt by ward staff during team training led to sustained improvements in the hospital response to critically deteriorating in-patients, significantly improved patient outcomes and substantial savings. Integration of regular in-situ simulation training of medical emergency teams, including key ward staff, in routine clinical care has potential application in all acute specialties. Copyright © 2017. Published by Elsevier B.V.

Integrated community case management of malaria, pneumonia and diarrhoea across three African countries: A qualitative study exploring lessons learnt and implications for further scale up

PubMed Central

Strachan, Clare; Wharton–Smith, Alexandra; Sinyangwe, Chomba; Mubiru, Denis; Ssekitooleko, James; Meier, Joslyn; Gbanya, Miatta; Tibenderana, James K.; Counihan, Helen

2014-01-01

Numerous studies highlight the effectiveness of an integrated approach for the management of malaria, pneumonia and diarrhoea at the community level. There has however been little study on lessons learnt from implementation in practice and stakeholder experiences which could inform future programmatic planning and evaluation frameworks. A participatory, qualitative evaluation was conducted in the three varied settings of South Sudan, Uganda and Zambia, which have seen the scale up of integrated community case management (iCCM) over the last five years. All key in–country stakeholders were consulted on study design, with a particular focus on scope and methodology. Data collection methods included stakeholder consultations (key informant interviews, focus group discussions), and a review of project and Ministry of Health documentation. Data analysis followed the Framework Approach. Results suggest that iCCM implementation generally followed national pre–agreed guidelines. Overarching key programmatic recommendations included: collaboration with implementing partners in planning stages to positively impact on community acceptance and ownership; adoption of participatory training methods adapted to low literacy populations; development of alternative support supervision methods such as peer support groups; full integration of community level data into the health management information system and emphasizing data analysis, use and feedback at all levels; strengthened supply chains through improved quantification and procurement of commodities in conjunction with the national distribution network; community engagement to establish a support system for community health workers to increase their motivation; enhanced sensitisation and behaviour change communication to raise awareness and usage of appropriate health services; and advocacy at the national level for funding and logistical support for the continuation and integration of iCCM. This qualitative study is a valuable contribution in understanding the ‘hows’ of iCCM implementation with key insights for improved feasibility and acceptability. Main findings show how community support to iCCM and community health workers is necessary for sustained health benefits coupled with a focus on strengthening and ‘enabling’ the public health system. The participatory study design and methodologies used enabled the scope of the research enquiry to effectively capture various stakeholder perspectives. PMID:25520794

Incorporating Semantics into Data Driven Workflows for Content Based Analysis

NASA Astrophysics Data System (ADS)

Argüello, M.; Fernandez-Prieto, M. J.

Finding meaningful associations between text elements and knowledge structures within clinical narratives in a highly verbal domain, such as psychiatry, is a challenging goal. The research presented here uses a small corpus of case histories and brings into play pre-existing knowledge, and therefore, complements other approaches that use large corpus (millions of words) and no pre-existing knowledge. The paper describes a variety of experiments for content-based analysis: Linguistic Analysis using NLP-oriented approaches, Sentiment Analysis, and Semantically Meaningful Analysis. Although it is not standard practice, the paper advocates providing automatic support to annotate the functionality as well as the data for each experiment by performing semantic annotation that uses OWL and OWL-S. Lessons learnt can be transmitted to legacy clinical databases facing the conversion of clinical narratives according to prominent Electronic Health Records standards.

Dedifferentiated liposarcoma of the deep (paralaryngeal) soft tissue: lessons learnt from a case with a partly deceptively benign appearing dedifferentiated component.

PubMed

Petersson, Fredrik; Murugasu, Euan

2014-06-01

We present a case (female, 61 years of age) of dedifferentiated liposarcoma of the deep, cervical (paralaryngeal) soft tissue with a significant myxoid component and characteristic immunohistochemical (strong and diffuse expression of p16, mdm2 and cdk4 in both the well differentiated liposarcomatous and dedifferentiated components) and molecular genetic findings (MDM2-gene amplification on fluorescence in situ hybridization). The myxoid component which was present in the well differentiated liposarcomatous component gave the tumor atypical radiological features. The case presented initial diagnostic difficulties, mainly because of the bland histomorphological appearance of the limited biopsy material from the sampled non-lipogenic, dedifferentiated component. The dedifferentiated part of the tumor turned out to harbor significant heterogeneity with regards to cellularity, cytomorphology and proliferative activity.

CERNBox + EOS: end-user storage for science

NASA Astrophysics Data System (ADS)

Mascetti, L.; Gonzalez Labrador, H.; Lamanna, M.; Mościcki, JT; Peters, AJ

2015-12-01

CERNBox is a cloud synchronisation service for end-users: it allows syncing and sharing files on all major mobile and desktop platforms (Linux, Windows, MacOSX, Android, iOS) aiming to provide offline availability to any data stored in the CERN EOS infrastructure. The successful beta phase of the service confirmed the high demand in the community for an easily accessible cloud storage solution such as CERNBox. Integration of the CERNBox service with the EOS storage back-end is the next step towards providing “sync and share” capabilities for scientific and engineering use-cases. In this report we will present lessons learnt in offering the CERNBox service, key technical aspects of CERNBox/EOS integration and new, emerging usage possibilities. The latter includes the ongoing integration of “sync and share” capabilities with the LHC data analysis tools and transfer services.

Bridging the Divide- Adventures of an academic entrepreneur

NASA Astrophysics Data System (ADS)

Venkatesan, Thirumalai

2017-01-01

Academic research and entrepreneurship are simultaneously synergistic and conflicting as careers and my talk is about the challenges of bridging these careers. After a research career at Bell Labs and Bellcore which led to the invention of the Pulsed Laser Deposition Process I started Neocera as a company to translate products arising from academic research. Leaving Bell and building the company in Maryland as a Professor at UMD was a great learning experience. Managing creative people to productize, focusing on marketing/sales and managing cash flows constituted a world significantly different from what one encounters in the academia. Survival is key and a hasty decision can be the difference between success and bankruptcy. In my talk I will discuss the various lessons I learnt from the process and how one handles the challenges to eventually make an economic and societal impact.

Chicken pox outbreak in the Intensive Care Unit of a tertiary care hospital: Lessons learnt the hard way.

PubMed

Sarit, Sharma; Shruti, Sharma; Deepinder, Chhina; Chhina, R S

2015-12-01

Varicella-zoster virus (VZV) causes 2 clinically and epidemiologically distinct forms of diseases. Chickenpox (varicella) is the disease that results from primary infection with the VZV. Herpes zoster (HZ) results from the reactivation of VZV latently infecting the dorsal root ganglia. We are reporting an outbreak of varicella infection among the health care workers (HCWs) in the Intensive Care Unit (ICU) of a tertiary care hospital. We found transmission of varicella among eight HCWs of pulmonary ICU. They had a history of contact with a patient having HZ infection. Investigation of the outbreak was conducted as per guidelines. Better dissemination of information on disease transmission, isolation of infected patients inside the hospital, and adequate protection (including vaccination) for susceptible employees are important to prevent such outbreaks.

Cardiomed System for Medical Monitoring Onboard ISS

NASA Astrophysics Data System (ADS)

Lloret, J. C.; Aubry, P.; Nguyen, L.; Kozharinov, V.; Grachev, V.; Temnova, E.

2008-06-01

Cardiomed system was developed with two main objectives: (1) cardiovascular medical monitoring of cosmonauts onboard ISS together with LBNP countermeasure; (2) scientific study of the cardio-vascular system in micro-gravity. Cardiomed is an integrated end-to-end system, from the onboard segment operating different medical instruments, to the ground segment which provides real-time telemetry of on-board experiments and off-line analysis of physiological measurements. In the first part of the paper, Cardiomed is described from an architecture point of view together with some typical uses. In the second part, the most constraining requirements with respect to system design are introduced. Some requirements are generic; some are specific to medical follow-up, others to scientific objectives. In the last part, the main technical challenges which were addressed during the development and the qualification of Cardiomed and the lessons learnt are presented.

Fast vaccine design and development based on correlates of protection (COPs)

PubMed Central

van Els, Cécile; Mjaaland, Siri; Næss, Lisbeth; Sarkadi, Julia; Gonczol, Eva; Smith Korsholm, Karen; Hansen, Jon; de Jonge, Jørgen; Kersten, Gideon; Warner, Jennifer; Semper, Amanda; Kruiswijk, Corine; Oftung, Fredrik

2014-01-01

New and reemerging infectious diseases call for innovative and efficient control strategies of which fast vaccine design and development represent an important element. In emergency situations, when time is limited, identification and use of correlates of protection (COPs) may play a key role as a strategic tool for accelerated vaccine design, testing, and licensure. We propose that general rules for COP-based vaccine design can be extracted from the existing knowledge of protective immune responses against a large spectrum of relevant viral and bacterial pathogens. Herein, we focus on the applicability of this approach by reviewing the established and up-coming COPs for influenza in the context of traditional and a wide array of new vaccine concepts. The lessons learnt from this field may be applied more generally to COP-based accelerated vaccine design for emerging infections. PMID:25424803

The effects of plague on the distribution of property: Ivrea, Northern Italy 1630.

PubMed

Alfani, Guido

2010-03-01

The demographic effects of the epidemics of plague in Early Modern Europe and their economic consequences illuminate the evolution of property structures and of wealth distribution during and after a mortality crisis. An analysis of the high-quality data available for the Italian city of Ivrea at the time of the 1630 plague shows the exceptional resilience of property structures. Like the social structures of the period, property structures were able to recover quickly, informed as they were by the lessons learnt by trial and error by the patrician families of the late Middle Ages, whose patrimonies had been badly damaged by the Black Death. In a period of recurrent catastrophes that struck European populations during the Old Demographic Regime, apparently 'inegalitarian' institutions seem to have had long-term 'egalitarian' effects.

Experience gained from the application of basic quality assurance procedures in a Greek university engineering department

NASA Astrophysics Data System (ADS)

Stamatelos, A. M.

2010-06-01

During the last decade, significant funding has become available to Greek public universities to support the convergence to the common European space of higher education. In a number of departments, this funding was wisely invested in the development of a quality culture, covering not only the educational process, but also the services offered by the department's administration and technical support staff. This paper presents the design and implementation of a quality-oriented studies' reform plan in the Mechanical Engineering Department, University of Thessaly in the period 2002-2008. Based on the successful experience from its application, a significant part of the personnel and students have become acquainted with basic quality assurance procedures and performance evaluation. Experience and lessons learnt from this effort are reported and discussed in this paper.

What kind of leadership does integrated care need?

PubMed Central

2012-01-01

Primary care clinicians and clinical commissioners are the current focus for much leadership investment and development. In this article I propose that we need to look beyond traditional thinking about effective leader behaviour and conventional approaches to leader development based on this thinking. The paper identifies some of the lessons that can be learnt from both the current academic discussion of collaborative leadership, and from an analysis of successes and failures of leadership within the NHS. Two leadership strategies are considered: the development of communities of practice and the use of connected mini-transformations to generate wider system transformation. In a period of systems change, with potential for conflict between providers and commissioners, these strategies are helpful in encouraging the ‘mindfulness’ that is needed to ensure integration across the complex landscape of healthcare in London. PMID:25949659

Including patients in core outcome set development: issues to consider based on three workshops with around 100 international delegates.

PubMed

Young, Bridget; Bagley, Heather

2016-01-01

This commentary article describes three interactive workshops that explored how patients can contribute to decisions about what outcomes are measured in clinical trials across the world. Outcomes like quality of life, side-effects and pain are used in trials to measure whether a treatment is effective. Here, we outline how research groups are increasingly coming together to develop 'core outcomes sets' for particular conditions. Core outcome sets are lists of agreed outcomes. Their use will help in identifying which treatments are effective by enabling people to compare the findings of different clinical trials in the same condition. Currently, it is often very difficult to make these comparisons because different studies often measure different outcomes. Delegates attending the workshops included patients, clinicians and researchers. They discussed ways of making core outcome set development more meaningful and accessible for patients, and ensuring that they have a genuine say in the development process. This article summarises these discussions and concludes by identifying three distinctive challenges in securing patient input to core outcome set development: the process and objectives can seem far removed from the immediate concerns of patients, difficulties can arise in securing patient input on an international scale, and difficulties can also arise in bringing multiple stakeholder groups together to achieve consensus. While patient participation, involvement and engagement in core outcome set development can draw on lessons from other research areas, these distinctive challenges point to the need for distinctive solutions to enable meaningful patient input to core outcome set development. Background This article describes three workshops that explored how patients can contribute to decisions about what outcomes are measured in clinical trials. People need evidence about what treatments are best for particular health conditions. The strongest evidence comes from systematic reviews comparing outcomes across different studies of treatments for a particular condition. However, it is often difficult to do these comparisons because the different studies-even though they have all investigated the same condition-often measure different outcomes. To tackle this problem, research teams are increasingly coming together to develop core outcome sets (COS) for particular conditions or treatments. The goal is that across the world, all the research teams working on the same condition or treatment will then use the COS in their research. Main body We report on three interactive workshops that explored how patients and the public can contribute to decision making about what outcomes should be included in a COS. About 100 international delegates, including researchers, clinicians and patients, attended the workshops. The workshops were held in the United Kingdom, Italy and Canada as part of the COMET (Core Outcome Measures in Effectiveness Trials) Initiative annual meetings. Patients who had some experience as research advisors, collaborators, partners or co-ordinators facilitated the workshops together with a researcher. Notes made during each workshop informed the preparation of this article. Workshop discussion focussed on ways of making core outcome set development more meaningful and accessible for patients. Delegates wanted patients to have a genuine say, alongside other stakeholders, in what outcomes are included in COS. Delegates felt that key to ensuring this is recognising that patient participation in COS development alone is not enough, and that patients will also need to be involved in the design of COS development studies. Conclusion We conclude by pointing to some distinctive challenges in including patients in COS development. While the COS development community can draw on the lessons learnt from other research areas about patient participation, involvement and engagement, the distinctive challenges that arise in COS development point to the need for some distinctive solutions too.

Social learning improves survivorship at a life-history transition.

PubMed

Manassa, R P; McCormick, M I

2013-04-01

During settlement, one of the main threats faced by individuals relates to their ability to detect and avoid predators. Information on predator identities can be gained either through direct experience or from the observation and/or interaction with others, a process known as social learning. In this form of predator recognition, less experienced individuals learn from experienced members within the social group, without having to directly interact with a predator. In this study, we examined the role of social learning in predator recognition in relation to the survival benefits for the damselfish, Pomacentrus wardi, during their settlement transition. Specifically, our experiments aimed to determine if P. wardi are capable of transmitting the recognition of the odour of a predator, Pseudochromis fuscus, to conspecifics. The experiment also examined whether there was a difference in the rate of survival between individuals that directly learnt the predator odour and those which acquired the information through social learning compared to naïve individuals. Results show that naïve P. wardi are able to learn a predator's identity from experienced individuals via social learning. Furthermore, survival between individuals that directly learnt the predator's identity and those that learnt through social learning did not significantly differ, with fish from both treatments surviving at least five times better than controls. These results demonstrate that experience may play a vital role in determining the outcome of predator-prey interactions, highlighting that social learning improves the ability of prey to avoid and/or escape predation at a life-history transition.

Community-based prevention of hepatitis-B-related liver cancer: Australian insights

PubMed Central

Kansil, Melanie Q; Porwal, Mamta; Penman, Andrew G; George, Jacob

2014-01-01

Abstract Problem Although most primary hepatocellular cancers (HCCs) are attributable to chronic viral hepatitis and largely preventable, such cancers remain a leading cause of cancer-related mortality wherever chronic hepatitis B is endemic. Approach Many HCCs could be prevented by increasing awareness and knowledge of hepatitis B, optimizing the monitoring of chronic hepatitis B and using antiviral treatments – but there are gaps in the implementation of such strategies. Local setting The “B Positive” programme, based in Sydney, Australia, is designed to improve hepatitis-B-related health outcomes among immigrants from countries with endemic hepatitis B. The programme offers information about disease screening, vaccination and treatment options, as well as optimized access to care. Relevant changes The B Positive programme has been informed by economic modelling. The programme offers culturally tailored education on chronic hepatitis B to target communities and their health practitioners and regular follow-up through a population-based registry of cases. Lessons learnt As the costs of screening for chronic hepatitis B and follow-up are relatively low and less than one in every four cases may require antiviral drugs, optimizing access to treatment seems an appropriate and cost-effective management option. The identification and accurate staging of cases and the judicious use of antiviral medications are predicated upon an informed and educated health workforce. As establishing community trust is a lengthy process, delaying the implementation of programmes against chronic hepatitis B until antiviral drugs become cheaper is unwarranted. PMID:24839327

Advance market commitment for pneumococcal vaccines: putting theory into practice

PubMed Central

Cernuschi, Tania; Schwalbe, Nina; Jones, Andrew; Berndt, Ernst R; McAdams, Susan

2011-01-01

Abstract Markets for life-saving vaccines do not often generate the most desired outcomes from a public health perspective in terms of product quantity, quality, affordability, programmatic suitability and/or sustainability for use in the lowest income countries. The perceived risks and uncertainties about sustainably funded demand from developing countries often leads to underinvestment in development and manufacturing of appropriate products. The pilot initiative Advance Market Commitment (AMC) for pneumococcal vaccines, launched in 2009, aims to remove some of these market risks by providing a legally binding forward commitment to purchase vaccines according to predetermined terms. To date, 14 countries have already introduced pneumococcal vaccines through the AMC with a further 39 countries expected to introduce before the end of 2013. This paper describes early lessons learnt on the selection of a target disease and the core design choices for the pilot AMC. It highlights the challenges faced with tailoring the AMC design to the specific supply situation of pneumococcal vaccines. It points to the difficulty – and the AMC’s apparent early success – in establishing a long-term, credible commitment in a constantly changing unpredictable environment. It highlights one of the inherent challenges of the AMC: its dependence on continuous donor funding to ensure long-term purchases of products. The paper examines alternative design choices and aims to provide a starting point to inform discussions and encourage debate about the potential application of the AMC concept to other fields. PMID:22271949

Double degree master program: Optical Design

NASA Astrophysics Data System (ADS)

Bakholdin, Alexey; Kujawinska, Malgorzata; Livshits, Irina; Styk, Adam; Voznesenskaya, Anna; Ezhova, Kseniia; Ermolayeva, Elena; Ivanova, Tatiana; Romanova, Galina; Tolstoba, Nadezhda

2015-10-01

Modern tendencies of higher education require development of master programs providing achievement of learning outcomes corresponding to quickly variable job market needs. ITMO University represented by Applied and Computer Optics Department and Optical Design and Testing Laboratory jointly with Warsaw University of Technology represented by the Institute of Micromechanics and Photonics at The Faculty of Mechatronics have developed a novel international master double-degree program "Optical Design" accumulating the expertise of both universities including experienced teaching staff, educational technologies, and experimental resources. The program presents studies targeting research and professional activities in high-tech fields connected with optical and optoelectronics devices, optical engineering, numerical methods and computer technologies. This master program deals with the design of optical systems of various types, assemblies and layouts using computer modeling means; investigation of light distribution phenomena; image modeling and formation; development of optical methods for image analysis and optical metrology including optical testing, materials characterization, NDT and industrial control and monitoring. The goal of this program is training a graduate capable to solve a wide range of research and engineering tasks in optical design and metrology leading to modern manufacturing and innovation. Variability of the program structure provides its flexibility and adoption according to current job market demands and personal learning paths for each student. In addition considerable proportion of internship and research expands practical skills. Some special features of the "Optical Design" program which implements the best practices of both Universities, the challenges and lessons learnt during its realization are presented in the paper.

Physical Activity in Physical Education: Are Longer Lessons Better?

PubMed Central

Smith, Nicole J.; Monnat, Shannon M.; Lounsbery, Monica A.F.

2015-01-01

BACKGROUND The purpose of this study was to compare physical activity (PA) outcomes in a sample of high school physical education (PE) lessons from schools that adopted traditional versus modified block schedule formats. METHODS We used the System for Observing Fitness Instruction Time (SOFIT) to conduct observations of 168 high school (HS) PE lessons delivered by 22 PE teachers in 4 schools. We used t-tests and multilevel models were used to explore variability in moderate PA and vigorous PA. RESULTS PA outcomes were significantly different between modified block and traditional schools. Students who attended traditional schools engaged in more vigorous PA in PE lessons. Modified block lessons lost more scheduled lesson time due to poor transition to and from the locker room. PA outcomes were positively associated with fitness and teacher promotion of PA and negatively associated with lost time, class size, management, and knowledge. CONCLUSIONS Though PE proponents widely advocate for more PE minutes, this study showed that greater time scheduled in PE does not necessarily result in more student accrual of MVPA minutes. PMID:25611935

Exploration of the Hypothalamic-Pituitary-Adrenal Axis to Improve Animal Welfare by Means of Genetic Selection: Lessons from the South African Merino.

PubMed

Hough, Denise; Swart, Pieter; Cloete, Schalk

2013-05-17

It is a difficult task to improve animal production by means of genetic selection, if the environment does not allow full expression of the animal's genetic potential. This concept may well be the future for animal welfare, because it highlights the need to incorporate traits related to production and robustness, simultaneously, to reach sustainable breeding goals. This review explores the identification of potential genetic markers for robustness within the hypothalamic-pituitary-adrenal axis (HPAA), since this axis plays a vital role in the stress response. If genetic selection for superior HPAA responses to stress is possible, then it ought to be possible to breed robust and easily managed genotypes that might be able to adapt to a wide range of environmental conditions whilst expressing a high production potential. This approach is explored in this review by means of lessons learnt from research on Merino sheep, which were divergently selected for their multiple rearing ability. These two selection lines have shown marked differences in reproduction, production and welfare, which makes this breeding programme ideal to investigate potential genetic markers of robustness. The HPAA function is explored in detail to elucidate where such genetic markers are likely to be found.

Fukushima nuclear power plant accident and comprehensive health risk management-global radiocontamination and information disaster.

PubMed

Yamashita, Shunichi

2014-06-01

The Great East Japan Earthquake on March 11, 2011, besides further studying the appropriateness of the initial response and post-countermeasures against the severe Fukushima nuclear accident, has now increased the importance of the epidemiological study in comprehensive health risk management and radiation protection; lessons learnt from the Chernobyl accident should be also implemented. Therefore, since May 2011, Fukushima Prefecture has started the "Fukushima Health Management Survey Project" for the purpose of long-term health care administration and early diagnosis/treatment for the prefectural residents. Basic survey is under investigation on a retrospective estimation of external exposure of the first four months. As one of the four detailed surveys, the thyroid ultrasound examination has clarified the increased detection rate of childhood thyroid cancers as a screening effect in the past three years and so thyroid cancer occurrence by Fukushima nuclear power plant accident, especially due to radioactive iodine will be discussed despite of difficult challenge of accurate estimation of low dose and low-dose rate radiation exposures. Through the on-site valuable experience and a difficult challenge for recovery, we should learn the lessons from this severe and large-scale nuclear accident, especially how to countermeasure against public health emergency at the standpoint of health risk and also social risk management.

Towards a comparative analysis of health systems reforms in the Asia-Pacific Region.

PubMed

Phua, Kai Hong; Chew, Amelia Huibin

2002-01-01

The paper will review a representative selection of health systems reforms throughout the Asia-Pacific region to summarise the regional experience, identify the key lessons learnt from innovative health reforms and propose policy recommendations for sustainable health systems development. Broad descriptive trends of health systems reforms will be compared across the Asia-Pacific region within the context of rapid demographic, health and socio-economic development. More specifically, the study will address the following questions: 1. What are the main features of innovative health systems reforms? 2. How have these reforms affected the health systems? 3. Are there lessons and other implications from these reforms? A common conceptual framework to compare health systems reforms is adopted, using a standardised format to report data of national health systems. A classification of health systems is constructed by categorising them according to the level of development of their respective economies: 1) Developed 2 )High Performing 3) Newly Industrialising 4) Transitional, and 5) Developing. A typology of common issues, challenges and responses are generalised for these health systems at different stages of socio-economic development of individual countries. Evaluative criteria are proposed to compare the long-term effects of these reforms on national health systems in terms of efficiency, equity, quality and sustainability.

How to build an information gathering and processing system: lessons from naturally and artificially intelligent systems.

PubMed

Chappell, Jackie; Demery, Zoe P; Arriola-Rios, Veronica; Sloman, Aaron

2012-02-01

Imagine a situation in which you had to design a physical agent that could collect information from its environment, then store and process that information to help it respond appropriately to novel situations. What kinds of information should it attend to? How should the information be represented so as to allow efficient use and re-use? What kinds of constraints and trade-offs would there be? There are no unique answers. In this paper, we discuss some of the ways in which the need to be able to address problems of varying kinds and complexity can be met by different information processing systems. We also discuss different ways in which relevant information can be obtained, and how different kinds of information can be processed and used, by both biological organisms and artificial agents. We analyse several constraints and design features, and show how they relate both to biological organisms, and to lessons that can be learned from building artificial systems. Our standpoint overlaps with Karmiloff-Smith (1992) in that we assume that a collection of mechanisms geared to learning and developing in biological environments are available in forms that constrain, but do not determine, what can or will be learnt by individuals. Copyright © 2011 Elsevier B.V. All rights reserved.

Retreat from Alma Ata? The WHO's report on Task Shifting to community health workers for AIDS care in poor countries.

PubMed

Campbell, C; Scott, K

2011-01-01

This paper examines the potential of community health worker (CHW) programmes, as proposed by the 2008 World Health Organisation (WHO) document Task Shifting to tackle health worker shortages, to contribute to HIV/AIDS prevention and treatment and various Millennium Development Goals in low-income countries. It examines the WHO proposal through a literature review of factors that have facilitated the success of previous CHW experiences. The WHO has taken account of five key lessons learnt from past CHW programmes (the need for strong management, appropriate selection, suitable training, adequate retention structures and good relationships with other healthcare workers). It has, however, neglected to emphasise the importance of a sixth lesson, the 'community embeddedness' of CHWs, found to be of critical importance to the success of past CHW programmes. We have no doubt that the WHO plans will increase the number of workers able to perform medically oriented tasks. However, we argue that without community embeddedness, CHWs will be unable to successfully perform the socially oriented tasks assigned to them by the WHO, such as health education and counselling. We locate the WHO's neglect of community embeddedness within the context of a broader global public health trend away from community-focused primary healthcare towards biomedically focused selective healthcare.

'Mental health is everybody's business': roles for an intersectoral approach in South Africa.

PubMed

Skeen, Sarah; Kleintjes, Sharon; Lund, C; Petersen, Inge; Bhana, Arvin; Flisher, Alan J

2010-01-01

Intersectoral action is increasingly recognized as necessary to address the social determinants of mental health. This study aims to assess South Africa's progress in intersectoral collaboration for mental health, and provide recommendations for intersectoral collaboration, to generate lessons for other low- and middle-income countries. We conducted a survey of the existing mental health system in South Africa using the World Health Organization Assessment Instrument for Mental Health Systems. We also conducted 96 semi-structured interviews and 12 focus group discussions with a range of stakeholders at national, provincial and district level. Data were analysed thematically to understand the roles and responsibilities of different sectors in realizing the right to mental health. A range of key sectors were identified as having roles in mental health promotion, illness prevention and service delivery. In discussing South Africa's progress, respondents gave several suggestions about how to formulate an intersectoral response in this context, including increasing high level political commitment, and using leadership from the health sector. We outline roles and responsibilities for various sectors and lessons that can be learnt from this context. These include the importance of developing programmes alongside legislation, employing targeted awareness-raising to engage sectors, and developing a structured approach to intersectoral action.

Review of esophageal injuries and stenosis: Lessons learn and current concepts of management.

PubMed

Ramareddy, Raghu Sampalli; Alladi, Anand

2016-01-01

To review the patients with esophageal injuries and stenosis with respect to their etiology, clinical course, management, and the lessons learnt from these. Retrospective descriptive observation review of children with esophageal injuries and stenosis admitted between January 2009 and April 2015. Eighteen children with esophageal injuries of varied etiology were managed and included, seven with corrosive injury, five with perforation due to various causes, three with mucosal erosion, two with trachea esophageal fistula (TEF), and one wall erosion. The five children who had perforation were due to poststricture dilatation in a child with esophageal atresia and secondary to foreign body impaction or its attempted retrieval in four. Alkaline button cell had caused TEF in two. Three congenital esophageal stenosis (CES) had presented with dysphagia and respiratory tract infection. Six corrosive stricture and two CES responded to dilatation alone and one each of them required surgery. Four of the children with esophageal perforation were detected early and required drainage procedure (1), diversion (1), and medical management (2). Pseudo diverticulum was managed expectantly. Among TEF, one had spontaneous closure and other one was lost to follow-up. All the remaining nineteen children have recovered well except one CES had mortality. Esophageal injuries though rare can be potentially devastating and life-threatening.

Fukushima Nuclear Power Plant Accident and Comprehensive Health Risk Management—Global Radiocontamination and Information Disaster

PubMed Central

2014-01-01

The Great East Japan Earthquake on March 11, 2011, besides further studying the appropriateness of the initial response and post-countermeasures against the severe Fukushima nuclear accident, has now increased the importance of the epidemiological study in comprehensive health risk management and radiation protection; lessons learnt from the Chernobyl accident should be also implemented. Therefore, since May 2011, Fukushima Prefecture has started the “Fukushima Health Management Survey Project” for the purpose of long-term health care administration and early diagnosis/treatment for the prefectural residents. Basic survey is under investigation on a retrospective estimation of external exposure of the first four months. As one of the four detailed surveys, the thyroid ultrasound examination has clarified the increased detection rate of childhood thyroid cancers as a screening effect in the past three years and so thyroid cancer occurrence by Fukushima nuclear power plant accident, especially due to radioactive iodine will be discussed despite of difficult challenge of accurate estimation of low dose and low-dose rate radiation exposures. Through the on-site valuable experience and a difficult challenge for recovery, we should learn the lessons from this severe and large-scale nuclear accident, especially how to countermeasure against public health emergency at the standpoint of health risk and also social risk management. PMID:25425958

On the design of learning outcomes for the undergraduate engineer's final year project

NASA Astrophysics Data System (ADS)

Thambyah, Ashvin

2011-03-01

The course for the final year project for engineering students, because of its strongly research-based, open-ended format, tends to not have well defined learning outcomes, which are also not aligned with any accepted pedagogical philosophy or learning technology. To address this problem, the revised Bloom's taxonomy table of Anderson and Krathwohl (2001) is utilised, as suggested previously by Lee and Lai (2007), to design new learning outcomes for the final year project course in engineering education. Based on the expectations of the engineering graduate, and integrating these graduate expectations into the six cognitive processes and four knowledge dimensions of the taxonomy table, 24 learning outcomes have been designed. It is proposed that these 24 learning outcomes be utilised as a suitable working template to inspire more critical evaluation of what is expected to be learnt by engineering students undertaking final year research or capstone projects.

Training clinicians treating HIV to diagnose cytomegalovirus retinitis

PubMed Central

Tun, NiNi; Maningding, Ernest; Heiden, Matthew; Rose-Nussbaumer, Jennifer; Chan, Khin Nyein; Khizniak, Tamara; Yakubenko, Alexandra; Lewallen, Susan; Keenan, Jeremy D; Saranchuk, Peter

2014-01-01

Abstract Problem Acquired immunodeficiency syndrome (AIDS)-related cytomegalovirus (CMV) retinitis continues to be a neglected source of blindness in resource-poor settings. The main issue is lack of capacity to diagnose CMV retinitis in the clinical setting where patients receive care and all other opportunistic infections are diagnosed. Approach We developed and implemented a four-day workshop to train clinicians working in human immunodeficiency virus (HIV) clinics how to perform binocular indirect ophthalmoscopy and diagnose CMV retinitis. Workshops comprised both classroom didactic instruction and direct clinical eye examinations in patients with advanced AIDS. Between 2007 and 2013, 14 workshops were conducted in China, Myanmar and the Russian Federation. Local setting Workshops were held with local clinicians at HIV clinics supported by nongovernmental organizations, public-sector municipal hospitals and provincial infectious disease referral hospitals. Each setting had limited or no access to locally- trained ophthalmologists, and an HIV-infected population with advanced disease. Relevant changes Clinicians learnt how to do binocular indirect ophthalmoscopy and to diagnose CMV retinitis. One year after the workshop, 32/38 trainees in Myanmar did systematic eye examination for early diagnosis of CMV retinitis as standard care for at-risk patients. In China and the Russian Federation, the success rates were lower, with 10/15 and 3/5 trainees, respectively, providing follow-up data. Lessons learnt Skills necessary for screening and diagnosis of CMV retinitis can be taught in a four-day task-oriented training workshop. Successful implementation depends on institutional support, ongoing training and technical support. The next challenge is to scale up this approach in other countries. PMID:25552774

PA6 Death chat: engaging with dying and death.

PubMed

Goodhead, Andrew; Hartley, Nigel

2015-04-01

Talking about death continues to be a social taboo. St Christopher's has a large, welcoming social space, (The Anniversary Centre) and is committed to opening up its buildings in a number of ways. The St Christopher's social programme, of which Death Chat is part, aims to break down social taboos. Hospices have a responsibility to engage creatively with patients, family members, carers and the wider community. Death Chat, held in the hospice buildings, enables honest discussion about dying and death and topics surrounding these themes. Death Chat meets weekly and is an open meeting that takes a different subject each week as the starting point for conversation. Cheese and wine are shared and participants quickly find a place in the group. Death Chat has attracted patients, family members, bereaved relatives and the community since September 2013. Attendees have reflected that coming has broken taboos. Peter said, 'it's nowhere near as depressing as it sounds; it's a nice, friendly atmosphere - a convivial place.' Molly found Death Chat to be a welcoming, open and challenging space, 'I have learnt that death is more about my attitude to life than anything else. It has been by far the most important lesson I have learnt since dealing with bereavement.' Death Chat provides a forum in which discussion of dying and death for recognises that these are social events and reclaims them from being taboo, to being a normal part of life's experience. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The burden of disease and injury in Australia.

PubMed Central

Mathers, C. D.; Vos, E. T.; Stevenson, C. E.; Begg, S. J.

2001-01-01

An overview of the results of the Australian Burden of Disease (ABD) study is presented. The ABD study was the first to use methodology developed for the Global Burden of Disease study to measure the burden of disease and injury in a developed country. In 1996, mental disorders were the main causes of disability burden, responsible for nearly 30% of total years of life lost to disability (YLD), with depression accounting for 8% of the total YLD. Ischaemic heart disease and stroke were the main contributors to the disease burden disability-adjusted life years (DALYs), together causing nearly 18% of the total disease burden. Risk factors such as smoking, alcohol consumption, physical inactivity, hypertension, high blood cholesterol, obesity and inadequate fruit and vegetable consumption were responsible for much of the overall disease burden in Australia. The lessons learnt from the ABD study are discussed, together with methodological issues that require further attention. PMID:11731817

Exploitation of the vulnerable in research: Responses to lessons learnt in history.

PubMed

Dhai, Amaboo

2017-05-24

The Nuremberg Trials raised insightful issues on how and why doctors who were trained in the Hippocratic tradition were able to commit such egregious and heinous medical crimes. The vulnerable were considered to be subhuman, of decreased intelligence, of no moral status and lacking human dignity. The reputation of the medical profession had been undermined, professionalism questioned and the doctor-patient relationship damaged as a result of the Nazi medical experiments. The World Medical Association's Declaration of Helsinki has been hailed as one of the most successful efforts in rescuing medical research from the darkness of the scandals and tragedies in health research. The first Research Ethics Committee in South Africa was established in 1966 at the University of the Witwatersrand. From the mid-1970s other institutions followed suit. The promulgation of the National Health Act No. 61 of 2003, in 2004, resulted in strong protectionism for research participants in the country.

Fetal stem cell transplantation: Past, present, and future

PubMed Central

Ishii, Tetsuya; Eto, Koji

2014-01-01

Since 1928, human fetal tissues and stem cells have been used worldwide to treat various conditions. Although the transplantation of the fetal midbrain substantia nigra and dopaminergic neurons in patients suffering from Parkinson’s disease is particularly noteworthy, the history of other types of grafts, such as those of the fetal liver, thymus, and pancreas, should be addressed as there are many lessons to be learnt for future stem cell transplantation. This report describes previous practices and complications that led to current clinical trials of isolated fetal stem cells and embryonic stem (ES) cells. Moreover, strategies for transplantation are considered, with a particular focus on donor cells, cell processing, and the therapeutic cell niche, in addition to ethical issues associated with fetal origin. With the advent of autologous induced pluripotent stem cells and ES cells, clinical dependence on fetal transplantation is expected to gradually decline due to lasting ethical controversies, despite landmark achievements. PMID:25258662

Fifteen hundred guidelines and growing: the UK database of clinical guidelines.

PubMed

van Loo, John; Leonard, Niamh

2006-06-01

The National Library for Health offers a comprehensive searchable database of nationally approved clinical guidelines, called the Guidelines Finder. This resource, commissioned in 2002, is managed and developed by the University of Sheffield Health Sciences Library. The authors introduce the historical and political dimension of guidelines and the nature of guidelines as a mechanism to ensure clinical effectiveness in practice. The article then outlines the maintenance and organisation of the Guidelines Finder database itself, the criteria for selection, who publishes guidelines and guideline formats, usage of the Guidelines Finder service and finally looks at some lessons learnt from a local library offering a national service. Clinical guidelines are central to effective clinical practice at the national, organisational and individual level. The Guidelines Finder is one of the most visited resources within the National Library for Health and is successful in answering information needs related to specific patient care, clinical research, guideline development and education.

[What can we learn from the Scott Reuben case? Scientific misconduct in anaesthesiology].

PubMed

Rittner, H L; Kranke, P; Schäfer, M; Roewer, N; Brack, A

2009-12-01

In February 2009 a major case of scientific misconduct was discovered. The American pain researcher Dr. S. Reuben had published 21 papers over a period of 15 years that were found to be fraudulent. Suddenly many advances in postoperative pain therapy which had been assumed to be correct seemed questionable. In this review article the lessons which can be learnt from this case are described. This review also reveals that it is almost impossible for reviewers or readers of scientific journals to detect scientific fraud. However, several warning signs can be identified that might be useful when reading clinical papers. In retrospect many of these signs were detectable in Reuben's studies. Based on the fraudulent papers of Reuben it will be shown how and to what extent falsified results can affect other types of literature, such as practice guidelines, meta-analyses, review articles and oral presentations.

Adoption of a Nationwide Shared Medical Record in France: Lessons Learnt after 5 Years of Deployment

PubMed Central

Séroussi, Brigitte; Bouaud, Jacques

2016-01-01

Information sharing among health practitioners, either for coordinated or unscheduled care, is necessary to guarantee care quality and patient safety. In most countries, nationwide programs have provided tools to support information sharing, from centralized care records to health information exchange between electronic health records (EHRs). The French personal medical record (DMP) is a centralized patient-controlled record, created according to the opt-in consent model. It contains the documents health practitioners voluntarily push into the DMP from their EHRs. Five years after the launching of the program in December 2010, there were nearly 570,000 DMPs covering only 1.5% of the target population in December 2015. Reasons for this poor level of adoption are discussed in the perspective of other countries’ initiatives. The new French governmental strategy for the DMP deployment in 2016 is outlined, with the implementation of measures similar to the US Meaningful Use. PMID:28269907

China-Africa and China-Asia Collaboration on Schistosomiasis Control: A SWOT Analysis.

PubMed

Xu, J; Bergquist, R; Qian, Y-J; Wang, Q; Yu, Q; Peeling, R; Croft, S; Guo, J-G; Zhou, X-N

2016-01-01

Schistosomiasis, a disease caused by a trematode, parasitic worm, is a worldwide public health problem. In spite of great progress with regard to morbidity control, even elimination of this infection in recent decades, there are still challenges to overcome in sub-Saharan Africa and endemic areas in Southeast Asia. Regarded as one of the most successful countries with respect to schistosomiasis control, The People's Republic of China has accumulated considerable experience and learnt important lessons in various local settings that could benefit schistosomiasis control in other endemic countries. Based on an analysis of conceived strengths, weaknesses, opportunities and threats (SWOT) of potential collaborative activities with regard to schistosomiasis in Africa and Asia, this article addresses the importance of collaborative efforts and explores the priorities that would be expected to facilitate the transfer of Chinese experience to low- and middle-income countries in Africa and Asia. Copyright © 2016 Elsevier Ltd. All rights reserved.

The IBM Story

NASA Astrophysics Data System (ADS)

Loving, Charles

This chapter explores an actual transition from a product-based company to one where services dominate. That company is IBM and the transition started in the early 1990s. As you will see, the changes do not happen overnight in a "big bang" ­apocalyptic event but more gradually in a series of phases; indeed, at the time of writing (2009), we are almost 20 years into the transition and we know that we are not finished yet. Underneath the headline change from products to services, there are a myriad of other process and procedural changes that have to be made to support the business and allow it to change dynamically in order to meet the needs of its clients, its shareholders and its suppliers. In this chapter, we will show how IBM has responded to these requirements and how it is applying the lessons learnt in this process to create an agenda for innovation in service creation and delivery to address global problems.

Developing the revised NICE appraisal technical guidance to manufacturers and sponsors: opportunity or threat?

PubMed

Taylor, Rod S; Hutton, John; Culyer, Anthony J

2002-01-01

One of the principal roles of the National Institute for Clinical Excellence (NICE) is to appraise selected existing and emerging healthcare technologies and, as a result, produce guidance for the National Health Service (NHS) in England and Wales. A central part of this appraisal is the potential for manufacturers and sponsors to make a data submission. This paper describes the process of development of the second edition of technical guidance to manufacturers and sponsors for submission to NICE. The revision process took place during the period May 2000 and January 2001 and involved a number of key steps -- establishment of a guidance steering committee, review of current international guidelines of clinical and cost effectiveness, drafting of the guidance, detailed consultation with stakeholders, revision of the guidance and, finally, publication. The lessons learnt from revision of the NICE guidance for manufacturers and sponsors and some main issues for its future development are discussed.

Lessons learnt from many years of experience using anti-D in humans for prevention of RhD immunization and haemolytic disease of the fetus and newborn

PubMed Central

Kumpel, B M

2008-01-01

For 40 years prophylactic anti-D has been given to D-negative women after parturition to prevent haemolytic disease of the fetus and newborn. Monoclonal or recombinant anti-D may provide alternatives to the current plasma-derived polyclonal IgG anti-D, although none of them have yet proved as effective in phase 1 clinical trials. The variation in efficacy of the antibodies may have been influenced by heterogeneity in glycosylation of anti-D produced from different cell lines. Some aspects of the conduct of the human studies, most notably the use of low doses of anti-D and target D positive red cells in vivo, may aid the design of the clinical development of other immunomodulatory drugs in order to minimize adverse effects. PMID:18727626

MFIX simulation of NETL/PSRI challenge problem of circulating fluidized bed

DOE PAGES

Li, Tingwen; Dietiker, Jean-François; Shahnam, Mehrdad

2012-12-01

In this paper, numerical simulations of NETL/PSRI challenge problem of circulating fluidized bed (CFB) using the open-source code Multiphase Flow with Interphase eXchange (MFIX) are reported. Two rounds of simulation results are reported including the first-round blind test and the second-round modeling refinement. Three-dimensional high fidelity simulations are conducted to model a 12-inch diameter pilot-scale CFB riser. Detailed comparisons between numerical results and experimental data are made with respect to axial pressure gradient profile, radial profiles of solids velocity and solids mass flux along different radial directions at various elevations for operating conditions covering different fluidization regimes. Overall, the numericalmore » results show that CFD can predict the complex gas–solids flow behavior in the CFB riser reasonably well. In addition, lessons learnt from modeling this challenge problem are presented.« less

Reflections on a Multi-stakeholder National Campaign in India around Comet ISON

NASA Astrophysics Data System (ADS)

Shastri, Prajval

2015-08-01

Astronomy has been repeatedly demonstrated to be an effective vehicle to promote learning science by doing and to propagate a scientific temper among the public. In this spirit, the efforts undertaken in India during the international Year of Astronomy enabled the building of collaborations between professional astrophysicists, amateur astronomers, science teachers, science activists, theatre artistes and artist-designers. In the six years since, these networks have managed to not only sustain, but expand in reach, and have built focused attention of school-going children around astronomical events. The activities that were part of the build-up to both the Transit of Venus (2012) and the arrival of Comet ISON (2013) will be described. A somewhat informal consortium led the campaign around the comet. The campaigners were enabled by open-source digitally based resource material available in both English and regional languages. The lessons learnt will be discussed.

From Exotic to Mainstream: A 10-year Odyssey from Internet Speed to Boundary Spanning with Scrum

NASA Astrophysics Data System (ADS)

Baskerville, Richard; Pries-Heje, Jan; Madsen, Sabine

Based on four empirical studies conducted over a 10-year time period from 1999 to 2008 we investigate how local software processes interact with global changes in the software development context. In 1999 companies were developing software at high speed in a desperate rush to be first-to-market. In 2001 a new high speed/quick results development process had become established practice. In 2003 changes in the market created the need for a more balanced view on speed and quality, and in 2008 companies were successfully combining agile and plan driven approaches to achieve the benefits of both. The studies reveal a twostage pattern in which dramatic changes in the market causes disruption of established practices, experimentation, and process adaptations followed by consolidation of lessons learnt into a new (and once again mature) software development process. Limitations, implications, and areas for future research are discussed.

Reprint of: Client interfaces to the Virtual Observatory Registry

NASA Astrophysics Data System (ADS)

Demleitner, M.; Harrison, P.; Taylor, M.; Normand, J.

2015-06-01

The Virtual Observatory Registry is a distributed directory of information systems and other resources relevant to astronomy. To make it useful, facilities to query that directory must be provided to humans and machines alike. This article reviews the development and status of such facilities, also considering the lessons learnt from about a decade of experience with Registry interfaces. After a brief outline of the history of the standards development, it describes the use of Registry interfaces in some popular clients as well as dedicated UIs for interrogating the Registry. It continues with a thorough discussion of the design of the two most recent Registry interface standards, RegTAP on the one hand and a full-text-based interface on the other hand. The article finally lays out some of the less obvious conventions that emerged in the interaction between providers of registry records and Registry users as well as remaining challenges and current developments.

Client interfaces to the Virtual Observatory Registry

NASA Astrophysics Data System (ADS)

Demleitner, M.; Harrison, P.; Taylor, M.; Normand, J.

2015-04-01

The Virtual Observatory Registry is a distributed directory of information systems and other resources relevant to astronomy. To make it useful, facilities to query that directory must be provided to humans and machines alike. This article reviews the development and status of such facilities, also considering the lessons learnt from about a decade of experience with Registry interfaces. After a brief outline of the history of the standards development, it describes the use of Registry interfaces in some popular clients as well as dedicated UIs for interrogating the Registry. It continues with a thorough discussion of the design of the two most recent Registry interface standards, RegTAP on the one hand and a full-text-based interface on the other hand. The article finally lays out some of the less obvious conventions that emerged in the interaction between providers of registry records and Registry users as well as remaining challenges and current developments.

Retinoic acid signaling in cancer: The parable of acute promyelocytic leukemia.

PubMed

Ablain, Julien; de Thé, Hugues

2014-11-15

Inevitably fatal some 40 years, acute promyelocytic leukemia (APL) can now be cured in more than 95% of cases. This clinical success story is tightly linked to tremendous progress in our understanding of retinoic acid (RA) signaling. The discovery of retinoic acid receptor alpha (RARA) was followed by the cloning of the chromosomal translocations driving APL, all of which involve RARA. Since then, new findings on the biology of nuclear receptors have progressively enlightened the basis for the clinical efficacy of RA in APL. Reciprocally, the disease offered a range of angles to approach the cellular and molecular mechanisms of RA action. This virtuous circle contributed to make APL one of the best-understood cancers from both clinical and biological standpoints. Yet, some important questions remain unanswered including how lessons learnt from RA-triggered APL cure can help design new therapies for other malignancies. © 2014 UICC.

Development, implementation, and evaluation of the Apollo model of pediatric rehabilitation service delivery.

PubMed

Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Bergeron, Sophie; Lambert, Carole

2013-05-01

This article presents the experience of a rehabilitation program that undertook the challenge to reorganize its services to address accessibility issues and improve service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical perspective on the planning; implementation; and evaluation phases of the process are described. In the planning phase, the constitution of the working committee, the data collected, and the information found in the literature are presented. Apollo, the new service delivery model, is then described along with each of its components (e.g., community, group, and individual interventions). Actions and lessons learnt during the implementation of each component are presented. We hope by sharing our experiences that we can help others make informed decisions about service reorganization to improve the quality of services provided to children with disabilities, their families, and their communities.

Fission products and nuclear fuel behaviour under severe accident conditions part 1: Main lessons learnt from the first VERDON test

NASA Astrophysics Data System (ADS)

Pontillon, Y.; Geiger, E.; Le Gall, C.; Bernard, S.; Gallais-During, A.; Malgouyres, P. P.; Hanus, E.; Ducros, G.

2017-11-01

This paper describes the first VERDON test performed at the end of September 2011 with special emphasis on the behaviour of fission products (FP) and actinides during the accidental sequence itself. Two other papers discuss in detail the post-test examination results (SEM, EPMA and SIMS) of the VERDON-1 sample. The first VERDON test was devoted to studying UO2 fuel behaviour and fission product releases under reducing conditions at very high temperature (∼2883 K), which was able to confirm the very good performance of the VERDON loop. The fuel sample did not lose its integrity during this test. According to the FP behaviour measured by the online gamma station (fuel sight), the general classification of the FP in relation to their released fraction is very accurate, and the burn-up effect on the release rate is clearly highlighted.

Malaria vaccines: looking back and lessons learnt

PubMed Central

Lorenz, Veronique; Karanis, Panagiotis

2011-01-01

The current status of malaria vaccine approaches has the background of a long and arduous path of malaria disease control and vaccine development. Here, we critically review with regard to unilateral interventional approaches and highlight the impact of socioeconomic elements of malaria endemicity. The necessity of re-energizing basic research of malaria life-cycle and Plasmodium developmental biology to provide the basis for promising and cost-effective vaccine approaches and to reach eradication goals is more urgent than previously believed. We closely analyse the flaws of various vaccine approaches, outline future directions and challenges that still face us and conclude that the focus of the field must be shifted to the basic research efforts including findings on the skin stage of infection. We also reflect on economic factors of vaccine development and the impact of public perception when it comes to vaccine uptake. PMID:23569729

Mathematics is always invisible, Professor Dowling

NASA Astrophysics Data System (ADS)

Cable, John

2015-09-01

This article provides a critical evaluation of a technique of analysis, the Social Activity Method, recently offered by Dowling (2013) as a `gift' to mathematics education. The method is found to be inadequate, firstly, because it employs a dichotomy (between `expression' and `content') instead of a finer analysis (into symbols, concepts and setting or phenomena), and, secondly, because the distinction between `public' and `esoteric' mathematics, although interesting, is allowed to obscure the structure of the mathematics itself. There is also criticism of what Dowling calls the `myth of participation', which denies the intimate links between mathematics and the rest of the universe that lie at the heart of mathematical pedagogy. Behind all this lies Dowling's `essentially linguistic' conception of mathematics, which is criticised on the dual ground that it ignores the chastening experience of formalism in mathematical philosophy and that linguistics itself has taken a wrong turn and ignores lessons that might be learnt from mathematics education.

A cluster-randomized controlled trial of strategies to increase adolescents' physical activity and motivation during physical education lessons: the Motivating Active Learning in Physical Education (MALP) trial.

PubMed

Rosenkranz, Richard R; Lubans, David R; Peralta, Louisa R; Bennie, Andrew; Sanders, Taren; Lonsdale, Chris

2012-10-01

The physical activity (PA) levels of many children and adolescents in Australia are currently insufficient to promote health benefits. Physical education (PE) programs aim to promote PA and reach nearly all school-aged children, but PA levels within PE lessons are often low. PE teachers may influence children's motivation to be physically active in PE lessons, but little is known about teacher strategies that effectively motivate children to participate in PA, and few intervention studies have examined motivational strategies in PE. The purpose of this study was to compare the effect of three motivational strategies, each based on Self-Determination Theory (SDT), on PA levels, and their hypothesized antecedents, during year 8 PE lessons. This study employed a cluster-randomized controlled trial design. Following a familiarization session, PA levels and hypothesized PA antecedents were measured during a baseline lesson and a post-intervention or control lesson. Teachers (n = 16) and their classes from five secondary schools in Sydney, Australia were randomly assigned into four blocks and instructed to provide one of four 20-min lesson teaching strategy conditions: (1) explaining the relevance of activities; (2) providing choice from PA options selected by the teacher; (3) providing equipment and free choice of activities; or (4) usual practice. The primary outcomes were lesson time spent in moderate-to-vigorous PA, and motivation towards the lesson. Secondary outcomes were perceptions of teacher behavior, psychological needs satisfaction, and lesson time spent in sedentary behavior. PA and sedentary behavior were measured during baseline and post-intervention lessons with waist-mounted Actigraph GT3X accelerometers. Teacher behavior, psychological needs satisfaction, and motivation were assessed via questionnaires at the end of each lesson. Linear mixed-model analyses will be run on all outcomes, with students nested within teachers as a random effect. Study findings will inform the development of effective SDT-based teaching strategy interventions to enhance students' psychological needs satisfaction, motivation, and PA levels. More effective teaching strategies may be identified that are capable of improving adolescents' PA levels, and thereby provide beneficial population health outcomes. This trial is registered with Current Controlled Trials and is traceable as ISRCTN07038258.

A cluster-randomized controlled trial of strategies to increase adolescents’ physical activity and motivation during physical education lessons: the Motivating Active Learning in Physical Education (MALP) trial

PubMed Central

2012-01-01

Background The physical activity (PA) levels of many children and adolescents in Australia are currently insufficient to promote health benefits. Physical education (PE) programs aim to promote PA and reach nearly all school-aged children, but PA levels within PE lessons are often low. PE teachers may influence children’s motivation to be physically active in PE lessons, but little is known about teacher strategies that effectively motivate children to participate in PA, and few intervention studies have examined motivational strategies in PE. The purpose of this study was to compare the effect of three motivational strategies, each based on Self-Determination Theory (SDT), on PA levels, and their hypothesized antecedents, during year 8 PE lessons. Methods/design This study employed a cluster-randomized controlled trial design. Following a familiarization session, PA levels and hypothesized PA antecedents were measured during a baseline lesson and a post-intervention or control lesson. Teachers (n = 16) and their classes from five secondary schools in Sydney, Australia were randomly assigned into four blocks and instructed to provide one of four 20-min lesson teaching strategy conditions: (1) explaining the relevance of activities; (2) providing choice from PA options selected by the teacher; (3) providing equipment and free choice of activities; or (4) usual practice. The primary outcomes were lesson time spent in moderate-to-vigorous PA, and motivation towards the lesson. Secondary outcomes were perceptions of teacher behavior, psychological needs satisfaction, and lesson time spent in sedentary behavior. PA and sedentary behavior were measured during baseline and post-intervention lessons with waist-mounted Actigraph GT3X accelerometers. Teacher behavior, psychological needs satisfaction, and motivation were assessed via questionnaires at the end of each lesson. Linear mixed-model analyses will be run on all outcomes, with students nested within teachers as a random effect. Discussion Study findings will inform the development of effective SDT-based teaching strategy interventions to enhance students’ psychological needs satisfaction, motivation, and PA levels. More effective teaching strategies may be identified that are capable of improving adolescents’ PA levels, and thereby provide beneficial population health outcomes. Trial registration This trial is registered with Current Controlled Trials and is traceable as ISRCTN07038258. PMID:23025261

Writing Learning Outcomes for English Language Lessons in Multilingual Schools

ERIC Educational Resources Information Center

Jones, Sally Ann

2016-01-01

This article proposes a pedagogic innovation in teacher education by articulating a method for writing learning outcomes for English language lessons in multilingual school contexts. The argument for this approach is founded on curriculum studies; however, the practice also draws specifically on applied psycholinguistic and sociolinguistic…

The effectiveness of behavioural interventions in the primary prevention of Hepatitis C amongst injecting drug users: a randomised controlled trial and lessons learned

PubMed Central

Abou-Saleh, Mohammed; Davis, Paul; Rice, Philip; Checinski, Ken; Drummond, Colin; Maxwell, Douglas; Godfrey, Christine; John, Christopher; Corrin, Betsy; Tibbs, Christopher; Oyefeso, Adenekan; de Ruiter, Marian; Ghodse, Hamid

2008-01-01

Aim To develop and evaluate the comparative effectiveness of behavioural interventions of enhanced prevention counselling (EPC) and simple educational counselling (SEC) in reducing hepatitis C viral (HCV) infection in sero-negative injecting drug users (IDU). Design Randomised controlled trial (RCT) of EPC intervention in comparison with simple educational counselling (SEC). Setting Specialised Drug services in London and Surrey, United Kingdom. Participants and Measurements Ninety five IDUs were recruited and randomised to receive EPC (n = 43) or SEC (n = 52). Subjects were assessed at baseline using the Addiction Severity Index (ASI), the Injecting Risk Questionnaire (IRQ), and Drug Injecting Confidence Questionnaire (DICQ). The primary outcome was measured by the rate of sero-conversion at 6 months and 12 months from baseline and by the ASI, IRQ and DICQ at 6 months from baseline. Hepatitis C testing was undertaken by the innovative test of the dried blood spot (DBS) test which increased the rate of testing by 4 fold compared to routine blood testing. Findings Seventy Eighty two subjects (82%) out of the 95 recruited were followed up at 6 months and 62 (65%) were followed up at 12 months. On the primary outcome measure of the rate of seroconversion, 8 out of 62 patients followed-up at twelve months seroconverted, three in the EPC group and five in the SEC group, indicating incidence rates of 9.1 per 100 person years for the EPC group, 17.2 per 100 person years for the SEC group, and 12.9 per 100 person years for the cohort as a whole. Analysis of the secondary outcome measures on alcohol use, risk behaviour, psychological measures, quality of life, showed no significant differences between the EPC and the SEC groups. However, there were significant changes on a number of measures from baseline values indicating positive change for both groups. Conclusion We were not able to prove the efficacy of EPC in comparison with SEC in the prevention of hepatitis C in IDUs. This was related to low recruitment and retention rates of the participants. Moreover there was a low adherence rate to EPC. The study provided the benefits of developing and introducing behavioural interventions of the EPC and SEC and the DBS screening for Hepatitis C. Moreover the main lessons learnt were that piloting of a new intervention is a crucial first step before conducting pragmatic RCTs of psychological interventions in the field of addiction; that an infrastructure and culture for psychosocial interventions is needed to enable applied research in the service environment, and research funding is needed for enabling the recruitment of dedicated trained therapists for the delivery of these interventions. PMID:18671853

The effectiveness of behavioural interventions in the primary prevention of hepatitis C amongst injecting drug users: a randomised controlled trial and lessons learned.

PubMed

Abou-Saleh, Mohammed; Davis, Paul; Rice, Philip; Checinski, Ken; Drummond, Colin; Maxwell, Douglas; Godfrey, Christine; John, Christopher; Corrin, Betsy; Tibbs, Christopher; Oyefeso, Adenekan; de Ruiter, Marian; Ghodse, Hamid

2008-07-31

To develop and evaluate the comparative effectiveness of behavioural interventions of enhanced prevention counselling (EPC) and simple educational counselling (SEC) in reducing hepatitis C viral (HCV) infection in sero-negative injecting drug users (IDU). Randomised controlled trial (RCT) of EPC intervention in comparison with simple educational counselling (SEC). SETTING SPECIALISED: Drug services in London and Surrey, United Kingdom. Ninety five IDUs were recruited and randomised to receive EPC (n = 43) or SEC (n = 52). Subjects were assessed at baseline using the Addiction Severity Index (ASI), the Injecting Risk Questionnaire (IRQ), and Drug Injecting Confidence Questionnaire (DICQ). The primary outcome was measured by the rate of sero-conversion at 6 months and 12 months from baseline and by the ASI, IRQ and DICQ at 6 months from baseline. Hepatitis C testing was undertaken by the innovative test of the dried blood spot (DBS) test which increased the rate of testing by 4 fold compared to routine blood testing. FINDINGS SEVENTY: Eighty two subjects (82%) out of the 95 recruited were followed up at 6 months and 62 (65%) were followed up at 12 months. On the primary outcome measure of the rate of seroconversion, 8 out of 62 patients followed-up at twelve months seroconverted, three in the EPC group and five in the SEC group, indicating incidence rates of 9.1 per 100 person years for the EPC group, 17.2 per 100 person years for the SEC group, and 12.9 per 100 person years for the cohort as a whole. Analysis of the secondary outcome measures on alcohol use, risk behaviour, psychological measures, quality of life, showed no significant differences between the EPC and the SEC groups. However, there were significant changes on a number of measures from baseline values indicating positive change for both groups. We were not able to prove the efficacy of EPC in comparison with SEC in the prevention of hepatitis C in IDUs. This was related to low recruitment and retention rates of the participants. Moreover there was a low adherence rate to EPC. The study provided the benefits of developing and introducing behavioural interventions of the EPC and SEC and the DBS screening for Hepatitis C. Moreover the main lessons learnt were that piloting of a new intervention is a crucial first step before conducting pragmatic RCTs of psychological interventions in the field of addiction; that an infrastructure and culture for psychosocial interventions is needed to enable applied research in the service environment, and research funding is needed for enabling the recruitment of dedicated trained therapists for the delivery of these interventions.

A narrative account of implementation lessons learnt from the dissemination of an up-scaled state-wide child obesity management program in Australia: PEACH™ (Parenting, Eating and Activity for Child Health) Queensland.

PubMed

Croyden, Debbie L; Vidgen, Helen A; Esdaile, Emma; Hernandez, Emely; Magarey, Anthea; Moores, Carly J; Daniels, Lynne

2018-03-13

PEACH™QLD translated the PEACH™ Program, designed to manage overweight/obesity in primary school-aged children, from efficacious RCT and small scale community trial to a larger state-wide program. This paper describes the lessons learnt when upscaling to universal health coverage. The 6-month, family-focussed program was delivered in Queensland, Australia from 2013 to 2016. Its implementation was planned by researchers who developed the program and conducted the RCT, and experienced project managers and practitioners across the health continuum. The intervention targeted parents as the agents of change and was delivered via parent-only group sessions. Concurrently, children attended fun, non-competitive activity sessions. Sessions were delivered by facilitators who received standardised training and were employed by a range of service providers. Participants were referred by health professionals or self-referred in response to extensive promotion and marketing. A pilot phase and a quality improvement framework were planned to respond to emerging challenges. Implementation challenges included engagement of the health system; participant recruitment; and engagement. A total of 1513 children (1216 families) enrolled, with 1122 children (919 families) in the face-to-face program (105 groups in 50 unique venues) and 391 children (297 families) in PEACH™ Online. Self-referral generated 68% of enrolments. Unexpected, concurrent and, far-reaching public health system changes contributed to poor program uptake by the sector (only 56 [53%] groups delivered by publicly-funded health organisations) requiring substantial modification of the original implementation plan. Process evaluation during the pilot phase and an ongoing quality improvement framework informed program adaptations that included changing from fortnightly to weekly sessions aligned with school terms, revision of parent materials, modification of eligibility criteria to include healthy weight children and provision of services privately. Comparisons between pilot versus state-wide waves showed comparable prevalence of families not attending any sessions (25% vs 28%) but improved number of sessions attended (median = 5 vs 7) and completion rates (43% vs 56%). Translating programs developed in the research context to enable implementation at scale is complex and presents substantial challenges. Planning must ensure there is flexibility to accommodate and proactively manage the system changes that are inevitable over time. ACTRN12617000315314 . This trial was registered retrospectively on 28 February, 2017.

Internet of Things Platform for Smart Farming: Experiences and Lessons Learnt.

PubMed

Jayaraman, Prem Prakash; Yavari, Ali; Georgakopoulos, Dimitrios; Morshed, Ahsan; Zaslavsky, Arkady

2016-11-09

Improving farm productivity is essential for increasing farm profitability and meeting the rapidly growing demand for food that is fuelled by rapid population growth across the world. Farm productivity can be increased by understanding and forecasting crop performance in a variety of environmental conditions. Crop recommendation is currently based on data collected in field-based agricultural studies that capture crop performance under a variety of conditions (e.g., soil quality and environmental conditions). However, crop performance data collection is currently slow, as such crop studies are often undertaken in remote and distributed locations, and such data are typically collected manually. Furthermore, the quality of manually collected crop performance data is very low, because it does not take into account earlier conditions that have not been observed by the human operators but is essential to filter out collected data that will lead to invalid conclusions (e.g., solar radiation readings in the afternoon after even a short rain or overcast in the morning are invalid, and should not be used in assessing crop performance). Emerging Internet of Things (IoT) technologies, such as IoT devices (e.g., wireless sensor networks, network-connected weather stations, cameras, and smart phones) can be used to collate vast amount of environmental and crop performance data, ranging from time series data from sensors, to spatial data from cameras, to human observations collected and recorded via mobile smart phone applications. Such data can then be analysed to filter out invalid data and compute personalised crop recommendations for any specific farm. In this paper, we present the design of SmartFarmNet, an IoT-based platform that can automate the collection of environmental, soil, fertilisation, and irrigation data; automatically correlate such data and filter-out invalid data from the perspective of assessing crop performance; and compute crop forecasts and personalised crop recommendations for any particular farm. SmartFarmNet can integrate virtually any IoT device, including commercially available sensors, cameras, weather stations, etc., and store their data in the cloud for performance analysis and recommendations. An evaluation of the SmartFarmNet platform and our experiences and lessons learnt in developing this system concludes the paper. SmartFarmNet is the first and currently largest system in the world (in terms of the number of sensors attached, crops assessed, and users it supports) that provides crop performance analysis and recommendations.

Integrating the Clearance in NPP Residual Material Management

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

Garcia-Bermejo, R.; Lamela, B.

Previous Experiences in decommissioning projects are being used to optimize the residual material management in NPP, metallic scrap usually. The approach is based in the availability of a materials Clearance MARSSIM-based methodology developed and licensed in Spain. A typical project includes the integration of segregation, decontamination, clearance, quality control and quality assurance activities. The design is based in the clearance methodology features translating them into standard operational procedures. In terms of ecological taxes and final disposal costs, significant amounts of money could be saved with this type of approaches. The last clearance project managed a total amount of 405 tonsmore » scrap metal and a similar amount of other residual materials occupying a volume of 1500 m{sup 3}. After less than a year of field works 251 tons were finally recycled in a non-licensed smelting facility. The balance was disposed as LILW. In the planning phase the estimated cost savings were 4.5 Meuro. However, today a VLLW option is available in European countries so, the estimated cost savings are reduced to 1.2 Meuro. In conclusion: the application of materials clearance in NPP decommissioning lessons learnt to the NPP residual material management is an interesting management option. This practice is currently going on in Spanish NPP and, in a preliminary view, is consistent with the new MARSAME Draft. An interesting parameter is the cost of 1 m3 of recyclable scrap. The above estimates are very project specific because in the segregation process other residual materials were involved. If the effect of this other materials is removed the estimated Unit Cost were in this project around 1700 euro/m{sup 3}, this figure is clearly below the above VLLW disposal cost of 2600 euro. In a future project it appears feasible to descend to 839 euro/m{sup 3} and if it became routine values and is used in big Decommissioning projects, around 600 euro/m{sup 3} or below possibly could be achieved. A rough economical analysis permits to estimate a saving around 2000 US$ to 13000 US$ per cubic meter of steel scrap according the variability of materials and disposal costs. Many learnt lessons of this practice were used as a feed back in the planning of characterization activities for decommissioning a Spanish NPP and today are considered as a significant reference in our Decommissioning engineering approaches.« less

Swarm slide - debris flow disaster induced by extreme rainfall in Hiroshima, August 2014 and lessons learnt in urban designing

NASA Astrophysics Data System (ADS)

Fukuoka, H.; Wang, C.

2015-12-01

Hiroshima city was hit by swarm debris flows along a narrow, and linear-shaped rain band of 2 km x 10 km which appeared in the early morning of August 20, 2014. Most of the flows were induced by shallow slide in the upstream. This disaster claimed 74 death, although this city experienced very similar disaster in 1999, claiming more than 30 residents lives. In the most severely affected debris flow torrent, more than 50 residents were killed. Most of the casualties arose in the wooden, vulnerable houses constructed in front of the exit of torrents. Points and lessons learnt from the disaster are as follows:1. Authors collected two types of sands from the source scar of the initial debris slides which induced debris flows. Tested by the ring shear apparatus under pore-pressure control condition, clear "Sliding surface liquefaction" was confirmed for both samples even under small normal stress, representing the small thickness of the slides. These results shows even instant excess pore pressure could initiate the slides and trigger slide-induced debris flow byundrained loading onto the torrent deposits.2. Apparently long-term land-use change since 1945 affected and raised the vulnerability of the community. Residential area had expanded into hill-slope (mountainous / semi-mountainous area) especially along the torrents. Those communities were developed on the past debris flow fan.3. As the devastated area is very close to downtown of Hiroshima city, it gave large societal impact to the Japanese citizens. After 1999 Hiroshima debris flow disaster, the Landslide disaster reduction law which intends to promote designation of landslide potential risk zones, was adopted in 2000. Immediately after 2014 disaster, national diet approved revision of the bill to promote rapid completion of the designation over the national territory. MLIT (Ministry of Land, Infrastructure, Tranportation and Tourism) decided to install X-band rain radars at more sites to cover whole city zones of the country. However, narrow extreme rain bands or spots which can not be detected effectively, often appear these years. It means more rain gauges conncted to the net should be implemented at upstreams of the communities facing torrent exits and on debris fan.

Image dependency in the recognition of newly learnt faces.

PubMed

Longmore, Christopher A; Santos, Isabel M; Silva, Carlos F; Hall, Abi; Faloyin, Dipo; Little, Emily

2017-05-01

Research investigating the effect of lighting and viewpoint changes on unfamiliar and newly learnt faces has revealed that such recognition is highly image dependent and that changes in either of these leads to poor recognition accuracy. Three experiments are reported to extend these findings by examining the effect of apparent age on the recognition of newly learnt faces. Experiment 1 investigated the ability to generalize to novel ages of a face after learning a single image. It was found that recognition was best for the learnt image with performance falling the greater the dissimilarity between the study and test images. Experiments 2 and 3 examined whether learning two images aids subsequent recognition of a novel image. The results indicated that interpolation between two studied images (Experiment 2) provided some additional benefit over learning a single view, but that this did not extend to extrapolation (Experiment 3). The results from all studies suggest that recognition was driven primarily by pictorial codes and that the recognition of faces learnt from a limited number of sources operates on stored images of faces as opposed to more abstract, structural, representations.

Safe Schooling: Always at the Ready

ERIC Educational Resources Information Center

Moore, Brian N.

2012-01-01

Those who spent time in the classroom recognize the need to formulate well-designed lesson plans before they can provide a first-rate education. A lesson plan provides guidance on what they will be teaching, the tools they will need to teach a lesson, and their expectations for the outcomes of the lesson--what kids will learn. The same is true for…

Organisational development in general practice: lessons from practice and professional development plans (PPDPs)

PubMed Central

Elwyn, Glyn; Hocking, Paul

2000-01-01

Background Improving the quality and effectiveness of clinical practice is becoming a key task within all health services. Primary medical care, as organised in the UK is composed of clinicians who work in independent partnerships (general practices) that collaborate with other health care professionals. Although many practices have successfully introduced innovations, there are no organisational development structures in place that support the evolution of primary medical care towards integrated care processes. Providing incentives for attendance at passive educational events and promoting 'teamwork' without first identifying organisational priorities are interventions that have proved to be ineffective at changing clinical processes. A practice and professional development plan feasibility study was evaluated in Wales and provided the experiential basis for a summary of the lessons learnt on how best to guide organisational development systems for primary medical care. Results Practice and professional development plans are hybrids produced by the combination of ideas from management (the applied behavioural science of organisational development) and education (self-directed adult learning theories) and, in conceptual terms, address the lack of effectiveness of passive educational strategies by making interventions relevant to identified system wide needs. In the intervention, each practice participated in a series of multidisciplinary workshops (minimum 4) where the process outcome was the production of a practice development plan and a set of personal portfolios, and the final outcome was a realised organisational change. It was apparent during the project that organisational admission to a process of developmental planning needed to be a stepwise process, where initial interest can lead to a fuller understanding, which subsequently develops into motivation and ownership, sufficient to complete the exercise. The advantages of introducing expert external facilitation were clear: evaluations of internal group processes were possible, strategic issues could be raised and explored and financial probity ensured. These areas are much more difficult to examine when only internal stakeholders are engaged in a planning process. Conclusions It is not possible to introduce practice and professional development plans (organisational development and organisational learning projects) in a publicly funded health care system without first addressing existing educational and management structures. Existing systems are based on educational credits for attendance and emerging accountability frameworks (criteria checklists) for clinical governance. Moving to systems that are less summative and more formative, and based on the philosophies of continual quality improvement, require changes to be made in the relevant support systems in order achieve policy proposals. PMID:11178111

SU-E-P-03: The Australian Clinical Dosimetry Service, a Bespoke National Solution

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

Williams, I; Lye, J; Alves, A

Purpose: The Australian Clinical Dosimetry Service, (ACDS) was a pilot program to enable the Australian Government to determine whether a locally designed audit program was suitable for mitigating dosimetric error risk to radiotherapy patients within Australia. The outcomes from four years of operations will be presented and discussed with a focus why and how the pilot requirements were met. The consequnces of success will be considered, the lessons learnt from the pilot program and how they are impacting the future ACDS design, operation and engagement with stakeholders. Methods: The ACDS was designed over 2010/11 by experts drawn from the threemore » professions in consultation with the national Department of Health. The list of outcomes required over a three year pilot was expressed in a Memorandum of Understanding, (MoU) between Health and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) which hosted the ACDS. Results: The ACDS has achieved all the MoU requirements. This paper describes how the staff within the ACDS engaged with the professional clinical workforce and provided a successful and functioning audit service. It identifies the strengths and weaknesses within the MoU and the ACDS structure and how the ACDS resolved a number of conflicting issues. It identifies the successes within the ACDS and how these were achieved. It provides details to assist and advise those seeking to design or modify national or regional auditing programs. Finally the paper reviews potential futures for the ACDS. Conclusion: The raw number of audits and outcomes indicate that the ACDS has met the MoU auditing requirements. The reasons for the ACDS’ success are highly dependent on: attracting quality staff who can respond with agility to changing situations, a high level of communication with the professional community, a high level of engagement by the community and an interested and engaged Federal Department. The Australian Clinical Dosimetry Service is a joint initiative between the Australian Department of Health and the Australian Radiation Protection and Nuclear Safety Agency.« less

A pivotal registration phase III, multicenter, randomized tuberculosis controlled trial: design issues and lessons learnt from the Gatifloxacin for TB (OFLOTUB) project.

PubMed

Merle, Corinne S C; Sismanidis, Charalambos; Sow, Oumou Bah; Gninafon, Martin; Horton, John; Lapujade, Olivier; Lo, Mame Bocar; Mitchinson, Denis A; Perronne, Christian; Portaels, Francoise; Odhiambo, Joseph; Olliaro, Piero; Rustomjee, Roxana; Lienhardt, Christian; Fielding, Katherine

2012-05-18

There have been no major advances in tuberculosis (TB) drug development since the first East African/British Medical Research Council short course chemotherapy trial 35 years ago. Since then, the landscape for conducting TB clinical trials has profoundly changed with the emergence of HIV infection, the spread of resistant TB bacilli strains, recent advances in mycobacteriological capacity, and drug discovery. As a consequence questions have arisen on the most appropriate approach to design and conduct current TB trials. To highlight key issues discussed: Is a superiority, equivalence, or non-inferiority design most appropriate? What should be the primary efficacy outcome? How to consider re-infections in the definition of the outcome? What is the optimal length of patient follow-up? Is blinding appropriate when treatment duration in test arm is shorter? What are the appropriate assumptions for sample size calculation? Various drugs are currently in the development pipeline. We are presenting in this paper the design of the most recently completed phase III TB trial, the OFLOTUB project, which is the pivotal trial of a registration portfolio for a gatifloxacin-containing TB regimen. It is a randomized, open-label, multicenter, controlled trial aiming to evaluate the efficacy and safety of a gatifloxacin-containing 4-month regimen (trial registration: ClinicalTrial.gov database: NCT00216385). In the light of the recent scientific and regulatory discussions, we discuss some of the design issues in TB clinical trials and more specifically the reasons that guided our choices, in order to best answer the trial objectives, while at the same time satisfying regulatory authority requirements. When shortening TB treatment, we are advocating for a non-inferiority, non-blinded design, with a composite unfavorable endpoint assessed 12 months post treatment completion, and added trial procedures specifically aiming to: (1) minimize endpoint unavailability; and (2) distinguish between relapse and re-infection.

Towards cash transfer interventions for tuberculosis prevention, care and control: key operational challenges and research priorities.

PubMed

Boccia, Delia; Pedrazzoli, Debora; Wingfield, Tom; Jaramillo, Ernesto; Lönnroth, Knut; Lewis, James; Hargreaves, James; Evans, Carlton A

2016-06-21

Cash transfer interventions are forms of social protection based on the provision of cash to vulnerable households with the aim of reduce risk, vulnerability, chronic poverty and improve human capital. Such interventions are already an integral part of the response to HIV/AIDS in some settings and have recently been identified as a core element of World Health Organization's End TB Strategy. However, limited impact evaluations and operational evidence are currently available to inform this policy transition. This paper aims to assist national tuberculosis (TB) programs with this new policy direction by providing them with an overview of concepts and definitions used in the social protection sector and by reviewing some of the most critical operational aspects associated with the implementation of cash transfer interventions. These include: 1) the various implementation models that can be used depending on the context and the public health goal of the intervention; 2) the main challenges associated with the use of conditionalities and how they influence the impact of cash transfer interventions on health-related outcomes; 3) the implication of targeting diseases-affected households and or individuals versus the general population; and 4) the financial sustainability of including health-related objectives within existing cash transfer programmes. We aimed to appraise these issues in the light of TB epidemiology, care and prevention. For our appraisal we draw extensively from the literature on cash transfers and build upon the lessons learnt so far from other health outcomes and mainly HIV/AIDS. The implementation of cash transfer interventions in the context of TB is still hampered by important knowledge gaps. Initial directions can be certainly derived from the literature on cash transfers schemes and other public health challenges such as HIV/AIDS. However, the development of a solid research agenda to address persisting unknowns on the impact of cash transfers on TB epidemiology and control is vital to inform and support the adoption of the post-2015 End TB strategy.

Conducting research in individual patients: lessons learnt from two series of N-of-1 trials

PubMed Central

Wegman, Anke CM; van der Windt, Daniëlle AWM; Stalman, Wim AB; de Vries, Theo PGM

2006-01-01

Background Double-blind randomised N-of-1 trials (N-of-1 trials) may help with decisions concerning treatment when there is doubt regarding the effectiveness and suitability of medication for individual patients. The patient is his or her own control, and receives the experimental and the control treatment during several periods of time in random order. Reports of N-of-1 trials are still relatively scarce, and the research methodology is not as firmly established as that of RCTs. Recently, we have conducted two series of N-of-1 trials in general practice. Before, during, and after data-collection, difficulties regarding outcome assessment, analysis of the results, the withdrawal of patients, and the follow-up had to be dealt with. These difficulties are described and our solutions are discussed. Discussion To prevent or anticipate difficulties in N-of-1 trials, we argue that that it is important to individualise the outcome measures, and to carefully consider the objective, type of randomisation and the analysis. It is recommended to use the same dosages and dosage forms that the patient used before the trial, to start the trial with a run-in period, to formulate both general and individualised decision rules regarding the efficacy of treatment, to adjust treatment policies immediately after the trial, and to provide adequate instructions and support if treatment is adjusted. Summary Because of the specific characteristics of N-of-1 trials it is difficult to formulate general 'how to do it' guidelines for designing N-of-1 trials. However, when the design of each N-of-1 trial is tailored to the specific characteristics of each individual patient and the underlying medical problem, most difficulties in N-of-1 trials can be prevented or overcome. In this way, N-of-1 trials may be of help when deciding on drug treatment for individual patients. PMID:16984636

A pivotal registration phase III, multicenter, randomized tuberculosis controlled trial: design issues and lessons learnt from the Gatifloxacin for TB (OFLOTUB) project

PubMed Central

2012-01-01

Background There have been no major advances in tuberculosis (TB) drug development since the first East African/British Medical Research Council short course chemotherapy trial 35 years ago. Since then, the landscape for conducting TB clinical trials has profoundly changed with the emergence of HIV infection, the spread of resistant TB bacilli strains, recent advances in mycobacteriological capacity, and drug discovery. As a consequence questions have arisen on the most appropriate approach to design and conduct current TB trials. To highlight key issues discussed: Is a superiority, equivalence, or non-inferiority design most appropriate? What should be the primary efficacy outcome? How to consider re-infections in the definition of the outcome? What is the optimal length of patient follow-up? Is blinding appropriate when treatment duration in test arm is shorter? What are the appropriate assumptions for sample size calculation? Methods Various drugs are currently in the development pipeline. We are presenting in this paper the design of the most recently completed phase III TB trial, the OFLOTUB project, which is the pivotal trial of a registration portfolio for a gatifloxacin-containing TB regimen. It is a randomized, open-label, multicenter, controlled trial aiming to evaluate the efficacy and safety of a gatifloxacin-containing 4-month regimen (trial registration: ClinicalTrial.gov database: NCT00216385). Results In the light of the recent scientific and regulatory discussions, we discuss some of the design issues in TB clinical trials and more specifically the reasons that guided our choices, in order to best answer the trial objectives, while at the same time satisfying regulatory authority requirements. Conclusion When shortening TB treatment, we are advocating for a non-inferiority, non-blinded design, with a composite unfavorable endpoint assessed 12 months post treatment completion, and added trial procedures specifically aiming to: (1) minimize endpoint unavailability; and (2) distinguish between relapse and re-infection. PMID:22607233

Preliminary Findings of a Randomized Trial of Non-Pharmaceutical Interventions to Prevent Influenza Transmission in Households

PubMed Central

Cowling, Benjamin J.; Fung, Rita O. P.; Cheng, Calvin K. Y.; Fang, Vicky J.; Chan, Kwok Hung; Seto, Wing Hong; Yung, Raymond; Chiu, Billy; Lee, Paco; Uyeki, Timothy M.; Houck, Peter M.; Peiris, J. S. Malik; Leung, Gabriel M.

2008-01-01

Background There are sparse data on whether non-pharmaceutical interventions can reduce the spread of influenza. We implemented a study of the feasibility and efficacy of face masks and hand hygiene to reduce influenza transmission among Hong Kong household members. Methodology/Principal Findings We conducted a cluster randomized controlled trial of households (composed of at least 3 members) where an index subject presented with influenza-like-illness of <48 hours duration. After influenza was confirmed in an index case by the QuickVue Influenza A+B rapid test, the household of the index subject was randomized to 1) control or 2) surgical face masks or 3) hand hygiene. Households were visited within 36 hours, and 3, 6 and 9 days later. Nose and throat swabs were collected from index subjects and all household contacts at each home visit and tested by viral culture. The primary outcome measure was laboratory culture confirmed influenza in a household contact; the secondary outcome was clinically diagnosed influenza (by self-reported symptoms). We randomized 198 households and completed follow up home visits in 128; the index cases in 122 of those households had laboratory-confirmed influenza. There were 21 household contacts with laboratory confirmed influenza corresponding to a secondary attack ratio of 6%. Clinical secondary attack ratios varied from 5% to 18% depending on case definitions. The laboratory-based or clinical secondary attack ratios did not significantly differ across the intervention arms. Adherence to interventions was variable. Conclusions/Significance The secondary attack ratios were lower than anticipated, and lower than reported in other countries, perhaps due to differing patterns of susceptibility, lack of significant antigenic drift in circulating influenza virus strains recently, and/or issues related to the symptomatic recruitment design. Lessons learnt from this pilot have informed changes for the main study in 2008. Trial Registration ClinicalTrials.gov NCT00425893 HKClinicalTrials.com HKCTR-365 PMID:18461182

Key considerations for the experimental training and evaluation of cancer odour detection dogs: lessons learnt from a double-blind, controlled trial of prostate cancer detection

PubMed Central

2014-01-01

Background Cancer detection using sniffer dogs is a potential technology for clinical use and research. Our study sought to determine whether dogs could be trained to discriminate the odour of urine from men with prostate cancer from controls, using rigorous testing procedures and well-defined samples from a major research hospital. Methods We attempted to train ten dogs by initially rewarding them for finding and indicating individual prostate cancer urine samples (Stage 1). If dogs were successful in Stage 1, we then attempted to train them to discriminate prostate cancer samples from controls (Stage 2). The number of samples used to train each dog varied depending on their individual progress. Overall, 50 unique prostate cancer and 67 controls were collected and used during training. Dogs that passed Stage 2 were tested for their ability to discriminate 15 (Test 1) or 16 (Tests 2 and 3) unfamiliar prostate cancer samples from 45 (Test 1) or 48 (Tests 2 and 3) unfamiliar controls under double-blind conditions. Results Three dogs reached training Stage 2 and two of these learnt to discriminate potentially familiar prostate cancer samples from controls. However, during double-blind tests using new samples the two dogs did not indicate prostate cancer samples more frequently than expected by chance (Dog A sensitivity 0.13, specificity 0.71, Dog B sensitivity 0.25, specificity 0.75). The other dogs did not progress past Stage 1 as they did not have optimal temperaments for the sensitive odour discrimination training. Conclusions Although two dogs appeared to have learnt to select prostate cancer samples during training, they did not generalise on a prostate cancer odour during robust double-blind tests involving new samples. Our study illustrates that these rigorous tests are vital to avoid drawing misleading conclusions about the abilities of dogs to indicate certain odours. Dogs may memorise the individual odours of large numbers of training samples rather than generalise on a common odour. The results do not exclude the possibility that dogs could be trained to detect prostate cancer. We recommend that canine olfactory memory is carefully considered in all future studies and rigorous double-blind methods used to avoid confounding effects. PMID:24575737

Visual health screening by schoolteachers in remote communities of Peru: implementation research

PubMed Central

Latorre-Arteaga, Sergio; Gil-González, Diana; Bascarán, Covadonga; Núñez, Richard Hurtado; Morales, María del Carmen Peral; Orihuela, Guillermo Carrillo

2016-01-01

Abstract Objective To describe the adaptation and scaling-up of an intervention to improve the visual health of children in the Apurimac region, Peru. Methods In a pilot screening programme in 2009–2010, 26 schoolteachers were trained to detect and refer visual acuity problems in schoolchildren in one district in Apurimac. To scale-up the intervention, lessons learnt from the pilot were used to design strategies for: (i) strengthening multisector partnerships; (ii) promoting the engagement and participation of teachers and (iii) increasing children’s attendance at referral eye clinics. Implementation began in February 2015 in two out of eight provinces of Apurimac, including hard-to-reach communities. We made an observational study of the processes and outcomes of adapting and scaling-up the intervention. Qualitative and quantitative analyses were made of data collected from March 2015 to January 2016 from programme documents, routine reports and structured evaluation questionnaires completed by teachers. Findings Partnerships were expanded after sharing the results of the pilot phase. Training was completed by 355 teachers and directors in both provinces, belonging to 315 schools distributed in 24 districts. Teachers’ appraisal of the training achieved high positive scores. Outreach eye clinics and subsidies for glasses were provided for poorer families. Data from six districts showed that attendance at the eye clinic increased from 66% (45/68 children referred) in the pilot phase to 92% (237/259) in the implementation phase. Conclusion Adaptation to the local context allowed the scaling-up of an intervention to improve visual health in children and enhanced the equity of the programme. PMID:27708470

Large-scale mHealth professional support for health workers in rural Maharashtra, India.

PubMed

Hegde, Shailendra Kumar B; Saride, Sriranga Prasad; Kuruganty, Sudha; Banker, Niraja; Patil, Chetan; Phanse, Vishal

2018-04-01

Expanding mobile telephony in India has prompted interest in the potential of mobile-telephone health (mHealth) in linking health workers in rural areas with specialist medical advice and other professional services. In 2012, a toll-free helpline offering specialist medical advice to community-based health workers throughout Maharashtra was launched. Calls are handled via a 24 h centre in Pune, staffed by health advisory officers and medical specialists. Health advisory officers handle general queries, which include medical advice via validated algorithms; blood on-call services; grievance issues; and mental health support - the latter calls are transferred to a qualified counsellor. Calls requiring more specialist advice are transferred to the appropriate medical specialist. This paper describes the experience of the first 4 years of this helpline, in terms of the services used, callers, nature of calls, types of queries serviced and lessons learnt. In the first 4 years of the helpline, 669 265 calls were serviced. Of these calls, 453 373 (67.74%) needed medical advice and were handled by health advisory officers. Specialist services were required to address 199 226 (29.77%) calls. Blood-bank-related services accounted for 7919 (1.18%) calls, while 2462 (0.37%) were grievance calls. Counselling for mental health issues accounted for 6285 (0.94%) calls. The large-scale mHealth professional support provided by this helpline in Maharashtra has reached many health workers serving rural communities. Future work is required to explore ways to expand the reach of the helpline further and to measure its effectiveness in improving health outcomes.

[Succession caused by beaver (Castor fiber L.) life activity: I. What is learnt from the calibration of a simple Markov model].

PubMed

Logofet, D O; Evstigneev, O I; Aleĭnikov, A A; Morozova, A O

2014-01-01

A homogeneous Markov chain of three aggregated states "pond--swamp--wood" is proposed as a model of cyclic zoogenic successions caused by beaver (Castor fiber L.) life activity in a forest biogeocoenosis. To calibrate the chain transition matrix, the data have appeared sufficient that were gained from field studies undertaken in "Bryanskii Les" Reserve in the years of 2002-2008. Major outcomes of the calibrated model ensue from the formulae of finite homogeneous Markov chain theory: the stationary probability distribution of states, thematrix (T) of mean first passage times, and the mean durations (M(j)) of succession stages. The former illustrates the distribution of relative areas under succession stages if the current trends and transition rates of succession are conserved in the long-term--it has appeared close to the observed distribution. Matrix T provides for quantitative characteristics of the cyclic process, specifying the ranges the experts proposed for the duration of stages in the conceptual scheme of succession. The calculated values of M(j) detect potential discrepancies between empirical data, the expert knowledge that summarizes the data, and the postulates accepted in the mathematical model. The calculated M2 value falls outside the expert range, which gives a reason to doubt the validity of expert estimation proposed, the aggregation mode chosen for chain states, or/and the accuracy-of data available, i.e., to draw certain "lessons" from partially successful calibration. Refusal to postulate the time homogeneity or the Markov property of the chain is also discussed among possible ways to improve the model.

Assessing barriers to a rational chemoprevention trial design in young patients with familial adenomatous polyposis.

PubMed

Wood, Joanna P; Howells, Lynne M; Brown, Karen; Thomas, Anne L

2017-07-01

Familial adenomatous polyposis coli (FAP) is an autosomal dominant condition caused by a germline mutation in the adenomatous polyposis coli gene. Colonic adenomas form and almost all patients will develop colorectal cancer if they are not managed at an early stage. The safest preventive strategy is surgical resection of the colon, most commonly performed in late teenage years. There is a paucity of trials investigating the use of primary chemoprevention to delay polyp formation in paediatric FAP. There are extensive preclinical and early clinical data demonstrating that curcumin may be a safe and effective chemotherapeutic agent in reducing the polyp burden in this disease. We ultimately proposed to design and conduct a clinical study to assess whether curcumin treatment delays the need for surgery and/or prevents cancer in young patients with FAP. Research into clinical trial protocols has demonstrated that assessing patients' perceptions at the initial stage leads to better outcomes. We therefore conducted a questionnaire study of patients and parents of children affected by FAP to gain information to aid the protocol design. Results demonstrated that there are some FAP patients for whom this study is relevant and desirable. Those with a personal history of curcumin use reported that it was well tolerated. However, the response rate was poor (25%), indicating that there are potential difficulties ensuring adequate recruitment to the proposed trial. This report draws on lessons learnt from prior trials and the findings from the questionnaire to outline the challenges faced in designing such a study.

Reaching consensus on reporting patient and public involvement (PPI) in research: methods and lessons learned from the development of reporting guidelines

PubMed Central

Brett, Jo; Staniszewska, Sophie; Simera, Iveta; Seers, Kate; Mockford, Carole; Goodlad, Susan; Altman, Doug; Moher, David; Barber, Rosemary; Denegri, Simon; Entwistle, Andrew Robert; Littlejohns, Peter; Suleman, Rashida; Thomas, Victoria; Tysall, Colin

2017-01-01

Introduction Patient and public involvement (PPI) is inconsistently reported in health and social care research. Improving the quality of how PPI is reported is critical in developing a higher quality evidence base to gain a better insight into the methods and impact of PPI. This paper describes the methods used to develop and gain consensus on guidelines for reporting PPI in research studies (updated version of the Guidance for Reporting Patient and Public Involvement (GRIPP2)). Methods There were three key stages in the development of GRIPP2: identification of key items for the guideline from systematic review evidence of the impact of PPI on health research and health services, a three-phase online Delphi survey with a diverse sample of experts in PPI to gain consensus on included items and a face-to-face consensus meeting to finalise and reach definitive agreement on GRIPP2. Challenges and lessons learnt during the development of the reporting guidelines are reported. Discussion The process of reaching consensus is vital within the development of guidelines and policy directions, although debate around how best to reach consensus is still needed. This paper discusses the critical stages of consensus development as applied to the development of consensus for GRIPP2 and discusses the benefits and challenges of consensus development. PMID:29061613

Lessons from high-throughput protein crystallization screening: 10 years of practical experience

PubMed Central

JR, Luft; EH, Snell; GT, DeTitta

2011-01-01

Introduction X-ray crystallography provides the majority of our structural biological knowledge at a molecular level and in terms of pharmaceutical design is a valuable tool to accelerate discovery. It is the premier technique in the field, but its usefulness is significantly limited by the need to grow well-diffracting crystals. It is for this reason that high-throughput crystallization has become a key technology that has matured over the past 10 years through the field of structural genomics. Areas covered The authors describe their experiences in high-throughput crystallization screening in the context of structural genomics and the general biomedical community. They focus on the lessons learnt from the operation of a high-throughput crystallization screening laboratory, which to date has screened over 12,500 biological macromolecules. They also describe the approaches taken to maximize the success while minimizing the effort. Through this, the authors hope that the reader will gain an insight into the efficient design of a laboratory and protocols to accomplish high-throughput crystallization on a single-, multiuser-laboratory or industrial scale. Expert Opinion High-throughput crystallization screening is readily available but, despite the power of the crystallographic technique, getting crystals is still not a solved problem. High-throughput approaches can help when used skillfully; however, they still require human input in the detailed analysis and interpretation of results to be more successful. PMID:22646073

JERM model of care: an in-principle model for dental health policy.

PubMed

Lam, Raymond; Kruger, Estie; Tennant, Marc

2014-01-01

Oral diseases are the most prevalent conditions in the community. Their economic burden is high and their impact on quality of life is profound. There is an increasing body of evidence indicating that oral diseases have wider implications beyond the confines of the mouth. The importance of oral health has not been unnoticed by the government. The Commonwealth (Federal) government under the Howard-led Coalition in 2004 had broken tradition by placing dentistry in its universal health insurance scheme, Medicare. Known as the Chronic Disease Dental Scheme (CDDS), the program aimed to manage patients with chronic conditions as part of the Enhanced Primary Care initiative. This scheme was a landmark policy for several reasons. Besides being the first major dental policy under Medicare, the program proved to be the most expensive and controversial. Unfortunately, cost containment and problems with service provision led to its cessation in 2012 by the Gillard Labor Government. Despite being seen as a failure, the CDDS provided a unique opportunity to assess national policy in practice. By analysing the policy-relevant effects of the CDDS, important lessons can be learnt for policy development. This paper discusses these lessons and has formulated a set of principles recommended for effective oral health policy. The JERM model represents the principles of a justified, economical and research-based model of care.

A Mixed Methods Comparison of Teachers' Lunar Modeling Lesson Implementation and Student Learning Outcomes

ERIC Educational Resources Information Center

Lamar, Mary F.; Wilhelm, Jennifer Anne; Cole, Merryn

2018-01-01

The authors compare three teachers' adaptations and implementation of a lunar modeling lesson to explain marked differences in student learning outcomes on a spatial-scientific lunar assessment. They used a modified version of the Practices of Science Observation Protocol (P-SOP; Forbes, Biggers, & Zangori, 2013) to identify ways in which…

Learning from the Mexico City Earthquake in 1985

NASA Astrophysics Data System (ADS)

Santos-Reyes, Jaime; Alvarado-Corona, Rafael

2010-05-01

Natural disasters are increasing alarmingly worldwide in recent years. They have killed millions of people, and adversely affected the life of at least one billion people. Given this, natural disasters present a great challenge to society today concerning how they are to be mitigated so as to produce an acceptable risk is a question which has come to the fore in dramatic ways recently. The paper addresses the following question: what could be learnt from natural disasters? The paper presents some preliminary results of the analysis of the Mexico City earthquake in 1985, by applying the Management Oversight Risk Tree (MORT) model. On September 19, 1985, at 7:19 hrs local time an intense earthquake with a magnitude of 8.1 on the Richter scale struck the country. The epicentre was located near the coast of the state of Guerrero, about 400 kilometres southeast of Mexico City. It is believed that thousands of people were affected and more than 10000 people were killed by the earthquake. On the other hand, the MORT model may be regarded as a structured checklist in the form of a complex ‘fault-tree' model that is intended to ensure that all aspects of an organization's management are looked into when assessing the possible causes of an incident. Moreover, the MORT has been applied extensively to the analysis of past failure of socio-technical systems; this is the first time that it has been applied to the case of natural disasters. A number of organizational failures have been highlighted by the model. It is hoped that by conducting such analysis lessons can be learnt and disseminated so that the impact of natural disasters such as Earthquakes can be mitigated in the future.

Linguistic influence on mathematical development is specific rather than pervasive: revisiting the Chinese Number Advantage in Chinese and English children

PubMed Central

Mark, Winifred; Dowker, Ann

2015-01-01

The relative linguistic transparency of the Asian counting system has been used to explain Asian students’ relative superiority in cross-cultural comparisons of mathematics achievement. To test the validity and extent of linguistic transparency in accounting for mathematical abilities, this study tested Chinese and British primary school children. Children in Hong Kong can learn mathematics using languages with both regular (Chinese) and irregular (English) counting systems, depending on their schools’ medium of instruction. This makes it possible to compare groups with varying levels of exposure to the regular and irregular number systems within the same educational system, curriculum, and cultural environment. The study included three groups of first/second graders and third/fourth graders with varying degrees of experience to the Chinese language and counting systems: no experience (UK; n = 49); spoke Chinese at home and learnt to count in English at school (HK-E; n = 43); spoke Chinese at home and learnt to count in Chinese at school (HK-C; n = 47). They were compared on counting, numerical abilities and place value representation. The present study also measured nonverbal reasoning, attitude toward mathematics, involvement of parents, and extra-curricular mathematics lessons to explore alternative explanations of children’s numeric ability. Results indicated that students in HK-C were better at counting backward and on the numeric skills test than those in HK-E, who were in turn better than the UK students. However, there was no statistical difference in counting forward, place value understanding, and a measure of arithmetic. Our findings add to existent literature suggesting that linguistic transparency does not have an all-pervasive influence on cross-national differences in arithmetic performance. PMID:25767456

Biology Teachers Designing Context-Based Lessons for Their Classroom Practice--The Importance of Rules-of-Thumb

ERIC Educational Resources Information Center

Wieringa, Nienke; Janssen, Fred J. J. M.; Van Driel, Jan H.

2011-01-01

In science education in the Netherlands new, context-based, curricula are being developed. As in any innovation, the outcome will largely depend on the teachers who design and implement lessons. Central to the study presented here is the idea that teachers, when designing lessons, use rules-of-thumb: notions of what a lesson should look like if…

A non-equivalent group pilot trial of a school-based physical activity and fitness intervention for 10-11 year old english children: born to move.

PubMed

Fairclough, Stuart J; McGrane, Bronagh; Sanders, George; Taylor, Sarah; Owen, Michael; Curry, Whitney

2016-08-24

PE lessons are the formal opportunity in schools for promotion of physical activity and fitness. This study aimed to evaluate the effectiveness of a pilot PE intervention on physical activity, fitness, and psychosocial outcomes. Participants were 139 children aged 10-11 years from four schools. For six weeks children in two schools received a twice-weekly pilot 'Born to Move' (BTM) physical activity (PA) and fitness intervention alongside one regular PE lesson. Children in the two comparison (COM) schools received their regular twice weekly PE lessons. Outcomes were lesson time and whole-day light (LPA), moderate (MPA), vigorous (VPA), and MVPA, and sedentary time, muscular fitness, cardiorespiratory fitness (CRF), and lesson-specific perceived exertion, enjoyment, and perceived competence. Outcomes were assessed at baseline (T0), midway through the intervention (T1), and at the end (T2) using ANOVAs and ANCOVAs. Intervention fidelity was measured using child and teacher surveys at T2 and analysed using Chi-square tests. The BTM group engaged in moderate PA for significantly more lesson time (29.4 %) than the COM group (25.8 %; p = .009, d = .53). The amount of moderate-to-vigorous PA (MVPA) during the T1 BTM lesson contributed 14.0 % to total MVPA, which was significantly more than the COM group's T1 PE lesson (11.4 %; p < .001, d = .47). The BTM group were significantly more active during the whole-day (p < .05) and the school-day (p < .01). In both groups push-up test performance increased (p < .001) and CRF test performance decreased (p < .01). Perceived exertion, enjoyment, and perceived competence increased in both groups (p < .05), but the BTM group rated their enjoyment of the T1 BTM lesson higher than the COM group rated their PE lesson (p = .02, d = .56). The children's and teachers' responses to the intervention indicated that the delivery aims of enjoyment, engagement, inclusivity, and challenge were satisfied. The BTM pilot programme has potential to positively impact on physical activity, fitness, and psychosocial outcomes. Further, BTM was enjoyed by the children, and valued by the teachers. This study can inform the design of a modified larger-scale cluster RCT evaluation.

Issues in Violent Risk Assessment: Lessons Learned and Future Directions

ERIC Educational Resources Information Center

Kroner, Daryl G.

2005-01-01

Realizing that the assessment of dangerousness with a yes/no format as a poor form of violent risk assessment has been the most important lesson learned about violence in the last 20 years. Further examining (a) what outcome and (b) how the indicators of the outcome should be measured has resulted in better violent risk assessment. The most…

Challenge Activities for the Physical Education Classroom: Affective Learning Outcomes

ERIC Educational Resources Information Center

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

2017-01-01

The purpose of this article is to share three challenge-based lesson plans that can be implemented by physical educators in their classroom. Each of the lesson examples addresses the three learning domains: psychomotor, cognitive and affective. Additionally, each lesson is aligned with SHAPE America's National Standards for K-12 Physical…

Companion Guides for Lesson Planning: A Planning Template and the Lesson Plan Pro Forma

ERIC Educational Resources Information Center

Pang, May

2016-01-01

Jason Anderson's proposal, in "ELT Journal" (2015), for an affordance-based approach to lesson planning raises important issues in teacher education. However, his arguments against the role of planned outcomes in favour of an affordance-based focus using learning opportunities as units of planning fail to acknowledge the complexities…

The Measurement of Psychological Constructs in Peace Education.

ERIC Educational Resources Information Center

Christie, Daniel J.

Peace education research typically is designed to evaluate the effects of a single lesson or a group of lessons (unit) on some attitudinal or learning outcomes. The current research was designed to evaluate a set of procedures for identifying a mix of peace education lessons that desirably impact on students. Three curriculum consultants were…

MO-AB-BRA-10: Cancer Therapy Outcome Prediction Based On Dempster-Shafer Theory and PET Imaging

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

Lian, C; University of Rouen, QuantIF - EA 4108 LITIS, 76000 Rouen; Li, H

2015-06-15

Purpose: In cancer therapy, utilizing FDG-18 PET image-based features for accurate outcome prediction is challenging because of 1) limited discriminative information within a small number of PET image sets, and 2) fluctuant feature characteristics caused by the inferior spatial resolution and system noise of PET imaging. In this study, we proposed a new Dempster-Shafer theory (DST) based approach, evidential low-dimensional transformation with feature selection (ELT-FS), to accurately predict cancer therapy outcome with both PET imaging features and clinical characteristics. Methods: First, a specific loss function with sparse penalty was developed to learn an adaptive low-rank distance metric for representing themore » dissimilarity between different patients’ feature vectors. By minimizing this loss function, a linear low-dimensional transformation of input features was achieved. Also, imprecise features were excluded simultaneously by applying a l2,1-norm regularization of the learnt dissimilarity metric in the loss function. Finally, the learnt dissimilarity metric was applied in an evidential K-nearest-neighbor (EK- NN) classifier to predict treatment outcome. Results: Twenty-five patients with stage II–III non-small-cell lung cancer and thirty-six patients with esophageal squamous cell carcinomas treated with chemo-radiotherapy were collected. For the two groups of patients, 52 and 29 features, respectively, were utilized. The leave-one-out cross-validation (LOOCV) protocol was used for evaluation. Compared to three existing linear transformation methods (PCA, LDA, NCA), the proposed ELT-FS leads to higher prediction accuracy for the training and testing sets both for lung-cancer patients (100+/−0.0, 88.0+/−33.17) and for esophageal-cancer patients (97.46+/−1.64, 83.33+/−37.8). The ELT-FS also provides superior class separation in both test data sets. Conclusion: A novel DST- based approach has been proposed to predict cancer treatment outcome using PET image features and clinical characteristics. A specific loss function has been designed for robust accommodation of feature set incertitude and imprecision, facilitating adaptive learning of the dissimilarity metric for the EK-NN classifier.« less

Scripted and Unscripted Science Lessons for Children with Autism and Intellectual Disability.

PubMed

Knight, Victoria F; Collins, Belva; Spriggs, Amy D; Sartini, Emily; MacDonald, Margaret Janey

2018-02-27

Both scripted lessons and unscripted task analyzed lessons have been used effectively to teach science content to students with intellectual disability and autism spectrum disorder. This study evaluated the efficacy, efficiency, and teacher preference of scripted and unscripted task analyzed lesson plans from an elementary science curriculum designed for students with intellectual disability and autism spectrum disorder by evaluating both lesson formats for (a) student outcomes on a science comprehension assessment, (b) sessions to criterion, and (c) average duration of lessons. Findings propose both lesson types were equally effective, but unscripted task analyzed versions may be more efficient and were preferred by teachers to scripted lessons. Implications, limitations, and suggestions for future research are also discussed.

The key to using a learning or skill acquisition plan.

PubMed

Nicholls, Delwyn; Sweet, Linda; Westerway, Sue Campbell; Gibbins, Annie

2014-11-01

A learning plan is a tool to guide the development of knowledge, skills and professional attitudes required for practice. A learning plan is an ideal tool for both supervisors and mentors to guide the process of teaching and learning a medical ultrasound examination. A good learning plan will state the learning goal, identify the learning activities and resources needed to achieve this goal, and highlight the outcome measures, which when achieved indicate the goal has been accomplished. A skill acquisition plan provides a framework for task acquisition and skill stratification; and is an extension of the application of the student learning plan. One unique feature of a skill acquisition plan is it requires the tutor to first undertake a task analysis. The task steps are progressively learnt in sequence, termed scaffolding. The skills to develop and use a learning or skill acquisition plan are also learnt, but are an integral component to the ultrasound tutors skill set. This paper will provide an outline of how to use and apply a learning and skill acquisition plan. We will review how these tools can be personalised to each student and skill teaching environment.

Dynamic Emotional Faces Generalise Better to a New Expression but not to a New View.

PubMed

Liu, Chang Hong; Chen, Wenfeng; Ward, James; Takahashi, Nozomi

2016-08-08

Prior research based on static images has found limited improvement for recognising previously learnt faces in a new expression after several different facial expressions of these faces had been shown during the learning session. We investigated whether non-rigid motion of facial expression facilitates the learning process. In Experiment 1, participants remembered faces that were either presented in short video clips or still images. To assess the effect of exposure to expression variation, each face was either learnt through a single expression or three different expressions. Experiment 2 examined whether learning faces in video clips could generalise more effectively to a new view. The results show that faces learnt from video clips generalised effectively to a new expression with exposure to a single expression, whereas faces learnt from stills showed poorer generalisation with exposure to either single or three expressions. However, although superior recognition performance was demonstrated for faces learnt through video clips, dynamic facial expression did not create better transfer of learning to faces tested in a new view. The data thus fail to support the hypothesis that non-rigid motion enhances viewpoint invariance. These findings reveal both benefits and limitations of exposures to moving expressions for expression-invariant face recognition.

Dynamic Emotional Faces Generalise Better to a New Expression but not to a New View

PubMed Central

Liu, Chang Hong; Chen, Wenfeng; Ward, James; Takahashi, Nozomi

2016-01-01

Prior research based on static images has found limited improvement for recognising previously learnt faces in a new expression after several different facial expressions of these faces had been shown during the learning session. We investigated whether non-rigid motion of facial expression facilitates the learning process. In Experiment 1, participants remembered faces that were either presented in short video clips or still images. To assess the effect of exposure to expression variation, each face was either learnt through a single expression or three different expressions. Experiment 2 examined whether learning faces in video clips could generalise more effectively to a new view. The results show that faces learnt from video clips generalised effectively to a new expression with exposure to a single expression, whereas faces learnt from stills showed poorer generalisation with exposure to either single or three expressions. However, although superior recognition performance was demonstrated for faces learnt through video clips, dynamic facial expression did not create better transfer of learning to faces tested in a new view. The data thus fail to support the hypothesis that non-rigid motion enhances viewpoint invariance. These findings reveal both benefits and limitations of exposures to moving expressions for expression-invariant face recognition. PMID:27499252

SMART-1 operations experience and lessons learnt

NASA Astrophysics Data System (ADS)

Camino, Octavio; Alonso, Maria; Gestal, Daniel; de Bruin, Jurriaan; Rathsman, Peter; Kugelberg, Joakim; Bodin, Per; Ricken, Sascha; Blake, Rick; Voss, Pablo Pardo; Stagnaro, Luca

2007-06-01

SMART-1 is the first of a series of ESA Small Missions for Advance Research and Technology where elements of the platform and the payload technology have been conceived as a demonstration for future cornerstone missions and an early opportunity for science. SMART-1 has also been an opportunity to experiment with new ways of conducting ground operations taking advantage of both increased satellite autonomy and ground automation tools. The paper will focus on three areas: The accumulated performance of the technology demonstration components since launch as the electrical propulsion engine, the triple-junction solar cells, the lithium-ion batteries, the 32 bit CPU ERC32 Single Chip, the CAN bus, the DTU Star Trackers and the complex on-board autonomy. The changes implemented on-board and on the ground during the lunar phase to increase the data return. The pros and contras in some of the choices made for SMART-1, the developments and solutions implemented to mitigate the problems, the tools developed to automate the operations and the distribution of data.

Pesticide leaching through sandy and loamy fields - long-term lessons learnt from the Danish Pesticide Leaching Assessment Programme.

PubMed

Rosenbom, Annette E; Olsen, Preben; Plauborg, Finn; Grant, Ruth; Juhler, René K; Brüsch, Walter; Kjær, Jeanne

2015-06-01

The European Union authorization procedure for pesticides includes an assessment of the leaching risk posed by pesticides and their degradation products (DP) with the aim of avoiding any unacceptable influence on groundwater. Twelve-year's results of the Danish Pesticide Leaching Assessment Programme reveal shortcomings to the procedure by having assessed leaching into groundwater of 43 pesticides applied in accordance with current regulations on agricultural fields, and 47 of their DP. Three types of leaching scenario were not fully captured by the procedure: long-term leaching of DP of pesticides applied on potato crops cultivated in sand, leaching of strongly sorbing pesticides after autumn application on loam, and leaching of various pesticides and their DP following early summer application on loam. Rapid preferential transport that bypasses the retardation of the plow layer primarily in autumn, but also during early summer, seems to dominate leaching in a number of those scenarios. Copyright © 2015 Elsevier Ltd. All rights reserved.

Biomedical research in a Digital Health Framework

PubMed Central

2014-01-01

This article describes a Digital Health Framework (DHF), benefitting from the lessons learnt during the three-year life span of the FP7 Synergy-COPD project. The DHF aims to embrace the emerging requirements - data and tools - of applying systems medicine into healthcare with a three-tier strategy articulating formal healthcare, informal care and biomedical research. Accordingly, it has been constructed based on three key building blocks, namely, novel integrated care services with the support of information and communication technologies, a personal health folder (PHF) and a biomedical research environment (DHF-research). Details on the functional requirements and necessary components of the DHF-research are extensively presented. Finally, the specifics of the building blocks strategy for deployment of the DHF, as well as the steps toward adoption are analyzed. The proposed architectural solutions and implementation steps constitute a pivotal strategy to foster and enable 4P medicine (Predictive, Preventive, Personalized and Participatory) in practice and should provide a head start to any community and institution currently considering to implement a biomedical research platform. PMID:25472554

Method and application of ocean environmental awareness measurement: Lessons learnt from university students of China.

PubMed

Umuhire, Marie Louise; Fang, Qinhua

2016-01-30

Different studies have proved that enhancing public Ocean Environmental Awareness (OEA) will lead to increased public support for ocean environmental protection. Our study develops a questionnaire to investigate current levels of students' OEA from three aspects including ocean environmental concerns, ocean environment knowledge and willingness to participate in ocean related activities. This questionnaire was applied to students from Xiamen University to understand the OEA of university students in China, of which there are few studies. Using data gathered from a random purposive sample, the OEA level of students in Xiamen University was investigated and then the influencing factors (education, geographical situation, age and gender etc.) were further analyzed. Findings suggest that most students are concerned about the ocean environment but their knowledge is not enough that makes the willingness to participate in ocean related actions limited as well. The results show there is an urgent need to improve students' OEA. Copyright © 2015 Elsevier Ltd. All rights reserved.

Improving compliance with requirements on junior doctors' hours

PubMed Central

Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E

2003-01-01

Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942

Policy Support and Resources Mobilization for the National Schistosomiasis Control Programme in The People's Republic of China.

PubMed

Zhu, H; Yap, P; Utzinger, J; Jia, T-W; Li, S-Z; Huang, X-B; Cai, S-X

2016-01-01

Schistosomiasis remains a public health problem in many developing countries around the world. After the founding of The People's Republic of China, from 1949 till date, all levels of government, from central to local, have been attaching great importance to schistosomiasis control in The People's Republic of China. With considerable policy support and resources mobilization, the national schistosomiasis control programmes have been implemented during the past 65years. Here, we summarize the successful experience of schistosomiasis control during the process. Recommendations for the future management of the Chinese national schistosomiasis elimination programme are put forward after considering the remaining challenges, shortcomings and lessons learnt from 65years of schistosomiasis control drives in The People's Republic of China. They will help to sustain past achievements, foster the attainment of the ultimate goal of schistosomiasis elimination for the country and provide reference for schistosomiasis control programme in other countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

EU-AIMS Longitudinal European Autism Project (LEAP): the autism twin cohort.

PubMed

Isaksson, Johan; Tammimies, Kristiina; Neufeld, Janina; Cauvet, Élodie; Lundin, Karl; Buitelaar, Jan K; Loth, Eva; Murphy, Declan G M; Spooren, Will; Bölte, Sven

2018-01-01

EU-AIMS is the largest European research program aiming to identify stratification biomarkers and novel interventions for autism spectrum disorder (ASD). Within the program, the Longitudinal European Autism Project (LEAP) has recruited and comprehensively phenotyped a rare sample of 76 monozygotic and dizygotic twins, discordant, or concordant for ASD plus 30 typically developing twins. The aim of this letter is to complete previous descriptions of the LEAP case-control sample, clinically characterize, and investigate the suitability of the sample for ASD twin-control analyses purposes and share some 'lessons learnt.' Among the twins, a diagnosis of ASD is associated with increased symptom levels of ADHD, higher rates of intellectual disability, and lower family income. For the future, we conclude that the LEAP twin cohort offers multiple options for analyses of genetic and shared and non-shared environmental factors to generate new hypotheses for the larger cohort of LEAP singletons, but particularly cross-validate and refine evidence from it.

Ineffective pictorial health warnings on tobacco products: lessons learnt from India.

PubMed

Arora, Monika; Tewari, Abha; Nazar, Gaurang P; Gupta, Vinay K; Shrivastav, Radhika

2012-01-01

Pictorial warnings are effective in promoting smoking cessation as shown by research in the developed countries. This study aims to determine perceptions of Indians about the effectiveness of pictorial health warnings on tobacco packs which existed from May 31, 2009, to December 1, 2011. A cross-sectional survey was undertaken in five states of India with 1897 participants (56% males; 54% tobacco users). More tobacco users expressed that the pictorial warnings are inadequate to convey the health impact of tobacco use when compared with nonusers (71.50% vs. 62.75%; P < 0.001). More illiterates when compared with literates expressed their concern that the current pictorial warnings will not motivate them to quit (61.17% vs. 51.01%; P < 0.001). The new warnings implemented from December 1, 2011, in India are also not field-tested. Field testing and assessment of effectiveness of health warnings should be a mandatory requirement for Parties reporting on Article 11 of Framework Convention on Tobacco Control (FCTC).

Listening to the student voice to improve educational software.

PubMed

van Wyk, Mari; van Ryneveld, Linda

2017-01-01

Academics often develop software for teaching and learning purposes with the best of intentions, only to be disappointed by the low acceptance rate of the software by their students once it is implemented. In this study, the focus is on software that was designed to enable veterinary students to record their clinical skills. A pilot of the software clearly showed that the program had not been received as well as had been anticipated, and therefore the researchers used a group interview and a questionnaire with closed-ended and open-ended questions to obtain the students' feedback. The open-ended questions were analysed with conceptual content analysis, and themes were identified. Students made valuable suggestions about what they regarded as important considerations when a new software program is introduced. The most important lesson learnt was that students cannot always predict their needs accurately if they are asked for input prior to the development of software. For that reason student input should be obtained on a continuous and regular basis throughout the design and development phases.

The international development of forensic science standards - A review.

PubMed

Wilson-Wilde, Linzi

2018-04-16

Standards establish specifications and procedures designed to ensure products, services and systems are safe, reliable and consistently perform as intended. Standards can be used in the accreditation of forensic laboratories or facilities and in the certification of products and services. In recent years there have been various international activities aiming at developing forensic science standards and guidelines. The most significant initiative currently underway within the global forensic community is the development of International Organization for Standardization (ISO) standards. This paper reviews the main bodies working on standards for forensic science, the processes used and the implications for accreditation. This paper specifically discusses the work of ISO Technical Committee TC272, the future TC272 work program for the development of forensic science standards and associated timelines. Also discussed, are the lessons learnt to date in navigating the complex environment of multi-country stakeholder deliberations in standards development. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Google Books: making the public domain universally accessible

NASA Astrophysics Data System (ADS)

Langley, Adam; Bloomberg, Dan S.

2007-01-01

Google Book Search is working with libraries and publishers around the world to digitally scan books. Some of those works are now in the public domain and, in keeping with Google's mission to make all the world's information useful and universally accessible, we wish to allow users to download them all. For users, it is important that the files are as small as possible and of printable quality. This means that a single codec for both text and images is impractical. We use PDF as a container for a mixture of JBIG2 and JPEG2000 images which are composed into a final set of pages. We discuss both the implementation of an open source JBIG2 encoder, which we use to compress text data, and the design of the infrastructure needed to meet the technical, legal and user requirements of serving many scanned works. We also cover the lessons learnt about dealing with different PDF readers and how to write files that work on most of the readers, most of the time.

Community participation in natural resources management: reality or rhetoric? Lessons learnt from the Kasanka Game Management Area (GMA) communities, Serenje District, Zambia.

PubMed

Mutamba, Emmanuel

2004-12-01

In the developing world, the term 'participation' has in recent years become a household word in the same way that 'democracy' or 'gender' have. Development agencies are demanding increased participation in their programmes. The use of the word or its application has become a centre of debate. Due to the difficulties involved in measuring 'participation' or indeed determining levels at which participation should take place, who participates and when, many 'doubting Thomases' have questioned its effectiveness. It has, however been acknowledged in many areas that popular participation changes policies and enhances management and governance. In complex issues of natural resources management, participatory techniques have helped communities develop collective responsibilities towards management of their resources and projects. This paper discusses the complexities of community participation in natural resources management, ranging from interrelations among stakeholders to resource ownership based on the experiences in the Kasanka Game Management Area (KGMA).

Setting research priorities for HIV/AIDS-related research in a post-graduate training programme: lessons learnt from the Nigeria Field Epidemiology and Laboratory Training Programme scientific workshop.

PubMed

Poggensee, Gabriele; Waziri, Ndadilnasiya Endie; Bashorun, Adebobola; Nguku, Patrick Mboya; Fawole, Olufunmilayo Ibitola; Sabitu, Kabir

2014-01-01

In Nigeria the current prevalence of HIV is 4.1% with over 3.5 million infected and estimated 1.5 million in need of anti-retroviral treatment. Epidemiological and implementation studies are necessary for monitoring and evaluation of interventions. To define research areas which can be addressed by participants of the Nigeria Field Epidemiology and Training Programme (NFELTP) a workshop was held in April 2013 in Abuja, Nigeria. Priority research areas were identified using criteria lists for ranking of the relevance of research questions. Based on a research matrix, NFELTP residents developed the aims and objectives, study design for HIV-related research proposals. This workshop was the first workshop held by the NFELTP to establish an inventory of research questions which can be addressed by the residents within their training period. This inventory will help to increase HIV/AIDS-related activities of NFELTP which are in accordance with research needs in Nigeria and PEPFAR objectives.

The Robust Software Feedback Model: An Effective Waterfall Model Tailoring for Space SW

NASA Astrophysics Data System (ADS)

Tipaldi, Massimo; Gotz, Christoph; Ferraguto, Massimo; Troiano, Luigi; Bruenjes, Bernhard

2013-08-01

The selection of the most suitable software life cycle process is of paramount importance in any space SW project. Despite being the preferred choice, the waterfall model is often exposed to some criticism. As matter of fact, its main assumption of moving to a phase only when the preceding one is completed and perfected (and under the demanding SW schedule constraints) is not easily attainable. In this paper, a tailoring of the software waterfall model (named “Robust Software Feedback Model”) is presented. The proposed methodology sorts out these issues by combining a SW waterfall model with a SW prototyping approach. The former is aligned with the SW main production line and is based on the full ECSS-E-ST-40C life-cycle reviews, whereas the latter is carried out in advance versus the main SW streamline (so as to inject its lessons learnt into the main streamline) and is based on a lightweight approach.

Comprehensive strategies for the prevention and control of diabetes and cardiovascular diseases in Africa: future directions.

PubMed

Muna, Walinjom F T

2013-01-01

The countries of the Sub Saharan African region have insufficient resources and healthcare systems that are poorly adapted to cope with the longstanding burden associated with communicable diseases and the ongoing HIV/AIDS pandemic. In addition, the rising burden of non-communicable diseases, including diabetes, cardiovascular diseases, and their risk factors, poses additional challenges. These countries need to urgently develop strategies to address these challenges of disease prevention and control. These strategies will require a new vision and more relevant and 'suitable' vocabulary in dealing with healthcare design, planning and implementation (using a cross-sectorial approach). Lessons learnt from the past (e.g. primary health care) in sub-Saharan Africa and other regions of the world may equally prove useful in developing strategies for the prevention and control of non-communicable diseases. Any potential strategy must emphasize the crucial role of economic, social, and environmental health determinants as well as the use of appropriate health technology. © 2013.

Nanomanufacturing and sustainability: opportunities and challenges

NASA Astrophysics Data System (ADS)

Busnaina, Ahmed A.; Mead, Joey; Isaacs, Jacqueline; Somu, Sivasubramanian

2013-10-01

New nanomanufacturing technologies, although still in research labs, present a great opportunity to drastically reduce the cost of making nanostructures on a large scale and at high-rates. Such new bottom-up directed assembly-based approaches involve adding materials selectively thereby both reducing waste and the number of required processes. Directed assembly-based processes are conducted at room pressure and temperatures which significantly reduces the cost of nanomanufacturing equipment and tools, ensuring long-term sustainability by reducing energy, consumables, and waste costs. This paradigm shift in nanomanufacturing will unleash not only a wave of creativity in sustainable nanomanufacturing but lessons learnt along the way can be used in various other sectors. Along with the exquisite technological promise that nanotechnology holds, nano-enabled products are heralded as a means for energy and resource reduction, resulting in potential manufacturing cost reductions and further, for potential improvements to environmental remediation. Sustainable nanomanufacturing will, by dramatically lowering current nanomanufacturing barriers, spur innovation, and the creation of entirely new industries by leveling the playing and ultimately leading to the democratization of nanomanufacturing.

Dysonian Approach to SETI: A Fruitful Middle Ground?

NASA Astrophysics Data System (ADS)

Bradbury, R. J.; Cirkovic, M. M.; Dvorsky, G.

We critically assess the prevailing currents in the Search for Extraterrestrial Intelligence (SETI), embodied in the notion of radio-searches for intentional artificial signals as envisioned by pioneers such as Frank Drake, Philip Morrison, Michael Papagiannis and others. In particular, we emphasize (1) the necessity of integrating SETI into a wider astrobiological and future studies context, (2) the relevance of and lessons to be learnt from the anti-SETI arguments, in particular Fermi's paradox, and (3) a need for complementary approach which we dub the Dysonian SETI. It is meaningfully derived from the inventive and visionary ideas of Freeman J. Dyson and his imaginative precursors, like Konstantin E. Tsiolkovsky, Olaf Stapledon, Nikola Tesla or John B. S. Haldane, who suggested macro-engineering projects as the focal points in the context of extrapolations about the future of humanity and, by analogy, other intelligent species. We consider practical ramifications of the Dysonian SETI and indicate some of the promising directions for future work.

Bilateral Malar Reconstruction Using Patient-Specific Polyether Ether Ketone Implants in Treacher-Collins Syndrome Patients With Absent Zygomas.

PubMed

Sainsbury, David C G; George, Alan; Forrest, Christopher R; Phillips, John H

2017-03-01

The authors performed bilateral malar reconstruction using polyether ether ketone implants in 3 patients with Treacher-Collins syndrome with absent, as opposed to hypoplastic, zygomata. These patient-specific implants were fabricated using computed-aided design software reformatted from three-dimensional bony preoperative computed tomography images. The first time the authors performed this procedure the implant compressed the globe resulting in temporary anisocoria that was quickly recognized intraoperatively. The implant was immediately removed and the patient made a full-recovery with no ocular disturbance. The computer-aided design and manufacturing process was adjusted to include periorbital soft-tissue boundaries to aid in contouring the new implants. The same patient, and 2 further patients, subsequently underwent malar reconstruction using this soft tissue periorbital boundary fabrication process with an additional 2 mm relief removed from the implant's orbital surface. These subsequent procedures were performed without complication and with pleasing aesthetic results. The authors describe their experience and the salutary lessons learnt.

Disaster relief and initial response to the earthquake and tsunami in Meulaboh, Indonesia.

PubMed

Lee, V J; Low, E; Ng, Y Y; Teo, C

2005-10-01

The Singapore Humanitarian Assistance Support Group deployed a team of 32 medical relief workers to Meulaboh, Indonesia to provide medical assistance for victims of the 26 December earthquake and tsunami disaster. The team was deployed at a primary healthcare clinic at an internally displaced persons' (IDP) camp and at the sole hospital's emergency and surgical departments. The team saw a total of 1841 patients, 1371 at the clinic and 446 at the hospital's emergency department, and performed surgery on 24 patients. Tsunami-related trauma cases accounted for 31.8% (142) of cases at the emergency department, 1.6% (22) of cases at the clinic, and 91.7% (22) of surgeries. This paper details the difficulties and lessons learnt by the team, including the lack of important resources for healthcare delivery. Water, sanitation, hygiene, and vector control were some of the problems faced, with the goal to provide the most effective public health for the greatest number of people given the limited resources available.

A review of the National pharmacovigilance system in Malta - implementing and operating a pharmacovigilance management system.

PubMed

Tanti, Amy; Micallef, Benjamin; Serracino-Inglott, Anthony; Borg, John-Joseph

2017-01-01

Regulatory authorities have a legal mandate to implement and maintain a Pharmacovigilance System designed to monitor the safety of authorised medicinal products and detect any change to their risk-benefit balance. Areas covered: This review maps the implementation of pharmacovigilance activities in Malta since accession in the EU in mid 2004 and discusses the challenges the Maltese Regulator encountered while setting up adequate and effective systems to fulfil its legal mandate. Areas reviewed are those around ADR reporting, promotion and safety communications including rapid alerts and recalls, direct healthcare professional communications, risk minimisation measures and safety circulars and quality systems. Expert opinion: Within a ten year period, 3 EU directives on pharmacovigilance were implemented by our agency. Despite limitations to resources, based on a prioritised implementation, the legislation provisions are now fully operational with a good level of sustainability. Lessons learnt from this process are discussed in this review. The coming years will involve strengthening and consolidation of existing processes.

Challenges associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience.

PubMed

Sidze, Estelle M; Beekink, Erik; Maina, Beatrice W

2015-05-05

Universal access to reproductive health services entails strengthening health systems, but requires significant resource commitments as well as efficient and effective use of those resources. A number of international organizations and governments in developing countries are putting efforts into tracking the flow of health resources in order to inform resource mobilization and allocation, strategic planning, priority setting, advocacy and general policy making. The UNFPA/NIDI-led Resource Flows Project ("The UNFPA/NIDI RF Project") has conducted annual surveys since 1997 to monitor progress achieved by developing countries in implementing reproductive health financial targets. This commentary summarizes the Project experiences and challenges in gathering data on allocation of resources for reproductive health at the domestic level in sub-Saharan African countries. One key lesson learnt from the Project experience is the need for strengthening tracking mechanisms in sub-Saharan African countries and making information on reproductive health resources and expenditures available, in particular the private sector resources.

Is naturalistic driving research possible with highly instrumented cars? Lessons learnt in three research centres.

PubMed

Valero-Mora, Pedro M; Tontsch, Anita; Welsh, Ruth; Morris, Andrew; Reed, Steven; Touliou, Katerina; Margaritis, Dimitris

2013-09-01

This paper provides an overview of the experiences using Highly Instrumented Cars (HICs) in three research Centres across Europe; Spain, the UK and Greece. The data collection capability of each car is described and an overview presented relating to the relationship between the level of instrumentation and the research possible. A discussion then follows which considers the advantages and disadvantages of using HICs for ND research. This includes the obtrusive nature of the data collection equipment, the cost of equipping the vehicles with sophisticated Data Acquisition Systems (DAS) and the challenges for data storage and analysis particularly with respect to video data. It is concluded that the use of HICs substantially increases the depth of knowledge relating to the driver's behaviour and their interaction with the vehicle and surroundings. With careful study design and integration into larger studies with Low(ly) instrumented Cars (LICs), HICs can contribute significantly and in a relatively naturalistic manner to the driver behaviour research. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Survey of Geosensor Networks: Advances in Dynamic Environmental Monitoring

PubMed Central

Nittel, Silvia

2009-01-01

In the recent decade, several technology trends have influenced the field of geosciences in significant ways. The first trend is the more readily available technology of ubiquitous wireless communication networks and progress in the development of low-power, short-range radio-based communication networks, the miniaturization of computing and storage platforms as well as the development of novel microsensors and sensor materials. All three trends have changed the type of dynamic environmental phenomena that can be detected, monitored and reacted to. Another important aspect is the real-time data delivery of novel platforms today. In this paper, I will survey the field of geosensor networks, and mainly focus on the technology of small-scale geosensor networks, example applications and their feasibility and lessons learnt as well as the current research questions posed by using this technology today. Furthermore, my objective is to investigate how this technology can be embedded in the current landscape of intelligent sensor platforms in the geosciences and identify its place and purpose. PMID:22346721

Considerations for sustainable influenza vaccine production in developing countries.

PubMed

Nannei, Claudia; Chadwick, Christopher; Fatima, Hiba; Goldin, Shoshanna; Grubo, Myriam; Ganim, Alexandra

2016-10-26

Through its Global Action Plan for Influenza Vaccines (GAP), the World Health Organization (WHO) in collaboration with the United States Department of Health and Human Services has produced a checklist to support policy-makers and influenza vaccine manufacturers in identifying key technological, political, financial, and logistical issues affecting the sustainability of influenza vaccine production. This checklist highlights actions in five key areas that are beneficial for establishing successful local vaccine manufacturing. These five areas comprise: (1) the policy environment and health-care systems; (2) surveillance systems and influenza evidence; (3) product development and manufacturing; (4) product approval and regulation; and (5) communication to support influenza vaccination. Incorporating the checklist into national vaccine production programmes has identified the policy gaps and next steps for countries involved in GAP's Technology Transfer Initiative. Lessons learnt from country experiences provide context and insight that complement the checklist's goal of simplifying the complexities of influenza prevention, preparedness, and vaccine manufacturing. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

An Analysis of Strategies for Teaching Standards-Based Lesson Plan Alignment to Preservice Teachers

ERIC Educational Resources Information Center

Drost, Bryan R.; Levine, Anita C.

2015-01-01

Research consistently shows that well-aligned lesson plans lead to better student learning outcomes. The development of these plans challenges both preservice teachers and the teacher educators who instruct them. This exploratory study examined strategies for teaching lesson plan alignment utilized by 87 teacher educators in the United States.…

Improving Weight Loss Outcomes of Community Interventions by Incorporating Behavioral Strategies

PubMed Central

Crane, Melissa M.; Thomas, J. Graham; Kumar, Rajiv; Weinberg, Brad

2010-01-01

Objectives. We examined whether adding behavioral weight loss strategies could improve the outcomes of a community weight loss campaign. Methods. Shape Up RI is a 12-week, online, team-based program for health improvement in Rhode Island. In study 1, we randomly assigned participants to the standard Shape Up RI program or to the program plus video lessons on weight loss. In study 2, we randomly assigned participants to the standard program or to the program plus video lessons; daily self-monitoring of weight, eating, and exercise; and computer-generated feedback. Results. Adding video lessons alone (study 1) did not result in significantly improved weight loss (2.0 ±2.8 kg vs 1.4 ±2.9 kg; P = .15). However, when the video lessons were supplemented with self-monitoring and feedback (study 2), the average weight loss more than doubled (3.5 ±3.8 kg vs 1.4 ±2.7 kg; P < .01), and the proportion of individuals achieving a weight loss of 5% or more tripled (40.5% vs 13.2%; P < .01). Participants in study 2 submitted self-monitoring records on 78% of days, and adherence was significantly related to outcome. Conclusions. Adding behavioral strategies to community campaigns may improve weight loss outcomes with minimal additional cost. PMID:20966375

"Estuaries and coasts" CLIL* lesson plans in English and geology fieldtrip to Cornwall for students in European section

NASA Astrophysics Data System (ADS)

Bontempelli, Nathalie; Voyer, Karine; Lebourgeois, Patrick

2013-04-01

When the European section was created in our high school we had to choose an overarching theme. After considering that we live both in the River Seine estuary and near the English Channel it became obvious that our theme should be "estuaries and coasts". We began the 2012-2013 school year with a day-trip around the River Seine estuary to introduce the theme. First we made a general landscape study from a viewpoint, then we discussed the history of the navigation on the Seine, of local farming on marshland and finally we focused on farmhouse architecture. To conclude we visited the natural reserve near the "Normandy Bridge". As an introduction our poster aims at presenting this part of Normandy. And then we would like to show some examples of our CLIL lesson plans about this chosen topic. The aim of a CLIL lesson is to create interactive speaking between students working in pairs or in groups. There are three different stages: - Warm-up activities - In-depth study: listening, reading, echoing, looking for information on the internet, making a slide show and doing an oral presentation, participating to a role play… - Assessment : using what has been learnt to answer questions Finally we wish to present our field trip to Cornwall. We have already done it twice before (in 2002 and 2004) and this year it is scheduled in May 2013 with our European section students. The aim of this trip is to study geology and botany in English in order to extend what we teach in our CLIL lessons about estuaries and coasts. It also helps promoting exchanges with British families and building intercultural knowledge and understanding. Our program includes for example, fossil hunting and studying the Jurassic cliffs in Charmouth, observing an old ocean crust in Coverack, visiting Saint-Mickael's mount, discovering a tin mine in Geevor, walking through the "Lost Gardens of Heligan" and thus discovering an example of this world-renowned restored English garden, and last but not least having an overview of the biodiversity in the Lizard peninsula. *(Content and Language Integrated Learning)

Communication in a Human biomonitoring study: Focus group work, public engagement and lessons learnt in 17 European countries.

PubMed

Exley, Karen; Cano, Noemi; Aerts, Dominique; Biot, Pierre; Casteleyn, Ludwine; Kolossa-Gehring, Marike; Schwedler, Gerda; Castaño, Argelia; Angerer, Jürgen; Koch, Holger M; Esteban, Marta; Schoeters, Greet; Den Hond, Elly; Horvat, Milena; Bloemen, Louis; Knudsen, Lisbeth E; Joas, Reinhard; Joas, Anke; Dewolf, Marie-Christine; Van de Mieroop, Els; Katsonouri, Andromachi; Hadjipanayis, Adamos; Cerna, Milena; Krskova, Andrea; Becker, Kerstin; Fiddicke, Ulrike; Seiwert, Margarete; Mørck, Thit A; Rudnai, Peter; Kozepesy, Szilvia; Cullen, Elizabeth; Kellegher, Anne; Gutleb, Arno C; Fischer, Marc E; Ligocka, Danuta; Kamińska, Joanna; Namorado, Sónia; Reis, M Fátima; Lupsa, Ioana-Rodica; Gurzau, Anca E; Halzlova, Katarina; Jajcaj, Michal; Mazej, Darja; Tratnik, Janja Snoj; Huetos, Olga; López, Ana; Berglund, Marika; Larsson, Kristin; Sepai, Ovnair

2015-08-01

A communication strategy was developed by The Consortium to Perform Human Biomonitoring on a European Scale (COPHES), as part of its objectives to develop a framework and protocols to enable the collection of comparable human biomonitoring data throughout Europe. The framework and protocols were tested in the pilot study DEMOCOPHES (Demonstration of a study to Coordinate and Perform Human biomonitoring on a European Scale). The aims of the communication strategy were to raise awareness of human biomonitoring, encourage participation in the study and to communicate the study results and their public health significance. It identified the audiences and key messages, documented the procedure for dissemination of results and was updated as the project progressed. A communication plan listed the tools and materials such as press releases, flyers, recruitment letters and information leaflets required for each audience with a time frame for releasing them. Public insight research was used to evaluate the recruitment material, and the feedback was used to improve the documents. Dissemination of results was coordinated in a step by step approach by the participating countries within DEMOCOPHES, taking into account specific national messages according to the needs of each country. Participants received individual results, unless they refused to be informed, along with guidance on what the results meant. The aggregate results and policy recommendations were then communicated to the general public and stakeholders, followed by dissemination at European level. Several lessons were learnt that may assist other future human biomonitoring studies. Recruitment took longer than anticipated and so social scientists, to help with community engagement, should be part of the research team from the start. As a European study, involving multiple countries, additional considerations were needed for the numerous organisations, different languages, cultures, policies and priorities. Therefore, communication documents should be seen as templates with essential information clearly indicated and the option for each country to tailor the material to reflect these differences. Future studies should consider setting up multidisciplinary networks of medical professionals and communication experts, and holding training workshops to discuss the interpretation of results and risk communication. Publicity and wide dissemination of the results helped to raise awareness of human biomonitoring to the general public, policy makers and other key stakeholders. Effective and timely communication, at all stages of a study, is essential if the potential of human biomonitoring research to improve public health is to be realised. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Internet of Things Platform for Smart Farming: Experiences and Lessons Learnt

PubMed Central

Jayaraman, Prem Prakash; Yavari, Ali; Georgakopoulos, Dimitrios; Morshed, Ahsan; Zaslavsky, Arkady

2016-01-01

Improving farm productivity is essential for increasing farm profitability and meeting the rapidly growing demand for food that is fuelled by rapid population growth across the world. Farm productivity can be increased by understanding and forecasting crop performance in a variety of environmental conditions. Crop recommendation is currently based on data collected in field-based agricultural studies that capture crop performance under a variety of conditions (e.g., soil quality and environmental conditions). However, crop performance data collection is currently slow, as such crop studies are often undertaken in remote and distributed locations, and such data are typically collected manually. Furthermore, the quality of manually collected crop performance data is very low, because it does not take into account earlier conditions that have not been observed by the human operators but is essential to filter out collected data that will lead to invalid conclusions (e.g., solar radiation readings in the afternoon after even a short rain or overcast in the morning are invalid, and should not be used in assessing crop performance). Emerging Internet of Things (IoT) technologies, such as IoT devices (e.g., wireless sensor networks, network-connected weather stations, cameras, and smart phones) can be used to collate vast amount of environmental and crop performance data, ranging from time series data from sensors, to spatial data from cameras, to human observations collected and recorded via mobile smart phone applications. Such data can then be analysed to filter out invalid data and compute personalised crop recommendations for any specific farm. In this paper, we present the design of SmartFarmNet, an IoT-based platform that can automate the collection of environmental, soil, fertilisation, and irrigation data; automatically correlate such data and filter-out invalid data from the perspective of assessing crop performance; and compute crop forecasts and personalised crop recommendations for any particular farm. SmartFarmNet can integrate virtually any IoT device, including commercially available sensors, cameras, weather stations, etc., and store their data in the cloud for performance analysis and recommendations. An evaluation of the SmartFarmNet platform and our experiences and lessons learnt in developing this system concludes the paper. SmartFarmNet is the first and currently largest system in the world (in terms of the number of sensors attached, crops assessed, and users it supports) that provides crop performance analysis and recommendations. PMID:27834862

Lessons from the pilot of a mobile application to map assistive technology suppliers in Africa.

PubMed

Visagie, Surona J; Matter, Rebecca; Kayange, George M; Chiwaula, Mussa; Harniss, Mark; Mji, Gubela; Scheffler, Elsje

2018-01-01

A pilot project to develop and implement a mobile smartphone application (App) that tracks and maps assistive technology (AT) availability in southern Africa was launched in Botswana in 2016. The App was developed and tested through an iterative process. The concept of the App (AT-Info-Map) was well received by most stakeholders within the pilot country, and broader networks. Several technical and logistical obstacles were encountered. These included high data costs; difficulty in accessing AT information from the public healthcare sector, the largest supplier of AT; and the high human resource demand of collecting and keeping up-to-date device-level information within a complex and fragmented supply sector that spans private, public and civil society entities. The challenges were dealt with by keeping the data burden low and eliminating product-level tracking. The App design was expanded to include disability services, contextually specific AT categories and make navigation more intuitive. Long-term sustainability strategies like generating funding through advertisements on the App or supplier usage fees must be explored. Outreach and sensitisation programmes about both the App and AT in general must be intensified. The project team must continually strengthen partnerships with private and public stakeholders to ensure ongoing project engagement. The lessons learnt might be of value to others who wish to embark on initiatives in AT and/or implement Apps in health or disability in southern Africa and in low-resourced settings around the world.

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

Hyman, E.L.

Efforts at promoting more fuel-efficient charcoal stoves to replace traditional charcoal stoves in Kenya offer some lessons for the dissemination of appropriate technologies. This paper looks at the market-based approach which has made the Kenyan charcoal stoves project a success. Trends in woodfuels (wood and charcoal) consumption in Kenya are identified; the traditional technology for charcoal combustion and the upgraded traditional technologies are described; production achievement and the dissemination and promotion strategy used are examined; and a financial and economic analysis is performed with social, health and environmental effects assessed. Other ways to achieve a more favourable balance between woodfuelsmore » consumption and supply are then discussed looking at more efficient charcoal kilns and household woodstoves, improved institutional stoves and increased wood production. The replication potential of the Kenya experiment in other countries is also explored. The lessons learnt from the the Kenya experience concern the relationship between technology, choice and delivery systems as they interact with, economic, institutional, and policy factors. In this case, the design work accepted the traditional technology as a starting point which helped ensure widespread acceptance by households. The potential desirability of relying on local artisans to manufacture consumer durables using existing private sector channels to market these goods is also shown. It also highlights the importance of going beyond a laissez-faire approach and supporting training, demonstration, and publicity to faciliate the workings of the private sector. In the Kenyan case, technology choice was relatively unsubsidized and left ot the preferences of consumers.« less

Lessons learnt from the development of the Patient Safety Incidents Reporting an Learning System for the Spanish National Health System: SiNASP.

PubMed

Vallejo-Gutiérrez, Paula; Bañeres-Amella, Joaquim; Sierra, Eduardo; Casal, Jesús; Agra, Yolanda

2014-01-01

To describe the development process and characteristics of a patient safety incidents reporting system to be implemented in the Spanish National Health System, based on the context and the needs of the different stakeholders. Literature review and analysis of most relevant reporting systems, identification of more than 100 stakeholder's (patients, professionals, regional governments representatives) expectations and requirements, analysis of the legal context, consensus of taxonomy, development of the software and pilot test. Patient Safety Events Reporting and Learning system (Sistema de Notificación y Aprendizajepara la Seguridad del Paciente, SiNASP) is a generic reporting system for all types of incidents related to patient safety, voluntary, confidential, non punitive, anonymous or nominative with anonimization, system oriented, with local analysis of cases and based on the WHO International Classification for Patient Safety. The electronic program has an on-line form for reporting, a software to manage the incidents and improvement plans, and a scoreboard with process indicators to monitor the system. The reporting system has been designed to respond to the needs and expectations identified by the stakeholders, taking into account the lessons learned from the previous notification systems, the characteristics of the National Health System and the existing legal context. The development process presented and the characteristics of the system provide a comprehensive framework that can be used for future deployments of similar patient safety systems. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Ebola virus - epidemiology, diagnosis, and control: threat to humans, lessons learnt, and preparedness plans - an update on its 40 year's journey.

PubMed

Singh, Raj Kumar; Dhama, Kuldeep; Malik, Yashpal Singh; Ramakrishnan, Muthannan Andavar; Karthik, Kumaragurubaran; Khandia, Rekha; Tiwari, Ruchi; Munjal, Ashok; Saminathan, Mani; Sachan, Swati; Desingu, Perumal Arumugam; Kattoor, Jobin Jose; Iqbal, Hafiz M N; Joshi, Sunil Kumar

2017-12-01

Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are underway for testing against EBOV. In the absence of any effective control measure, the adaptation of high standards of biosecurity measures, strict sanitary and hygienic practices, strengthening of surveillance and monitoring systems, imposing appropriate quarantine checks and vigilance on trade, transport, and movement of visitors from EVD endemic countries remains the answer of choice for tackling the EBOV spread. Herein, we converse with the current scenario of EBOV giving due emphasis on animal and veterinary perspectives along with advances in diagnosis and control strategies to be adopted, lessons learned from the recent outbreaks and the global preparedness plans. To retrieve the evolutionary information, we have analyzed a total of 56 genome sequences of various EBOV species submitted between 1976 and 2016 in public databases.

The role of the food industry in health: lessons from tobacco?

PubMed

Capewell, Simon; Lloyd-Williams, Ffion

2018-03-01

In this review, we highlight poor diet as the biggest risk factor for non-communicable diseases. We examine the denial tactics used by the food industry, how they reflect the tactics previously used by the tobacco industry, and how campaigners can use this knowledge to achieve future public health successes. Data sources are wide ranging, notably publications relating to public health, obesity and processed food, the effectiveness hierarchy and food industry denialism tactics. Global burden of disease analyses consistently demonstrate that poor diet produces a bigger burden of non-communicable disease than tobacco, alcohol and inactivity put together. The lessons learnt from the tobacco control experience of successfully fighting the tobacco industry can be applied to other industries including processed food and sugary drinks. Tackling obesity and poor diet is a more complex issue than tobacco. Food industries continue to promote weak or ineffective policies such as voluntary reformulation, and resist regulation and taxation. However, the UK food industry now faces increasing pressure from professionals, public and politicians to accept reformulation and taxes, or face more stringent measures. The rise in childhood and adult obesity needs to be arrested and then reversed. Unhealthy processed food and sugary drinks are a major contributing factor. There is increasing interest in the tactics being used by the food industry to resist change. Advocacy and activism will be essential to counter these denialism tactics and ensure that scientific evidence is translated into effective regulation and taxation.

Bridging Theory with Practice: An Exploratory Study of Visualization Use and Design for Climate Model Comparison

DOE PAGES

Dasgupta, Aritra; Poco, Jorge; Wei, Yaxing; ...

2015-03-16

Evaluation methodologies in visualization have mostly focused on how well the tools and techniques cater to the analytical needs of the user. While this is important in determining the effectiveness of the tools and advancing the state-of-the-art in visualization research, a key area that has mostly been overlooked is how well established visualization theories and principles are instantiated in practice. This is especially relevant when domain experts, and not visualization researchers, design visualizations for analysis of their data or for broader dissemination of scientific knowledge. There is very little research on exploring the synergistic capabilities of cross-domain collaboration between domainmore » experts and visualization researchers. To fill this gap, in this paper we describe the results of an exploratory study of climate data visualizations conducted in tight collaboration with a pool of climate scientists. The study analyzes a large set of static climate data visualizations for identifying their shortcomings in terms of visualization design. The outcome of the study is a classification scheme that categorizes the design problems in the form of a descriptive taxonomy. The taxonomy is a first attempt for systematically categorizing the types, causes, and consequences of design problems in visualizations created by domain experts. We demonstrate the use of the taxonomy for a number of purposes, such as, improving the existing climate data visualizations, reflecting on the impact of the problems for enabling domain experts in designing better visualizations, and also learning about the gaps and opportunities for future visualization research. We demonstrate the applicability of our taxonomy through a number of examples and discuss the lessons learnt and implications of our findings.« less

Bridging Theory with Practice: An Exploratory Study of Visualization Use and Design for Climate Model Comparison

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

Dasgupta, Aritra; Poco, Jorge; Wei, Yaxing

Evaluation methodologies in visualization have mostly focused on how well the tools and techniques cater to the analytical needs of the user. While this is important in determining the effectiveness of the tools and advancing the state-of-the-art in visualization research, a key area that has mostly been overlooked is how well established visualization theories and principles are instantiated in practice. This is especially relevant when domain experts, and not visualization researchers, design visualizations for analysis of their data or for broader dissemination of scientific knowledge. There is very little research on exploring the synergistic capabilities of cross-domain collaboration between domainmore » experts and visualization researchers. To fill this gap, in this paper we describe the results of an exploratory study of climate data visualizations conducted in tight collaboration with a pool of climate scientists. The study analyzes a large set of static climate data visualizations for identifying their shortcomings in terms of visualization design. The outcome of the study is a classification scheme that categorizes the design problems in the form of a descriptive taxonomy. The taxonomy is a first attempt for systematically categorizing the types, causes, and consequences of design problems in visualizations created by domain experts. We demonstrate the use of the taxonomy for a number of purposes, such as, improving the existing climate data visualizations, reflecting on the impact of the problems for enabling domain experts in designing better visualizations, and also learning about the gaps and opportunities for future visualization research. We demonstrate the applicability of our taxonomy through a number of examples and discuss the lessons learnt and implications of our findings.« less

The use of computer mediated communication in providing patient support: A review of the research literature.

PubMed

Wagg, Amanda J; Callanan, Margie M; Hassett, Alexander

2018-03-16

The aim of this study is to explore how computer mediated communication has been used by a variety of healthcare,professionals to support their patients and discuss the implication that this may have for future practice. A systematized review of the literature. A review of empirical studies within the literature was carried out in April 2016 in CINAHL, MEDLINE, ASSIA, BNI, Psychinfo, and Web of Science databases. The databases searched produced 2930 titles, of which 190 publications were considered relevant to the objectives. Titles and abstracts were then reviewed and duplicates removed producing 67 publications. Exclusion and inclusion criteria were applied. The inclusion criteria were (1) interventions that facilitate two-way communication between any healthcare professional and their patients via a computer; (2) Interventions aimed at providing any type of support e.g. emotional, tangible, informational, or esteem support; (3) English language; (4) Primary empirical studies. Data quality was assessed and thematic analysis applied. Thirty-one publications were included in this study. Intervention types included Email (n = 8), Videoconferencing (n = 7), Online Social Support Groups (n = 9) and multifaceted interventions (n = 7). Three themes emerged from the data including increasing access to healthcare, adding value to healthcare delivery and improving patient outcomes. Twenty-five (81%) of the studies found that computer mediated communication could produce positive effects. Computer mediated communication could be both what patients want and a way of delivering support to patients in a resource tight environment. This has implications for a range of health support needs and professionals including nurses, midwives and allied healthcare professionals. Reviewing the lessons learnt will ensure future interventions are tailored to the support needs of the patients, carefully planned and mindful of the risks. Copyright © 2018 Elsevier Ltd. All rights reserved.

The new opt-out Dutch National Breast Implant Registry - Lessons learnt from the road to implementation.

PubMed

Rakhorst, Hinne A; Mureau, Marc A M; Cooter, Rodney D; McNeil, John; van Hooff, Miranda; van der Hulst, René; Hommes, Juliette; Hoornweg, Marije; Moojen-Zaal, Laura; Liem, Patricia; Mathijssen, Irene M J

2017-10-01

An estimated 1-3% of all women in the Netherlands carry breast implants. Since the introduction five decades ago, problems with a variety of breast implants have emerged with direct consequences for the patients' health. Plastic surgeons worldwide reacted through campaigning for auditing on long-term implant quality, surgeon performance, and institutional outcomes in implant registries. Especially, the PIP implant scandal of 2010 demonstrated the paucity of epidemiological data and uncovered a weakness in our ability to even 'track and trace' patients. In addition, a recent report of the Dutch Institute of National Health showed a lack of compliance of 100% of breast implant producers to CE requirements. These arguments stress the need for an independent implant registry. Insufficient capture rates or dependence from the implant producers made the variety of national and international patient registries unreliable. The Dutch Breast Implant Registry (DBIR) is unique because it is an opt-out registry without the need for informed consent and thus a high capture rate. Furthermore, an estimated 95% of breast implants are implanted by board-certified plastic surgeons. Funding was received from a non-governmental organisation to increase the quality of health care in the Netherlands, and maintenance is gathered by 25 euros per implant inserted. This article describes the way the Dutch have set up their system, with special attention to the well-known hurdles of starting a patient registry. Examples include: funding, medical ethical issues, opt out system, benchmarking, quality assurance as well as governance and collaboration. The Dutch consider their experience and data shareware for others to be used globally to the benefit of patient safety and quality improvement. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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

PubMed

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

2005-01-01

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

Future of medical physics: Real-time MRI-guided proton therapy.

PubMed

Oborn, Bradley M; Dowdell, Stephen; Metcalfe, Peter E; Crozier, Stuart; Mohan, Radhe; Keall, Paul J

2017-08-01

With the recent clinical implementation of real-time MRI-guided x-ray beam therapy (MRXT), attention is turning to the concept of combining real-time MRI guidance with proton beam therapy; MRI-guided proton beam therapy (MRPT). MRI guidance for proton beam therapy is expected to offer a compelling improvement to the current treatment workflow which is warranted arguably more than for x-ray beam therapy. This argument is born out of the fact that proton therapy toxicity outcomes are similar to that of the most advanced IMRT treatments, despite being a fundamentally superior particle for cancer treatment. In this Future of Medical Physics article, we describe the various software and hardware aspects of potential MRPT systems and the corresponding treatment workflow. Significant software developments, particularly focused around adaptive MRI-based planning will be required. The magnetic interaction between the MRI and the proton beamline components will be a key area of focus. For example, the modeling and potential redesign of a magnetically compatible gantry to allow for beam delivery from multiple angles towards a patient located within the bore of an MRI scanner. Further to this, the accuracy of pencil beam scanning and beam monitoring in the presence of an MRI fringe field will require modeling, testing, and potential further development to ensure that the highly targeted radiotherapy is maintained. Looking forward we envisage a clear and accelerated path for hardware development, leveraging from lessons learnt from MRXT development. Within few years, simple prototype systems will likely exist, and in a decade, we could envisage coupled systems with integrated gantries. Such milestones will be key in the development of a more efficient, more accurate, and more successful form of proton beam therapy for many common cancer sites. © 2017 American Association of Physicists in Medicine.

Learning in the Circumstances of Practice

ERIC Educational Resources Information Center

Billett, Stephen

2014-01-01

Learning in the circumstances of practice stands as the commonest and most enduring way occupational capacities have been learnt across human history, and, likely, are currently learnt. Yet, a comprehensive account of this means of learning remains absent, which limits the legitimacy of workplaces as sites of learning, the learning arising from…

The role of simulation in surgical training.

PubMed Central

Torkington, J.; Smith, S. G.; Rees, B. I.; Darzi, A.

2000-01-01

Surgical training has undergone many changes in the last decade. One outcome of these changes is the interest that has been generated in the possibility of training surgical skills outside the operating theatre. Simulation of surgical procedures and human tissue, if perfect, would allow complete transfer of techniques learnt in a skills laboratory directly to the operating theatre. Several techniques of simulation are available including artificial tissues, animal models and virtual reality computer simulation. Each is discussed in this article and their advantages and disadvantages considered. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:10743423

Pedagogical Techniques and Student Outcomes in Applied Instrumental Lessons Taught by Experienced and Pre-Service American Music Teachers

ERIC Educational Resources Information Center

Henninger, Jacqueline C.; Flowers, Patricia J.; Councill, Kimberly H.

2006-01-01

The purpose of the study was to examine the effect of teacher experience on student progress and performance quality in an introductory applied lesson. Nine experienced teachers and 15 pre-service teachers taught an adult beginner to play "Mary Had a Little Lamb" on a wind instrument. The lessons were videotaped for subsequent analysis of teaching…

Scientix in our school- discovering STEM

NASA Astrophysics Data System (ADS)

Melcu, Cornelia

2017-04-01

My name is Cornelia Melcu and I am a primary school teacher in Brasov. Additionally, I am a teacher trainer of Preparatory Class Curriculum, Google Application in Education Course and European Projects Course and a mentor to new teachers and students in university. I am an eTwinning, Scientix and ESERO ambassador too. During the last three school years my school was involved in several STEM projects, part of Scientix community. The main goal of those projects was to develop basic STEM skills of our students based on project work integrated into the curriculum. Open the Gates to the Universe (http://gatestotheuniverse.blogspot.ro; https://twinspace.etwinning.net/12520/home) is an eTwinning project for primary school students started on September 2015 and finished on September 2016. Some of our partners were from the Mediterranean area. The students discovered different aspects of space science and astronomy working on international groups. They explored some aspects of Science included in their curriculum using resources from ESERO, ROEDUSEIS and Space Awareness (e.g. Calculate with Rosetta, Writing the travel diary, Build Rosetta, How to become an astronaut, etc.) The project was a great opportunity to apply integrated learning methods for developing competencies which are a part of the primary school curriculum in Romania. In Language and Communication classes the students talked about their partners living places and their traditions and habits. They learnt some basic words in their partners language related to the weather. They created stories- both in Romanian and English; they described life in space and astronomical phenomena. They talked to the other partners during the several online meetings we organized and wrote short stories in English. In Mathematics and Science they found out about the Milky Way, the Solar System, the weather, famous astronauts and astronomers. They calculated, solved problems, made experiments and explained specific natural phenomena related to Space. During the ICT lessons, they used different devices for creating and playing online games and quizzes, took photos and edited them, searched for and found specific information related to the topic. In Art they made cards, posters, drawings and paintings. They learnt songs in Music and in PE made outdoor experiments (like calculating the distance between planets in our Solar System using a scale). During the Personal Development lessons the students found out solutions for problems (e.g. How would you survive in Space?) and they presented their project work to their schoolmates, teachers and parents. The project 'started where the children were', it was built on the knowledge and ideas children brought with them to lessons and helped them to develop their understanding of scientific concepts related to the Universe. It helped them to understand the diversity of weather conditions and as part of a world community and their responsibility for the environment. The students are able to identify main planets and stars on the sky and they have of basic notions related to Earth and Sun; In conclusion, the project provides opportunities for learning STEM topics in pre-primary and primary education. Implementing the project gave the children and all the adults involved (staff, parents) a lot of fun and satisfaction.

Key Programme Science lessons from an HIV prevention 'Learning Site' for sex workers in Mombasa, Kenya.

PubMed

McClarty, Leigh M; Bhattacharjee, Parinita; Isac, Shajy; Emmanuel, Faran; Kioko, Japheth; Njiraini, Margaret; Gichangi, Peter; Okoth, Clifford Duncan; Musimbi-Mbole, Janet; Blanchard, James F; Moses, Stephen; Muysyoki, Helgar; Becker, Marissa L

2017-12-14

In 2013, Kenya's National AIDS and STI Control Programme established a Learning Site (LS) in Mombasa County to support and strengthen capacity for HIV prevention programming within organisations working with sex workers. A defining feature of LS was the use of a Programme Science approach throughout its development and implementation. We provide an overview of the key components of LS, present findings from 23 months of programme monitoring data, and highlight key Programme Science lessons from its implementation and monitoring. Routine monitoring data collected from September 2013 through July 2015 are presented. Individual-level service utilisation data were collected monthly and indicators of interest were analysed over time to illustrate trends in enrolment, programme coverage and service utilisation among sex workers in Mombasa County. Over the monitoring period, outreach programme enrolment occurred rapidly; condom distribution targets were met consistently; rates of STI screening remained high and diagnoses declined; and reporting of and response to violent incidents increased. At the same time, enrolment in LS clinics was relatively low among female sex workers, and HIV testing at LS was low among both female and male sex workers. Lessons learnt from operationalising the Programme Science framework through the Mombasa LS can inform the development and implementation of similar LS in different geographical and epidemiological contexts. Importantly, meaningful involvement of sex workers in the design, implementation and monitoring processes ensures that overall programme performance is optimised in the context of local, 'on-the-ground' realities. Additionally, learnings from LS highlight the importance of introducing enhanced monitoring and evaluations systems into complex programmes to better understand and explain programme dynamics over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Methods for implementing a medicine outlet survey: lessons from the anti-malarial market.

PubMed

O'Connell, Kathryn A; Poyer, Stephen; Solomon, Tsione; Munroe, Erik; Patouillard, Edith; Njogu, Julius; Evance, Illah; Hanson, Kara; Shewchuk, Tanya; Goodman, Catherine

2013-02-05

In recent years an increasing number of public investments and policy changes have been made to improve the availability, affordability and quality of medicines available to consumers in developing countries, including anti-malarials. It is important to monitor the extent to which these interventions are successful in achieving their aims using quantitative data on the supply side of the market. There are a number of challenges related to studying supply, including outlet sampling, gaining provider cooperation and collecting accurate data on medicines. This paper provides guidance on key steps to address these issues when conducting a medicine outlet survey in a developing country context. While the basic principles of good survey design and implementation are important for all surveys, there are a set of specific issues that should be considered when conducting a medicine outlet survey. This paper draws on the authors' experience of designing and implementing outlet surveys, including the lessons learnt from ACTwatch outlet surveys on anti-malarial retail supply, and other key studies in the field. Key lessons and points of debate are distilled around the following areas: selecting a sample of outlets; techniques for collecting and analysing data on medicine availability, price and sales volumes; and methods for ensuring high quality data in general. The authors first consider the inclusion criteria for outlets, contrasting comprehensive versus more focused approaches. Methods for developing a reliable sampling frame of outlets are then presented, including use of existing lists, key informants and an outlet census. Specific issues in the collection of data on medicine prices and sales volumes are discussed; and approaches for generating comparable price and sales volume data across products using the adult equivalent treatment dose (AETD) are explored. The paper concludes with advice on practical considerations, including questionnaire design, field worker training, and data collection. Survey materials developed by ACTwatch for investigating anti-malarial markets in sub-Saharan Africa and Asia provide a helpful resource for future studies in this area.

'Nurture the sprouting bud; do not uproot it'. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda.

PubMed

Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Muhumuza Kananura, Rornald; Mutebi, Aloysius; Jane, Pacuto; Tumuhairwe, Juliet; Tetui, Moses; Kiwanuka, Suzanne N

2017-08-01

Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups. This qualitative study was done in three districts in Eastern Uganda. Saving groups were identified and provided with support to enhance members' access to maternal and newborn health. Fifteen focus group discussions (FGDs) and 18 key informant interviews (KIIs) were conducted to elicit members' views about saving practices. Document review was undertaken to identify key lessons for supporting saving groups. Qualitative data are presented thematically. Awareness of the importance of saving, safe custody of money saved, flexible saving arrangements and easy access to loans for personal needs including transport during obstetric emergencies increased willingness to save with saving groups. Saving groups therefore provided a safety net for the poor during emergencies. Poor management of saving groups and detrimental economic practices like gambling constrained saving. Efficient running of saving groups requires that they have a clear management structure, which is legally registered with relevant authorities and that it is governed by a constitution. Saving groups were considered a useful form of saving that enabled easy acess to cash for birth preparedness and transportation during emergencies. They are like 'a sprouting bud that needs to be nurtured rather than uprooted', as they appear to have the potential to act as a safety net for poor communities that have no health insurance. Local governments should therefore strengthen the management capacity of saving groups so as to ensure their efficient running through partnerships with non-governmental organizations that can provide support to such groups.

Implementing maternal death surveillance and response: a review of lessons from country case studies.

PubMed

Smith, Helen; Ameh, Charles; Roos, Natalie; Mathai, Matthews; Broek, Nynke van den

2017-07-17

Maternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify lessons for improving implementation. A secondary analysis of ten case studies from countries at different stages of MDSR implementation, using a policy analysis framework to draw out lessons learnt and opportunities for improvement. We identify the consistent drivers of success in countries with well-established systems for MDSR, and common barriers in countries were Maternal Death Review (MDR) systems have been less successful. MDR is accepted and ongoing at subnational level in many countries, but it is not adequately institutionalised and the shift from facility based MDR to continuous MDSR that informs the wider health system still needs to be made. Our secondary analysis of country experiences highlights the need for a) social and team processes at facility level, for example the existence of a 'no shame, no blame' culture, and the ability to reflect on practice and manage change as a team for recommendations to be acted upon, b) health system inputs including adequate funding and reliable health information systems to enable identification and analysis of cases c) national level coordination of dissemination, and monitoring implementation of recommendations at all levels and d) mandatory notification of maternal deaths (and enforcement of this) and a professional requirement to participate in MDRs. Case studies from countries with established MDSR systems can provide valuable guidance on ways to set up the processes and overcome some of the barriers; but the challenge, as with many health system interventions, is to find a way to provide catalytic assistance and strengthen capacity for MDSR such that this becomes embedded in the health system.

‘Nurture the sprouting bud; do not uproot it’. Using saving groups to save for maternal and newborn health: lessons from rural Eastern Uganda

PubMed Central

Ekirapa-Kiracho, Elizabeth; Paina, Ligia; Muhumuza Kananura, Rornald; Mutebi, Aloysius; Jane, Pacuto; Tumuhairwe, Juliet; Tetui, Moses; Kiwanuka, Suzanne N

2017-01-01

ABSTRACT Background: Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health. Objectives: This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups. Methods: This qualitative study was done in three districts in Eastern Uganda. Saving groups were identified and provided with support to enhance members’ access to maternal and newborn health. Fifteen focus group discussions (FGDs) and 18 key informant interviews (KIIs) were conducted to elicit members’ views about saving practices. Document review was undertaken to identify key lessons for supporting saving groups. Qualitative data are presented thematically. Results: Awareness of the importance of saving, safe custody of money saved, flexible saving arrangements and easy access to loans for personal needs including transport during obstetric emergencies increased willingness to save with saving groups. Saving groups therefore provided a safety net for the poor during emergencies. Poor management of saving groups and detrimental economic practices like gambling constrained saving. Efficient running of saving groups requires that they have a clear management structure, which is legally registered with relevant authorities and that it is governed by a constitution. Conclusions: Saving groups were considered a useful form of saving that enabled easy acess to cash for birth preparedness and transportation during emergencies. They are like ‘a sprouting bud that needs to be nurtured rather than uprooted’, as they appear to have the potential to act as a safety net for poor communities that have no health insurance. Local governments should therefore strengthen the management capacity of saving groups so as to ensure their efficient running through partnerships with non-governmental organizations that can provide support to such groups. PMID:28820046

Challenges and lessons learned from implementing a risk-based approach to school advice and closure during the containment phase of the 2009 influenza pandemic in the West Midlands, England.

PubMed

Awofisayo, A; Ibbotson, S; Smith, G E; Janmohamed, K; Mohamed, H; Olowokure, B

2013-07-01

School closure as a social distancing measure was used in some countries during the initial phases of the influenza A(H1N1)pdm09 pandemic. The objective of this paper is to describe the use of a risk-based approach to public health interventions for schools during the 'containment phase' of the pandemic and to describe lessons learnt. The development of a framework for risk assessment and decision-making to determine school closures in the West Midlands, England, during the 'containment phase' of influenza A(H1N1)pdm09 pandemic is described. Using the framework developed during the 'containment phase', assessments were conducted for 344 educational institutions who reported confirmed cases or 'particularly high absenteeism'. Of these, 209 (60%) had confirmed cases and 65 were closed, mainly for public health or operational reasons. Schools were closed on an individual basis, during the most intense period of the pandemic and for an average period of six days (maximum 11 days). The risk-based approach evolved as experience and knowledge of influenza A(H1N1)pdm09 pandemic virus increased, however some decisions were difficult to communicate to parents, schools and stakeholders particularly when the number of schools affected escalated and the pandemic response phases changed. The management of school closures is an 'uncertain art'. Numerous challenges and lessons were identified in attempting, during the containment phase of the influenza A(H1N1)pdm09 pandemic, to ensure consistency and transparency in an increasingly complex process. The overall approach described could be further developed to improve decision-making for infectious diseases in schools. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Feasibility study and pilot cluster-randomised controlled trial of the GoActive intervention aiming to promote physical activity among adolescents: outcomes and lessons learnt

PubMed Central

Corder, Kirsten; Brown, Helen E; Schiff, Annie; van Sluijs, Esther M F

2016-01-01

Objectives Assess the feasibility of implementing the GoActive intervention in secondary schools, to identify improvements, test study procedures, determine preliminary effectiveness to increase moderate-to-vigorous physical activity (MVPA), and inform power calculations to establish programme effectiveness. Setting Feasibility study (1 school) and pilot cluster-randomised controlled trial (CRCT; 2 intervention; 1 control school(s)). Participants 460 participants (46.6% female; 13.2 (0.4) years old). Interventions 8-week intervention (2013) involved: classes choosing weekly activities encouraged by mentors (older adolescents) and in-class peer leaders. Students gain points for trying activities which are entered into an intramural competition. Primary and secondary outcome measures Planned quantitative (questionnaire) and qualitative (focus groups) process evaluation addressed enjoyment, confidence, participation, suggested improvements. Outcomes were assessed at baseline and follow-up (week 8) in pilot CRCT and included accelerometer-assessed MVPA; adolescent-reported activity type, well-being, peer support, shyness, sociability. Analysis of covariance was used to assess preliminary effectiveness as change in MVPA adjusted for baseline. Results All year 9 students in intervention schools were exposed to the intervention; over all schools 77% of eligible students were measured. 71% boys and 74% girls found GoActive ‘fun’; 38% boys and 32% girls said it increased confidence, and 64% boys and 59% girls said they would continue with a GoActive activity. Suggested improvements included more mentorship; improved training; streamlined points recording. Pilot results indicated potential effectiveness ((adjusted mean difference (95% CI) p value; MVPA mins; 5.1 (1.1 to 9.2) p=0.014)) and suggest recruitment of 16 schools (2400 adolescents) for a full trial. Compared with control, intervention students reported greater peer support 0.5 (0.1 to 0.9) p=0.03, well-being 1.8 (0.1 to 3.4) p=0.04 but no difference in shyness/sociability. Participation in activity types approached significance (intervention group 2.3 (−0.2 to 4.7) p=0.07 more activity types). Conclusions Results suggest feasibility and indicate potential effectiveness of GoActive to increase MVPA and support a fully powered evaluation of effectiveness and cost-effectiveness. Process evaluation data were used to refine GoActive prior to a full trial. Trial registration number ISRCTN31583496; pre-results. PMID:27836873

First- and Second-Language Learnability Explained by Orthographic Depth and Orthographic Learning: A "Natural" Scandinavian Experiment

ERIC Educational Resources Information Center

van Daal, Victor H. P.; Wass, Malin

2017-01-01

Effects of orthographic depth on orthographic learning ability were examined in 10- to 13-year-old children who learnt to read in similar orthographies differing in orthographic depth, defined as consistency of grapheme-to-phoneme correspondences. Danish children who learnt to read a deep orthography underperformed their Swedish counterparts who…

Outcome producing potential influences twelve-month-olds' interpretation of a novel action as goal-directed.

PubMed

Biro, Szilvia; Verschoor, Stephan; Coalter, Esther; Leslie, Alan M

2014-11-01

Learning about a novel, goal-directed action is a complex process. It requires identifying the outcome of the action and linking the action to its outcome for later use in new situations to predict the action or to anticipate its outcome. We investigated the hypothesis that linking a novel action to a salient change in the environment is critical for infants to assign a goal to the novel action. We report a study in which we show that 12-month-old infants, who were provided with prior experience with a novel action accompanied with a salient visible outcome in one context, can interpret the same action as goal-directed even in the absence of the outcome in another context. Our control condition shows that prior experience with the action, but without the salient effect, does not lead to goal-directed interpretation of the novel action. We also found that, for the case of 9-month-olds infants, prior experience with the outcome producing potential of the novel action does not facilitate a goal-directed interpretation of the action. However, this failure was possibly due to difficulties with generalizing the learnt association to another context rather than with linking the action to its outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

Health and development of ART conceived young adults: a study protocol for the follow-up of a cohort

PubMed Central

2013-01-01

Background Use of assisted reproductive technologies (ART) continues to increase, yet little is known of the longer term health of ART conceived offspring. There are some adverse birth outcomes associated with ART conception but the subsequent developmental trajectory is unclear. Undertaking research in this area is challenging due the sensitive nature of the topic and the time elapsed since birth of the ART conceived young adults. The aim of this report is to describe a research protocol, including design and ethical considerations, used to compare the physical and psychosocial health outcomes of ART conceived young adults aged 18-28 years, with their spontaneously conceived peers. Design This is a retrospective cohort study of mothers who conceived with ART in Victoria, Australia and gave birth to a singleton child between 1982 and 1992. A current address for each mother was located and a letter of invitation to participate in the study was sent by registered mail. Participation involved completing a telephone interview about her young adult offspring’s health and development from birth to the present. Mothers were also asked for consent for the researcher to contact their son/daughter to invite them to complete a structured telephone interview about their physical and psychosocial health. A comparison group of women living in Victoria, Australia, who had given birth to a spontaneously conceived singleton child between 1982 and 1992 was recruited from the general population using random digit dialling. Data were collected from them and their young adult offspring in the same way. Regression analyses were used to evaluate relationships between ART exposure and health status, including birth defects, chronic health conditions, hospital admissions, growth and sexual development. Psychosocial wellbeing, parental relationships and educational achievement were also assessed. Factors associated with the age of disclosure of ART conception were explored with the ART group only. Discussion The conceptualization and development of this large project posed a number of methodological, logistical and ethical challenges which we were able to overcome. The lessons we learnt can assist others who are investigating the long-term health implications for ART conceived offspring. PMID:23497379

Sequences show rapid motor transfer and spatial translation in the oculomotor system.

PubMed

Stainer, Matthew J; Carpenter, R H S; Brotchie, Peter; Anderson, Andrew J

2016-07-01

Every day we perform learnt sequences of actions that seem to happen almost without awareness. It has been argued that for learning such sequences parallel learning networks exist - one using spatial coordinates and one using motor coordinates - with sequence acquisition involving a progressive shift from the former to the latter as a sequence is rehearsed. When sequences are interrupted by an out-of-sequence target, there is a delay in the response to the target, and so here we transiently interrupt oculomotor sequences to probe the influence of oculomotor rehearsal and spatial coordinates in sequence acquisition. For our main experiments, we used a repeating sequences of eight targets in length that was first learnt either using saccadic eye movements (left/right), manual responses (left/right or up/down) or as a sequence of colour (blue/red) requiring no motor response. The sequence was immediately repeated for saccadic eye movements, during which the influence of on out-of-sequence target (an interruption) was assessed. When a sequence is learnt beforehand in an abstract way (for example, as a sequence of colours or of orthogonally mapped manual responses), interruptions are immediately disruptive to latency, suggesting neither motor rehearsal nor specific spatial coordinates are essential for encoding sequences of actions and that sequences - no matter how they are encoded - can be rapidly translated into oculomotor coordinates. The magnitude of a disruption does, however, correspond to how well a sequence is learnt: introducing an interruption to an extended sequence before it was reliably learnt reduces the magnitude of the latency disruption. Copyright © 2016 Elsevier Ltd. All rights reserved.

`Question Moments': A Rolling Programme of Question Opportunities in Classroom Science

NASA Astrophysics Data System (ADS)

Pedrosa-de-Jesus, Helena; Leite, Sara; Watts, Mike

2016-06-01

This naturalistic study integrates specific `question moments' into lesson plans to increase pupils' classroom interactions. A range of tools explored students' ideas by providing students with opportunities to ask and write questions. Their oral and written outcomes provide data on individual and group misunderstandings. Changes to the schedule of lessons were introduced to explore these questions and address disparities. Flexible lesson planning over 14 lessons across a 4-week period of high school chemistry accommodated students' contributions and increased student participation, promoted inquiring and individualised teaching, with each teaching strategy feeding forward into the next.

Creutzfeldt-Jakob disease and mad cows: lessons learnt from yeast cells.

PubMed

Hofmann, J; Wolf, H; Grassmann, A; Arndt, V; Graham, J; Vorberg, I

2012-01-24

Transmissible spongiform encephalopathies are fatal neurodegenerative diseases that affect mammals including humans. The proteinaceous nature of the infectious agent, the prion, and its propagation, challenge established dogmas in biology. It is now widely accepted that prion diseases are caused by unconventional agents principally composed of a misfolded host-encoded protein, PrP. Surprisingly, major break-throughs in prion research came from studies on functionally unrelated proteins in yeast and filamentous fungi. Aggregates composed of these proteins act as epigenetic elements of inheritance that can propagate their alternative states by a conformational switch into an ordered ß-sheet rich polymer just like mammalian prions. Since their discovery prions of lower eukaryotes have provided invaluable insights into all aspects of prion biogenesis. Importantly, yeast prions provide proof-of-principle that distinct protein conformers can be infectious and can serve as genetic elements that have the capacity to encipher strain specific information. As a powerful and tractable model system, yeast prions will continue to increase our understanding of prion-host cell interaction and potential mechanisms of protein-based epigenetic inheritance.

Paperless registration during survey enumerations and large oral cholera mass vaccination in Zanzibar, the United Republic of Tanzania

PubMed Central

Deen, Jaqueline L; Khatib, Ahmed; Enwere, Godwin; von Seidlein, Lorenz; Reyburn, Rita; Ali, Said Mohammed; Chang, Na Yoon; Perroud, Valérie; Marodon, Frédérique; Saleh, Abdul A; Hashim, R; Lopez, Anna Lena; Beard, James; Ley, Benedikt N; Thriemer, Kamala; Puri, Mahesh K; Sah, Binod; Jiddawi, Mohamed Saleh; Clemens, John D

2010-01-01

Abstract Problem Field trials require extensive data preparation and complex logistics. The use of personal digital assistants (PDAs) can bypass many of the traditional steps that are necessary in a paper-based data entry system. Approach We programmed, designed and supervised the use of PDAs for a large survey enumeration and mass vaccination campaign. Local setting The project was implemented in Zanzibar in the United Republic of Tanzania. Zanzibar is composed of two main islands, Unguja and Pemba, where outbreaks of cholera have been reported since the 1970s. Relevant changes PDAs allowed us to digitize information at the initial point of contact with the respondents. Immediate response by the system in case of error helped ensure the quality and reliability of the data. PDAs provided quick data summaries that allowed subsequent research activities to be implemented in a timely fashion. Lessons learnt Portability, immediate recording and linking of information enhanced structure data collection in our study. PDAs could be more useful than paper-based systems for data collection in the field, especially in impoverished settings in developing countries. PMID:20616976

Status of the Consolidation of the LHC Superconducting Magnets and Circuits

NASA Astrophysics Data System (ADS)

Tock, J. Ph; Atieh, S.; Bodart, D.; Bordry, F.; Bourcey, N.; Cruikshank, P.; Dahlerup-Petersen, K.; Dalin, J. M.; Garion, C.; Musso, A.; Ostojic, R.; Perin, A.; Pojer, M.; Savary, F.; Scheuerlein, C.

2014-05-01

The first LHC long shutdown (LS1) started in February 2013. It was triggered by the need to consolidate the 13 kA splices between the superconducting magnets to allow the LHC to reach safely its design energy of 14 TeV center of mass. The final design of the consolidated splices is recalled. 1695 interconnections containing 10 170 splices have to be opened. In addition to the work on the 13 kA splices, the other interventions performed during the first long shut-down on all the superconducting circuits are described. All this work has been structured in a project, gathering about 280 persons. The opening of the interconnections started in April 2013 and consolidation works are planned to be completed by August 2014. This paper describes first the preparation phase with the building of the teams and the detailed planning of the operation. Then, it gives feedback from the worksite, namely lessons learnt and adaptations that were implemented, both from the technical and organizational points of view. Finally, perspectives for the completion of this consolidation campaign are given.

The need for guidelines and the use of economic evidence in decision-making in Thailand: lessons learnt from the development of the national list of essential drugs.

PubMed

Wibulpolprasert, Suwit

2008-06-01

Since 2004, the Subcommittee for Development of the National List of Essential Drugs (NLED) has embarked upon an historical evolution of applying evidence to the revision, inclusion and exclusion of medicines into and from the list. Then, the revision of the 2008 NLED was the first time in Thai history where the drug selection process in Thailand formally incorporated pharmacoeconomics. At present, the lack of a standard methodology for conducting economic evaluation is a major barrier that diminishes the potential use of economic evidence. The development of national economic evaluation guidelines by a group of national experts was subsequently endorsed by members in the Subcommittee as useful tools for future NLED revision. They emphasize that these guidelines should be applied not only to those evaluations conducted by public institutions but also by private pharmaceutical companies that often use this evidence for their marketing, or even for future requirements of economic information from industry, as complementary evidence for inclusion of health technology.

Listening to the student voice to improve educational software

PubMed Central

van Wyk, Mari; van Ryneveld, Linda

2017-01-01

ABSTRACT Academics often develop software for teaching and learning purposes with the best of intentions, only to be disappointed by the low acceptance rate of the software by their students once it is implemented. In this study, the focus is on software that was designed to enable veterinary students to record their clinical skills. A pilot of the software clearly showed that the program had not been received as well as had been anticipated, and therefore the researchers used a group interview and a questionnaire with closed-ended and open-ended questions to obtain the students’ feedback. The open-ended questions were analysed with conceptual content analysis, and themes were identified. Students made valuable suggestions about what they regarded as important considerations when a new software program is introduced. The most important lesson learnt was that students cannot always predict their needs accurately if they are asked for input prior to the development of software. For that reason student input should be obtained on a continuous and regular basis throughout the design and development phases. PMID:28678678

The rise of governmentality in the Italian National Health System: physiology or pathology of a decentralized and (ongoing) federalist system?

PubMed

Lega, Federico; Sargiacomo, Massimo; Ianni, Luca

2010-11-01

In this paper, we aim to discuss the implications and lessons that can be learnt from the ongoing process of federalism affecting the Italian National Health System (INHS). Many countries are currently taking decisions concerning the decentralization or re-centralization of their health-care systems, with several key issues that are illustrated in the recent history of the INHS. The decentralization process of INHS has produced mixed results, as some regions took advantage of it to strengthen their systems, whereas others were not capable of developing an effective steering role. We argue that the mutual reinforcement of the decentralization and recentralization processes is not paradoxical, but is actually an effective way for the State to maintain control over the equity and efficiency of its health-care system while decentralizing at a regional level. In this perspective, we provide evidence backing up some of the assumptions made in previous works as well as new food-for thought - specifically on how governmentality and federalism should meet - to reshape the debate on decentralization in health care.

Improving the efficiency and standards of a National Immunization Program Review: lessons learnt from United Republic of Tanzania.

PubMed

Lyimo, Dafrossa; Kamugisha, Christopher; Yohana, Emmanuel; Eshetu, Messeret; Wallace, Aaron; Ward, Kirsten; Mantel, Carsten; Hennessey, Karen

2017-01-01

A National Immunization Program Review (NIP Review) is a comprehensive external assessment of the performance of a country's immunization programme. The number of recommended special-topic NIP assessments, such as those for vaccine introduction or vaccine management, has increased. These assessments often have substantial overlap with NIP reviews, raising concern about duplication. Innovative technical and management approaches, including integrating several assessments into one, were applied in the United Republic of Tanzania's 2015 NIP Review. These approaches and processes were documented and a post-Review survey and group discussion. The Tanzania Review found that integrating assessments so they can be conducted at one time was feasible and efficient. There are concrete approaches for successfully managing a Review that can be shared and practiced including having a well-planned desk review and nominating topic-leads. The use of tablets for data entry has the potential to improve Review data quality and timely analysis; however, careful team training is needed. A key area to improve was to better coordinate and link findings from the national-level and field teams.

Setting Research Priorities for HIV/AIDS-related research in a post-graduate training programme: lessons learnt from the Nigeria Field Epidemiology and Laboratory Training Programme scientific workshop

PubMed Central

Poggensee, Gabriele; Waziri, Ndadilnasiya Endie; Bashorun, Adebobola; Nguku, Patrick Mboya; Fawole, Olufunmilayo Ibitola; Sabitu, Kabir

2014-01-01

In Nigeria the current prevalence of HIV is 4.1% with over 3.5 million infected and estimated 1.5 million in need of anti-retroviral treatment. Epidemiological and implementation studies are necessary for monitoring and evaluation of interventions. To define research areas which can be addressed by participants of the Nigeria Field Epidemiology and Training Programme (NFELTP) a workshop was held in April 2013 in Abuja, Nigeria. Priority research areas were identified using criteria lists for ranking of the relevance of research questions. Based on a research matrix, NFELTP residents developed the aims and objectives, study design for HIV-related research proposals. This workshop was the first workshop held by the NFELTP to establish an inventory of research questions which can be addressed by the residents within their training period. This inventory will help to increase HIV/AIDS-related activities of NFELTP which are in accordance with research needs in Nigeria and PEPFAR objectives. PMID:25426209

Measles Elimination Activities in the Western Pacific Region: Experience from the Republic of Korea

PubMed Central

Choe, Young June; Jee, Youngmee; Oh, Myoung-don

2015-01-01

We describe the global status of measles control and elimination, including surveillance and vaccination coverage data provided by the World Health Organization (WHO). Since 2000, two doses of measles vaccine (MCV2) became recommended globally and the achievement of high vaccination coverage has led to dramatic decrease in the measles incidence. Our finding indicates that, in the Western Pacific Region (WPR), substantial progress has been made to control measles transmission in some countries; however, the measles virus continues to circulate, causing outbreaks. The Republic of Korea (ROK) experienced a series of resurgence of measles due to the importation and healthcare-associated transmission in infants, however overall incidence and surveillance indicators met the WHO criteria for measles elimination. The ROK was verified to be measles-free along with Australia, Mongolia, and Macau, China in 2014. One of the effective elimination activities was the establishment of solid keep-up vaccination system in school settings. The lessons learnt from the measles elimination activities in Korea may contribute to enhancing the surveillance schemes and strengthening of vaccination programs in member countries and areas of WPR. PMID:26617443

(Sn)DICE: A Calibration System Designed for Wide Field Imagers

NASA Astrophysics Data System (ADS)

Regnault, N.; Barrelet, E.; Guyonnet, A.; Juramy, C.; Rocci, P.-F.; Le Guillou, L.; Schahmanèche, K.; Villa, F.

2016-05-01

Dark Energy studies with type Ia supernovae set very tight constraints on the photometric calibration of the imagers used to detect the supernovae and follow up their flux variations. Among the key challenges is the measurement of the shape and normalization of the instrumental throughput. The DICE system was developed by members of the Supernova Legacy Survey (SNLS) , building upon the lessons learnt working with the MegaCam imager. It consists in a very stable light source, placed in the telescope enclosure, and generating compact, conical beams, yielding an almost flat illumination of the imager focal plane. The calibration light is generated by narrow spectrum LEDs selected to cover the entire wavelength range of the imager. It is monitored in real time using control photodiodes. A first DICE demonstrator, SnDICE has been installed at CFHT. A second generation instrument (SkyDICE) has been installed in the enclosure of the SkyMapper telescope. We present the main goals of the project. We discuss the main difficulties encoutered when trying to calibrate a wide field imager, such as MegaCam (or SkyMapper) using such a calibrated light source.

Water management in Angkor: human impacts on hydrology and sediment transportation.

PubMed

Kummu, Matti

2009-03-01

The city of Angkor, capital of the Khmer empire from the 9th to 15th century CE, is well known for its impressive temples, but recent research has uncovered an extensive channel network stretching across over 1000 km2. The channel network with large reservoirs (termed baray) formed the structure of the city and was the basis for its water management. The annual long dry season associated with the monsoon climate has challenged water management for centuries, and the extensive water management system must have played an important role in the mitigation of such marked seasonality. However, by changing the natural water courses with off-take channels the original catchments were also reshaped. Moreover, severe problems of erosion and sedimentation in human built channels evolved and impacted on the whole water management system. This paper describes the present hydrology of the area and discusses the impacts of water management on hydrology during the Angkor era. The paper, moreover, attempts to summarise lessons that could be learnt from Angkorian water management that might apply to present challenges within the field.

Lessons learnt from a birthday party: a Bacillus cereus outbreak, Bari, Italy, January 2012.

PubMed

Martinelli, Domenico; Fortunato, Francesca; Tafuri, Silvio; Cozza, Vanessa; Chironna, Maria; Germinario, Cinzia; Pedalino, Biagio; Prato, Rosa

2013-01-01

Bacillus cereus, a ubiquitous bacterium, can be isolated in various starchy food items, causing both emetic and diarrhoeal disease. The real burden of B. cereus outbreaks is actually poorly known in Italy. We report a B. cereus foodborne outbreak that occurred in a pub in Bari (Italy) on January 22nd 2012 during a birthday party, promptly reported by the pub owner. Between January 22nd and 24th 2012, we performed a retrospective cohort study among the guests of the party to identify risk factors associated with illness. Leftovers of different meals were available for microbiological analysis. Faecal specimens were collected from cases. A total of 12 cases among the 13 customers (attack rate: 92%) were reported. All cases had consumed basmati rice and sweet and sour vegetables (aetiological fraction: 100%). B. cereus was isolated from both basmati rice served during the party and faecal specimens. The close collaboration between the pub owner and the public health officers and the possibility to test food leftovers and stool samples contributed to prevent further cases.

Measles Elimination Activities in the Western Pacific Region: Experience from the Republic of Korea.

PubMed

Choe, Young June; Jee, Youngmee; Oh, Myoung-don; Lee, Jong-Koo

2015-11-01

We describe the global status of measles control and elimination, including surveillance and vaccination coverage data provided by the World Health Organization (WHO). Since 2000, two doses of measles vaccine (MCV2) became recommended globally and the achievement of high vaccination coverage has led to dramatic decrease in the measles incidence. Our finding indicates that, in the Western Pacific Region (WPR), substantial progress has been made to control measles transmission in some countries; however, the measles virus continues to circulate, causing outbreaks. The Republic of Korea (ROK) experienced a series of resurgence of measles due to the importation and healthcare-associated transmission in infants, however overall incidence and surveillance indicators met the WHO criteria for measles elimination. The ROK was verified to be measles-free along with Australia, Mongolia, and Macau, China in 2014. One of the effective elimination activities was the establishment of solid keep-up vaccination system in school settings. The lessons learnt from the measles elimination activities in Korea may contribute to enhancing the surveillance schemes and strengthening of vaccination programs in member countries and areas of WPR.

The role of experts in postaccident recovery: lessons learnt from Chernobyl and Fukushima.

PubMed

Gariel, J C; Rollinger, F; Schneider, T

2018-01-01

Following a nuclear accident, a major dilemma for affected people is whether to stay or leave the affected area, or, for those who have been evacuated, whether or not to return to the decontaminated zones. Populations who have to make such decisions have to consider many parameters, one of which is the radiological situation. Feedback from Chernobyl and Fukushima has demonstrated that involvement and empowerment of the affected population is a way to provide them with the necessary elements to make informed decisions and, if they decide to return to decontaminated areas, to minimise exposure by contributing to the development of a prudent attitude and vigilance towards exposure. However, involving stakeholders in postaccident management raises the question of the role of experts and public authorities in supporting the inhabitants who have to make decisions about their future. Based on experiences in Chernobyl and Fukushima, this paper will discuss various principles that have to be taken into account by experts and public authorities about their role and position when dealing with stakeholders in a postaccident recovery process.

Taking innovative vector control interventions in urban Latin America to scale: lessons learnt from multi-country implementation research.

PubMed

Quintero, Juliana; García-Betancourt, Tatiana; Caprara, Andrea; Basso, Cesar; Garcia da Rosa, Elsa; Manrique-Saide, Pablo; Coelho, Giovanini; Sánchez-Tejeda, Gustavo; Dzul-Manzanilla, Felipe; García, Diego Alejandro; Carrasquilla, Gabriel; Alfonso-Sierra, Eduardo; Monteiro Vasconcelos Motta, Cyntia; Sommerfeld, Johannes; Kroeger, Axel

2017-09-01

Prior to the current public health emergency following the emergence of chikungunya and Zika Virus Disease in the Americas during 2014 and 2015, multi-country research investigated between 2011 and 2013 the efficacy of novel Aedes aegypti intervention packages through cluster randomised controlled trials in four Latin-American cities: Fortaleza (Brazil); Girardot (Colombia), Acapulco (Mexico) and Salto (Uruguay). Results from the trials led to a scaling up effort of the interventions at city levels. Scaling up refers to deliberate efforts to increase the impact of successfully tested health interventions to benefit more people and foster policy and program development in a sustainable way. The different scenarios represent examples for  a 'vertical approach' and a 'horizontal approach'. This paper presents the analysis of a preliminary process evaluation of the scaling up efforts in the mentioned cites, with a focus on challenges and enabling factors encountered by the research teams, analysing the main social, political, administrative, financial and acceptance factors.

Visiting Holocaust-Related Sites with Medical Students as an Aid in Teaching Medical Ethics.

PubMed

González-López, Esteban; Ríos-Cortés, Rosa

2016-05-01

During the Nazi period numerous doctors and nurses played a nefarious role. In Germany they were responsible for the sterilization and killing of disabled persons. Furthermore, the Nazi doctors used concentration camp inmates as guinea pigs in medical experiments for military or racial purposes. A study of the collaboration of doctors with National Socialism exemplifies behavior that must be avoided. Combining medical teaching with lessons from the Holocaust could be a way to transmit Medical Ethics to doctors, nurses and students. The authors describe a study tour with medical students to Poland, to the largest Nazi extermination camp, Auschwitz, and to the city of Krakow. The tour is the final component of a formal course entitled: "The Holocaust, a Reflection from Medicine" at the Autónoma University of Madrid, Spain. Visiting sites related to the Holocaust, the killing centers and the sites where medical experiments were conducted has a singular meaning for medical students. Tolerance, non-discrimination, and the value of human life can be both learnt and taught at the very place where such values were utterly absent.

Multifaceted contributions: health workers and smallpox eradication in India.

PubMed

Bhattacharya, Sanjoy

2008-01-01

Smallpox eradication in South Asia was a result of the efforts of many grades of health-workers. Working from within the confines of international organisations and government structures, the role of the field officials, who were of various nationalities and also drawn from the cities and rural enclaves of the countries in these regions, was crucial to the development and deployment of policies. However, the role of these personnel is often downplayed in official histories and academic histories, which highlight instead the roles played by a handful of senior officials within the World Health Organization and the federal governments in the sub-continent. This article attempts to provide a more rounded assessment of the complex situation in the field. In this regard, an effort is made to underline the great usefulness of the operational flexibility displayed by field officers, wherein lessons learnt in the field were made an integral part of deploying local campaigns; careful engagement with the communities being targeted, as well as the employment of short term workers from amongst them, was an important feature of this work.

Uncertainty in structural interpretation: Lessons to be learnt

NASA Astrophysics Data System (ADS)

Bond, Clare E.

2015-05-01

Uncertainty in the interpretation of geological data is an inherent element of geology. Datasets from different sources: remotely sensed seismic imagery, field data and borehole data, are often combined and interpreted to create a geological model of the sub-surface. The data have limited resolution and spatial distribution that results in uncertainty in the interpretation of the data and in the subsequent geological model(s) created. Methods to determine the extent of interpretational uncertainty of a dataset, how to capture and express that uncertainty, and consideration of uncertainties in terms of risk have been investigated. Here I review the work that has taken place and discuss best practice in accounting for uncertainties in structural interpretation workflows. Barriers to best practice are reflected on, including the use of software packages for interpretation. Experimental evidence suggests that minimising interpretation error through the use of geological reasoning and rules can help decrease interpretation uncertainty; through identification of inadmissible interpretations and in highlighting areas of uncertainty. Understanding expert thought processes and reasoning, including the use of visuospatial skills, during interpretation may aid in the identification of uncertainties, and in the education of new geoscientists.

The 2010 outbreak of poliomyelitis in Tajikistan: epidemiology and lessons learnt.

PubMed

Yakovenko, M L; Gmyl, A P; Ivanova, O E; Eremeeva, T P; Ivanov, A P; Prostova, M A; Baykova, O Y; Isaeva, O V; Lipskaya, G Y; Shakaryan, A K; Kew, O M; Deshpande, J M; Agol, V I

2014-02-20

A large outbreak of poliomyelitis, with 463 laboratory-confirmed and 47 polio-compatible cases, took place in 2010 in Tajikistan. Phylogenetic analysis of the viral VP1 gene suggested a single importation of wild poliovirus type 1 from India in late 2009, its further circulation in Tajikistan and expansion into neighbouring countries, namely Kazakhstan, Russia, Turkmenistan and Uzbekistan. Whole-genome sequencing of 14 isolates revealed recombination events with enterovirus C with cross-overs within the P2 region. Viruses with one class of recombinant genomes co-circulated with the parental virus, and representatives of both caused paralytic poliomyelitis. Serological analysis of 327 sera from acute flaccid paralysis cases as well as from patients with other diagnoses and from healthy people demonstrated inadequate immunity against polio in the years preceding the outbreak. Evidence was obtained suggesting that vaccination against poliomyelitis, in rare cases, may not prevent the disease. Factors contributing to the peculiarities of this outbreak are discussed. The outbreak emphasises the necessity of continued vaccination against polio and the need, at least in risk areas, of quality control of this vaccination through well planned serological surveillance.

Winning the battle against the scourge of poliomyelitis in the African Region.

PubMed

Moeti, Matshidiso

2016-10-10

Recently we have recorded some progress against the transmission of poliovirus in the African Region. This is attributable to a number of factors, including commitment of global partnerships against polio, improvement of existing strategies as well as a number of innovations in response to the disease in the Region. The WHO Regional Office in Africa documented these practices that led to the noticeable progress in the polio eradication initiative in the African Region, as lessons learnt and as part of polio legacy planning. The documentation exercise covered eight countries, namely Angola, Chad, Cote d'Ivoire, Democratic Republic of Congo, Ethiopia, Nigeria, Tanzania and Togo. A number of practices were identified. Some of these practices cut across countries while others were peculiar to specific countries. We have thus developed some manuscripts to capture these practices for publication in scientific journal so as to place them in the public domain for use. It is hoped that these practices will be deployed to other public health programmes in the Region and beyond. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Developing an Inpatient Group Psychotherapy Program: Challenges and Lessons Learnt

PubMed Central

Razaghi, Emran Mohammad; Tabatabaee, Maryam; Pourramzani, Ali; Shirali Mohammadpour, Reza; Mousazade Moghaddam, Arezou; Yahyavi, Seyyed Taha

2015-01-01

In Iran, inpatient group psychotherapy has been limited to transient practices for research purposes or fulfilling personal interest of therapists. The goal of this paper is to share and explain the experience of developing an inpatient group psychotherapy program in Roozbeh Psychiatric Hospital, Tehran, Iran. After theoretical delineation and preparation of a draft of the program guideline, two pilot sessions were held. Based on this initial experience a final treatment guideline was prepared. Afterwards, the program was continued for more than 1 year in a female ward at Roozbeh Psychiatric Hospital. The output of this exercise was a guideline that covers important topics in development of inpatient group psychotherapy. It is concluded that inpatient group psychotherapy has its unique challenges. Of the most important challenges that can be mentioned in this regard are the participation of patients with significant differences in levels of psychopathology and psychiatric signs and symptoms, and high comorbidity with specific personality traits or disorders. Other challenges relevant to the structure of the group include items such as very limited time for working through and inevitable out-of-group contacts. PMID:26576176

Planning for post disaster recovery: Lesson learnt from flood events in Kelantan Malaysia

NASA Astrophysics Data System (ADS)

Rani, Wan Nurul Mardiah Wan Mohd; Nifa, Faizatul Akmar Abdul; Ismail, Mohd Noorizhar; Khalid, Khairin Norhashidah

2017-10-01

As the frequency of disaster occurrence increases, the world cities today are getting more difficult in terms of the management of the event. One of the most discussed issues today is the management of the post-disaster recovery that involves several stages such as the planning, management of multiple stakeholders, restoration, reconstruction and delivery. It is important to note that input from related stakeholders is necessary to make the right decision during this most critical period. In the process of building back after a disaster, it is important to ensure the newly constructed infrastructures are built to be more resilient and able to withstand a certain level of disaster recurrence. Elements of disaster risk reduction should be incorporated in the planning, redesign, construction and the operation of the built environment. In Malaysia, the disaster management has been the responsibility of the Disaster Management and Relief Committee that consists of agencies at the central, state and local levels. This is to ensure that all aspects are being considered and to be more effective in managing the situation.

Euro-VO-Coordination of virtual observatory activities in Europe

NASA Astrophysics Data System (ADS)

Genova, Françoise; Allen, Mark G.; Arviset, Christophe; Lawrence, Andy; Pasian, Fabio; Solano, Enrique; Wambsganss, Joachim

2015-06-01

The European Virtual Observatory Euro-VO has been coordinating European VO activities through a series of projects co-funded by the European Commission over the last 15 years. The bulk of VO work in Europe is ensured by the national VO initiatives and those of intergovernmental agencies. VO activities at the European level coordinate the work in support of the three "pillars" of the Virtual Observatory: support to the scientific community, take-up by the data providers, and technological activities. Several Euro-VO projects have also provided direct support to selected developments and prototyping. This paper explains the methodology used by Euro-VO over the years. It summarises the activities which were performed and their evolutions at different stages of the development of the VO, explains the Euro-VO role with respect to the international and national levels of VO activities, details the lessons learnt for best practices for the coordination of the VO building blocks, and the liaison with other European initiatives, documenting the added-value of European coordination. Finally, the current status and next steps of Euro-VO are briefly addressed.

CO2 evaporative cooling: The future for tracking detector thermal management

NASA Astrophysics Data System (ADS)

Tropea, P.; Daguin, J.; Petagna, P.; Postema, H.; Verlaat, B.; Zwalinski, L.

2016-07-01

In the last few years, CO2 evaporative cooling has been one of the favourite technologies chosen for the thermal management of tracking detectors at LHC. ATLAS Insertable B-Layer and CMS Pixel phase 1 upgrade have adopted it and their systems are now operational or under commissioning. The CERN PH-DT team is now merging the lessons learnt on these two systems in order to prepare the design and construction of the cooling systems for the new Upstream Tracker and the Velo upgrade in LHCb, due by 2018. Meanwhile, the preliminary design of the ATLAS and CMS full tracker upgrades is started, and both concepts heavily rely on CO2 evaporative cooling. This paper highlights the performances of the systems now in operation and the challenges to overcome in order to scale them up to the requirements of the future generations of trackers. In particular, it focuses on the conceptual design of a new cooling system suited for the large phase 2 upgrade programmes, which will be validated with the construction of a common prototype in the next years.

Maternal Near-Miss Audit: Lessons to Be Learnt.

PubMed

Kalhan, Meenakshi; Singh, Srishti; Punia, Anita; Prakash, Jai

2017-01-01

Mother and child constitute a large, vulnerable, and a priority group as the risk is involved with childbearing in women and of growth and development in children. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications. These women who nearly escape death are categorized under "near miss" which has been defined as "a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy." Maternal near-miss audits give us an opportunity to study the cases which were almost similar to those where maternal deaths happened; thus, their review may give concrete evidence of reasons/deficiencies in health care leading to severe complications and even grave consequences as maternal deaths. Near-miss audits will allow the care of critically ill women to be analyzed, deficiencies in the provision of care to be identified, and comparison within and between institutions and, ultimately, improve the quality of obstetric care and further reduce maternal morbidity and mortality.

Clinical negligence and duty of candour.

PubMed

Shekar, Vinita; Singh, Mark; Shekar, Kishore; Brennan, Peter

2011-12-01

The Department of Health is considering imposing a legal duty of candour on health care providers to ensure that an apology and explanation are given to patients when errors occur during medical treatment. This aims to improve quality of care and reduce adverse events during medical treatment. We present the current system of clinical negligence and the future of medical ethics. We discuss relevant cases with regard to duty of candour, and highlight the existence of serious imbalances in which patients' rights and corresponding ethical duties of professionals predominate over the responsibilities of patients themselves. It is known that most adverse events arise because of multiple factors for which no individual should be blamed. To improve healthcare services there is a need for a system in which lessons can be learnt from mistakes, and services can be improved in the interest of patient safety, and for transparency in the broad principles on which the decisions are based within which clinical performance is supervised and monitored. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Designing 3 Dimensional Virtual Reality Using Panoramic Image

NASA Astrophysics Data System (ADS)

Wan Abd Arif, Wan Norazlinawati; Wan Ahmad, Wan Fatimah; Nordin, Shahrina Md.; Abdullah, Azrai; Sivapalan, Subarna

The high demand to improve the quality of the presentation in the knowledge sharing field is to compete with rapidly growing technology. The needs for development of technology based learning and training lead to an idea to develop an Oil and Gas Plant Virtual Environment (OGPVE) for the benefit of our future. Panoramic Virtual Reality learning based environment is essential in order to help educators overcome the limitations in traditional technical writing lesson. Virtual reality will help users to understand better by providing the simulations of real-world and hard to reach environment with high degree of realistic experience and interactivity. Thus, in order to create a courseware which will achieve the objective, accurate images of intended scenarios must be acquired. The panorama shows the OGPVE and helps to generate ideas to users on what they have learnt. This paper discusses part of the development in panoramic virtual reality. The important phases for developing successful panoramic image are image acquisition and image stitching or mosaicing. In this paper, the combination of wide field-of-view (FOV) and close up image used in this panoramic development are also discussed.

Establishing support groups for HIV-infected women: using experiences to develop guiding principles for project implementation.

PubMed

Visser, Maretha J; Mundell, Jonathan P

2008-07-01

HIV-infected women need support to deal with their diagnosis as well as with the stigma attached to HIV. As part of their practical training, Master's-level psychology students negotiated with the staff of four clinics in townships in Tshwane, South Africa, to establish support groups for HIV+ women and offered to assist them in facilitating the groups. This study aimed to understand why the implementation of groups was successful in one clinic and not other clinics. The student reports on their experiences and interaction with clinic staff and clients were used as sources of data. Using qualitative data analysis, different dynamics and factors that could affect project implementation were identified in each clinic. The socio-ecological and systems theories were used to understand implementation processes and obstacles in implementation. The metaphor of building a bridge over a gorge was used to describe the different phases in and obstacles to the implementation of the intervention. Valuable lessons were learnt, resulting in the development of guiding principles for the implementation of support groups in community settings.

One-Click Data Analysis Software for Science Operations

NASA Astrophysics Data System (ADS)

Navarro, Vicente

2015-12-01

One of the important activities of ESA Science Operations Centre is to provide Data Analysis Software (DAS) to enable users and scientists to process data further to higher levels. During operations and post-operations, Data Analysis Software (DAS) is fully maintained and updated for new OS and library releases. Nonetheless, once a Mission goes into the "legacy" phase, there are very limited funds and long-term preservation becomes more and more difficult. Building on Virtual Machine (VM), Cloud computing and Software as a Service (SaaS) technologies, this project has aimed at providing long-term preservation of Data Analysis Software for the following missions: - PIA for ISO (1995) - SAS for XMM-Newton (1999) - Hipe for Herschel (2009) - EXIA for EXOSAT (1983) Following goals have guided the architecture: - Support for all operations, post-operations and archive/legacy phases. - Support for local (user's computer) and cloud environments (ESAC-Cloud, Amazon - AWS). - Support for expert users, requiring full capabilities. - Provision of a simple web-based interface. This talk describes the architecture, challenges, results and lessons learnt gathered in this project.

Water reform in Sub-Saharan Africa: what is the difference?

NASA Astrophysics Data System (ADS)

Van Koppen, Barbara

Since the early 1990s African governments took an active part in the global movement of water reform towards Integrated Water Resources Management (IWRM). The first step consisted primarily of assimilating the generic principles of IWRM. At this generic level, water reform in Sub-Saharan Africa seems quite similar to water reform elsewhere in the developed and developing world. However, in taking the second step of operationalizing generic principles into concrete actions on the ground, at least three salient differences between Sub-Saharan Africa and elsewhere emerged: (a) Africa’s relative abundance of water resources but its scarcity of economic means to harness available water resources; (b) the importance of agriculture and agricultural water development for economic growth and poverty eradication; and (c) the need for systems of water rights and financial resource mobilization that are separated and suit the African reality in which large water users are relatively few, while the bulk of water users are scattered smallholders. This paper discusses the early operationalization with regard to these three unique features and identifies lessons learnt.

Heavy-flavour and quarkonium production in the LHC era: from proton-proton to heavy-ion collisions

DOE PAGES

Andronic, A.; Arleo, F.; Arnaldi, R.; ...

2016-02-29

This report reviews the study of open heavy-flavour and quarkonium production in high-energy hadronic collisions, as tools to investigate fundamental aspects of Quantum Chromodynamics, from the proton and nucleus structure at high energy to deconfinement and the properties of the Quark-Gluon Plasma. Emphasis is given to the lessons learnt from LHC Run 1 results, which are reviewed in a global picture with the results from SPS and RHIC at lower energies, as well as to the questions to be addressed in the future. The report covers heavy flavour and quarkonium production in proton-proton, proton-nucleus and nucleus-nucleus collisions. This includes discussionmore » of the effects of hot and cold strongly interacting matter, quarkonium photo-production in nucleus-nucleus collisions and perspectives on the study of heavy flavour and quarkonium with upgrades of existing experiments and new experiments. The report results from the activity of the SaporeGravis network of the I3 Hadron Physics programme of the European Union 7th Framework Programme.« less

Respect for patient autonomy as a medical virtue.

PubMed

Cook, Thomas; Mavroudis, Constantine D; Jacobs, Jeffrey P; Mavroudis, Constantine

2015-12-01

Respect for patient autonomy is an important and indispensable principle in the ethical practice of clinical medicine. Legal tenets recognise the centrality of this principle and the inherent right of patients of sound mind - properly informed - to make their own personal medical decisions. In the course of everyday medical practice, however, challenging cases may result in ethical dilemmas for the patient, the physician, and society. Resolution of these dilemmas requires a thorough understanding of the underlying principles that allow the clinician to make informed decisions and to offer considered therapeutic options to the patient. We argue in this paper that there is also need for a transition of moral competency from understanding principles to attaining virtue in the classic Aristotelian tradition. Achieving moral virtue is based on a lifetime of learning, practising, and watching how others, who have achieved virtue, act and perform their duties. We further claim that learning moral virtue in medical practice is best realised by incorporating the lessons learnt during daily rounds where frank discussions and considered resolutions can occur under the leadership of senior practitioners who have achieved a semblance of moral excellence.

Optical biosensing strategies for DNA methylation analysis.

PubMed

Nazmul Islam, Md; Yadav, Sharda; Hakimul Haque, Md; Munaz, Ahmed; Islam, Farhadul; Al Hossain, Md Shahriar; Gopalan, Vinod; Lam, Alfred K; Nguyen, Nam-Trung; Shiddiky, Muhammad J A

2017-06-15

DNA methylation is an epigenetic modification of DNA, where a methyl group is added at the fifth carbon of the cytosine base to form 5 methyl cytosine (5mC) without altering the DNA sequences. It plays important roles in regulating many cellular processes by modulating key genes expression. Alteration in DNA methylation patterns becomes particularly important in the aetiology of different diseases including cancers. Abnormal methylation pattern could contribute to the pathogenesis of cancer either by silencing key tumor suppressor genes or by activating oncogenes. Thus, DNA methylation biosensing can help in the better understanding of cancer prognosis and diagnosis and aid the development of therapies. Over the last few decades, a plethora of optical detection techniques have been developed for analyzing DNA methylation using fluorescence, Raman spectroscopy, surface plasmon resonance (SPR), electrochemiluminescence and colorimetric readouts. This paper aims to comprehensively review the optical strategies for DNA methylation detection. We also present an overview of the remaining challenges of optical strategies that still need to be focused along with the lesson learnt while working with these techniques. Copyright © 2016 Elsevier B.V. All rights reserved.

Integrated multisensor perimeter detection systems

NASA Astrophysics Data System (ADS)

Kent, P. J.; Fretwell, P.; Barrett, D. J.; Faulkner, D. A.

2007-10-01

The report describes the results of a multi-year programme of research aimed at the development of an integrated multi-sensor perimeter detection system capable of being deployed at an operational site. The research was driven by end user requirements in protective security, particularly in threat detection and assessment, where effective capability was either not available or prohibitively expensive. Novel video analytics have been designed to provide robust detection of pedestrians in clutter while new radar detection and tracking algorithms provide wide area day/night surveillance. A modular integrated architecture based on commercially available components has been developed. A graphical user interface allows intuitive interaction and visualisation with the sensors. The fusion of video, radar and other sensor data provides the basis of a threat detection capability for real life conditions. The system was designed to be modular and extendable in order to accommodate future and legacy surveillance sensors. The current sensor mix includes stereoscopic video cameras, mmWave ground movement radar, CCTV and a commercially available perimeter detection cable. The paper outlines the development of the system and describes the lessons learnt after deployment in a pilot trial.

Deeply learnt hashing forests for content based image retrieval in prostate MR images

NASA Astrophysics Data System (ADS)

Shah, Amit; Conjeti, Sailesh; Navab, Nassir; Katouzian, Amin

2016-03-01

Deluge in the size and heterogeneity of medical image databases necessitates the need for content based retrieval systems for their efficient organization. In this paper, we propose such a system to retrieve prostate MR images which share similarities in appearance and content with a query image. We introduce deeply learnt hashing forests (DL-HF) for this image retrieval task. DL-HF effectively leverages the semantic descriptiveness of deep learnt Convolutional Neural Networks. This is used in conjunction with hashing forests which are unsupervised random forests. DL-HF hierarchically parses the deep-learnt feature space to encode subspaces with compact binary code words. We propose a similarity preserving feature descriptor called Parts Histogram which is derived from DL-HF. Correlation defined on this descriptor is used as a similarity metric for retrieval from the database. Validations on publicly available multi-center prostate MR image database established the validity of the proposed approach. The proposed method is fully-automated without any user-interaction and is not dependent on any external image standardization like image normalization and registration. This image retrieval method is generalizable and is well-suited for retrieval in heterogeneous databases other imaging modalities and anatomies.

Studying the hydro-meteorological extremes. The benefits from the European Flash Flood research oriented HYDRATE project.

NASA Astrophysics Data System (ADS)

Tsanis, Ioannis K.; Koutroulis, Aristeidis G.; Daliakopoulos, Ioannis N.; Grillakis, Emmanouil G.

2010-05-01

The present paper summarizes the advances of flash flood research for the Greek case study, within the frame of HYDRATE EC funded project. As a first step, a collation of homogenous primary data on flash floods occurred in Greece based on various data sources resulted in 21 documented events, enriching the HYDRATE database. Specific major events were selected for further detailed data collation and analysis. A common intensive post event field survey was conducted by various researchers with different skills and experience, in order to document the 18th of September 2007, Western Slovenia flash flood event. The observation strategy and the lessons learned during this campaign were applied successfully for surveying an event in Crete. Two flash flood events occurred in Crete were selected for detailed analysis, the 13th of January 1994 event occurred in Giofiros basin and the 17th of October 2006 event occurred in Almirida basin. Several techniques, like distributed rainfall-runoff modelling, hydraulic modelling, indirect and empirical peak discharge estimation, were applied for the understanding of the dominant flash flood processes and the effect of initial conditions on peak discharge. In a more general framework, the seasonality of the hydrometeorologic characteristics of floods that occurred in Crete during the period 1990-2007 and the atmospheric circulation conditions during the flood events were examined. During the three and a half years research period, many lessons have learnt from a fruitful collaboration among the project partners. HYDRATE project improved the scientific basis of flash flood research and provided research knowledge on flood risk management.

One WEEE, many species: lessons from the European experience.

PubMed

Deepali Sinha Khetriwal; Widmer, Rolf; Kuehr, Ruediger; Huisman, Jaco

2011-09-01

Electrical and electronic equipment (EEE) pervades modern lifestyles, but its quick obsolescence is resulting in huge quantities of EEE to be disposed of. This fast-growing waste stream has been recognized for its hazard potential. The European Union's (EU) Waste Electrical and Electronic Equipment (WEEE) Directive was essentially in response to the toxicity of e-waste - to ensure that it was collected and treated in an environmentally sound manner. Since then, the WEEE Directive has expanded its aims to include recovery of valuable resources as a means to reduce raw material extraction. With these objectives in mind, the Directive sets a common minimum legislative framework for all EU member states. However, the transposition of the Directive into national legislations has meant many differences in actual implementation models. There are 27 national transpositions of the Directive with different definitions, provisions and agreements. Each legislation reflects national situations, whether they are geographical considerations, legislative history, the influence of lobby groups and other national priorities. Although this diversity in legislations has meant massive problems in compliance and enforcement, it provides an opportunity to get an insight into the possible operational models of e-waste legislation. Building on the study by the United Nations University commissioned by the European Commission as part of its 2008 Review of the WEEE Directive, the paper identifies some key features of the Directive as well as legislative and operational differences in transposition and implementation in the various members states. The paper discusses the successes and challenges of the Directive and concludes with lessons learnt from the European experience.

Review paper on research ethics in Ethiopia: experiences and lessons learnt from Addis Ababa University College of Health Sciences 2007-2012.

PubMed

Feleke, Yeweyenhareg; Addissie, Adamu; Wamisho, Biruk L; Davey, Gail

2015-01-01

Health research in Ethiopia is increasing both in volume and type, accompanied with expansion of higher education and research since the past few years. This calls for a proportional competence in the governance of medical research ethics in Ethiopia in the respective research and higher learning institutes. The paper highlights the evolution and progress ofthe ethics review at Addis Ababa University - College of Health Sciences (AAU-CHS) in the given context of health research review system in Ethiopia. Reflections are made on the key lessons to be drawnfrom the formative experiences of the Institutional Review Board (IRB) and their implications to the Ethiopian health research review system. This article is a review paper based on review of published and un published documents on research ethics in Ethiopia and the AAU-CHS (2007-2012). Thematic summaries of review findings are presented in thematic areas - formation of ethics review and key factors in the evolution of ethics review and implications. The IRB at AAU-CHS has been pivotal in providing review and follow-up for important clinical studies in Ethiopia. It has been one of the first IRBs to get WHO/SIDCER recognition from Africa and Ethiopia. Important factors in the successes of the IRB among others included leadership commitment, its placement in institutional structure, and continued capacity building. Financial challenges and sustainability issues need to be addressed for the sustained gains registered so far. Similar factors are considered important for the new and younger IRBs within the emergent Universities and research centers in the country.

Beyond the crisis: building back better mental health care in 10 emergency-affected areas using a longer-term perspective.

PubMed

Epping-Jordan, JoAnne E; van Ommeren, Mark; Ashour, Hazem Nayef; Maramis, Albert; Marini, Anita; Mohanraj, Andrew; Noori, Aqila; Rizwan, Humayun; Saeed, Khalid; Silove, Derrick; Suveendran, T; Urbina, Liliana; Ventevogel, Peter; Saxena, Shekhar

2015-01-01

Major gaps remain - especially in low- and middle-income countries - in the realization of comprehensive, community-based mental health care. One potentially important yet overlooked opportunity for accelerating mental health reform lies within emergency situations, such as armed conflicts or natural disasters. Despite their adverse impacts on affected populations' mental health and well being, emergencies also draw attention and resources to these issues and provide openings for mental health service development. Cases were considered if they represented a low- or middle-income country or territory affected by an emergency, were initiated between 2000 and 2010, succeeded in making changes to the mental health system, and were able to be documented by an expert involved directly with the case. Based on these criteria, 10 case examples from diverse emergency-affected settings were included: Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, occupied Palestinian territory, Somalia, Sri Lanka, and Timor-Leste. These cases demonstrate generally that emergency contexts can be tapped to make substantial and sustainable improvements in mental health systems. From these experiences, 10 common lessons learnt were identified on how to make this happen. These lessons include the importance of adopting a longer-term perspective for mental health reform from the outset, and focusing on system-wide reform that addresses both new-onset and pre-existing mental disorders. Global progress in mental health care would happen more quickly if, in every crisis, strategic efforts were made to convert short-term interest in mental health problems into momentum for mental health reform.

Management of rural drinking water supplies and waste using the participatory hygiene and sanitation transformation (PHAST) initiative in Zimbabwe.

PubMed

Musabayane, N

2000-01-01

This paper focuses on the use of Participatory Hygiene and Sanitation Transformation (PHAST) and how the methodology can be taken to scale. It uses the Zimbabwe experience and highlights some of the benefits in the application of PHAST, conditions necessary for scaling up and possible constraints. The PHAST initiative started off as a pilot process seeking to promote improved hygiene behaviour and promotion of sanitation. Having successfully piloted PHAST, Zimbabwe has scaled up the use of the methodology at a country level. While impact studies have not yet been conducted, reviews of the effects of the process have indicated positive behaviour change in such areas as management of water, construction and use of latrines. The process has also led to a change of institutional approaches in planning for improved water and sanitation from supply driven projects to demand responsive approaches. Some lessons learnt have included the need for baseline surveys at the start of the use of PHAST, the difficulty in developing monitoring indicators and hence difficulty in measuring impacts. Conclusions being drawn using assessment studies are that the use of participatory approaches has led to improved hygiene behaviour with communities being able to link causes and effects. The use of participatory methods also necessitates a change in institutional approaches from supply driven approaches to demand responsiveness. Other lessons drawn were related to the creation of an enabling environment for the application of participatory processes. Such enabling environment includes capacity building, resource allocation, policy and institutional support.

The principles and practices of nutrition advocacy: evidence, experience and the way forward for stunting reduction.

PubMed

Pelletier, David; Haider, Rukhsana; Hajeebhoy, Nemat; Mangasaryan, Nune; Mwadime, Robert; Sarkar, Satyajit

2013-09-01

Advocacy represents an intervention into complex, dynamic and highly contextual socio-political systems, in which strategies and tactics must be adjusted on a continual basis in light of rapidly changing conditions, reactions from actors and feedback. For this reason, the practice of advocacy is often considered more art than science. However, capacities and practices for advocacy can be strengthened by sharing and analysing experiences in varying contexts, deriving general principles and learning to adapt these principles to new contexts. Nutrition is a particular context for advocacy, but to date, there has been little systematic analysis of experiences. The purpose of this paper is to illustrate and draw lessons from the practice of nutrition advocacy, especially in relation to stunting and complementary feeding, and suggest ways to strengthen capacities and practices in the future. The strategies and tactics, achievements and lessons learnt are described for three case studies: Uganda, Vietnam and Bangladesh. These cases, and experience from elsewhere, demonstrate that concerted, well-planned and well-implemented advocacy can bring significant achievements, even in short period of time. In light of the global and national attention being given to stunting reduction through the SUN (Scaling Up Nutrition) movement and other initiatives, there is now a need for much stronger investments in strategic and operational capacities for advocacy, including the human, organisational and financial resources for the advocacy and strategic communication themselves, as well as for monitoring and evaluation, supportive research and institutional capacity-building. © 2013 John Wiley & Sons Ltd.

Outercourse: Exploring Nonpenetrative Forms of Pleasurable Safer Sex

ERIC Educational Resources Information Center

Bakaroudis, Maria

2014-01-01

Best practices in comprehensive sexuality education call for rights-based, factual lessons that provide healthy options and are sensitive to the varied contextual factors affecting participants. Further, lessons are to better balance positive and negative outcomes of sexual expression that reflect the sexual realities of (young) men and women.…

Reconstructing Economics in Light of the 2007-? Financial Crisis

ERIC Educational Resources Information Center

Friedman, Benjamin M.

2010-01-01

The lessons learned from the recent financial crisis should significantly reshape the economics profession's thinking, including, importantly, what we teach our students. Five such lessons are that we live in a monetary economy and therefore aggregate demand and policies that affect aggregate demand are determinants of real economic outcomes; that…

Courtside: Lesson Lost?

ERIC Educational Resources Information Center

Zirkel, Perry A.

2004-01-01

In this month's Courtside, the author will stray somewhat from his usual format of describing a single case. Instead, he will be presenting the details of two separate cases, both of which involve similar circumstances, rely on similar legal arguments, and have similar outcomes. Most important, both appear to carry the same lesson. The lessons…

A Tale of 2 Units: Lessons in Changing the Care Delivery Model.

PubMed

Wharton, Glenda; Berger, Jill; Williams, Tracy

2016-04-01

In response to patient care quality and satisfaction concerns, a hospital determined the need to change the care delivery model on some inpatient units. Two pilot units adopted 2 different models of care. The authors describe the change project, successful outcomes, and lessons learned.

Physical Activity in Physical Education: Are Longer Lessons Better?

ERIC Educational Resources Information Center

Smith, Nicole J.; Monnat, Shannon M.; Lounsbery, Monica A. F.

2015-01-01

Background: The purpose of this study was to compare physical activity (PA) outcomes in a sample of high school (HS) physical education (PE) lessons from schools that adopted "traditional" versus "modified block" schedule formats. Methods: We used the System for Observing Fitness Instruction Time (SOFIT) to conduct observations…

Providing Culturally Responsive Teaching in Field-Based and Student Teaching Experiences: A Case Study

ERIC Educational Resources Information Center

Kea, Cathy D.; Trent, Stanley C.

2013-01-01

This mixed design study chronicles the yearlong outcomes of 27 undergraduate preservice teacher candidates' ability to design and deliver culturally responsive lesson plans during field-based experience lesson observations and student teaching settings after receiving instruction in a special education methods course. While components of…

Using Patient Reported Outcomes and PROMIS in Research and Clinical Applications: Experiences from the PCORI Pilot Projects

PubMed Central

Bingham, Clifton O.; Bartlett, Susan J.; Merkel, Peter A.; Mielenz, Thelma J.; Pilkonis, Paul A.; Edmundson, Lauren; Moore, Emily; Sabharwal, Rajeev K.

2016-01-01

Purpose The field of patient-centered outcomes research (PCOR) continues to develop. Patient-reported outcomes, and in particular, the Patient-Reported Outcomes Measurement Information System (PROMIS) contribute complementary data to clinician-derived outcomes traditionally used in health decision-making. However, there has been little work to understand how PROMIS measures may inform or be integrated into PCOR or clinical applications. Methods Lead investigators from four pilot projects funded by the Patient-Centered Outcomes Research Institute (PCORI) collaborated to discuss lessons learned about the use of PROMIS in PCOR studies via virtual and in-person meetings. In addition, a qualitative data collection tool was used to assess the pilot projects’ experiences. Results Lessons learned from the pilot projects centered on practical elements of research design, such as choosing the right outcomes to study, considering the advantages and limitations of the PROMIS short forms and computer adaptive technology versions, planning ahead for a feasible data collection process, maintaining the focus on patients by ensuring that the research is truly patient-centered, and helping patients and providers make the most of PROMIS in care. Conclusions The PCORI Pilot Projects demonstrated that PROMIS can be successfully used to conduct research that will help patients make decisions about their care. Interest in PCOR continues to grow and the lessons learned from these projects about the use of PROMIS will be helpful to investigators. Given the numerous benefits of PROMIS, implementing this tool in research and care will hopefully lead to significant progress in measuring health outcomes that are meaningful and relevant to all stakeholders. PMID:26914103

Using patient-reported outcomes and PROMIS in research and clinical applications: experiences from the PCORI pilot projects.

PubMed

Bingham, Clifton O; Bartlett, Susan J; Merkel, Peter A; Mielenz, Thelma J; Pilkonis, Paul A; Edmundson, Lauren; Moore, Emily; Sabharwal, Rajeev K

2016-08-01

The field of patient-centered outcomes research (PCOR) continues to develop. Patient-reported outcomes and, in particular the Patient-Reported Outcomes Measurement Information System (PROMIS) contribute complementary data to clinician-derived outcomes traditionally used in health decision-making. However, there has been little work to understand how PROMIS measures may inform or be integrated into PCOR or clinical applications. Lead investigators from four pilot projects funded by the Patient-Centered Outcomes Research Institute (PCORI) collaborated to discuss lessons learned about the use of PROMIS in PCOR studies via virtual and in-person meetings. In addition, a qualitative data collection tool was used to assess the pilot projects' experiences. Lessons learned from the pilot projects centered on practical elements of research design, such as choosing the right outcomes to study, considering the advantages and limitations of the PROMIS short forms and computer adaptive technology versions, planning ahead for a feasible data collection process, maintaining the focus on patients by ensuring that the research is truly patient-centered, and helping patients and providers make the most of PROMIS in care. The PCORI pilot projects demonstrated that PROMIS can be successfully used to conduct research that will help patients make decisions about their care. Interest in PCOR continues to grow and the lessons learned from these projects about the use of PROMIS will be helpful to investigators. Given the numerous benefits of PROMIS, implementing this tool in research and care will hopefully lead to significant progress in measuring health outcomes that are meaningful and relevant to all stakeholders.

Lesson Study as Professional Development within Secondary Physics Teacher Professional Learning Communities

NASA Astrophysics Data System (ADS)

Collins, Tonya Monique Nicki

Two Professional Learning Communities of physics teachers from different high schools voluntarily participated in Lesson Study as a means of professional development. The five teacher-participants and one participant-researcher partook of two Lesson Study cycles, each of which focused on student physics misconceptions. The Lesson Study resulted in two topics of physics: projectiles and gravitation. The researcher aimed to determine what happens to secondary physics teachers who undergo Lesson Study through this phenomenological case study. Specifically, (1) What is the process of Lesson Study with secondary physics teachers? and (2) What are the teacher-reported outcomes of Lesson Study with secondary physics teachers? Overall, Lesson Study provided an avenue for secondary physics teachers to conduct inquiry on their students in an attempt to better understand student thinking and learning. As a result, teachers collaborated to learn how to better meet the needs of their students and self-reported growth in many areas of teaching and teacher knowledge. The study resulted in twelve hypotheses to be tested in later research centering on idealizing the process of Lesson Study and maximizing secondary physics teacher growth.

Blending Pan-European and local hydrological models for water resource assessment in Mediterranean areas: lessons learnt from a mountainous catchment

NASA Astrophysics Data System (ADS)

José Polo, María; José Pérez-Palazón, María; Saénz de Rodrigáñez, Marta; Pimentel, Rafael; Arheimer, Berit

2017-04-01

Global hydrological models provide scientists and technicians with distributed data over medium to large areas from which assessment of water resource planning and use can be easily performed. However, scale conflicts between global models' spatial resolution and the local significant spatial scales in heterogeneous areas usually pose a constraint for the direct use and application of these models' results. The SWICCA (Service for Water Indicators in Climate Change Adaptation) Platform developed under the Copernicus Climate Change Service (C3S) offers a wide range of both climate and hydrological indicators obtained on a global scale with different time and spatial resolutions. Among the different study cases supporting the SWICCA demonstration of local impact assessment, the Sierra Nevada study case (South Spain) is a representative example of mountainous coastal catchments in the Mediterranean region. This work shows the lessons learnt during the study case development to derive local impact indicator tailored to suit the local end-users of water resource in this snow-dominated area. Different approaches were followed to select the most accurate method to downscale the global data and variables to the local level in a highly abrupt topography, in a sequential step approach. 1) SWICCA global climate variable downscaling followed by river flow simulation from a local hydrological model in selected control points in the catchment, together with 2) SWICCA global river flow values downscaling to the control points followed by corrections with local transfer functions were both tested against the available local river flow series of observations during the reference period. This test was performed for the different models and the available spatial resolutions included in the SWICCA platform. From the results, the second option, that is, the use of SWICCA river flow variables, performed the best approximations, once the local transfer functions were applied to the global values and an additional correction was performed based on the relative anomalies obtained instead of the absolute values. This approach was used to derive the future projections of selected local indicators for each end-user in the area under different climate change scenarios. Despite the spatial scale conflicts, the SWICCA river flow indicators (simulated by the E-HYPEv3.1.2 model) succeeded in approximating the observations during the reference period 1970-2000 when provided on a catchment scale, once local transfer functions and further anomaly correction were performed. Satisfactory results were obtained on a monthly scale for river flow in the main stream of the watershed, and on a daily scale for the headwater streams. The accessibility to the hydrological model WiMMed, which includes a snow module, locally validated in the study area has been crucial to downscale the SWICCA results and prove their usefulness.

An Interview with Joe McMann: Lessons Learned from Fifty Years of Observing Hardware and Human Behavior

NASA Technical Reports Server (NTRS)

McMann, Joe

2011-01-01

Pica Kahn conducted "An Interview with Joe McMann: Lessons Learned in Human and Hardware Behavior" on August 16, 2011. With more than 40 years of experience in the aerospace industry, McMann has gained a wealth of knowledge. This presentation focused on lessons learned in human and hardware behavior. During his many years in the industry, McMann observed that the hardware development process was intertwined with human influences, which impacted the outcome of the product.

Lessons learned after three years of legalized, recreational marijuana: The Colorado experience.

PubMed

Ghosh, Tista S; Vigil, Daniel I; Maffey, Ali; Tolliver, Rickey; Van Dyke, Mike; Kattari, Leonardo; Krug, Heather; Reed, Jack K; Wolk, Larry

2017-11-01

In November 2012 Colorado voters approved legalized recreational marijuana. On January 1, 2014 Colorado became the first state to allow legal sales of non-medical marijuana for adults over the age of 21. Since that time, the state has been monitoring potential impacts on population health. In this paper we present lessons learned in the first three years following legal sales of recreational marijuana. These lessons pertain to health behaviors and health outcomes, as well as to health policy issues. Our intent is to share these lessons with other states as they face the prospect of recreational marijuana legalization. Copyright © 2017 Elsevier Inc. All rights reserved.

Methodological, Theoretical, Infrastructural, and Design Issues in Conducting Good Outcome Studies

ERIC Educational Resources Information Center

Kelly, Michael P.; Moore, Tessa A.

2011-01-01

This article outlines a set of methodological, theoretical, and other issues relating to the conduct of good outcome studies. The article begins by considering the contribution of evidence-based medicine to the methodology of outcome research. The lessons which can be applied in outcome studies in nonmedical settings are described. The article…

Outcomes and lessons learned from evaluating TRICARE's disease management programs.

PubMed

Dall, Timothy M; Askarinam Wagner, Rachel C; Zhang, Yiduo; Yang, Wenya; Arday, David R; Gantt, Cynthia J

2010-06-01

To share outcomes and lessons learned from an evaluation of disease management (DM) programs for asthma, congestive heart failure (CHF), and diabetes for TRICARE patients. Multiyear evaluation of participants in voluntary, opt-out DM programs. Patient-centered programs, administered by 3 regional contractors, provide phone-based consultations with a care manager, educational materials, and newsletters. The study sample consisted of 23,793 asthma, 4092 CHF, and 29,604 diabetes patients with at least 6 months' tenure in the program. Medical claims were analyzed to quantify program effect on healthcare utilization, medical costs, and clinical outcomes. Multivariate regression analysis with an historical control group was used to predict patient outcomes in the absence of DM. The difference between actual and predicted DM patient outcomes was attributed to the program. A patient survey collected data on program satisfaction and perceived usefulness of program information and services. Modest improvements in patient outcomes included reduced inpatient days and medical costs, and (with few exceptions) increased percentages of patients receiving appropriate medications and tests. Annual per patient reductions in medical costs were $453, $371, and $783 for asthma, CHF, and diabetes program participants, respectively. The estimated return on investment was $1.26 per $1.00 spent on DM services. Findings suggest that the DM programs more than pay for themselves, in addition to improving patient health and quality of life. Lessons learned in program design, implementation, effectiveness, and evaluation may benefit employers contemplating DM, DM providers, and evaluators of DM programs.

The Teachers' Action, 1984-1986: Learning Lessons from History

ERIC Educational Resources Information Center

Rieser, Richard

2016-01-01

Thirty years ago teachers in the NUT and NASUWT were involved in a protracted industrial dispute. The outcome of the dispute had huge implications for education policy in the years that followed (most obviously the introduction of the 1987 Education Bill), and has important lessons for teacher unionism today. The author offers a personal…

Effects of Detailed Illustrations on Science Learning: An Eye-Tracking Study

ERIC Educational Resources Information Center

Lin, Yu Ying; Holmqvist, Kenneth; Miyoshi, Kiyofumi; Ashida, Hiroshi

2017-01-01

The eye-tracking method was used to assess the influence of detailed, colorful illustrations on reading behaviors and learning outcomes. Based on participants' subjective ratings in a pre-study, we selected eight one-page human anatomy lessons. In the main study, participants learned these eight human anatomy lessons; four were accompanied by…

Why Higher Education: Lessons Learned in a Learner-Centered College

ERIC Educational Resources Information Center

Shugart, Sanford C.

2016-01-01

Based on a decade of consistently improving student outcomes at Valencia College, first winner of the Aspen Prize for Excellence in Community Colleges, five lessons for connecting student and institutional purpose are described. These include: a focus on what students really experience, understanding the college as a bridge and not a destination,…

Gender Inequality in Biology Classes in China and Its Effects on Students' Short-Term Outcomes

NASA Astrophysics Data System (ADS)

Liu, Ning; Neuhaus, Birgit

2014-07-01

This study investigated gender inequality in biology lessons and analysed the effects of the observed inequality on students' short-term knowledge achievement, situational interest and students' evaluation of teaching (SET). Twenty-two biology teachers and 803 7th-grade students from rural and urban classrooms in China participated in the study. Each teacher was videotaped for 1 lesson on the topic blood and circulatory system. Before and after the lessons, the students completed tests and questionnaires. Chi-square analysis was conducted to compare the boys' and girls' participation rates of answering teachers' questions in the lessons. The findings revealed that in the urban classrooms the boys had a significantly higher rate of participation than did the girls, and hence also a higher situational interest. However, no such gender inequity was found among the rural students. The study also revealed that urban students answered more complicated questions compared with the rural students in general. The findings of this study suggest that the teachers should try to balance boys' and girls' participation and involve more students in answering questions in their lessons. The study also raises questions about long-term effects of students' participation in answering teachers' questions on their outcomes-knowledge achievement, situational interest and SET.

75 FR 79011 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-17

..., criminal justice and services outcomes, as well as lessons learned to inform future efforts. [[Page 79012... outcomes of interest and subpopulations of focus: homelessness, housing, treatment history, readiness to...